Cardinal Health Buys AssuraMed for $2 Billion

Cardinal Health, the second-largest distributor of prescription drugs, announced on Thursday that it was buying a large medical supplier in a $2 billion deal aimed at expanding the business into the growing area of home health care.

The medical supplier, the privately held AssuraMed, supplies products for home use to aid treatment of diabetes, wounds, incontinence and other conditions. It had revenue of $1 billion in 2012, Cardinal Health said.

AssuraMed, which has been owned by the private equity firms Clayton, Dubilier & Rice and Goldman Sachs’s GS Capital Partners, serves more than one million patients nationwide and sells more than 30,000 products.

In an interview, George S. Barrett, Cardinal’s chairman and chief executive, said the acquisition was aimed at taking advantage of a confluence of national trends: the aging population, which has led to an increase in patients with chronic conditions, and more treatment of those conditions at home or in nonhospital settings like doctors’ offices and outpatient clinics.

“One of the things that has become clear is we’re going to have to manage patients differently,” Mr. Barrett said. “It very strategically aligns with where we think health care is moving, and it’s a natural extension of our skill set.”

In a conference call with investors, Mr. Barrett said the home health care area was growing at nearly 7 percent and represented a market opportunity of about $16 billion.

The deal is expected to close in April and will be financed with a combination of $1.3 billion in senior unsecured notes and cash. Cardinal estimated the acquisition would add 2 to 3 cents to its earnings a share in 2013, and 18 cents a share by 2014.

Cardinal, based in Dublin, Ohio, had revenue of $108 billion in 2012, and ranks second in the drug-distribution market behind the McKesson Corporation, based in San Francisco. AssuraMed is based in Twinsburg, Ohio.

Shares in Cardinal closed up 56 cents, or 1.2 percent, at $46 on Thursday.

Cardinal was advised by Bank of America Merrill Lynch and the law firm Wachtell, Lipton, Rosen & Katz. Clayton Dubilier and GS Capital were advised by JPMorgan Chase, Goldman Sachs and the law firm Debevoise & Plimpton.

Read More..

Amazon shares climb on Kindle e-book optimism

SAN FRANCISCO (Reuters) – Amazon.com Inc shares climbed more than 4 percent on Tuesday after an analyst note fueled optimism about the company’s Kindle e-book business.

The e-book market is a lot bigger than previously thought, and owners of Kindle e-readers and tablets are reading more e-books, Morgan Stanley‘s Scott Devitt, a leading Internet and e-commerce analyst, told investors in the research note.

Devitt estimated worldwide e-book unit sales of 859 million in 2012, up considerably from a previous estimate of 567 million. With almost 45 percent of the e-book market, Amazon likely sold 383 million e-books last year, compared with an earlier estimate of 252 million, the analyst added.

Amazon’s broader strategy is to sell mobile devices at or near cost and make money when consumers use the gadgets to buy digital content, including e-books, music, videos, apps and games.

Devitt said on Wednesday that the strategy may be working with e-books, one of Amazon’s oldest digital categories.

“We initially assumed that early adopters of eReader devices would be avid readers and, therefore, the marginal buyer would read less,” Devitt wrote.

However, data from a recent Amazon presentation show that consumers who bought a Kindle in 2011 read 4.6 times more e-books, on average, in the 12 months following their gadget purchase, compared with the 12 months before getting the device, the analyst noted.

Similar data from 2008 show consumers reading e-books 2.6 times as much after their Kindle device purchase, on average, according to Devitt.

The success of Amazon’s Kindle business is important because it is more profitable than some of the company’s other operations, Devitt said.

The Kindle business, which includes the gadgets and related digital content sales, generated about 11 percent of Amazon’s sales last year and 34 percent of the company’s consolidated segment operating income, or CSOI, Devitt estimated. The CSOI is a closely watched measure of Amazon’s profitability.

“The Kindle franchise is a profit pool that subsidizes investments in other growth initiatives,” Devitt wrote.

Amazon shares rose 4.1 percent to $ 269.30 in afternoon trading on Wednesday.

(Reporting By Alistair Barr; editing by Gunna Dickson)

Gadgets News Headlines – Yahoo! News

Title Post: Amazon shares climb on Kindle e-book optimism
Url Post: http://www.news.fluser.com/amazon-shares-climb-on-kindle-e-book-optimism/
Link To Post : Amazon shares climb on Kindle e-book optimism
Rating:
100%

based on 99998 ratings.
5 user reviews.
Author: Fluser SeoLink
Thanks for visiting the blog, If any criticism and suggestions please leave a comment

Read More..

