Backup strep throat testing may be unnecessary

NEW YORK (Reuters Health) - Doctors don't need to double-check the results of a negative strep throat test because any missed cases typically don't result in additional health problems for patients, according to a new study.

Researchers found that among people with strep throat symptoms, an initial in-office test failed to detect the bacterial infection six percent of the time - but those oversights didn't lead to complications from the infection.

The findings support recent recommendations from the Infectious Diseases Society of America (IDSA) that for adult patients, doctors can rely on the rapid test results alone to make treatment decisions.

"Though I'm confident in our review of the data to say we aren't allowing serious diseases to go untreated, it's reassuring that there were no severe (complications) in persons who had a negative rapid test, but had a positive (secondary) test" in this study, said Dr. Chris Van Beneden, an epidemiologist at the U.S. Centers for Disease Control and Prevention who helped develop the IDSA guidelines.

Many doctors still send out throat swabs for backup testing after an initially negative result. Double-checking office results using a more involved DNA test is also a standard recommendation of the Joint Commission, a healthcare accreditation organization.

The Joint Commission does, however, allow doctors to opt out of backup testing if they can analyze their own procedures and show that the first, rapid test is sufficiently accurate.

The purpose of double-checking negative tests is to make sure no cases go overlooked, because untreated strep throat can develop into serious problems, such as rheumatic fever.

But extra testing costs money, so researchers wanted to see how much was spent on the testing and how many health complications were avoided because of it.

Dr. Georges Nakhoul and Dr. John Hickner at the Cleveland Clinic in Ohio collected medical records over a two-year period from 25,000 adult patients who had come to the clinic for a sore throat.

About 20,000 of the patients received an in-office strep test, and nearly 17,000 of those were negative.

The doctors sent a throat swab off for backup DNA testing for 15,500 patients, and 953 - or six percent - of those secondary tests came back positive.

No patients who were diagnosed based on the backup test developed complications related to their strep throat infection.

TOO MANY ANTIBIOTICS

Almost half of the 953 patients with a late diagnosis were prescribed antibiotics before the positive test result came back.

The other half received their prescription a couple of days after their initial doctor's visit - perhaps too late to be helpful anyway, Nakhoul said.

"By the time they got the call back from the physician to get the antibiotics, it's been two days. This is usually the window when the antibiotic is most effective... so we're not doing the patient any good," he told Reuters Health.

The results show backup testing didn't prevent any inappropriate use of antibiotics, the researchers reported in the Journal of General Internal Medicine.

Not only did many of the late-diagnosis patients get a prescription before the results of the second test came in, 45 percent of patients who had both a negative rapid test and a negative backup test also received antibiotics. Without a bacteria-related ailment, those drugs wouldn't be expected to do patients any good.

Over-prescription of antibiotics is a major public health concern, since any use of the drugs can contribute to resistance - making future infections much harder to treat.

"We know antibiotics are used inappropriately regardless of whether backup (testing) is used or not," Van Beneden told Reuters Health.

Each backup test costs patients or their insurance companies $113 at the Cleveland Clinic - which works out to a price tag of $1.7 million in this study alone.

Nakhoul said because none of the missed cases resulted in complications, the added expense isn't worth it.

For practices using an in-office rapid test, he said, "physicians should just believe the (test) and not do the second step."

SOURCE: http://bit.ly/Thuj4o Journal of General Internal Medicine, online October 6, 2012.

Source: http://news.yahoo.com/backup-strep-throat-testing-may-unnecessary-150143831.html

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Germany coach admits errors against Sweden

Germany coach Joachim Loew has admitted making mistakes during his team's 4-4 draw with Sweden in last week's World Cup qualifier after the Germans threw away a four-goal lead.

Germany were 4-0 up at Berlin's Olympic Stadium with more than an hour played before the hosts' defence folded in the final 30 minutes as Sweden roared back to claim a point.

Midfielder Rasmus Elm wrote himself into Swedish football folklore with the dramatic right-footed equaliser in the 93rd minute to leave Sweden second in Group C, three points behind leaders Germany, but with a game in hand.

