This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente. Reviewed by James Ives, M.Psych. (Editor)Oct 9 2018Calvin Brown doesn’t have a primary care doctor — and the peripatetic 23-year-old doesn’t want one.Since his graduation last year from the University of San Diego, Brown has held a series of jobs that have taken him to several California cities. “As a young person in a nomadic state,” Brown said, he prefers finding a walk-in clinic on the rare occasions when he’s sick.“The whole ‘going to the doctor’ phenomenon is something that’s fading away from our generation,” said Brown, who now lives in Daly City outside San Francisco. “It means getting in a car [and] going to a waiting room.” In his view, urgent care, which costs him about $40 per visit, is more convenient — “like speed dating. Services are rendered in a quick manner.”Brown’s views appear to be shared by many millennials, the 83 million Americans born between 1981 and 1996 who constitute the nation’s biggest generation. Their preferences — for convenience, fast service, connectivity and price transparency — are upending the time-honored model of office-based primary care.Many young adults are turning to a fast-growing constellation of alternatives: retail clinics carved out of drugstores or big-box retail outlets, free-standing urgent care centers that tout evening and weekend hours, and online telemedicine sites that offer virtual visits without having to leave home. Unlike doctors’ offices, where charges are often opaque and disclosed only after services are rendered, many clinics and telemedicine sites post their prices.A national poll of 1,200 randomly selected adults conducted in July by the Kaiser Family Foundation for this story found that 26 percent said they did not have a primary care provider. There was a pronounced difference among age groups: 45 percent of 18- to 29-year-olds had no primary care provider, compared with 28 percent of those 30 to 49, 18 percent of those 50 to 64 and 12 percent age 65 and older. (Kaiser Health News is an editorially independent program of the foundation.)A 2017 survey by the Employee Benefit Research Institute, a Washington think tank, and Greenwald and Associates yielded similar results: 33 percent of millennials did not have a regular doctor, compared with 15 percent of those age 50 to 64.“There is a generational shift,” said Dr. Ateev Mehrotra, an internist and associate professor in the Department of Health Care Policy at Harvard Medical School. “These trends are more evident among millennials, but not unique to them. I think people’s expectations have changed. Convenience [is prized] in almost every aspect of our lives,” from shopping to online banking.So is speed. Younger patients, Mehrotra noted, are unwilling to wait a few days to see a doctor for an acute problem, a situation that used to be routine. “Now,” Mehrotra said, “people say, ‘That’s crazy, why would I wait that long?’”Until recently, the after-hours alternative to a doctor’s office for treatment of a strep throat or other acute problem was a hospital emergency room, which usually meant a long wait and a big bill.Luring MillennialsFor decades, primary care physicians have been the doctors with whom patients had the closest relationship, a bond that can last years. An internist, family physician, geriatrician or general practitioner traditionally served as a trusted adviser who coordinated care, ordered tests, helped sort out treatment options and made referrals to specialists.But some experts warn that moving away from a one-on-one relationship may be driving up costs and worsening the problem of fragmented or unnecessary care, including the misuse of antibiotics.A recent report in JAMA Internal Medicine found that nearly half of patients who sought treatment at an urgent care clinic for a cold, the flu or a similar respiratory ailment left with an unnecessary and potentially harmful prescription for antibiotics, compared with 17 percent of those seen in a doctor’s office. Antibiotics are useless against viruses and may expose patients to severe side effects with just a single dose.“I’ve seen many people who go to five different places to be treated for a UTI [urinary tract infection] who don’t have a UTI,” said Dr. Janis Orlowski, a nephrologist who is chief health care officer at the Association of American Medical Colleges, or AAMC. “That’s where I see the problem of not having some kind of continuous care.”“We all need care that is coordinated and longitudinal,” said Dr. Michael Munger, president of the American Academy of Family Physicians, who practices in Overland Park, Kan. “Regardless of how healthy you are, you need someone who knows you.” The best time to find that person, Munger and others say, is before a health crisis, not during one.And that may mean waiting weeks. A 2017 survey by physician search firm Merritt Hawkins found that the average wait time for a new-patient appointment with a primary care doctor in 15 large metropolitan areas is 24 days, up from 18.5 days in 2014.While wait times for new patients may reflect a shortage of primary care physicians — in the view of the AAMC — or a maldistribution of doctors, as other experts argue, there is no dispute that primary care alternatives have exploded. There are now more than 2,700 retail clinics in the United States, most in the South and Midwest, according to Rand Corp. researchers.Connecting With CareRelated StoriesPerspectives on how to communicate to older adults about stopping cancer screeningResearchers analyze link between videogame addiction and school inadaptationAre physical examinations by family doctors still needed?To attract and retain patients, especially young adults, primary care practices are embracing new ways of doing business.Many are hiring additional physicians and nurse practitioners to see patients more quickly. They have rolled out patient portals and other digital tools that enable people to communicate with their doctors and make appointments via their smartphones. Some are exploring the use of video visits.Mott Blair, a family physician in Wallace, N.C., a rural community 35 miles north of Wilmington, said he and his partners have made changes to accommodate millennials, who make up a third of their practice.“We do far more messaging and interaction through electronic interface,” he said. “I think millennials expect that kind of connectivity.” Blair said his practice has also added same-day appointments.Although walk-in clinics may be fine as an option for some illnesses, few are equipped to provide holistic care, offer knowledgeable referrals to specialists or help patients decide whether they really need, say, knee surgery, he noted. Primary care doctors “treat the whole patient. We’re tracking things like: Did you get your mammogram? Flu shot? Pap smear? Eye exam?”Dr. Nitin Damle, an internist and past president of the American College of Physicians, said that young people develop diabetes, hypertension and other problems “that require more than one visit.”“We know who the best and most appropriate specialists in the area are,” said Damle, an associate clinical professor of medicine at Brown University in Providence, R.I. “We know who to go to for asthma, allergies, inflammatory bowel disease.”Marquenttha Purvis, 38, said her primary care doctor was instrumental in helping arrange treatment for her stage 2 breast cancer last year. “It was important because I wouldn’t have been able to get the care I needed” without him, said Purvis, who lives in Richmond, Va.Sometimes the fragmented care that can result from not having a doctor has serious consequences.Orlowski cites the case of a relative, a 40-year-old corporate executive with excellent medical insurance. The man had always been healthy and didn’t think he needed a primary care physician.“Between treating himself and then going to outpatient clinics,” he spent nearly a year battling a sore throat that turned out to be advanced throat cancer, she said.For patients without symptoms or a chronic condition such as asthma or high blood pressure, a yearly visit to a primary care doctor may not be necessary. Experts no longer recommend the once-sacrosanct annual physical for people of all ages.“Not all access has to be with you sitting on an exam table,” Munger said. “And I may not need to see you more than every three years. But I should be that first point of contact.”Convenience Is ParamountCaitlin Jozefcyk, 30, a high school history teacher in Sparta, N.J., uses urgent care when she’s sick. She dumped her primary care doctor seven years ago because “getting an appointment was so difficult” and he routinely ran 45 minutes behind schedule. During her recent pregnancy, she saw her obstetrician.Jozefcyk knows she’s not building a relationship with a physician — she sees different doctors at the center — but “really likes the convenience” and extended hours.Digital access is also important to her. “I can make appointments directly through an app, and prescriptions are sent directly to the pharmacy,” she said.After years of going to an urgent care center or, when necessary, an emergency room, Jessica Luoma, a 29-year-old stay-at-home mother in San Francisco, recently decided to find a primary care doctor.“I’m very healthy, very active,” said Luoma, who has been treated for a kidney infection and a miscarriage.Luoma said her husband pushed her to find a doctor after the insurance offered by his new employer kicked in.“He’s a little more ‘safety first’ than me,” she said. “I figured, ‘Why not?’ — just in case.” read more

