Analysis: U.S. emergency care cost estimates are too low

Apr. 29, 2013 ? U.S. emergency care costs may be more than twice previously published estimates, according to a new analysis that critiques those estimates, argues for improved accounting, and suggests considering the value of emergency care as well as total spending.

Alternately praised in the aftermath of horrible tragedies as a heroic service and lamented in policy debates as an expensive safety net for people without primary care, emergency medicine is often a hot topic. Despite that importance, an analysis published online April 26 in the Annals of Emergency Medicine finds that national expenditures on emergency care are likely significantly higher than previously thought.

"The ER has become increasingly important as a place where people go for acute unscheduled care, however there has been little rigorous analysis of its cost structure," said paper lead author Dr. Michael Lee, assistant professor of emergency medicine in the Warren Alpert Medical School of Brown University and a physician at Rhode Island Hospital and The Miriam Hospital.

Lee, who had a prior career in economics and finance before training in emergency medicine, co-wrote the analysis with Dr. Brian Zink, professor and chair of the Department of Emergency Medicine at the Alpert Medical School, and Dr. Jeremiah Schuur, assistant professor at Harvard Medical School and director of quality and patient safety for the Department of Emergency Medicine at the Brigham and Women's Hospital.

The challenge of properly accounting for the costs of emergency care, Lee said, becomes crucial as health care financing moves from a fee-for-service model to bundled payments for patient populations or episodes of care.

Clarifying costs

The analysis first examines current estimates of aggregate spending on emergency department (ED) care. The Agency for Healthcare Research and Quality's Medical Expenditure Panel Survey (MEPS) estimates $48.3 billion of spending on emergency care in 2010, or 1.9 percent of the nation's total health care expenditures of $2.6 trillion. With the message that "The total cost is small relative to the entire health care system," the American College of Emergency Physicians has embraced the AHRQ figure in its "Just 2 percent" public relations campaign.

How big a part of the whole bill?

A new cost analysis suggests that emergency care accounts for far more than the commonly accepted 1.9 percent of the nation's $2.6-trillion annual health care bill. It's more likely between 4.9 and 5.8 percent -- possibly as high as 6.2 to 10 percent.But Lee and his co-authors point out, based on data from other studies, that MEPS undercounts the number of ED visits and the number of ED patients who are admitted to hospitals. Adjusting for those discrepancies using data from a variety of other published sources, the authors estimate that ED costs are between 4.9 percent to 5.8 percent of total health care spending.

The authors went beyond national data sets, including the National Emergency Department Sample, to review ED spending data from a different source: a major national private insurer. The data included charges from doctors and hospitals for imaging, testing, and other procedures. But again there were accounting differences between admitted and discharged patients and a need to account fully for spending from Medicare and Medicaid. The authors' estimate based on this data is ED spending that is 6.2 to 10 percent of total health care spending.

Much of the debate in the academic literature around the expense of ED care has to do with whether the bulk of costs are fixed (e.g., expensive equipment and continuous staffing) or marginal (e.g., flexible staff time, expendable supplies). According to Lee, the cost structure of the ED remains poorly understood and is significantly more complex than what is modeled in existing studies.

As with assessments of total costs, the authors report, the studies vary widely even after adjusting for inflation. Across four major studies over the last three decades, the average cost per patient of an ED visit in 2010 dollars ranged from only $134 to more than $1,000, Lee and colleagues found. Meanwhile, the marginal cost of an ED visit (factoring out the fixed costs), ranged from $150 to $638.

Alternative accounting

The authors instead argue for an accounting based approach to ED costs using a methodology known as "Time-Driven Activity Based Costing (ABC)," which has been applied to health care by Robert Kaplan and Michael Porter, professors at the Harvard Business School.

The method maps all clinical, administrative, and diagnostic steps in a patient encounter and assigns costs to each activity, explicitly accounting for the time spent on each task.

ABC accounting might provide a more realistic and transparent measure of ED costs, Lee said, because the emphasis on time is particularly relevant for emergency medicine.

"The real cost of providing emergency care has to do with accurately measuring the resources that are used, and time is an important variable to take into account," he said.

The authors envision using the methodology to measure the cost of common ED processes or chief complaints, and to compare this to alternative sites such as primary care offices or clinics, he said. They also point out that ABC accounting gives "gives ED managers specific data they can use to improve the value of care by identifying high-cost steps in the process."

Emphasize value, not just cost

The authors acknowledge that an outcome of their analysis reporting higher overall costs for emergency care, may invite further criticism that the expense of emergency care represents unnecessary, inefficient care.

"However, we offer a more sanguine interpretation -- the high share of spending affirms the importance of emergency medicine within the health care system," they wrote. "With 130 million visits, 28 percent of all acute care visits, and accounting for nearly half of all admissions, emergency medicine should be expected to represent a large share of health care spending."

And Lee cautions, based on other studies, that efforts by private and government payers to divert ER care may not lead to large aggregate savings.

"Diverting nonemergency care may simply shift costs onto primary care offices and clinics which may not have the infrastructure to accommodate a large volume of unscheduled care," Lee said.

Instead there may be more potential for cost savings by focusing on reducing unnecessary diagnostic testing in the ED or unnecessary admissions that originate from the ED.

Lee and his co-authors call for the debate to include value, not just cost.

"More attention should be devoted to quantifying the value of specific aspects of emergency care," they wrote. "Rather than minimize the issue of cost, we should recognize the economic and strategic importance of the ED within the healthcare system and demonstrate that costs are commensurate with value.

Lee acknowledges that this remains a challenge for the field of emergency medicine. "The core of our business is ruling out critical diagnoses. Many of the things we look for are low probability but highly dangerous conditions. The big question is how do you quantify value when your work is often focused on trying to demonstrate the absence of something?"

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Story Source:

The above story is reprinted from materials provided by Brown University.

Note: Materials may be edited for content and length. For further information, please contact the source cited above.

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Journal Reference:

1. Michael H. Lee, Jeremiah D. Schuur, Brian J. Zink. Owning the Cost of Emergency Medicine: Beyond 2%. Annals of Emergency Medicine, 2013; DOI: 10.1016/j.annemergmed.2013.03.029

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/-2Lv_P_FvXM/130429130514.htm

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Navajo the chosen one for new 'Star Wars' dub

FLAGSTAFF, Ariz. (AP) ? In the new translation of "Star Wars," Darth Vader is Luke's bizhe'e.

The classic 1977 film that launched a science fiction empire and revealed the force within a farm boy who battles evil has been dubbed in Japanese, French, Spanish and about a dozen other languages. Add Navajo to the list.

Manuelito Wheeler, the director of the Navajo Nation Museum who reached out to Lucasfilm Ltd. with the idea, has a very good feeling about this. He sees it as entertaining, educational and a way to preserve the Navajo language at a time when fewer tribal members are speaking it.

"That's the beauty of what we're doing; we're teaching Navajo language to anybody who wants to learn the Navajo language," Wheeler said. "I find that very rewarding and somewhat ironic. We went from a country that wanted to limit our language, to the Navajo language saving our country through Code Talkers, to our language being part of a major motion picture."

Native languages on the big screen are a rarity. Independent films and documentaries at film festivals have been in the tongue of American Indian tribes. Yet it's far less common to see it done in mainstream movies and shown in commercial theaters. "Bambi" was dubbed in the Arapaho language, and the cartoon series "The Berenstain Bears" was translated into the Dakota and Lakota languages.

"There's a little bit of precedent but nothing like 'Star Wars' in the Navajo language," said Michael Smith, director of the American Indian Film Institute and a member of the Sioux Tribe of Montana.

A team of five Navajo speakers spent 36 hours translating the script for "Star Wars Episode IV: A New Hope," and now they're looking for fluent Navajo speakers to fill some two dozen roles. Casting calls are scheduled Monday in Burbank, Calif., and May 3 and 4 ? the unofficial "Star Wars" holiday ? at the Navajo Nation Museum in Window Rock, Ariz.

