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Blood pressure test changes expected to cut misdiagnoses

Roll-out of scheme that monitors patients for 24 hours could cut hypertension rates and save the NHS £10m a year More than a quarter of patients may have been misdiagnosed for high blood pressure, a finding that will see the way doctors identify hypertension changed for the first time in more than a century. Guidelines published on Wednesday by the National Institute for Health and Clinical Excellence (Nice) recommend that patients should be monitored for 24 hours to determine whether they have high blood pressure rather than having a measurement taken in a doctor’s surgery. The 24-hour process, ambulatory blood pressure monitoring (ABPM), involves wearing a cuff and a box on a belt for a day. The patient then brings it back the following day for the recording to be downloaded on to a computer and an automatic report generated. Currently patients have a number of appointments to have their blood pressure checked, and it is estimated that 25% suffer from “white-coat hypertension” – a syndrome in which people show elevated blood pressure in a surgery or hospital but nowhere else. Bryan Williams, professor of medicine at the University of Leicester, who chaired the Nice hypertension guideline committee, said any patients who had been misdiagnosed would be identified as the system was adopted across the NHS. He said: “Everybody on treatment is under periodic, usually annual, review and that is the opportunity to consider whether or not the original diagnosis was the right one.” He added that 10% of the NHS could introduce “this tomorrow … Our modelling showed that for every 100,000 people this new method would cost £2.5m in the first year. But by year five you would see savings of £10m a year.” The guideline panel expect that the new process will take about a year to introduce and that the cost of the machines, currently around £1,000 each, could halve. The new advice also recommends that people over 80 are treated for high blood pressure. In the past there has been debate over whether this will cause more harm than good. But Williams said that patients would benefit. In the UK 12 million people have high blood pressure and almost half are undiagnosed. It is estimated that the condition costs the NHS £1bn a year in drugs alone. Managing high blood pressure is the most important thing patients can do to lessen their risk of a stroke – the third most lethal condition after cancer and heart disease and leading cause of severe disability. It is estimated that 20% of hospital beds are occupied by stroke victims. Cathy Ross, senior cardiac nurse at the British Heart Foundation, said: “The number of people with high blood pressure in the UK is staggering. It’s a major risk factor for heart disease and strokes so it’s crucial we do all we can to get people diagnosed and properly treated as soon as possible.” Although there is no debate over the existence of white coat syndrome, some researchers argue that even mild exercise can influence readings and patients should be at home when an assessment is made. A study in Finland five years ago concluded that the home approach “is more convenient and better accepted by the patients for long-term use and also less costly compared to ambulatory monitoring.” However, a study accompanying the Nice guidelines found that ambulatory monitoring was the most cost-effective way to diagnose hypertension among men and women of all ages. For women aged 40, the saving was £323 for each patient. The health minister Anne Milton said: “Hypertension is a serious public health issue that affects up to a third of the population and needs to be better managed in primary care. “Getting the diagnosis right is vital in order to make sure that all patients who need treatment get it before they go on to develop a more serious condition.” NHS Health Randeep Ramesh guardian.co.uk

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Title: Stand By Me Artist: Ben E. King Jerry Leiber, famed lyricist of the duo Leiber and Stoller, died yesterday at 78. Leiber and Stoller penned some of the most iconic hits of their time, including ‘Hound Dog’, ‘Love Potion No. 9′, and this timeless classic sung by Ben E. King. R.I.P.

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Title: Stand By Me Artist: Ben E. King Jerry Leiber, famed lyricist of the duo Leiber and Stoller, died yesterday at 78. Leiber and Stoller penned some of the most iconic hits of their time, including ‘Hound Dog’, ‘Love Potion No. 9′, and this timeless classic sung by Ben E. King. R.I.P.

