Email reminders encourage end-of-life talks

(Reuters) - Email alerts may encourage cancer doctors to talk with terminally ill patients about their end-of-life wishes and to record those preferences in their medical records, according to a U.S. study.

Oncologists who were reminded each time one of their patients started a new chemotherapy regimen were more than twice as likely to note patients' wishes before they became very sick, said researchers in a report published in the Journal of Clinical Oncology.

"If, God forbid, the patient does end up in a medical emergency and it's unclear what their medical wishes are, then it's always a difficult situation for the doctor and the family," said Jennifer Temel, who led the study at Massachusetts General Hospital cancer Center in Boston.

Doctors tend to wait for a patient's condition to get much worse before bringing up their end-of-life wishes, such as whether they want health care staff to use CPR and other measures to try and prolong their lives, she said. But reminders may initiate those discussions earlier.

"Patients in the inpatient settings are in crisis, and it's a highly emotional state for patients and their families," Temel told Reuters Health.

"Everybody thinks it's better to have these discussions when people are less ill."

Temel and her colleagues surveyed doctors and nurse practitioners about their end-of-life conversations with people with incurable cancer, including how the health care providers would like to be prompted to have those conversations.

Then, the researchers designed and tested an email system that reminded doctors when they were seeing patients who were coming in to start a new chemo regimen.

The study included 100 people with advanced lung cancer. A year after the email alerts began, just over one-third of the patients had end-of-life wishes documented in their electronic health records.

In comparison, during the pre-alert period, fewer than 15 percent of people diagnosed with incurable lung cancer had had their wishes written down before they were hospitalized, the researchers said.

During both time periods, most patients who had end-of-life wishes recorded were listed as do not resuscitate (DNR) or do not intubate (DNI), meaning they didn't want doctors to take aggressive measures to keep them alive at the end.

Not only are such measures sometimes against a patient's wishes, they can also be very expensive.

"In the absence of these discussions, patients may receive unwanted, overly aggressive care that incurs cost for the patient and society and is associated with decreased quality of life for the patients and family, and worsened bereavement adjustment for caregivers," wrote Jamie Von Roenn in an editorial published with the study.

The change seen with email alerts "is an improvement, but we still have a long way to go," added Von Roenn, a palliative medicine specialist from Northwestern University's Feinberg School of Medicine in Chicago. SOURCE: http://bit.ly/S6L6HF

(Reporting from New York by Genevra Pittman at Reuters Health; editing by Elaine Lies)

Source: http://news.yahoo.com/email-reminders-encourage-end-life-talks-015747217.html

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Australia v Sri Lanka ? 3rd Test ? Live Cricket Score and Match ...

Australia v Sri Lanka ? 3^rd Test ? Live Cricket Score and Match Update ? Warner, Hughes establish foundation for Australia

David Warner and Phillip Hughes set a solid base for Australia, but were denied centuries by the Sri Lankan bowlers, after moving past the 80-run mark ? nevertheless, their contributions put the home team on steady ground, and Australia worked their way up to 241 for 3 by tea on the second day of the third Test, currently being played at the Sydney Cricket Ground, today on January 4.

Day one had seen the Aussie bowling attack coming out in full force after having won the toss and chosen to field first. Jackson Bird (19.4-10-41-4) looked to have slipped right into his role in the international side as he led the charge, and was backed by Mitchell Starc (19-0-71-3), Peter Siddle (15-3-46-2), and Nathan Lyon (19-2-69-1).

Sri Lanka, in turn, put forth a batting performance which can be described as average, at best. Lahiru Thirimanne remained the top-scorer with 91, while skipper Mahela Jayawardene (72) and Tillakaratne Dilshan (34) were the only other batsmen of note.

With the exception of these, Dinesh Chandimal (24), Angelo Mathews (15), Thilan Samaraweera (12), and Nuwan Pradeep (17*) were the only other batsmen who managed to reach double figures. The rest crumbled without putting up a fight, and Sri Lanka were eventually all out for 294 by stumps on day one.

