NSA Locates Cell Phones Even When Switched Off


Never mind the non-stop collection of metadata and other sneaky surveillance tools being implemented by the US: a new report has revealed the National Security Agency’s spy powers allow the government to grab location data on just about anyone.

cell_phone_nsa_2_610x344_610x344

The technology was allegedly developed by the NSA in 2004 as part of the agency’s cooperation with the military, the CIA and the clandestine Joint Special Operations Command (JSOC). By the time NSA analysts and data collectors have been helping them for three years to track down and kill “high value targets” among terrorist and militant groups in Afghanistan and later Iraq, according to a Washington Post report.

The newspaper provides few further details on the technology, only saying that JSOC troops called it “The Find” and that it gave them thousands of new targets to track and attack. The article further describes how post-September 2001 the NSA made “a gigantic leap from using the nation’s most sophisticated spy technology to record the words of presidents, kings and dictators to using it to kill a single man in a terrorist group.”

The fact that a mobile phone doubles as a tracking device, which identifies the owner’s location in real time through a mobile network’s communication with the device, through spy software operating on the phone, or by some other means, is hardly secret. But it is widely considered that a phone that is turned off cannot emit signals and is thus untraceable.

Some privacy-cautious people suggest removing a battery as an extra precaution. More hardline privacy activists, like software freedom activist and founder of the Free Software Foundation Richard Stallman, don’t use cellphones at all, saying that they can be not only used for tracking, but also converted remotely into listening devices with specific spyware.

The NSA is currently the focus of much criticism after former contractor Edward Snowden leaked secret documents revealing that the agency is involved in massive worldwide collection of personal data. The agency is accused of trawling phone communications, emails, financial transactions and other records concerning hundreds of millions of people who are not suspected of any crimes or considered a threat to any country’s national security. Critics call it a gross violation of privacy.

The targeted killings of militants by US military and the CIA is another controversial practice of the Bush and the Obama administrations. It expanded greatly with the wide introduction of drone aircraft, which made such killings more affordable. Critics question it on many accounts, from dubious legal grounds to murky process for selection of targets to civilian casualties and public outcries that such killings prompt.

 

 

 

Radioactive Apartment Buildings and Household Goods are Not as Unusual as You May Think… and it’s About to Get Worse.


The American government has developed a solution for all the excess radioactive metal from the medical industry and military: Make it into belt buckles. Or forks. Even cheese graters are fair game. The stainless steel beverage cups used to avoid the dangers of BPA? Those are threatened with radioactivity as well.

In an absurd twist of policy, The United States Department of Energy decided in December 2012 that it might be a good idea to revoke the ban on recycling radioactive material. The logic behind the proposed reversal is this: If you have a waste product that is costly to contain and dangerous, quietly offload it onto the unsuspecting masses in the form of consumer goods and building materials while turning a nice profit throughout.

radioactive-300x225

More Radiation Please

Just in case Americans do not have enough exposure to radiation as it is, the Department of Energy would like to give the population another dose in the form of radioactive surgical implants, bicycles, jewelry, zippers or common household goods like pots, pans and utensils. If the department is successful, 14,000 tons of contaminated metal will make its way into the mainstream fabrication industry, generating a tidy $10-40 million in revenue while avoiding exorbitant disposal fees.

If the ban is lifted, it would also open a floodgate for contaminated metals to enter the U.S. from abroad with little or no oversight.

Unfortunately, radioactive products are nothing new in America. Take for example the Bed, Bath & Beyond tissue holder debacle. The product was recalled from 200 stores in 20 states due to contamination of cobalt-60. Then there was the radioactive cheese grater that gave off the equivalent radiation of a chest X-ray for every 36 hours of exposure. And La-Z-Boy recliners fitted with cobalt-60 contaminated brackets. The chairs would have bathed their owners in a chest X-ray’s worth of radiation for every 1,000 hours of use if they had not been discovered before release from the warehouse.

This is just the tip of the iceberg. Conservative estimates from the U.S. Government Accountability Office state that over 500,000 contaminated metal objects are still unaccounted for in the U.S., with 18,740 documented cases of radioactive consumer goods.

The Surprising Health Risks of Handbags and Elevators

A majority of radioactive consumer products and building materials originate from India and China, with a smaller portion emerging from former Soviet Bloc countries and Africa. Incredibly, the Netherlands found 500 handbags from India to be radioactive due to contaminated decorative rings whereas France and Sweden uncovered 500 tainted elevator buttons.

