Sportblog Share on Messenger Facebook Twitter Facebook Share England cricket team Reply | Pick Share on Facebook recommendations Report newest When Kevin Pietersen admitted this week to sleepless nights as he wrestled with the demands of leading England back to India, it was enough to bring a slight wince of concern. One captain of recent vintage, Andrew Flintoff, has already suffered rapid overload because of the demands of captaining England. It does not bear thinking about that Pietersen might go the same way.What prevents too much concern is that Pietersen is a fearful embellisher, a man who naturally delights in the power of theatrical exaggeration. So admiration for a team-mate is expressed in terms of love and affection, a half-decent display is fantastic. We can conclude therefore that Pietersen’s sleepless nights are actually just a bit of tossing and turning. England should quietly check it out all the same, because anything else would be a reason to protect him before it is too late. A fortnight off before Christmas, however, is not an option.Almost without comment, he is well on the way to becoming the most powerful England captain for a generation. Michael Vaughan and Nasser Hussain were tough cookies, but they were answerable to Duncan Fletcher, the coach. Pietersen makes no such concessions to Peter Moores. He talks of “my team” and he won the argument for a less intensive training regime than in New Zealand last winter. And, in a major political crisis, while Pietersen has held counsel, Moores has remained in the background.England’s start under Pietersen was perfection: he made a hundred in his first game as captain against South Africa at The Oval, but from the outset the most noticeable aspect was how enthusiastically England responded to his leadership. He then led England to an overwhelming success in the one-day series. King Kev clearly had what it takes. Share on Twitter | Pick 0 1 Facebook Chinmay Twitter Share on Twitter Sign in or create your Guardian account to recommend a comment Share on Facebook Share There is something of the cocky kid-brother about Pieterson. Convinced he can do anything and talented enough to pull off most of it. That was fine as a cricketer and as a person, but as a captain his ability to learn, notice, adapt and exploit will be what defines success or failure, as it is with every other captain.This is where I’m… not worried… but… sceptical? He just doesn’t seem one for plans B and C. I’m sure he can cope with the demands of captaincy but can he plan, plot and scheme?If Fletcher were still coach, Pieterson’s cheerful camarderie would be a good foil. But Moores seems to think he’s a disciplinarian, which leads me to ask…Who is England’s strategist? Email (optional) Share on Twitter India cricket team Share Share on Twitter Share Share on LinkedIn Pieterson would have been a great captain in Football (you could say he is England’s cricket equivalent of Stevie G)Yeah, Stevie G but obnoxious. Personally, I don’t like Kevin Pietersen – he’s crass, up himself, and it still occasionally confuses me when I see a lot of refernce to KP, which is also my initials – but he’s doing a bloody good job. 0 1 Share via Email | Pick Facebook Report Report 0 1 Report Reply Show 25 First published on Wed 10 Dec 2008 19.01 EST oldest Report Report England’s captain Kevin Pietersen is surrounded by security at Chennai airport Photograph: INDRANIL MUKHERJEE/AFP/Getty Images Reply Share on Facebook 1 Twitter Share on Facebook Reply Twitter Share on Twitter Cameldancer Reply blogposts | Pick Reply 11 Dec 2008 20:43 Share on Facebook Finelegs – agreed, I think Pieterson can improve the performance of the England team by eliciting a more whole-hearted effort from the players. However, that will only help us beat the likes of the Windies and Kiwis. To beat India, Australia, SA and Sri Lanka something more will be required.Pity then that our next three series are India – WI – Australia. (Are Sri Lanka still coming early next summer?) weiguin FineLegs Facebook AndyinBrum I think David has it spot on here. I’m not a big fan of KP as a person and some of his platitudes and all-round campness make me wince. (on the other hand, the unrehearsed nature of his comments is a refreshing change to Moores’ polished nothingness).Personal views aside though, his performance so far has been decisive and impressive.In my view, KP is a fine example of how much the on-field nous of a captain is