British judge urges new press regulator due to hacking scandal

LONDON – In a highly anticipated and lengthy report, a senior judge Thursday recommended that a new, independent regulatory authority be set up to monitor Britain’s raucous press and to crack down on media abuses such as phone hacking and other unethical newsgathering practices.

Justice Brian Leveson said such a regulator was necessary because the press had at times “wreaked havoc in the lives of innocent people” through its intrusions on privacy and relentless pursuit of scoops.

The new regulatory body should be backed by law, but it should not include any politicians, in order to avoid government control of the press, nor any editors, in order to maintain full independence, Leveson said.

The regulator would replace a previous press complaints commission that is widely recognized in Britain to have been a failure, particularly with regard to the phone-hacking scandal. Evidence has emerged that hundreds of high-profile figures may have had their cellphones tapped by the now-defunct News of the World tabloid.

The scandal gave rise to a months-long, government-commissioned investigation into media culture and ethics by Leveson, who heard testimony from more than 300 witnesses.

The recommendations in his 2,000-page report are likely to please some hacking victims and satisfy demands of some lawmakers who say that Britain’s media, in particular its sensation-seeking and gossip-hungry tabloids, have been allowed to run amok.

But the news organizations themselves have expressed alarm over any form of regulation that has its roots in law and that, they fear, could be the first step toward government censorship. Although they recognize the need for oversight, many news outlets have pushed for a better system of self-regulation with no legal underpinning.

Leveson was eager to emphasize his respect for a free press and denied that his recommendations represented any threat to it.

“The press operating freely and in the public interest is one of the true safeguards of our democracy. As a result, it holds a privileged and powerful place in our society,” he told reporters. “But this power and influence carries with it responsibilities to the public interest in whose name it exercises these privileges. Unfortunately, as the evidence has shown beyond doubt, on too many occasions those responsibilities … have simply been ignored.”

The report has been eagerly awaited for months. As its release date neared, politicians and high-profile individuals dug in on either side, calling for laws to regulate the media or warning against them as an unacceptable infringement on a free press.

“As parliamentarians, we believe in free speech and are opposed to the imposition of any form of statutory control,” said a letter signed by 86 lawmakers. “The solution is not new laws but a profound restructuring of the self-regulatory system.”

A recent poll, however, found a majority of Britons in favor of some kind of regulation of the media backed by the force of the law.

The witnesses who appeared before Leveson included some of Britain’s best-known public figures, such as Prime Minister David Cameron. Actor Hugh Grant and "Harry Potter" author J.K. Rowling denounced media invasions of their privacy. Media baron Rupert Murdoch and other newspaper proprietors spoke about newsgathering practices.

The inquiry was launched last year after the hacking scandal exploded in the public consciousness with the revelation that the News of the World had tapped the voicemail messages of a missing 13-year-old girl, whose body was later found dumped in the woods by her killer.

Like a fast-spreading fire, the scandal quickly engulfed key pillars of British public life, putting the heat not just on tabloid newspapers but also the politicians who cozied up to them and the police who offered scoops in hopes of flattering coverage. Within days, the head of Scotland Yard resigned, as did one of Murdoch’s closest confidants, and the 168-year-old News of the World was shut down.

Three separate police investigations – into phone hacking, computer hacking and bribery of public officials – were spawned by the affair. Dozens of people, most of them journalists at Murdoch-owned publications, have been arrested.

Only a few hours before Leveson’s report was released, the former head of Murdoch’s newspapers in Britain and a onetime senior aide to Cameron appeared in court on charges of paying public officials for information.

ALSO:

Three managers arrested after deadly Bangladesh factory fire

Outgoing Mexican President Felipe Calderon heading to Harvard

Google opposes German push for search engines to pay newspapers

Read More..

Making a Dirt Dog, Vol. 4: As the Bike Turns

Editor’s note: For those of you joining us late, Peter Rubin’s a roadie making his first foray into mountain biking. He knows nothing — seriously, zero — about that side of cycling, so he’s chronicling his adventures in the hope that others might learn from his inevitable mistakes.

It’s Day 2 at Gene Hamilton’s Better Ride skills camp. After a day in which I spent close to eight hours in a parking lot and about 15 minutes riding on a trail, I can’t say I was all that excited about waking up at 7 on a Saturday for more of the same. But there I was (albeit in a different parking lot). And this time, we were learning how to steer.