The second day saw Australia losing opening batsman Ed Cowan (4) early via run out, but David Warner (85) and Phillip Hughes (87) steadied the team immediately, setting up a second wicket partnership worth 130 runs. However, shortly before tea, Australia lost both batsmen ? Warner off Dilshan, and Hughes off Rangana Herath.

However, no sooner had Sri Lanka gotten rid of the top three that they came face to face with Australia?s formidable middle order. The next batsmen to step up to the crease were Michael Clarke (42*) and Michael Hussey (18*), both of whom set up an as yet unbeaten 46-run partnership. Their combined efforts steadied the team after the departure of the top order, and got them up to 241 for 3 by tea ? trailing by 53 runs, with 7 wickets remaining in their first innings.

Source: http://blogs.bettor.com/Australia-v-Sri-Lanka-3rd-Test-Live-Cricket-Score-and-Match-Update-Warner,-Hughes-establish-foundation-for-Australia-a212625

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Gap moves into luxury market with Intermix buy

(Reuters) - Gap Inc , which owns clothing retailers Banana Republic and Old Navy as well as its namesake brand, expanded into the thriving luxury market with its purchase of women's apparel retailer Intermix Holdco Inc for $130 million.

Gap, which reported a better-than-expected 5 percent rise in same-store sales for December, also approved a $1 billion share repurchase program after an earlier $1 billion program ended in the fourth quarter.

Analysts had expected Gap to report a 3.5 percent rise in same-store sales, according to Thomson Reuters data.

Gap shares were up 5 percent at $33 in premarket trading.

Privately held Intermix sells clothes and accessories from renowned design houses such as Yigal Azrouel, Yves Saint Laurent, Brian Atwood and Jimmy Choo. It has 32 boutique stores in North America and also operates a retail website.

Gap has been attempting to turn around its business after losing ground to rivals including Inditex SA's Zara chain, which has a reputation for trendier clothes.

The company has also undertaken a major change in its management lineup, which helped to turn around sales.

News of the acquisition was first reported by the Wall Street Journal.

The deal marks the latest by Gap following its 2008 purchase of women's active apparel retailer Athleta.

Gap said Intermix would continue to operate under the leadership of its co-founder Khajak Keledjian in the role of chief creative officer.

Gap shares closed at $31.37 on the New York Stock Exchange on Wednesday.

(Reporting by Avik Das and Maria Ajit Thomas in Bangalore; Editing by Maju Samuel)

Source: http://news.yahoo.com/gap-moves-luxury-market-intermix-buy-143925256--finance.html

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Israel orders Bedouins to leave West Bank area

KHIRBET AL-MEITEH, West Bank (AP) ? The Israeli military on Wednesday ordered dozens of Palestinian Bedouins to leave their communities so it could conduct military exercises in a remote area of the West Bank.

The military said the order was temporary, and that the Palestinians were living illegally in closed military zones. The Bedouins say they have lived in the area for decades. While the army has issued temporary evacuation orders in the past, Bedouins say they have increased in frequency, and they charge the practice is meant to pressure them to leave their homes.

Israel has used largely empty areas of the West Bank for military bases, firing ranges and maneuvers since shortly after it captured the territory in 1967, marking off large areas for exclusive use of the military and bringing frequent complaints from Palestinians. The Palestinians claim all of the West Bank as a key part of a future state.

After receiving the latest evacuation order, one family dismantled its tents, and loaded sheep and small children onto a trailer in the community of Khirbet al-Meiteh alongside thin mattresses, pillows and blankets. "We will sleep here tonight, in this trailer," said Walid Zawahiri, 57. "There's nowhere else to go."

He and other residents said they had to leave their youngest sheep behind because they had nowhere warm to keep them. They feared that they would be eaten by wild animals or shot during military training. The communities rely on herding animals to survive.

Zawhiri said it was the fourth time he had been ordered to relocate in a year. Nearby, soldiers arrived in military vehicles, setting up dummies for target practice.

The evictions occurred in the Jordan Valley, a section of the West Bank along the border with Jordan. Although Palestinians have a measure of self-rule in other parts of the West Bank, Israel retrains overall military and administrative control over most of the Jordan Valley.