Kerry Says He Is Preparing Proposals on Syria Crisis

WASHINGTON — Secretary of State John Kerry said on Wednesday that he had ideas about how to persuade President Bashar al-Assad to agree to a political transition in Syria and planned to raise them on his first foreign trip this month.

“We need to address the question of President Assad’s calculation currently,” Mr. Kerry said after a meeting with Jordan’s foreign minister, Nasser Judeh. “I believe there are additional things that can be done to change his current perception. I’ve got a good sense of what I think we might propose.”

Mr. Kerry did not say what proposals he had in mind. He is expected to travel to the Middle East and Europe, but the trip has not been formally announced.

“I can assure you my goal is to see us change his calculation, my goal is to see us have a negotiated outcome and minimize the violence,” Mr. Kerry said. “It may not be possible. I am not going to stand here and tell you that’s automatic or easily achievable. There are a lot of forces that have been unleashed here over the course of the last months.”

Mr. Kerry made a similar statement during his Senate confirmation hearing last month. Despite his caution that progress might not be possible, the effect of Mr. Kerry’s comments was to heighten expectations for his trip. Mr. Kerry is also expected to try to make headway on the issues dividing the Palestinians and the Israelis and set the stage for President Obama’s trip to Israel next month.

Mr. Kerry’s comment on Syria came a day after Mr. Obama said little about the Syria crisis in his State of the Union address. In that speech, Mr. Obama said he would keep pressure on the Syrian regime, but he did not voice confidence, as he had in his 2012 address, that Mr. Assad would soon be forced to relinquish power.

Mr. Kerry said that Mr. Obama would begin by listening to Israeli and Arab leaders and would not be bringing a major new proposal.

“The president is not prepared at this point in time to do more than listen to the parties, which is why he has announced he is going to go to Israel,” he said.

Read More..

Jacques Rogge to meet with wrestling leader

LAUSANNE, Switzerland (AP) — Facing a wave of criticism from around the world, IOC President Jacques Rogge will meet with the head of wrestling's governing body to discuss ways the sport can fight to save its place in the Olympics.

The IOC executive board dropped wrestling from the program of the 2020 Games on Tuesday, a decision which brought a sharp backlash from wrestling organizations and national Olympic bodies around the world — including the United States, Russia and Iran.

The move must still be ratified by the full International Olympic Committee in September, giving wrestling time to try to overturn a decision against a sport which dates back to the ancient Olympics and has been featured since the inaugural modern games in 1896.

Rogge said Wednesday he has been contacted by Raphael Martinetti, the Swiss president of international wrestling federation FILA, and was encouraged by the sport's resolve to make changes and fight for its place.

"We agreed we would meet at the first opportunity to have discussions," Rogge said at a news conference at the close of a two-day board meeting. "I should say FILA reacted well to this disheartening news for them.

"They vowed to adapt the sport and vowed to fight to be eventually included in the 2020 slot."

Wrestling, which remains on the program for the 2016 Olympics in Rio de Janeiro, still has a chance to stay on the list for 2020 — if it manages to respond decisively to the wakeup call and convince the IOC to reverse course.

"This is not the end of the day. The door is not closed," IOC Vice President Thomas Bach of Germany said. "It's good to see the reaction of FILA to say, 'OK we have understood, we have to do something and we will present a plan for the future of wrestling.' That is the right attitude."

Wrestling now joins seven other sports vying for one opening on the 2020 program: a combined bid from baseball and softball, karate, squash, roller sports, sport climbing, wakeboarding and the martial art of wushu.

The IOC executive board will meet in May in St. Petersburg, Russia, to decide which sport or sports to propose for 2020 inclusion. The final vote will be made at the IOC general assembly in September in Buenos Aires, Argentina.

"The vote of yesterday is not an elimination of wrestling from the Olympic Games," Rogge said. "Wrestling will participate in the games in Rio de Janeiro. To the athletes who train now, I say, 'Continue training for your participation in Rio. Your federation is working for the inclusion in the 2020 Games.'"

Rogge was asked whether Tuesday's decision marked an end to wrestling's Olympic hopes.

"I cannot look into a crystal ball into the future," he said. "We have established a fair process by which the sport that would not be included in the core has a chance to compete with the seven other sports for the slot on the 2020 Games."

