(Reuters) - New York power company Consolidated Edison Inc said Wednesday it had restored power to over 160,000 of the 930,000 total customers knocked out by Hurricane Sandy, leaving about 764,000 still without power.
Sandy hit the U.S. East Coast Monday night and left almost 8.5 million homes and businesses without power in 21 states from North Carolina to Maine and as far west as Illinois, which surpassed the 8.4 million customers left in the dark by Hurricane Irene last year.
Sandy knocked out power to about 30 percent of Con Edison's more than three million power customers in New York City and Westchester County.
Con Edison said Sandy was the largest storm-related outage in its history. The previous record was the more than 200,000 customers affected by Hurricane Irene in 2011.
On Tuesday, Con Edison estimated that customers in Brooklyn and Manhattan served by underground electric equipment should have power back within four days.
Restoration to all customers in other areas served by overhead power lines will take at least a week.
Last night, the company said it had to cut power to about 160,000 customers in southern Brooklyn and central Staten Island due to Sandy-related problems on high-voltage systems supplying electricity to those areas.
The company also said it reduced voltage to several neighborhoods in Brooklyn by 8 percent last night as workers address the problem.
Officials at Con Edison were not immediately available to say where most of the outages were Wednesday morning. On Tuesday, the company said about 250,000 customers in Manhattan, 180,000 in Westchester County, 108,000 in Queens, 109,000 in Staten Island, 87,000 in Brooklyn, and 45,000 in the Bronx were without power. (Reporting by Scott DiSavino; Editing by James Dalgleish)
ARLINGTON, TX - OCTOBER 28: Jason Pierre-Paul #90 of the New York Giants celebrates his interception for a touchdown with Antrel Rolle #26 against the Dallas Cowboys at Cowboys Stadium on October 28, 2012 in Arlington, Texas. (Photo by Ronald Martinez/Getty Images)
Washington Redskins v Pittsburgh Steelers
PITTSBURGH, PA - OCTOBER 28: Leonard Pope #45 of the Pittsburgh Steelers celebrates his touchdown in front of Ryan Kerrigan #91 of the Washington Redskins on October 28, 2012 at Heinz Field in Pittsburgh, Pennsylvania. (Photo by Joe Sargent/Getty Images)
New England Patriots v St Louis Rams
LONDON, ENGLAND - OCTOBER 28: Stevan Ridley #22 of the New England Patriots pushes down Janoris Jenkins #21 of the St. Louis Rams during the NFL International Series match between the New England Patriots and the St. Louis Rams at Wembley Stadium on October 28, 2012 in London, England. (Photo by Scott Heavey/Getty Images)
New England Patriots v St Louis Rams
LONDON, ENGLAND - OCTOBER 28: Head coach Jeff Fisher of the St. Louis Rams looks on from the sideline during the NFL International Series match between the New England Patriots and the St.Louis Rams at Wembley Stadium on October 28, 2012 in London, England. (Photo by Jamie McDonald/Getty Images)
Miami Dolphins v New York Jets
EAST RUTHERFORD, NJ - OCTOBER 28: Wide receiver Marlon Moore #14 of the Miami Dolphins celebrates with teammates Jason Trusnik #93, Olivier Vernon #50, and Austin Spitler #53 after a blocked punt resulted in a touchdown against the New York Jets at MetLife Stadium on October 28, 2012 in East Rutherford, New Jersey. (Photo by Alex Trautwig/Getty Images)
Carolina Panthers v Chicago Bears
CHICAGO, IL - OCTOBER 28: Brandon Marshall #15 of the Chicago Bears catches the ball while being covered by Josh Norman #24 of the Carolina Panthers on October 28, 2012 at Soldier Field in Chicago, Illinois. (Photo by John Gress/Getty Images)
New York Giants v Dallas Cowboys
ARLINGTON, TX - OCTOBER 28: Corey Webster #23 of the New York Giants makes a pass interception intended for Miles Austin #19 of the Dallas Cowboys at Cowboys Stadium on October 28, 2012 in Arlington, Texas. (Photo by Ronald Martinez/Getty Images)
San Diego Chargers v Cleveland Browns
CLEVELAND, OH - OCTOBER 28: Running back Trent Richardson #33 of the Cleveland Browns runs for a gain under pressure from cornerback Antoine Cason #20 of the San Diego Chargers during the first half at Cleveland Browns Stadium on October 28, 2012 in Cleveland, Ohio. (Photo by Jason Miller/Getty Images)
Carolina Panthers v Chicago Bears
CHICAGO, IL - OCTOBER 28: Matt Forte #22 of the Chicago Bears scores a touchdown against Josh Thomas #22 of the Carolina Panthers on October 28, 2012 at Soldier Field in Chicago, Illinois. (Photo by John Gress/Getty Images)
San Diego Chargers v Cleveland Browns
CLEVELAND, OH - OCTOBER 28: Quarterback Philip Rivers #17 of the San Diego Chargers passes during the first half against the Cleveland Browns at Cleveland Browns Stadium on October 28, 2012 in Cleveland, Ohio. (Photo by Jason Miller/Getty Images)
Miami Dolphins v New York Jets
EAST RUTHERFORD, NJ - OCTOBER 28: Defensive end Cameron Wake #91 of the Miami Dolphins tackles quarterback Mark Sanchez #6 of the New York Jets at MetLife Stadium on October 28, 2012 in East Rutherford, New Jersey. (Photo by Alex Trautwig/Getty Images)
Miami Dolphins v New York Jets
EAST RUTHERFORD, NJ - OCTOBER 28: Head coach Joe Philbin of the Miami Dolphins reacts after a call against the New York Jets at MetLife Stadium on October 28, 2012 in East Rutherford, New Jersey. (Photo by Alex Trautwig/Getty Images)
Seattle Seahawks v Detroit Lions
DETROIT, MI - OCTOBER 28: Matthew Stafford #9 of the Detroit Lions throws a 46 yard touchdown pass to Titus Young #16 during the second quarter of the game against the Seattle Seahwaks at Ford Field on October 28, 2012 in Detroit, Michigan. (Photo by Leon Halip/Getty Images)
Jacksonville Jaguars v Green Bay Packers
GREEN BAY, WI - OCTOBER 28: Aaron Rodgers #12 of the Green Bay Packers runs with the ball during the NFL game against the Jacksonville Jaguars at Lambeau Field on October 28, 2012 in Green Bay, Wisconsin. (Photo by Andy Lyons/Getty Images)
Jacksonville Jaguars v Green Bay Packers
GREEN BAY, WI - OCTOBER 28: Justin Blackmon #14 of the Jacksonville Jaguars hauls in a pass against Davon House #31 and Casey Hayward #29 of the Green Bay Packers at Lambeau Field on October 28, 2012 in Green Bay, Wisconsin. (Photo by Dilip Vishwanat/Getty Images)
Indianapolis Colts v Tennessee Titans
NASHVILLE, TN - OCTOBER 28: Kendall Wright #13 of the Tennessee Titans makes a catch for a touchdown against Cassius Vaughn #32 of the Indianapolis Colts at LP Field on October 28, 2012 in Nashville, Tennessee. (Photo by Scott Cunningham/Getty Images)
Miami Dolphins v New York Jets
EAST RUTHERFORD, NJ - OCTOBER 28: Cornerback Nolan Carroll #28 of the Miami Dolphins forces quarterback Mark Sanchez #6 of the New York Jets to fumble at MetLife Stadium on October 28, 2012 in East Rutherford, New Jersey. (Photo by Alex Trautwig/Getty Images)