overstated in comparison to the chord he strikes in the dressing room. That is why I don’t share Cameldancer’s fears.Learn, notice, adapt, exploit… all skills have been shown by the previous incumbent, Vaughan, but brought us a largely uninspiring period since he returned from injury.What England need is not someone who can judge when to bring in a backward short leg or some part time off breaks. It’s someone who can fire up the like of Harmison, Prior, Cook, Bell and get them performing. Our problems generally surround the collective failure of the batting unit – that’s got nothing to do with the tactical acumen of the skipper and everything to do with imposing the right mentality on the team. zephirine | Pick 11 Dec 2008 23:53 BillyMills: or it might mean “despite the fact that you’d have thought the $20m prize would have made them get off their arses and put some effort into a paltry 40 overs” . 100 Reply | Pick | Pick Twitter Report Share Wed 10 Dec 2008 19.01 EST Reply 0 1 Comments 29 Share Share on Facebook 0 1 unthreaded weiguin Report Share 0 1 November 1 England are beaten in the final of the Stanford Series, despite the $20m prizeWhat an interesting use of the word “despite”. What on earth is this supposed to mean; that the size of the pot should have meant that it was England’s by right? Facebook 11 Dec 2008 23:36 cricfan: your comments are just insulting and worthy of no response. the one minute’s silence was a mess. why do you have to turn this into some nationalistic points scoring? if you are going to do it, do it properly, with a certain ceremony and dignity and clear announcements.mikedaniels: yes i remain totally happy to say that nasser hussain and michael vaughan were both “answerable” to duncan fletcher in many aspects of their work and i am sure they would agree. eacxh had their onw areas of responsibility — i did not suggest that they operated under duncan’s shadow. that does not deny your accurate point that they had a successful symbiotic relationship. the two are not exclusive. perhaps answerable is not the ideal word, but they would both agree that ultimately duncan fletcher, as the coach, was in charge.. In the case of KP it is striking how that balance has shifted..weiguin: perhaps you have misinterpreted! the liberal sentiments they happen to offend include mine. it was a neutral sentence. i’m delighted your liberal sentiments are offended so best not be guilty about it and read criticism were none is made. i would rather eat my own children than write for the Daily Mail. at least you are slagging me off from a sound political perspective ho hum. i dunno: you spend 15 years writing vaguely left wing stuff (as far as that is possible in sportswriting) and one double-meaning sentence and you are accused of being a Mail sympathiser. Facebook Reply Share on Facebook Cricket Reply Twitter Topics 11 Dec 2008 22:55 Share on Twitter weiguin | Pick | Pick Share on Twitter expanded BillyMills Shares00 MikeDaniels Reply 11 Dec 2008 17:33 11 Dec 2008 17:54 Twitter Reply Twitter Share 12 Dec 2008 2:55 Threads collapsed Reply Report Reply View more comments Chinmay Share on Facebook Share Twitter 0 1 Share on Facebook Facebook Report Facebook 0 1 | Pick Share on Facebook England in India 2008-09 David Hopps – Are you really suggesting that Nasser Hussain and Michael Vaughan were “answerable to” Duncan Fletcher? The catalyst for England’s revival from 1999 onwards was the partnership between Hussain and Fletcher, backed by the ECB introducing Central Contracts. Hussain was the man in charge of the team. Fletcher was, certainly initially, unsure of how he would be accepted in the dressing room as he had no experience in Test Cricket. He introduced a number of things into the organisation of the Team support structure and brought his vast playing and coaching experience to the table to act, as he has said he thinks the coach should act, as a consultant to the team and the captain.Hussain was key in introducing into the team the desire and commitment to improve both physically and technically and Fletcher was able to support him in that. Vaughan came into that environment and continued the work until his unfortunate and untimely injury.Nasser Hussain was by far the strongest captain in terms of being able to determine the path of the England team of the past generation.To suggest that Hussain and Vaughan operated in the shadow of Duncan Fletcher is nonsense. They built good working relationships