Rogge said he was fully aware of the strength of criticism leveled at the IOC for the move.

"We knew even before the decision was taken whatever sport would not be included in the core program would lead to criticism from the supporters of that sport," he said.

Still, complaints continued to pour in Wednesday from different parts of the world, uniting the U.S. and Iran on an issue in ways never imagined in diplomatic circles. The U.S. and Russia were also unlikely allies in the save-wrestling campaign.

Alexander Zhukov, head of the Russian Olympic Committee, said he would write to Rogge and "use all of our strength to persuade the IOC not to exclude wrestling from the Olympic program."

Wrestling has been one of Russia's strongest sports: Soviet and Russian wrestlers have won 77 gold medals.

In Tehran, Iranian wrestler Ali Reza Dabir, a gold medalist in 2000 Sydney Games, called wrestling "the identity" of the Olympics.

"Do we destroy our historical sites which are symbols of humanity?" he told The Associated Press. "No. Then, why should we destroy wrestling?"

The Wrestling Federation of India said it would do all that it can to reverse the decision, and the Olympic committee in Greece — the birthplace of the ancient and modern games — condemned "a decision that is clearly in total opposition to the history of the Olympic Games and of sports in general."

On Tuesday, U.S. Olympic Committee CEO Scott Blackmun questioned the IOC decision "given the history and tradition of wrestling, and its popularity and universality."

There are potential scenarios that would work in wrestling's favor.

IOC officials said it's possible the executive board could decide in May to put three sports forward for consideration, including wrestling. Then it would be up to the assembly to approve wrestling or not.

If the board decides to keep wrestling off the list, the IOC assembly — which has resisted past attempts by the board to impose changes to the sports program — could reject the proposed list of 25 sports altogether. That would mean the current 26 sports, including wrestling, would stay and the whole process would go back to square one.

Modern pentathlon — a five-sport discipline dating back to the 1912 Games — had been widely expected to face removal from the program but lobbied successfully to save its status.

IOC member Richard Carrion of Puerto Rico, who served on the executive board for eight years, said such decisions are inevitably swayed by politics.

"Some people are better at lobbying than others," he told the AP. "There is a political dimension to this. There are people who have connections, who have this and that. We may like it or not, but in a multi-national organization like this decisions get made in ways that are not completely logical."

___ Associated Press writers Ali Akbar Dareini in Tehran, Jim Heintz in Moscow and Elena Becatoros in Athens contributed to this report.

Read More..

Phys Ed: Getting the Right Dose of Exercise

Phys Ed

Gretchen Reynolds on the science of fitness.

Fitness Tracker

Marathon, half-marathon, 10k and 5K training plans to get you race ready.

A common concern about exercise is that if you don’t do it almost every day, you won’t achieve much health benefit. But a commendable new study suggests otherwise, showing that a fairly leisurely approach to scheduling workouts may actually be more beneficial than working out almost daily.

For the new study, published this month in Exercise & Science in Sports & Medicine, researchers at the University of Alabama at Birmingham gathered 72 older, sedentary women and randomly assigned them to one of three exercise groups.

One group began lifting weights once a week and performing an endurance-style workout, like jogging or bike riding, on another day.

Another group lifted weights twice a week and jogged or rode an exercise bike twice a week.

The final group, as you may have guessed, completed three weight-lifting and three endurance sessions, or six weekly workouts.

The exercise, which was supervised by researchers, was easy at first and meant to elicit changes in both muscles and endurance. Over the course of four months, the intensity and duration gradually increased, until the women were jogging moderately for 40 minutes and lifting weights for about the same amount of time.

The researchers were hoping to find out which number of weekly workouts would be, Goldilocks-like, just right for increasing the women’s fitness and overall weekly energy expenditure.

Some previous studies had suggested that working out only once or twice a week produced few gains in fitness, while exercising vigorously almost every day sometimes led people to become less physically active, over all, than those formally exercising less. Researchers theorized that the more grueling workout schedule caused the central nervous system to respond as if people were overdoing things, sending out physiological signals that, in an unconscious internal reaction, prompted them to feel tired or lethargic and stop moving so much.

To determine if either of these possibilities held true among their volunteers, the researchers in the current study tracked the women’s blood levels of cytokines, a substance related to stress that is thought to be one of the signals the nervous system uses to determine if someone is overdoing things physically. They also measured the women’s changing aerobic capacities, muscle strength, body fat, moods and, using sophisticated calorimetry techniques, energy expenditure over the course of each week.