No, really.

So here’s what you don’t do on a bike when you want to go around the corner: turn the handlebars. Well, kind of. Under 6 mph or so, that’s really the only way to do it. But once you’re going faster than that, wrenching the wheel in a given direction means you’re about a half-second away from kissing pavement. The front wheel will just keep turning in that direction until it hits a right angle and you fly over the handlebars. Don’t believe me? Try it yourself.

Done?

What happens, you no doubt noticed, is that you didn’t kiss the pavement. Your bike actually swerved in the opposite direction. That’s because your body, purely instinctively, counteracts what your brain thinks you’re trying to do. (Give it up for self-preservation!) All of this is to say that turning the wheel is not how you turn. The thing is, you already know that — at least, your body does. You’ve internalized what’s commonly known as “countersteering,” which essentially means initiating a turn in one direction with the intention of going the opposite direction. But as Hamilton, who founded Better Ride, and coach Dylan Renn pointed out, it’s not so much steering in the opposite direction as it is applying pressure in the opposite direction. That is, if you want to make a sharp left turn, you apply pressure on the left handlebar. That initiates a turn to the right, after which your bike will lean left to compensate, and you can lean into a sharp left turn.

Now, this is no secret among road cyclists and motorcyclists. But the effect on mountain biking is a bit more pronounced because the crux of MTBing is to stay balanced above your bike no matter what. From front to back and left to right, your mass should be centered above your bottom bracket. That means that if your bike is going to be leaning to the left for a sharp left turn, you separate your body from the bike and allow it to lean without leaning along with it. Which leads us, conveniently, to the Better Ride cornering method.

1. Attack position. Always attack position.


2. Look into the turn. Building on the vision drills of Day 1, we learned how to look at the apex of the turn as we initiated cornering, so that we’d be looking well past the turn by the time we were actually mid-corner.


3. Initiate cornering via counterpressure.


4. Separate from the bike by straightening the arm to the inside of the turn, and rotating the outside hand forward over the handlebar just enough so that the outside arm is bent at a 90-degree angle. (If this sounds confusing, see this image from Better Ride’s Facebook Page).

After lunch, we took to the trail (only five hours after the day’s class began!) and climbed through Pearson-Arastradero Preserve to the top of a series of sweeping turns. They weren’t switchbacks — that’s a whole ‘nother set of skills, and one I’d learn on Day 3 — but certainly tight enough that going through them with a good head of steam would press into service all the techniques drilled into me in the parking lot. Dylan stood at the apex of one, Gene at the apex of another, and we took turns bombing down through the turns. And then again. And again. Attack position. Counterpressure. Separate from the bike. And I swear to you, every time I headed down anew, my smile was bigger than the time before.

Read More..

Palm Springs Fest gives Robert Zemeckis’ awards campaign a boost

LOS ANGELES (TheWrap.com) – Robert Zemeckis has been named Director of the Year by the Palm Springs International Film Festival, making the “Flight” director the latest awards hopeful to be honored by one of the two big January film festivals that double as campaign stops on the awards circuit.

The announcement by Palm Springs organizers came one day after the Santa Barbara Film Festival declared “Silver Linings Playbook” star Jennifer Lawrence the Outstanding Performer of the Year.

Palm Springs holds its awards gala on the first Saturday of the new year, which this year falls on January 5, two days after Oscar polls close. Santa Barbara spreads out its awards over a two-week period in late January, after Oscar nominations are announced but before final voting begins.

Both festivals jockey to assemble lineups of probable Oscar nominees, and both are lobbied by Oscar campaigners as they make their selections. The two festivals try to stagger their announcements so as not to compete with each other.

Besides Zemeckis’ award, Palm Springs has announced that it will honor Naomi Watts with the Desert Palm Achievement Award for Acting and Helen Hunt with the Spotlight Award.

In addition to Lawrence, Santa Barbara will give its Modern Master Award to Ben Affleck. Robert De Niro will receive the festival’s Kirk Douglas Award for Excellence in Film, an honor that is presented at a separate black-tie event in December rather than during the festival.

Movies News Headlines – Yahoo! News

Read More..