Potential actors shouldn't worry if they don't sound exactly like Princess Leia, Luke Skywalker or Han Solo, only that they have Princess Leia's spunk and fire or Han Solo's daring, bad-boy-next-door attitude. Chewbacca and R2D2 will keep the language they speak in the Navajo version, and technical effects will be applied to Darth Vader and C-3PO so they sound like the originals, said Shana Priesz, senior director of localization for Deluxe, the studio overseeing the dubbing.

"Having the voice match isn't as much as I want someone who can deliver the lines," she said.

Wheeler and William Nakai, one of the translators, declined to say how some catch phrases or sci-fi jargon in the movie might carry over into Navajo. But Laura Tohe, a fluent Navajo speaker and English professor at Arizona State University said the translation process could have been similar to what Navajo Code Talkers did in coming up with communication that confounded the Japanese during World War II.

The Code Talkers recruited from the Navajo Nation were unfamiliar with things like grenades, observation planes, tanks and dive-bombers. So they thought of something on the reservation that had similar qualities. Grenades became potatoes, observation planes became owls, tanks became tortoises and so on.

"May the force be with you," might translate into "may you walk with great power," or "may you have the power within you," she said. It also might include a reference to mountains, which are a source of strength for the Navajo people.

Galaxies, stars and outer space are not far off concepts for Navajos, who sometimes base ceremonies on moon phases and constellations, Tohe said. Those words would translate directly.

"The Navajo people, like all indigenous tribes, were very observant of not only the world around them but the stars and constellations," she said. "I associate that with science fiction in a lot of ways. I think they would be well aware of it in "Star Wars," it takes place up in the heavens."

The first opportunity to see the film in Navajo will be during the tribe's Fourth of July activities in Window Rock and later in the year during the Navajo Nation Fair. Wheeler said he then plans to take it on tour across the reservation, which stretches into New Mexico, Utah and Arizona, and metropolitan areas with large Navajo populations at no cost to viewers. The Navajo Parks and Recreation Department is funding the project but wouldn't say how much it costs.

Anyone who doesn't understand Navajo can read English subtitles on the film as another tool to learn the language, Priesz said. More people ? nearly 170,000 ? speak Navajo at home than any other American Indian language, according to the U.S. Census Bureau, but it is being lost upon younger generations.

"You could have a grandmother that speaks Navajo, and she understands it but is sitting there with her grandson who doesn't speak Navajo," Priesz said. "He could be reading it, so they both can enjoy it."

___

Online:

www.navajonationmuseum.org/

Source: http://news.yahoo.com/navajo-chosen-one-star-wars-dub-145333500.html

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Could Hyundai Avoid Epic Suicide Ad PR Crisis - Business Insider

Hyundai / YouTube

A shot from the commercial.

After releasing an ad that tries to find comedy in a man's failed suicide attempt ? the "joke" being that the new car's exhaust emissions are made of water rather than carbon monoxide and, thus, aren't toxic ? Hyundai has unsurprisingly found itself in the midst of a PR crisis.

After freelance copywriter Holly Brockwell's heartfelt blog about her father, who successfully killed himself by inhaling his car's exhaust fumes, went viral Thursday, both Hyundai Motor America and the company as a whole, released apologies for the European-made ads.

Hyundai is in trouble with the public, but could the company have done anything to prevent it?

The most obvious answer, of course, is that the ad should never have been made and certainly never approved. Barring public service announcements, suicide has no place in advertising ? especially as a joke.

(Pepsi got in trouble for ads that came out in Dusseldorf in 2008?which a personified calorie committed suicide in various graphic ways.)

But even after the green light, Hyundai dropped the ball in a way that contributed to its current PR crisis.

On April 19, a full six days before Brockwell wrote her condemning blog post, Adweek published an article criticizing the "suicide" commercial.

While the story didn't immediately appear on other major media sites or incite mass outrage, it laid out the problems and noted, "Neither Hyundai nor ad agency Innocean responded to queries."

And there's the problem.?

Reporter David Gianatasio directly reached out for comment. And it looks like he was ignored. Perhaps the company thought the issue would go away on its own, but they were mistaken ??and it resurfaced in a major way, six days later.

Of course there's a risk involved in drawing attention to an issue that might magically disappear before the mass public has become aware of the misstep. Maybe Brockwell would still have seen the video and written her passionate piece, even if the company had apologized in Adweek.

But failing to acknowledge the mistake can be worse, and make the company look more callous.?

Assuming that a problem will go away and people will stop watching the ad on their own is a fundamental misstep. Companies can't assume that the internet will just forget.

The ad was bound to gain attention, and an earlier apology might have lessened the blow.

You can watch the ad below:

Source: http://www.businessinsider.com/could-hyundai-avoid-epic-suicide-ad-pr-crisis-2013-4

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How much does a trip to India cost? | Live Free Die Travelling

So you have a dream to travel to India and you need an answer to the simple question? ?How much does it cost to travel to and in India??
Well that really depends upon a number of factors; some which apply to all travellers, some which are consequent upon your itinerary and others which are very specifically determined by the comfort and style of travelling that only you can select.

6 weeks in India

My partner and I have just returned from a 6 week tour of India when we made every effort to realise her childhood dreams of visiting some of the most significant ancient places in India including the Taj Mahal in Agra and the Golden Temple at Amritsar.

Quit our jobs

Having resigned our positions in fairly stressful occupations and been going through a precarious house sale we decided our first incursion into the madness of India should be into the less frenetic Kerala State in the south for a relaxing recuperation on the beach. After that we moved throughout India in an attempt to capture as much as possible but certainly not wishing it to be a pure ?Tick in the Box? lightning tour.

What do I need to know?

I will attempt to highlight all the considerations needed to plan your tour of India and begin to understand the cost implications of each decision. Based upon our financial situation we decided, even though we might easily have afforded more, to average no more than ?65 daily but in this cost was the amortised cost of our flights which were paid for up front.

?65 daily budget for all costs including flights

For the backpacker this will shock because this is a huge amount on a backpacker budget but for us as house owners and ex professionals in our 50s, having become accustomed to good standard hotels, food, travel etc, this was sometimes a challenge but generally speaking quite fun to keep stock of on the trip. After all we no longer had jobs to support us!!

The factors to be considered (in no specific order of importance)

• Getting to India
• Accommodation in India
• Travel throughout India
• Activities in India
• Tourist Attractions in India
• Food and Drink
• Currency Exchange Rate
• On line banking
• Insurance
• Health
• Passport validity dates and Indian Visas
• Religious, Spiritual or Self Development ambitions
• Luggage
• Onward travel

Now- In more depth

Getting to India

• Where are you coming from?
• Is this a separate stage in a longer Asian tour
• Do you wish to fly or perhaps cruise on a liner
• Cost of flights
• Our flight costs from London Gatwick to Cochin International via Dubai were ?530 rtn and identified using Skyscanner a very convenient to use travel comparison site.
• Do you wish to break up your long haul flight with a stopover
• Do you wish to fly Economy, 1st Class or Business Class
• Do you have frequent flyer miles you could utilise
• Do you have a favourite airline and if so does it fly to India
• Which airport in India do you wish to land in and then where to leave from (we flew into Cochin and departed from Delhi to avoid having to return all the way to Cochin)?
• How will you get to the airport in your country (to avoid heavy parking charges for a 6 week period we hired a ?one way? car rental with drop off at Gatwick Airport)?cost about ?35
• Could you make this a ?Round the World? experience and take advantage of some offers on multi stop tickets whilst at the same time possibly visiting other countries you have always had on your ?bucket list?
• If you think there is a likelihood that you may wish to change dates on your flight/flights then consider buying a flexi ticket for a small premium giving you additional flexibility. I did this on my return ticket to allow me to extend my trip and achieved this through STA Travel who provided and excellent service.