By the end of the four-month experiment, all of the women had gained endurance and strength and shed body fat, although weight loss was not the point of the study. The scientists had not asked the women to change their eating habits.

There were, remarkably, almost no differences in fitness gains among the groups. The women working out twice a week had become as powerful and aerobically fit as those who had worked out six times a week. There were no discernible differences in cytokine levels among the groups, either.

However, the women exercising four times per week were now expending far more energy, over all, than the women in either of the other two groups. They were burning about 225 additional calories each day, beyond what they expended while exercising, compared to their calorie burning at the start of the experiment.

The twice-a-week exercisers also were using more energy each day than they had been at first, burning almost 100 calories more daily, in addition to the calories used during workouts.

But the women who had been assigned to exercise six times per week were now expending considerably less daily energy than they had been at the experiment’s start, the equivalent of almost 200 fewer calories each day, even though they were exercising so assiduously.

“We think that the women in the twice-a-week and four-times-a-week groups felt more energized and physically capable” after several months of training than they had at the start of the study, says Gary Hunter, a U.A.B. professor who led the experiment. Based on conversations with the women, he says he thinks they began opting for stairs over escalators and walking for pleasure.

The women working out six times a week, though, reacted very differently. “They complained to us that working out six times a week took too much time,” Dr. Hunter says. They did not report feeling fatigued or physically droopy. Their bodies were not producing excessive levels of cytokines, sending invisible messages to the body to slow down.

Rather, they felt pressed for time and reacted, it seems, by making choices like driving instead of walking and impatiently avoiding the stairs.

Despite the cautionary note, those who insist on working out six times per week need not feel discouraged. As long as you consciously monitor your activity level, the findings suggest, you won’t necessarily and unconsciously wind up moving less over all.

But the more fundamental finding of this study, Dr. Hunter says, is that “less may be more,” a message that most likely resonates with far more of us. The women exercising four times a week “had the greatest overall increase in energy expenditure,” he says. But those working out only twice a week “weren’t far behind.”

Read More..

Cisco Tops Expectations With Rise in Profit of 44%

SAN FRANCISCO — Cisco Systems reported surprisingly strong results for its second quarter despite concerns about weak demand in some areas.

Cisco, the San Jose, Calif., networking giant, said that net income in the second quarter rose 44 percent to $3.1 billion, or 59 cents a share, from the year-ago quarter.

The company said revenue climbed 5 percent, to $12.1 billion.

Excluding certain items, such as tax gains and stock-compensation expenses, Cisco had earnings of 51 cents per share.

The results exceeded the expectations of Wall Street analysts, who had projected earnings of 48 cents a share and revenue of $12.06 billion, according to a survey of analysts by Thomson Reuters.

“Cisco delivered record earnings,” John Chambers, Cisco’s chief executive officer, said in a release accompanying the results. “We are making solid progress towards our goal of becoming the number-one information technology company in the world.”

Cisco has traditionally met, or slightly exceeded, Wall Street’s earnings expectations.

Over the past two years, Cisco has reorganized, paring down much of its consumer business and refocusing on new technology initiatives, such as cloud computing.

In December, Mr. Chambers announced plans to move Cisco from just selling gear that routes Internet data into the development of highly networked systems of sensors and data analysis machines. That plan, which involves working closely with large companies and governments, remains in its early stages.

Sales of regular networking equipment to government remains a key part of Cisco’s business. Analysts had been concerned that poor demand from governments, along with economic jitters in Europe, could hurt Cisco’s performance.

Read More..

Stop blaming video games for America’s gun violence

Recently, America’s attention has been understandably focused on the potential causes of increased violence – especially gun violence – particularly among children and youth, and how to stop it. Alongside gun-control proposals, some of which President Obama is likely to highlight in his State of the Union address tonight, much of that attention has looked at the potential of violent video games to cause or exacerbate the tendencies of youth to engage in real, harmful violence.

While I applaud increased vigilance on the part of parents in supervising their children’s behaviors and pastimes, a child playing a violent video game does not necessarily increase the likelihood that he or she will engage in real violence at that age or later in life.

Various reports and commentaries have documented the fact that Sandy Hook shooter Adam Lanza’s video game playing included violent shooter games like Call of Duty, Counterstrike, and Starcraft. Some have cited that activity as a possible cause for his shooting massacre.