with a talented coach who was able to help them realise their desires for the team. Of course Fletcher would have an input into that but to suggest that Fletcher was the prime mover is to imply that Hussain and Vaughan were subservient to Fletcher and their inputs were minor compared to Fletcher’s.I suggest you would get short shrift from both Hussain and Vaughan if you wanted to put your theory to them.And, as far as I am aware, the Coach does not appoint the captain, therefore he is not “answerable” to the Coach. Hussain was also in post before Fletcher was appointed. Share on Twitter Share Share 11 Dec 2008 23:16 Facebook Chinmay, I know, I meant it’s an old question because it was asked about Vaughan and Hussain too, and people have been saying it ever since KP got the job. Should have put ‘a player’s game’, it would have been clearer.I see you don’t count ODIs as matches:) 0 1 Share on Facebook Report Share on Facebook 11 Dec 2008 18:13 50 11 Dec 2008 10:36 Share on Twitter oh grow up crikfan.A minutes silence should be just that, a minute of silence, with the fans told its going to happen so that they can pay their respects. Not just wonder why the hell the players are all stood around looking slightly gormless (or more gormless than usual in regards to Prior).Yes I’m grumpy, yes I’ve got a cold and yes I’ve not had much sleep and yes I think you’re a liverpool fan because you appear to be trying to find something/anything to take offence at, whether there is anything there or not. Share on Facebook All JimmyMightFixIt comments (29)Sign in or create your Guardian account to join the discussion. Share on Facebook Share on Facebook Since you’re here… zephirine Share via Email Twitter In considerable heat and luxury on the island of AntiguaThe well-paid English cricketers confronted the West Indians whose earnings were more meagreA large prize of twenty million dollars was on offerFrom a Texan person with a taste for publicity and a seemingly bottomless cofferBut far from buying pink Ferraris and having lots of expensive funEngland got thrashed like a redheaded stepchild and hung out to dry in the Caribbean sun.Sorry Billy, the best I could do:) Apologies Mr Hopps, off-topic a bit. Facebook | Pick Share on Twitter 0 1 Twitter Reason (optional) Report Loading comments… Trouble loading? 11 Dec 2008 19:16 Share on Twitter So that’s Ms K.P.Hieroglyph, then? A very fine name.I think the Kipper has done well over the recent crisis, but I’d expect him to – as David Hopps points out he has a somewhat theatrical personality and won’t be fazed by dramatic situations. I want to see how he gets on when England has a run of dull, drab losses and everyone in the media and blogosphere starts carping and snarking at him. It would have happened already without the events in Mumbai. How well can he take that kind of criticism, without getting paranoid and/or making daft decisions to try and make something happen? But he may be fine, he’s had plenty of criticism in his life after all.Today’s showing raises the old question about the captaincy affecting his game, too. 11 Dec 2008 19:18 Report Facebook Facebook Share on Twitter Report Facebook Report 11 Dec 2008 16:59 Share on Twitter 0 1 11 Dec 2008 23:07 Reply 11 Dec 2008 18:33 Share on Twitter Report Share on Twitter Report | Pick Facebook 0 1 His decision to walk out on South Africa in protest at racial quotas, rather than fight for his rights in a problematic post-apartheid environment, will always offend liberal sentiments, but he puts his unexpected toughness down to precisely that experienceOk, so criticising someone who jumped ship the moment the nation tried to implement racial fairness after a period of Apartheid is namby pamby Liberalism gone mad. How many of the South Africans clogging up the bars, and sporting institutions of this country would be here were institutional racism still in place in South AfricaIdiotic sentiments, awful article.I wish nothing but ill on this dark period of English cricket and cannot wait for Kevin to throw his adopted country under the bus the moment its interests conflict with his own (IPL!!)David, please naff off back to the Daily Mail. Reuse this content,View all comments > Report The keenest cricketing tacticians remain unimpressed with Pietersen’s nous. He tends to captain by committee, as slow over-rates show, and some of his bowling changes in the India one-day series lacked logic.In the praise of KP, David Hopps can write