It was the first time in the 104-year history of the German Football Federation (DFB) that a four-goal lead has been surrendered and the first time in three years Germany had dropped points in a qualifying match.

Loew, whose team face the Netherlands in a friendly in Amsterdam next month, admits he could have done better and can understand criticism levelled at him.

"Maybe I could have sent out a signal by making a substitution, with a defensive man who could have provided some relief to the team," Loew said in an interview with SID, an AFP subsidiary.

"I had also not experienced something like this in 20 years. I will also learn from this."

With debate now raging in Germany as to what went wrong, Loew said he could understand the criticism because he was "also stung" by the draw.

"Our players had the feeling of certain victory and didn't imagine it would come down to such a situation," he said.

"Then we resorted to inappropriate means in order to try and turn things around by making basic mistakes.

"If you want to avoid a sporting disaster like this, then you have to sometimes just do the simple things which put you in a strong position again."

Source: http://wwos.ninemsn.com.au/article.aspx?id=8552341

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Hilary Wagner: What You Gain from Public Speaking

In October 2010, when my first book came out, I was painfully nervous talking in front of groups. It didn't matter if it were kids or adults, I'd have so much anxiety I'd come close to backing out, that's how bad it got! On one occasion, I was scheduled to speak in front of 450 kids and came close to cancelling with some lame excuse, because I wasn't about to tell them it was my horrible fear of utter failure! My husband told me I had to do it. He said, he knew I was scared, but it was more important to not let the kids down, and in turn, not let down myself. He was so right! It was a rewarding experience and as soon as I got going I was fine. I still fought the anxiety for a while, but now, two years later, talking in front of groups, big or small, is such a pleasure!

I literally get goose bumps when kids sit up in their chairs and I can see them listening and thinking. And after my presentations, when kids come up and tell me about their stories and what they're writing, I can feel their excitement about writing. They ask for advice and ask me what I think about their ideas, and trust me, some of these kids have amazing ideas! They inspire ME!

Long story short, never be scared to share your story or give your advice. Even if you fall on your face, if you've inspired one writer, young or old, or they've inspired you, something amazing just happened!?

Source: http://hilarywagner.blogspot.com/2012/10/what-you-gain-from-public-speaking.html

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A Personal Loan To Settle Other Outstanding Debts ... - About Finance

Posted by Alex Cha on October 23rd, 2012Rating 9.0 ?Outstanding

Taking a new loan if you have other loans yet to repay may not be the smartest move to make. You just can?t pay debt with another debt. But there?s an exception to that law. If you have a lot of unpaid debts and their interests taking most of your instalment bill, then it?s prudent to consolidate your loans. This is especially helpful to people who have loans from different lending firms simultaneously and those who just pay the minimum monthly fee.

A lot of us have numerous payments to resolve every month. We need to pay basic utilities, insurance, credit cards, and our loans. If you?re the type who just pays the minimum monthly bill of your credit cards, then you have a far way to go before you can settle the total bill because chances are, you?re only paying the interest rate and annual charge. you?ve hardly touched the surface of the principal amount of the big purchase you made years ago. It would possibly take you forever before you can clear out your credit card and other loan payments.

Acquiring a personal loan to merge all your loans can make your job easier. You can take out a loan to pay off numerous banks and lending firms. This will remove the individual interest rates of your debts, which, as we all know, are what make loans really hard to repay in full. apply for a personal loan to pay off your consolidated debts so you would just need to settle one loan in monthly terms. It?s indubitably easier and more convenient to pay just one loan.

The interest can likewise be lowered because there are credit companies offering debt consolidation that negotiate lower interest rates with other lenders. The great thing about acquiring personal loans for loan consolidation is the flexible payment terms. A lot of credit companies offer affordable payment plans that are customised to the debtor?s capability to pay. So rather than being laden with high monthly payment instalments, the debtor can negotiate with the creditor for a more affordable payment term.

Personal loans are generally unsecured, which means the loan applicant doesn?t have to present a significant asset to the lending firm as a security guarantee for the loan. That is why personal loans are a popular option. People who don?t have a significant property have a chance of being granted for the loan.