Reviewed by James Ives, M.Psych. (Editor)Oct 17 2018In a survey-based study of 9,449 university students at a large, public Midwestern university, misusers of prescription opioid medications were more likely to live off campus, have a lower grade point average, and exhibit increased impulsivity. In the American Journal of Addictions study, prescription opioid misusers were also more likely to report earlier age of sexual activity and were less likely to use barrier protection during sexual activity.“This study identifies a number of risk factors for those misusing prescription opioids that can be used to develop and refine prescription opioid misuse screening tools for university health centers,” the authors wrote. “It also identifies a number of concurring behaviors that can simultaneously be addressed when prescription opioid misusers are identified.” Source:https://newsroom.wiley.com/press-release/study-examines-factors-linked-opioid-misuse-among-university-students read more

Reviewed by James Ives, M.Psych. (Editor)Dec 27 2018Taking antidepressants for depression, having post-traumatic stress disorder or anxiety diagnosed by a doctor are risk factors for a disruptive and sometimes violent sleep disorder called rapid eye movement (REM) sleep behavior disorder, according to a study published in the December 26, 2018, online issue of Neurology®, the medical journal of the American Academy of Neurology. The study also found men are more likely to have the disorder.REM sleep is the dream state of sleep. During normal REM sleep, your brain sends signals to prevent your muscles from moving. However, for people with REM sleep behavior disorder, those signals are disrupted. A person may act out violent or action-filled dreams by yelling, flailing their arms, punching or kicking, to the point of harming themselves or a sleep partner.”While much is still unknown about REM sleep behavior disorder, it can be caused by medications or it may be an early sign of another neurologic condition like Parkinson’s disease, dementia with Lewy bodies or multiple system atrophy,” said study author Ronald Postuma, MD, MSc, of McGill University in Montreal, Canada, and a member of the American Academy of Neurology. “Identifying lifestyle and personal risk factors linked to this sleep disorder may lead to finding ways to reduce the chances of developing it.”The study looked at 30,097 people with an average age of 63. Researchers screened participants for a variety of health conditions and asked about lifestyle, behavior, social, economic and psychological factors.In addition, every participant was asked, “Have you ever been told, or suspected yourself, that you seem to act out your dreams while asleep?”Researchers then identified 958 people, or 3.2 percent, with possible REM sleep behavior disorder, after excluding participants with Parkinson’s disease, dementia, Alzheimer’s disease or sleep apnea.Related StoriesPink noise enhances deep sleep for people with mild cognitive impairmentSleep quality linked to memory problems in new studySleep quality could be indicator for later Alzheimer’s disease finds studyResearchers found those with the disorder were over two-and-a-half times as likely to report taking antidepressants to treat depression, with 13 percent of those with the disorder taking them compared to 6 percent of those without the disorder. People with the disorder were also two-and-a-half times as likely to have post-traumatic stress disorder. They were twice as likely to have mental illness, and over one-and-a-half times as likely to have psychological distress.Other findings were that men were twice as likely as women to have possible REM sleep behavior disorder; 59 percent of those with the disorder were male, compared to 42 percent of those without the disorder. People with possible REM sleep behavior disorder were 25 percent more likely than those without the disorder to be moderate to heavy drinkers, with 19 percent of those with the disorder moderate to heavy drinkers compared to 14 percent of those without the disorder. They had slightly less education, an average of 13.2 years of education compared to an average of 13.6 years for those without the disorder. They also had lower income and were more likely to have smoked.”Our research does not show that these risk factors cause REM sleep behavior disorder, it only shows they are linked,” said Postuma. “Our hope is that our findings will help guide future research, especially because REM sleep behavior disorder is such a strong sign of future neurodegenerative disease. The more we understand about REM sleep behavior disorder, the better positioned we will be to eventually prevent neurologic conditions like Parkinson’s disease.”A limitation of the study was that 96 percent of participants were white, meaning the results may not apply to people of other ethnic backgrounds.Source: https://www.aan.com/PressRoom/Home/PressRelease/2685 read more

Source:https://www.massgeneral.org/about/pressrelease.aspx?id=2332 Reviewed by Kate Anderton, B.Sc. (Editor)Jan 2 2019Mass. General/Penn Medicine study suggests that 1.7 million female health care workers and their children live in povertyA study carried out by researchers at Massachusetts General Hospital (MGH) and the Perelman School of Medicine at the University of Pennsylvania finds that low wages and poor benefits leave many female health care workers living below the poverty line. The report that will appear in the January issue of the American Journal of Public Health has been published online.”Every day in the clinic and in the hospital, my colleagues who work in low-wage positions – as cleaners, dietary workers, medical assistants and nurse’s aides – make vital contributions to the care of our patients.” says Kathryn Himmelstein, MD, lead and corresponding author of the paper. “These workers should not have to go home to poverty or be unable to afford health care for themselves and their families.” A resident in the MGH Department of Medicine and postdoctoral fellow at Harvard Medical School, Himmelstein initiated the study as a medical student at the University of Pennsylvania.The authors note that more Americans are employed in health care than in any other industry, and three quarters of them are women. Their analysis of data from the 2017 Annual Social and Economic Supplement to the Current Population Survey, conducted by the U.S. Census Bureau and the Bureau of Labor Statistics, found that 18 percent of employed women responding to the 2017 survey and 23 percent of employed Black women work in health care, many of them in low-paying jobs.Although the average hourly wage for female health care workers of more than $19/hour was higher than the average of around $16/hour for all other industries, it was almost 25 percent lower than the average for men working in health care. The data suggested that 34 percent of female health care workers, and nearly half of the Black and Latina women working in the health sector, earned less than $15/hour. While the largest number of health care workers making less than $15/hour were employed by hospitals, such workers made up a larger share of the total workforce in home health care and at nursing homes and other residential care facilities. Relatively few women and even fewer women of color worked as physicians or managers.Related StoriesEven when HIV prevention drug is covered, other costs block treatmentPatients taking opioids for chronic pain could face health care access problemsNew federal health insurance rule could help millions of Americans save money on drugs and careProjecting the survey’s results across the entire U.S. population suggests that 5 percent of all women health care workers – including 10.6 percent of Black and 8.6 percent of Latina women health care workers – live in poverty, the authors note. Overall, 1.7 million women health care workers and their children lived below the poverty line in 2017, accounting for nearly 5 percent of all people living in poverty in the U.S. The researchers also found surprisingly high numbers of the female health care workers surveyed lack health insurance. Overall, 7 percent – projected to represent more than 1 million women nationwide – were uninsured, including more than 10 percent of Black and Latina women employed in health care.The researchers also projected the potential impact of raising the minimum wage to $15/hour, a policy already implemented in several cities and some medical centers. They found that adopting such a policy nationwide would decrease poverty rates among female health care workers by up to 50 percent, while increasing U.S. health care costs by less than 1.5 percent.Himmelstein says, “Public health experts have been urging hospitals and other health care providers to focus on the ‘social determinants’ of ill-health, and these institutions should start by addressing their own employment practices. But we shouldn’t just leave that up to health care employers; lawmakers have a tremendous opportunity to lift millions of people out of poverty and promote racial and gender justice in health care employment by raising statutory minimum wages.”Senior author Atheendar Venkataramani, MD, PhD, assistant professor of Medical Ethics and Health Policy at the Perelman School of Medicine, adds, “Wage inequality in the health care sector reflects what we are seeing in other sectors of the economy in the United States. In that spirit, these findings should inform active debates around the role of new policies – for example, raising minimum wages, expanding the Earned Income Tax Credit or expanding access to higher education – that seek to address widening income inequality and diminishing opportunities for upward mobility.” read more