Accommodation

• This comes in all forms from Former Raj Palaces, Colonial Mansions, small guest houses (homestays), budget, backpacker, 5*, houseboats and all manner in between
• To capture the true essence of India and to stimulate our passion for variety we sought to use as many different accommodations as possible within our budget.
• What is your tolerance to ?unusual? standards and could you adjust?otherwise you may have to consider quite expensive options to meet your standards?this is India the place you want to experience and it would not be India if everything was as you would expect back home.
• We would recommend booking your first night in any new location via the internet to ensure you reduce the stress related with searching in a new environment?often in the early hours of the morning.
• We usually booked a basic double room with en suite facilities and paid between Rs700 and Rs1400 but on the special occasion of my birthday, whilst visiting the Taj Mahal, we spent Rs2500 on the room.?
• The 24 hour Houseboat experience cost Rs9000 for two of us and this gave us our own room on board with and evening meal and breakfast served to us. The boat was ours exclusively and the slow meandering around the backwaters of Kerala is very much recommended.
• By stark contrast, and to gain an extra experience and a relaxing chill out we booked the Uppal Hotel in Delhi close to the airport so that we could do nothing other than relax by the pool before heading home?a sort of airlock/recalibration experience. This 5* luxury cost ?45 with the meals on top pretty much doubling that. Trust me though, whilst this piece of luxury may have been welcome after 6 weeks on the road and rail it was nothing other than what you would expect from a quality hotel ANYWHERE in the world?.this had nothing Indian about it other than some misinterpretations in the language.

Travel internal to India

Flights?

Trains

Now?you simply have to experience at least one train trip whilst in India otherwise you will never be able to tell the folks back home you REALLY experienced India.
Trains are extremely cheap, really cheap, cheap or very reasonable dependent upon the class of carriage you opt for. India has the largest rail network in the world and there is an excellent article outlining everything you need to know about trains in India here.

But in summary you have 3rd class, 2nd class, sleeper class and first class with variables dependent upon whether you go for the A/C (air conditioning) options which are not always available on certain routes. The express train is an oxymoron compared to European or American high speed services but will still get you there marginally before the non-express train.

Costs for our train journeys varied from Rs300 to Rs1600 (exchange rate at time ?1=Rs80) and these were all significant distances and usually overnight with varying sleeper classes experienced (we NEVER went cattle class because despite it costing only a few Rupees? this was just not worth it?packed, dirty and uncomfortable as opposed to packed, fairly dirty and less uncomfortable!)

Booking rail tickets has its own complications and is one of the areas which DOES require a little bit of prior planning. Do take additional photocopies of your passport with you along with additional passport type photographs?India is not quite up to speed with paperless processes so it is good to be prepared. These precautions could help you gain access to the emergency tourist quota of tickets available on most trains at a slight premium.

Bus

Like the trains in India there is a massive network which is the mainstay transport for the majority. It does mean there are varying standards however; in general, any routes servicing the needs of the tourist have a variety of buses and standards.
The bus is cheap. Munnar to Bangalore was about Rs1600 for two on a ?Volvo deluxe sleeper? and was about 11 hours journey?.at least two hours of which was equivalent to the scariest ride in Disneyland!!
There are standard tourist class buses similar to the UK National Express (old version of course) or the American Greyhound services and then there are the buses catering for overnight journeys which can be semi sleeper or full sleeper and we tried both of these. Usually you will need to take the bus from remote places like Daramsala, Periyar, Munnar etc because the rail link does not reach here and you only other option would be to hire a taxi (driver and car as opposed to a metered ride)

Taxi

We discovered whilst in Kerala that the best way to get to some of our destinations was by hiring a driver and car (taxi) at a negotiated fixed rate dependent upon the distance covered and the terrain. We used drivers on numerous occasions and this did give us flexibility and saved worrying about directions, catching buses, changing buses, toilets etc?all covered and accommodated by having your own man. For backpackers this appears expensive but if you have a few people going the same way then it provides and economy of scale with no hassle.
A driver and A/C car will cost between ?25 and ?40 per day and the trip can be up to 5 hours driving into the hills, it sounds perhaps a little expensive but when you consider the time and distance this is pretty good value. A friend of ours from Wales, UK, hired a driver for 2 weeks and directed him to find good clean budget accommodation each evening as part of his duties and the cost was about ?400 for the 2 weeks?and the experienced chauffeur took them to places they could never have expected to reach by public transport?.and they did not have to worry about the accommodation (cost of accommodation was separate but the driver was directed to find it within the budget set by our friend)

Auto Rickshaw

Everywhere in India has its own auto rickshaws or tuk tuks?.you will simply have no option but to use them but after the first time when you will probably be frightened for your life you will come to enjoy the freedom to see around and simultaneously be mesmerised by the driving antics all around you.

These modes of transport afford you the best, quickest and most reliable form of short distance travel?enjoy.

The price is another element of course and you simply must agree the price prior to getting in the tuk tuk. The driver will ALWAYS request a higher fare so the easiest and best way to negotiate a price/barter if you are not familiar with the ?going rate? is to cut the drivers price in half and then when he gasps just insist it is your last offer?he will come back with different and then you can decide to be fair and add about 10-20% on top of your final offer. The process is fun and let?s face it the costs are ridiculously low compared to a cab in our country?a good friendly driver is worth holding on to and they will undoubtedly offer you their extended services. Rides cost from Rs10 to Rs250 on long journeys.

Where to visit

India is a massive country and the question of where to go is probably the biggest set of decisions to be made in the planning of your trip.
That said, our trip was largely spontaneous so we planned nothing other than our first port of call and then ?winged it? from then on; but this was OUR conscious decision because we wished for the flexibility this afforded us you may well need to organise things differently. In the whole of this marvellous country we had only two key places which were ?must sees? and the journeys between were easy to fill with unique experiences in this land of plenty.
Arriving in a city is one thing; the ?attractions? in that city are another; so you need to be prepared for the number and scale of what there is to see in each location. Travel guides and websites like this one have a wealth of useful information to help make your choices.

Attractions & Things to Do

All attractions will have an associated cost whether it be in getting there or entrance fees once you do get there. Because they are common places of worship, most of the temples are cost free other than your cost to get there, the exceptions being the ?Muslim Mosques where you will often incur a cost. As an Indian citizen the entrance cost for most attractions is a mere RS20 when to the tourist the costs range from Rs100 to Rs750 at the Taj Mahal (but worth it for sure).

Wildlife reserves and the official and unofficial safaris or tours come at a price and in most cases these are actually set by the Government which means that most tour operator offer almost EXACTLY the same tour dressed up slightly differently.

A worthwhile visit to a Spice Garden in Periyar was Rs100 and worth every Rupee whilst the entrance fee to the Tea Museum & Factory was about Rs500 and didn?t match the garden for value. The facts are that you WILL pay??out so just budget for it.

My estimate would be to factor in Rs300 per attraction and the cost should average out nicely

?Places of Interest

• Temples?
• Mosques
• Wildlife reserves
• State Monuments
• People Places
• Shopping opportunities
• Adventure opportunities
• Food, Drink and Culture
• Museums
• Formal Gardens
• Botanic Gardens
• Zoos
• Galleries
• Theatres
• Parades
• Festivals
• Rituals
• Villages

Insurance

• A good comprehensive insurance is a must when heading to foreign countries and perhaps more so when heading to India with the omnipresent potential for ailments due to the completely different culture.
• Insurance is often best purchased on a long term basis so that it covers for more than one trip but you do need to be conscious of length of trips.
• Age plays a factor in your insurance?.my son bought yearly backpacker insurance for a pittance ?but the same company would not cover me because I was over 55. I eventually gained insurance for 4 months for about ?120.