Washington Redskins v Pittsburgh Steelers
PITTSBURGH, PA - OCTOBER 28: on October 28, 2012 at Heinz Field in Pittsburgh, Pennsylvania. (Photo by Joe Sargent/Getty Images)
Oakland Raiders v Kansas City Chiefs
KANSAS CITY, MO - OCTOBER 28: Punter Shane Lechler #9 of the Oakland Raiders congratulates kicker Sebastian Janikowski #11 of the Oakland Raiders after a field goal during the game against the Kansas City Chiefs at Arrowhead Stadium on October 28, 2012 in Kansas City, Missouri. (Photo by Jamie Squire/Getty Images)
Washington Redskins v Pittsburgh Steelers
PITTSBURGH, PA - OCTOBER 28: Jonathan Dwyer #27 of the Pittsburgh Steelers avoids a tackle by Reed Doughty #37 of the Washington Redskins on October 28, 2012 at Heinz Field in Pittsburgh, Pennsylvania. (Photo by Joe Sargent/Getty Images)
Miami Dolphins v New York Jets
EAST RUTHERFORD, NJ - OCTOBER 28: Cornerback Nolan Carroll #28 of the Miami Dolphins forces quarterback Mark Sanchez #6 of the New York Jets to fumble at MetLife Stadium on October 28, 2012 in East Rutherford, New Jersey. (Photo by Alex Trautwig/Getty Images)
San Diego Chargers v Cleveland Browns
CLEVELAND, OH - OCTOBER 28: Running back Trent Richardson #33 of the Cleveland Browns salutes the fans after scoring a touchdown during the first half against the San Diego Chargers at Cleveland Browns Stadium on October 28, 2012 in Cleveland, Ohio. (Photo by Jason Miller/Getty Images)
New England Patriots v St Louis Rams
LONDON, ENGLAND - OCTOBER 28: Jerod Mayo #51 of the New England Patriots tackles Steven Jackson #39 of the St. Louis Rams during the NFL International Series match between the New England Patriots and the St. Louis Rams at Wembley Stadium on October 28, 2012 in London, England. (Photo by Jamie McDonald/Getty Images)
Indianapolis Colts v Tennessee Titans
NASHVILLE, TN - OCTOBER 28: Kendall Wright #13 of the Tennessee Titans makes a catch for a touchdown against Cassius Vaughn #32 of the Indianapolis Colts at LP Field on October 28, 2012 in Nashville, Tennessee. (Photo by Scott Cunningham/Getty Images)
Jacksonville Jaguars v Green Bay Packers
GREEN BAY, WI - OCTOBER 28: Blaine Gabbert #11 of the Jacksonville Jaguars looks to pass the ball during the game against the Green Bay Packers at Lambeau Field on October 28, 2012 in Green Bay, Wisconsin. (Photo by Dilip Vishwanat/Getty Images)
Atlanta Falcons v Philadelphia Eagles
PHILADELPHIA, PA - OCTOBER 28: Julio Jones #11 of the Atlanta Falcons reaches for the end zone for a touchdown as Nate Allen #29 of the Philadelphia Eagles attempts to grab him in the second quarter during a game at Lincoln Financial Field on October 28, 2012 in Philadelphia, Pennsylvania. (Photo by Rich Schultz /Getty Images)
Indianapolis Colts v Tennessee Titans
NASHVILLE, TN - OCTOBER 28: Quarterback Matt Hasselbeck #8 of the Tennessee Titans points to a replay on the jumbotron after an offensive pass interference penalty was called in favor of the Indianaplis Colts at LP Field on October 28, 2012 in Nashville, Tennessee. (Photo by Frederick Breedon/Getty Images)
New York Giants v Dallas Cowboys
ARLINGTON, TX - OCTOBER 28: Eli Manning #10 of the New York Giants celebrates a touchdown by Henry Hynoski #45 against the Dallas Cowboys at Cowboys Stadium on October 28, 2012 in Arlington, Texas. (Photo by Ronald Martinez/Getty Images)
Carolina Panthers v Chicago Bears
CHICAGO, IL - OCTOBER 28: Cam Newton #1 of the Carolina Panthers fumbles at the goal line against the Chicago Bears on October 28, 2012 at Soldier Field in Chicago, Illinois. (Photo by David Banks/Getty Images)
Indianapolis Colts v Tennessee Titans
NASHVILLE, TN - OCTOBER 28: Quarterback Andrew Luck #12 of the Indianaplis Colts rolls out to throw a pass against the Tennessee Titans at LP Field on October 28, 2012 in Nashville, Tennessee. (Photo by Frederick Breedon/Getty Images)
Seattle Seahawks v Detroit Lions
DETROIT, MI - OCTOBER 28: Sidney Rice #18 of the Seattle Seahawks celebrates a nine yard touchdown pass from Russell Wilson #3 and is congratulted by teammate Charly Martin #14 during the second quarter of the game at Ford Field on October 28, 2012 in Detroit, Michigan. (Photo by Leon Halip/Getty Images)
Atlanta Falcons v Philadelphia Eagles
PHILADELPHIA, PA - OCTOBER 28: Nnamdi Asomugha #24 and strong safety Nate Allen #29 of the Philadelphia Eagles look on as wide receiver Julio Jones #11 of the Atlanta Falcons scores a touchdown during the second quarter at Lincoln Financial Field on October 28, 2012 in Philadelphia, Pennsylvania. (Photo by Rob Carr/Getty Images)
Washington Redskins v Pittsburgh Steelers
PITTSBURGH, PA - OCTOBER 28: Leonard Pope #45 of the Pittsburgh Steelers catches a one yard touchdown pass in the first quarter against the Washington Redskins during the game on October 28, 2012 at Heinz Field in Pittsburgh, Pennsylvania. (Photo by Justin K. Aller/Getty Images)
Washington Redskins v Pittsburgh Steelers
PITTSBURGH, PA - OCTOBER 28: Leonard Pope #45 and Ben Roethlisberger #7 of the Pittsburgh Steelers celebrate after a one yard touchdown pass in the first quarter during the game on October 28, 2012 at Heinz Field in Pittsburgh, Pennsylvania. (Photo by Justin K. Aller/Getty Images)
New England Patriots v St Louis Rams
LONDON, ENGLAND - OCTOBER 28: The St.Louis cheerleaders perform during the NFL International Series match between the New England Patriots and the St.Louis Rams at Wembley Stadium on October 28, 2012 in London, England. (Photo by Scott Heavey/Getty Images)
Oakland Raiders v Kansas City Chiefs
KANSAS CITY, MO - OCTOBER 28: Quarterback Carson Palmer #3 of the Oakland Raiders looks to pass during the game against the Kansas City Chiefs at Arrowhead Stadium on October 28, 2012 in Kansas City, Missouri. (Photo by Jamie Squire/Getty Images)
Atlanta Falcons v Philadelphia Eagles
PHILADELPHIA, PA - OCTOBER 28: Wide receiver Jeremy Maclin #18 of the Philadelphia Eagles flips the ball away before being tackled by Chris Owens #21 of the Atlanta Falcons as a desperation move on the game's final play at Lincoln Financial Field on October 28, 2012 in Philadelphia, Pennsylvania. The Falcons defeated the Eagles 30-17. (Photo by Rich Schultz /Getty Images)
New York Giants v Dallas Cowboys
ARLINGTON, TX - OCTOBER 28: Bear Pascoe #86 of the New York Giants fumbles the ball under pressure from Bruce Carter #54 of the Dallas Cowboys, Dan Connor #52 of the Cowboys and Gerald Sensabaugh #43 of the Cowboys at Cowboys Stadium on October 28, 2012 in Arlington, Texas. (Photo by Tom Pennington/Getty Images)
CLAYTON, MO (KTVI) ? Carol Morse Perkins, well-known conservationist, humanitarian, author, lecturer and photographer, and the widow of the world famous zoologist Dr. R. Marlin Perkins, died Saturday (Oct. 20, 2012) at her home in Clayton, Mo., after she had been in declining health for several years. She was 95 (born May 25, 1917).?