These instances are not a minor issue — exposure to radioactive materials cause dire health consequences. In Taiwan, a study of 6,000 Taiwanese between 1983 to 2005 discovered that those who lived in flats built with radioactive reinforcing steel had significantly higher rates of leukemia and breast cancer. Likewise, Indian scrap metal workers have died from handling contaminated metal. Cobalt-60 (or any radioactive material for that matter) is certainly not an element we want in our household products, clothing or building materials if we would like to remain healthy and disease free.

“Nothing has changed since 2000 that would justify lifting its current ban. Rather, just the opposite: since then the National Academy of Sciences has acknowledged that there is no safe level of radiation exposure, and we’ve learned that women are even more vulnerable to radiation than men, while children have long been known to be more vulnerable than adults,” said the Nuclear Information and Resource Service in response to the proposed radioactive metal recycling plan.

Sources for this article include:

Source: Natural News.

 

New Water Splitting Technique Efficiently Produces Hydrogen Fuel.


 A University of Colorado Boulder team has developed a radically new technique that uses the power of sunlight to efficiently split water into its components of hydrogen and oxygen, paving the way for the broad use of hydrogen as a clean, green fuel.

The CU-Boulder team has devised a solar-thermal system in which sunlight could be concentrated by a vast array of mirrors onto a single point atop a central tower up to several hundred feet tall. The tower would gather heat generated by the mirror system to roughly 2,500 degrees Fahrenheit (1,350 Celsius), then deliver it into a reactor containing chemical compounds known as metal oxides, said CU-Boulder Professor Alan Weimer, research group leader.

130801142331

As a metal oxide compound heats up, it releases oxygen atoms, changing its material composition and causing the newly formed compound to seek out new oxygen atoms, said Weimer. The team showed that the addition of steam to the system — which could be produced by boiling water in the reactor with the concentrated sunlight beamed to the tower — would cause oxygen from the water molecules to adhere to the surface of the metal oxide, freeing up hydrogen molecules for collection as hydrogen gas.

“We have designed something here that is very different from other methods and frankly something that nobody thought was possible before,” said Weimer of the chemical and biological engineering department. “Splitting water with sunlight is the Holy Grail of a sustainable hydrogen economy.”

A paper on the subject was published in the Aug. 2 issue of Science. The team included co-lead authors Weimer and Associate Professor Charles Musgrave, first author and doctoral student Christopher Muhich, postdoctoral researcher Janna Martinek, undergraduate Kayla Weston, former CU graduate student Paul Lichty, former CU postdoctoral researcher Xinhua Liang and former CU researcher Brian Evanko.

One of the key differences between the CU method and other methods developed to split water is the ability to conduct two chemical reactions at the same temperature, said Musgrave, also of the chemical and biological engineering department. While there are no working models, conventional theory holds that producing hydrogen through the metal oxide process requires heating the reactor to a high temperature to remove oxygen, then cooling it to a low temperature before injecting steam to re-oxidize the compound in order to release hydrogen gas for collection.

“The more conventional approaches require the control of both the switching of the temperature in the reactor from a hot to a cool state and the introduction of steam into the system,” said Musgrave. “One of the big innovations in our system is that there is no swing in the temperature. The whole process is driven by either turning a steam valve on or off.”

“Just like you would use a magnifying glass to start a fire, we can concentrate sunlight until it is really hot and use it to drive these chemical reactions,” said Muhich. “While we can easily heat it up to more than 1,350 degrees Celsius, we want to heat it to the lowest temperature possible for these chemical reactions to still occur. Hotter temperatures can cause rapid thermal expansion and contraction, potentially causing damage to both the chemical materials and to the reactors themselves.”

In addition, the two-step conventional idea for water splitting also wastes both time and heat, said Weimer, also a faculty member at CU-Boulder’s BioFrontiers Institute. “There are only so many hours of sunlight in a day,” he said.

The research was supported by the National Science Foundation and by the U.S. Department of Energy.

With the new CU-Boulder method, the amount of hydrogen produced for fuel cells or for storage is entirely dependent on the amount of metal oxide — which is made up of a combination of iron, cobalt, aluminum and oxygen — and how much steam is introduced into the system. One of the designs proposed by the team is to build reactor tubes roughly a foot in diameter and several feet long, fill them with the metal oxide material and stack them on top of each other. A working system to produce a significant amount of hydrogen gas would require a number of the tall towers to gather concentrated sunlight from several acres of mirrors surrounding each tower.

Weimer said the new design began percolating within the team about two years ago. “When we saw that we could use this simpler, more effective method, it required a change in our thinking,” said Weimer. “We had to develop a theory to explain it and make it believable and understandable to other scientists and engineers.”