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Back in March, USA Today broke the story about test score cheating in the Washington, DC school system under Michelle Rhee’s watch. Since then, Rhee has been cozy with the DeVos family, Rick Scott, worked to undermine Tennessee schools, and continues her crusade with the assistance of former DNC official Hari Sevugan to bust unions in her quest “for the children.” Yet, she is curiously circumspect when it comes to answering allegations on the cheating scandals, particularly the Washington, DC cheating scandal. The New York Times reports : These days, as director of an advocacy group she founded, StudentsFirst, she crisscrosses the country pushing her education politics: she’s for vouchers and charter schools, against tenure, for teachers, but against their unions. Always, she preens for the cameras. Early in her chancellorship, she was trailed for a story by the education correspondent of PBS News Hour John Merrow. At one point, Ms. Rhee asked if his crew wanted to watch her fire a principal. “We were totally stunned,” Mr. Merrow said. She let them set up the camera behind the principal and videotape the entire firing. “The principal seemed dazed,” said Mr. Merrow. “I’ve been reporting 35 years and never seen anything like it.” And yet, as voracious as she is for the media spotlight, Ms. Rhee will not talk to USA Today . The video at the top of her firing the principal is one on Rhee’s StudentsFirst website. She actually is proud of it, and perhaps it was justified. We really don’t know one way or the other on that. But what we do know is that Beverly Hall may face criminal charges for the cheating in Atlanta on her watch. We know that Hall may go to jail over what appears to be the most egregious case of widespread cheating in U.S. history. The cheating on Rhee’s watch appears to be a close second to Hall’s, which leads me to ask some questions about whether her principal firings were because they wouldn’t cheat, or because they were incompetent. More importantly, why are Democrats still lining up behind Rhee? She could possibly be one of the most divisive forces in the Democratic party today. Between her cozy relationships with the ultra-right wing “reformers,” and her push to bust unions, it makes no sense at all. Stephen Brill’s book Class Warfare seems to confirm a strong tie between Rupert Murdoch and Rhee. According to Brill, Rhee received donations and/or pledges from Eli Broad, Rupert Murdoch, Julian Roberson, Ken Langone and others. At the time, donations for StudentsFirst were being collected from Democrats for Education Reform (DFER), which can only be described as a Third Way-type organization led by hedge fund managers and fat cat investor types. You know, the kind that would love to see public education become a new “market.” Education reform is necessary, but not the kind of education reform Rhee sells. Over on K12 News Network, educator Marion Brady has some harsh words for both the diagnosis and the so-called cure. Here is one of her ideas for a real cure: First,they could stop basing education policy on the opinions of business leaders, syndicated columnists, mayors, lawyers and assorted other education “experts” who haven’t passed the 10,000-hour test – 10,000 hours of face-to-face dialog with real students in real classrooms, all the while thinking analytically about what they’re doing and why. “Experts” who see more rigor, more tests, more international comparisons, more “data-driven decision-making,” more math and science, more school closings, more Washington-initiated, top-down reform policy as the primary cure for education’s ills are amateurs.And policymakers who can’t see the perversity of simultaneously spending billions on innovation and billions on standardization, should find other work. Read the whole thing. Brady debunks the entire myth of “data-based solutions” and brings the discussion to where it should really be: On how best to educate students by meeting them where they are. Rhee and her ilk will continue to get the press, especially as long as businesses will profit from what she’s selling, but these “solutions” are no solutions at all, and threaten to destroy public education entirely.

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Bozell Column: NPR, the Statism Network

One of the greatest perversions of statism is the use of taxpayer money to push for ever more government spending and more government intervention. A casual listener to the far-left end of the FM dial, National Public Radio, will quickly conclude that NPR is one of America's leading offenders in this perversion. Let's just take one show, the August 22 evening newscast “All Things Considered,” perhaps one of the most ill-named programs in the history of radio. Conservatism is never considered. It is only besmirched, assaulted, and rhetorically dismembered. NPR anchor Robert Siegel was covering the new Martin Luther King memorial statue on the Washington Mall. So in order to consider all things, he asked black wacko-leftist Julian Bond if Tea Party activists were racist. Siegel threw this softball at Bond: “Some people read into the Tea Party's almost neuralgic reaction to government spending, a sense that white people figure black people benefit disproportionately from federal programs. Do you suspect a racial subtext to that whole argument?” Bond said “absolutely,” that “there is a racial animus there.” This was actually a little well-behaved for Bond. In the past, Bond has denounced the Tea Party as the the “Taliban wing” of the GOP. Speaking of Republicans, Bond sated afdter the 1994 revolution that the “running dogs of the wacky radical right” insured “white supremacy” was “everywhere in America,” and insisted then that in the Reagan years, the Republicans were a “crazed swarm of right-wing locusts.” That's who NPR turns to for sober analysis. Later in the same program, NPR offered a profile of Democrat Sen. Max Baucus, a member of the new “super committee” that will somehow magically reduce the deficit in a way the larger Congress cannot. Only liberals are allowed to analyze. Liberal number one: “Pat Williams was Montana's Democratic congressman through the 1980s and '90s. While he considers Baucus a friend, he doesn't agree with many of his fiscal policies.” Williams said “most notably, I've been disappointed in that he was the leading Democrat who engineered the passage of George W. Bush's tax cuts, which have been disastrous for the country.” (NPR has no time for anyone who thinks the Bush tax cuts were not “disastrous” for America.) Liberal number two: University of Montana professor Christopher Muste, who put Baucus on the right-wing fringe. Muste “says while Baucus is considered a progressive on many social and environmental issues, he's become a conservative anchor for the Democratic party on fiscal issues.” To suggest there is a “conservative anchor” in the Democrat Party is to flirt with a mental walk on the wild side. That's like suggesting there's a conservative anchor at…NPR. Muste warned Baucus is “very cautious” and “cautiousness makes him even more moderate in a lot of his policy actions.” NPR suggested on health care, “Baucus angered many liberal Democrats when he took the public option off the table in a failed attempt to bring more conservative Republicans onboard.” Muste added, “So I think he's got to view this bipartisan commission as one of his few chances to actually really come back and reestablish his credibility as one of the key players in deficit reduction in Congress.” Did you catch that? Baucus has to “reestablish his credibility” on deficit reduction by pleasing liberal Democrats. That would mean by increasing taxes and refusing to touch Obamacare, Medicare, and Social Security – anything. Right after this came another statism story: the endless rerun of billionaire Warren Buffett beating his breast and insisting he's dramatically undertaxed. I'm bored just writing that. NPR anchor Melissa Block interviewed Joseph Thorndike so he could denounce the under-taxation of the rich. Buffett can pontificate ad infinitum on this, perhaps because he knows NPR will not point out the obvious: Buffett doesn't live by his own credo. He could, but won't, write out his own check to the government. In fact, he does just the opposite, pouring more and more into the (liberal) Bill and Melinda Gates Foundation, thus protecting his money from federal taxation. In July he parked another $1.5 billion there, bringing his total to $9.5 billion. Buffett and Gates have both argued for a stiffer estate tax, which this foundation craftily avoids. To real journalists, this would be a story. But not at NPR.