?It is with great sadness that we witness the loss of Carol, who with her husband was a great voice for conservation and ecology and who carried that message across the airwaves and the globe, working to educate children and adults on the importance of preserving animals now and for future generations,? said Dr. Jeffrey Bonner, Dana Brown president and CEO at the Saint Louis Zoo.
?It is with a sad heart that I heard of the passing of Carol Perkins,? said Virginia Busch, executive director of the Endangered Wolf Center in Eureka, Mo. ?She led a wonderfully full life filled with passion to change the hearts and minds of people about wildlife and their value to our planet.? I am more than proud to work for the organization that she and her late husband founded and to continue the legacy of saving the most endangered wolf in North America.??
Mrs. Perkins and her husband worked with Washington University in St. Louis to found the Wild Canid Survival and Research Center, now known as the Endangered Wolf Center.? The Center, established in 1971, has been responsible for saving two species of North American wolves from extinction. Today, red wolves and Mexican gray wolves are living free in the wild again thanks to the vision, determination and hard work of Mrs. Perkins and her husband.
In 1974 and again in 1977, Carol Perkins was instrumental in organizing the first two national symposiums on the status of North American endangered species of wildlife.?
In 1962, as director of the Saint Louis Zoo, Marlin Perkins began working on television?s Mutual of Omaha?s Wild Kingdom. The program, which won four Emmys, was on the air for 26 years until his death in 1986. In his autobiography, My Wild Kingdom, Marlin Perkins noted that Mrs. Perkins often accompanied him on trips for the show. ?It was always much more fun when she went along,? he wrote.
With her husband, Mrs. Perkins traveled worldwide to film wildlife for lectures, books and television. She also encouraged Dr. Perkins to hire Charlie Hoessle after hearing him at a community presentation; Hoessle served as director of the Saint Louis Zoo from 1982 to 2002 and worked at the Zoo for 42 years.????
Mrs. Perkins led dozens of safaris in Africa, Australia, India, Nepal and Sikkim. St. Louis newspapers often reported on those, including a story about her expedition to find diamonds by sifting delta sand dug from the bed of a river in Venezuela. Mrs. Perkins founded and served as chairman of the St. Louis Chapter of the Explorers Club, where she was named Chairman Emerita.?
Mrs. Perkins was also a popular lecturer on conservation topics for luncheons and dinners across the nation. She was the conservation commentator for five years on The Eye-Witness News on KSDK (Channel 5) in St. Louis.
Over the years Mrs. Perkins received numerous honors, including the Distinguished Citizen Award by Alpha Gamma Delta sorority for her volunteer work with international wildlife conservation. The Ladies Home Journal nominated her for Woman of the Year for her work in conservation. From 1974 until 1995, she served on the National Board of the American Cancer Society, and received its Volunteer of the Year Award.? Mrs. Perkins received the 1991 Conservation Medal from the Missouri D.A.R., and an honorary Doctor of Law degree from the College of St. Mary?s, Omaha, Neb.
Mrs. Perkins was also the author of numerous books, including I Saw You From Afar, which relates the story of a personal visit to the Bushman of the Kalahari Desert in southwest Africa; The Sound of Boomerangs Returning, which described her observations of the lifestyle of Aborigines; and Little Pierre, which tells the story of the star performer of the famous Saint Louis Zoo chimpanzee show.?
As marketers, we spend a lot of time thinking about our message, as well we should. Our job is to tell prospective customers how we can help them, so we focus on what we say. The Internet has turned the tables on marketers, however. Time was that marketing messages were conceived by extremely creative people to get attention for products, but now, listening to what customers say and do are just as important as creativity. Old-time marketers have always listened to a few customers in focus groups, so you can think of the Internet is the biggest focus group of all time.
All Internet marketing is more successful when you listen before you speak. And if you listen before you speak again. You must listen to what your customers say and you must watch what they do. Only by seeing what works and what doesn't do you have a chance of persuading them to believe your marketing message.
Take social media as an example. A proven social media practitioner would advise you that before you engage in social media that you should first listen to the conversation that is already out there about your products and your industry. Failing to do so is like walking into a cocktail party where you don't know anyone, not listening to what is going on, and just starting to talk to no one in particular.
Working with a firm that employs listening technology as part of itsmodus operandi will get your social media marketing off on the right foot. Merely going at this like an ad agency with a clever person who comes up with ideas in a vacuum just won't achieve the same success, in my experience.
But it's not just social media. With search, you must wait for the searcher to initiate-so you are listening first. With banner ads, you can test them to see which ones work better than others. With e-mail, you can test response with small mailing lists before sending the winning version to the main list.
With all forms of Internet marketing, listening to what customers say and watching what they do are the key methods for fine-tuning your message until it resonates with your audience.
This might sound like a lot of work. It is.
Instead of just thinking up your message and delivering it, you are constantly tweaking and changing what you say based on the customer response. And it is time-consuming, honestly. It undoubtedly is less work to come up with just one message and deliver it, than it is to come up with dozens of messages, constantly tinkering to get your final one.
But you're not trying to minimize the amount of work to come up with a message. You're trying to maximize response. And there's no way that your first message will be as good as your 50th. So, even though it seems like coming up with 50 messages is more work than coming up with one (because it is), it ends up being easier to get results this way. So, if you can guarantee getting good results one way, but not the other, which one is less work in the long run?