ANOTHER VIEW: Gabrielle Giffords and NRA are both right about one thing: US culture of violence

But if Lanza was playing Call of Duty 4, he was one of millions. On the Xbox 360 console alone, the game’s developer, Infinity Ward, has documented nearly 4.4 million online players, not counting players who use a PlayStation 3 or aren’t online. The statistics for Counterstrike are similar – an estimated 62,142 per day. And Starcraft is so popular in Korea, that it has professional leagues and an estimated online player population of around 50,000 each day.

Of those millions of players, few commit an act of violence, certainly not enough to say that, statistically, video game play is a principle cause – or even a significant cause – of real-world violent behavior.

So why are so many people blaming the video game industry?

It’s a phenomenon known as “cultural lag,” and it’s what causes us to be hesitant in adopting new technologies, trying new fads, and changing our social mores. Cultural lag can be a good thing – some new things are dangerous, come with high levels of risk, and can infinitely do more harm than good. But cultural lag also can inhibit the development of technologies and society because of irrational fears, which is what I’m seeing with recent criticism of the gaming industry.

Before video games, society blamed rock ‘n’ roll for violence and bad behavior among young people. Before rock ‘n’ roll, we blamed television. Before television, movies. Before movies, mystery novels, which were once known as “penny dreadfuls.” Before mystery novels, Shakespeare, who repeatedly was accused of producing violent, lecherous, and otherwise improper behavior in his audience.

In essence, as a society, we always will try to find out “why” bad things happen, but we aren’t actually very good at finding the answers. We look back at our past with rose-colored glasses and look forward into the future with trepidation.

We see our own childhoods as joyful and carefree, and when, as adults, we are exposed to the grim realities of our world, we wonder, “What happened?”. And then we try to explain the difference between the past that we remember and the present as we perceive it. When we do this, we very often look to technologies that did not exist 20, 30, or 40 years ago, and we think: That didn’t exist back then when things were “better,” therefore it must have some impact on why things have “gotten worse” now.

First of all, I am unconvinced that “things have gotten worse,” but even if we assume that they have, in blaming technologies like video games for real-life violence, we assume causation, where numerous studies show there is only correlation – at best. This is tantamount to assuming, as journalist Jeanine Celestin-Greer of Gamastura (a gaming journalism website) points out, that because Lanza drank Mountain Dew, Mountain Dew causes violent behavior.

In a recent article in The Chronicle of Higher Education, Christopher J. Ferguson, a psychologist at Texas A&M International University, claimed that the recent outcry against video games as the cause of “school shootings” in general is patently fallacious. He explains that among hundreds of studies on violence and video games, not a single one has proven conclusively a causal relationship between violent behaviors in the real world and violent video-game play. And yet, scholars and politicians who often have little to no experience playing video games themselves continue to suggest that this is the case.

Americans need to stop trying to blame something other than ourselves for the increase – if there is an increase – in violent behavior.

Video games, music, television, movies, novels, and Shakespeare don’t cause violence. Mental illness, psychological abuse, and physical abuse cause violence. Ideologies that reward and condone aggression, particularly in men, cause violence. Global genocide causes violence. The only conclusive evidence we do have is that it is real-life violence that causes real-life violence.

As long as we, as a society, condone violence in the name of nationalism, continue to minimize domestic violence and rape, and promote aggression as ideal masculinity, violence will continue to be a problem in our homes, on our streets, and in our schools. Critics will argue that the imagery and plots of video games do just that – and in turn, perpetuate those behaviors. Yes, video games reflect some of these highly problematic aspects of our society that contribute to a tolerance of violence. Just like movies and books. But they don’t cause it.

Remove video games from the equation and you will still have a commensurate level of violence.

And yes, video games can influence ideology, but they aren’t the only – or even the predominant – influence on society or an individual. In fact, video games can influence our ideologies in as many if not more positive ways than they do negative ones. Many recent games actually encourage players to play non-violently and reward players for humane treatment and good judgment.

So while video games are influencing us, and sometimes through violent images and play, many of them are pushing us to criticize the very violence that some people seem to believe they are causing.

OPINION: 6 reasons why President Obama will defeat the NRA and win universal background checks

The dialogue we need to have is about real violence, not virtual violence, and I sincerely hope that America’s leaders recognize this as we move forward in addressing the problem.