Related articles on Personal Loans or visit www.monetiumcredit.com.sg

Under Topics: consolidated debts, consolidated loans, credit company, finance, lending company,

Source: http://www.vvy.in/finance/a-personal-loan-to-settle-other-outstanding-debts/43116/

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Ongoing Children's Classes At The Longview Recreation Center ...

The Williamson County Parks and Recreation Department will offer a variety of ongoing classes for children in November at the Longview Recreation Center, 2909 Commonwealth Drive in Spring Hill. Classes require pre-registration and space may be limited. For information about activities at the Longview Recreation Center, call (615)302-0971, ext. 10 or view the monthly newsletter at www.wcparksandrec.com. You may also receive department information by ?liking? us on Facebook. The Longview Recreation?Center is a?public facility, here to benefit the community. Anyone, including out-of-county residents, can register for and participate in?classes and events held at Longview, even if you don?t have a facility pass!

LONGVIEW JUDO/KARATE

Join Instructor Richard Javitt?s?martial arts program; a combination of Judo and Karate. Great for exercise, confidence and self defense. This class for ages 8 and older will meet on Mondays, November 5-26 (skip 11/12) from 5:15-6:15 p.m. at the Longview Recreation Center, 2909 Commonwealth Drive in Spring Hill. The class fee is $30 per person. Please register by calling (615)302-0971, ext. 10.

MARTIAL ARTS FITNESS

This class combines the elements of Kick Boxing, Karate, judo and the sword to develop fitness, increased flexibility, coordination and lifelong wellness. All levels of fitness are welcome. This class for ages 8 and older will be held on Mondays, November 5-26 (skip 11/12) from 6:30-7:30 p.m. at the Longview Recreation Center, 2909 Commonwealth Drive in Spring Hill. The class fee is $30, and the instructor is Richard Javitt. Please register by calling (615)302-0971, ext. 10.

POLYNESIAN DANCING

Learn to dance like the natives of Hawaii, Samoa, New Zealand and Tahiti in this fun 4-week class of Polynesian dancing. Instructor Chris Hendrickson uses these dance representations as a form of both exercise and education. Adults and teens are welcome in the class which will meet on Wednesdays, November 7-28 (skip 11/21) with a beginner class from 5:15-6 p.m. and an intermediate class from 6-7 p.m. at the Longview Recreation Center, 2909 Commonwealth Drive in Spring Hill. The class fee is $18.75 for the first family member and $15 for each additional family member. The supply fee is $5. To register, call (615)302-0971, ext. 10.

AMERICAN RED CROSS BABYSITTER?S TRAINING
This class will give participants, ages 11-15, the skills and confidence they need to become great babysitters. This course covers training in care-giving, decision making, safety and first aid skills, plus preventing and responding to emergencies. Pre-registration with the instructor is required. This class will meet on Saturday, November 10 from 9 a.m.-3 p.m. at the Longview Recreation Center, 2909 Commonwealth Drive in Spring Hill. Participants should bring a sack lunch to class. The class fee is $85. To register, call instructor Cyndea Wendell (615) 585-9055. For more information about this class visit the website at www.redcrossbabysitter.com

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Tags: featured, Longview Recreation Center, Maury County, moms, Spring Hill, thompson's station, Williamson County Parks and Recreation Department

Category: Events, Fundraisers & Announcements

Source: http://springhillfresh.com/blog/2012/10/21/ongoing-childrens-classes-at-the-longview-recreation-center/

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Campaigning during cancer recovery cost me votes: Chavez | The ...

By Agence France-Presse
Sunday, October 21, 2012 10:25 EDT

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CARACAS ? Venezuelan President Hugo Chavez, who was diagnosed with cancer in 2011 and won re-election this month, acknowledged that campaigning while in recovery cost him votes.

Chavez on Saturday said in a meeting shown on state television VTV that after radiation therapy, he had only done ?10 percent? of what he would have normally done on the campaign trail, adding he would have done more if he had been ?fully fit.?

The 58-year-old populist socialist leader, in power since 1999, won 55.26 percent of the vote on October 7, against 44.13 percent for challenger Henrique Capriles, a businessman and governor of Miranda state.

