Amid widespread flu, CDC calls for more antiviral use

first_imgWith signs of a rough influenza season continuing to accumulate, the Centers for Disease Control and Prevention (CDC) today said doctors too often are failing to use antiviral medications that could help high-risk flu patients.”They work, but they aren’t being used nearly often enough,” CDC Director Tom Frieden, MD, MPH, told reporters at a briefing. He referred to the neuraminidase inhibitors, including oseltamivir (Tamiflu), zanamivir (Relenza), and peramivir.Frieden said flu is widespread over almost the entire nation, and influenza A/H3N2 continues to be the predominant strain. Those factors and others point to a bad season.”Hospitalizations in the over-65 age-group are rising sharply,” with a cumulative rate of 92 per 100,000 people, he said. “That’s high, but typical of H3N2 seasons.”He also reminded reporters that about two thirds of circulating H3N2 isolates don’t match well with the H3N2 component of this year’s vaccine, noting, “Protection with vaccination against this drifted H3N2 virus will probably be reduced.” (Some experts, however, have said there is little correlation between vaccine match and effectiveness.)The flu season is now 7 weeks old, and a typical season is 13 weeks, he said, adding, “There are signs that flu activity might be declining in some states where the season started early. But it’s too soon to say if we’ve peaked.”Mixed flu markersThe CDC’s weekly flu activity update, issued today and covering the week ending Jan 3, shows generally high activity, but a few markers are down a bit from the previous week.For example, 26 states reported high flu activity, compared with 29 states the week before. On the other hand, 46 states reported geographically widespread flu, up from 43 states a week earlier.The share of clinic visits prompted by flu-like illness was estimated at 5.6% last week, down a bit from the 5.9% a week earlier. The proportion of respiratory samples that tested positive for flu also was lower: 24.7% versus 30.4%.The CDC reported 5 flu-related deaths in children, as compared with 6 the week before. That brought the season’s total to 26.The fraction of deaths attributed to pneumonia and flu last week was 7.0%, a notch above the epidemic threshold of 6.9%. In the previous week it was, at 6.8%, slightly below the threshold.A neglected toolFrieden said the CDC issued a Health Alert Network (HAN) advisory today encouraging the use of antivirals for high-risk flu patients. The advisory says flu should be high on the list of possible diagnoses for patients, given the high level of flu activity, and that all hospitalized and high-risk patients with suspected flu should be treated as early as possible with one of the three antivirals.”In the context of a less effective vaccine, treatment with an antiviral drug is even more important than usual,” Frieden said, referring to the H3N2 mismatch.He said many people don’t know there are prescription flu drugs available, and many doctors don’t prescribe them. One study, he said, showed that only 1 out of 5 high-risk patients who should have received antiviral treatment actually received it.He speculated that some clinicians may be unaware of the CDC guidance on flu antivirals, while others may wait for a positive flu test or may think that it’s too late to treat if a patient has been sick for more than 2 days. The CDC advocates not waiting for test results in high-risk patients and says treatment begun more than 2 days after illness onset may still be beneficial.”If people with underlying conditions who have flu or flu-like illness got treated, we could prevent potentially tens of thousands of hospitalizations and thousands of deaths,” Frieden said.In response to questions about the effectiveness of oseltamivir, he said studies have consistently shown that when treatment is started early, it helps reduce the duration and severity of flu illness. One study in hospitalized flu patients, he added, showed they were much less likely to end up in intensive care if they were treated.No major shortagesFrieden said a few spot shortages of antivirals have been reported this season, but no major supply problems. “You may have to call around to a couple pharmacies,” he said. “There’s no overall shortage.”In response to a question, he acknowledged that the cost of antiviral drugs can be a barrier for some people. But he observed that the number of Americans with health insurance has surged—an apparent reference to the Affordable Care Act—and that the copay for a prescription is far lower than that for hospitalization.A reporter asked CDC officials what people should do if they have possible flu symptoms at a time when clinics and emergency rooms are crowded with possible flu patients.”We want to see in the clinic especially people at high risk for severe flu, said Joe Bresee, MD, chief of epidemiology and prevention in the CDC’s flu division. “We don’t want people to avoid seeking healthcare if they have flu and high-risk conditions. Nurse triage lines are a good idea.”Frieden added that it’s important for sick people to call their doctor. If they have an uncomplicated case, the doctor may be able to order a prescription without seeing them first, he said. If symptoms are more serious, it’s important for the person to seek care.”We’re working on newer ways to get treatment out more promptly,” he added. “We may have more information on that next week.”In other comments, Frieden said the CDC expects to have a preliminary estimate of the effectiveness of this year’s vaccine in a week or two. He encouraged people to get vaccinated if they haven’t yet, as the vaccine is expected to provide good protection against influenza B, which can surge late in the season.He also recommended that people 65 and older get the recommended pneumococcal vaccines.See also: Jan 9 CDC FluView updateJan 9 CDC HAN notice on antiviralsRelated Dec 5, 2014, CIDRAP News story “CDC’s flu warning raises questions about vaccine match”last_img read more