Kristin M.S. Bezio is an assistant professor at the University of Richmond’s Jepson School of Leadership Studies. Her research explores the intersection of literature and leadership, looking at influences ranging from Shakespeare to video gaming.

Related stories

Read this story at csmonitor.com

Become a part of the Monitor community

Gaming News Headlines – Yahoo! News

Title Post: Stop blaming video games for America’s gun violence
Url Post: http://www.news.fluser.com/stop-blaming-video-games-for-americas-gun-violence/
Link To Post : Stop blaming video games for America’s gun violence
Rating:
100%

based on 99998 ratings.
5 user reviews.
Author: Fluser SeoLink
Thanks for visiting the blog, If any criticism and suggestions please leave a comment

Read More..

Putin Aims to Limit Officials’ Investments Abroad

MOSCOW — President Vladimir V. Putin introduced a draft law on Tuesday that would ban senior Russian officials from holding bank accounts or stocks outside Russia, the latest in a series of recent measures intended to insulate the country’s governance from foreign influences.

The draft law, which requires legislative approval, applies to a wide range of top officials, including lawmakers, ministers, top officials at the Central Bank and other state funds, and those whose work involves “the sovereignty or national security of the Russian Federation,” as well as their spouses and young children.

The change, though appealing to the broad public, would come as a jolt to many in Russia’s ruling class, who are both wealthy and deeply integrated into the West.

First presented in discussions on “nationalization of the elite,” the ban has been framed primarily as a way to guarantee officials’ loyalty to Russia, and also as a check on corruption, a topic on which the Kremlin knows that it is politically vulnerable. Commenting on a similar proposal by legislators last fall, a Kremlin spokesman, Dmitri S. Peskov, said officials with investments outside Russia “are not safe, in terms of being firm in defending the state’s interests.”

If the measure becomes law, as expected, officials will have three months to close their foreign accounts and sell their stock, or else face possible dismissal based on “lack of trust.” State auditors can initiate investigations into officials based on information provided by journalists, law enforcement bodies, political organizations and other sources.

The introduction of the draft law met with cheers from lawmakers, who have embraced a series of populist —some say reactionary — measures in the months since Mr. Putin returned to the presidency. An ultranationalist lawmaker, Vladimir V. Zhirinovsky, said foreign holdings marked government officials as members of a “fifth column.”

“They’ve bought half of Europe — the real estate, the accounts in all banks, they vacation there, their children study there, their relatives live there, they give birth there, they get medical treatment there,” he told a television reporter. “And it’s easy to influence them. A fifth column is formed here. One has to live at home, vacation at home, work and study. If you don’t like it, do not enter state service.”

A number of legislators said Tuesday that Mr. Putin’s measure could be broadened. Nikolai Levichev, of the party A Just Russia, suggested widening the circle of relatives who would come under scrutiny, noting that there are “multiple cases when a grown son or a niece of some governor or minister is a multimillionaire, in some cases invested in foreign banks.” In their proposal, some legislators had recommended banning Russians from owning real estate overseas as well, but Mr. Putin seems to have set that provision aside.

Foreign bank accounts have traditionally been used by officials as “an instrument for bribetaking,” noted Yevgeny Minchenko, a political analyst, in an interview with the Kommersant FM radio station. But the measure presented Tuesday leaves gaping loopholes, he said, because officials can still keep their money in accounts associated with offshore companies, or under the names of proxies or friends. “It’s clear that any law can be bypassed,” he said.

High-level corruption — and especially lavish spending by Russian officials overseas — has been a perennial theme for Mr. Putin’s critics, and some saw the measure presented on Tuesday as the president’s attempt to claim the issue as his own. Kirill Kabanov, chairman of the National Anticorruption Committee, a watchdog organization, said he believed that Mr. Putin had resolved to wrest control over the financial practices of the elite.

He said officials were being presented with a choice: either leave state service and retain foreign assets, or “stay in the real vertical — but if it becomes clear that in reality you are thinking about how to maintain your life in Côte d’Azur, you will be thrown out of the caste.”

“It’s not a secret to anybody that for many people, the motive for entering state service is to provide for a quiet life beyond the borders of our motherland at the expense of our budget,” he said.

Read More..

Gonzalez maintains he hasn't used PEDs

VIERA, Fla. (AP) — Gio Gonzalez arrived at spring training with the Washington Nationals on Tuesday and maintained he has not used performance-enhancing drugs.

