Analyzing The FDA Bills Course Bipartisanship Or Something Else

first_imgAnalyzing The FDA Bill’s Course: Bipartisanship Or Something Else? Politico: FDA Bill No Model For BipartisanshipThe bipartisan treatment the FDA user fee bill has enjoyed did not fall like manna from heaven. It came at the insistence of the pharmaceutical and medical device industries, the FDA and legislators on both sides of the aisle who agreed early on they would get a deal done. And then actually did it (Norman, 6/25). This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.last_img read more

House GOP Seeks Details On Administration Health Spending

first_imgHouse GOP Seeks Details On Administration Health Spending This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription. Members of the House Ways and Means Committee and the Energy and Commerce Committee are following the spending trail of Obama administration health programs.The Hill: House Republicans Ask For Details On Health Care Implementation SpendingHouse Republicans on Thursday asked government auditors for a detailed accounting of the money being used to implement President Obama’s healthcare law. Republican leaders on the Ways and Means Committee asked the Government Accountability Office (GAO) to investigate how much money the Obama administration has spent implementing the law — and how much it expects to spend through 2014, when most of the major provisions take effect (Baker, 8/9).Kaiser Health News: 3 House Republican Ask For GAO Report On CMS SpendingIn January 2011, Department of Health and Human Services Secretary Kathleen Sebelius announced that the Office of Consumer Information and Insurance Oversight, one of several agencies charged with implementing the health law, would be moved from her office into CMS. The reorganization,  Sebelius wrote, was done to improve implementation of the health law and to create “administrative savings and organizational efficiencies.”  The agency was renamed the Center for Consumer Information and Insurance Oversight, or CCIIO. In their letter Thursday, the House Republicans suggested a different motive for the shift. “We suspect what precipitated this reorganization was the desire by Obama Administration officials to tap into the significant financial resources at CMS’ disposal” (Carey, 8/10).CQ HealthBeat: Republicans Concerned About Use Of Funds For Health Insurance Oversight OfficeTop House Ways and Means Committee Republicans on Thursday requested a financial analysis of money spent on a health care oversight center, saying the Obama administration may have diverted funds from Medicare and Medicaid. Three GOP lawmakers asked the Government Accountability Office to audit all the money allocated to the Center for Consumer Information and Insurance Oversight (CCIIO), which was created under the 2010 health care law (Ethridge, 8/9).The Hill: GOP Wants More Records On $8B Medicare ProgramHouse Republicans say the Obama administration hasn’t fully answered questions about a controversial Medicare program. Republican leaders on the Energy and Commerce Committee wrote to the Health and Human Services Department on Thursday to request more information about the $8 billion program, which is under fire from lawmakers as well as the nonpartisan Government Accountability Office. GAO has said HHS should simply end the demonstration program, which gives bonus payments to Medicare Advantage plans that meet certain quality standards (Baker, 8/9).last_img read more

Average Exchange Premiums Show Slight Decline In 2015 Report

first_imgInsurance filings in 16 major cities for benchmark “silver” plans sold on the online marketplaces show premiums will decline by less than 1 percent, the report by the Kaiser Family Foundation found.Kaiser Health News: Capsules: Early Results: Average 2015 Exchange Premiums Decline SlightlyIn preliminary but encouraging news for consumers and taxpayers, insurance filings show that average premiums will decline slightly next year in 16 major cities for a benchmark Obamacare plan. Prices for a benchmark “silver” or mid-priced plan sold through the health law’s online marketplaces aren’t all moving in the same direction, however, a report from the Kaiser Family Foundation (KFF) shows. (Kaiser Health News is an editorially independent program of the foundation.) In Nashville, the premium will rise 8.7 percent, the largest increase in the study, while in Denver it will fall 15.6 percent, the largest decrease (Hancock, 9/5). Politico Pro: Premiums For Benchmark Obamacare Plans Dropping Slightly, Kaiser FindsPremiums for the benchmark plan used to calculate Obamacare subsidies are tilting down by less than 1 percent next year, according to a new analysis from the Kaiser Family Foundation. That means a smaller bite out of the federal budget, but may mean consumers should switch plans for the best deal. Kaiser looked at premiums in the largest cities in 15 states and the District of Columbia and found that the second-lowest cost silver plan, which is used to calculate subsidies, will decrease on average by 0.8 percent in 2015 (Villacorta, 9/4).Modern Healthcare: Insurance Exchange Premium Increases Look Modest For 2015Consumers in certain silver health insurance exchange plans can expect to see a drop in their premium costs for 2015, while some in bronze plans will see increases, a new analysis finds. … Those in bronze-level plans, which are the least expensive option to satisfy the ACA’s requirement for coverage, should expect to see their premiums rise an average of 3.3%. Rate changes examined for bronze plans ranged from a 15.7% decrease in Hartford, Conn. to a 13.3% increase in Baltimore (Dickson, 9/5). In other news about premium rates -Charlotte Observer: Claims About NC Rate Hikes For Health Insurance Aren’t Easy To ProveWhen U.S. Senate candidate Thom Tillis talked in Wednesday’s debate about health care costs rising 11 percent, he was using data that has North Carolina officials and health care analysts baffled. A report from PricewaterhouseCoopers’ Health Research Institute purports to list proposed rate increases for health insurance policies that will be sold on the Affordable Care Act exchange in North Carolina next year. A spokeswoman for the New York-based firm said that information came from the N.C. Department of Insurance website. But unlike some states, North Carolina doesn’t make rate requests public. … The confusion highlights the anxiety and mistrust in the air as the Affordable Care Act approaches its second year. Rate increases are anticipated for at least some of the policies purchased through the exchange this year, many of which came with federal subsidies (Helms, 9/4). Average Exchange Premiums Show Slight Decline In 2015: Report This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.last_img read more

Colorado Projects 30 Percent Enrollment Attrition

first_imgColorado Projects 30 Percent Enrollment Attrition This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription. Meanwhile, a new judge is assigned to hear Oregon’s lawsuit against Oracle after the first one withdraws from the case.Health News Colorado: Thirty-Percent Attrition Bites Into Exchange RevenuesHealth exchange managers expect to lose about 30 percent of enrollees due to attrition by year’s end, meaning they’ll start the 2015 open enrollment with about 114,000 customers. Connect for Health Colorado managers expect enrollments to slide back from a total of 146,000 so far. For 2015, managers are hoping to retain a base of 114,000. Then, initial projections for next year predict low-end sign-ups of 54,500, a mid-level goal of 80,000 and a high-end target of 128,500 additional customers (Kerwin McCrimmon, 9/25).Oregonian: Judge Withdraws From Cover Oregon Case Against Oracle AmericaThe judge overseeing Oregon’s lawsuit against Oracle America over the Cover Oregon health exchange has withdrawn from hearing the case, saying that for her to do so would be “inappropriate.” The case, a priority for Gov. John Kitzhaber, has now been reassigned from Marion County Circuit Court Judge Cheryl Pellegrini to her colleague Courtland Geyer, a third-year judge. Marion County assigns cases randomly between its 12 downtown Salem judges, a court administrator said (Budnick, 9/25).last_img read more