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Empty Bowls

first_imgTwenty-five local chefs served all-you-could-eat of their best soups at the American Legion Post in Amagansett on Sunday, March 8, to support the work of Project MOST. The annual “Empty Bowls” event benefited Project MOST’s after-school, evening, and weekend programs, including activities at its new Community Learning Center at The Neighborhood House in East Hampton. Sharelast_img

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Linde signs forward start revolving credit facility.

first_imgSubscribe Get instant access to must-read content today!To access hundreds of features, subscribe today! At a time when the world is forced to go digital more than ever before just to stay connected, discover the in-depth content our subscribers receive every month by subscribing to gasworld.Don’t just stay connected, stay at the forefront – join gasworld and become a subscriber to access all of our must-read content online from just $270.last_img

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Outreach Buys Tech Safe Systems

first_imgOutreach Ltd., the supplier of hydraulic handling, lifting and access equipment based in Falkirk, has acquired of one of the UK’s top suppliers of Launch and Recovery Systems (LARS) for remotely operated underwater vehicles (ROVs).Outreach Ltd has acquired, for an undisclosed sum, Great Yarmouth based Tech Safe Systems (UK) Ltd., specialists in the design, engineering and manufacture of LARS, Control Cabins and Workshops for ROVs, used most commonly in deep water industries such as oil and gas and offshore renewables. Tech Safe Systems Ltd supplies its equipment to ROV operating companies worldwideBased at the Gapton Hall Industrial Estate in Great Yarmouth, Tech Safe Systems employs 22 personnel including skilled specialist engineers and is recognised as one of the leading suppliers of custom built ROV operating equipment.Gary Potts, Managing Director – Sales and Marketing, Outreach Ltd, said, “From the outset, we were very much aware of the great synergies between Outreach Ltd and Tech Safe Systems. Both companies have a focus on innovative design and manufacture and Tech Safe Systems has carved an attractive niche in the ROV market which is entirely complementary to what Outreach currently offers in the offshore oil and gas, renewables and marine sectors. We believe there is strong potential to grow the business within the Outreach group of companies.”Potts outlined plans to grow the Tech Safe Systems operation at its existing Great Yarmouth site and confirmed significant investment plans, including the recruitment of further employees over the next 12-18 months, mainly on the service side.He added, “Both Outreach Ltd and Tech Safe Systems have significant business in the North Sea, through oil and gas and offshore wind and Great Yarmouth is an ideal location to service this business, alongside our facilities in Scotland.”Peter Evans started Tech Safe Systems Ltd in 1996 after piloting manned submersibles and working in the offshore industry for many years. With his experience of ROVs and a passion for design and innovation, he saw a niche in the market, to provide a complete package of LARS, winches, cabins and workshops, integrated and tested with the customer’s ROV as a complete system. This ensured all the equipment worked together prior to going offshore.Peter Evans, company founder Tech Safe Systems Ltd., said, “From the beginning, our philosophy was ’large enough to cope, small enough to care’ and the principle was to build high quality equipment to ‘The Best of British’ design. Despite the company having grown in size and capability, this is still our ethos and we have to thank our superb staff for their support over the years. With the sale of the company to Outreach Ltd, I wish them all success with their expansion plan to take the company forwards at our Great Yarmouth site.”The acquisition of Tech Safe Systems is the latest investment by Outreach Ltd which has, in the past 18 months, invested £3 million in its Access Division fleet, creating Scotland’s largest independent hirer of truck mounted access equipment and £500,000 in new production equipment for its Specialist Bodies Division which focuses on vehicle body building and conversions.Press Release, August 06, 2014; Image: Tech Safelast_img read more