The Miami New Times reported last month that Gonzalez was among a half-dozen major league players listed as receiving PEDs in purported records of Biogenesis of America LLC, a now-closed anti-aging clinic in Coral Gables, Fla. Gonzalez hopes to be exonerated.

"I feel very confident," the 27-year-old left hander said. "I think that at the end of the day I've never taken performance-enhancing drugs, and I never will."

Gonzalez, a 21-game winner last year, denied the allegations on Twitter on the day they were reported.

"You're stunned. You're shocked," he said Tuesday. "Your name has been brought up out of nowhere. You can't do nothing about it. You just have to wait it out and listen to what's going on. You can't jump the gun. You can't jump to conclusions. At the end of the day you just have to listen in and wait patiently."

Gonzalez said he had been contacted by Major League Baseball officials and has cooperated with their investigation. Gonzalez said he has "done everything that they want, and I feel strong with their program and what they're doing, and at the end of the day I'm waiting on them."

Gonzalez's father, Max, also was listed in the purported Biogenesis records.

"There's no connection for the fact that I say my father admitted that he was a patient there. A legitimate patient," the pitcher said. "And then after that, you know how my father is. ... All of south Florida, all of baseball knows that my father is the most proud father in baseball. He tells everyone about his son. And that's the best I can say. Other than that, I have no clue why my name was on that list, or on a notebook or anything."

Gonzalez doesn't want the allegations to be a distraction for his teammates.

"I'm going to do my best to keep it away from the locker room," he said. "I don't want any of this to be about me. Again, it's about the organization and it's about the team together."

Teammate Drew Storen said he isn't worried.

"Gio's a big part of this team, obviously. He's always been a big character guy for us," Storen said. "I think he'll continue to do that. He'll come in and be able to separate that stuff out. I think that's one of the things our clubhouse has been special for, we're able to cut out the outside factors. . I think we're going to be in good shape. Gio's a stand-up, character guy for us in this clubhouse. It's not going to change a thing."

Gonzalez said he plans to pitch for the United States in next month's World Baseball Classic following an invitation from manager Joe Torre. He figures to bolster a rotation missing David Price, Justin Verlander, Jered Weaver, Clayton Kershaw and Matt Cain.

___

Follow Kyle Hightower on Twitter at http://www.twitter.com/khightower

Read More..

Well: Straining to Hear and Fend Off Dementia

At a party the other night, a fund-raiser for a literary magazine, I found myself in conversation with a well-known author whose work I greatly admire. I use the term “conversation” loosely. I couldn’t hear a word he said. But worse, the effort I was making to hear was using up so much brain power that I completely forgot the titles of his books.

A senior moment? Maybe. (I’m 65.) But for me, it’s complicated by the fact that I have severe hearing loss, only somewhat eased by a hearing aid and cochlear implant.

Dr. Frank Lin, an otolaryngologist and epidemiologist at Johns Hopkins School of Medicine, describes this phenomenon as “cognitive load.” Cognitive overload is the way it feels. Essentially, the brain is so preoccupied with translating the sounds into words that it seems to have no processing power left to search through the storerooms of memory for a response.

---

Katherine Bouton speaks about her own experience with hearing loss.

A transcript of this interview can be found here.

---

Over the past few years, Dr. Lin has delivered unwelcome news to those of us with hearing loss. His work looks “at the interface of hearing loss, gerontology and public health,” as he writes on his Web site. The most significant issue is the relation between hearing loss and dementia.

In a 2011 paper in The Archives of Neurology, Dr. Lin and colleagues found a strong association between the two. The researchers looked at 639 subjects, ranging in age at the beginning of the study from 36 to 90 (with the majority between 60 and 80). The subjects were part of the Baltimore Longitudinal Study of Aging. None had cognitive impairment at the beginning of the study, which followed subjects for 18 years; some had hearing loss.

“Compared to individuals with normal hearing, those individuals with a mild, moderate, and severe hearing loss, respectively, had a 2-, 3- and 5-fold increased risk of developing dementia over the course of the study,” Dr. Lin wrote in an e-mail summarizing the results. The worse the hearing loss, the greater the risk of developing dementia. The correlation remained true even when age, diabetes and hypertension — other conditions associated with dementia — were ruled out.

In an interview, Dr. Lin discussed some possible explanations for the association. The first is social isolation, which may come with hearing loss, a known risk factor for dementia. Another possibility is cognitive load, and a third is some pathological process that causes both hearing loss and dementia.