Food and Drink

Food

One of the reason for travelling to India must surely be to sample the fantastic aromatic and spicy dishes on offer around the country. As for the budget then the news is fairly good depending upon where you eat.

You can experience great food from many of the kerbside stalls, experience equally great food from the many shady looking cafes and restaurants, experience equally wonderful food in better surroundings and trappings in a more expensive place. Generally speaking though, regardless of how diligent you are at?hygiene, there is every chance you might get the dreaded Delhi belly at some point and the guarantee is you will have no clue which part of the Indian culture brought it on!

Sensible precautions are obviously recommended but even this may do nothing other than perhaps spoil an experience of a lifetime by not trying some of the local food.

?2 for breakfast ?4 for lunch and ?4 for evening meal

As for the cost?.meals in middle of the road restaurants will cost between ?1 and ?4 for most main courses?often for the whole meal including drinks. Budget for about ?2 for breakfast ?4 for lunch and ?4 for evening meal if you can stomach it. We probably did not come near this though and the portions of food in general are enormous. Sadly this was no help to me because my partner is vegetarian and I aint?.she wins in India!!!

Drink

Drink though is much more of an issue. Unless you are staying 5* and prepared to pay a sizeable amount for a bottle of wine?forget wine on the trip. The local wine we sampled was the only drink?almost in my whole life?that I refused to drink and sent back.

All?alcohol?in many parts of India is restricted to say the least but when available and on offer, beer will cost between Rs150 and Rs350 per 650ml bottle.

In Rishikesh for example there was no beer ANYWHERE and no meat either?despite this we actually stayed here the longest period during our trip.

Currency Exchange Rate

Little to say on this one other than to gauge when the right time is to change any currency but the best option is to load up a Cash Currency Card available from a number of places but we got ours from Thomas Cookes in UK. Thisis a safe way to carry currency and saves on cash withdrawal charges.It is just like a debit card really but preloaded.

Online Banking

There is no cost implications here but it is worthwhile notifying your bank so that your card is not stopped. Be aware that you willincur banking charges for each withdrawal?and this can mount up because the maximum I have been able to withdraw per visit has been Rs10000 just over ?100. It is worth taking two bank cards if you have two bank accounts?just belt and braces.

Health

• Make sure you have any medical and dental check-ups needed before travelling
• Make sure you have all?inoculations?and jabs?relevant?to where you are visiting; some of these will cost to have updated.
• If travelling for a longer period ensure you have sufficient medication or contact lenses to last the duration.
• Purchase what ever Malaria protection your doctors recommend.
• Medical assistance in India is remarkably good and surprisingly cheap too.

Passport validity dates and Indian Visa

Your passport must have sufficient time left on it otherwise you will need to consider renewing it prior to travel at the relevant cost.

You will certainly require a visa and this varies in cost from country to country. In the UK we paid ?100 but you dohave to send away your passport and allow time for processing so do allow at least 2 weeks.

Religious, Spiritual or Self Development ambitions

If you are intentupon conducting any courses whilst in In India you should factor in the cost of these. There are a plethora of yoga, meditation and slf enlightenment courses on offer virtually everywhere in India and the difficulty will be to determine one that suits and at what cost.

As an example, yoga and meditation courses we attended in and Ashram in Rishikesh cost us Rs100 to Rs150 per session and a course can last pretty much any length of time you wish.

Luggage

All the Samsonite and Gucci designer luggage is going to be wasted in India. There are few places you could use a ?wheelie? case so dont even consider bringing it. Both of us bought rucksacks with front opening capability and are really glad we done so?but it is an extra expense of about ?50 to ?110.

Onward travel

If you have booked return flights then this really doesn?t apply but for me I had decided to head into Nepal and so there is the cost?associated?with this to consider.

My flight from Delhi to Kathmandu cost ?60 and my entry visa another $40.

Summary Cost

The final figure for our trip is now fully realised and we were able to stay within our budget give or take a few quid so the upshot is that doing a long trip like this is possible on ?65 per day.

If you do decide on a shorter trip then obviously the cost of the flights would be more significant when looked at on a daily basis.

I hope this brief article might help you at least to consider certain elements in your planning and if you have questions on any aspect please feel free to post a comment and I will respond fairly sharply?..safe trip and do not be put off by some of my flippant comments?India is a unique and wonderful place to travel to.

cheers ?Gary

How much does a trip to India cost?

Need more info, have a question or got some feedback? If so, please use the comments section below and I'll get back to you in a flash! ?

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Source: http://www.livefreedietravelling.com/travel/how-much-does-a-trip-to-india-cost/

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Maude Standish: Data Is The New Astrology - Huffington Post

Wearable technology is going to change everything. Yes, it will change when, where, and how we "connect." But, even bigger than that, it will reshape the way we find happiness--no longer looking for it in self help books or friends' advice. Instead, in our search for answers and fulfillment, we will dive into the data our bodies and actions create.

Data will become the new astrology. We will use it to divine our personal futures and deconstruct our present. It will alter the "human ideal" and change the meaning of what we think of as "success." Perfection will be quantified and comparable. We will search less in our own interior brains and memories for the answers but instead we'll try to understand ourselves in the context of others. We will know averages for happiness, weight, sleep, laughter, excitement, how clean our hands are, how strong our brain is--to be told exactly how we compare to those averages, rank listed among our peers.

Despite Heidegger's assurances that our own actions are technology, most of us understand technology as something separate from our bodies. It is something we make, control, hold, and are disconnected from. But, to feel fulfilled, the growing societal shift towards a culture of constant connectivity and data worshipping has made us increasingly reliant and emotionally dependent on technology.

As we've entered a co-dependency with technology, we've grown more open to applying it internally and externally to our own bodies. Responding to this new market, a growing crop of wearable technologies have popped up, each with its own compelling promise on how they can modify our lives positively.

There is the IntelligentM, a digital wristband that alerts medical employees if they haven't washed their hands well enough. Though it's currently only being used in the medical world, it's easy to foresee how it could move like Purell out of the medical community to the general population. There are all sorts of fitness related wearable technologies dedicated to tracking your health and wellbeing, including Nike's FuelBand, FitBit, and Jawbone Up.

It's impossible to talk about wearable technology without bringing up Google Glass. Though the glasses have already been worn down the runway during fashion week, the specs were announced only recently, giving us a clearer idea of their capabilities. We now know that the glasses will have 12 GB of usable memory synced with Google cloud storage and 16GB Flash memory total. Supposedly, the battery is made for an entire day of use, though video and recording and Google Hangouts will drain it quicker. Through the glasses you'll be able to take photos, access apps, connect to the web and effortlessly track much of your day.

Sure, Goolgle Glass isn't mainstream yet, but they have slipped into the popular imagination enough to inspire their own slang such as "Glassholes." There is little doubt in my mind that with the help of hip companies like Google and Nike, the integration of wearable technology (and the data tracking it has to offer) will likely be ubiquitous in five years time. And as wearable technology continues to effortlessly collect data about us, we will turn to that data to "solve" our problems. Advice will be dished out not from friends' mouths, but from algorithms. We'll distinguish "right" and "wrong" by what is above average or below average. Instead of eagerly looking at tomorrow's horoscope, we will download yesterday's data in order to see our future.

A version of this blog was originally published on Metropolis Magazine.

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Follow Maude Standish on Twitter: www.twitter.com/MaudeChild

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Source: http://www.huffingtonpost.com/maude-standish/data-is-the-new-astrology_b_3150148.html

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YouTube's first Comedy Week kicks off May 19th, features big-name lineup

Whether it's politics or flamboyant music videos, YouTube certainly has a little something for (mostly) everyone on the interwebs. But, if you're a fan of comedy, things are about to get a tad bit better: on May 19th, YouTube's set to launch its own Comedy Week, a first for the Google-owned video giant. As part of the various live streams, online viewers will be able to enjoy "a mix" of stand-up sets, sketches and music shows -- which includes performances by a slew of well-known productions and comedians, such as Funny or Die, CollegeHumor, Improv Everywhere, Ed Helms, Seth Rogen, George-Michael Michael Cera and many, many more.