?If I had been ? fully fit, I would have beaten the (opposition) candidate by at least 20 percent,? boasted Chavez, who was criticized by the opposition for keeping details of his illness close to the vest, and for seeking treatment in Cuba.

The anti-US firebrand has vowed to deepen his oil-funded socialist revolution after a ?perfect? victory.

But he also reached out to disenchanted voters by pledging to work with the opposition, a tacit acceptance that this was a narrower victory than in the past and that Venezuela is a country very much divided.

The fate of Chavez, the leading voice of Latin America?s left, was closely watched by communist ally Cuba, which heavily depends on Venezuela?s oil, and other regional partners.

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Source: http://www.rawstory.com/rs/2012/10/21/campaigning-during-cancer-recovery-cost-me-votes-chavez/

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phxsoul.com: Urban Projex Presents Poetic-Artistic Showcase on ...

Music and spoken word artists/lovers are invited to attend the Urban Projex Poetic-Artistic Showcase hosted by Harold Branch of HomeBase Poetry on November 18 at Hard Rock Cafe, 3 South 2nd Street, Phoenix. Doors open at 7pm.

Live house band Missin Links featuring Will Gaines, Lamar Gaines, Jermaine L.aka-UNLIMITED/Urban Projex

Featured acts: Kevin Daily from the late WordPlay Poetry, Shaikh Sammod, MysticBlu, Roosevelt Watts, Kafiah Winston, Nikki G, Vaughn SWIF Willis, Tomas Stanton, D. Fahie, Charles Levett, and IamJones!

With special guest performances from: Morris Alan, Mocha, Connie Muhammad, Art Hughes, Kaos!

Also spinning the hits DJ Private!

There will also be a open mic sign-up from 9-9:30pm

Drink specials and happy hour prices!

$10 cover. VIP tables for $15.

****Dress fashionably nice!****

Event subject to change without notice

Source: http://www.phxsoul.com/blackweblogs/2012/10/urban-projex-presents-poetic-artistic-showcase-on-november-18-at-hard-rock-cafe-in-phoenix.html

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Understanding That You'll Never Be Perfect | World of Psychology

Understanding That You'll Never Be PerfectI?ve been gradually learning something about myself:

I want to be perfect.

And the fact that I?m not causes me suffering.

All of the major world religions teach this lesson upfront: you?re not perfect, and the sooner you accept that fact, the less agony you?ll put yourself through trying to prove otherwise.

In his book, Living Wabi Sabi, Taro Gold writes:

Those who inspire us most do not achieve perfection through greatness: They achieve greatness through imperfection. All of the world?s best-loved truth-seekers and religious figures, including Jesus and Buddha, led obviously less-than-perfect lives and were the first to let us know that they, too, were not perfect people?

Did you know that numerous imperfections, failures, and mistakes led to the discovery of DNA, penicillin, aspirin, X-rays, Teflon, Velcro, nylon, cornflakes, Coca-Cola, and chocolate-chip cookies? In our own lives, it?s not the parties and vacations but the mind-opening trials of heart and soul that lead us to our greatest personal discoveries.

This is good news for people who are depressed. Because rarely do we get a vacation from the hard work of preserving sanity, and, well, I?m thinking the parties at therapy and within the hospital psych units are a tad different than the ones Taro had in mind. Most days involve trudging, ever so diligently, up the hill of recovery that usually feels like a mountain.

I guess that?s what I?ve been doing the last few weeks: trudging.

I want to be perfect.

I want to erect boundaries one time, and have them stay there, like boulders, for the rest of my life ? uncompromised in times of stress and uncertainty. But that?s not life. Which presents one dilemma after another, just to make sure you don?t stop using all the problem-solving techniques you learned in therapy.

I want to be perfect.

I don?t want to have to discern between a ?conviction? ? like being a more attentive mom, and dealing with tantrums better than overpowering the screaming by blasting Mozart in my ears ? and a ?condemnation? ? telling myself I am a bad, bad mom who isn?t capable of keeping good boundaries. I don?t want to have to learn the same damn lesson over and over and over again.