Source:https://www.henryford.com/news/2019/01/keloids-linked-to-early-onset-and-late-stage-breast-cancer Reviewed by James Ives, M.Psych. (Editor)Jan 25 2019Findings from a new study conducted by researchers at Henry Ford Health System suggest a link between keloids and increased risk of being diagnosed with breast cancer, particularly among African Americans. Keloids are benign fibroproliferative tumors, which can result in excessive growths of scar-like tissue on the skin. Keloids have been reported to affect some 11 million people worldwide. Despite this prevalence, the exact cause of keloid formation is unknown.The multi-disciplinary research team hypothesized African American women with a history of keloids would reflect a population of breast cancer patients with aggressive tumors and poor outcomes. Medical record review of 13,033 patients with scar codes in the Henry Ford Health System electronic health record, between 2005-2015 was conducted.Related StoriesBacteria in the birth canal linked to lower risk of ovarian cancerStudy reveals link between inflammatory diet and colorectal cancer riskUsing machine learning algorithm to accurately diagnose breast cancerOf these patients, 255 also had a concurrent breast cancer diagnosis. Of this group of 255 patients with a breast cancer diagnosis, 102 had a confirmed history of keloids and 152 did not have keloids. Using this patient cohort, the researchers conducted multivariate analysis to identify associations between breast cancer related clinical factors, and keloid status.The researchers found a race-specific age association, with African American patients displaying significantly younger ages at breast cancer diagnosis in keloid-positive patients, average age 52-years-old, versus keloid-negative patients, average age 58-years-old. In addition, keloid patients had a larger percentage of late stage breast cancers (11.7% versus 4.8%). The group hypothesizes that ethnic variations in tumor immune response may underlie their unique cancer risk.”It is well-documented that keloids and certain aggressive breast cancer such as triple negative and inflammatory types disproportionately affect African American Women,” said Lamont R Jones, M.D., MBA, vice chair for the Department of Otolaryngology – Head and Neck Surgery at Henry Ford Health System, and principal investigator of this study. “We need to better understand how immune-related differences, specific to African Americans, result in more aggressive types of cancer. While the results of this study are preliminary, we believe further investigating a possible link between breast cancer and keloids may provide more insight.” read more

Reviewed by James Ives, M.Psych. (Editor)Apr 25 2019Medicare-covered stroke patients receive vastly different amounts of physical and occupational therapy during hospital stays despite evidence that such care is strongly associated with positive health outcomes, a new study by Brown University researchers found.The research team, led by Amit Kumar, an adjunct assistant professor at Brown’s School of Public Health, analyzed Medicare claims data from 2010 for approximately 104,000 stroke patients. They found that 15 percent of patients received no physical therapy (PT) or occupational therapy (OT), while on average stroke patients received 2 hours of therapy during their hospital stay. Some patients received almost 4 hours of therapy, but these tended to be patients with the longest hospital stays, Kumar added.”For stroke patients, rehabilitation services are one of the most important components in providing treatment after they are stabilized in the acute setting,”said Kumar, who is also an assistant professor of physical therapy at Northern Arizona University. “This is the only treatment that helps patients regain activities for daily living, such as walking or using the restroom independently. So it’s really important to start physical therapy and occupational therapy as early as possible.”The findings were published on Wednesday, April 24, in the Physical Therapy Journal.The paper builds on additional work from the same group published January in the Archives of Physical Medicine and Rehabilitation. That study showed that stroke patients who receive more PT — which helps patients restore movement to parts of the body affected by a stroke and regain functions such as walking, balancing or moving their arms — have lower risks of hospital readmission within a month after discharge.In fact, Medicare patients diagnosed with an ischemic stroke — the most common type of stroke, which occurs when a brain artery becomes blocked, reducing blood flow — who received 75 minutes or more of PT while in the hospital were 14 percent less likely to be readmitted than those who received none. Even 30 minutes lowered the risk of readmission by 10 percent.Yet the researchers found that the amount of OT, which focuses on helping patients to regain facility with everyday tasks such as getting dressed or using the restroom, had minimal impact on readmission risks.Kumar believes that PT reduces the risk of hospital readmission two ways. One, it helps patients restore movement and regain the ability to accomplish tasks. Second, it allows physical and occupational therapists to play a role in planning for and preparing patients for the next stage of post-acute care — whether that is an inpatient rehabilitation facility, a skilled nursing facility or the patient’s home, with home health care assistance.In the second paper, the research team found that 61.5 percent of stroke patients received both PT and OT services, 22 percent received only PT, 1.7 percent received only OT and 15 percent received neither PT nor OT. For patients who received physical or occupational therapy, on average they received 14 more minutes of therapy for each additional day spent in the hospital.Related StoriesStroke should be treated 15 minutes earlier to save lives, study suggestsMeasuring blood protein levels in diabetic patients to predict risk of strokeNew discovery may explain some forms of strokePatients who were dually enrolled in Medicare and Medicaid, indicative of more complex clinical needs and lower socioeconomic status, were 16 percent less likely to receive either rehabilitation service. Patients who had a feeding tube inserted, indicative of a severe stroke, were 53 percent less likely to receive rehabilitation services, the researchers found. The findings indicate a failure to provide rehabilitation care to patients with more complex needs and with more severe conditions, they said.Patients treated in a hospital with more than 370 stroke patients a year were more likely to receive rehabilitation services but received 6 fewer minutes of therapy on average than those at hospitals with fewer than 124 stroke patients a year.A portrait of Amit Kumar, an adjunct assistant professor at Brown’s School of Public Health.Amit Kumar, an adjunct assistant professor at Brown’s School of Public Health and lead author.On the other hand, patients treated in a hospital with an inpatient rehabilitation unit were more likely to receive rehabilitation services and received 8 more minutes of therapy, on average. This indicates that financial incentives established by the Centers for Medicare and Medicaid Services, such as bundled payment programs, appear to be effective at improving the coordination of acute and post-acute care and improving patient outcomes, Kumar said. In the first study, his team found that patients treated in a hospital with an inpatient rehabilitation unit were 8 percent less likely to be readmitted.Now Kumar is looking at 2017 Medicare claims data for a variety of potentially disabling conditions including stroke, heart failure, joint replacement and hip fracture to see if Medicare policy changes since 2010 have improved the amount of rehabilitation services patients receive. Kumar will also examine when rehabilitation services are initiated to see if that has an impact on patient outcomes.Currently there are no clear guidelines for the timing and amount of rehabilitation services offered during hospital stays, Kumar said. And the current Medicare diagnostic-based reimbursement model for hospitals doesn’t include metrics for patient functional status or rehabilitation services, which may disincentivize providers from recommending rehabilitation services, he added.Kumar thinks a randomized controlled trial on the amount and timing of hospital rehabilitation services is necessary. The results of such a clinical trial could inform clear rehabilitation guidelines from the American Heart Association/American Stroke Association, a revised Medicare payment model and ultimately better patient outcomes.Source: https://www.brown.edu/news/2019-04-19/stroke read more