only 3 lines. imagining or dreaming the criticism (of England team or media) has never been easy.David Hopps:if you really, really interested in writing about something other than cricket or India tour, you have been advised lots of options earlier by many.No wonder, you are best pointing out the bad side of opposition, you are worst when it comes to view the other way. I have yet to read any imagination in criticism of England losing 5-0 of the level the criticism or tarnishing of other trivial things which only English journalist find out easily. So are you saying you are from the very gentleman side of the world of journalism?Such shoddy writing, and saying something in OBOs behind curtains: “That has to be the most badly-run minute’s silence for a long time. The players trooped out and there was no announcement of any sort. Most of us on the other side of the ground caught onto what was happening when it was virtually over. Indian organisation, or lack of it, at its worst. If you are going to do it, do it properly.”Either you are really out of mind or you really are yearning to get back home. To say-if you are going to do it, do it properly-considering the situation in which players are playing cricket, is very disgraceful towards the people who lost lives. Very disgraceful. Share 0 1 Share on Facebook | Pick zephirine 11 Dec 2008 22:33 Twitter Reply 0 1 0 1 Today’s showing raises the old question about the captaincy affecting his game, too.”Old question”? For heaven’s sake, this is his second match as captain, and he hit a century in his first! Please select Personal abuse Off topic Legal issue Trolling Hate speech Offensive/Threatening language Copyright Spam Other Twitter 2 Share on Twitter 0 1 | Pick England in India 2008-09 Read more Twitter Share Share Pieterson would have been a great captain in Football (you could say he is England’s cricket equivalent of Stevie G), but I have doubts about him as a captain in cricket, which requires tactical nous in addition to inspiration and leadership. Sportblog Share Fair point, zeph, fair point. Maybe we should write them a $20m ode? Share on Facebook 0 1 Twitter | Pick Report 11 Dec 2008 17:36 Share on Twitter Share on Facebook Share on Twitter Share on Twitter Share Twitter David Hopps Facebook 0 1 | Pick Share on Pinterest Almost unnoticed, KP is fast becoming the most powerful England captain for a generation | Pick Facebook Twitter Order by oldest David, Thanks for agreeing that “answerable” was not the best word to use. The relationships between Hussain/Vaughan and Fletcher were, as you say, symbiotic. Your comment seemed to be implying an employer/employee relationship which did not exist then and does not exist now with Pietersen/Moores. I feel you are damning with faint praise the efforts of Hussain and Vaughan as captains. I don’t necessarily think they will agree with you that they thought DF was in charge of the team. If you get the chance to ask them, please let me know what they say.Many coaches/commentators are of the opinion, as is Duncan Fletcher, that the man in charge of the Team is the captain. The Coach facilitates the work/role of the Captain. Pietersen is, quite rightly, moulding the Team and the team’s modus operandi to achieve the goals that he wishes the team to achieve. That’s not to say that the coach and other team management won’t influence Pietersen’s thinking, but the team is Pietersen’s, not Moores’. I hope that they will be supported in their work, not lampooned if results don’t go their way, as progress will, inevitably, be uneven. 0 1 Share on Twitter Share on Twitter MikeDaniels Facebook Report davidhopps Facebook Reply Facebook Report 0 1 25 Facebook Share on Twitter Twitter Share 0 1 BillyMills Reply Share on Facebook Kevin Pietersen | Pick Reply Share Facebook Share Twitter | Pick 11 Dec 2008 21:28 And as for doing well in a crisis.Come onThere is but 1 reason Pietersen, Flintoff and Harmison (who hilariously came out of 1 day retirement to watch Priors missus get felt up in Antigua) are back in the sub-continent: the moolah on offer from the IPL. If this is not the case, and if the England team are actually showing solidarity with the people of India, then i look forward to seeing the itinerary of Englands upcoming tour to Pakistan. Even the sceptics were impressed, confining themselves to the sage reminder that the real test of Pietersen would be when the defeats started. The implication was that it would only