Despite the discovery, the commercialization of such a solar-thermal reactor is likely years away. “With the price of natural gas so low, there is no incentive to burn clean energy,” said Weimer, also the executive director of the Colorado Center for Biorefining and Biofuels, or C2B2. “There would have to be a substantial monetary penalty for putting carbon into the atmosphere, or the price of fossil fuels would have to go way up.”

C2B2 is an arm of the Colorado Energy Research Collaboratory involving CU-Boulder, the Colorado School of Mines, Colorado State University and the National Renewable Energy Laboratory in Golden. The collaboratory works with industry partners, public agencies and other institutions to commercialize renewable energy technologies, support economic growth in the state and nation and educate the future workforce.

Source: Science Daily

 

Climate change occurring 10 times faster than at any time in past 65 million years.


The planet is undergoing one of the largest changes in climate since the dinosaurs went extinct. But what might be even more troubling for humans, plants and animals is the speed of the change. Stanford climate scientists warn that the likely rate of change over the next century will be at least 10 times quicker than any climate shift in the past 65 million years.

If the trend continues at its current rapid pace, it will place significant stress on terrestrial ecosystems around the world, and many species will need to make behavioral, evolutionary or geographic adaptations to survive.

Although some of the changes the planet will experience in the next few decades are already “baked into the system,” how different the climate looks at the end of the 21st century will depend largely on how humans respond.

The findings come from a review of climate research by Noah Diffenbaugh, an associate professor of environmental Earth system science, and Chris Field, a professor of biology and of environmental Earth system science and the director of the Department of Global Ecology at the Carnegie Institution. The work is part of a special report on climate change in the current issue of Science.

Diffenbaugh and Field, both senior fellows at the Stanford Woods Institute for the Environment, conducted the targeted but broad review of scientific literature on aspects of climate change that can affect ecosystems, and investigated how recent observations and projections for the next century compare to past events in Earth’s history.

For instance, the planet experienced a 5 degree Celsius hike in temperature 20,000 years ago, as Earth emerged from the last ice age. This is a change comparable to the high-end of the projections for warming over the 20th and 21st centuries.

The geologic record shows that, 20,000 years ago, as the ice sheet that covered much of North America receded northward, plants and animals recolonized areas that had been under ice. As the climate continued to warm, those plants and animals moved northward, to cooler climes.

“We know from past changes that ecosystems have responded to a few degrees of global temperature change over thousands of years,” said Diffenbaugh. “But the unprecedented trajectory that we’re on now is forcing that change to occur over decades. That’s orders of magnitude faster, and we’re already seeing that some species are challenged by that rate of change.”

Some of the strongest evidence for how the global climate system responds to high levels of carbon dioxide comes from paleoclimate studies. Fifty-five million years ago, carbon dioxide in the atmosphere was elevated to a level comparable to today. The Arctic Ocean did not have ice in the summer, and nearby land was warm enough to support alligators and palm trees.

“There are two key differences for ecosystems in the coming decades compared with the geologic past,” Diffenbaugh said. “One is the rapid pace of modern climate change. The other is that today there are multiple human stressors that were not present 55 million years ago, such as urbanization and air and water pollution.”

Record-setting heat

Diffenbaugh and Field also reviewed results from two-dozen climate models to describe possible climate outcomes from present day to the end of the century. In general, extreme weather events, such as heat waves and heavy rainfall, are expected to become more severe and more frequent.

For example, the researchers note that, with continued emissions of greenhouse gases at the high end of the scenarios, annual temperatures over North America, Europe and East Asia will increase 2-4 degrees C by 2046-2065. With that amount of warming, the hottest summer of the last 20 years is expected to occur every other year, or even more frequently.

By the end of the century, should the current emissions of greenhouse gases remain unchecked, temperatures over the northern hemisphere will tip 5-6 degrees C warmer than today’s averages. In this case, the hottest summer of the last 20 years becomes the new annual norm.

“It’s not easy to intuit the exact impact from annual temperatures warming by 6 C,” Diffenbaugh said. “But this would present a novel climate for most land areas. Given the impacts those kinds of seasons currently have on terrestrial forests, agriculture and human health, we’ll likely see substantial stress from severely hot conditions.”

The scientists also projected the velocity of climate change, defined as the distance per year that species of plants and animals would need to migrate to live in annual temperatures similar to current conditions. Around the world, including much of the United States, species face needing to move toward the poles or higher in the mountains by at least one kilometer per year. Many parts of the world face much larger changes.

The human element

Some climate changes will be unavoidable, because humans have already emitted greenhouse gases into the atmosphere, and the atmosphere and oceans have already been heated.

“There is already some inertia in place,” Diffenbaugh said. “If every new power plant or factory in the world produced zero emissions, we’d still see impact from the existing infrastructure, and from gases already released.”