Reviewed by James Ives, M.Psych. (Editor)Apr 27 2019California regularly portrays itself as a national trendsetter on political issues, and Gov. Gavin Newsom is claiming that title on prescription drugs.Newsom has a plan to take on the drug industry, and at an April 17 news conference in Southern California, he declared that two other governors already want to join his effort.”California is leading the nation in holding drug companies accountable and fighting prescription drug prices,” Newsom said via a press release that day, marking his 100th full day in office.There’s no question the Democratic governor is aggressively taking on the pharmaceutical industry — vowing to leverage his state’s purchasing power to extract lower prices, and bluntly telling drugmakers that taxpayers are tired of being “screwed.”But Newsom’s claim that California leads the nation on this issue prompted us to ask: Is that really the case?What is Newsom doing about prescription drugs?Newsom marked his first day in office, Jan. 7, with a direct message to the pharmaceutical industry: The nation’s most populous state is fed up with the meteoric rise in prescription drug prices.He signed an executive order directing the state to negotiate drug prices for the roughly 13 million enrollees of Medi-Cal, the country’s largest Medicaid program that serves low-income residents, by 2021. And he ordered his administration to study how state agencies could band together and buy prescription drugs in bulk.With the state buying drugs for all Medi-Cal enrollees and state entities, Newsom argues that California will leverage its purchasing power as the third-largest buyer in the country to demand lower prices from drugmakers. Eventually, Newsom envisions private purchasers — including small businesses, health plans and self-insured Californians — taking part.Newsom has said several times he hopes this collaboration can be a model for the rest of the country.Newsom traveled to Downey, Calif., last week to announce that Los Angeles County would join California’s bulk purchasing pool, a move intended to show that others are eager to join his initiative.How do California’s efforts on prescription drugs compare with those of other states?We interviewed five health care experts who commended Newsom for his focus on prescription drugs, but each noted that he is not the only lawmaker tackling the issue.”Is California a leader? Yes. Is it the leader?” asked Edwin Park, a research professor at Georgetown University’s Center for Children and Families. “That’s not doing an assessment of what all the other states are doing.”A number of states in recent years have enacted laws to regulate pharmacy benefit managers, the so-called middlemen who negotiate with drugmakers; impose drug price transparency rules; outlaw “gag clauses” that prevent pharmacists from telling consumers about cheaper drug alternatives; and authorize the importation of drugs from Canada.At least 28 states and the District of Columbia already participate in multistate purchasing pools — joining forces to get bigger discounts for their Medicaid programs or state employees. The Northwest Prescription Drug Consortium, formed by Oregon and Washington in 2006, invites state and local government agencies, businesses, labor unions and uninsured consumers to voluntarily pool their purchasing power.Related StoriesComputers, games, crafting keep the aging brain sharpA Portable Solution for the On-scene Identification of KratomAntibiotic combination effective against drug-resistant PseudomonasRoughly 1.1 million people are represented by the consortium, either as individuals or through public and private entities such as the Washington State Department of Corrections, Washington’s Medicaid program and SAIF Corp.”Other states are actively looking at us as a partner,” said Trevor Douglass, director of the Oregon Prescription Drug Program.Earlier this month, Maryland lawmakers passed legislation that would create the nation’s first prescription drug affordability board, which, if signed by Republican Gov. Larry Hogan, would let the state cap certain drug prices.”There’s extraordinary activity” on prescription drug prices, said Trish Riley, executive director of the National Academy for State Health Policy, which tracks bills in state legislatures around the country. “Hundreds of bills were introduced this year.”What makes California’s effort novel, Newsom spokesman Nathan Click said, is the mandatory inclusion of all state agencies and the Medi-Cal program — which he said would make it the largest purchaser of drugs after Medicare and the Department of Veterans Affairs. Programs in other states are more limited, and some are voluntary.Health care experts agreed that California’s size by default makes it a national leader on the health care front, not the national leader. But if California is successful, they say, it could lower the price of drugs nationally.Our rulingNewsom said “California is leading the nation in holding drug companies accountable and fighting prescription drug prices.”States across the county are addressing the rising cost of prescription drugs in a variety of ways. California is not the only, or the first, one.The scope of what Newsom is attempting could bring down drug prices for California residents, and possibly residents in other states that join the effort. But Newsom’s sweeping plan is still in its infancy with many details pending, so it’s too soon to gauge success.We rate the claim HALF TRUE. This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente. read more

By Sally Robertson, B.Sc.Apr 30 2019Reviewed by Kate Anderton, B.Sc. (Editor)A new study by researchers at the University of Adelaide has found that time-restricted eating (also known as intermittent fasting), may help to regulate blood glucose levels among people who are at risk of type 2 diabetes. Fasting was shown to improve glycemic (blood sugar) responses in men with a high risk of developing diabetes, irrespective of how much food they ate.Dima Sobko | Shutterstock Putting intermittent fasting to the testAs reported in the journal Obesity, the team analyzed the effects or time-restricted eating among 15 at-risk men (aged an average of 55 years) over the course of two seven-day test periods. The men followed their usual diet but limited their daily food intake to a nine-hour time period – either eating between 8.00am and 5.00pm for a week or between noon and 9.00pm for a week.All participants wore a continuous glucose monitor and were assessed for glucose tolerance following a standard meal at the start and end of the experiment.  The researchers report that time-restricted eating improved glucose control, irrespective of when the men chose to stop eating. Time-restricted eating regimes demonstrate that we can enjoy foods that are perceived to be ‘bad’ for us if we allow our bodies to have more time fasting each night.”Leonie Heilbronn, Lead Author Our results suggest that modulating when, rather than what, we eat can improve glucose control. We did see a tiny amount of weight loss in this study, which may have contributed to the results.”Leonie Heilbronn, Lead Author Most people following this diet abstain from food for 16 hours of the day and eat within an 8 hour time period. The theory is that longer fasting periods increase the body’s ability to deal with larger volumes of food.Time-restricted eating is a popular diet trend that involves intermittent fasting. The theory behind time-restricted eating is that people can enjoy foods usually thought of as unhealthy, providing they consume them at within a specific time period in the day. Participants experienced ‘significant’ improvementsOne of the study participants was Fred Rochler, who followed his usual diet between 9:30am and 7:30pm over the course of eight weeks.”The restricted eating regime was initially challenging, but soon became more manageable. I only ate up until 7.30pm as I found this worked well with my lifestyle. Over the trial, I found that my fasting blood glucose tolerance improved significantly. It changed from ‘increased risk’ level to ‘normal’. This was without changing any of the foods that I like to eat,” said Fred.Helibronn notes that the findings would need to be replicated in studies involving more participants and conducted over a longer period of time before any conclusions can be drawn.”While these early results show some promise for controlling blood glucose, a larger study over a longer duration is required to fully investigate the effectiveness of this pattern of time-restricted eating,” she concludes. read more

