From securing financing to finding the right real estate to buy, the entire process of purchasing can leave you tired and frustrated. Preparing yourself to make smart real estate decisions through self-education is extremely important.
Be moderate in your real estate negotiations. Many times people are too aggressive because they are trying to get the best price, and they end up losing out entirely. Be clear about what you want, but let your lawyer and real estate agent negotiate, since they have experience with those types of negotiations.
Before you put the furniture in your home, and all your belongings as well, get some insurance. If you put off buying insurance, you?ll be sorry if there is an unpredictable act of nature that causes irreparable harm.
TIP! Never forget your primary goals while investing in property. Figure out whether you are trying to meet your long-term goals or your short-term ones.
Have a professional inspector look at the home you are interested in. Buying a house that requires renovations is a decision that can cost you a lot of money if you don?t know what you are getting into. This can cost you a ton and it could cause you to have to make other homing arrangements while the renovations are happening.
If you plan to purchase a house that has a nice view, don?t base your purchase solely on that fact. Even if you love the view, and you want to sell it later on, the buyer might not agree. Therefore, do not over pay for a home simply because you are entranced with the view.
If you made the seller an offer that was rejected, they may still find some way to make the home affordable so you buy it. Perhaps the seller will offer to cover the closing costs or pay for the some of the property?s needed repairs .
TIP! Ascertain that any real estate appraiser that you hire has a a minimum of five years experience. Never hire the appraiser recommended by your real estate agent.
When you are looking to purchase a new house, think about your long term picture. At the moment you might not have kids, but if this is a place where you plan on living for awhile then you might want to check out the local school situation to ensure it is suitable for your kids.
When purchasing a house, be sure that you are the one employing the professional workforce you need. It could be tempting to consult with house inspectors or appraisers that the seller chooses, but do not do it. Nobody likes to spend their money on things that they can get for free. However, the best option is to hire those individuals you feel comfortable with and have a level of trust with. This is one situation where learning the truth can potentially save you thousands of dollars and much heartache.
TIP! Before you start shopping for a new house, take a look at what?s in your credit report. Get a copy of the report and check it very carefully, report any discrepancies that are there.
You need to expect extra fees or costs if you are buying a home. The closing costs are usually calculated by adding the prorated taxes, bank points and down payment. Closing costs of a home can have extra things included like school taxes or improvement bonds!
Hiring a quality Realtor is a necessity for you when you are ready to buy. This information can be easily obtained through reviews on the Internet and also from the Better Business Bureau. You can also ask family, co-workers, or friends for recommendations.
Look for programs that assist with down payments. There are quite a few available, and there is sure to be one that is just right for you. When you add this with the seller taking responsibility for closing costs, you can greatly reduce the needed funds for making your initial home investment.
TIP! When negotiating your sales contract, ask for a home warranty. When you buy a brand-new home, get the builder to provide a warranty, or get the seller of a pre-owned home to provide you with at least a one-year warranty.
Research the properties you?re interested in prior to buying them. There are a number of features to look at when buying rental property. The most important feature is ease of maintenance. How is the condition of the property and how much upkeep will it require in the future? The second key feature to consider is the location of the property. Especially with property that you plan to rent, location can make all the difference. You need to ensure that your tenants can get to where they need to go and that the property is near commonly used retailers and service providers. Thirdly is the median income for the area. This differs from physical location since high rent areas are better locations than those with lower rent. Location doesn?t always matter as much in areas where the rent is higher then average. It can be much more of an issue when options are limited in areas with lower rents.
Use the information here as your initial vantage point in procuring the knowledge and resources you want in your search for a new home. Make certain that you use any information here that may be useful so that you don?t run into a lot of common problems. With this advice in mind, you won?t need luck to be successful in your search for a new home that will bring you happiness and comfort for many years to come.
An owner of a New Jersey residential roofing and construction company pled guilty this week and may face serious prison time for stealing over $450,000 in unpaid workers? compensation premiums and state income tax.? Herlindo Garcia-Merlos was president of Orients Construction Company, Inc in Trenton, New Jersey until March 2009, when he began doing business as Melrose Construction, Inc.? Yesterday, he pled guilty to two counts of second-degree theft by deception for reporting false information to his companies? workers? compensation insurance carrier and to the state of New Jersey tax office regarding the wages he himself earned.? He also failed to file corporate tax returns for his companies over the five years covered by the investigation which led to his arrest.
A press release from the office of New Jersey Attorney General Jeffrey S. Chiesa quoted Acting Insurance Fraud Prosecutor Ronald Chillemi who said:
?This defendant was responsible for making sure that he had adequate and lawful workers? compensation coverage for his companies.? By providing misinformation to his workers? compensation carrier, he not only failed in this responsibility but also defrauded an insurance company out of hundreds of thousands of dollars.? The cost of such fraud is passed on to consumers through increased premiums.?
Under the plea agreement, the state will recommend that Garcia-Merlos be sentenced to eight years in state prison.? In addition, the state is seeking restitution on behalf of New Jersey Manufacturers Insurance Group in the amount of $315,680 and New Jersey Department of Treasury in the amount of $135,462.
Chillemi also said that some important cases have started with anonymous tips.? People who are concerned about insurance cheating and have information about a fraud can report it anonymously by calling the toll-free hotline at 1-877-55-FRAUD (1-877-553-7283), or by visiting the web site for the New Jersey Office of the Insurance Fraud Prosecutor.
Four Rings holding beasts capable of destroying the world are in the hands of four nerdy,meek girls... what could go wrong?(Old and New Roleplayers welcome.)
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Karen Mills, President Obama's?Small Business Administration chief, claimed this morning on MSNBC that she has not heard one case of Obamacare hurting small business:
"You know, I travel all around the country, every week I go to a different part of the country. I'm with small businesses. And I'm not hearing that," Mills said in response to a question about how she would explain employers cutting work hours for employees because of Obamacare regulations.
"You've never heard that?" host Joe Scarborough responded. "You need to talk to your staff and tell them to get you out of the bubble, because we are hearing that all the time."