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Hapag-Lloyd: MPS Sailings Cancelled amid Congestion

first_imgGerman liner company Hapag-Lloyd said that sailings on its Mediterranean Pacific Service (MPS) westbound have been cancelled due to US West Coast congestion that has brought about severe delays.As informed, there will be no sailing available from the Mediterranean to US West Coast, Canada-West Coast, Mexico-West Coast and destinations in Latin America.The cancellations are expected to last from February 16th to March 1st.“Depending on the development on the US West Coast port situation, we anticipate that schedule pattern will come back to more regularity as of week 10,” the company said.The congestion is feared to reach a complete gridclock in the US West Coast ports as talks between the International Longshore and Warehouse Union (ILWU) and the Pacific Maritime Association (PMA) drag along for the nineth month.Two days ago, the PMA made what they called an ”All-In” offer that would increase compensation to members of the ILWU.ILWU has not yet declared on the offer, however it pledged to keep the ports open and keep cargo flowing.World Maritime News Stafflast_img read more

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Port Saint John Welcomes New 7-Year Labor Agreement

first_imgCanada’s Port Saint John has praised the Port of Saint John Employers Association (PSJEA) and International Longshoremen’s Association Local 273 (ILA 273) for recently ratifying a new 7-year collective labor agreement. The agreement went into effect on October 4, 2015 and is retroactive to January 1, 2015.”Along with monetary increases, this new contract provides for increased training opportunities for our current employees as well as a mechanism to grow the number of unionized positions within the Port of Saint John” Port of Saint John Employers Association Vice President & General Manager Donald Scott said.Back in January, the port submitted a CAD 205 million (USD 164.8m) application to the Federal Government’s Building Canada Fund, National Infrastructure Component to modernize its container infrastructure on the west side of the Port over the next seven years. The project is a three-way partnership with the Federal Government, Port Saint John, and the Provincial Government over a seven-year period.The Federal Government allocated CAD 68.3 million for the west side modernization project in July, with Port Saint John responsible for securing all the remaining funding necessary to complete the project and for any cost overruns.The project involves improving and consolidating the Rodney and Navy Island terminals to allow the port to accommodate larger vessels. New operational systems and technology will also be installed to enhance cargo-handling capabilities.The project covers a 60-acre area: 25 acres will be transformed into container storage, 10 acres into a multipurpose yard, and the rest will be used for terminal access roads, stevedoring operations, trans-loading and cargo-consolidation warehouses, and lay-down areas for break-bulk and project cargoes. The main channel at the port will also be deepened from 8.4 to 10 meters as part of the project.“We are extremely pleased that the PSJEA and ILA 273 have come together to provide labour stability at this critical period of business growth and particularly in light of recent support for our plans to modernize West Side container and intermodal cargo handling facilities,” said Jim Quinn, President & CEO, Port Saint John.last_img read more

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Buyers found for HSH Nordbank

first_imgAccording to the WSJ, the deal could be announced this week.HSH Nordbank, owned by the German states of Schleswig-Holstein and Hamburg, is racing to find a buyer by the end of February or face liquidation, after suffering massive losses on non-performing shipping loans. J.C. Flowers already owns approximately 5 percent of HSH.Media reports suggest that, up until six months ago, the bank’s owners were expecting a sale price of EUR200 million (USD245.9 million), but a gradual recovery in the shipping industry, higher earnings expectations and a substantial reduction in bad shipping loans have made the lender more attractive.  www.hsh-nordbank.de www.jcfco.com www.cerberuscapital.comlast_img read more