Take driving for instance. As the background scenery whizzes by, it is imperative that a driver see and avoid cars, pedestrians, and other objects on the road.There are two basic ways the brain can distinguish such objects from moving backgrounds. It can enhance the objects that matter; or, it can suppress the background, and, by virtue of this suppression, enhance the objects. The latter is “the more efficient option,” Tadin says. “Think about trying to have a conversation in a room with high background noise. It is more effective to find a way to turn off the noise than it is to just try speaking more loudly.”While these strategies are not the only ones the brain uses to highlight moving objects–attention is another factor, for instance–previous research from Tadin’s lab found a link between IQ and an ability to suppress background motion. The researchers speculated that in healthy, young people, a region in the brain called the middle temporal visual area (MT) is responsible for this suppression.In order to test people’s ability to identify moving objects on a moving background, the researchers showed study participants moving textured patterns. Within the textured background, there was a smaller patterned object moving in the direction opposite from the background. The participants were instructed to report either the location or the shape of the smaller patterned object.The researchers found that younger adults were better at seeing smaller moving objects in the foreground and worse at seeing background motion. Older adults–participants aged 65 and above–were the opposite. They were poorer at seeing the smaller moving objects because they had a heightened awareness of the backdrop against which the objects moved. Younger adults took on average 20 milliseconds to pick out the moving objects, and older adults took about 30 milliseconds.Related StoriesStudy provides new insight into longitudinal decline in brain network integrity associated with agingRush University Medical Center offers new FDA-approved treatment for brain aneurysmsPosterior parietal cortex plays crucial role in making decisions, research showsWhile both groups were efficient at the task, taking only a fraction of a second to detect the movement of the object against the background, “those extra milliseconds could make a big difference,” says Woon Ju Park, a former postdoctoral associate in Tadin’s lab and currently a research associate at the University of Washington. “Think about things that matter for your survival.” A split second could mean the difference between hitting or avoiding a pedestrian; or it could be just enough time to lose sight of a rambunctious child. In the case of the animal world, it could mean the difference between life and death.”Think of an animal in the wild,” Park says. “If it sees a moving object, that could either be lunch for the animal or something that could eat that animal for lunch. Animals are really good at camouflage, but even the best camouflage pulls apart with motion.”The researchers speculate that older adults have impaired motion segregation because as people age, their vision changes and becomes “noisier.” As an adaptive mechanism, the aging brain then might prioritize integrating motion information in general over suppressing and segmenting background from foreground. The results also suggest that people with psychiatric conditions such as schizophrenia–associated with similar “noisier” visual systems–might also experience the trade-off between integration and segregation.Although the research shows that the ability to detect moving objects against a moving background decreases with age, the research also offers some good news for older adults.”With training, we can make older adults be more like younger adults,” Tadin says.The researchers found that older adults could train their brains to process motion more like younger adults by practicing visual segmentation of moving objects. Older participants performed the study task for four weeks, with four sessions per week, and became quicker at the task, narrowing the gap in performance with their younger counterparts. Surprisingly, the researchers found, the older participants who underwent training did not in fact get better at seeing the smaller moving object; their ability to see the object was just as good as it was at the beginning of the training. What changed with training was that the older adults became less sensitive to the background motion, just like younger adults.”Most of the time when you train something in the brain, things get better,” Tadin says. “This is a case where, with training, you get better at seeing objects, while at the same time get worse at seeing the background. This showed us that these two things are really integrally connected, because when we affected one, the other one also changed.” Source:University of Rochester The human brain cannot possibly process all of the information around us. Being less sensitive to things that are less important makes the brain more efficient and faster at accomplishing the more important tasks.”Duje Tadin, Study Lead Author and Professor of Brain and Cognitive Sciences, Rochester Reviewed by Alina Shrourou, B.Sc. (Editor)Jul 2 2019Visual motion is an important source of information for separating objects from their backgrounds.A spider camouflaged against a branch, for instance, immediately loses its invisibility once it starts moving. A friend you’re trying to spot in a crowded airport terminal is more distinguishable once she begins waving her hands.While the process of separating an object from a background is seemingly effortless, researchers don’t know how our visual system manages to rapidly pick out and segregate moving objects from their backgrounds.According to new research from scientists at the University of Rochester, one reason human beings are good at discerning smaller moving objects in the foreground is that the brain becomes desensitized to the motion in the larger background. Conversely, when a person’s brain is more sensitive to background motion, the negative trade-off is that she will be less sensitive to smaller foreground objects. The research, published in the journal Nature Communications, could lead to new training programs for elderly adults and patients with conditions such as schizophrenia, which has been linked to weaker motion segregation. read more

This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only. Explore further In its latest transparency report, Twitter said it suspended 274,460 accounts between July and December 2017 “for violations related to the promotion of terrorism.”The figure is down 8.4 percent from the previous reporting period and is the second consecutive decline, a Twitter statement said.”We continue to see the positive, significant impact of years of hard work making our site an undesirable place for those seeking to promote terrorism, resulting in this type of activity increasingly shifting away from Twitter,” said the statement from the messaging platform’s public policy team.Twitter has faced pressure from governments around the world to crack down on jihadists and others calling for violent attacks, while at the same time maintaining an open platform for free speech.In the latest six-month reporting period, Twitter said 93 percent of the suspended accounts were “flagged by internal, proprietary tools,” and that 74 percent were cut off before their first tweet.It said government reports of violations related to the promotion of terrorism represent less than 0.2 percent of all suspensions in the period.Twitter also used the report to express concerns about what it called “legal threats to freedom of expression” online in countries around the world.”With the passage of new legislation and ongoing regulatory discussions taking place around the world about the future of public discourse online, we are seeing a potential chilling effect with regards to freedom of expression,” the report said.It cited a Human Rights Watch report suggesting that “governments around the world (are) increasingly look to restrict online speech by forcing social media companies to act as their censors.” © 2018 AFP Twitter touts victories in war on extremist content Twitter says more than one million accounts have been suspended since 2015 for “promotion of terrorism” Citation: Twitter: 1 million accounts suspended for ‘terrorism promotion’ (2018, April 5) retrieved 18 July 2019 from https://phys.org/news/2018-04-twitter-million-accounts-terrorism.html Twitter said Thursday it has suspended over one million accounts for “promotion of terrorism” since 2015, claiming its efforts have begun to make the platform “an undesirable place” to call for violence. read more