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Rep. Chip Cravaack of Minnesota, a tea party favorite, has steadfastly refused to hold a town hall meeting in Duluth, the largest city in his district, until a group of activist grandmothers shamed him into it as he appeared at a meeting for the National Federation of Independent Businesses on Tuesday. Cravaack had numerous meetings with special interest groups, but has yet to answer to the biggest voting block in his district. If Cravaack actually shows up ( since his staff doesn’t know anything about a town hall scheduled for Wednesday ), here are some questions attendees at the town hall might ask him: -Will he actually be ready to answer constituent questions? -Why did Cravaack vote to shut down the Federal Aviation Administration ? -Did he know that the FAA shutdown was solely about assaulting unions and how does he justify such a thing? -Why did Cravaack move his family out of the district and how will he stay connected to Minnesotans with so little time in the district. -Why did he vote against every single crucial vote for Minnesota’s working families ? -How does cutting taxes for Big Oil and billionaires create jobs? -Why hasn’t Cravaack done anything to create jobs . -If he believes in limiting government spending , why is he charging taxpayer $1,000 per month for his car rental? Those interested in attending the Town Hall, which will be held Wednesday at 3:00 p.m. local time at the Duluth International Airport, can RSVP here .

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US earthquake leads to evacuation of White House

No reports of deaths but from Manhattan to Washington DC, aeroplanes were grounded and offices evacuated As natural disasters go, it was hardly a catastrophe, but the earthquake felt across parts of America on Tuesday certainly had an impact. As buildings swayed from Manhattan to Detroit to Washington DC, aeroplanes were grounded and offices

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Virginia Nuclear Plant Had Quake Sensors Removed Due to Budget Cuts

Click here to view this media A nuclear power plant that was shut down after an earthquake struck central Virginia Tuesday had seismographs removed in 1990s due to budget cuts. U.S. nuclear officials said that the North Anna Power Station, which has two nuclear reactors, had lost offsite power and was using diesel generators to maintain cooling operations after an 5.9 earthquake hit the region. The North Anna plant, which was near the epicenter of Tuesday’s quake, is reportedly located on a fault line. Institute for Policy Studies (IPS) Senior Scholar Bob Alvarez told the Project on Government Oversight (POGO) that the North Anna plant was built to withstand a 5.9-6.1 quake. The U.S. Nuclear Regulatory Commission rates the plant as the seventh most likely to receive core damage from a quake. But they say the chances of that are only 1 in 22,727. According to the Virginia Department of Mines, Minerals and Energy (DMME), the Virginia Tech Seismological Observatory (VTSO) removed all seismographs from around the plant in the 1990s due to budget cuts. In February, Dominion Virginia Power confirmed its commitment to add a third reactor to the plant. “While Dominion has not decided on the schedule to build the unit, the company will continue to move forward with the federal combined operating license process and preliminary site development work,” Dominion CEO Thomas F. Farrell II said in a statement.