Ask yourself: If you aren't listening to your customers to fine-tune your messaging, just what are you listening to?
If you play long enough in the NFL, you're eventually going to have a season that doesn't go your way.
See more: http://blodic.us/sports/a-former-player-s-guide-to-staying-motivated-during-a-disappointing-nfl-season-15-0.htm
It doesn't matter if it's because of key injuries, bad coaching or bad players, losing seasons are always going to test everyone's character.
I didn't have to wait long at all to experience a losing season in the league. In 1996 as a rookie with the Tampa Bay Buccaneers, we went 6-10, and for much of the season, I was miserable. This was something so foreign to me that, at first, I really didn't know how to deal with it.
The first game of the year was a home game against the Green Bay Packers, and not only were we blown out, but our stadium was full of green and gold. At the time, I was just on the practice squad and couldn't believe what I had just seen.
We went on to lose the next four games as well, and eventually, we were 1-8 heading into our 10th game of the year. I have to tell you that the rest of my teammates and I were miserable at that point, and it was hard to stay motivated every week.
We found a way to keep the faith, however, and ended up winning five of our last seven games which set us up for quite a bit of success over the course of the next five years.
The most important lesson I learned from that tough first year is that it takes strong coaching and strong leaders to bring you through the storm and turn things around.
European regulators have charged Microsoft for not giving Windows 7 users a choice of internet browsers when they install the OS. Although this is only an initial step towards a fine for the software maker, Microsoft agreed with the European Commission to offer browser choices to its Windows users over three years ago, avoiding a heavy antitrust penalty. Unfortunately, while Microsoft acknowledged the "technical error", this wasn't before the European Commission picked up the issue -- the EU's antitrust watchdog said in July that Microsoft had not complied with the order from February 2011. According to a Reuters report earlier this year, and echoed in the EU's statement below, the fine could amount to as much as 10 percent of the Redmond company's global turnover.
Update: Microsoft has issued a statement on the EU charge, received by The Verge.
"We take this matter very seriously and moved quickly to address this problem as soon as we became aware of it. Although this was the result of a technical error, we take responsibility for what happened, and we are strengthening our internal procedures to help ensure something like this cannot happen again. We sincerely apologize for this mistake and will continue to cooperate fully with the Commission."
Pursuant to section 10(a) of the Federal Advisory Committee Act, as amended (5 U.S.C. App.), notice is hereby given of a meeting of the National Cancer Institute Clinical Trials and Translational Research Advisory Committee.
The meeting will be open to the public, with attendance limited to space available. Individuals who plan to attend and need special assistance, such as sign language interpretation or other reasonable accommodations, should notify the Contact Person listed below in advance of the meeting.
Dated: October 17, 2012.
Melanie J. Gray,
Program Analyst, Office of Federal Advisory Committee Policy.
Psychotherapy is as effective ? and in many cases, more effective ? than medications. Yet psychotherapy remains on the decline, while people run to their pharmacy to fill their psychiatric scripts.
Despite the progress we?ve made over the past two decades to help people better understand psychotherapy ? what it is, how it works, and why it?s effective for some but not for others ? there are still a lot of misconceptions about therapy.
Pharmaceutical companies have deep advertising budgets to ensure you (and your doctor) get a lot of information and marketing about their drugs. There is no equivalent in the psychotherapy world.
That?s why I?m pleased to introduce Therapy That Works with Marla W. Deibler, Psy.D. This blog discuss common therapy issues, help correct therapy misconceptions, and talk about the value of evidence-based treatment. Evidence-based treatment (EBT) refers to treatments that have a solid backing in research.
Marla W. Deibler, Psy.D., is a clinical psychologist and nationally-recognized expert in anxiety disorders and the obsessive-compulsive spectrum, including trichotillomania and other body-focused repetitive behaviors, obsessive-compulsive disorder, hoarding, and tic disorders. She is the Founder and Executive Director of The Center for Emotional Health of Greater Philadelphia in New Jersey. You can learn more about her here.
Please give Dr. Deibler a warm Psych Central welcome over on her blog, Therapy That Works, now.
Dr. John Grohol is the CEO and founder of Psych Central. He is an author, researcher and expert in mental health online, and has been writing about online behavior, mental health and psychology issues -- as well as the intersection of technology and human behavior -- since 1992. Dr. Grohol sits on the editorial board of the journal Cyberpsychology, Behavior and Social Networking and is a founding board member and treasurer of the Society for Participatory Medicine.
Like this author? Catch up on other posts by John M. Grohol, PsyD (or subscribe to their feed).
This is an announcement only, so there are no comments.
????Last reviewed: By John M. Grohol, Psy.D. on 23 Oct 2012 ????Published on PsychCentral.com. All rights reserved.
APA Reference Grohol, J. (2012). Introducing Therapy That Works. Psych Central. Retrieved on October 24, 2012, from http://psychcentral.com/blog/archives/2012/10/24/introducing-therapy-that-works/
Steve McIntyre reports that the AGU is schlepping for Dr. Mann?s legal defense with a live audio webcast:
An Inside Look at the Michael Mann Case Featuring Peter Fontaine, counsel to Michael Mann and a leader of Cozen O?Connor?s Brownfield Development and Climate Change practices
To join the meeting:
http://agu.adobeconnect.com/legalwebinar2/
? Please login as a guest with your first and last name. The meeting does not require a password. The meeting hosts will authorize you to enter the meeting. ? We recommend you use the audio on your computer. You will be able to hear the presentation and ask questions via a chat box.
I find this really, really, strange that the AGU would be sponsoring such a meeting. For those of you thinking about bailing out of AGU membership, this is probably your cue.
In an ironic twist, another Peter Fontaine (the actor, not the lawyer) was in this movie:
Rain brought by the outer bands of Tropical Storm Sandy fall in the Standpipe neighborhood of Kingston, Jamaica, Tuesday, Oct. 23, 2012. The U.S. National Hurricane Center in Miami said Sandy was expected to become a hurricane as it nears Jamaica on Wednesday. (AP Photo/David McFadden)
Rain brought by the outer bands of Tropical Storm Sandy fall in the Standpipe neighborhood of Kingston, Jamaica, Tuesday, Oct. 23, 2012. The U.S. National Hurricane Center in Miami said Sandy was expected to become a hurricane as it nears Jamaica on Wednesday. (AP Photo/David McFadden)
Commuters wait at a bus stop as rain brought by the outer bands of Tropical Storm Sandy falls in Kingston, Jamaica, Tuesday, Oct. 23, 2012. The U.S. National Hurricane Center in Miami said Sandy was expected to become a hurricane as it nears Jamaica on Wednesday. (AP Photo/Collin Reid)
Garth Malcolm, left, covers with plywood a primary health center as rain brought by the outer bands of Tropical Storm Sandy falls in Kingston, Jamaica, Tuesday, Oct. 23, 2012. The U.S. National Hurricane Center in Miami said Sandy was expected to become a hurricane as it nears Jamaica on Wednesday. (AP Photo/Collin Reid)
Commuters board a bus as rain brought by the outer bands of Tropical Storm Sandy fall in Kingston, Jamaica, Tuesday, Oct. 23, 2012. The U.S. National Hurricane Center in Miami said Sandy was expected to become a hurricane as it nears Jamaica on Wednesday. (AP Photo/Collin Reid)
Pauline Daley covers herself as rain brought by the outer bands of Tropical Storm Sandy falls in Kingston, Jamaica, Tuesday, Oct. 23, 2012. The U.S. National Hurricane Center in Miami said Sandy was expected to become a hurricane as it nears Jamaica on Wednesday. (AP Photo/Collin Reid)
KINGSTON, Jamaica (AP) ? Jamaicans stocked up on supplies and reinforced roofs on Tuesday ahead of the arrival of Tropical Storm Sandy, which is expected to hit the Caribbean island of posh resorts and sprawling shantytowns as a hurricane with lashing rain and wind.