Indian government grounds Air India sale plans: reports Explore further Indian airlines operate in a hyper-competitive market, and are scrambling to cut costs India’s aviation market is expected to become the world’s third-largest by 2025 “The key challenge faced by Indian airlines is on the cost front as 60-70 percent of expenditure is exposed to fluctuations in oil prices and currency markets,” Binit Somaia, South Asia director at the Centre for Aviation (CAPA), told AFP.Millions of dollars have been wiped off the value of Jet’s stock this year and its financial situation has been the subject of furious speculation in Indian media in recent weeks.That intensified after the carrier failed to release its first-quarter earnings as scheduled earlier this month, before finally releasing them on Monday showing a second successive loss.In July, it denied a report in the Economic Times that it needed to make major cost cuts or face having to shut down operations within 60 days. ‘Ongoing crisis’Air India is about $8 billion in the red and reported losses of almost 58 billion rupees for the financial year ending March 2017.In June, it sought an urgent loan of 10 billion rupees to maintain day-to-day operations and last week, local media reported it was defaulting on bank loan payments and had sought a $5 billion bailout.A handful of carriers, most notably fugitive tycoon Vijay Mallya’s Kingfisher Airlines, have already gone bust.Airlines have to navigate a fiercely competitive market, with a host of budget airlines offering steep discounts to attract passengers. Some tickets, before taxes, are as low as 999 rupees.Analysts agree that Indian airlines cannot hold off passing on the rising operating costs to customers much longer.”Pricing has been irrational and unsustainable. Airlines will have to raise fares in the coming months to match costs even if it means a subsequent passenger crunch,” Devesh Agarwal, editor of the Bangalore Aviation website, told AFP.They also say carriers must lobby the government to reduce taxes.”Indian airlines need to avoid price wars… and provide a much unified front to tackle the ongoing crisis,” said Pandurangi. Citation: Cheap fares, costly fuel send India’s airlines into a tailspin (2018, August 29) retrieved 18 July 2019 from https://phys.org/news/2018-08-cheap-fares-costly-fuel-india.html But the carrier announced with its earnings Monday that it would implement a “comprehensive cost reduction programme” amounting to 20 billion rupees over the next two years and seek investment to help turn around its fortunes.”Airlines can’t solely rely on oil prices being low to bring in profitability. They need to be careful with pricing and manage costs better,” said Amrit Pandurangi, an independent aviation expert.Jet’s struggles are not unique.IndiGo’s profits plunged 97 percent on-year in April-June, sending its stock plunging.And Air India, once the country’s monopoly airline and known affectionately as the “Maharaja of the skies”, has been haemorrhaging money for years and losing market share to low-cost rivals. India’s aviation sector is expected to become the world’s third-largest by 2025, with passenger numbers increasing six-fold over the past decade as a growing middle class take advantage of better connectivity and inexpensive flights.But experts warn cheap tickets and an over-reliance on favourable fuel pricing is unsustainable.India’s top two airlines by market share, IndiGo and Jet Airways, and debt-laden state carrier Air India are all suffering financial woes, while SpiceJet’s boss has said the industry is in “great stress”.”The rise in the price of Brent fuel, a depreciating rupee and a resulting mismatch between high fuel prices and low fares have adversely impacted the Indian aviation industry, including Jet Airways,” Jet CEO Vinay Dube said this week.Brent crude has risen 50 percent a over the past year, while the impact has been exacerbated by the rupee recently touching a record low of 70 to the dollar.Then they must pay taxes of up to 44 percent on jet fuel, the highest in Asia according to Bloomberg News, all the while stumping up billions for new planes to keep up with passenger demand.Profits nosediveOn Monday, Jet Airways reported a loss of 13.23 billion rupees ($189 million) for the three months ended June 30, compared with a profit of 535 million rupees for the same period a year earlier. © 2018 AFP Bargain-basement fares, high oil prices and a tumbling rupee are causing turbulence in India’s hyper-competitive aviation market, virtually wiping out airlines’ profits and leaving them scrambling to cut costs to survive. Air India, the country’s debt-laden state carrier, has been hemorrhaging money for years This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only. read more

Run by Google, the app drew great praise for being groundbreaking and fun to play with. It also attracted criticism, and raised concerns about AI’s dangers.My study of how emerging technologies affect people’s lives has taught me that the problems go beyond the admittedly large concern about whether algorithms can really create music or art in general. Some complaints seemed small, but really weren’t, like observations that Google’s AI was breaking basic rules of music composition.In fact, efforts to have computers mimic the behavior of actual people can be confusing and potentially harmful.Impersonation technologiesGoogle’s program analyzed the notes in 306 of Bach’s musical works, finding relationships between the melody and the notes that provided the harmony. Because Bach followed strict rules of composition, the program was effectively learning those rules, so it could apply them when users provided their own notes.The Bach app itself is new, but the underlying technology is not. Algorithms trained to recognize patterns and make probabilistic decisions have existed for a long time. Some of these algorithms are so complex that people don’t always understand how they make decisions or produce a particular outcome. This article is republished from The Conversation under a Creative Commons license. Read the original article. Citation: Artificial intelligence can now emulate human behaviors – soon it will be dangerously good (2019, April 5) retrieved 17 July 2019 from https://phys.org/news/2019-04-artificial-intelligence-emulate-human-behaviors.html Explore further The Google Doodle team explains the Bach program. AI systems are not perfect – many of them rely on data that aren’t representative of the whole population, or that are influenced by human biases. It’s not entirely clear who might be legally responsible when an AI system makes an error or causes a problem. This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only. Is this face just an assembly of computer bits? Credit: Michal Bednarek/Shutterstock.com When artificial intelligence systems start getting creative, they can create great things – and scary ones. Take, for instance, an AI program that let web users compose music along with a virtual Johann Sebastian Bach by entering notes into a program that generates Bach-like harmonies to match them. Be careful what videos you believe. In early 2019, a fake nude photo of U.S. Rep. Alexandria Ocasio-Cortez circulated online. Fabricated videos, often called “deepfakes,” are expected to be increasingly used in election campaigns. Members of Congress have started to look into this issue ahead of the 2020 election. The U.S. Defense Department is teaching the public how to spot doctored videos and audio. News organizations like Reuters are beginning to train journalists to spot deepfakes.But, in my view, an even bigger concern remains: Users might not be able to learn fast enough to distinguish fake content as AI technology becomes more sophisticated. For instance, as the public is beginning to become aware of deepfakes, AI is already being used for even more advanced deceptions. There are now programs that can generate fake faces and fake digital fingerprints, effectively creating the information needed to fabricate an entire person – at least in corporate or government records.Machines keep learningAt the moment, there are enough potential errors in these technologies to give people a chance of detecting digital fabrications. Google’s Bach composer made some mistakes an expert could detect. For example, when I tried it, the program allowed me to enter parallel fifths, a music interval that Bach studiously avoided. The app also broke musical rules of counterpoint by harmonizing melodies in the wrong key. Similarly, OpenAI’s text-generating program occasionally wrote phrases like “fires happening under water” that made no sense in their contexts.As developers work on their creations, these mistakes will become rarer. Effectively, AI technologies will evolve and learn. The improved performance has the potential to bring many social benefits – including better health care, as AI programs help democratize the practice of medicine.Giving researchers and companies freedom to explore, in order to seekthese positive achievements from AI systems, means opening up the riskof developing more advanced ways to create deception and other socialproblems. Severely limiting AI research could curb that progress. But giving beneficial technologies room to grow comes at no small cost – and the potential for misuse, whether to make inaccurate “Bach-like” music or to deceive millions, is likely to grow in ways people can’t yet anticipate. Provided by The Conversation First artificial intelligence Google Doodle features Bach Now, though, artificial intelligence technologies are getting advanced enough to be able to approximate individuals’ writing or speaking style, and even facial expressions. This isn’t always bad: A fairly simple AI gave Stephen Hawking the ability to communicate more efficiently with others by predicting the words he would use the most.More complex programs that mimic human voices assist people with disabilities – but can also be used to deceive listeners. For example, the makers of Lyrebird, a voice-mimicking program, have released a simulated conversation between Barack Obama, Donald Trump and Hillary Clinton. It may sound real, but that exchange never happened.From good to badIn February 2019, nonprofit company OpenAI created a program that generates text that is virtually indistinguishable from text written by people. It can “write” a speech in the style of John F. Kennedy, J.R.R. Tolkien in “The Lord of the Rings” or a student writing a school assignment about the U.S. Civil War.The text generated by OpenAI’s software is so believable that the company has chosen not to release the program itself.Similar technologies can simulate photos and videos. In early 2018, for instance, actor and filmmaker Jordan Peele created a video that appeared to show former U.S. President Barack Obama saying things Obama never actually said to warn the public about the dangers posed by these technologies. read more