Medicare Is Faulted in Electronic Medical Records Conversion

The conversion to electronic medical records — a critical piece of the Obama administration’s plan for health care reform — is “vulnerable” to fraud and abuse because of the failure of Medicare officials to develop appropriate safeguards, according to a sharply critical report to be issued Thursday by federal investigators.

Mike Spencer/Wilmington Star-News, via Associated Press

Celeste Stephens, a nurse, leads a session on electronic records at New Hanover Regional Medical Center in Wilmington, N.C.

Centers for Medicare and Medicaid Services

Marilyn Tavenner, acting administrator for Medicare.

The use of electronic medical records has been central to the aim of overhauling health care in America. Advocates contend that electronic records systems will improve patient care and lower costs through better coordination of medical services, and the Obama administration is spending billions of dollars to encourage doctors and hospitals to switch to electronic records to track patient care.

But the report says Medicare, which is charged with managing the incentive program that encourages the adoption of electronic records, has failed to put in place adequate safeguards to ensure that information being provided by hospitals and doctors about their electronic records systems is accurate. To qualify for the incentive payments, doctors and hospitals must demonstrate that the systems lead to better patient care, meeting a so-called meaningful use standard by, for example, checking for harmful drug interactions.

Medicare “faces obstacles” in overseeing the electronic records incentive program “that leave the program vulnerable to paying incentives to professionals and hospitals that do not fully meet the meaningful use requirements,” the investigators concluded. The report was prepared by the Office of Inspector General for the Department of Health and Human Services, which oversees Medicare.

The investigators contrasted the looser management of the incentive program with the agency’s pledge to more closely monitor Medicare payments of medical claims. Medicare officials have indicated that the agency intends to move away from a “pay and chase” model, in which it tried to get back any money it has paid in error, to one in which it focuses on trying to avoid making unjustified payments in the first place.

Late Wednesday, a Medicare spokesman said in a statement: “Protecting taxpayer dollars is our top priority and we have implemented aggressive procedures to hold providers accountable. Making a false claim is a serious offense with serious consequences and we believe the overwhelming majority of doctors and hospitals take seriously their responsibility to honestly report their performance.”

The government’s investment in electronic records was authorized under the broader stimulus package passed in 2009. Medicare expects to spend nearly $7 billion over five years as a way of inducing doctors and hospitals to adopt and use electronic records. So far, the report said, the agency has paid 74, 317 health professionals and 1,333 hospitals. By attesting that they meet the criteria established under the program, a doctor can receive as much as $44,000 for adopting electronic records, while a hospital could be paid as much as $2 million in the first year of its adoption. The inspector general’s report follows earlier concerns among regulators and others over whether doctors and hospitals are using electronic records inappropriately to charge more for services, as reported by The New York Times last September, and is likely to fuel the debate over the government’s efforts to promote electronic records. Critics say the push for electronic records may be resulting in higher Medicare spending with little in the way of improvement in patients’ health. Thursday’s report did not address patient care.

Even those within the industry say the speed with which systems are being developed and adopted by hospitals and doctors has led to a lack of clarity over how the records should be used and concerns about their overall accuracy.

“We’ve gone from the horse and buggy to the Model T, and we don’t know the rules of the road. Now we’ve had a big car pileup,” said Lynne Thomas Gordon, the chief executive of the American Health Information Management Association, a trade group in Chicago. The association, which contends more study is needed to determine whether hospitals and doctors actually are abusing electronic records to increase their payments, says it supports more clarity.

Although there is little disagreement over the potential benefits of electronic records in reducing duplicative tests and avoiding medical errors, critics increasingly argue that the federal government has not devoted enough time or resources to making certain the money it is investing is being well spent.

House Republicans echoed these concerns in early October in a letter to Kathleen Sebelius, secretary of health and human services. Citing the Times article, they called for suspending the incentive program until concerns about standardization had been resolved. “The top House policy makers on health care are concerned that H.H.S. is squandering taxpayer dollars by asking little of providers in return for incentive payments,” said a statement issued at the same time by the Republicans, who are likely to seize on the latest inspector general report as further evidence of lax oversight. Republicans have said they will continue to monitor the program.

In her letter in response, which has not been made public, Ms. Sebelius dismissed the idea of suspending the incentive program, arguing that it “would be profoundly unfair to the hospitals and eligible professionals that have invested billions of dollars and devoted countless hours of work to purchase and install systems and educate staff.” She said Medicare was trying to determine whether electronic records had been used in any fraudulent billing but she insisted that the current efforts to certify the systems and address the concerns raised by the Republicans and others were adequate.