The U.S. National Hurricane Center in Miami said the strengthening storm was churning over warm Caribbean waters and should reach Jamaica on Wednesday, most likely as a Category 1 hurricane. The late-season storm is expected to travel from south to north over the island, which local meteorologists say hasn't sustained a direct hit from a hurricane's eye since powerful Hurricane Gilbert in 1988.
Acting Prime Minister Peter Phillips said "all Jamaicans must take the threat of this storm seriously" and asked people to look out for their neighbors, especially children, the elderly and the disabled.
Hurricane conditions were possible in eastern Cuba by Wednesday night. The storm is forecast to pass near the U.S. naval base at Guantanamo Bay, where pretrial hearings are being held for a suspect in the attack on the Navy destroyer the USS Cole. Authorities at the base had considered suspending this week's proceedings, but said that as of late Tuesday they planned to continue despite Sandy.
On Tuesday night, the outer bands of Sandy were drenching parts of Jamaica with steady rain that sent brown water rushing down streets and gullies. Tropical storm winds were expected to hit later in the night or early Wednesday.
Schools, government offices and Kingston's port shut down early and the country's international airports prepared to close Wednesday morning.
The Jamaican Constabulary Force called numerous curfews in neighborhoods across the island to prevent crime and protect properties.
In the poor Kingston community of Standpipe, Christopher "Boxer" Bryce and his relatives were bracing for the worst as they quickly tried to finish repairs to their concrete home's leaking roof.
"This is giving all of us a nervous feeling, old and young. I'm hoping the storm doesn't leave too many problems," said Bryce, as his brother Brian adjusted a plastic bucket to catch more of the water dripping steadily down from the cracked ceiling.
Across a debris-clogged gully, dreadlocked Philip Salmon was trying to find more sheet metal to bolster his shack's rusting roof. The laborer lives by himself in a ramshackle settlement of illegal homes near the U.S. Embassy.
"Everybody's worried about it here, I can tell you. This storm is no small thing," said Salmon, whose sheet metal roof is held in place by rocks, just like that of many of his neighbors.
Two years ago, six members of a family living along a nearby stretch of the gully were swept away during the relatively weak Tropical Storm Nicole after part of their home collapsed into the waterway's raging current. People living in the shantytowns are warned repeatedly to move for their own safety but most refuse to relocate.
About a mile away in the riverside town of Tavern, Errol Heron rushed back to his home next to the rushing Hope River carrying a loaf of bread. He said he's confident his home will manage Sandy intact since a new retaining wall was built below his property.
"But I'm looking forward to this being over," Heron said Tuesday evening on a bridge in the community.
Jamaica's government issued a hurricane warning on Tuesday morning and announced schools would close on Wednesday. It has urged people in flood-prone areas to be on alert and advised fishermen on outlying cays to return to the mainland. There were reports in local media saying roughly 100 fishermen were stranded on the lobster- and conch-rich Pedro Cays because they didn't have enough fuel for the journey.
In Kingston, Jamaica's biggest city, some residents flocked to grocery stories to stock up on food, propane, tarp, batteries and water. At one major supermarket, hardly any bread remained on the shelves.
In Cuba, authorities issued a hurricane watch for several provinces and there were intermittent rains over Haiti, where a tropical storm warning was in effect. A tropical storm watch was called for the central and southeastern Bahamas, meaning stormy conditions were possibly within 48 hours.
Although Florida was not expected to receive any direct impact from Sandy, Brian Koon, director of the U.S. state's emergency management division, said residents should remain aware of the storm and take precautions to keep themselves safe from indirect impacts such as windy conditions, rain and rip currents.
In Jamaica, Sandy was expected to dump more than 10 inches (25 centimeters) of rainfall, especially over central and eastern parts of the island, according to the country's meteorological service. Flash flooding and landslides are likely on the mountainous island, Jamaican forecasters said.
Sandy's maximum sustained winds Tuesday evening were roughly 50 mph (85 kph). It was moving north-northeast at about 8 mph (13 kph) and its center was about 225 miles (360 kilometers) south-southwest of Kingston by 8 p.m. EDT.
Sandy on Monday became the 18th named storm of this year's busy Atlantic season, which officially ends Nov. 30.
Meanwhile, U.S. forecasters said a tropical depression in the Atlantic could possibly become a tropical storm later Tuesday or Wednesday. There were no coastal watches or warnings in effect as it spun over open waters some 990 miles (1,590 kilometers) northeast of the Leeward Islands. The depression's maximum sustained winds were near 35 mph (55 kph).
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ScienceDaily (Oct. 22, 2012) ? A stay in the hospital may not be the only way to acquire Clostridium difficile diarrhea -- but the potentially life-threatening infection may be associated with a number of health complications in hospitalized children, according to the findings from two studies unveiled October 22 at the American College of Gastroenterology's (ACG) 77th Annual Scientific meeting in Las Vegas. In a separate case report also presented October 22, fecal microbiota transplantation in a 20-month old with recurrent Clostridium difficile infection (CDI) suggests the therapeutic potential fecal bacteriotherapy in pediatric patients who fail standard therapy for CDI.
In one study, researchers from Sinai Hospital in Baltimore retrospectively analyzed the changing epidemiological trends of patients with Clostridium difficile-associated diarrhea (CDAD) who were admitted to an acute care hospital between January 2005 and December 20120. The results of their analysis, "Changing Epidemiology of Clostridium difficile-Associated Diarrhea (CDAD) Among Long-Term Care Facility Patients," suggest a changing shift in the way CDAD is acquired -- from a traditional hospital-acquired infection to a community and long-term-care facility-based infection.
For the study, CDAD was defined as having clinical signs and symptoms of Clostridium difficile infection and a positive c. difficile stool toxin assay. The patients in the study were divided into three groups: nosocomial (hospital-acquired); long-term-care facility (LTCF); and community-acquired. Of the 258 toxin-positive CDAD patients in the analysis, 53 (20.6 percent) were nosocomial (hospital acquired); 119 were LTCF (46.1 percent) and 86 (33.3 percent) were in the community. The mean age for LTCF patients was higher than the other groups. Presenting symptoms were divided into diarrhea and non-diarrheal symptoms including fever, abdominal pain, and altered mental status. According to the results, the incidence of acute diarrhea was significantly lower in LTCF (18) patients as compared to patients from community (25).