Mills continue, "We are out there every single day--"
And then?Scarborough, still surprised, interrupted to ask again, "Have you never heard that before?"
KABUL, Afghanistan (AP) ? Afghanistan's president has accused U.S. forces of continuing to capture and hold Afghans in violation of an agreement signed earlier this year between the two countries.
Hamid Karzai's statement late Sunday came at a sensitive time ? just days after the beginning of negotiations on a bilateral security agreement that will govern the U.S. military presence in the country after the majority of troops draw down in 2014. Karzai's critics say he frequently strikes populist, nationalist stances that give him leverage in talks with the Americans.
In the statement, the Afghan president said some detainees are still being held by U.S. forces even though Afghan judges have ruled that they be released. He also decried the continued arrest of Afghans by U.S. forces.
Karzai spokesman Aimal Faizi on Monday told reporters that more than 70 detainees continue to be held by the Americans despite being ordered released by Afghan courts.
The two countries signed the detainee transfer pact in March but the handover of detention facilities has been slowed by the U.S., which has argued both that the Afghans are not ready to take over their management and insisted that the Afghan government agree to hold without trial some detainees that the U.S. deems too dangerous to release.
"These acts are completely against the agreement that has been signed between Afghanistan and the U.S. president," said Karzai's statement and urged Afghan officials to "take serious measures" to push for taking over all responsibility for the detention center on the edge of the main U.S. base in eastern Afghanistan.
Detention without trial, often called administrative detention, is against Afghan law, said Faizi, the Afghan president's spokesman.
"There is nothing by the name of 'administration detention' in our laws, yet the U.S. is insisting that there are a number of people who, while there is not enough evidence against them, are a threat to U.S. national security," he said.
Faizi also said that Karzai had agreed in a video conference call with President Barack Obama earlier this fall to give the Americans two months to figure out an alternative to detention without trial, until after the U.S. presidential election. This grace period has now expired, said the spokesman.
The detainee transfer deal was one of two pacts that were key to a broad but vague strategic partnership agreement signed by Kabul and Washington in May that set forth an American commitment to Afghanistan for years to come. The second pact covers "special operations" such as certain American raids and other conduct on the battlefield.
A third detailed pact ? dubbed the bilateral security agreement ? is now under negotiation, and covers logistical and legal questions such as the size and number of bases and the immunity of U.S. forces from prosecution.
The two countries officially opened negotiations on the bilateral security agreement last week, and have given themselves a year to sign the pact.
Karzai is under pressure to give an appearance of upholding Afghan sovereignty ? which he has repeatedly claimed to champion ? without putting so many restrictions on U.S. forces that an agreement becomes impossible.
It is believed that the United States wants to retain up to 20,000 troops in Afghanistan after 2014 to train and support Afghan forces and go after extremists and groups, including al-Qaida. Afghanistan now has about 66,000 U.S. troops and it remains unclear how many will be withdrawn next year as they continue to hand over security to Afghan forces. The foreign military mission is evolving from combat to advising, assisting and training Afghan forces.
The bilateral security agreement will set up a legal framework needed to operate military forces in Afghanistan, including taxation, visas and other technical issues. It does not need to be ratified by Congress. The U.S. has similar agreements with dozens of countries. In Iraq, a similar deal fell apart after U.S. officials were unable to reach an agreement with the Iraqis on legal issues and troop immunity that would have allowed a small training and counterterrorism force to remain there.
Karzai said last month that the issue of soldiers being protected from prosecution in Afghanistan could be a problem in the talks. He has said Afghanistan might demand prosecutions in some cases.
The issue took on new meaning following the case of Staff Sgt. Robert Bales charged in the attacks on Afghan civilians in two villages in southern Afghanistan earlier this year. The American soldier faces 16 counts of premeditated murder and six counts of attempted murder in the March 11 attacks against civilians. A preliminary hearing was held this week at Joint Base Lewis-McChord in Washington state.
____
Associated Press writer Heidi Vogt contributed from Kabul.
FILE - This Friday, Sept. 12, 2008 file photo shows French Justice Minister Rachida Dati, who is pregnant, arriving to a welcoming ceremony for the visit of Pope Benedict XVI, unseen, at the Elysee Palace in Paris. Rachida Dati built her against-the-odds career by defying convention. So it was in character when _ while serving as France?s justice minister _ she had a daughter and refused to say who the father was. This week, Dati took one of France?s richest men to court in a bid to prove he is the father of her 3-year-old. A court in Versailles has set a Dec. 4, 2012 date to decide whether to order Dominique Desseigne, the multimillionaire owner of luxury hotels and casinos, to take a paternity test. (AP Photo/Laurent Rebours, File)
FILE - This Friday, Sept. 12, 2008 file photo shows French Justice Minister Rachida Dati, who is pregnant, arriving to a welcoming ceremony for the visit of Pope Benedict XVI, unseen, at the Elysee Palace in Paris. Rachida Dati built her against-the-odds career by defying convention. So it was in character when _ while serving as France?s justice minister _ she had a daughter and refused to say who the father was. This week, Dati took one of France?s richest men to court in a bid to prove he is the father of her 3-year-old. A court in Versailles has set a Dec. 4, 2012 date to decide whether to order Dominique Desseigne, the multimillionaire owner of luxury hotels and casinos, to take a paternity test. (AP Photo/Laurent Rebours, File)
FILE - This Friday, Sept. 12, 2008 file photo shows French Justice Minister Rachida Dati, who is pregnant, arriving to a welcoming ceremony for the visit of Pope Benedict XVI, unseen, at the Elysee Palace in Paris. Rachida Dati built her against-the-odds career by defying convention. So it was in character when _ while serving as France?s justice minister _ she had a daughter and refused to say who the father was. This week, Dati took one of France?s richest men to court in a bid to prove he is the father of her 3-year-old. A court in Versailles has set a Dec. 4, 2012 date to decide whether to order Dominique Desseigne, the multimillionaire owner of luxury hotels and casinos, to take a paternity test. (AP Photo/Alessandra Tarantino, File)
FILE - This Sept. 17, 2009 file photo shows Casinos Barriere group chairman Dominique Desseigne during a press conference in Paris. Rachida Dati, while serving as France?s justice minister, had a daughter and refused to say who the father was. This week, Dati took one of France?s richest men to court in a bid to prove he is the father of her 3-year-old. A court in Versailles has set a Dec. 4, 2012 date to decide whether to order Dominique Desseigne, the multimillionaire owner of luxury hotels and casinos, to take a paternity test.(AP Photo/Remy de la Mauviniere)
FILE - This Tuesday, July 14, 2009, file photo show French European deputy Rachida Dati at the European Parliament, in Strasbourg, eastern France. Rachida Dati built her against-the-odds career by defying convention. So it was in character when _ while serving as France?s justice minister _ she had a daughter and refused to say who the father was. This week, Dati took one of France?s richest men to court in a bid to prove he is the father of her 3-year-old. A court in Versailles has set a Dec. 4, 2012 date to decide whether to order Dominique Desseigne, the multimillionaire owner of luxury hotels and casinos, to take a paternity test. (AP Photo/Christian Lutz, File)
PARIS (AP) ? Rachida Dati built her against-the-odds career by defying convention. So it was in character when ? while serving as France's justice minister ? she had a daughter and refused to say who the father was.