Read More..

Medicare Is Faulted in Electronic Medical Records Conversion

The conversion to electronic medical records — a critical piece of the Obama administration’s plan for health care reform — is “vulnerable” to fraud and abuse because of the failure of Medicare officials to develop appropriate safeguards, according to a sharply critical report to be issued Thursday by federal investigators.

Mike Spencer/Wilmington Star-News, via Associated Press

Celeste Stephens, a nurse, leads a session on electronic records at New Hanover Regional Medical Center in Wilmington, N.C.

Centers for Medicare and Medicaid Services

Marilyn Tavenner, acting administrator for Medicare.

The use of electronic medical records has been central to the aim of overhauling health care in America. Advocates contend that electronic records systems will improve patient care and lower costs through better coordination of medical services, and the Obama administration is spending billions of dollars to encourage doctors and hospitals to switch to electronic records to track patient care.

But the report says Medicare, which is charged with managing the incentive program that encourages the adoption of electronic records, has failed to put in place adequate safeguards to ensure that information being provided by hospitals and doctors about their electronic records systems is accurate. To qualify for the incentive payments, doctors and hospitals must demonstrate that the systems lead to better patient care, meeting a so-called meaningful use standard by, for example, checking for harmful drug interactions.

Medicare “faces obstacles” in overseeing the electronic records incentive program “that leave the program vulnerable to paying incentives to professionals and hospitals that do not fully meet the meaningful use requirements,” the investigators concluded. The report was prepared by the Office of Inspector General for the Department of Health and Human Services, which oversees Medicare.

The investigators contrasted the looser management of the incentive program with the agency’s pledge to more closely monitor Medicare payments of medical claims. Medicare officials have indicated that the agency intends to move away from a “pay and chase” model, in which it tried to get back any money it has paid in error, to one in which it focuses on trying to avoid making unjustified payments in the first place.

Late Wednesday, a Medicare spokesman said in a statement: “Protecting taxpayer dollars is our top priority and we have implemented aggressive procedures to hold providers accountable. Making a false claim is a serious offense with serious consequences and we believe the overwhelming majority of doctors and hospitals take seriously their responsibility to honestly report their performance.”

The government’s investment in electronic records was authorized under the broader stimulus package passed in 2009. Medicare expects to spend nearly $7 billion over five years as a way of inducing doctors and hospitals to adopt and use electronic records. So far, the report said, the agency has paid 74, 317 health professionals and 1,333 hospitals. By attesting that they meet the criteria established under the program, a doctor can receive as much as $44,000 for adopting electronic records, while a hospital could be paid as much as $2 million in the first year of its adoption. The inspector general’s report follows earlier concerns among regulators and others over whether doctors and hospitals are using electronic records inappropriately to charge more for services, as reported by The New York Times last September, and is likely to fuel the debate over the government’s efforts to promote electronic records. Critics say the push for electronic records may be resulting in higher Medicare spending with little in the way of improvement in patients’ health. Thursday’s report did not address patient care.

Even those within the industry say the speed with which systems are being developed and adopted by hospitals and doctors has led to a lack of clarity over how the records should be used and concerns about their overall accuracy.

“We’ve gone from the horse and buggy to the Model T, and we don’t know the rules of the road. Now we’ve had a big car pileup,” said Lynne Thomas Gordon, the chief executive of the American Health Information Management Association, a trade group in Chicago. The association, which contends more study is needed to determine whether hospitals and doctors actually are abusing electronic records to increase their payments, says it supports more clarity.

Although there is little disagreement over the potential benefits of electronic records in reducing duplicative tests and avoiding medical errors, critics increasingly argue that the federal government has not devoted enough time or resources to making certain the money it is investing is being well spent.

House Republicans echoed these concerns in early October in a letter to Kathleen Sebelius, secretary of health and human services. Citing the Times article, they called for suspending the incentive program until concerns about standardization had been resolved. “The top House policy makers on health care are concerned that H.H.S. is squandering taxpayer dollars by asking little of providers in return for incentive payments,” said a statement issued at the same time by the Republicans, who are likely to seize on the latest inspector general report as further evidence of lax oversight. Republicans have said they will continue to monitor the program.