Among the other findings:
* Most LTCF patients (80) presented with non-diarrheal symptoms whereas 47 community patients had non-diarrheal symptoms
* Use of proton pump inhibitors (PPI)s was more frequent in LTCF patients (73 percent) and nosocomial patients (69.8 percent) as compared to community patients (43 percent) -more-
* No clear indication was found for PPI use in 24.13 percent of LTCF patients using PPIs (21 out of 87), compared t 12.9 percent (4 out of 35) of nosocomial patients and 32.1 percent (9 out of 37) of community.
"There seems to be an epidemiological shift in C. difficile associated diarrhea from a traditional hospital -acquired infection to a community and long-term care facility-based infection," said co-investigator Vivek Kumar, M.D. He noted that diarrhea was not found to be the main presentation in LTCF patients. "This finding suggests that suspicion of C. difficile associated diarrhea should be high even if they present with non-specific symptoms such as abdominal pain, fever and altered mental status." He adds that more large scale epidemiological studies are needed to help us understand the spread of CDAD in the community.
Study Suggests CDI Associated with Increased Length of Hospital Stay, Other Health Implications for Children
While hospital and population-based studies have shown an increased incidence of C. difficile infection (CDI) in both adults and children, relatively little is known about the outcomes of infection in hospitalized children with CDI, according to researchers from the Mayo Clinic who analyzed the National Hospital Discharge Survey (NHDS) database to determine the epidemiology and outcomes of CDI in hospitalized children in another study. "The Epidemiology and Outcomes of Clostridium difficile Infection in Children from 2005-2009: Results from a Nationwide Survey," suggest that despite increased awareness of CDI in children and advancements in the management of CDI and infection and control practices, CDI remains a "major problem" in hospitalized children, and is associated with increased length of stay, colectomy, in-hospital mortality and discharge to a short-or-long-term care facility (DTCF).
There were an estimated 13.7 million children over the five-year study period, with a median age of 5 years and 47.8 percent female. Of this group, there were about 46,176 CDI cases (0.34 percent of all pediatric admissions) with a median age of 3 years; 48.1 percent female. The annual rate of CDI varied from 2.4 to 4.3 cases per thousand over the study period with no significant trend up or down, according to co-investigator Sahil Khanna, M.D.
Among the key findings children with C. difficile infection, compared to controls, had:
? Longer median length of stay (LOS): 6 versus 2 days
? Higher rates of colectomy (1.6 percent versus .32 percent)
? Higher all-cause in-hospital mortality (1.2 percent versus 0.48 percent) ? Higher discharge to long-term care facility (4.3 percent versus 2.7 percent)
"We did find that children with C. difficile infection were likely to stay in the hospital four days longer than children without the infection; twice as likely to lose part or all of their colon, and two and a half more times as likely to die in the hospital," said Dr. Khanna. "Despite increased awareness of C. difficile infection in children and advancements in management of C. difficile infection and infection prevention and control practices, this study suggests that CDI remains as major problem in hospitalized children. After adjusting for age, sex and cormorbidities, this study also suggests that C. difficile infection was an independent and the strongest predictor of increased length of stay, higher rates of colectomy, higher all-cause in-hospital mortality and higher discharge to a long-term care facility," Dr. Khanna explained.
"In hospitalized children C. difficile infection can be a major cause of morbidity and mortality. CDI should be considered as a differential in hospitalized children with diarrhea and managed aggressively," added Dr. Khanna.
Fecal microbiota therapy to treat recurrent C. difficile infection
"Recurrent C. difficile infection (CDI) has become a major problem in children often requiring recurrent and prolonged course of antibiotics," said co-investigator Dr. Sudhir Dutta. In a separate case-report also presented October 22, Dr. Dutta and a team of physicians from Sinai Hospital-Johns Hopkins Program in Internal Medicine and the Pediatric GI Department reported success after using fecal microbiota therapy to treat a case of recurrent C. difficile infection in a 20-month old male who was born premature at 27 weeks of gestation.
Fecal Microbiota Transplantation (FMT) involves taking the stool of a healthy person and putting it into the colon of a person with disease to help restore health. In persons with C. difficile infection, the goal is to restore the natural balance of good and bad bugs in the gut and eliminate the recurrent diarrhea, which can be life-threatening.
"While fecal microbiota therapy is successfully being used in adults with recurrent C. difficile infection, to our knowledge there is only one reported case in the pediatric literature where treatment with fecal microbiota transfer resulted in spontaneous improvement of symptoms and improvement of diarrhea," said Dr. Dutta.
In this case, the patient presented with a two-month history of diarrhea, rectal bleeding, and failure to thrive with a past medical history that included chronic lung disease and gastroesophageal reflux disease as well as treatment with multiple courses of antibiotics.
Co-investigator Dr. Rita Batra, of Sinai's Pediatric GI Department, noted that the decision to conduct FMT in the 20-month old patient was due to the severity of symptoms and because the procedure, "allows the fastest means of colonic composition of its normal microbiome components thus providing a primary line of defense against colonization and proliferation of opportunistic pathogenic bacteria including C. difficile."
After receiving donor stool from his mother via colonoscope in the right colon, the patient has now remained symptom-free with complete resolution of diarrhea, rectal bleeding and has consistently gained weight over the past three months, according to the case report.
"This case demonstrates the therapeutic potential of fecal bacteriotherapy in pediatric patients who fail standard therapy for C. difficile infection," said Dr. Dutta. "Randomized controlled studies with long-term follow up are needed to support the efficacy and safety of fecal microbiota therapy in pediatric patients."
About C. difficile
C. difficile causes diarrhea linked to 14,000 American deaths each year. Deaths related to C. difficile increased 400 percent between 2000 and 2007, due in part to a stronger germ strain, according to the Centers for Disease Control. C. difficile infections cost at least $1 billion in extra health care costs annually. Source: CDC
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If you aren?t familiar with the song ?Gangnam Style,? you must have been living under a rock or something. The latest song by South Korean pop singer/rapper?Psy?has been going crazy for the past few months from all over the world.
It?s already the most viewed video on YouTube and people can?t get enough of the catchy tune. Many have already done their mock-ups of it, some who are celebrities and other who are athletes.
For?Indiana Pacers?center?Roy Hibbert, he decided to join in on it and he did it himself at a local mall in Indiana. It took him a while to get in to create suspense, as some Pacers fans started out doing it, maybe some who are part of Hibbert?s ?Area 55? fanbase.
When it was towards to building up to the chorus, Hibbert came in the most?suspenseful?way with his 7-2 frame, coming in with a white tuxedo and breaking it down for the public to enjoy that saw this performance coming out of nowhere.