Now, what was once thought to be an exercise in discretion has morphed into a messy scandal involving tales of power, sex and ambition. Dati, now 46, says simply: "I have a complicated private life."
Dati was the toast of Paris and foreign capitals when she served as justice minister under then-President Nicolas Sarkozy from June 2007 to June 2009. With her Algerian and Moroccan parents and humble origins as one of 11 children in a housing project, she was his emblem of diversity in a new France. Her bling-bling style ? a penchant for Dior clothes, stiletto heels and expensive jewels ? quickly transformed her into Cabinet cover girl.
This week, Dati took one of France's richest men to court in a bid to prove he is the father of her 3-year-old. A court in Versailles has set a Dec. 4 date to decide whether to order Dominique Desseigne, the multimillionaire owner of luxury hotels and casinos, to take a paternity test.
The 68-year-old Desseigne, a friend of Sarkozy and the widowed father of two, is reportedly planning to exercise his right to refuse to provide a DNA sample. Experts say he would do so at his own risk.
The tale is the latest in a series of amorous sideshows that has spiced up the French political scene. These increasingly complicated liaisons have gnawed away at the country's long-standing veil of silence over top politicians' private lives.
Today, the press doesn't shirk at recounting the jealousies of President Francois Hollande's live-in companion toward the mother of his four children. Or Sarkozy's divorce while in office after his wife had an affair, and his quick remarriage to former model and singer Carla Bruni. Or the series of sexual lawsuits involving Dominique Strauss-Kahn, the former chief of the International Monetary Fund.
Nor has it held back with the Dati case. The newspaper Le Monde suggested that Dati entertained a string of eight lovers around the time she was seeing Desseigne. Le Point ran a five-page spread entitled "The Incredible Story of Rachida Dati," prompting Dati to announce Friday that she plans to sue the magazine's director "and his band of so-called journalists."
"What bothers them about me? That I have a life ... that I'm a free woman?" she said on RTL radio, denouncing articles based on "rumors and calumny."
As the country's top judicial official, Dati had a bevy of detractors and raised the ire of lawyers, magistrates and aides who resigned one after the other. The nation, of course, was fascinated.
Still, her star was falling by the time Zohra was born on Jan. 2, 2009. Dati hung on until a government reshuffling in June. She now serves as a member of the European Parliament and keeps a link to the Paris power elite as the mayor of the capital's tony 7th district.
Throughout her pregnancy, rumors flew about the baby's father. An Arab sheik? A French politician? A Sarkozy brother? The name of the Spain's then-prime minister, Jose Maria Aznar, was bandied about so prominently that he was forced to publicly deny it was he.
Dati still hasn't spoken about the little girl's father. But she wants Desseigne, chief of the Lucien Barriere casino group and owner of the famed Champs-Elysees establishment Fouquet's, to step forward. Doing so would give her daughter his name, access to child support and rights as an heir.
The court in Versailles has refused to release any information. But Desseigne, whose wife died in 2001, told M magazine he would contest the request for DNA.
Legal experts say that may be harder than he thinks.
Under the French Civil Code, paternity tests are given voluntarily. But text messages, emails, photos and airline tickets showing the two vacationed together all can be used to prove a relationship, said family law expert Laurence Mayer. And with such corroborating evidence, refusing a paternity test "can be analyzed as an admission."
The man denying fatherhood can try to discredit the woman by "showing she led a dissolute life," but Mayer said he does so "at his risk and peril."
Dati has already shown she is not to be taken lightly. Two men ? both prison inmates who wrote letters claiming they were the father of Dati's child ? have been convicted of insulting a public official.
Mayer doubts Dati would go this route without strong reason.
"If she does this, she is sure of herself," Mayer said. "Mrs. Dati is not just anyone. I don't think she will make herself ridiculous."
Nvidia just released a new version of its GeForce Linux drivers.
The company promises "double the performance and dramatically reduce[d] game loading times."
According to the company, the R310 driver was developed in collaboration with game developers over the course of "almost a year" and "showcase the enormous potential of the world's biggest open-source operating system." Nvidia said that the driver was "thoroughly" tested with Valve's Steam for Linux.
The press release published to support the release of the driver has plenty of calming words for the Linux community, which has grown increasingly unhappy with Nvidia's tight grip on its Linux drivers. It is unlikely that Linux enthusiasts will change their mind simply because of the release of an improved driver, but those who use Linux for gaming would be ?silly not to take advantage of the driver.
However, Valve's quote - "Nvidia took an unquestioned leadership position developing R310 drivers with us and other studios to provide an absolutely unequalled solution for Linux gamers", attributed to the company's vice president of marketing, Doug Lombardi, may not sit so well with the Linux community, which would prefer Nvidia to be in a position to make its code accessible and give the community that "leadership" position.