The more dramatic changes that could occur by the end of the century, however, are not written in stone. There are many human variables at play that could slow the pace and magnitude of change – or accelerate it.

Consider the 2.5 billion people who lack access to modern energy resources. This energy poverty means they lack fundamental benefits for illumination, cooking and transportation, and they’re more susceptible to extreme weather disasters. Increased energy access will improve their quality of life – and in some cases their chances of survival – but will increase global energy consumption and possibly hasten warming.

Diffenbaugh said that the range of climate projections offered in the report can inform decision-makers about the risks that different levels of climate change pose for ecosystems.

“There’s no question that a climate in which every summer is hotter than the hottest of the last 20 years poses real risks for ecosystems across the globe,” Diffenbaugh said. “However, there are opportunities to decrease those risks, while also ensuring access to the benefits of energy consumption.”

Source: Scinece

 

Waking Up Tired? Blame Electricity.


Our internal clocks are drifting out of sync, and indoor lighting may be to blame. A new study suggests that just a few days in the great outdoors puts us back in tune with the solar cycle, and reconnecting with the sun could make us less drowsy.

Electricity has given us the freedom to choose our bedtimes; staying up after dark is as easy as flipping a light switch. But we pay a price for this luxury, says integrative physiologist Kenneth Wright of the University of Colorado, Boulder, who led the new study. People with later bedtimes and wake times are exposed to more artificial light and less sunlight, he says, which means their bodies aren’t getting the natural cues humans once relied on.

sn-camping

To understand how falling out of sync with the sun changes our body’s internal clock—or circadian rhythm—sleep researchers look to the timekeeping mechanisms in the brain, particularly how we regulate the hormone melatonin. Released about 2 hours before sleep, melatonin makes us feel drowsy as we wind down for rest, Wright says. It then decreases as we become alert in the morning. The mechanisms driving our clock are complex and hard to measure, but the daily spike and drop in melatonin are like its chimes. “Melatonin tells us what time it is in the body,” Wright says.

And when we keep strange schedules, our melatonin goes haywire. Turning lights on at night can delay melatonin release and shift the timing of our internal clock, says sleep physiologist Derk-Jan Dijk of the University of Surrey in the United Kingdom, who was not involved in the work. But it wasn’t clear just what would happen in modern, electricity-adapted humans if all artificial light were suddenly taken away. “This is the first time that somebody has done the obvious but important experiment,” he says.

Wright and his colleagues outfitted eight subjects with activity-tracking watches that carry light intensity detectors and motion sensors to keep tabs on sleep and wake times. For the first week, the participants went about their lives, spent mostly in artificially lit buildings. They then spent 24 hours in a lab, where the researchers periodically tested the melatonin levels in their saliva. In the second week, the group went camping in the Colorado Rockies, where they could sleep and wake up whenever they wanted but had no access to TV, cell phones, or even flashlights. Their world was illuminated only by sunlight and campfires. The group returned from their excursion for another stint of saliva sampling.

Data from the watches showed that subjects got about the same amount of sleep in the two settings. But the shift from artificial to natural light, which nearly quadrupled their total light exposure, also tinkered with their internal clocks. After camping, the subject’s biological cycles had shifted to align with the sun. Their bodies released melatonin right at sunset—2 hours earlier than under artificial light conditions—and shut it off again just after sunrise, the team reports online today in Current Biology.

“When we expose ourselves to only natural light, we are in sync with that light-dark cycle quite strongly,” Wright says. The natural night owls in the group saw an especially dramatic shift in their melatonin cycle and became more similar to the early birds. The team suggests that artificial light had been exerting a particularly strong influence on the internal clocks of the night owls. The subjects weren’t asked to report whether they felt less drowsy after the change in lighting.

Observing changes in human rhythms in a natural environment represents a “breakthrough,” says Marie Dumont, a chronobiologist at the University of Montreal in Canada. “I think we forget most of the time that the knowledge that we have comes from laboratory and artificial conditions,” she says. Dumont cautions, however, that few conclusions can be drawn from this small group of individuals. Changes in physical activity during the camping trip and the social interaction subjects had also likely influenced the retiming of their internal clocks, she says.

But the work may offer clues about the tiredness that plagues many night owls. Other studies have shown that our low point in alertness, when melatonin production is shutting off in the morning, tends to occur about 2 hours after awakening. “We wake up, but then our clock still promotes sleepiness, and we don’t feel well,” explains Dijk, whose research group first described this unfortunate paradox. After the week of camping, participants’ melatonin shutoff occurred before they awoke instead of after. Wright says that the discrepancy between our melatonin cycle and our sleep-wake cycle could account for our morning sleepiness—an explanation Dijk calls “an interesting suggestion” that needs more thorough study.