According to YouTube, the goal for Comedy Week is to "create a one of a kind experience" for those who love the genre, with VP of Marketing Danielle Tiedt adding that the site is indeed "the home of comedy for the next generation." Chances are it'll be a week filled with plenty of LOLs, so perhaps you should take this time to bookmark the corresponding channel -- link for that can be found in the PR after the break.

Filed under: Home Entertainment, Internet, HD, Google

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Family upset over Air Force officer's transfer

PHOENIX (AP) ? The Air Force's decision to transfer a lieutenant colonel to a Tucson military base after his sexual assault conviction was overturned by a commander has outraged the family of the woman who made the allegations, adding to the growing criticism of the military justice system.

The family says Lt. Col. James Wilkerson' transfer of to Davis-Monthan Air Force Base on the southern edge of Tucson is upsetting because roughly half the woman's family lives there. They're planning a protest Thursday outside the base.

The news comes amid a congressional uproar over the Wilkerson case, and follows heavy criticism of the military's handling of another case involving sex-crime allegations in California.

"They could send him to a number of places," said Stephen Hanks, an orthopedic surgeon in Tucson who is the brother of Wilkerson's accuser. "Why send him to a place where her family lives? It makes no sense."

The woman, a civilian employee who works with service members, accused Wilkerson of sexually assaulting her after a party at his house. Wilkerson and his wife denied the charges but said the woman stayed at their house that night.

A military jury in November convicted Wilkerson, a former inspector general at Aviano Air Base in Italy, of aggravated sexual assault and other charges. He was sentenced to one year in prison and dismissal from the service.

But a commander overturned the verdict and dismissed the charges, saying he found Wilkerson and his wife more believable than the alleged victim. Wilkerson already has reported for duty in southern Arizona, where he will work as a safety officer for the 12th Air Force.

Air Force spokesman Lt. Col. Brett Ashworth said military officials wouldn't have known about the woman's family in Tucson when Wilkerson's transfer was decided.

"His assignment was based on his qualifications and the needs of the Air Force," Ashworth said.

Wilkerson declined an interview request from The Associated Press.

The decision by Lt. Gen. Craig Franklin, commander of the 3rd Air Force at Ramstein Air Base in Germany, to overturn the verdict has been criticized by congressional leaders and advocates for confronting the problem of sexual assaults in the military.

The move led the Defense Department to propose that commanders be largely stripped of their ability to reverse criminal convictions of service members.

Under military law, a commander who convenes a court martial is known as the convening authority and has the discretion to reduce or set aside guilty verdicts and sentences, or to reverse a jury's verdict.

Protect Our Defenders, which advocates for military members who have been sexually assaulted, is calling for Defense Secretary Chuck Hagel to fire Franklin. The group's president, Nancy Parrish, said the Wilkerson case demonstrates that the military justice system needs to be changed.

Commanders who have broad authority in letting cases go forward face a conflict of interest, Parrish said.

"They are incentivized to sweep these cases under the rug. A commander's career is on the chopping block if a rape happens under his or her watch," said Parrish, whose group is pressing the Defense Department on behalf of Wilkerson's accuser.

The military justice system also came under heavy criticism in February, after a former soldier killed two police officers in California.

Records show the Army commander of the former soldier, Jeremy Goulet, allowed Goulet to resign from the military instead of facing a court-martial when he was twice accused of rape. The Army said a lack of evidence prevented it from prosecuting Goulet on charges dating back to 2006.

Critics say Goulet's case is as an example of what can go wrong when military cases are dropped.

Goulet shot and killed two detectives when they went to his house to question him about allegations that he was sexually inappropriate with a former co-worker. Goulet died in the Feb. 26 shootout with police in Santa Cruz, Calif.

Ashworth declined to comment on the group's call for Franklin to be fired. Franklin declined an interview request from the AP.

In a letter to a Pentagon official that surfaced earlier this month, Franklin said a combination of details led to his decision, including that the victim turned down offers to be driven home from the party, didn't accurately describe the house layout and gave a version of events that he didn't find credible. He said Wilkerson was a doting father with a good career, and it would be "incongruent" for him to leave his wife in bed, go downstairs and assault a sleeping woman he'd met earlier that evening.

Protect Our Defenders issued a response to Franklin's letter Tuesday, saying Franklin's account of the woman's options for rides home was inaccurate, Franklin showed blind loyalty toward the accused officer, and that the jury found the woman's story credible.

Source: http://news.yahoo.com/family-upset-over-air-force-officers-transfer-080951538.html

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Bush's Global Legacy of Death and Destruction

Yahoo News asked voters to consider President George W. Bush's legacy as his presidential library opens Thursday in Dallas. Here's one perspective.

COMMENTARY | George W. Bush's global legacy is one of widespread death and destruction, epitomized by the so-called War on Terror his administration waged in response to the horrific September 11, 2001, terror attacks on New York and Washington.

The invasions and occupations that followed resulted in the deaths of more than 15,000 innocent civilians in Afghanistan and more than 100,000 in Iraq-- a nation whose fate "The Decider" allegedly decided long before 9/11. In addition to the dead and the maimed, Bush's wars have caused a refugee crisis in which millions have been displaced.

Then there are the wartime atrocities, for which Bush ultimately bears responsibility. These include, but are by no means limited to, torture, murder, intentional false imprisonment of innocent men, women and children, and rape. Additionally, Iraq was left in utter ruins and it is very likely that toxic poisoning from U.S. weapons is behind an alarming spike in horrific birth defects among Iraqi children.

While Bush did not personally authorize most of these crimes, top officials in his administration certainly did and, ultimately, the president is responsible for what happens on his watch. Bush may not have ordered the torture and murder of innocent detainees at Abu Ghraib or the rape and murder of Iraqi children by American troops, but he did endorse the wars and the gloves-off approach that guided U.S. actions in them. He did authorize Guant?namo Bay, waterboarding, drones, extraordinary rendition and secret prisons operating outside the boundaries of the law. As Vice President Cheney once said, the U.S. had gone over to the "dark side."

Sadly, not only has President Barack Obama protected Bush and his top administration officials from facing justice, the new president has continued -- and expanded -- some of his predecessor's deadliest policies and actions.

The death and destruction of American policies and actions did not begin nor end with George W. Bush. But during his tumultuous tenure, they reached a level unseen since the senseless slaughter of Vietnam. This, ultimately, is the legacy of America's 43rd president.

Brett Wilkins is a San Francisco-based author and the editor of Moral Low Ground.

Source: http://news.yahoo.com/bushs-global-legacy-death-destruction-211500305.html

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New private rocket launches into orbit on maiden voyage

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NASA / Bill Ingalls

The Orbital Sciences Corporation Antares rocket is seen as it launches from Pad-0A of the Mid-Atlantic Regional Spaceport (MARS) at the NASA Wallops Flight Facility in Virginia, Sunday.

By Tariq Malik, Space.com

A new commercial U.S. rocket soared into the Virginia sky Sunday on a debut flight that paves the way for eventual cargo flights to the International Space Station for NASA.

The third try was the charm for the?private Antares rocket, which?launched into space from a new pad at NASA's Wallops Flight Facility, its twin engines roaring to life at 5 p.m. EDT (2100 GMT) to carry a mock cargo ship out over the Atlantic Ocean and into orbit. The successful liftoff came after two delays caused by a minor mechanical glitch and bad weather.?

Built by the Dulles, Va.- based spaceflight company Orbital Sciences, the Antares rocket is a two-stage booster designed to launch tons of supplies to the International Space Station aboard a new unmanned cargo ship called Cygnus. Orbital has a $1.9 billion contract with NASA to provide at least eight resupply flights to the station using Antares and Cygnus. [See photos of Antares rocket's 1st launch]?