It?s pretty fun to watch, though Hibbert wasn?t too great at it. He did look pretty stiff doing it and really couldn?t gel, but at least he did his part and gave people some enjoyment out of it. I know I did; it was pretty funny to watch.
Basically, we?ve seen the Pacers center just about everywhere now.
He?s been in MMA training places, he plays a role in?Parks & Recreation, he tries out to be?a member of Samcro or a One-Niner on Sons of Anarchy, he brings his fans to go see?Prometheus and now he does his own version of Gangnam Style in a mall.
Libya's leadership has struggled to impose their authority in a well-armed country. Opposing militias have been shelling Bani Walid, a former Gaddafi stronghold.
By Ali Shuaib,?Reuters / October 21, 2012
Argentine President Cristina Fernandez de Kirchner (front r.) and her Irish counterpart Michael D. Higgins shake hands at the Casa Rosada Presidential Palace in Buenos Aires, October 11.
Martin Acosta/Reuters
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Libyan militiamen aligned to the?Defence Ministry?shelled the former Gaddafi stronghold of Bani Walid on Sunday, extending a feud between two towns that demonstrates the country's deep divisions a year after the veteran leader was killed.
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Militias, many of whom are from Misrata, have been shelling the hilltop town of 70,000 people for several days. Libyan state news agency LANA said late on Saturday 14 people had been killed and 200 injured in the fighting.
Libya's new rulers have led the nation to elections but have struggled to impose their authority on a country awash with weapons. Underscoring the chaos and confusion were conflicting reports over the fate of Gaddafi's former spokesman and his son.
While Misrata spent weeks under siege by Gaddafi forces in last year's war,?Bani Walid?was one of the towns that remained loyal to Gaddafi longest. It remains isolated from the rest of?Libya?and former rebels say it still harbours pockets of support for the old government.
"The attacks are continuing,"?Bani Walid militia?leader?Abdelkarim Ghomaid?said by phone. "The shelling is coming from all sides."
He said?Bani Walid?fighters had captured 16 cars belonging to militias from Misrata. This could not be immediately independently verified.
Leisure boats threaten the Swedish West Coast archipelagoPublic release date: 22-Oct-2012 [ | E-mail | Share ]
Contact: Kjell Nordberg kjell.nordberg@gvc.gu.se 46-706-370-596 University of Gothenburg
The number of leisure boats along the Swedish West Coast has risen dramatically over the last 20 years, resulting in a risk that the inner archipelago might be destroyed. These are the findings of new research from the University of Gothenburg, Sweden.
In Sanns Fjord, a silled fjord to the north of Grebbestad in Bohusln, researchers from the University of Gothenburg have studied the marine environment in the inner archipelago and built a treatment plant for flushing water from the washing of boats with painted hulls in connection with the autumn haul-out. Researchers have also given courses to those bringing boats ashore and to the people responsible for ports and the environment in coastal municipalities.
There have been significant increases in both the number of leisure boats and in boat traffic in recent decades, with definite negative consequences for the environment. There are currently around 25,000 berths in Northern Bohusln alone. Researchers therefore believe that it is very important to slow down this trend significantly and to limit emissions from leisure boats in our most sensitive fjords and archipelagos.
"The toxic, anti-fouling hull paints on the boats release both heavy metals and toxic substances to prevent growth on the boats. Motor boats also emit large amounts of noxious hydrocarbons and acidifying substances into the water through their exhaust fumes, which have increased as boats have become greater in number and are fitted with more powerful engines that also consume more fuel," says Kjell Nordberg, who is Professor in the Department of Earth Sciences at the University of Gothenburg and is in charge of the project.
Fjords and protected inner archipelagos act as sedimentation basins or sediment traps, in which heavy metals and organic environmental toxins contaminate and accumulate with sediments on the sea floor in fjords and estuaries.
Problems with pollutants in our inner archipelagos and fjords are particularly widespread in Sweden compared with many other European countries, where strong tides bring in fresh, new bottom-water twice a day.
"It's a worrying trend bearing in mind that the number of boats is rising all the time, with increasingly powerful engines that consume more and more petrol. The situation at present is already very precarious," says Kjell Nordberg.
When marine geologist Kjell Nordberg examined various sediment samples in the Sanns Fjord in Tanum, he discovered not only high levels of polyaromatic hydrocarbons and heavy metals, but also a lack of oxygen in the beds during late summer and autumn in virtually the whole fjord, even in shallow waters.
"You could tell from the occasionally black sediments, laminations and bacterial mats that this has been going on since the 1990s. There's not much alive here in the summer," says Kjell Nordberg.
The lack of oxygen started back in the late 1980s, when there was a dramatic rise in leisure boat activity. This may have contributed to the fact that there are now virtually no demersal fish left in the inner archipelago.
"I don't think many boat owners are aware of the correlation between exhaust emissions and the environmental destruction of the sea. Just because people have more four-stroke engines nowadays, most of us boat owners think everything's OK, but that's not the case at all," says Kjell Nordberg.
Researchers are calling for new ways of owning boats, such as introducing boat pools and launching options based further out from the coast, so that not all boat owners begin their trips with a long, polluting journey through the inner archipelago. Another possibility is to have boat hotels and storage locations on land where boats can be "parked" without any toxic anti-fouling hull paint when they are not in use.
###
Contact:
Kjell Nordberg, Professor, Dept. of Earth Sciences, University of Gothenburg
Tel.: +46 (0)31-786 28 61, +46 (0)706-37 05 96,
kjell.nordberg@gvc.gu.se
[ | E-mail | Share ]
?
AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.
Leisure boats threaten the Swedish West Coast archipelagoPublic release date: 22-Oct-2012 [ | E-mail | Share ]
Contact: Kjell Nordberg kjell.nordberg@gvc.gu.se 46-706-370-596 University of Gothenburg
The number of leisure boats along the Swedish West Coast has risen dramatically over the last 20 years, resulting in a risk that the inner archipelago might be destroyed. These are the findings of new research from the University of Gothenburg, Sweden.
In Sanns Fjord, a silled fjord to the north of Grebbestad in Bohusln, researchers from the University of Gothenburg have studied the marine environment in the inner archipelago and built a treatment plant for flushing water from the washing of boats with painted hulls in connection with the autumn haul-out. Researchers have also given courses to those bringing boats ashore and to the people responsible for ports and the environment in coastal municipalities.
There have been significant increases in both the number of leisure boats and in boat traffic in recent decades, with definite negative consequences for the environment. There are currently around 25,000 berths in Northern Bohusln alone. Researchers therefore believe that it is very important to slow down this trend significantly and to limit emissions from leisure boats in our most sensitive fjords and archipelagos.
"The toxic, anti-fouling hull paints on the boats release both heavy metals and toxic substances to prevent growth on the boats. Motor boats also emit large amounts of noxious hydrocarbons and acidifying substances into the water through their exhaust fumes, which have increased as boats have become greater in number and are fitted with more powerful engines that also consume more fuel," says Kjell Nordberg, who is Professor in the Department of Earth Sciences at the University of Gothenburg and is in charge of the project.