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To save lives and reduce costs, there would be tremendous advantage if science had a way to stop a devastating hurricane like Sandy. And scientists have thought of it before.
One idea that rears its head almost every hurricane season recently is the notion of bombing a hurricane into submission. The theory goes that the energy released by a nuclear bomb detonated just above and ahead of the eye of a storm would heat the cooler air there, disrupting the storm's convection current.
Unfortunately, this idea, which has been around in some form since the 1960s, wouldn't work.
[50 Amazing Hurricane Facts]
Chris Landsea, science and operations officer at the National Hurricane Center, posted an explanation when he was a research meteorologist with NOAA.
"The main difficulty with using explosives to modify hurricanes is the amount of energy required," Landsea wrote.
A hurricane gets its energy from warm ocean water, and in the process of water vapor condensing into rain droplets. The heat released during condensation serves to continue to warm the surrounding air, which causes more seawater to evaporate, condense, and continue the cycle.
A fully developed hurricane releases 50 or more terawatts of heat energy at any given moment, only about 1 percent of which is converted into wind. The heat release, Landsea wrote, "is equivalent to a 10-megaton nuclear bomb exploding every 20 minutes."? The entire human race in 2011 used about a third of the energy present in an average hurricane.
So bombing a hurricane might be about as effective as trying to stop a speeding Buick with a feather.
There's also the possibility that bombing the hurricane, if it had any effect at all, would just add to the storm's heat supply, making it even stronger.
Why not, then, just nuke tropical depressions before they have a chance to become hurricanes? Partly it's a numbers game, Landsea explained. "About 80 of these disturbances form every year in the Atlantic basin, but only about 5 become hurricanes in a typical year. There is no way to tell in advance which ones will develop." That, and a tropical disturbance is already a pretty powerful beast. If it were just 10 percent as powerful as a full-blown hurricane, it'd still take a huge effort to nip it in the bud.
Finally, whether the bomb would have a minor positive effect, a negative effect, or none at all on the storm's convection cycle, one thing is for sure: It would create a radioactive hurricane, which would be even worse than a normal one. The fallout would ride Trade Winds to land ? arguably a worse outcome than a landfalling hurricane.
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Study suggests too much risk associated with SSRI usage and pregnancyPublic release date: 31-Oct-2012 [ | E-mail | Share ]
Contact: Kelly Lawman klawman@bidmc.harvard.edu 617-667-7305 Beth Israel Deaconess Medical Center
Antidepressants should only be prescribed with great caution
BOSTON Elevated risk of miscarriage, preterm birth, neonatal health complications and possible longer term neurobehavioral abnormalities, including autism, suggest that a class of antidepressants known as selective serotonin reuptake inhibitors (SSRI) should only be prescribed with great caution and with full counseling for women experiencing depression and attempting to get pregnant, say researchers at Beth Israel Deaconess Medical Center, Tufts Medical Center and MetroWest Medical Center.
"Depression and infertility are two complicated conditions that more often than not go hand in hand. And there are no definitive guidelines for treatment," says lead author Alice Domar, Ph.D, Obstetrics and Gynecology, Beth Israel Deaconess Medical Center and Executive Director of the Domar Center for Mind/Body Health at Boston IVF. "We hope to provide a useful analysis of available data to better inform decisions made by women and the providers who care for them."
Domar and colleagues conducted a review of published studies evaluating women with depressive symptoms who took antidepressants while pregnant. The results appear online October 31 in the journal Human Reproduction.
"There are three main points that stand out from our review of the scientific studies on this topic," says senior author Adam Urato, MD, Chairman of Obstetrics and Gynecology at MetroWest Medical Center and a Maternal-Fetal Medicine specialist at Tufts Medical Center. "First, there is clear and concerning evidence of risk with the use of the SSRI antidepressants by pregnant women, evidence that these drugs lead to worsened pregnancy outcomes. Second, there is no evidence of benefit, no evidence that these drugs lead to better outcomes for moms and babies. And third, we feel strongly that patients, obstetrical providers, and the public need to be fully aware of this information."
Over the last 20 years antidepressant usage has increased 400 percent. Antidepressants are now the most commonly prescribed medication in the United States for people between 18 and 44 years of age, the childbearing years for most women. And as women enter their late 30s and early 40s they are more likely to experience infertility.
"According to the Centers for Disease Control, more than 1 percent of the babies born in the USA each year are the result of an IVF cycle," write the authors. "And most women will report symptoms of depression during infertility treatment, especially following unsuccessful treatment cycles."
As many as 11 percent of women undergoing fertility treatment report taking an SSRI to combat depressive symptoms, but Domar and colleagues found no evidence of improved pregnancy outcomes with antidepressant usage, and in fact, found the opposite. They also found plenty of controversy around SSRI efficacy. Many studies found SSRIs to be no more effective or only slightly more effective than placebos in treating depression. "More broadly, there is little evidence of benefit from the antidepressants prescribed for the majority of women of childbearing ageand there is ample evidence of risk," the authors write.
For starters, there is mounting evidence that SSRIs may decrease pregnancy rates for women undergoing fertility treatment. Additionally, studies consistently show that women using antidepressants experience increased rates of miscarriage. There is also a strong signal of congenital abnormalities, the most noted of which is the association between the use of the antidepressant, Paxil, and cardiac defects. In 2005, this association prompted the FDA to ask Paxil's manufacturer, GlaxoSmithKline to change Paxil's risk factor from a C to a D, where a D rating indicates a demonstrated risk to the fetus.
"Preterm birth is, perhaps, the most pressing obstetrical complication," write the authors. In more than 30 studies, the evidence overwhelmingly points to increased risk for early delivery in women who are taking antidepressants. "This is a significant finding because we know that babies born before 37 weeks are at risk for many short and long-term health problems," says Urato. "Caring for premature babies adds up to billions of dollars in healthcare expenditures."