Because we’re not going to abandon our electrified existence anytime soon, Wright says that certain habits can counteract our estrangement from the sun. He recommends letting plenty of light into your room in the morning, exposing yourself to more natural light throughout the day, and dimming the lighting in your home a couple hours before bed. Now have a good night.

Soure: BIOLOGY

 

 

 

Ice core data supports ancient space impact idea.


New data from Greenland ice cores suggest North America may have suffered a large cosmic impact about 12,900 years ago.

A layer of platinum is seen in ice of the same age as a known abrupt climate transition, US scientists report.

The climate flip has previously been linked to the demise of the North American “Clovis” people.

The data seem to back the idea that an impact tipped the climate into a colder phase, a point of current debate.

Rapid climate change occurred 12,900 years ago, and it is proposed that this is associated with the extinction of large mammals such as the mammoth, widespread wildfires, and rapid changes in atmospheric and ocean circulation.

All of these have previously been linked to a cosmic impact, but the theory has been hotly disputed due to lack of clear evidence.

_69073068_69072747

New platinum measurements were made on ice cores that allow conditions 13,000 years ago to be determined at a time resolution of better than five years, report Michail Petaev and colleagues from Harvard University. Their results are published in the journal Proceedings of the National Academy of Sciences.

A 100-fold spike in platinum concentration occurs in ice that is around 12,890 years old, at just the same moment that rapid cooling of the climate is indicated from oxygen isotope measurements, at the start of a climatic period called the “Younger Dryas”.

The Younger Dryas started and finished abruptly, and is one of a number of shorter periods of climate change that appear to have occurred since the last glacial maximum of 20,000 years ago.

Each end of the Younger Dryas period may have involved very rapid changes in temperature as the climate system reached a tipping point, with suggestions that dramatic changes in temperature occurred over as short as timescale as a decade or so.

Asteroid apocalypse?

The observations lend credence to earlier, disputed, reports that finds of microscopic grains of diamond and a mineral called lonsdaleite in lake sediments dated to the same time were identified with a possible meteorite impact.

Those measurements resemble the most recent observations of remnants of the Tunguska meteorite impact in Siberia, reported last month.

Sphere-shaped particles have also been identified at many localities in sediments dating to this event, most recently reported this month by a team led from Canada in the Journal of Geology. Such particles are characteristic of the rapidly heated and cooled splatter of material thrown up when meteorites hit Earth.

While the platinum data and the spherical particles add to evidence for an impact event, doubters have pointed out that, as yet, no impact site has been identified.

It has been suggested that debris thrown into the atmosphere in an impact tipped the Earth into global cooling at a rate as rapid as the global changes in climate in the reverse direction seen in the last century.

Such rapid climate change makes it difficult for ecologies and societies to adjust: It is the fluctuation that has been invoked as the cause of the extinction of massive mammals (megafauna) like the mammoth, and native cultures such as the Clovis people in North America.

The possible role of cosmic impacts in causing huge changes to life on Earth is receiving increased attention. The mass extinction 66 million years ago that wiped out the dinosaurs is generally believed to be linked to a space strike in southern Mexico’s Yucatan Peninsula.

Recently, a group of scientists led by Eric Tohver at the University of Western Australia reported that the biggest extinction of all, which occurred 252.3 million years ago at the end of the Permian period, could be explained by an asteroid impact in Brazil.

Nasa is now focusing resources towards detection of future Earth-threatening asteroids, receiving over 400 responses to their recent request for ideas to feed into their Asteroid Grand Challenge, in which they hope to redirect a space rock and send humans to study it.

Source: BBC

 

Imaging Adventure Creates Happy Endings for Kids.


Pediatric imaging is a tricky business. Staying still represents a challenge for pint-sized patients, translating into routine sedation of children for imaging exams, which in turn, brings safety concerns as well as throughput challenges. Children’s Hospital of Pittsburgh of UPMC (CHP) addressed the problem by launching its Adventure Series program, which employs theme-based imaging suites outfitted with music and videos and staffed by carefully trained technologists. After launching the first room in September 2005, the program expanded to nine rooms in May 2009.

CT Ahoy

CHP-Space

CT served as the pilot project for the adventure series. CHP houses two themed CT suites: Pirate Island and Coral City. The number of sedations for pediatric CT plummeted from 354 cases in 2005 to four in 2009. Total sedation among all imaging modalities dropped another 25 percent between 2009 and 2011. The program eliminated the department’s 16- to 18-day CT backlog, while volume swelled 66 percent between 2009 and 2011. Partial credit for these outcomes rests with rewards for patients. Pirate Island includes a treasure chest where children can choose their reward for remaining still and being brave, says Kathleen Kapsin, (RT), MS, director of radiology at CHP.