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Riots: Conservative MP warns of ‘rushed justice’

James Clappison’s comments follow disclosure of Scotland Yard’s decision at height of riots to deny bail to all those charged People arrested on riot-related offences could face “rushed justice” because of the pressure on police and the courts after the UK riots, the Conservative MP and senior member of the Commons home affairs committee James Clappison has warned. His comments follow the disclosure that Scotland Yard adopted a policy of remanding in custody everyone arrested in relation to the riots, regardless of the severity of the charges they face or their criminal record, and comes as a Guardian poll reveals there is public support for the tough stance taken by the courts. The Metropolitan police said the policy was necessary to prevent further public disorder as violence spread through the capital. But the document also acknowledged that the force was so stretched at the height of the riots that it was “impractical” to bail people while they conducted “protracted” investigations, suggesting that investigating officers use special rules to fast-track cases to the courts with less evidence than is normally required. Clappison said: “There has to be firm, deterrent sentencing but rushed justice will be bad justice particularly when you’re trying to sort the professional repeat offenders and organisations from the weak followers.” Referring to the report of the leaked document, he said: “The situation is tough for the police, but we can’t have short cuts to justice. In every case we have to have normal high standards of justice for determining guilt and innocence and the right sentence.” The Met said that though it had advocated remanding people in custody it did not amount to a policy of not issuing cautions or denying people bail without reasonable cause. It said that of the 1,881 arrests, 1,063 resulted in charges. Some 623 were bailed to return pending further inquiries, 17 cautioned and 125 released with no other action. Overall some 62% of people arrested on riot-related offences were remanded in custody compared with 10% in comparable cases at other times, government figures show. The Guardian/ICM poll found that about 70% of respondents thought people convicted of riot-related offences should get a tougher than normal sentence, compared with 25% who opposed the idea and 5% who didn’t know. • ICM Research interviewed a random sample of 1,004 adults aged 18+ by telephone on 19-21 August 2011. Interviews were conducted across the country and the results have been weighted to the profile of all adults. ICM is a member of the British Polling Council. UK riots Conservatives Police Crime UK criminal justice Metropolitan police London Polly Curtis Adam Gabbatt guardian.co.uk

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Riots: Conservative MP warns of ‘rushed justice’

James Clappison’s comments follow disclosure of Scotland Yard’s decision at height of riots to deny bail to all those charged People arrested on riot-related offences could face “rushed justice” because of the pressure on police and the courts after the UK riots, the Conservative MP and senior member of the Commons home affairs committee James Clappison has warned. His comments follow the disclosure that Scotland Yard adopted a policy of remanding in custody everyone arrested in relation to the riots, regardless of the severity of the charges they face or their criminal record, and comes as a Guardian poll reveals there is public support for the tough stance taken by the courts. The Metropolitan police said the policy was necessary to prevent further public disorder as violence spread through the capital. But the document also acknowledged that the force was so stretched at the height of the riots that it was “impractical” to bail people while they conducted “protracted” investigations, suggesting that investigating officers use special rules to fast-track cases to the courts with less evidence than is normally required. Clappison said: “There has to be firm, deterrent sentencing but rushed justice will be bad justice particularly when you’re trying to sort the professional repeat offenders and organisations from the weak followers.” Referring to the report of the leaked document, he said: “The situation is tough for the police, but we can’t have short cuts to justice. In every case we have to have normal high standards of justice for determining guilt and innocence and the right sentence.” The Met said that though it had advocated remanding people in custody it did not amount to a policy of not issuing cautions or denying people bail without reasonable cause. It said that of the 1,881 arrests, 1,063 resulted in charges. Some 623 were bailed to return pending further inquiries, 17 cautioned and 125 released with no other action. Overall some 62% of people arrested on riot-related offences were remanded in custody compared with 10% in comparable cases at other times, government figures show. The Guardian/ICM poll found that about 70% of respondents thought people convicted of riot-related offences should get a tougher than normal sentence, compared with 25% who opposed the idea and 5% who didn’t know. • ICM Research interviewed a random sample of 1,004 adults aged 18+ by telephone on 19-21 August 2011. Interviews were conducted across the country and the results have been weighted to the profile of all adults. ICM is a member of the British Polling Council. UK riots Conservatives Police Crime UK criminal justice Metropolitan police London Polly Curtis Adam Gabbatt guardian.co.uk

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