"Antares has delivered the A-ONE test mission payload into orbit," an Orbital Sciences commentator said. There were cheers out of Orbital's launch control room at ever successful stage of the launch, with the team breaking out in handshakes and hugs as the rocket reached orbit.?

Orbital had much riding on today's successful liftoff, which marked a critical test flight of a new commercial launch system.

The company has invested about $300 million developing the?Cygnus spacecraft?alone, slightly more in the rocket itself, Orbital executive vice president Frank Culbertson told reporters after the successful launch. The result, he added, was an amazing show with apparently no significant glitches aside from a brush fire ignited near the launch pad.

"This was a majestic liftoff during ascent," said Culbertson, who is a former NASA astronaut and Orbital's general manager for advanced programs. The Antares rocket as a low thrust to weight ratio, which means it has a slow start rising off the launch pad, he added. "It was a beautiful liftoff."

NASA chief Charles Bolden attended the launch and lauded the Orbital launch team on the successful flight.

"This is an incredibly historic day," Bolden told Orbital's team. "You couldn't have gone any farther without today. This was a first, huge step." [Launch Video: Antares Soars Into Orbit on 1st Flight]?

NASA TV

The first private Antares rocket built by Orbital Sciences Corp. launches toward space from NASA's Wallops Flight Facility in Wallops Island, Va., on April 21, 2013. It marks the first flight test for the rocket.

Virginia's biggest rocket launch?
Antares is the largest rocket ever to launch from?NASA's Wallops Flight Facility. It lifted off from the new Pad 0A, which is at Wallops but managed by the Mid-Atlantic Regional Spaceport (MARS) and overseen by the Virginia Commercial Spaceflight Authority. Altogether, the Commonwealth of Virginia and MARS officials spent about $140 million to build the new launch pad complex.

Today's launch was expected to be visible from locations all along the East Coast, from Maine to South Carolina, weather permitting. Orbital even released several photos advising what the rocket would look like from famous landmarks around the Capitol.?

Orbital initially tried to launch the Antares rocket on Wednesday but called off the attempt when a vital data cable separated from the rocket earlier than planned, about 12 minutes before liftoff. The company spent Thursday analyzing the glitch and opted not to try for a Friday launch due to foul weather. Strong winds forced a delay on Saturday, but Mother Nature cooperated for Sunday's launch.

In a Twitter post before launch, officials at NASA's Wallops facility reported that the site's visitor center was completely packed for today's launch, despite the delays. MARS officials hope the Orbital launches will help serve as a new source of tourism for the region.

"It's definitely something we're all excited about," Basia Shields, manager of the Lighthouse Inn on nearby Chincoteague Island, told SPACE.com before Sunday's liftoff. "I mean, this is the off season for us and almost every room is booked just for this thing."

Private space cargo ships?
Orbital Sciences?is one of two companies with NASA contracts for commercial cargo deliveries to the space station. The other firm is Space Exploration Technologies (SpaceX) of Hawthorne, Calif., which has a $1.6 billion deal for 12 space station cargo missions.

With the retirement of NASA's space shuttle fleet in 2011, the agency is relying on commercial companies like Orbital Sciences and?SpaceX to provide the vital resupply services ? and, eventually, crew launches ? required to keep the space station fully stocked and staffed. Before the commercial program, NASA was dependent on Russian, Japanese and European cargo ships for supplies, and it still temporarily relies on?Russian Soyuz vehicles?for crewed missions.

"This is a new way of doing business, and with any new investment, there is a risk," Alan Lindenmoyer, head of NASA's commercial crew and cargo program at the Johnson Space Center in Houston, told reporters after the successful launch. "But it sure is nice to see a return on that investment and things go your way. I think this is a great day for everyone."

NASA picked Orbital Sciences as a commercial cargo partner in 2008, awarding the firm $288 million to begin developing the Cygnus spacecraft under the agency's Commercial Orbital Transportation Services program.?SpaceX?won its first COTS award in 2006.

"This is the culmination of a plan that we've been on for several years," NASA deputy administrator Lori Garver told reporters before the Wednesday launch try. "I am thrilled to have two competitors."

Garver said that at least two companies providing cargo services for NASA is vital since it assures access to space and does not allow one company to have a monopoly on station cargo deliveries.

Orbital and SpaceX also offer slightly different services. Unlike SpaceX's?Dragon space capsules, which can return cargo to Earth from the station, Orbital's Cygnus vehicles are disposable and are intentionally burned up in the atmosphere at mission's end.?

NASA TV

The Earth drops away from Orbital Sciences first Antares rocket in this amazing view captured by the rocket's ATK-built second stage during a test launch on April 21, 2013.

Antares test flight success?
During the test launch, the Antares rocket launched on a southeast trajectory over the Atlantic and took 10 minutes to reach its target orbit 155 miles (250 kilometers) above Earth. The rocket carried an 8,377-pound (3,800 kilograms) dummy payload to mimic the weight of an actual Cygnus spacecraft. The mockup was packed with 70 sensors to record how the Antares rocket launch would affect a Cygnus vehicle.

"It looks like all the expectations we had for today's flight were beautifully met," Lindenmoyer said.?

The dummy module is expected to spend at least two weeks in orbit before burning up in Earth's atmosphere, Orbital officials said.

Antares also carried three?coffee cup-size Phonesat satellites?? called Alexander, Graham and Bell ? into orbit as part of a space technology experiment for NASA's Ames Research Center in California. The tiny 4-inch-wide satellites use commercial smartphones as their main computers. Another small satellite the size of a bread box, called Dove-1, also rode into orbit as part of a commercial agreement for the California-based company Cosmogia. Dove-1 is reportedly an Earth-observation and remote sensing satellite, according to a NOAA remote sensing license document.

Orbital's Antares rocket is a two-stage booster that stands 131 feet (40 meters) tall and weighs 639,341 pounds (290,000 kilograms) at liftoff.?

The first stage is powered by two Aerojet AJ26 liquid-fueled rocket engines originally developed to launch Russia's giant N-1 moon rocket in the 1960s. Today's launch marked their first flight ever from U.S. soil.? The Antares second stage is a solid-fueled motor built by Allliant Techsystems (ATK), the same company that built the twin solid rocket boosters for NASA's space shuttle launches.

NASA / Bill Ingalls

The Orbital Sciences Corporation Antares rocket is seen on the Mid-Atlantic Regional Spaceport (MARS) Pad-0A at the NASA Wallops Flight Facility on April 16, 2013 on Wallops Island, Va.

With the test flight now complete, Orbital is now looking forward to up to two more launches this year, both of them headed to theInternational Space Station. That first cargo flight, a demonstration mission, could launch in late June or early July, Orbital officials said.

"This is not a one-shot deal," Lindenmoyer said. "They're going to be here awhile."

Culbertson said that Orbital hopes to launch Antares rockets from Wallops every three to six months for the cargo delivery flights.

Editor's note:?If you snap a great photo of Orbital's Antares rocket launch that?you'd like to share for a possible story or image gallery, send photos, comments and your name and location to managing editor Tariq Malik at?spacephotos@space.com.

?UPDATE:?This story was updated at 7:52 p.m. EDT to include new comments and details of today's Antares rocket launch.

Email Tariq Malik at tmalik@space.com or follow him?@tariqjmalik?and?Google+.?Follow us?@Spacedotcom,?Facebook?and?Google+. Original article on??SPACE.com.

Copyright 2013?SPACE.com, a TechMediaNetwork company. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

This story was originally published on Sat Apr 20, 2013 5:17 PM EDT

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Joe Berti, Marathon Runner, Witnessed Both Boston Bombings And Texas Explosion

People keep asking Joe Berti if he feels unlucky.