Blast-off to MR

CHP’s four MR suites employ a space camp theme. Technologists invite children to board the space capsule rather than the scanner, and play the part of astronauts rather than healthcare providers. Children can watch a movie during the scan using one of three sets of virtual reality goggles. The combination of videos and goggles cut MR sedation 35 percent in 2007.

CHP aims to further drop this rate with an MR simulator to be deployed this fall. The life-sized simulator is a step up from toy scanners that allow kids to image stuffed animals. By assessing how a child de-sentitizes in the simulator, staff may better identify candidates able to bypass sedation as well as reduce prep time in the actual scanner, says Kapsin.

Adventure Therapy

Adventure Beach, a.k.a. the radiation oncology suite, features a linear accelerator disguised as a sand castle, a hybrid surfboard/transport table and a scuba tank for oxygen.

During the year-long planning period preceding the launch of the themed rooms, an in-house team comprised of nurses, technologists and child-life specialists collaborated with the imaging vendor to develop engaging designs and story lines. A music therapist created themed music while the child-life specialist crafted educational materials, including coloring books for children and parent pointers to help their children through the procedures. Online pointers for parents given ahead of appointment times detail comfort-care positions for IV placement and an overview of distraction tools like deep breathing and guided imagery.

CHP-Beach

Tot Talk

“Learning how to talk to children is one of most important strategies for staff to learn,” says Kapsin. CHP Child-life Specialist Natalie Sten recommends giving children a voice and a choice. “Children are concrete thinkers and we have to use concrete language, not medical jargon,” she adds. Sten recommends staff tailor language to the child’s age and medical experiences.

Giraffe on Staff

CHP-Giraffe

A key member of CHP imaging team is Giraffe on Staff, a vein viewer that uses ultraviolet light to locate vessels. Like his human counterparts, Giraffe wears a name tag with his picture on it.

Dollars, Cents & Strategies

Each CHP suite carried a $35,000 to $40,000 price tag, costs the hospital maintains can be recouped through decreased sedation and increased throughput related to fewer cancellations and shorter scans. Facilities on a shoestring budget can pilot lower cost interventions such as a disco ball, projector, CD or DVD player, aromatherapy and bubble columns, which total less than a few hundred dollars. “These are doable in anyone’s budget,” says Kapsin.

Other low-cost strategies include staff training on age-appropriate relaxation techniques, such as singing, role playing and story telling. Children’s imaginations take over, says Kapsin. They believe the stories, which captivates and distracts them.

Source:  Children’s Hospital of Pittsburgh

 

 

Many Patients Getting Needless Heart Test, Study Contends.


Most echocardiograms don’t change patients’ care, so they’re not clinically useful, researchers say

Many patients get heart tests called echocardiograms unnecessarily, according to researchers from the University of Texas Southwestern Medical Center at Dallas.

Echocardiograms — noninvasive ultrasound tests that reveal how well the heart is functioning — are safe, but most patients who get them see no change in treatment. Therefore, they are not clinically useful, the researchers said.

Echocardiogram

“The majority of echocardiograms are appropriate in terms of current guidelines,” said lead researcher Dr. Susan Matulevicius, an assistant professor in the medical center’s cardiology division. “But no one has looked at what an echo does to change a patient’s management.

“If we keep using echoes all the time just because we can and we are not going to be doing something with that information, you are just using health care dollars that could have been used for someone else,” Matulevicius said.

However, not all heart experts agree with her conclusions, which were published online July 22 in the journal JAMA Internal Medicine.

Echocardiograms cost between $100 and $1,000 depending on where in the United States they are done, and they account for almost half of all cardiac-imaging services performed in the country, according to the study. In 2010, echocardiograms accounted for more than $1.1 billion — 11 percent — of total Medicare imaging costs, the researchers said.

Millions of dollars could be saved each year if only patients who needed the test got it, Matulevicius said.

For the study, the researchers reviewed data on 535 patients who underwent echocardiograms at UT Southwestern Medical Center in April 2011. They found that only one in three tests resulted in a change in the patient’s care.

Nearly half resulted in continuation of the patient’s current care, the study found.

The findings suggest “there are limitations to the current guidelines,” Matulevicius said.

Echocardiograms are appropriate for many patients, such as those with heart failure, she said. However, many patients get the test because it is widely available and their doctor wants it done as a matter of course.

Matulevicius said diagnostic tests shouldn’t be ordered unless they are likely to change the patient’s care. “A diagnostic test can give us information, but it doesn’t necessarily impact patient care,” she said.