In a study last month, Dr. Lin and colleagues looked at 1,984 older adults beginning in 1997-8, again using a well-established database. Their findings reinforced those of the 2011 study, but also found that those with hearing loss had a “30 to 40 percent faster rate of loss of thinking and memory abilities” over a six-year period compared with people with normal hearing. Again, the worse the hearing loss, the worse the rate of cognitive decline.

Both studies also found, somewhat surprisingly, that hearing aids were “not significantly associated with lower risk” for cognitive impairment. But self-reporting of hearing-aid use is unreliable, and Dr. Lin’s next study will focus specifically on the way hearing aids are used: for how long, how frequently, how well they have been fitted, what kind of counseling the user received, what other technologies they used to supplement hearing-aid use.

What about the notion of a common pathological process? In a recent paper in the journal Neurology, John Gallacher and colleagues at Cardiff University suggested the possibility of a genetic or environmental factor that could be causing both hearing loss and dementia — and perhaps not in that order. In a phenomenon called reverse causation, a degenerative pathology that leads to early dementia might prove to be a cause of hearing loss.

The work of John T. Cacioppo, director of the Social Neuroscience Laboratory at the University of Chicago, also offers a clue to a pathological link. His multidisciplinary studies on isolation have shown that perceived isolation, or loneliness, is “a more important predictor of a variety of adverse health outcomes than is objective social isolation.” Those with hearing loss, who may sit through a dinner party and not hear a word, frequently experience perceived isolation.

Other research, including the Framingham Heart Study, has found an association between hearing loss and another unexpected condition: cardiovascular disease. Again, the evidence suggests a common pathological cause. Dr. David R. Friedland, a professor of otolaryngology at the Medical College of Wisconsin in Milwaukee, hypothesized in a 2009 paper delivered at a conference that low-frequency loss could be an early indication that a patient has vascular problems: the inner ear is “so sensitive to blood flow” that any vascular abnormalities “could be noted earlier here than in other parts of the body.”

A common pathological cause might help explain why hearing aids do not seem to reduce the risk of dementia. But those of us with hearing loss hope that is not the case; common sense suggests that if you don’t have to work so hard to hear, you have greater cognitive power to listen and understand — and remember. And the sense of perceived isolation, another risk for dementia, is reduced.

A critical factor may be the way hearing aids are used. A user must practice to maximize their effectiveness and they may need reprogramming by an audiologist. Additional assistive technologies like looping and FM systems may also be required. And people with progressive hearing loss may need new aids every few years.

Increasingly, people buy hearing aids online or from big-box stores like Costco, making it hard for the user to follow up. In the first year I had hearing aids, I saw my audiologist initially every two weeks for reprocessing and then every three months.

In one study, Dr. Lin and his colleague Wade Chien found that only one in seven adults who could benefit from hearing aids used them. One deterrent is cost ($2,000 to $6,000 per ear), seldom covered by insurance. Another is the stigma of old age.

Hearing loss is a natural part of aging. But for most people with hearing loss, according to the National Institute on Deafness and Other Communication Disorders, the condition begins long before they get old. Almost two-thirds of men with hearing loss began to lose their hearing before age 44. My hearing loss began when I was 30.

Forty-eight million Americans suffer from some degree of hearing loss. If it can be proved in a clinical trial that hearing aids help delay or offset dementia, the benefits would be immeasurable.

“Could we do something to reduce cognitive decline and delay the onset of dementia?” he asked. “It’s hugely important, because by 2050, 1 in 30 Americans will have dementia.

“If we could delay the onset by even one year, the prevalence of dementia drops by 15 percent down the road. You’re talking about billions of dollars in health care savings.”

Should studies establish definitively that correcting hearing loss decreases the potential for early-onset dementia, we might finally overcome the stigma of hearing loss. Get your hearing tested, get it corrected, and enjoy a longer cognitively active life. Establishing the dangers of uncorrected hearing might even convince private insurers and Medicare that covering the cost of hearing aids is a small price to pay to offset the cost of dementia.

---

---

Katherine Bouton is the author of the new book, “Shouting Won’t Help: Why I — and 50 Million Other Americans — Can’t Hear You,” from which this essay is adapted.

---

This post has been revised to reflect the following correction:

Correction: February 12, 2013

An earlier version of this article misstated the location of the Medical College of Wisconsin. It is in Milwaukee, not Madison.

Read More..