Available data also suggests that antidepressant usage, especially if it extends beyond the first trimester, leads to an increased risk of pregnancy-induced hypertension and preeclampsia. "Given the importance of the hypertensive disorders of pregnancy in terms of maternal and newborn morbidity and mortality, and the widespread use of antidepressants during pregnancy, further investigation into this area will be essential," write the authors.
Similarly, long-term exposure to SSRIs appears to correspond to an increased incidence of birth weight falling below the 10th percentile, coupled with increased rates of respiratory distress.
The health complications associated with antidepressant usage can be carried into infancy and beyond. A 2006 study showed that infants exposed to antidepressants in utero had a 30 percent risk of Newborn Behavioral Syndrome, most commonly associated with persistent crying, jitteriness and difficulty feeding. In more rare instances the syndrome can produce seizures and breathing difficulties leading to the need for intubation. Studies have also shown delayed motor development in babies and toddlers. And a Kaiser Permanente study showed a "two-fold increased risk of autism spectrum disorders associated with maternal treatment with SSRI antidepressants during the pregnancy, with the strongest effect associated with treatment during the first trimester."
"There is enough evidence to strongly recommend that great caution be exercised before prescribing SSRI antidepressants to women who are pregnant or who are attempting to get pregnant, whether or not they are undergoing infertility treatment," says Domar. "We want to stress that depressive symptoms should be taken seriously and should not go untreated prior to or during pregnancy, but there are other options out there that may be as effective, or more effective than SSRIs without all the attendant risks."
Domar and team looked at studies assessing different treatment modalities for depression in the general population, including psychotherapy, exercise, relaxation training, yoga, acupuncture and nutritional supplements. While many of these options were shown to provide some benefit, psychotherapy, specifically cognitive behavioral therapy (CBT) showed the most promise. "There is overwhelming evidence that CBT is equivalent to antidepressant medication in the treatment of mild to moderate depression and more recent research indicates that it is effective in the treatment of severe depression as well," write the authors.
A 2008 study showed impressive results for CBT in depressed women undergoing infertility treatments. The results showed that 79 percent of women who received CBT reported a significant decrease in symptoms, compared with 50 percent of women in the medication group.
"These alternative treatment options may not be appropriate for everyone, still we think it's important for women on an antidepressant who are considering becoming pregnant to have a conversation with their physician about the risks and benefits of continuing to take their medication," says Domar. "Because at this point in time, with no data to indicate an advantage to taking an SSRI during pregnancy, the research all points to increased risk."
###
In addition to Domar and Urato, other co-authors include: Vasiliki A. Moragianni, MD, MS and David A. Ryley, MD of Beth Israel Deaconess Medical Center and Boston IVF.
Beth Israel Deaconess Medical Center is a patient care, teaching and research affiliate of Harvard Medical School, and currently ranks third in National Institutes of Health funding among independent hospitals nationwide. BIDMC is clinically affiliated with the Joslin Diabetes Center and is a research partner of Dana-Farber/Harvard Cancer Center. BIDMC is the official hospital of the Boston Red Sox. For more information, visit www.bidmc.org.
MetroWest Medical Center is a full-service community teaching hospital system dedicated to meeting the health care needs of the MetroWest region of Massachusetts by providing advanced care with a community touch. The 269-bed health care system the largest between Worcester and Boston includes Framingham Union Hospital, Leonard Morse Hospital in Natick, MetroWest HomeCare and Hospice, and The MetroWest Wellness Center, an outpatient diagnostic imaging and rehabilitation center.
Tufts Medical Center is an exceptional, not-for-profit, 415-bed academic medical center that is home to both a full-service hospital for adults and Floating Hospital for Children. Conveniently located in downtown Boston, the Medical Center is the principal teaching hospital for Tufts University School of Medicine. Floating Hospital for Children is the full-service children's hospital of Tufts Medical Center and the principal pediatric teaching hospital of Tufts University School of Medicine. Tufts Medical Center is affiliated with seven community hospitals and with New England Quality Care Alliance, its community physicians' network. For more information, please visit www.tuftsmedicalcenter.org.
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Study suggests too much risk associated with SSRI usage and pregnancyPublic release date: 31-Oct-2012 [ | E-mail | Share ]
Contact: Kelly Lawman klawman@bidmc.harvard.edu 617-667-7305 Beth Israel Deaconess Medical Center
Antidepressants should only be prescribed with great caution
BOSTON Elevated risk of miscarriage, preterm birth, neonatal health complications and possible longer term neurobehavioral abnormalities, including autism, suggest that a class of antidepressants known as selective serotonin reuptake inhibitors (SSRI) should only be prescribed with great caution and with full counseling for women experiencing depression and attempting to get pregnant, say researchers at Beth Israel Deaconess Medical Center, Tufts Medical Center and MetroWest Medical Center.
"Depression and infertility are two complicated conditions that more often than not go hand in hand. And there are no definitive guidelines for treatment," says lead author Alice Domar, Ph.D, Obstetrics and Gynecology, Beth Israel Deaconess Medical Center and Executive Director of the Domar Center for Mind/Body Health at Boston IVF. "We hope to provide a useful analysis of available data to better inform decisions made by women and the providers who care for them."
Domar and colleagues conducted a review of published studies evaluating women with depressive symptoms who took antidepressants while pregnant. The results appear online October 31 in the journal Human Reproduction.
"There are three main points that stand out from our review of the scientific studies on this topic," says senior author Adam Urato, MD, Chairman of Obstetrics and Gynecology at MetroWest Medical Center and a Maternal-Fetal Medicine specialist at Tufts Medical Center. "First, there is clear and concerning evidence of risk with the use of the SSRI antidepressants by pregnant women, evidence that these drugs lead to worsened pregnancy outcomes. Second, there is no evidence of benefit, no evidence that these drugs lead to better outcomes for moms and babies. And third, we feel strongly that patients, obstetrical providers, and the public need to be fully aware of this information."