In her letter in response, which has not been made public, Ms. Sebelius dismissed the idea of suspending the incentive program, arguing that it “would be profoundly unfair to the hospitals and eligible professionals that have invested billions of dollars and devoted countless hours of work to purchase and install systems and educate staff.” She said Medicare was trying to determine whether electronic records had been used in any fraudulent billing but she insisted that the current efforts to certify the systems and address the concerns raised by the Republicans and others were adequate.

Read More..

27 indicted in Mexican Mafia drug case in Ventura County

From a prison cell outside California, an inmate known as "Evil" was making himself known on Ventura County's streets.

Martin Madrigal, 39, was squeezing drug profits from street gangs for the prison-based Mexican Mafia, according to a grand jury indictment released Tuesday. He was so feared that rival gangs cooperated on extortion schemes, drug deals and violent crimes, according to law enforcement officials.

The 35-count indictment portrays Madrigal as a powerful figure representing an efficient and merciless organization that law enforcement officials believe has been operating for decades, largely from behind bars, calling shots among street gangs. He was one of 27 people named in the indictment, 24 of whom have been arrested. Officials declined to disclose where or why Madrigal is serving time.

The forced cooperation among rival gangs alleged in the indictment may be a sign that Mexican drug cartels are attempting to extend their authority over California drug trafficking, according to Ventura County Assistant Sheriff Gary Pentis.

Madrigal operated as a kind of regional manager, with a Ventura County gang member named Edwin "Sporty" Mora enforcing his decisions on the street with a written hit list from Madrigal and "permission to conduct extortion on behalf of the Mexican Mafia," according to the indictment. In one of the document's counts, Mora is said to have indicated that a gang member named Little Rudy "was going to kick in money by Wednesday and if he can't make that happen, Mora wanted the fool in the dirt."

Dozens of weapons, including an AK47, were confiscated during a series of arrests starting in May and ending earlier this month.

The Ventura County probe, dubbed Operation Wicked Hand, started with two shootings in Moorpark in April and a heroin bust about the same time.

"We soon came to realize the incidents weren't happenstance," Ventura County Sheriff Geoff Dean said.

Sheriff's officials said investigators thwarted several crimes, including two planned killings and a drugstore robbery.

Officials would not reveal details of how the investigation was conducted. The indictment, returned Nov. 14, makes it clear authorities had access to text messages and phone calls that gang members made among themselves.

More than 70 officers from the Sheriff's Department participated in the investigation, as well as officers from the Oxnard Police Department and other agencies.

"This case has dealt a crushing blow to organized crime in Ventura County," Pentis said. "We have incapacitated the organization from the top through its geographic managers."

Bail for those arrested, including two juveniles, ranges from $1 million to $5 million. Dist. Atty. Greg Totten said a number of suspects are facing multiple charges, and three are facing possible life sentences under the state's three-strikes law.

Totten said his office submitted the case to a criminal grand jury rather than opting for a preliminary hearing because of its complexity and the ongoing investigation's need for secrecy.

The indictment names more individuals than any other in Ventura County's history, he said.

steve.chawkins@latimes.com

Read More..

Robotic Autobot Transformer Shows Other 3D-Printed Gear Who's Boss

Forget scale models of the Aston Martin DB5 or personalized action figures. This is what 3D printers were meant to do: create real, robotic Transformers.

Or at least a version of a Transformer that would actually fit in your living room.

Brave Robotics developed a 1/12 scale Autobot transformer using a custom 3D printer, and it will be on display at Maker Faire Tokyo next week. Once fully morphed out of its initial automobile form, it takes the shape of a bipedal robot that moves about much like two-legged soccer-playing robots we’ve seen at Robocup and Robogames. This robot also has the ability to shoot some sort of dart from each of its arms.

A fully assembled and programed mini-Autobot, complete with remote control and housed in its own case, will be available for purchase, but a price has not yet been disclosed. Production is limited to 10 units, but you can choose the colors of your Decepticon fighting robot. Once you’ve placed your order, it’ll take about a month to produce.

Check out this Earth-defending, shape-shifting robot in action below.

via Hobby Media

Read More..

Van Gogh, John Lennon letters coming to NY auction

NEW YORK (AP) — An upcoming auction of over 300 historical documents includes rare letters written by Vincent van Gogh, George Washington, John Lennon and other iconic figures.