Medicare Enacts Major Reimbursement Change For Knee And Hip Replacements

first_img This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription. Private ambulance company owners in South Carolina have become increasingly critical of a Medicare experiment designed to eliminate insurance fraud and save the federal government money. … Medicare implemented the new rule in South Carolina almost a year ago. It requires patients to obtain prior authorization before the government pays for routine, non-emergency ambulance transportation. In theory, the rule makes sure only the sickest patients who can’t transport themselves qualify for the expensive service. But ambulance owners have complained that the company designated to administer Medicare in South Carolina seems to approve and deny transportation requests at whim. (Sausser, 11/16) The (Charleston, S.C.) Post and Courier: Medicare Rule Draws Sharp Criticism From Ambulance Industry The Associated Press: Medicare Launches Payment Overhaul For Hip, Knee Replacement Surgery center_img Medicare Enacts Major Reimbursement Change For Knee And Hip Replacements To try to bring down costs and improve quality, payments and rewards will be tied to the results of the surgical procedure. Elsewhere, South Carolina ambulance owners complain that a Medicare experiment requiring patients to obtain prior authorization for non-emergency ambulance transportation is not being administered properly. Striving for better quality and more predictable costs, Medicare on Monday launched a major payment change for hip and knee replacements, the most common inpatient surgery for its 55 million beneficiaries. Starting April 1, hospitals in 67 metropolitan areas — from Akron, Ohio, to Wichita, Kansas — will be held responsible for the results of hip and knee replacements. The aim is better coordination that starts with the surgery itself, and continues through recovery and rehabilitation. (Alonso-Zaldivar, 11/16) last_img read more

Viewpoints Obamacare News SinglePayer Debates And Other Health Reform Buzz Words Medicares

first_img For more than half a century, the clinical development of anticancer drugs has followed a predictable and orderly set of sequential stages: phase 1 trials were designed to determine the drug’s safety, tolerability, and dose; phase 2 trials then explored the drug’s activity in a variety of cancers; and phase 3 trials compared the new drug with existing treatments and served as the basis for regulatory approval. Advances in our understanding of cancer biology in the past decade have led to both development of more effective drugs and improved patient selection made possible by early biomarker discovery and companion diagnostic development. Desire for early access to transformative new anticancer drugs has resulted in increased demand for patient entry into first-in-human trials, as well as calls for expediting the drug development and approval process. The three distinct sequential phases of drug development have therefore become increasingly blurred. (Tatiana M. Prowell, Marc R. Theoret and Richard Pazdur, 4/13) Investors have not had their fill of digital health deals, according to new fundraising reports from Rock Health and Startup Health, two outfits which have led the digital health revolution and produce complementary reports on how much capital is flowing into the sector. While other sectors have wobbled recently, digital health (which was only defined as a market five or six years ago) continues to attract venture capital. (John Graham, 4/13) The Boston Globe: Don’t Deny Hepatitis C Patients A Cure The Chicago Sun-Times: Treating Mentally Ill As Criminals Destroys Lives, Wastes Money Bloomberg: Obama’s Health-Care Act Encounters Another Bump In The Road Well, the hammer has fallen: The largest health insurer in the U.S. has started pulling out of select Obamacare exchanges.(Megan McArdle, 4/13) If we paid for homes or college education the way that we pay for curative drugs, much fewer Americans would own a home and America’s tertiary education attainment rate wouldn’t be fifth highest in the OECD. So despite the problems in our student loan system, and the (obvious) concerns about promoting too much home ownership, perhaps our pharmaceutical reimbursement systems can benefit from some outside “disruption.” (Yevgenly Feyman, 4/13) In his smart opinion piece last week, “A Mason-Dixon Line of Progress,” Timothy Egan noted the “retreat to bigotry” sweeping across the old South as politicians clinging to the past (under the banner of religious freedom) line up to authorize discrimination against gay people. The column prompted me to think about whether the battlegrounds in the never-ending abortion wars display a similar geographic concentration. The answer is that to a startling degree they don’t. The battleground is much bigger. With the exception of the West Coast and most (but not all) of the Northeast, recently enacted abortion restrictions can be found almost everywhere. (Linda Greenhouse, 4/13) This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription. Forbes: Let’s Pay For Cures Like We Pay For Homes JAMA: Medicare’s Vision For Advanced Primary Care The Wall Street Journal: What Paul Ryan’s Stance On 2016 Means For Health Care How do you justify withholding a wonder drug from patients infected with a liver-killing virus until the disease starts to ravage their bodies? Why, in other words, do they have to become seriously ill before receiving help? Although biomedical advances have given rise to a new class of drugs that can cure hepatitis C, which is often fatal, a basic socioeconomic problem remains to be solved: Because of the high cost of the medicine, many public and private health insurers restrict access to treatment until the onset of liver damage. It’s a short-sighted approach that causes suffering and is at odds with a basic tenet of modern medicine — early intervention. (4/14) Paying doctors a fee for each service they provide gives them incentive to offer the maximum number of treatments, as well as pay less attention to how well patients recover. This is why the Barack Obama administration — and just about everyone else — wants to change the way doctors get paid. (4/13) The New York Times’ Upshot: News About Obamacare Has Been Bad Lately. How Bad? The New England Journal Of Medicine: Seamless Oncology-Drug Development Ever since passage of the Affordable Care Act, a fierce debate has been waged over whether the law would work as advertised. While advocates promised that the design of new insurance markets would transform the way consumers buy health insurance, critics warned that the new market would never succeed. Reed Abelson and Margot Sanger-Katz have had front-row seats to the debate, and the two reporters took a few minutes to discuss when — and if — the market would stabilize. (Reed Abelson and Margot Sanger-Katz, 4/13) center_img Modern Healthcare: Arkansas Governor Uses Highway Funding As A Chip To Protect Medicaid Expansion The decision by House Speaker Paul Ryan to bow out of any attempt to draft him as the Republican presidential nominee in Cleveland and press ahead with his domestic policy agenda could be significant for health care. The next big debate might not be about Republican proposals to repeal and replace the Affordable Care Act. It might focus more on the future of the two largest public health-care programs, Medicare and Medicaid. As the chart above shows, Medicare covered 55 million and Medicaid covered 66 million people in 2015 at a cost of more than $1 trillion. Together, they represented 23% of the federal budget. (Drew Altman, 4/13) Forbes: Digital Health Funding Defies Expectations The 2016 U.S. presidential campaign has produced many surprises. One unexpected turn is the reemergence of single-payer health insurance on the public agenda. Senator Bernie Sanders has made Medicare for All a centerpiece of his platform. His opponent for the Democratic party’s presidential nomination, former Secretary of State Hillary Clinton, has criticized Sanders’s plan as unrealistic. An old debate has thus reopened. What are the virtues and vices of single-payer reform? Is it a realistic option for the United States or a political impossibility? (Jonathan Oberlander, 4/14) The New York Times: The Abortion Map Today Consistent with the goals of the Affordable Care Act and the Medicare Access and CHIP Reauthorization Act of 2015, the Centers for Medicare & Medicaid Services (CMS) is increasingly paying for health care through alternative payment models that reward value and quality.1 These models include accountable care organizations, bundled payments, and advanced primary care medical homes. In this Viewpoint, we focus on advanced primary care medical homes. (Laura L. Sessums, Sarah J. McHugh and Rahul Rajkumar, 4/11) The Wall Street Journal: The Orphan Drug Act’s Successes Outweigh Its Failures Thirty-three years ago ago, the U.S. Congress passed the Orphan Drug Act, which was signed into law by President Reagan. This act provided incentives for the development and commercialization of drugs to treat orphan or rare diseases, defined as those illnesses affecting fewer than 200,000 individuals. In the decade prior to its passage, 10 such drugs became available. After the act’s signing, 400 novel therapies entered the market. In the past year (2015) alone, the Food and Drug Administration approved 21 new entities. (Howard Forman, 4/13) The Concord Monitor: Our Turn: Emergency Room Is No Place To Treat Mental Illness “We don’t do hospitals. We do jail.” That, we are told, is what a Chicago police sergeant said in 2012 when the parents of man who was exhibiting bizarre and aggressive behavior asked the police to take their son to a hospital. (4/13) Viewpoints: Obamacare News, Single-Payer Debates And Other Health Reform Buzz Words; Medicare’s Doctor Payment Overhaul A selection of opinions from around the country. Bloomberg: Doctor-Pay Reform Crawls At The Speed Of Medicare Imagine rushing an acutely ill friend or loved one to a local emergency room, having your worst fears confirmed by the doctor, and then being told that it could be days before they can be admitted to the right hospital for treatment because of a waiting list. In the meantime, the critically ill person is left in or near the emergency room receiving less than adequate care and treatment for several more days. (John Broderick and Ken Norton, 4/14) The New England Journal Of Medicine: The Virtues And Vices Of Single-Payer Health Care Supporters of Arkansas’ Medicaid expansion say it’s worth preserving for the sake of improving people’s health and shoring up hospitals’ finances. A pivotal group of Republican state lawmakers isn’t buying that. But Gov. Asa Hutchinson is betting they will be swayed by the prospect of rutted roads. (Harris Meyer, 4/13)last_img read more