The area, mostly desert, is home to 60,000 Palestinians, the United Nations estimates. Some 8,000 are Bedouins, a culturally distinct community that once roved between winter and summer grazing sites with its livestock. Now they are mostly tethered to one area, and rely on sheep herding and manual labor to get by. They tend to live on the poor margins of Palestinian society.

The Jordan Valley is among the 60 percent of the West Bank that remains under full Israeli control, nearly two decades after interim peace accords granted the Palestinians autonomy elsewhere in the territory. The Israeli-controlled section includes military bases, nature reserves and Jewish settlements.

In a separate incident Wednesday, dozens of Israeli settlers tried to block access to a strip of land that Palestinians sought to cultivate near the northern West Bank village of Jaloud. The Palestinians obtained a court order allowing them enter their lands after Israeli settlers in the past tried to claim the land as their own, said lawyer Qamar Mashriqi.

The military said soldiers dispersed the crowd.

The settlers of the Esh Kodesh outpost rolled flaming tires at Palestinian-owned tractors before the soldiers intervened.

Source: http://news.yahoo.com/israel-orders-bedouins-leave-west-bank-area-133307241.html

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Cup color influences the taste of hot chocolate

Jan. 3, 2013 ? Two researchers from the Polytechnic University of Valencia and the University of Oxford have demonstrated that hot chocolate tastes better in an orange or cream coloured cup than in a white or red one. The study adds to recent research demonstrating how our senses perceive food in a different way depending on the characteristics of the container from which we eat and drink.

"The colour of the container where food and drink are served can enhance some attributes like taste and aroma," as explained by Betina Piqueras-Fiszman, researcher at the Polytechnic University of Valencia (Spain). Along with her colleague Charles Spence, from the University of Oxford (UK), the scientist has come to the conclusion in the case of drinking chocolate.

Both conducted an experiment in which 57 participants had to evaluate samples of hot chocolate served in four different types of plastic cup. They were the same size but of different colours: white, cream, red and orange with white on the inside.

Published in the Journal of Sensory Studies, the results reveal that the flavour of chocolate served in orange or cream coloured cups was better for the tasting volunteers.

However, the sweetness (not the flavour of the cocoa) and the aroma (the smell) where hardly influenced by the colour of the cup, despite the participants mentioning that the chocolate was slightly sweeter and more aromatic in a cream coloured cup.

"There is no fixed rule stating that flavour and aroma are enhanced in a cup of a certain colour or shade," recognised Piqueras-Fiszman. "In reality this varies depending on the type of food, but the truth is that, as this effect occurs, more attention should be paid to the colour of the container as it has more potential than one could imagine."

According to the study, these results are relevant for those scientists interested in understanding how the brain integrates visual information not just from the food itself but from the receptacle or container from which it is consumed.

In addition, this information could encourage chefs, catering professionals and even the packaging industry to think more about the colour of crockery and packaging. As the researcher explains, "it is a case of experimenting to understand how the container itself affects the perceptions that the consumers have on the product."

In the same article the conclusions of previous studies are brought together that also confirm the effect of the container on the sensory characteristics of the food or beverage. There are many examples, from yellow tins to improve the flavour of lemon to soft drinks in cold colours, like blue, to seem more thirst-quenching than warm colours like red. Furthermore, if drinks come in pink, they are even perceived as being more sugary.

In other cases, it has been demonstrated that a strawberry mousse appears to be sweeter and more intense on a white plate compared to a black plate. And as for coffee, the majority of those surveyed associated brown packaging to a stronger flavour and aroma, whereas reds seem to accentuate this sensation and blues and yellows make the drink seems softer.

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Journal Reference:

1. Betina Piqueras-Fiszman, Charles Spence. The Influence of the Color of the Cup on Consumers' Perception of a Hot Beverage. Journal of Sensory Studies, 2012; 27 (5): 324 DOI: 10.1111/j.1745-459X.2012.00397.x

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.

Source: http://feeds.sciencedaily.com/~r/sciencedaily/top_news/top_health/~3/pRyOFd7oIwo/130103073238.htm

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Bieber calls for tough rules after paparazzo death

LOS ANGELES (AP) ? The 29-year-old photographer had just snapped shots of Justin Bieber's exotic white Ferrari when he was struck and killed by a passing car ? a death that has spurred renewed debate over dangers paparazzi can bring on themselves and the celebrities they chase.