A bomb exploded at the finish line of the Boston Marathon moments after Berti finished the race. Two days later, he was in his home state of Texas when he saw a fertilizer plant explode near Waco.

"I was just like, `I can't believe this!'" said Berti, who said he had never witnessed an explosion before. Then he thought: "I just want to get out of here and get away from all these explosions."

But Berti, as it turns out, is far from unlucky. Instead, he feels fortunate. He left both tragedies unscathed, while members of his running group and his wife ? who was closer to the Boston explosion than he was ? were also unhurt.

"It's a miracle," he said Thursday in an interview with The Associated Press. "People keep saying, `Don't you feel unlucky?' and I was actually the opposite ? saying not only do I not feel unlucky, but I feel blessed that my wife could be 10 yards from the explosion and not have a scratch."

The bombings in Boston, which happened about 10 seconds apart at the finish line of Monday's marathon, killed three people and left more than 180 wounded. In West, Texas, which is near Waco, a fertilizer plant exploded Wednesday, killing at least five people, injuring more than 160, and leveling homes, apartments and a school.

"We're grateful that God has been merciful to us," said Berti's wife, Amy. "We are just praying for the people who were so much less fortunate than we were."

Berti's road to the Boston marathon started just a couple months ago, when he decided to run with Champions4Children, a charity that helps kids with rare or undiagnosed disorders and their families. He was one of eight Austin-area runners who ran the marathon with that group. Each ran for a sick child or "training partner," who tracked his or her runner's marathon progress from home.

During the last four miles, the 43-year-old Berti, who wore bib number 25472, felt his body shutting down, and his pace slowed. But he was running for his partner Drew, and he vowed to finish.

"I had just run to the finish line and... (moments) later I heard the first explosion, and then turned around and saw the smoke," he said. "I knew immediately that it was a bomb. ... Then the second explosion occurred and I saw a wave of people running."

At that point, he said, he was so exhausted he couldn't run anymore. He worried about getting caught in a stampede. He was concerned about members of his running group who were behind him. He also thought about his wife, whom he was unable to reach and was probably wondering where he was. He told himself she was fine, because she was supposed to be at a restaurant.

"But then, I was like, `She never listens to me, and she may have been at the finish line,'" a thought he quickly tried to remove from his mind.

As it turns out, Amy Berti and a friend were just yards from the first explosion. She had just taken a picture of Joe, and was heading to the finish line to find him when the bomb went off. She and her friend were both hit by shrapnel. Amy was uninjured, her friend was bruised.

But a woman right next to Amy had her leg torn off from the knee down, and lost all the fingers in her left hand. Amy Berti went to get help, and once that woman was being cared for, Amy's frantic search for her husband began.

His cellphone battery died. He wasn't on the bus. He wasn't in the medical tents.

"I had just watched him cross where that bomb was, so I didn't know if he made it through and I couldn't find him," she said. "I started to freak out a little bit."

After about an hour, the couple reunited at their hotel, both of them OK. They left Boston Tuesday morning and returned to Austin, with every hope of getting back to life as normal with their two girls, ages 8 and 11.

Joe Berti went back to work. On Wednesday, he had a daylong meeting in Dallas, followed by a museum tour. He was heading home on Interstate 35 and nearing Waco Wednesday night when he saw black smoke up ahead to his left. As he drove closer, he saw ? and felt ? his second explosion in two days.

"You've got to be kidding!" he remembers thinking. He described the giant fireball as a massive force that shook his car. He said it looked like pictures of nuclear explosions that he has seen on television.

He didn't know what he had just witnessed ? but he pulled over and took a picture.

"My next reaction was to get out of there because something fell on the top of my car ? some debris or something fell from the sky," he said.

As black smoke billowed over the highway in front of him, Berti held his breath and drove through it. After a few attempts, he was able to reach his wife ? sparing her another round of worry.

"I'm like, `Honey, what is with your luck? Why are you in all of these places?" Amy Berti said. When a reporter suggested that Joe should stay home for a while, she joked, "We need to keep him moving. Maybe he just needs to stand in an open field."

___

Follow Amy Forliti on Twitter: http://www.twitter.com/amyforliti

___

Associated Press photo editor Karly Domb Sadof and Susan James at The Associated Press News and Information Research Center contributed to this report.

Also on HuffPost:

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Source: http://www.huffingtonpost.com/2013/04/18/joe-berti-marathon-runner_n_3113489.html

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Humana says started internal review after private medicare leak

(Reuters) - Health insurer Humana Inc said on Thursday that it has begun an internal review of the events around an announcement on April 1 of a government policy change related to private Medicare.

News of the government's change in how it would reimburse insurers leaked into the market that day ahead of the announcement and Humana's shares rose sharply.

Humana spokesman Ton Noland confirmed that the company has started the probe and fired the law firm of the lobbyist who was working for Humana and who had been named by the Wall Street Journal as having been involved in the leak.

Republican Senator Charles Grassley of Iowa said after the Journal report that he had began looking into the circumstances of the announcement and that he believed the policy decision may have been leaked.

On April 1, the government was due to announce after the stock market closed details of how much it would pay insurers who provide private Medicare plans for the elderly, called Medicare Advantage. But about 20 minutes before the market closed, the investment research firm Height Securities sent out an alert saying that the government had decided to go with a more favorable payment plan, according to the Wall Street Journal.

The government then announced after the market closed that it would raise the reimbursement rate instead of cutting it by 2.3 percent, as it had initially proposed in February.

Insurers are reimbursed for Medicare Advantage, private insurance for seniors and the disabled by the government. This type of insurance accounts for about two-thirds of Humana's annual revenues. Insurers had lobbied loudly against the proposed cut, saying it would cost the industry $11 billion.

The Journal reported that a lobbyist who worked for both law firm Greenberg Traurig and Humana had been involved in the leak. Greenberg Traurig and Height Securities were not immediately available for comment.

The Centers for Medicare & Medicaid Services, which set the policy, said on April 9 that it was investigating the events around the decision. Shares of Humana, UnitedHealth Group Inc and Aetna Inc all soared on the news.

Humana did not have advance knowledge of the CMS decision on the rates, Noland said. News of the internal investigation was first reported in the Wall Street Journal on Thursday.

(Additional reporting by Sharon Begley, reporting by Caroline Humer; Editing by Bernard Orr)

Source: http://news.yahoo.com/humana-says-started-internal-review-private-medicare-leak-000539487--sector.html

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UBS industrials banker Knapp leaves for Blackstone: sources

NEW YORK (Reuters) - UBS' global head of industrial investment banking has left the firm to join The Blackstone Group's advisory business, according to two sources familiar with the matter.

Karl Knapp was also a vice chairman at UBS, which is working to revamp its investment banking business after a number of high profile departures over the last few years.

UBS Chief Executive Sergio Ermotti hired Andrea Orcel to reshape its struggling investment bank business in July 2012. Italian banker Orcel has since brought in a group of close collaborators from Bank of America where he and Ermotti worked for years.

The Swiss bank cut its overall bonus pool for 2012 by 7 percent to 2.5 billion francs and introduced a scheme under which bankers can be paid in a form of deferred financial instruments that are revoked if the bank's capital targets are not met.

Knapp and UBS could not be immediately reached for comment.

(Reporting By Michael Erman and Soyoung Kim; Editing by Kenneth Barry)

Source: http://news.yahoo.com/ubs-industrials-banker-knapp-leaves-blackstone-sources-214927631--sector.html

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Epic's Torq Roadster three-wheeled EV gets taken on a test drive (video)

While the Tesla Roadster did a great job of satisfying our jones for an electric vehicle with great performance and no roof, it was a bit pricey and is now out of production. Into that void steps the three-wheeled Torq Roadster from Epic EV, a team also responsible for that electric-engined DeLorean prototype we saw a couple of years ago. This video shows Translogic's Bradley Hasemeyer behind the wheel of the track-friendly (but also street legal, licensed as a motorcyle) vehicle and talking to the people who built it. It's not quite as fast as the Tesla Roadster, but it's still capable of 0 - 60 in about four seconds and a top speed of 110mph.