Galaxy Note 10 benchmark leak suggests itll be seriously powerful

first_imgGalaxy Note 10 Samsung’s Galaxy Note 10 is gearing up to be a top-notch smartphone to look forward to in the latter half of 2019 and newly-leaked performance benchmarking scores place it alongside the best in the business.Samsung’s Note series has always been a flagship-class family of devices and the new Geekbench 4 scores, first spotted by MySmartPrice, point to similarly competitive performance on 2019’s upcoming Galaxy Note 10.Related: Samsung Galaxy Note 10 – Everything you need to knowSamsung typically uses a mix of Qualcomm’s flagship Snapdragon chipsets and its own brightest Exynos processors in both Galaxy S and Note devices, with one or the other being used based on launch market (for example, US-based Galaxy S/Note devices always use Snapdragon chipsets).These benchmarking results don’t just let us glean performance but also highlight two distinctly different models of Note 10. Model number SM-N976V employs a Snapdragon 855 processor and a whopping 12GB of RAM, which some believe make this the anticipated 5G variant of the Note 10 destined for US carrier, Verizon.Model number SM-N976B, meanwhile, is stated as using 8GB of RAM and an Exynos 9825 chipset – an enhanced version of the Exynos 9820 SoC currently powering the Galaxy S10 family. It’s built on a smaller 7nm process, like the Snapdragon 855 (the 9820 uses an 8nm process), which should result in some power efficiency gains, albeit small ones.As for the benchmark results themselves, the Snapdragon-powered Note 10 scored 3529 in single-core testing and 10840 in multi-core testing, while the Exynos model scored 3557 in single-core testing and 9654 in multi-core testing.Both land respectable figures that place them amongst the best-scoring rivals there are, trumped only by the likes of the Black Shark 2 (at least in multi-core) and iPhone XS.In our own tests, the 8GB RAM Galaxy S10 Plus scored 4435 in single-core testing and 9765 in multi-core testing – pretty similar to that of these supposedly superior Note 10 devices. With this in mind, it’s likely that Samsung still has more tweaking to do before the phone’s chipsets are ready for prime time.In case you were wondering, popular benchmarking app Geekbench pits your phone’s processor up against a series of tasks, some based on real-world use-case scenarios and some, more abstract computational challenges. The faster the phone completes these tests, the higher it scores; spitting out both a single and multi-core performance score. Sign up for the Mobile NewsletterSign Up Please keep me up to date with special offers and news from Goodtoknow and other brands operated by TI Media Limited via email. You can unsubscribe at any time. Show More Unlike other sites, we thoroughly review everything we recommend, using industry standard tests to evaluate products. We’ll always tell you what we find. We may get a commission if you buy via our price links.Tell us what you think – email the Editorcenter_img We’d also like to send you special offers and news just by email from other carefully selected companies we think you might like. Your personal details will not be shared with those companies – we send the emails and you can unsubscribe at any time. Please tick here if you are happy to receive these messages.By submitting your information, you agree to the Terms & Conditions and Privacy & Cookies Policy. This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.last_img read more