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Jury

first_img R v C and others: Court of Appeal, Criminal Division: 28 March 2013 Discharge of jury – Apparent bias – Forced labour – Conspiracy to hold a person in servitude The defendants were part of an extended family which originated from the Irish travelling community. They were convicted of offences which included conspiracy to hold a person in servitude, assault occasioning actual bodily harm, holding a person in servitude and requiring forced labour. The prosecution case was that the defendant, TC senior, his children and son-in-law, recruited vulnerable adults to work for them on the pretence that they would be paid, fed and housed. Once in the clutches of the defendants, many of them had had no means to escape. They were forced to carry out hard physical labour for extensive hours, without payment and were subjected to physical violence and threats. It was contended that the victims had been kept against their will at a succession of traveller’s sites. The defence case was that the victims had lied or exaggerated. During the course of the trial, the judge received a note from a member of the jury which stated that: ‘Throughout the trial and especially since we were given a room, it has become quite obvious that certain jurors, not all, are quite anti-traveller/prejudiced.’ The judge did not discharge the jury but gave the relevant directions. The defendants were convicted. They appealed, among other things, against conviction. The issue for consideration was whether the convictions were unsafe by reason of apparent bias on the part of the jury. In particular, whether the judge had erred in failing to discharge the jury. The defendants submitted that any fair-minded and informed observer would conclude that there was a real danger that the jury was or would be biased. The appeals would be dismissed. The receipt of any communication by a juror or jurors complaining of possible irregularities by or among the other jurors demanded rapid and close attention. It behoved the judge to decide whether the integrity of the trial process had been irretrievably damaged or whether the trial could continue notwithstanding the complaints. Depending on the individual facts it might be appropriate for the judge to discharge the jury as a whole, or one or more individual members of it, or to continue with the trial, with any necessary direction or warning sufficient to deal with the specific problem. A member of a jury finding himself or herself in a minority might not bring a trial to a halt by writing a measured letter to a judge complaining of irregularities by the other members of the jury (see [29], [33] of the judgment). In the instant case, the judge had not been bound to discharge the jury because of the letter, however troublesome its contents signed by one juror. Equally, in the circumstances, it would have been inappropriate for him to try and conduct an investigation into what had been happening in the jury room. The judge had handled the problem presented to him impeccably, and his assessment of the integrity of the jury had been amply justified. In the context of alleged jury bias, there was no reason to doubt the safety of the guilty verdicts returned by the jury (see [34], [36] of the judgment). R v Smith and another [2005] 2 Cr App R 10 considered; R v Thompson and others [2010] 2 Cr App Rep (S) 27 considered.center_img Karen Walton and Mark Himsworth for JC(2); Giles Cockings and Daniel Jameson for JJC(3); Paul Crampin and Alex Di Francesco for PC(4); Lewis Power QC and Andrew Selby for TC (Senior); Benjamin Gumpert (instructed by the Crown Prosecution Service) for the Crown.last_img read more

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VR Group names CEO

first_imgRolf Jansson has succeeded Mikael Aro as President & CEO of Finnish national railway VR Group. Harri Lukkarinen has replaced Ville Saksi as Managing Director of VR Track, while Saksi has taken over as CEO of Länsimetro Oy, the company overseeeing the Helsinki metro extension to Espoo, following the dismissal of Matti Kokkinen. Mattias Hörling has been appointed CEO of VR Track Sweden.last_img

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Iarnród Éireann deploys ticket sales software

first_imgIRELAND: Iarnród Éireann has deployed a Sqills S3 Passenger sales, distribution and revenue management software platform to replace legacy systems and introduce dynamic pricing capabilities.S3 Passenger enables fares to be set from a single source and updated in real-time across all sales channels, helping operators to optimise train occupancy and maximise revenue by better matching supply and demand.The Iarnród Éireann deployment was rolled out by a consortium including Cubic Transportation Systems, Rail Solutions, Microsoft and Marketo.last_img read more

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