The property of an anonymous American collector is being offered by Profiles in History in an online and phone auction on Dec. 18.

Among the highlights is a two-page letter from Washington to an Anglican clergyman.

Another top item is a signed van Gogh letter, written in 1890, to Joseph and Marie Ginoux, who were proprietors of the Cafe de la Gare in Arles, France, where the Dutch post-impressionist artist lived for a time.

Each of those letters is estimated to bring $ 200,000 to $ 300,000.

A handwritten letter from John Lennon to Eric Clapton has a pre-sale estimate of $ 20,000 to $ 30,000.

The collection will be exhibited Dec. 3-9 at Douglas Elliman’s Madison Avenue art gallery.

Washington‘s letter was written on Aug. 15, 1798, to the Rev. Jonathan Boucher, amid an undeclared naval war with France. Washington thanks Boucher for sending him his “View of the Causes and Consequences of the American Revolution,” a book of 13 discourses Boucher preached.

“Peace, with all the world is my sincere wish, I am sure it is our true policy — and am persuaded it is the ardent desire of the Government,” the former president and Founding Father wrote.

In a Jan. 20, 1890, four-page letter, handwritten in French to his friends Monsieur and Madame Ginoux, van Gogh wishes the ailing proprietress a speedy recovery.

“Illnesses are there to make us remember again that we are not made of wood,” the artist wrote. “That’s what seems the good side of all this to me. Then afterwards one goes back to one’s everyday work less fearful of the annoyances, with a new store of serenity.” Van Gogh died less than seven months later.

He suffered from acute anxiety and bouts of depression throughout his life. Madame Ginoux and the cafe were frequent subjects of his work.

The eight-page letter from Lennon is a draft he wrote to Clapton on Sept. 29, 1971, and signed “John and Yoko.” The whereabouts of the final version is unknown.

Lennon writes candidly about his admiration for the great British guitarist and suggests forming a “‘nucleus’ group (Plastic Ono Band) . — and of course had YOU!!! In mind as soon as we decided.” He writes that drummer Jim Kelnter, artist Klaus Voormann, pianist Nicky Hopkins and producer Phil Spector “all agreed so far” to join.

“Anyway, the point is, after missing the Bangla-Desh concert, we began to feel more and more like going on the road, but not the way I used with the Beatles — night after night of torture. We mean to enjoy ourselves, take it easy, and maybe even see some of the places we go to! We have many ‘revolutionary’ ideas for presenting shows that completely involve the audience .”

Other luminaries whose papers will be sold include Lou Gehrig, Louis Pasteur, Sigmund Freud, Charles Darwin, Marie Curie, Giuseppe Verdi, Peter Tchaikovsky, Cole Porter, King Henry II and Napoleon I.

The December auction is the first of several sales that will be held over two years. The entire collection contains 3,000 items.

__

Online:

Information on how to bid is available on www.profilesinhistory.com.

Entertainment News Headlines – Yahoo! News

Read More..

The New Old Age Blog: Doctor's Orders? Another Test

It is no longer news that Americans, and older Americans in particular, get more routine screening tests than they need, more than are useful. Prostate tests for men over 75, annual Pap smears for women over 65 and colonoscopies for anyone over 75 — all are overused, large-scale studies have shown.

Now it appears that many older patients are also subjected to too-frequent use of the other kind of testing, diagnostic tests.

The difference, in brief: Screening tests are performed on people who are asymptomatic, who aren’t complaining of a health problem, as a way to detect incipient disease. We have heard for years that it is best to “catch it early” — “it” frequently being cancer — and though that turns out to be only sometimes true, we and our doctors often ignore medical guidelines and ongoing campaigns to limit and target screening tests.

Diagnostic tests, on the other hand, are meant to help doctors evaluate some symptom or problem. “You’re trying to figure out what’s wrong,” explained Gilbert Welch, a veteran researcher at the Dartmouth Institute for Health Policy and Clinical Practice.

For these tests, medical groups and task forces offer many fewer guidelines on who should get them and how often — there is not much evidence to go on — but there is general agreement that they are not intended for routine surveillance.

But a study using a random 5 percent sample of Medicare beneficiaries — nearly 750,000 of them — suggests that often, that is what’s happening.