take a couple of losses before he had a fearful tantrum and caught a fast plane to nowhere.It can safely be said that such a test has now been passed. Pietersen has had to contend with England losing the one-day series in India 5-0, and seemingly heading inexorably for a whitewash before the last two matches were cancelled, and then the fallout of the attack on Mumbai. To date he has survived everything with near-impeccable judgment. He has behaved in a manner of which few suspected he was capable: he listened, he assessed, he made a rational response.His decision to walk out on South Africa in protest at racial quotas, rather than fight for his rights in a problematic post-apartheid environment, will always offend liberal sentiments, but he puts his unexpected toughness down to precisely that experience.”It’s been tough,” he said yesterday, ahead of today’s first Test at the MA Chidambaram Stadium. “I don’t mind when the going gets tough because it is more satisfying when you do well.”There is no doubt that Pietersen has an actor’s appreciation of “performance”. He connects with the crowd, and he also understands the image-creating moment. That is not to accuse him of dishonesty, merely to recognise that he knows how to connect. While Flintoff marched out of – and then back into – India with grim expression, a sportsman in unfamiliar territory, Pietersen’s instincts were faultless. He left with a seriousness appropriate to a tragic situation, but when he returned to Chennai he gave a thumbs-up signal to the crowd from the team bus. He might not have known, but it was the same thumbs-up gesture given by Indian commandos when they had cleared the Taj Mahal hotel of the last of the terrorists. Without as much as a single word, it quietly signalled defiance.Pietersen has also liberated England’s players. They might still be losing more than we would like, but their spirit has been strikingly good. Even Flintoff, who was never a soulmate, now speaks fondly of the relaxed atmosphere. Vaughan encouraged England to express themselves, but Pietersen’s very persona gives them permission to do just that. He liberates them from their anxieties.The keenest cricketing tacticians remain unimpressed with Pietersen’s nous. He tends to captain by committee, as slow over-rates show, and some of his bowling changes in the India one-day series lacked logic.Pietersen has assessed the nature of India with remarkable skill. When he and Mahendra Singh Dhoni, his home counterpart, appeared together for promotional pictures yesterday, in a room far too small and disorganised for the occasion, the Indian media turned the occasion into a scrum that sent England’s security man white with shock. In the middle of it all, Pietersen looked amused, bemused, unflustered and unfailingly polite. He knows there are some things in India that you can never tame. He has been just the man for a crisis. Who would ever have expected that?Highs and lowsJune 26 Named stand-in captain of one-day side after Paul Collingwood is banned for three matchesJune 28 Defeat by New Zealand in first match as captain seals a 3-1 series defeatJuly 10 Makes a century in his first Test against South AfricaAugust 4 Appointed Test captain after Michael Vaughan resignsAugust 11 England win their first Test under Pietersen, who scores a first-innings centuryNovember 1 England are beaten in the final of the Stanford Series, despite the $20m prizeNovember 26 India complete 5-0 series whitewash in one-dayersDecember 7 England decide to return to India for two-match Test series Facebook weiguin | Pick Report Twitter Share hieroglyph Sign up to the Spin – our weekly cricket round-up Share 0 1 collapsed Share on Facebook Share on Facebook Share on Facebook Reply 11 Dec 2008 20:38 Share on Facebook Share on Twitter Reply Close report comment form BillyMills 2 Reply | Pick Twitter Cameldancer Report crikfan … we have a small favour to ask. The Guardian will engage with the most critical issues of our time – from the escalating climate catastrophe to widespread inequality to the influence of big tech on our lives. At a time when factual information is a necessity, we believe that each of us, around the world, deserves access to accurate reporting with integrity at its heart.More people are reading and supporting The Guardian’s independent, investigative journalism than ever before. And unlike many news organisations, we have chosen an approach that allows us to keep our journalism