WatchTrump decision on auto tariffs looms closer with Commerce report expected in

first_img The Associated Press Email Tom Krisher And Paul Wiseman Trump orders agencies to buy U.S.-made steel, aluminum and cement ‘to the greatest extent’ possible Reddit Trump’s auto tariffs threat is making it harder to secure a NAFTA deal Auto tariffs would put Bank of Canada ‘between a rock and a hard place’ when moving rates, Poloz says Related Stories Facebook DETROIT — Sometimes, on a bad night, Brad Strong wakes at 2 a.m. and can’t get back to sleep. The insomnia isn’t about his family or money or health. It’s about tariffs.The Strong family’s three car dealerships in Salt Lake City could suffer a significant blow if President Donald Trump proceeds with a proposal to impose tariffs of 20 to 25 per cent on imported autos and auto parts.Strong may be in for a few more sleepless nights.By Sunday, Trump’s Commerce Department is expected to issue an opinion on whether auto imports endanger U.S. national security enough to justify such import taxes. Trump would then have 90 days to decide whether to impose them.The department could decide to postpone its conclusion. Or it could just hand its recommendations to Trump without making them public. Soft on Rusal, tough on Canada: Pressure on Trump to cut tariffs on Canadian aluminum producers Trump’s metal tariffs ‘contradict’ new NAFTA and will have to go, says Chrystia Freeland China moves on the U.S. car tariff cut that Trump tweeted about But if it does suggest that Trump impose the tariffs, Commerce would be advocating a major escalation in Trump’s combative trade policies. So far, he has stuck tariffs on imported steel, aluminum, dishwashers, solar panels and hundreds of Chinese goods. The tariffs have become a financial burden for U.S. companies that import goods and parts and have led some to pass on their higher costs to customers. Many economists worry about the eventual impact on the U.S. economy.U.S. auto tariffs would almost surely lead Japan and the European Union to retaliate. They could also spark a rebellion in the U.S. Congress — including from Trump’s fellow Republicans — over concern that he is raising tariffs by invoking his authority to label certain imports a threat to America’s national security.“I don’t believe that minivans from Canada or other allies are a threat to our national security,” said Republican Sen. Rob Portman of Ohio. “I hope the administration takes a step back and reconsiders any auto tariffs.”The tariffs could have far-reaching consequences — on the companies that make cars, often with imported parts; on the dealerships that sell them; and on the consumers who buy them. U.S. imports of passenger vehicles and auto parts amounted to US$340 billion in 2017.U.S. President Donald Trump has threatened to impose tariffs of 20 to 25 per cent on imported autos and auto parts. February 15, 201912:08 PM ESTLast UpdatedFebruary 15, 201912:22 PM EST Filed under News Economy center_img More Share this storyTrump decision on auto tariffs looms closer with Commerce report expected in president’s hands this weekend Tumblr Pinterest Google+ LinkedIn 14 Comments Trump decision on auto tariffs looms closer with Commerce report expected in president’s hands this weekend If 25 per cent tariffs are imposed on imported parts and vehicles, including from Canada and Mexico, imported car prices will jump more than 17 per cent Twitter Join the conversation → All three of Strong’s dealerships sell vehicles made by German automakers — Volkswagen, Audi and Porsche. No Porsches or Audis are built in America. Only a couple of Volkswagen models are. The likely result is higher prices and lower sales for Strong and other dealers who sell imported vehicles.“I worry about the people that work for me and their families,” said Strong, who fears that his dealerships would have to lay off some of their 225 employees.If 25 per cent tariffs were imposed on imported parts and vehicles, including from Canada and Mexico, the price of imported vehicles would jump more than 17 per cent, or an average of around US$5,000 each, according to IHS Markit. Even the prices of vehicles made in the U.S. would rise by about 5 per cent, or US$1,800, because all use some imported parts.Luxury brands would absorb the sharpest increase: US$5,800 on average, IHS concluded. Mass-market vehicle prices would rise an average of US$3,300.If the tariffs are fully assessed, IHS senior economist Peter Nagle predicts that price increases would cause U.S. auto sales to fall by an average of 1.8 million vehicles a year through 2026.“We’re talking about an environment where sales are slowing already,” Nagle said.In addition to Audi and Porsche, the most affected brands would be Mazda, Aston Martin and McLaren, which build all of their vehicles outside the U.S. The tariffs also would hit Audi, Porsche, Volvo, BMW, Mercedes-Benz, Hyundai and Volkswagen hard. Nearly 100 per cent of Volvos sold in the U.S. were produced elsewhere last year. The figure is 67 per cent for BMW, 63 per cent for Mercedes, 84 per cent for the VW group and 62 per cent for Hyundai.“I think it would be harmful to the whole economy,” said Howard Hakes, president of Hitchcock Automotive, which has three Toyota showrooms in metro Los Angeles. “You put a 25 per cent tariff on that, you’re slowing down the train that’s rolling already.”Mario Murgado, who owns Honda, Volkswagen, Audi and other dealerships in the Miami and Chicago areas, has a different view. He says he’s willing to sacrifice sales if necessary to make global trade fairer. Other countries, Murgado argues, assess higher tariffs than the U.S. does, while countries like Japan impose other barriers to importing U.S. vehicles.“I’m just trying to do the right thing that’s in the best interest of our country,” he said.Of the 17.2 million vehicles sold in the U.S. in 2017, 52 per cent were produced in the U.S., according to the Center for Automotive Research. Fourteen per cent came from Mexico and 11 per cent from Canada. Ten per cent were made in Japan, 5 per cent in South Korea, 3 per cent in Germany and 5 per cent elsewhere.There are many ways auto tariffs could be imposed. The worst-case scenario for the industry would be tariffs on both vehicles and parts. The administration also could slap levies on vehicles but not parts. Or it could suspend tariffs and use them for bargaining.But the tariffs would likely invite retaliation aimed at U.S. farmers or other sectors of the economy, said Kristin Dziczek, a vice-president at the Center for Automotive Research.“If we (tax) Audis, Germany could say, ‘We don’t want your peanut butter,’ ” she said.Trump ran for president on a vow to shrink America’s trade deficit with the rest of the world by renegotiating trade deals and attacking what he called abusive practices by other nations.The administration has invoked a little-used weapon in trade policy: Section 232 of the Trade Expansion Act of 1962, which empowers a president to restrict imports and impose unlimited tariffs if Commerce finds that they threaten national security. The administration has used that authority to tax imported steel and aluminum. Now, it may use it on auto imports.Especially in the case of autos, the administration seems to be relying on a broad definition of national security. Commerce Secretary Wilbur Ross last year said it could include “a very big variety of things that one would not normally associate directly with military security,” including the U.S. economy.Trump has sought to use the steel and aluminum tariffs — and the threat of auto tariffs — as leverage in trade negotiations, including a rewrite of a North American agreement with Mexico and Canada.To the shock of many lawmakers and businesses, Trump kept in place the steel and aluminum tariffs on Canada and Mexico even after they agreed to a new pact last year. So it’s not clear if he is content to use them as a negotiating tactic or if they’re a permanent policy from a president who has called himself a “Tariff Man.”“It’s hard to know exactly what the intent of the policies are,” said Bryan Riley, director of the Free Trade Initiative at the conservative National Taxpayers Union.In her view, said Syracuse University economist Mary Lovely: “This is not a negotiating tactic. Trump is a true believer … He wrongly believes tariffs will help the U.S. auto industry.”The auto industry itself opposes auto tariffs.And Congress is getting restless. Sens. Pat Toomey, R-Penn., and Mark Warner, D-Va., have introduced legislation to reassert congressional control over trade. Their bill would give Congress 60 days to approve any tariffs imposed on national security grounds. It would also shift responsibility for Section 232 investigations away from Commerce to the Pentagon.Toomey noted that Trump agreed last summer to hold off on any auto tariffs while the U.S. and EU held trade talks.“Negotiations are continuing,” Toomey said. “That means we should not see a new round of auto tariffs.” Nicholas Kamm/AFP/Getty Images Commentlast_img read more