Fjords and protected inner archipelagos act as sedimentation basins or sediment traps, in which heavy metals and organic environmental toxins contaminate and accumulate with sediments on the sea floor in fjords and estuaries.
Problems with pollutants in our inner archipelagos and fjords are particularly widespread in Sweden compared with many other European countries, where strong tides bring in fresh, new bottom-water twice a day.
"It's a worrying trend bearing in mind that the number of boats is rising all the time, with increasingly powerful engines that consume more and more petrol. The situation at present is already very precarious," says Kjell Nordberg.
When marine geologist Kjell Nordberg examined various sediment samples in the Sanns Fjord in Tanum, he discovered not only high levels of polyaromatic hydrocarbons and heavy metals, but also a lack of oxygen in the beds during late summer and autumn in virtually the whole fjord, even in shallow waters.
"You could tell from the occasionally black sediments, laminations and bacterial mats that this has been going on since the 1990s. There's not much alive here in the summer," says Kjell Nordberg.
The lack of oxygen started back in the late 1980s, when there was a dramatic rise in leisure boat activity. This may have contributed to the fact that there are now virtually no demersal fish left in the inner archipelago.
"I don't think many boat owners are aware of the correlation between exhaust emissions and the environmental destruction of the sea. Just because people have more four-stroke engines nowadays, most of us boat owners think everything's OK, but that's not the case at all," says Kjell Nordberg.
Researchers are calling for new ways of owning boats, such as introducing boat pools and launching options based further out from the coast, so that not all boat owners begin their trips with a long, polluting journey through the inner archipelago. Another possibility is to have boat hotels and storage locations on land where boats can be "parked" without any toxic anti-fouling hull paint when they are not in use.
###
Contact:
Kjell Nordberg, Professor, Dept. of Earth Sciences, University of Gothenburg
Tel.: +46 (0)31-786 28 61, +46 (0)706-37 05 96,
kjell.nordberg@gvc.gu.se
[ | E-mail | Share ]
?
AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.
ScienceDaily (Oct. 17, 2012) ? Coronary angioplasty improves survival in all patients with out of hospital cardiac arrest, according to research presented at the Acute Cardiac Care Congress 2012. The study was presented by Dr Annamaria Nicolino from the Santa Corona General Hospital in Pietra Ligure, Italy.
The Acute Cardiac Care Congress 2012 is the first annual meeting of the newly launched Acute Cardiovascular Care Association (ACCA) of the European Society of Cardiology (ESC). It takes place during 20-22 October in Istanbul, Turkey, at the Istanbul Lufti Kirdar Convention and Exhibition Centre (ICEC).
Out of hospital cardiac arrest is a leading cause of mortality and acute coronary occlusion is the leading cause of cardiac arrest. It is well known that when an electrocardiogram (ECG) shows that a patient has ST elevation, primary angiography must be done as soon as possible. If severe coronary disease is found, coronary angioplasty with percutaneous coronary intervention (PCI) is performed to open the blocked vessel.
But Dr Nicolino said: "There is controversy about what to do when a patient with out of hospital cardiac arrest has a normal ECG that does not show ST elevation. ESC Clinical Practice Guidelines are inconclusive -- they say to consider performing coronary angiography but they don't say 'do it' or 'don't do it'."
She added: "Some previous studies have found that if the ECG is normal (no ST elevation) the patient can still have severe coronary disease and therefore needs a coronary angiography, followed by coronary angioplasty, to clear the blocked vessel."
The current study aimed to discover whether performing urgent coronary angiography, and PCI if required, would improve survival in all patients with out of hospital cardiac arrest (both those with ST elevation and those without).
The study included 70 patients who had out of hospital cardiac arrest between 2006 and 2009. Successful urgent coronary angiography and PCI improved hospital survival in all patients with acute coronary syndrome. The treatment increased hospital survival rates in patients with ST elevation myocardial infarction (STEMI) from 51% to 83% (p=0.003) and in non-STEMI (NSTEMI) patients from 55% to 81% (p=0.004).
"In our study, a successful urgent coronary angioplasty improved hospital survival in patients with STEMI and NSTEMI," said Dr Nicolino. "All patients with out of hospital cardiac arrest, if there is no non-cardiac cause, must have an urgent coronary angiography followed by coronary angioplasty if there is coronary disease."
Non-cardiac causes of cardiac arrest which should be ruled out before performing coronary angiography are trauma, brain haemorrhage and metabolic problems such as severe hypoglycaemia.
Dr Nicolino added: "ECG results can be misleading -- we found that ECG detected just one-third of acute coronary syndrome in NSTEMI patients. This means that even if the ECG is not showing ST elevation, you cannot rule out an acute coronary syndrome. Coronary angiography should be performed urgently to see if there is any acute coronary disease which needs treatment with PCI."
Post-resuscitation neurologic injury (PNI) was the biggest complication. This can occur if resuscitation is not performed early enough, since the brain's blood supply stops during cardiac arrest. The 32.8% of patients who had PNI were at the greatest risk of death. Early signs of PNI were associated with underuse of coronary angioplasty and PCI.
Provided there was no neurological injury, MI patients who had angioplasty after cardiac arrest achieved the same one-year survival rates as patients with MI alone.
The first heart rhythm was a ventricular fibrillation (VF) or a ventricular tachycardia (VT) in 62% of patients. Most of these patients had an acute coronary syndrome (STEMI or NSTEMI). The incidence of VF and VT was the same in STEMI and NSTEMI patients. "For many years we have thought that patients with STEMI have a greater arrhythmic risk than NSTEMI patients," said Dr Nicolino. "But we found that both STEMI and NSTEMI patients are at high risk of arrhythmias."
She added: "If the first recorded rhythm is a VF or a VT an acute coronary syndrome is highly probable and it's important to perform a coronary angiography immediately without waiting for a diagnosis of infarction (using an enzyme test)."
Dr Nicolino concluded: "Patients with out of hospital cardiac arrest must be managed by cardiologists, intensive care doctors and anaesthesiologists. This team can save the brain from injury using cooling therapy, and save the heart and life of the patient using coronary angioplasty."
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The above story is reprinted from materials provided by European Society of Cardiology (ESC).
Note: Materials may be edited for content and length. For further information, please contact the source cited above.
Note: If no author is given, the source is cited instead.
Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.
Psychotherapy is as effective ? and in many cases, more effective ? than medications. Yet psychotherapy remains on the decline, while people run to their pharmacy to fill their psychiatric scripts. 
Dr. John Grohol is the CEO and founder of Psych Central. He is an author, researcher and expert in mental health online, and has been writing about online behavior, mental health and psychology issues -- as well as the intersection of technology and human behavior -- since 1992. Dr. Grohol sits on the editorial board of the journal Cyberpsychology, Behavior and Social Networking and is a founding board member and treasurer of the Society for Participatory Medicine.
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Public release date: 22-Oct-2012
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