The accident prompted some stars including the teen heartthrob himself on Wednesday to renew their calls for tougher laws to rein in their pursuers, though previous urgings have been stymied by First Amendment protections.

The Los Angeles County coroner's office confirmed Thursday that the photographer was Christopher James Guerra. Officials did not know his hometown, coroner's Lt. Larry Dietz said.

In a statement, Bieber said his prayers were with the photographer's family. Ironically, the singer wasn't even in the Ferrari on Tuesday.

"Hopefully this tragedy will finally inspire meaningful legislation and whatever other necessary steps to protect the lives and safety of celebrities, police officers, innocent public bystanders, and the photographers themselves," Bieber said in the statement released by Island Def Jam Music Group.

Much of Hollywood was abuzz about the death, including Miley Cyrus, who sent several tweets critical of some of the actions of paparazzi and lamenting that the unfortunate accident was "bound to happen."

"Hope this paparazzi/JB accident brings on some changes in '13," Cyrus said on her Twitter page. "Paparazzi are dangerous! Wasn't Princess Di enough of a wake-up call?!"

Paparazzi roaming the streets of Southern California have been commonplace for more than a decade as the shutterbugs looked to land exclusive shots that can fetch hundreds of thousands of dollars.

Industry veterans recalled incidents where paparazzi chasing celebrities have been injured, but they couldn't remember a photographer being killed while working.

"Here in the state of California, I'm surprised this hasn't happened before," said Giles Harrison, a celebrity photographer and owner of London Entertainment Group.

Harrison is familiar with the backlash against paparazzi. He and another photographer were convicted of misdemeanor false imprisonment and sentenced to jail for boxing in Arnold Schwarzenegger and his family as they sat in their Hummer in 1998.

Citing that incident and the death of Princess Diana, the state Legislature passed its first anti-paparazzi measure a year later. It created hefty civil penalties that could be paid to stars whose privacy was invaded.

Six months ago, a paparazzo was charged with reckless driving in a high-speed pursuit of Bieber and with violating a separate, 2010 state law that toughened punishment for those who drive dangerously in pursuit of photos for commercial gain.

However, a judge last month dismissed the paparazzi law charges, saying the law was overly broad.

The judge cited problems with the statute, saying it was aimed at newsgathering activities protected by the First Amendment, and lawmakers should have increased penalties for reckless driving rather than target those who photograph celebrities.

City prosecutors said they would appeal the judge's ruling.

The law was prompted by the experiences of Jennifer Aniston, who provided details to a lawmaker about being unable to drive away after she was surrounded by paparazzi on Pacific Coast Highway.

On Tuesday, a friend of Bieber's was behind the wheel of the Ferrari when a California Highway Patrol officer pulled it over for speeding along Interstate 405, authorities said.

"This photographer evidently had been following the white Ferrari" and when it was pulled over after sundown he stopped, parked and crossed the street to snap photos, Los Angeles police Detective Charles Walton said.

The photographer stood on a low freeway railing to shoot photographs of the traffic stop over a chain-link fence, authorities said.

"The CHP officer told him numerous times that it wasn't safe for him to be there and to return to his vehicle," Walton said.

There were no sidewalks or pedestrian crossings along the street where the photographer had parked, so the driver of the car that struck him had no reason to expect a pedestrian, Walton said of the accident.

"It would have been very difficult for her to see him," the detective said.

It wasn't immediately clear how fast the motorist, a 69-year-old woman, was traveling, but she was not believe to be at fault and was unlikely to be cited, police said.

Harrison said he routinely tells his photographers to be safe when they are working.

"In any job you have to exercise a degree of common sense and caution," he said.

Harrison hopes celebrities and paparazzi examine their actions to ensure a similar event doesn't happen again. No photo is worth someone's life, he said.

"Everybody wants to be the first one to get that shot, get that scoop," Harrison said. "But at the end of the day, you can't spend money if you are dead."

___

Associated Press writer Robert Jablon contributed to this report.

Source: http://news.yahoo.com/bieber-calls-tough-rules-paparazzo-death-090809707.html

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