Watch Tesla Model 3 Regen Accel Tests On Steep Hills In San

first_img Author Liberty Access TechnologiesPosted on December 24, 2018Categories Electric Vehicle News One pedal driving on San Francisco’s steepest hills?Tesla Explained shared results of an interesting test of a Tesla Model 3 (the rear-wheel drive, long-range version). The test was on San Francisco’s steepest hills.The idea was to see whether regenerative braking will be strong enough going downhill to not use brakes. And, on the flip side, to find out whether acceleration is still brisk going uphill.As you can see, the steepest being Filbert Street at 31.5 degrees, Model 3 speed up from 4 to 21 mph using only regenerative braking.Regenerative braking Source: Electric Vehicle News The Nitty Gritty Details On Audi’s Two-Pedal EV Braking System Is One-Pedal Driving Possible In A Jaguar I-Pace? Tesla Model 3 RWD Loses Regen With Winter Tires? On the less steep slopes, top speed was 15 mph using regen only and then 14 mph at 20°.In the case of uphill acceleration on Jones Street (30°), Model 3 speed up from 0 to 35 mph.Electric vehicles seem to be a perfect fit for such hilly city. It’s expected that the dual motor all-wheel drive Tesla Model 3 will be an even better choice. That’s mainly due to its stronger regen.last_img read more

CATL Delivered Chinas Largest 100 MWh Battery Energy Storage

first_imgCATL is now doing similarly big ESS projects as TeslaContemporary Amperex Technology Co. (CATL) launched in China‘s the largest energy storage system with capacity of 100 MWh, which will complement the world’s first multi-mixed energy power station, which combines into one unified system on the grid several renewable sources:wind – 400 MWphotovoltaic – 200 MWconcentrated solar power – 50 MWIn terms of capacity, the energy storage system is not far from the world’s largest installation of 129 MWh/100 MW, delivered by Tesla in Australia.ESS news Q4 2018: Tesla Deployed 225 MWh Of Energy Storage, 73 MW Of Solar The huge battery at the Luneng Haixi Multi-mixed Energy Demonstration Project in Golmud is required to withstand temperatures from -33.6 to 35.5 degrees Celsius over at least 15 years.More about the system:“The Station coordinates three different renewable, with fluctuating and particularly unstable, sources of energy and is required to respond consistently to fluctuating demand, making its batteries and battery management system crucial to the reliability of the system. CATL, the exclusive battery supplier for the Project, overcome the requirements during product design and development stage and took merely 17 days to test and commission the BESS to the grid.Huang Shilin, Vice Chairman and Chief Strategy Officer of CATL, said, “The Station is the first of its kind – a multi-functional, centralized power plant integrated with an electrochemical energy storage system. Its technical reliability and affordability will promote further global deployment of different renewable energy applications.”The first priority when building an energy storage station is safety. By selecting reliable materials, CATL minimize the possibility of failure incident and second damage explosion. CATL also follows the Potential Failure Mode and Effects Analysis(FMEA) design process to identify risks and execute risk mitigation plans in early stages of product development, manufacturing and management to ensure safe operation of the battery system with well-designed battery cell, module, cabinet and control system. Utilizing a three-layer relay protection system, CATL further assures performance of the battery system from damages caused by over-charging/discharging, over-current, mitigate over and under temperature working conditions.One of the key challenges of safety and performances that CATL and the industry face is thermal management. The Station, installed at Golmud where temperature varies from -33.6 to 35.5 degrees Celsius. To ensure 15 years of battery performance, CATL has deployed a cooling system that uses air passages and air flow designs to maintain a consistent cabinet temperature. A battery management unit will kick-in the battery cooling system as soon as it detects thermo concerns, while pre-stored electricity protects the battery from capacity loss or lithium plating caused by charging in cold temperatures.In addition, the Project has tough structural requirements, as Golmud lies in an active seismic zone, which calls for vibration and shock absorption. CATL’s state of the art Test & Validation Center carried out rigorous testing and simulation to prove its batteries are able to withstand a potential earthquake of magnitude 8.According to Dr. Hui Dong, Chief Scientist of China Electric Power Research Institute, the Station is “the World’s first and China’s largest electromechanical energy storage station with virtual synchronous generator.” With the Station as an important part and an expected annual electricity generation amount of 126,250MWh (401,500 tons of coal generated energy), the Project is expected to be a good showcase of different new energy applications, thereby setting standards and smart grid applications around the world.” Source: Electric Vehicle News Author Liberty Access TechnologiesPosted on February 8, 2019Categories Electric Vehicle News 50 MWh Tesla Battery ESS Launched At Solar Farm In Australia Chevron Invests In Natron To Develop ESS For EV Charging Stationslast_img read more