Patients should ask their doctors why they want a specific test done and what they expect to learn from it, she said.

“Being a more informed consumer is important and also allows better communication between your physician and you, so you can understand what’s going on,” she said.

One expert disagreed with the study’s conclusions. The end point the researchers used — a change in patient care — isn’t a definitive reason to limit the use of echocardiograms, said Dr. Gregg Fonarow, a professor of cardiology at the University of California, Los Angeles, and a spokesman for the American Heart Association.

“The American College of Cardiology partnered with other professional societies to develop so-called appropriate-use criteria,” Fonarow said. “These criteria are being increasingly applied to help ensure that diagnostic testing is ordered and performed when it is most consistent with current evidence and guidelines.”

This study found that the vast majority of echocardiograms at one medical center were deemed appropriate based on the current criteria, he said.

“However, the criteria the investigators used to determine so-called clinical usefulness has not been validated and thus any further implications of this study are uncertain,” Fonarow said.

SOURCES: Susan Matulevicius, M.D., assistant professor, cardiology, University of Texas Southwestern Medical Center at Dallas; Gregg Fonarow, M.D., professor of cardiology, University of California, Los Angeles, and spokesman, American Heart Association; July 22, 2013, JAMA Internal Medicine, online

 

Blood Clots and Travel: What You Need to Know.


More than 300 million people travel on long-distance flights (generally more than four hours) each year.1  Blood clots, also called deep vein thrombosis (DVT), can be a serious risk for some long-distance travelers.  Most information about blood clots and long-distance travel comes from information that has been gathered about air travel.  However, anyone traveling more than four hours, whether by air, car, bus, or train, can be at risk for blood clots. 

jet airplane landing

Blood clots can form in the deep veins (veins below the surface that are not visible through the skin) of your legs during travel because you are sitting still in a confined space for long periods of time.  The longer you are immobile, the greater is your risk of developing a blood clot.  Many times the blood clot will dissolve on its own.  However, a serious health problem can occur when a part of the blood clot breaks off and travels to the lungs causing a blockage.  This is called a pulmonary embolism, and it may be fatal.  The good news is there are things you can do to protect your health and reduce your risk of blood clots during a long-distance trip.
Understand What Can Increase Your Risk for Blood Clots

Even if you travel a long distance, the risk of developing a blood clot is generally very small.   Your level of risk depends on the duration of travel as well as whether you have any other risks for blood clots.  Most people who develop travel-associated blood clots have one or more other risks for blood clots, such as:

  • Older age (risk increases after age 40)
  • Obesity (body mass index [BMI] greater than 30kg/m2)
  • Recent surgery or injury (within 3 months)
  • Use of estrogen-containing contraceptives (for example, birth control pills, rings, patches)
  • Hormone replacement therapy (medical treatment in which hormones are given to reduce the effects of menopause)
  • Pregnancy and the postpartum period (up to 6 weeks after childbirth)
  • Previous blood clot or a family history of blood clots
  • Active cancer or recent cancer treatment
  • Limited mobility (for example, a leg cast)
  • Catheter placed in a large vein
  • Varicose veins

The combination of long-distance travel with one or more of these risks may increase the likelihood of developing a blood clot.  The more risks you have, the greater your chances of experiencing a blood clot.   If you plan on traveling soon, talk with your doctor to learn more about what you can do to protect your health.  The most important thing you can do is to learn and recognize the symptoms of blood clots.
Recognize the Symptoms

Deep Vein Thrombosis (DVT)

About half of people with DVT have no symptoms at all. The following are the most common symptoms of DVT that occur in the affected part of the body (usually the leg or arm):

  1. Swelling of your leg or arm
  2. Pain or tenderness that you can’t explain
  3. Skin that is warm to the touch
  4. Redness of the skin

If you have any of these symptoms, contact your doctor as soon as possible.

Pulmonary Embolism (PE)

You can have a PE without any symptoms of a DVT.  Symptoms of a PE can include:

  1. Difficulty breathing
  2. Faster than normal or irregular heartbeat
  3. Chest pain or discomfort, which usually worsens with a deep breath or coughing
  4. Anxiety
  5. Coughing up blood
  6. Lightheadedness, or fainting

If you have any of these symptoms, seek medical help immediately.