Over the last 20 years antidepressant usage has increased 400 percent. Antidepressants are now the most commonly prescribed medication in the United States for people between 18 and 44 years of age, the childbearing years for most women. And as women enter their late 30s and early 40s they are more likely to experience infertility.
"According to the Centers for Disease Control, more than 1 percent of the babies born in the USA each year are the result of an IVF cycle," write the authors. "And most women will report symptoms of depression during infertility treatment, especially following unsuccessful treatment cycles."
As many as 11 percent of women undergoing fertility treatment report taking an SSRI to combat depressive symptoms, but Domar and colleagues found no evidence of improved pregnancy outcomes with antidepressant usage, and in fact, found the opposite. They also found plenty of controversy around SSRI efficacy. Many studies found SSRIs to be no more effective or only slightly more effective than placebos in treating depression. "More broadly, there is little evidence of benefit from the antidepressants prescribed for the majority of women of childbearing ageand there is ample evidence of risk," the authors write.
For starters, there is mounting evidence that SSRIs may decrease pregnancy rates for women undergoing fertility treatment. Additionally, studies consistently show that women using antidepressants experience increased rates of miscarriage. There is also a strong signal of congenital abnormalities, the most noted of which is the association between the use of the antidepressant, Paxil, and cardiac defects. In 2005, this association prompted the FDA to ask Paxil's manufacturer, GlaxoSmithKline to change Paxil's risk factor from a C to a D, where a D rating indicates a demonstrated risk to the fetus.
"Preterm birth is, perhaps, the most pressing obstetrical complication," write the authors. In more than 30 studies, the evidence overwhelmingly points to increased risk for early delivery in women who are taking antidepressants. "This is a significant finding because we know that babies born before 37 weeks are at risk for many short and long-term health problems," says Urato. "Caring for premature babies adds up to billions of dollars in healthcare expenditures."
Available data also suggests that antidepressant usage, especially if it extends beyond the first trimester, leads to an increased risk of pregnancy-induced hypertension and preeclampsia. "Given the importance of the hypertensive disorders of pregnancy in terms of maternal and newborn morbidity and mortality, and the widespread use of antidepressants during pregnancy, further investigation into this area will be essential," write the authors.
Similarly, long-term exposure to SSRIs appears to correspond to an increased incidence of birth weight falling below the 10th percentile, coupled with increased rates of respiratory distress.
The health complications associated with antidepressant usage can be carried into infancy and beyond. A 2006 study showed that infants exposed to antidepressants in utero had a 30 percent risk of Newborn Behavioral Syndrome, most commonly associated with persistent crying, jitteriness and difficulty feeding. In more rare instances the syndrome can produce seizures and breathing difficulties leading to the need for intubation. Studies have also shown delayed motor development in babies and toddlers. And a Kaiser Permanente study showed a "two-fold increased risk of autism spectrum disorders associated with maternal treatment with SSRI antidepressants during the pregnancy, with the strongest effect associated with treatment during the first trimester."
"There is enough evidence to strongly recommend that great caution be exercised before prescribing SSRI antidepressants to women who are pregnant or who are attempting to get pregnant, whether or not they are undergoing infertility treatment," says Domar. "We want to stress that depressive symptoms should be taken seriously and should not go untreated prior to or during pregnancy, but there are other options out there that may be as effective, or more effective than SSRIs without all the attendant risks."
Domar and team looked at studies assessing different treatment modalities for depression in the general population, including psychotherapy, exercise, relaxation training, yoga, acupuncture and nutritional supplements. While many of these options were shown to provide some benefit, psychotherapy, specifically cognitive behavioral therapy (CBT) showed the most promise. "There is overwhelming evidence that CBT is equivalent to antidepressant medication in the treatment of mild to moderate depression and more recent research indicates that it is effective in the treatment of severe depression as well," write the authors.
A 2008 study showed impressive results for CBT in depressed women undergoing infertility treatments. The results showed that 79 percent of women who received CBT reported a significant decrease in symptoms, compared with 50 percent of women in the medication group.
"These alternative treatment options may not be appropriate for everyone, still we think it's important for women on an antidepressant who are considering becoming pregnant to have a conversation with their physician about the risks and benefits of continuing to take their medication," says Domar. "Because at this point in time, with no data to indicate an advantage to taking an SSRI during pregnancy, the research all points to increased risk."
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In addition to Domar and Urato, other co-authors include: Vasiliki A. Moragianni, MD, MS and David A. Ryley, MD of Beth Israel Deaconess Medical Center and Boston IVF.
Beth Israel Deaconess Medical Center is a patient care, teaching and research affiliate of Harvard Medical School, and currently ranks third in National Institutes of Health funding among independent hospitals nationwide. BIDMC is clinically affiliated with the Joslin Diabetes Center and is a research partner of Dana-Farber/Harvard Cancer Center. BIDMC is the official hospital of the Boston Red Sox. For more information, visit www.bidmc.org.
MetroWest Medical Center is a full-service community teaching hospital system dedicated to meeting the health care needs of the MetroWest region of Massachusetts by providing advanced care with a community touch. The 269-bed health care system the largest between Worcester and Boston includes Framingham Union Hospital, Leonard Morse Hospital in Natick, MetroWest HomeCare and Hospice, and The MetroWest Wellness Center, an outpatient diagnostic imaging and rehabilitation center.
Tufts Medical Center is an exceptional, not-for-profit, 415-bed academic medical center that is home to both a full-service hospital for adults and Floating Hospital for Children. Conveniently located in downtown Boston, the Medical Center is the principal teaching hospital for Tufts University School of Medicine. Floating Hospital for Children is the full-service children's hospital of Tufts Medical Center and the principal pediatric teaching hospital of Tufts University School of Medicine. Tufts Medical Center is affiliated with seven community hospitals and with New England Quality Care Alliance, its community physicians' network. For more information, please visit www.tuftsmedicalcenter.org.