Autonomy The Quest to Build the Driverless Car – And How It

first_imgAutonomy: The Quest to Build the Driverless Car – And How It Will Reshape Our Worldby Lawrence D. Burns and Christopher ShulganPublisher: Ecco (August 28, 2018)368 pages When it comes to vehicle autonomy, you could hardly find someone more experienced than Larry Burns, who was deeply involved with GM’s autonomy and electrification efforts as Corporate VP of R&D and Planning from 1998 to 2009, and later an important consultant to Google’s Waymo. In “Autonomy: The Quest to Build the Driverless Car – And How It Will Reshape Our World,” Lawrence D. Burns and Christopher Shulgan tell the story of how autonomy evolved from a science fair project to a nascent industry that’s attracting billions of bucks worth of investment.This is a good read, full of compelling stories and colorful personalities. In the first part, Burns tells us about the DARPA Challenge, in which several teams of iconoclasts and misfits straight from central casting competed to build a “robot car” that could complete an urban-style obstacle course. Here we learn some fascinating details about the mechanics of teaching cars to negotiate streets on their own.Inexplicably, GM, which had actually funded the winning team, showed no real interest in developing autonomous technology, nor did any of the other major automakers (a tale familiar to anyone who’s followed the halting progress of electrification). It fell to Google to take up the torch. The next section of Burns’s book takes us to Silicon Valley, the land of big budgets and bigger egos. Anyone who thought of engineers as altruistic non-mercenary types may be shocked to read the highly entertaining story of the power struggles among prima donnas that brought Waymo to where it is today.Inevitably, given his background, Burns is an unapologetic booster for vehicle autonomy, which he is convinced will reduce traffic and emissions, and almost completely eliminate crashes. Some, including your correspondent, are more skeptical. While most observers believe that AVs will improve road safety, this has yet to be proven. And the idea that they will reduce traffic seems doubtful, to say the least. If, as Burns and others predict, Transportation as a Service (TaaS) makes mobility a lot cheaper and more convenient, common sense dictates that people will use a lot more of it, starving out public transport and exacerbating sprawl.As numerous other writers do, Burns assumes that the AVs of the future will be efficient, appropriately sized EVs, but I’ve yet to hear a convincing technical reason why this must be so. Waymo is currently using Chrysler PHEV minivans (although it has announced plans to buy Jaguar I-Paces) and Uber is using fossil fuel-powered Volvo SUVs.Mr. Burns dismisses fears of widespread job losses, pointing out that workers displaced by previous tech revolutions eventually adapted (they did, but in more than a few cases, they also sparked revolutions and world wars). I’d be the last one to argue for attempting to protect jobs by hobbling new technologies, but I do believe that governments need to protect the workers who get screwed, and there is zero reason to expect this to be the case outside of socialist-leaning enclaves such as Scandinavia. In the US, job losses in the short and medium terms could be massive, and the political repercussions could be ugly.Be that as it may, autonomy is coming, and Burns’s vision of the future is a positive one. I hope he’s right and I’m wrong. Either way – autonomy good or autonomy bad – this book is well worth reading. Source: Electric Vehicles Magazinelast_img read more

Audi A4Sized Electric Sedan To Ride On Porsche EV Platform

first_imgSource: Electric Vehicle News By the middle of the next decade, Audi will have a total of 12 pure electric models on sale, with an assortment of crossovers, sedans, wagons, and hatchbacks in the offering. Speaking of sedans, the aforementioned E-Tron GT will be joined by a smaller sedan similar in size with the A4 to go up against the Tesla Model 3. It’s more than just a rumor as the reveal was made in an interview with Autocar by Audi’s design boss, Marc Lichte, so it’s entirely legit.Without going into too many details, the man behind Ingolstadt’s latest design language confirmed that development of the smaller electric sedan has already started. The new zero-emissions model will ride on the same PPE platform as the E-Tron GT, which by the way will have approximately the same size as the A6 Sedan.In case you’re not familiar with “PPE,” it stands for “Premium Platform Electric” and represents a joint effort between Audi and Porsche. The first PPE-based models are scheduled to hit the market towards the end of 2021. In Audi’s case, PPE will be used on a variety of models “covering the high-volume B through D segments.”According to the British magazine, the A4-sized EV is earmarked for a 2023 release. If that’s correct, it could mean we will see the production version as early as 2022. If history has taught us anything, it’s that there will be a concept car to preview the real thing, much like it was the case with the E-Tron GT.Source: Audi via Autocar Watch Tesla Model 3 Performance Race Audi TT, RWD Model 3 More Audi News Audi TT Faces Death By Batterycenter_img Author Liberty Access TechnologiesPosted on April 1, 2019Categories Electric Vehicle News Audi Q2 E-Tron Electric Car Caught Testing In the Snow It will ride on an EV platform co-developed with Porsche.Better late than never? Audi is kicking its electrification plans into high gear with the launch of the E-Tron due to be followed later this year by its more stylish sibling, the E-Tron Sportback. These two fully electric crossovers will be joined by the Tesla Model S-rivaling E-Tron GT in the second half of next year, with a road-going Q4 E-Tron in the pipeline for a late 2020 launch.last_img read more

Paris wants to limit electric scooters to 8 kmh 5 mph Bird

first_imgSource: Charge Forward Paris, like many large International cities, has not been immune to the electric scooter phenomenon. As thousands of electric scooters have flooded Paris streets over the last year, the city has made efforts to curtail their expansion. Now Paris’ Mayor has announced that the scooters will no longer be able to park on the sidewalk and has attempted to severely limit the speed of the electric scooters across the city. more…Subscribe to Electrek on YouTube for exclusive videos and subscribe to the podcast. post Paris wants to limit electric scooters to 8 km/h (5 mph), Bird & Lime respond appeared first on Electrek.last_img read more