And yet, ironically, that?s where the wonder and amazement are. Mornings like today, when my imperfections are as obvious as the rain outside, is when I discover what I?m made of. Anna Quindlen writes in Being Perfect:

What?s really hard and really amazing, is giving up on being perfect and beginning the work of becoming yourself. More difficult because there is no zeitgeist to read, no template to follow, no mask to wear. Terrifying, actually, because it requires you to set aside what your friends expect, what your family and your co-workers demand, what your acquaintances require, to set aide the messages this culture sends, through its advertising, its entertainment, its disdain, and its disapproval, about how you should behave?

Begin with the most frightening of all things, a clean slate. And then look, every day, at the choices you are making, and when you ask yourself why you are making them, find this answer: Because they are what I want, or wish for. Because they reflect who I am.

This is the hard work of life in the world, to acknowledge within yourself the introvert, the clown, the artist, the homebody, the goofball, the thinker. Look inside. That way lies dancing to the melodies spun by your own heart.

I am not perfect.

I?m as close to perfection as Antarctica is to Brazil.

But that means I get to start over each day, to figure out a new system that can function with new rules, another game plan that will assist me in getting my boundaries right again. And if that configuration doesn?t work, I?ll wake up and try yet again.

Therese J. Borchard is the author of Beyond Blue: Surviving Depression & Anxiety and Making the Most of Bad Genes and The Pocket Therapist: An Emotional Survival Kit. Write to her at comment@thereseborchard.com or follow her on Twitter @thereseborchard.

Like this author?
Catch up on other posts by Therese J. Borchard (or subscribe to their feed).



????Last reviewed: By John M. Grohol, Psy.D. on 20 Oct 2012
????Published on PsychCentral.com. All rights reserved.

APA Reference
Borchard, T. (2012). Understanding That You?ll Never Be Perfect. Psych Central. Retrieved on October 21, 2012, from http://psychcentral.com/blog/archives/2012/10/21/understanding-that-youll-never-be-perfect/

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Source: http://psychcentral.com/blog/archives/2012/10/21/understanding-that-youll-never-be-perfect/

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Katich hopeful on ending the CL T20 campaign on a high ? Cricket ...

Katich hopeful on ending the CL T20 campaign on a high ? Cricket News Update

Simon Katich has said that Perth Scorchers will be aiming to end the Champions League T20 on a high when they take on Auckland Aces in their final group game on Tuesday, at Centurion.

After finishing up runners up in the first edition of the lucrative Big Bash League, the Scorchers failed to impress in the ongoing T20 event after remaining pointless from their first three games. They opened their campaign against the Titans but suffered a 39-run loss before watching rain interrupt the proceedings in their second match against the Kolkata Knight Riders, which had to be called off.

They needed a big win against Delhi Daredevils last night, but found themselves again on the receiving end, the outcome of which ensured that they remained bottom of their group. While taking total blame of their current standing, Katich said that the players are eager to end their campaign on a high and make amends for letting themselves down. The team lock horns with the Aces, who are desperately in need of a win to keep their semi-final hopes alive.

"I'd like to think they'll have a lot of pride in their own performance and the team's performance," he said. "We certainly haven't played anywhere near what we did last summer, and hopefully that's going to bug quite a few of the guys to put in a good performance to finish well."

Despite having players with considerable international know-how, the likes of Herschelle Gibbs, Paul Collingwood and Katich himself, the left-hander said that the tournament has been a great journey for some of the younger, inexperienced blokes.

Most of these youngsters ply their trade in the Australian domestic circuit, and Katich feels that the exposure of playing against some of the world?s best has been positive for their development which will hold them in good stead for their future endeavours.

"There's a lot of guys in our squad that haven't played a lot of international cricket, and they're trying to press for higher honours," he said. "It's a great experience for them to come up, and for Beery [Michael Beer] to bowl at the likes of Pietersen, Sehwag and Ross Taylor and face Morne Morkel, because these guys are all very good international players. So from their development point of view it's been a positive.?

Source: http://blogs.bettor.com/Katich-hopeful-on-ending-the-CL-T20-campaign-on-a-high-Cricket-News-Update-a196634

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