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Killing drug lords gets headlines, but complexity analysis suggests they are the wrong people to target to bring down a cartel
WHEN the Mexican navy announced on 9 October that Heriberto Lazcano, leader of the country's most violent criminal cartel, Los Zetas, had been killed it was hailed as a major victory in the war on drugs. But it's doubtful that Lazcano's death will be the end of Los Zetas - or reduce violence in Mexico. After all, there is already a new leader.
More useful targets might be those apparently minor players with key connections, according to a complexity analysis approach that could help Colombia - the world's largest producer of cocaine - investigate and prosecute cartel members.
Complexity analysis depicts drugs cartels as a complex network with each member as a node and their interactions as lines between them. Algorithms compute the strength and importance of the connections. At first glance, taking out a central "hub" seems like a good idea. When Colombian drug lord Pablo Escobar was killed in 1993, for example, the Medellin cartel he was in charge of fell apart. But like a hydra, chopping off the head only caused the cartel to splinter into smaller networks. By 1996, 300 "baby cartels" had sprung up in Colombia, says Michael Lawrence of the Waterloo Institute for Complexity and Innovation in Canada, and they are still powerful today. Mexican officials are currently copying the top-down approach, says Lawrence, but he doubts it will work. "Network theory tells us how tenuous the current policy is," he says.
Now Colombian prosecutors have a new tool to add to their investigation methods: network analysis. This can be an integral part of the modern war on drugs, says Eduardo Salcedo-Albaran, director of the Vortex Foundation based in Bogot?.
Vortex uses network-analysis algorithms to construct diagrams for court cases that show the interactions between cartel members, governors and law enforcers. These reveal links that are not otherwise visible, what Salcedo-Albaran calls "betweeners" - people who are not well-connected, but serve as a bridge linking two groups. In Mexico and Colombia, these are often police or governors who are paid by the cartels.
"The betweener is the guy who connects the illegal with the legal," says Salcedo-Albaran. Because many cartels depend on their close ties with the law to operate successfully, removing the betweeners could devastate their operations.
It's a reasonable strategy, says Michael Kenney of the University of Pittsburgh in Pennsylvania, although it shouldn't be the only one governments use. The ideal strategy depends on government goals. If it is the end of the drug trade they are after, removing the leaders may work. But if the goal is to reduce violence, as incoming Mexican president Enrique Pe?a Nieto has vowed to do, targeting kingpins like Lazcano will have the opposite effect, says Vanda Felbab-Brown of the Brookings Institution in Washington DC. Smaller organisations that emerge from a broken cartel tend to assert their power by torturing and killing people.
Fighting all these factions would require even more firepower. Sean Gourley, of the data analysis organisation Quid in San Francisco, used public data from nine recent insurgencies, including Colombia's drug war, to determine mathematically how these battles play out (Nature, doi.org/bv2tf5). "Unfortunately, if you put more forces on the ground, you elongate the violence," he says.
Data collected by the Transborder Institute in San Diego, California, supports this. Prior to the crackdowns that began in 2006, drug-related crimes in Mexico killed about 3700 people per year. In 2011, that number was more than 16,000.
"People keep saying that the violence [in Mexico] will get worse before it gets better, and the cartels are at the end of their lives, but those predictions have been going on for years," says Lawrence. At some point, he suggests, a more mathematical approach will win out.
Lost your cartel? Just Google it
Mexican cartels aren't subtle about their whereabouts. To intimidate their rivals and the government, they advertise their latest crimes through the media and threaten each other on blogs and websites.
But this practice has been revealing their inner workings to Viridiana Rios and Michele Coscia of Harvard University. In a paper that will be presented at the CIKM conference in Hawaii this month, the two created a program called MOGO that searches Google News for references to the different cartels, their locations and their influence between 1999 and 2011.
They used MOGO to construct a map showing where all the cartels were working at each point in time. Their map turned out to be quite accurate, correlating closely with those developed by the global intelligence firm Stratfor.
The cartels' movements reveal a lot about their business strategies, says Rios. Some, such as Los Zetas, are very aggressive, expanding quickly into new territories and competing with rivals. Older organisations such as Sinaloa prefer to strengthen their own territories rather than seek new ones. Understanding the cartels' logic might make it easier to predict their movements, Rios says.
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In a Harvard Business Review article, Thomas Davenport and D.J. Patil named ?data scientist? as the sexiest job of the 21st century. Indeed.com confirms: data scientist is one of the fasting growing job postings in its database.
But are data scientists an entirely new breed of data analysts? Not entirely, according to Michael Griffin, founder and CTO of retail search engine marketing company Adlucent. And he should know: he?s looking to hire a data scientist himself.
?Data scientist is just the new-age term applied to people who have worked in statistics, machine learning or artificial learning in the past,? says Griffin. ?It?s a new moniker to apply to some of the same people.?
So what does a data scientist look like? Bruno Aziza, VP of Worldwide Marketing at SiSense, notes that he finds the most successful data scientists can expertly manipulate databases, collaborate with team members and successfully relay analyses to those outside of the world of data. ?Think of a data scientist more like the business analyst-plus,? says Aziza.
If you?re up to the challenge and want to obtain a job as a data scientist, the time is now. Demand for data professionals is far outpacing supply, and that should continue as more companies look to analyze and benefit from the data they?re collecting. For those interested in becoming the next-great wave of data scientists, here are three secrets to success.
1. Sharpen Your Scientific Saw
Data scientists need to be comfortable with manipulating and analyzing any data?even when it?s housed in exceptionally large, incomplete and disorganized databases. This often requires individuals to hypothesize and test multiple scenarios to find the right solution in unexpected situations.
But we would say the dominant trait among data scientists is an intense curiosity?a desire to go beneath the surface of a problem, find the questions at its heart, and distill them into a very clear set of hypotheses that can be tested. ? Thomas Davenport and D.J. Patil, Harvard Business Review
Krishna Gopinathan, COO and founder of big data platform company Global Analytics Holdings, reinforces the importance of a scientific approach to data analysis. ?The solution to a problem may be hidden in a particular machine learning algorithm or a traditional statistical model,? says Gopinathan. ?Individuals experienced in various domains and working with different problems will be the ones who succeed.?