You'll notice a Samsung tablet mounted on the dash, and many of the components are sourced from Volkswagen. Unlike most of the daily driver-aimed electric vehicles we're familiar with that are very locked down, founder Chris Anthony claims its design allows owners to tweak and tune many features. Its DC motor means there's no regenerative braking, but he claims it's cheaper and allows owners to rewind the armature or upgrade the brushes. The first Torq Roadster was delivered earlier this month to a former Tesla exec and you can read about his experiences on BoostedGroup. Those of us who haven't paid the $65,000 base price can check it out in the video, which is embedded after the break.

Filed under: Transportation

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Via: Autoblog

Source: Translogic, TorqEV

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At desert monastery, Egypt's monks join new Christian assertiveness in face of Islamist power

ST. ANTHONY'S MONASTERY, Egypt - In a cave here high in the desert mountains of eastern Egypt, the man said to be the father of monasticism took refuge from the temptations of the world some 17 centuries ago. At the foot of the mountain, the monks at the St. Anthony's Monastery bearing his name continue the ascetic tradition.

But even this remote spot is touched by the turbulent times facing Egypt's Christians, who fear for their future under the rising power of Islamists. Monks normally immersed in spirituality are joining the increasingly assertive tone of many in the minority community, vowing Christian voices won't be silenced.

Their tone reflects the growing activist political role of the Coptic Orthodox Church, which for decades had adopted a quietist policy, avoided rocking the boat and relied on backroom dealings with the country's leadership to try to preserve the community's rights. In doing so, the church is essentially following the lead of many young Christians who ? caught up in the fervour of Egypt's revolution ? insist they must stand up for themselves rather than trusting politicians to protect them.

"Anyone who thinks of hurting our church will face divine retribution," Father Yacoub, the monastery's deputy head, told The Associated Press this week. "Our church grows stronger with martyrdom. My faith and confidence tell me that so long as our church is in the hands of God, no one can hurt it."

Islamist President Mohammed Morsi, of the Muslim Brotherhood, has vowed to promote equality between Egypt's Muslim majority and Christian minority. But Christians have been worried by the growing influence in society and government of Muslim conservatives and hard-liners, many of whom espouse rhetoric consigning Christians to second-class status.

A mob attack this month on the Cairo cathedral that serves as the seat of the Coptic pope raised alarm bells among Christians, who make up about 10 per cent of the country's 90 million people. There has been a surge in attacks on Christians and churches in the two years since the ouster of autocrat Hosni Mubarak. But for Christians, the cathedral violence laid bare their vulnerability. Morsi quickly condemned the violence, saying attacking the cathedral was like attacking him personally. But the Coptic Pope Tawadros II accused him of failing to protect the cathedral in an unprecedented direct criticism.

One of the world's oldest monasteries, St. Anthony's would seem a world away from such concerns, with its atmosphere of isolation.

Nestled at the foot of an imposing rock mountain in the desert near the Red Sea 100 miles (160 kilometres) southeast of Cairo, its fortress-like walls enclose churches, chapels and chambers for its around 100 monks. The oldest section ? a small chapel ? is believed to date to the 4th Century. Until several years ago, a spring was the sole source of water for the monks and their date palms and olive trees.

Little disturbs the routine of spiritual contemplation. Before dawn earlier this week, the monastery was still engulfed in darkness, only a sliver of moon in the sky, when the black-clad monks emerged from their cells. They walked up a cobblestone alley to the 15th Century Church of the Apostles to start their day with two hours of hymns and prayers.

With Orthodox Christians deep into Lent ? their Easter Sunday is May 5 ? that pre-dawn prayer is followed by three more liturgies, two hours each, the last ending at 5 p.m.

But the monks are definitely in touch. Yacoub sports both a Blackberry and an IPhone. He frequently drops mentions of what he reads on social networking sites. He is also willing to cast off some of the caution and diplomacy that the church has been renowned for in dealing with politics.

"If there is someone out there who thinks that persecuting the church or attacking the cathedral will drive us out of Egypt, then they are making a big mistake," said Yacoub, a 51-year-old trained engineer. "They are pestering us so as to drown the Coptic voice that rose during the revolution."

"No one can cover up facts or silence Egyptians any more. That party is over."

For monks to talk like this is a dramatic sign of the sentiment among Christians here. Egypt's estimated 1,200 monks constitute the heart and soul of the Coptic Orthodox Church, one of the world's oldest denominations. Monasticism is believed to have started in Egypt. St. Anthony, born in the mid-3rd Century, is believed to be one of the first, shedding his possessions to live in the desert. His followers gathered to first build the monastery here below his hermit's cave.

Over the centuries, monks offered spiritual guidance to Christians and have been seen as protectors during bouts of persecution through history, starting with the Romans. Egypt's monasteries saw a revival in the 1970s, and since then many have been renovated. Today, tens of thousands of Christians flock to festivals on saint's days at major monasteries like St. Anthony's and Deir el-Muharraq, near the Nile River in southern Egypt. They also often come individually for visits to pray and meditate through the night.

"The monks are the church's first line of defence because our role is to constantly pray to protect the church and comfort the flock," said 65-year-old Father Bakhomious, a monk at St. Anthony's.

He said the attack on the cathedral in Cairo was "painful ? a defining moment in the history of Egypt and the church."

"Revolutions have their cons and pros and we as Christians must endure and pray for stability and peace."

Another monk, Father Hedra, says the church can feel the worries among the flock. In a sign of Egypt's overall economic woes, donations of food by the faithful to St. Anthony's to distribute to the poor have gotten smaller, he said.

"People are weighed down by their troubles and they come to us to rest and breathe fresh clean air," he said. "I can also sense the burden on everyone from the attacks on the church. When we have a crisis like that last one, the whole church is praying."

Christians felt empowered by their participation in unusually large numbers in the 18-day revolution that toppled Mubarak's authoritarian regime. Like Muslims, they rose up to create a democratic state that safeguards the dignity and rights of all Egyptians.

The April 7 violence at the cathedral showed Christians' anger and readiness to push back.

The violence followed a funeral service at the cathedral for four Christians killed a day earlier in sectarian violence in a town north of Cairo. During the service, aired live on several TV networks, mourners broke into chants against Morsi and his Muslim Brotherhood ? an unheard-of show of politics inside a church. "Hold your head high, you are a Copt" and "We will never leave our country," were among the chants.

When several hundred mourners attempted to march outside the cathedral to protest the killings, a Muslim mob set upon them, pelting them with rocks and firebombs, leading to a battle between crowds inside the cathedral and outside.

Morsi ordered a full investigation, reassuring Christians about their safety. However, a senior presidential aide in charge of foreign relations later issued a statement in English saying the violence erupted when Christian protesters vandalized cars ? a comment Christians saw as blaming them. Islamist hard-liners delivered sharp public warnings to the church against involving itself in politics.

Tawadros, the pope, was dismissive of Morsi's promises, including his reviving of a commission on equality. "We want action not words and, let me say this, there are many names and committees but there is no action on the ground," he said.

Still, alongside their more assertive tone, the monks preserve their tradition of finding solace in prayer ? along with the long-term perspective engrained over the centuries.

"As monks, we will pray until God lifts his anger and help us cope with what we are facing," said a monk at Deir el-Muharraq in southern Egypt, also named Father Bakhomious. "Egypt has seen a lot over the ages and what is happening now is a chaotic phase that will eventually end," he added.

Source: http://news.yahoo.com/desert-monastery-egypts-monks-join-christian-assertiveness-face-205931003.html

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