Workplace messaging startup Slack to go public Slack CEO Stewart Butterfield speaks at his company’s Frontiers conference in San Francisco ahead of the workplace collaboration firm’s Wall Street listing Citation: Workplace messaging startup Slack to list on Wall Street (2019, April 26) retrieved 17 July 2019 from https://phys.org/news/2019-04-messaging-app-slack-ipo.html The “direct listing” will raise no cash for the California-based firm but will enable employees and early investors to sell their shares in the fast-growing tech firm.Slack, which has become a popular application for businesses looking to move away from email to real-time messaging, said it had some 10 million users at the end of January.That included 88,000 paying customers and 65 of the Fortune 100 firms.”Our vision is to make people’s working lives simpler, more pleasant and more productive,” Slack said in its filing with the Securities & Exchange Commission.”Slack is a new layer of the business technology stack that brings together people, applications, and data—a single place where people can effectively work together, access hundreds of thousands of critical applications and services, and find important information to do their best work.”Slack, which has users in 150 countries, has raised more than $1 billion from investors with the latest round valuing the company at $7.1 billion, making it one of the most richly valued “unicorns”—startups with private funding worth at least $1 billion.In its first release of financial data, Slack said it lost $141 million in the 12 months to January 31 on revenue of $400 million.Created in 2013, Slack has been a leader in the new segment but faces competition from the likes of Microsoft, Facebook and others offering workplace collaboration tools.Analysts say Slack has found a niche, especially among small- and medium-sized businesses.Its clients include software giant Oracle, the French luxury goods maker LVMH, Liberty Mutual insurance and the NASA Jet Propulsion Laboratory.It is available in eight languages and gets about one-third of its revenue from outside the United States.Slack’s chief executive and founder Stewart Butterfield was part of the team that started the photo-sharing service Flickr.The direct listing, which was also used by the streaming music giant Spotify, does not add fresh capital to the firm but enables free trading of shares while avoiding the underwriting costs of a public offering.Slack will trade under the symbol “SK.” Explore further © 2019 AFP This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only. The workplace messaging startup Slack filed documents Friday to list its shares on the New York Stock Exchange, the latest of a group of richly valued tech enterprises to look to Wall Street. read more

COMMENT How to match and contain the last-leg high pitch campaign of the BJP is the biggest worry among the Congress leaders and workers in Rajasthan during this election. Though the party believes the anti-incumbency against Vasundhara Raje government is giving a definite edge for it in the polls, it is apprehensive about the well-oiled booth level mechanism of its opponent, the BJP. The party is well aware that BJP is much ahead of them in men and resources.The speeches by senior leader and one of the contenders for thechief minister’s post, CP Joshi, is a clear indication of what the Congress thinks. Addressing a crowd of party supporters Sema village near Nathdwara, Joshi asks the party workers to be careful about the “fake news”. “One should know how to use the mobile phones wisely. It is being used to spread fake news. Many of our people fell for it in 2014,” the former psychology professor told the crowd. He also explained the necessity of meeting people and asking them to come and vote for the Congress on December 7.On communal forcesTalking to BusinessLine, Joshi said the BJP may unleash a communal campaign towards the end. He recounted that Rajsamand witnessed one of a gruesome hate crime of the recent past when Shambhulal Regar killed a Muslim labourer Mohammed Afzul. “Communal forces have even offered him a Lok Sabha ticket. They will use such issues to polarise the electorate in the last-leg of the campaign. See how channels are debating the Mandir issue. They will remember about temples when elections come,” Joshi said.The Congress thinks that there is “double anti-incumbency” in Rajasthan. “The tug of war between Prime Minister Narendra Modi and Chief Minister Vasundhara Raje is very apparent. Raje believes it’s because of her that BJP got so many seats in Rajasthan in 2013 and 2014. There is an ego problem between both of them,” Joshi said. Many people in the constituency want him as Chief Minister. But Joshi cleared the air and said Congress has a tradition that it will fight the election under the Pradesh Congress Committee (PCC) president. “After the election, the MLAs select the Chief Minister. In 1998, We fought the election under Ashok Gehlot who was then the PCC president. There were many senior leaders, but Gehlot was elected as CM. In 2008, I was PCC chief, but Gehlot was made CM. We never decide the CM first, though there are some aberrations,” he said. In 2008, Joshi lost for a single vote in Nathdwara, which he represented since 1980 for four occasions. He is coming back to the constituency, his hometown, after a gap of 10 years. “It is a refreshing experience for me. In the last 10 years I learned a lot by working from Delhi. I can use that experience now in Nathdwara,” he adds.“I interact with the young generation to identity their aspirations. Employment is not a solution. We will have to do massive skill enhancement. We will have to address farmers’ issues,” Joshi said and added that loan waiver will be a priority for the Congress as it is a commitment made by party president Rahul Gandhi. Published on Rajasthan November 22, 2018 politics Rajasthan Polls SHARE SHARE SHARE EMAIL Congress leader CP Joshi at an election rally near Nathdwara, Rajasthan   –  Gaurav Gehlot COMMENTS read more