A variety of academic backgrounds provide a good foundation to be a data scientist. Griffin is looking for a Ph.D. in computer science, machine learning, statistics, applied mathematics, physics or similar disciplines. Gopinathan adds econometrics as another useful discipline of study. Advanced proficiency with mathematics is of course a prerequisite.
In addition, Gopinathan emphasizes the importance of keeping abreast of current research by reading journals such as the Journal of Machine Learning Research or IEEE PAMI.
2. Learn the Language of Business
The responsibilities of a data scientist have a very clear end-goal: derive actionable, profitable insights from data. Individuals transitioning from academia must focus on organizational, project management and communication skills to excel.
?Working in a commercial environment is just different than academia,? says Griffin. For example, Griffin notes that unlike in most academic environments, his position at Adlucent affords a team of developers to assist as needed. To succeed, individuals must be able to delegate tasks, manage projects and lead teams?in addition to wizardly manipulating data.
?You have to be able to produce something that makes a difference very quickly," Griffin says.
Gopinathan notes he has built exceptional data teams around individuals who ask questions about the business, its data and the processes behind its collection. This knowledge ensures that scientists stay focused on projects, tell the most accurate, ?data story,? and make an impact on the business quickly. Knowing the context of data collection and the implication of analyses can position individuals for success on projects that have a widespread impact on the organization.
As Gopinathan notes, ?Insight from a data scientist can reshape an entire company.?
Gopinathan strongly suggests individuals read about how businesses are using data as much as they read trends in data and computing. One of his favorite books: Competing on Analytics, written by Davenport and Jeanne Harris.
3. Keep Adding to Your Technical Toolbelt
Which technologies and tools look best on a resume? Do you need to know HBase, Cassandra, MySQL, Excel, SPSS, R or SAS? The answer: all of the above.
?Becoming an effective data scientist is all about playing with the data cards you?re dealt. The more tools you?ve mastered, the stronger your play,? says Gopinathan.
While working as the chief data scientist at Facebook, Jeff Hammerbacher described how, on any given day, a scientist team would utilize Python, R and Hadoop, and then have to relay the analyses to colleagues. Additionally, a recent SiSense data professionals study found that 60 percent of respondents use three or more data warehouse and business intelligence interfaces.
Thankfully, there are ample resources on the Web to develop and hone your skills. Big Data University, for example, offers free resources to help data professionals gain proficiency in JAQL, MapReduce, Hive, Pig and others.
It?s also important to gain experience using these skills in the ?real world.? Gopinathan advises aspiring data scientists to participate heavily in open-source projects and data contests, such as Kaggle, to practice utilizing technical, scientific and visual skills in real business scenarios.
I?d like to hear other suggestions on how individuals can take their career in data to the next level. What advice would you provide to aspiring data scientists? Please leave your thoughts in the comments section below.
Old Milwaukee, a unit of the PabstBrewing Co., doesn't like to make a big deal out of its ads. In fact, they seem to deliberately hide them.
Business Insider has been diligently following their hidden ad gems over the past year, noting that each spot is in equal measure funny, memorable ? and difficult to find.
Curious why a brand would do this, we set out to understand Old Milwaukee's strategy/non-strategy, beginning with a conversation with the creators of, "Hey, Pass Me a Beer," the latest Old Milwaukee commercial.
Meet Nick and Jack Packard.
They are the creative duo behind? "Hey, Pass Me A Beer," and also happen to be brothers.
During the day, Nick is a marketing consultant, and Jack is the content supervisor for Funny or Die. By night, they are The Packard Brothers, "a truly odd mix of talent that creates a perfect storm of awesome."
So, here's the deal with the Old Mil commercial.
While sitting around the house one afternoon, Jack recalls, "we had this idea for beer passing. We did some test shots, and ended up going through three cases of our own beer. We needed more beer (obviously), so we asked Old Mil, and they were nice enough to supply the rest of the beer for the video."
By the end of filming, they had gone through 192 beers! But, somehow had enough left for "a wicked after party."
Once the video was edited and produced, the brothers shared it with Old Milwaukee. "They really liked it. But, initially, they wanted wanted to put a harder promotional push behind the video," said Jack.
Nick and Jack did not agree with this approach. Instead, they convinced Old Milwaukee to let them post the video on Funny or Die's website to see what would happen.
?It had a very natural build-up,? notes Nick, however, ?had there been a money exchange they [Old Milwaukee] would have wanted more control, so because we weren?t really getting paid for it, we were able to do things how we wanted.?
Shortly there after, "the video was illegally uploaded to a YouTube user's page," said Jack, and quickly went viral.
At its peak, that video had more than 6.5 million views. The brothers never asked the user to take the video down, only to give them a credit, but eventually the user removed the video. Today, the official video is still on YouTube, and has just over 700,000 views.
Nick went on to say "when videos are taken and put up on other pages that is usually a good thing ... It sucks from a monetary point of view, but it's the internet, so you take the good with the bad."
The brothers are currently talking to Old Milwaukee about creating, "Hey, Pass Me a Beer 2." They are hoping to stage similar beer passing stunts around the equipment at the Old Milwaukee factory. If all goes well, the video should be out sometime during the first half of 2013.
Here's the video ... in case you couldn't find it.
An owner of a New Jersey residential roofing and construction company pled guilty this week and may face serious prison time for stealing over $450,000 in unpaid workers? compensation premiums and state income tax.? Herlindo Garcia-Merlos was president of Orients Construction Company, Inc in Trenton, New Jersey until March 2009, when he began doing business as Melrose Construction, Inc.? Yesterday, he pled guilty to two counts of second-degree theft by deception for reporting false information to his companies? workers? compensation insurance carrier and to the state of New Jersey tax office regarding the wages he himself earned.? He also failed to file corporate tax returns for his companies over the five years covered by the investigation which led to his arrest.
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Public release date: 31-Oct-2012
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