“It begins to look like some of these tests are being routinely repeated, and it’s worrisome,” said Dr. Welch, lead author of the study just published in The Archives of Internal Medicine. “Some physicians are just doing them every year.”

He is talking about tests like echocardiography, or a sonogram of the heart. More than a quarter of the sample (28.5 percent) underwent this test between 2004 and 2006, and more than half of those patients (55 percent) had a repeat echocardiogram within three years, most commonly within a year of the first.

Other common tests were frequently repeated as well. Of patients who underwent an imaging stress test, using a treadmill or stationery bike (or receiving a drug) to make the heart work harder, nearly 44 percent had a repeat test within three years. So did about half of those undergoing pulmonary function tests and chest tomography, a CAT scan of the chest.

Cytoscopy (a procedure in which a viewing tube is inserted into the bladder) was repeated for about 41 percent of the patients, and endoscopy (a swallowed tube enters the esophagus and stomach) for more than a third.

Is this too much testing? Without evidence of how much it harms or helps patients, it is hard to say — but the researchers were startled by the extent of repetition. “It’s inconceivable that it’s all important,” Dr. Welch said. “Unfortunately, it looks like it’s important for doctors.”

The evidence for that? The study revealed big geographic differences in diagnostic testing. Looking at the country’s 50 largest metropolitan areas, it found that nearly half the sample’s patients in Miami had an echocardiogram between 2004 and 2006, and two thirds of them had another echocardiogram within three years — the highest rate in the nation.

In fact, for the six tests the study included, five were performed and repeated most often in Florida cities: Miami, Jacksonville and Orlando. “They’re heavily populated by physicians and they have a long history of being at the top of the list” of areas that do a lot of medical procedures and hospitalizations, Dr. Welch said.

But in Portland, Ore., where “the physician culture is very different,” only 17.5 percent of patients had an echocardiogram. The places most prone to testing were also the places with high rates of repeat testing. Portland, San Francisco and Sacramento had the lowest rates.

We often don’t think of tests as having a downside, but they do. “This is the way whole cascades can start that are hard to stop,” Dr. Welch said. “The more we subject ourselves, the more likely some abnormality shows up that may require more testing, some of which has unwanted consequences.”

Properly used, of course, diagnostic tests can provide crucial information for sick people. “But used without a good indication, they can stir up a hornet’s nest,” he said. And of course they cost Medicare a bundle.

An accompanying commentary, sounding distinctly exasperated, pointed out that efforts to restrain overtesting and overtreatment have continued for decades. The commentary called it “discouraging to contemplate fresh evidence by Welch et al of our failure to curb waste of health care resources.”

It is hard for laypeople to know when tests make sense, but clearly we need to keep track of those we and our family members have. That way, if the cardiologist suggests another echocardiogram, we can at least ask a few pointed questions:

“My father just had one six months ago. Is it necessary to have another so soon? What information do you hope to gain that you didn’t have last time? Will the results change the way we manage his condition?”

Questions are always a good idea. Especially in Florida.

Paula Span is the author of “When the Time Comes: Families With Aging Parents Share Their Struggles and Solutions.”

Read More..

Ex-NASA Scientist’s Data Fears Come True

In 2007, Robert M. Nelson, an astronomer, and 27 other scientists at the Jet Propulsion Laboratory sued NASA arguing that the space agency’s background checks of employees of government contractors were unnecessarily invasive and violated their privacy rights.

Privacy advocates chimed in as well, contending that the space agency would not be able to protect the confidential details it was collecting.

The scientists took their case all the way to the Supreme Court only to lose last year.

This month, Dr. Nelson opened a letter from NASA telling him of a significant data breach that could potentially expose him to identity theft.

The very thing he and advocates worried about had occurred. A laptop used by an employee at NASA’s headquarters in Washington had been stolen from a car parked on the street on Halloween, the space agency said.

Although the laptop itself was password protected, unencrypted files on the laptop contained personal information on about 10,000 NASA employees — including details like their names, birth dates, Social Security numbers and in some cases, details related to background checks into employees’ personal lives.

Millions of Americans have received similar data breach notices from employers, government agencies, medical centers, banks and retailers. NASA in particular has been subject to “numerous cyberattacks” and computer thefts in recent years, according to a report from the Government Accountability Office, an agency that conducts research for Congress.