SHARE parties and movements Published on Rajasthan will go to polls on December 7 The Rajasthan Congress released the party manifesto on Thursday, promising to waive the loan of farmers and provide free education to women and jobs to youth.Rajasthan Congress chief Sachin Pilot, former chief minister Ashok Gehlot and chairman of the manifesto committee Harish Choudhary released the party manifesto. Pilot said the manifesto was prepared after taking opinions through multiple platforms such as social media. Two lakh suggestions were received for the preparation of the manifesto, he said.Pilot said the Congress party will waive the loans of farmers if voted to power, an announcement the party president had made during an election meeting in Jaisalmer’s Pokhran Assembly constituency on Monday. He said the Congress intends to give Rs 3,500 monthly allowance to unemployed youths in the state.The party has also promised to bring a legislation for the protection of journalists in the state. The party has promised to form an implementation committee for time-bound implementation of the manifesto. The assembly election is scheduled for December 7.Also read: Candidates list of CongressRead also: Survey gives thumping majority to Cong in Rajasthan Rajasthan Polls Rajasthan November 29, 2018 COMMENTS File Photo of Rajasthan Congress chief Sachin Pilot.   –  PTI SHARE SHARE EMAIL COMMENT read more

Tamil Nadu Governor Banwarilal Purohit addressing the State Assembly in Chennai on Wednesday, Assembly Speaker Dhanapal and Chief Minister Edappadi K Palaniswami are also seen. Photo: B Jothi Ramalingam   –  The Hindu January 02, 2019 state politics SHARE SHARE EMAIL Governor’s address to Assembly sets the tone TN to introduce electric buses in select cities Published on RELATED Tamil Nadu COMMENTS Ahead of the Global Investors Meet 2019, a slew of initiatives is being proposed by the Tamil Nadu government to woo investors. The initiatives include a new policy on start up and innovation, Aerospace and Defence industries; strengthening power transmission infrastructure; restructuring programme for transport corporations and procurement of electric buses for major metros.In his customary address to mark opening of the State Assembly this season, Governor Banwarilal Purohit said start up and innovation policy will improve the start up environment. Start up entrepreneurs are being promoted under New Entrepreneur-cum-Enterprise Development Scheme.State government will soon release the Tamil Nadu Aerospace and Defence Industrial policy. The establishment of industrial hubs for defence products in Chennai – Vellore – Salem – Hosur – Coimbatore – Tiruchirapalli corridor will improve the prospects of Tamil Nadu as a major defence manufacturing force. He urged the Centre to expedite implementation of the Defence industrial production corridor project.“This government is embarking on a comprehensive restructuring programme for transport corporations with the support of German bilateral financing agency KfW to replace ageing fleet with fuel efficient BS-VI buses. The government will also procure electric buses to be run in Chennai, Coimbatore and Madurai,” he said.His speech was boycotted by the opposition parties led by the DMK for State government’s failure in getting sufficient funds from the Centre to carry out relief and rehabilitation work in cyclone Gaja-affected areas and also continuance of health minister C Vijaya Baskar, who is facing a CBI inquiry in the ‘gutka’ case, in the Cabinet.FinanceTamil Nadu, the Governor said, has continued to be a fiscally prudent State despite several financial challenges. However, the revenue deficit has been on the rise in recent years due to the devolution formulae evolved by the 14th Finance Commission, and has adversely affected State finances.Implementation of Ujwal Discom Assurance Yojana and 7th Pay Commission recommendations has also widened the revenue deficit. The delay in release of Integrated Goods and Services Tax (IGST) and Goods and Services Tax (GST) compensation due to the State has accentuated this problem. “I earnestly hope that the 15th Finance Commission will uphold the principles of equity and efficiency and will give a fair deal in financial devolution to the State of Tamil Nadu,” he added.The Centre is yet to make IGST settlement of ₹5,454 crore relating to 2017-18 and short payments on GST compensation of ₹455 crore for 2017-18 and ₹1,305 crore for the period April to September 2018. This delay is adversely affecting the State finances. “I urge the Centre to settle these dues at the earliest and ensure prompt release of such dues in future,” he said.PowerOn the power sector, Purohit said the government is implementing thermal and hydro-electric projects of 17,100 MW at a total estimated cost of ₹1.27 lakh crore. Tamil Nadu continues to top the States producing renewable energy, with an installed capacity of 11,716 MW.The transmission infrastructure throughout the State is being strengthened with assistance from Japan International Co-operation Agency, Asian Development Bank, KfW and National Clean Energy Fund at a cost of ₹9,178 crore. “A robust power sector has become the biggest strength of the State for attracting new investments,” he said.Chennai MetroThe first phase of Chennai Metro Rail has already commenced operations and is expected to be fully commissioned by end of this month. The Phase-I extension from Washermenpet to Wimco Nagar at an estimated cost of ₹3,770 crore will be ready for inauguration by June 2020, he said.The Chennai Unified Metropolitan Transport Authority Act and its relevant rules will be notified on January 16 to make the integrated functioning of multi-modal transportation system a reality, he said. SHARE COMMENT read more

Representative image   –  istock.com/EvgenyMiroshnichenko SHARE COMMENT RELATED SHARE SHARE EMAIL COMMENTS The Centre has cancelled the sixth and seventh rounds of coal mines auction under which it was planning to put on sale 19 blocks.However, the government did not specify the reasons for the cancellation.Under the sixth round, the Government had earlier announced the auction of 13 blocks for the regulated sectors, including iron and steel, cement and aluminium. The mines were Brahampuri, Bundu, Gondkari, Gondulpara, Jaganathpur — A, Jaganathpur—B, Khappa and Extn, Bhaskarpara, Marki Mangli — IV, Sondiha, Chitarpur, Jamkhani and Gare Palma IV/1.In the seventh tranche the coal ministry had said it would auction six coking coal blocks for iron and steel sector.The blocks were Brahmadiha, Choritand Tilaiya, Jogeshwar and Khas Jogeshwar, Rabodh, Rohne and Urtan North. The tender process under the sixth and seventh rounds was “initiated vide notice inviting tender dated October 25, 2018”, the ministry had said. A source had earlier said the successful allottees of the 19 coal blocks will be allowed to sell up to 25 per cent of the actual production in open market at prices fixed by state-owned Coal India. The government had last month allowed sale of 25 per cent of coal production from captive mines in the open market, a move aimed at increasing competitiveness and making future auction of blocks attractive. The decision was taken during a meeting of the Cabinet Committee on Economic Affairs (CCEA) under the chairmanship of Prime Minister Narendra Modi, an official release had said. The allottee of a coal mine for specified end use or own consumption was not permitted to sell coal in open market earlier. Published on In the seventh tranche the coal ministry had said it would auction six coking coal blocks for iron and steel sector coal March 10, 2019 Coal India needs to up supply by at least 8% to meet GoM plan: report read more