In The FCPA Space Who Speaks For Whom

first_imgI launched this website in 2009 and have writing on Foreign Corrupt Practices Act and related topics on a near daily basis. Everything I have written or said about the FCPA (whether on this website, my more formal articles or my Congressional testimony) has represented my genuine beliefs and you can hold me accountable for them.Yet when it comes to many others writing and speaking in the FCPA space, the question arises – who speaks for whom?  Are others expressing genuine beliefs and willing to be held accountable for what they say and write.Numerous prior posts have exposed the flip-flopping of former DOJ/SEC enforcement officials on various FCPA topics (see here for instance) and the reverse of the situation was first highlighted on these pages when an FCPA enforcement critic and reform advocate – Andrew Weissman – was recently selected as the DOJ’s new fraud section chief.Others – including those on Capitol Hill – soon picked up on the issue.  As highlighted in this recent post Attorney General Nominee Loretta Lynch’s was specifically asked by a Senator as follows.Q: As you know, the Criminal Division’s Fraud Section is charged with investigating and enforcing the criminal provisions of the FCPA. Recently, Andrew Weissmann was selected to be the Chief of the Fraud Section. Mr. Weissmann is a former prosecutor and FBI general counsel. In private practice, however, Mr. Weissmann has been an outspoken critic of DOJ’s FCPA program. Specifically, in a report36 Mr. Weissmann drafted for the U.S. Chamber of Commerce’s Institute for Legal Reform, he has recommended that: (1) a compliance defense to the FCPA should be added; (2) a company’s liability should be limited for the prior actions of a company it has acquired; (3) a “willfulness” element should be added for corporate criminal liability; (4) a company’s liability should be limited for the actions of a subsidiary; and (5) the definition of “foreign official” under the FCPA should be changed. Do you agree with any, some, or all of Weissmann’s proposals for reforming the FCPA?RESPONSE: It is my understanding that Mr. Weissmann made these comments while in private practice and in connection with his representation of the U.S. Chamber Institute for Legal Reform (“Chamber”). It is also my understanding that, in the intervening time period, the Department has met with the Chamber, as well as other stakeholders, to engage in a healthy and productive dialogue regarding the Department’s interpretation and application of the FCPA. If confirmed as Attorney General, I would continue to foster dialogue with the Chamber and other stakeholders regarding our FCPA program.That was a nice dodge by Ms. Lynch.Yet it conveniently ignored – as highlighted in the previous post – that Weissmann, in his personal capacity, has long challenged traditional notions of corporate criminal liability and argued that when the DOJ “seeks to charge a corporation as a defendant, the government should bear the burden of establishing as an additional element that the corporation failed to have reasonably effective policies and procedures to prevent the conduct.  See “Rethinking Corporate Criminal Liability,” 82 IND. L.J. 411, 414 (2007).Some will say that when a lawyer in private practice writes a law review article that he/she is advancing their clients interests.Sure, a lawyer is advancing their client’s interest in writing a legal brief or making an argument before a court.But a law review article?  What about a law firm client alert? What about when a lawyer appears on an FCPA panel at a conference and spontaneously responds to fellow panelist comments or audience questions?Are we to discount everything the lawyer says about the FCPA because they are lawyer?  If so, is there any genuine or legitimate beliefs being articulated about the FCPA that people are willing to be held accountable for?This recent Bloomberg article about Weissmann and his new DOJ position states:“A person familiar with Weissmann’s thinking said he viewed most of his [FCPA] congressional testimony as giving his personal views rather than doing work for a client. In the instances where he didn’t disclose his Chamber connection, Weissmann agreed to testify after congressional officials reached out to him proactively, said the person, who asked not to be named because he wasn’t authorized to speak publicly.”The irony of this general topic is that when DOJ/SEC FCPA enforcement attorneys speak on FCPA topics their comments are preceded by the standard disclaimer – something to the effect of – the views I express today are my own and do not necessarily represent the views of the DOJ/SEC.Hardly. The enforcement attorney is often carrying forward the talking points of the DOJ/SEC (a dynamic that is apparent when one compares various speeches, etc.).So the question remains – in the FCPA space, who speak for whom?All I know is that everything I have written or said about the FCPA has represented my genuine beliefs and you can hold me accountable for them.last_img read more

Compliance 20 – A Mostly Meaningless Buzzword

first_imgUnderstanding the answers to the above questions and incorporating them into an FCPA compliance program are leaps and bounds more important than “tone at the top” and the specifics of the reporting relationship between a chief compliance officer and the board of directors.Moreover, Compliance 2.0, like most buzzwords, can be counter-productive because they create a false sense of results by inferring that adherence to the buzzword will show results. Indeed, a recent survey by the Institute of Leadership & Management suggests that a meaningful percent of employees consider management jargon as pointless and often irritating.In short, decide for yourself whether Compliance 2.0 is a useful concept or mostly a meaningless buzzword.And when you are done with that, turn your attention to Compliance 3.0 (see here). This recent article in the Journal of Judgment and Decision Making titled “On the Reception and Detection of Pseudo-Profound Bullshit” caught my eye. The article focuses “on pseudo-profound bullshit, which consists of seemingly impressive assertions that are presented as true and meaningful but are actually vacuous.”Perhaps you’ve noticed the emergence of the term “compliance 2.0” in the Foreign Corrupt Practices Act space and beyond?You can read a three part series on Compliance 2.0 (here, here, and here) on the FCPA Blog.You can read a five part series on Compliance 2.0 (here, here, here, here, here) on Corruption Crime and Compliance.Panels at conferences are titled “Compliance 2.0: How to Build and Implement a Strong Compliance Program for FCPA” and other areas.You can read the above links and decide for yourself whether those promoting Compliance 2.0 as some kind of secret sauce have a point or are mostly speaking in vague generalities and thus gobbledygook.My own two cents is that Compliance 2.0, as used in the FCPA space, is mostly a meaningless buzzword.Using the word “no” FCPA issue is a bit strong because, after all, a broken clock is right twice a day (pardon the buzzword / cliche).However, few if any FCPA issues are going to be “nipped in the bud” (pardon the buzzword / cliche) based on the following purported components of Compliance 2.0: the reporting relationship between a board of directors and chief compliance officer or general counsel; a CEO or other executive officer’s “tone at the top” (another mostly meaningless buzzword in the FCPA space); or consideration of other stakeholders.Rather, FCPA issues arise – and can thus best be mitigated and managed – by understanding how real people, operating in foreign countries with real business conditions, interact with real foreign officials.The narrative roadmap for many FCPA issues is as follows. How does the company’s product enter and exit the country? Does the company use the services of a customs broker or freight forwarder? How does the company do business and/or interact with customers or potential customers in the country?  Does the company use third parties in the foreign countries? Who are the company’s customers or potential customers in each country?  Is the customer a government (whether federal, state, or local) department, agency or instrumentality?  Does a government department, agency, or instrumentality, or individual associated with such units, have an ownership or equity interest in the customer?center_img Barriers, distortions and conditions create bureaucracyBureaucracy creates points of contact with foreign officialsPoints of contact with foreign officials create discretionDiscretion creates the opportunity for a foreign official to misuse their position by making bribe demands.Instead of complicating the compliance playbook with a mostly meaningless buzzword, business organizations should keep it simple and focus on blocking and tackling type issues (pardon the buzzword / cliche) such as the following questions relevant to conducting an FCPA risk assessment:In which countries does the company do business?  As to each country, what is the country’s reputation for corruption? What licenses, permits, or certifications does the company need to do business in the country?  As to each license, permit or certification, how does the company obtain such approvals? Is the company subject to other unique forms of government regulation in the country?  What other points of contact does the company have with foreign government in the country (such as tax and immigration authorities)?last_img read more

TK Names New Firm Leaders

first_img Password Username John Cohn, Greg Curry, Mark Sloan, Wesley Williams, Roger Aksamit and Luis Gomar are stepping into new leadership roles . . .You must be a subscriber to The Texas Lawbook to access this content. Not a subscriber? Sign up for The Texas Lawbook.center_img Remember me Lost your password?last_img