For more information on blood clots

Protect Yourself and Reduce Your Risk of Blood Clots During Travel

  • Know what to look for.  Be alert to the signs and symptoms of blood clots.
  • Talk with your doctor if you think you may be at risk for blood clots.  If you have had a previous blood clot, or if a family member has a history of blood clots or an inherited clotting disorder, talk with your doctor to learn more about your individual risks.
  • Move your legs frequently when on long trips and exercise your calf muscles to improve the flow of blood.  If you’ve been sitting for a long time, take a break to stretch your legs. Extend your legs straight out and flex your ankles (pulling your toes toward you). Some airlines suggest pulling each knee up toward the chest and holding it there with your hands on your lower leg for 15 seconds, and repeat up to 10 times.  These types of activities help to improve the flow of blood in your legs.
  • If you are at risk, talk with your doctor to learn more about how to prevent blood clots. For example, some people may benefit by wearing graduated compression stockings.
  • If you are on blood thinners, also known as anticoagulants, be sure to follow your doctor’s recommendations on medication use.

References

1Gavish I, Brenner B.  Air travel and the risk of thromboembolism.  Intern Emerg Med 2011 Apr;6(2):113-6.

Source: CDC

Kidney Stones Linked to Higher Heart Risk.


Women with a history of kidney stones had a modestly increased risk of coronary heart disease, two large prospective cohort studies showed.

The magnitude of the increase ranged between 20% and 50% in the two studies. Similar increases emerged from separate analyses of fatal and nonfatal myocardial infarction (MI) and revascularization, reported Pietro Manuel Ferraro, MD, of Columbus-Gemelli Hospital in Rome, and colleagues online in the Journal of the American Medical Association.

No associations were observed in men from a third large cohort, either in the CHD composite endpoint or the individual components, they added.

“Our finding of no significant association between history of kidney stones and risk of CHD in men but an increased risk in women is difficult to explain, even though we could not determine whether this was due to sex or some other difference between the male and female cohorts,” the authors said. “However, differences by sex are not infrequent in studies analyzing the association between nephrolithiasis and either CHD or risk factors for CHD.”

Several previous cross-sectional studies had yielded inconsistent results about the relationship between kidney stones and CHD, said co-author Gary Curhan, MD, ScD, of Brigham and Women’s Hospital in Boston. None of the studies had the statistical power afforded by the large number of participants in the current analysis.

“We were able to adjust for numerous factors, and I have to admit that we were a little surprised that we still found an independent and significant association between a history of kidney stones and coronary heart disease, but in the two female cohorts,” Curhan toldMedPage Today.

Clinicians should be careful about changing clinical practice on the basis of findings from an observational study, he added. Nonetheless, the findings suggest that women with a history of nephrolithiasis might warrant more scrutiny for signs of CHD.

A previous study indicated that light exercise can lower the risk of kidney stones in women.

Several other studies have identified associations between nephrolithiasis and systemic diseases, including atherosclerosis, hypertension, diabetes, metabolic syndrome, andcardiovascular disease. In general, however, the studies had various limitations, which included no confirmation of clinical events and lack of statistical adjustment for confounding factors, the authors noted.

In an effort to bring some clarity to the relationship between kidney stones and CHD, investigators analyzed data from three large, prospective cohort studies, two involving women (Nurses’ Health Study [NHS] I and II) and the other with all male participants (Health Professionals Follow-up Study). Collectively, the studies included 45,748 men, ages 40 to 75, and 196,357 women, ages 30 to 55, all without CHD at baseline.

The studies’ data encompassed follow-up of 18 years in women and 24 years in men. Diagnoses of kidney stones and CHD were updated during biennial follow-up assessments.

The primary endpoint was CHD, which consisted of MI (fatal and nonfatal) and revascularization. All endpoints were confirmed by the biennial reviews and individual participants’ medical records.

Overall, 19,678 participants in the three studies combined reported a history of kidney stones. Investigators documented CHD events in 16,838 participants.

After extensive adjustment for confounding factors in NHS I, women with a history of kidney stones had a CHD incidence rate of 754 per 100,000 person years compared with 514 per 100,000 person-years among women without kidney stones. Multivariable analysis resulted in a hazard ratio of 1.18 (95% CI 1.08-1.28).

Data from NHS II showed CHD incidence rates of 144 versus 55 per 100,000 person years for women with and without a history of kidney stones. The difference translated into an HR of 1.48 (95% CI 1.23-1.78).

Men with and without a history of kidney stones had higher rates of CHD compared with women (1,355 versus 1,022 per 100,000 person-years), but the difference failed to achieve statistical significance in a multivariable analysis (HR 1.06, 95% CI 0.99-1.13).

The authors cautioned that the study had some limitations including a lack generalizability because the majority of the participants were white.

“Race has an influence on both nephrolithiasis (with white populations being more prone to form stones compared with black and Hispanic populations) and CHD (with higher incidence among black populations),” they explained.

Source: American Heart Association