Even so, Dr. Nelson, who recently retired from the Jet Propulsion Laboratory, a research facility operated by the California Institute of Technology under a contract with NASA, stands out as a glaring example of security lapses involving personal data, privacy advocates say.

“To the extent that Robert Nelson looks like millions of other people working for firms employed by the federal government, this would seem to be a real problem,” said Marc Rotenberg, the executive director of the Electronic Privacy Information Center, an advocacy group which filed a friend-of-the-court brief for Dr. Nelson in the Supreme Court case.

In a 2009 report titled “NASA Needs to Remedy Vulnerabilities in Key Networks,” the Government Accountability Office noted that the agency had reported 1,120 security incidents in fiscal 2007 and 2008 alone.

It also singled out an incident in 2009 in which a NASA center reported the theft of a laptop containing about 3,000 unencrypted files about arms traffic regulations and wind tunnel tests for a supersonic jet.

“NASA had not installed full-disk encryption on its laptops at all three centers,” the report said. “As a result, sensitive data transmitted through the unclassified network or stored on laptop computers were at an increased risk of being compromised.” Other federal agencies have had similar problems. In 2006, for example, the Department of Veteran’s Affairs reported the theft of an employee laptop and hard drive that contained personal details on about 26.5 million veterans. Last year, the G.A.O. cited the Internal Revenue Service for weaknesses in data control that could “jeopardize the confidentiality, integrity, and availability of financial and sensitive taxpayer information.”

Also last year, the Securities and Exchange Commission warned its employees that their confidential financial information, like brokerage transactions, might have been compromised because an agency contractor had granted data access to a subcontractor without the S.E.C.’s authorization.

In a phone interview, Dr. Nelson, the astronomer, said he planned to hold a news conference on Wednesday morning in which he would ask members of Congress to investigate NASA’s data collection practices and the recent data breach.

Robert Jacobs, a NASA spokesman, said the agency’s data security policy already adequately protected employees and contractors because it required computers to be encrypted before employees took them off agency premises. “We are talking about a computer that should not have left the building in the first place,” Mr. Jacobs said. “The data would have been secure had the employee followed policy.”

The government argued in the case Dr. Nelson filed that a law called the Privacy Act, which governs data collection by federal agencies, provided the scientists with sufficient protection. The case reached the Supreme Court, which upheld government background checks for employees of contractors. The roots of Dr. Nelson’s case against NASA date back to 2004 when the Department of Homeland Security, under a directive signed by President George Bush, required federal agencies to adopt uniform identification credentials for all civil servants and contract employees. As part of the ID card standardization process, the department recommended agencies institute background checks.

Several years later, when NASA announced it intended to start doing background checks at the Jet Propulsion Laboratory, Dr. Nelson and other scientists there objected.

Those security checks could have included inquiries into medical treatment, counseling for drug use, or any “adverse” information about employees such as sexual activity, or participation in protests, said Dan Stormer, a lawyer representing Dr. Nelson.

But Dr. Nelson and other long-term employees of the lab challenged the legality of those checks, arguing that they violated their privacy rights. NASA, they said, had not established a legitimate need for such extensive investigations about low-risk employees like themselves who did not have security clearances or handle confidential information. Dr. Nelson, for example, specializes in solar system science — concerning, for example, Jupiter’s moon Io and Titan, a moon of Saturn — and publishes his work in scientific journals

“It was an invitation to an open-ended fishing expedition,” Dr. Nelson said of the background checks.

In friend of the court briefs for Dr. Nelson, privacy groups cited many data security problems at federal agencies, arguing that there was a risk that NASA was not equipped to protect the confidential details it was collecting about employees and contractors.

In 2008, the United States Court of Appeals for the Ninth Circuit in San Francisco temporarily halted the background checks, saying that the case had raised important questions about privacy rights. But last year, the Supreme Court upheld the background investigations of employees of government contractors.

Dr. Nelson said he retired from the Jet Propulsion Laboratory last June rather than submit to a background check. He now works as a senior scientist at the Planetary Science Institute of Tucson.

NASA has contracted with ID Experts, a data breach company, to help protect employees whose data was contained on the stolen laptop against identity theft. Mr. Jacobs, the NASA spokesman, said the agency has encrypted almost 80 percent of its laptops and plans to encrypt the rest by Dec. 21. He added that he too received a letter from NASA warning that his personal information might have been compromised by the laptop theft.

Read More..