Eating honey can reduce serious injuries in children who swallowed button battery

first_img Source: Jun 11 2018A team of ear, nose, and throat (ENT) specialists has demonstrated that eating honey after swallowing a button battery has the potential to reduce serious injuries in small children. Based on findings in laboratory animals, the research suggests that this common household product may significantly reduce morbidity and mortality from highly caustic batteries.”Button batteries are ingested by children more 2,500 times a year in the United States, with more than a 12-fold increase in fatal outcomes in the last decade compared to the prior decade,” said Co-Principal Investigator, Ian N. Jacobs, MD, Director of the Center for Pediatric Airway Disorders and a pediatric otolaryngologist at Children’s Hospital of Philadelphia (CHOP). “Since serious damage can occur within two hours of ingesting a battery, the interval between ingestion and removal is a critical time to act in order to reduce esophageal injury.”Jacobs collaborated with researchers at CHOP and Co-Principal Investigator, Kris R. Jatana, MD, a pediatric otolaryngologist and Director of Pediatric Otolaryngology Quality Improvement at Nationwide Children’s Hospital, in a study published online in The Laryngoscope.Because of their size, candy-like shape and shiny metallic surface, button batteries have posed a risk for toddlers for decades. When the battery reacts with saliva and tissue of the esophagus, it creates a hydroxide-rich, alkaline solution that essentially dissolves tissue. Children with an esophageal button battery may present with symptoms of sore throat, cough, fever, difficulty swallowing, poor oral intake or noisy breathing. This can cause severe complications like esophageal perforation, vocal cord paralysis and erosion into the airway or major blood vessels. The longer it takes for the battery to be removed, the higher the risk for these children, particularly those without access to hospitals with specialized anesthesiologists and endoscopists experienced in removing foreign objects.The research team wanted to determine successful interventions for mitigating these injuries in both a home and clinical setting and test their effectiveness in a live animal model, in this case, laboratory pigs. Specifically, the researchers sought palatable, more viscous liquids that could create a protective barrier between the tissue and the battery, as well as neutralize harsh alkaline levels. The team screened various options, including common household beverages such as juices, sodas, and sports drinks, in laboratory experiments.Related StoriesPuzzling paralysis affecting healthy children warns CDCResearchers identify gene mutations linked to leukemia in children with Down’s syndromeRepurposing a heart drug could increase survival rate of children with ependymoma”We explored a variety of common household and medicinal liquid options, and our study showed that honey and sucralfate demonstrated the most protective effects against button battery injury, making the injuries more localized and superficial,” said Jatana. “The findings of our study are going to be put immediately into clinical practice, incorporated into the latest National Capital Poison Center Guidelines for management of button battery ingestions.”Prior published studies by this team had tested weakly acidic liquids like lemon juice as a proof of concept. However, many children do not enjoy drinking lemon juice. By contrast, the sweet taste of honey is much more palatable to young children.”Our recommendation would be for parents and caregivers to give honey at regular intervals before a child is able to reach a hospital, while clinicians in a hospital setting can use sucralfate before removing the battery,” Jacobs said. However, the authors caution against using these substances in children who have a clinical suspicion of existing sepsis or perforation of the esophagus, known severe allergy to honey or sucralfate, or in children less than one-year-old due to a small risk of botulism.”While future studies could help establish the ideal volume and frequency for each treatment, we believe that these findings serve as a reasonable benchmark for clinical recommendations,” Jacobs said. “Safely ingesting any amount of these liquids prior to battery removal is better than doing nothing.””Button batteries are commonly found in households, and they should always be stored in a secured container, out of reach of children,” said Jatana. “Parents and caregivers should check all electronic products in the home and make certain that the battery is enclosed in a compartment that requires a tool to open and periodically check to ensure it stays secure over time.”last_img read more

Blood pressure medications linked to increased mortality memory problems in old and

first_img Source: Jun 28 2018Old and frail patients have an increased mortality risk and increased memory problems when their blood pressure is lowered too much through medication. This is what has been discovered by researchers from the University of Bern and University of Leiden (Netherlands) in a large-scale study – thus relativizing the official recommendations for antihypertensive medications. They were awarded with the 2018 research prize by the Kollegium für Hausartztmedizin [College of General Medicine] for their work.Lowering blood pressure by using medication helps many people and saves lives, particularly among patients aged 60 and over. At the same time, the population is aging – people aged 80 and over constitute the fastest-growing age group in our society, yet, at the same time, prove the hardest group to research. The range of patients is broad: from severely handicapped 75-year-olds who live in nursing homes to 95-year-olds who still participate in sports. However, blood pressure guidelines often ignore this broad spectrum and – as is currently the case in the US – make the generally-accepted recommendation that blood pressure levels among all over-60s should be lowered to below 130mmHg.”The lower the better”is one recommendation which applies for many people, including the elderly, as randomized studies were able to demonstrate. However, there can be a catch here, according to PD Sven Streit from the Institute of Primary Health Care (BIHAM) at the University of Bern: “Such studies exclude very old and frail people who have multiple illnesses and who are taking multiple types of medication. Thus, even results from the best of studies can only be applied to older people to a certain extent.”However, general practitioners deal with the whole spectrum of very old people, i.e. a spectrum which includes those excluded from clinical studies. The group of patients under investigation included all inhabitants aged 85 of the city of Leiden in the Netherlands. This also accounted for patients suffering from dementia, living in nursing homes, or who are otherwise frail. The researchers discovered that antihypertensive medications led to an increased risk of mortality and to quicker cognitive decline among these patients. The study was published in the journal “Age and Ageing”.Related StoriesDon’t ignore diastolic blood pressure values, say researchersScientists turn type A blood into universal type O, potentially doubling blood transfusion stocksBlood pressure medication associated with increased risk of diverticulosisResults generally applicable for the first timeFrom the just under 600 people investigated, Sven Streit and his colleagues from University of Leiden were able to demonstrate that the lower the extent to which blood pressure was reduced using antihypertensive medications, the higher the levels of total mortality and cognitive decline. This correlation only arose in those people who took antihypertensive medication, and particularly in those who were frail.With this study, the researchers confirmed that which had already been speculated in previous observational studies. However, this is the first study whose results can be applied across the entire population. “Beforehand, the belief was already increasingly taking hold among general practitioners that additional antihypertensive therapy should only be recommended after an individual evaluation of its benefits and risks, especially in the case of frail patients”, says Streit. “Now, we can prove that their belief was correct – contrary to official recommendations.”The pressing nature of this study also convinced the British Geriatric Society, who asked Streit for a contribution to their blog, as well as the SwissKollegium für Hausarztmedizin, which awarded the team, led by Streit, with the 2018 research prize, valued at CHF 10,000.00.​last_img read more