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Workers’ compensation rates in West Virginia are expected to decline by 2.9% beginning Nov.  -More- 
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A study by Allstate Insurance found that the country’s worst motorists reside in Philadelphia, Los Angeles and Dallas, while  -More- 
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More companies are expanding their businesses globally, relying more heavily on outsourcing and international supply chains,  -More- 
does anyone know when this will take effect

Companies that seek to benefit from globalization should strive to understand the emerging risks that accompany it, according -More- 
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maybe this will change things

National survey of the current provision of specialist palliative care services for patients with end-stage renal disease.
Nephrol Dial Transplant. 2010 Sep 2;
Authors: Hobson K, Gomm S, Murtagh F, Caress AL
BACKGROUND: Patients with end-stage renal disease (ESRD) experience a significant symptom burden and have complex needs. However, involvement of specialist palliative care (SPC) services with these patients has previously been shown to be limited. This study assesses the current provision of and access to SPC services for ESRD patients in the UK and considers how the provision has evolved over recent years. METHODS: A questionnaire was sent to the lead clinician for all UK adult hospital, hospice and community SPC services, identified from the Hospice and Palliative Care Directory 2008. Non-responders were mailed again after 5 weeks. Descriptive statistics and qualitative thematic analysis were performed. RESULTS: Three hundred and eighteen of 611 (52%) questionnaires were returned. Ninety-six per cent stated that SPC services have a role in caring for patients with ESRD. Two hundred and eighty-one of 318 (88%) accepted referrals, and 185 of 281 (66%) reported that ‘none or few were referred’. Only 7% and 17% of respondents used specific ESRD referral and treatment guidelines, respectively; whereas 79% used the Liverpool Care Pathway for the Dying Patient. Seven per cent undertook joint renal and SPC multi-disciplinary team (MDT) meetings, and 3% held joint out-patient clinics. Forty percent of respondents proposed initiatives to improve palliative care for ESRD patients, with mutual education and collaborative working being key themes for improvement. CONCLUSIONS: The majority of SPC services accept ESRD patients, but limited numbers are referred. Respondents indicated that this barrier could be addressed by closer collaboration and better communication and education between renal and SPC services. Other initiatives to enable delivery of SPC to increased numbers of ESRD patients include the use of specific referral and clinical care guidelines and expansion of joint MDT meetings and out-patient clinics.
PMID: 20813768 [PubMed - as supplied by publisher]

can believe what i am reading, so unfair

Telehealth in palliative care in the UK: a review of the evidence.
J Telemed Telecare. 2010 Sep 2;
Authors: Kidd L, Cayless S, Johnston B, Wengstrom Y
We reviewed telehealth applications which were being used in palliative care settings in the UK. Electronic database searches (Medline, CINAHL, PsychInfo and Embase), searches of the grey literature and cited author searches were conducted. In total, 111 papers were identified and 21 documents were included in the review. Telehealth was being used by a range of health professionals in oncology care settings that included specialist palliative care, hospices, primary care settings, nursing homes and hospitals as well as patients and carers. The most common applications were: out-of-hours telephone support, advice services for palliative care patients, carers and health professionals, videoconferencing for interactive case discussions, consultations and assessments, and training and education of palliative care and other health-care staff. The review suggests that current technology is usable and acceptable to patients and health professionals in palliative care settings. However, there are several challenges in integrating telehealth into routine practice.
PMID: 20813893 [PubMed - as supplied by publisher]

how does this impact my state

Hybrid palliation of interrupted aortic arch in a high-risk neonate.
Ann Pediatr Cardiol. 2010 Jan;3(1):74-6
Authors: Karimi M, Farouk A, Golden A, Gilkeson R
We report a case of a high-risk neonate with interrupted aortic arch (IAA) and ventricular septal defect who underwent a successful hybrid palliative procedure using a ductal stent and bilateral branch pulmonary artery banding. This case represents not only a successful use of hybrid approach in high-risk neonates with IAA, but also introduces an alternative and safe access for ductal stent insertion through the right ventricular infundibulum.
PMID: 20814480 [PubMed - in process]

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Balloon atrial septostomy through internal jugular vein in a 45-day-old child with transposition of great arteries.
Ann Pediatr Cardiol. 2010 Jan;3(1):77-9
Authors: Padhi SS, Bakshi KD, Londhe AP
Balloon atrial septostomy is a common palliative procedure in D-transposition of great arteries. It is technically easy before 2-3 weeks of age when the septum primum is thin. Femoral vein or umbilical vein, when available, is the common access used for this procedure. In situations when these accesses are not available or in case of inferior vena cava interruption, trans-hepatic access is used. Internal jugular vein (IJV) access is not used as it is difficult to enter the left atrium through this route. We describe a case of successful Balloon atrial septostomy done through IJV in a 45-day-old child with emphasis on the technique, hardware and precautions necessary during the procedure.
PMID: 20814481 [PubMed - in process]

this is so true

Epilepsy surgery: Recommendations for India.
Ann Indian Acad Neurol. 2010 Apr;13(2):87-93
Authors: Chandra PS, Tripathi M
The following article recommends guidelines for epilepsy surgery for India. This article reviews the indications, the various surgical options available and the outcome of surgery for drug resistant epilepsy based on current evidence. Epilepsy surgery is a well-established option for patients who have been diagnosed to have drug resistant epilepsy (DRE) (on at least two appropriate, adequate anti-epileptic drugs (AEDs) (either in monotherapy or in combination) with continuing seizures), where the presurgical work-up has shown concordance of structural imaging (magnetic resonance imaging) and electrical mapping data (electroencephalography (EEG), video EEG). There may be a requirement of functional imaging techniques in a certain number of DRE like positron emission tomography (PET), single photon emission tomography, (SPECT)). Invasive monitoring should be restricted to a few when all noninvasive investigations are inconclusive, there is a dual pathology or there is a discordance of noninvasive data. The types of surgery could be curative (resective surgeries: amygdalo hippocampectomy, lesionectomy and multilobar resections; functional surgeries: hemispherotomy) and palliative (multiple subpial transaction, corpus callosotomy, vagal nerve stimulation). Epilepsy surgery in indicated cases has a success range from 50 to 86% in achieving seizure freedom as compared with <5% success rate with AEDs only in persons with DRE. Centers performing surgery should be categorized into Level I and Level II.
PMID: 20814490 [PubMed - in process]

wonder what this really means