accessible to all, regardless of where they live or what they can afford. But we need your ongoing support to keep working as we do.Our editorial independence means we set our own agenda and voice our own opinions. Guardian journalism is free from commercial and political bias and not influenced by billionaire owners or shareholders. This means we can give a voice to those less heard, explore where others turn away, and rigorously challenge those in power.We need your support to keep delivering quality journalism, to maintain our openness and to protect our precious independence. Every reader contribution, big or small, is so valuable. Support The Guardian from as little as $1 – and it only takes a minute. Thank you. 11 Dec 2008 12:45 Share on Twitter Reply 11 Dec 2008 19:58 0 1 Share 11 Dec 2008 23:42 Well played Andrew Strauss. Good to see. Doubtless there will be a queue of knockers on here later to tell us how it was the worst thing that could have happened, but what more could we ask of the man? Share Share on Twitter 1 Share on Facebook | Pick Share on Twitter Twitter 11 Dec 2008 19:23 11 Dec 2008 10:48 zephirine Twitter Pietersen takes crisis in stride to raise his standing | Pick Reply And there is nothing unexpected about his toughness, he has proved that decency will not stand in his way when there are bucks to be made.I say again this tour is continuing because of the IPL and the England players didnt get the 500k from Stanford.Priors’ wife did get…. Twitter Support The Guardian Share on Facebook Share on Facebook 11 Dec 2008 9:48 Report Facebook Chinmay Share I see you don’t count ODIs as matches:)I don’t think ODIs outside the WC actually count that much. It’s a bit like track and field event. Or a swimming event. You train hard for precisely one thing — the Olympic gold. Everything else is sort of immaterial. I really don’t care how many Kitply cups or Idea cups or Airtel Trophies India really wins after about a week after it is won. May be this is so because India play a lot of ODI cricket, so much that it becomes hard to remember exactly how many tournaments we participated in.Of course, there are a few iconic trophies in ODI cricket, like the triangular series in Australia (which has now been scrapped) or the Asia cup held now and then, or the almost farcical Champions Trophy, but then, again, I’d swap them all for a test series win against Australia.Perhaps the only ODI series I really watched with sustained interest was the one held in Sarjah, but that’s now gone too.The bottom line is, ODI isn’t actual cricket because, it’s not what you are going to measure a player with after his retirement. Share 0 1 can the next person who disagrees with David Hopps, or indeed any other writer on the site, PLEASE STOP using the words ‘awful’ / ‘shoddy’ / ‘poor’ etc. journalism as criticism.as an article, it scans well, so whatever you think about the sentiment is your subjective opinion, rather than objective lexical analysis. it winds me up no end.crikfan – your unnecessary reference to the dead of the Mumbai terror attacks is more of a slur than anything David could write. if the last couple of weeks have taught us nothing else, they’ve taught us that bickering over the internecine power struggles of world cricket is fairly inconsequential in the scheme of things. so as the previous responder advised you, grow up, you’re pathetic. David, I unreservedly apologise.I do however stand behind the sentiment that KP has not had anywhere near enough flak over his departure from S Africa.It says a lot about the psyche of the man that he feels having a sub chav 3 lions tattoo carved on his arm dispels all questions as to his motivation in coming to England Shame about his batting this innings. What annoys me about journalists is this constant rush to judgement. The fact is that we still know almost nothing about KP as a captain. Come back and write about it in 2 years time, if he’s still in the job. And’ please do not quote the players’ statements; who in their right mind is going to slag off their captain? | Pick Report Share on WhatsApp Facebook 0 1 Sorry there was an error. Please try again later. If the problem persists, please contact Userhelp Reply Cameldancer | Pick Twitter Share on Facebook Report Share on Twitter
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Plaintiffs’ lawyers battling Johnson & Johnson in a multi-district litigation over allegedly defective hip implants faced what appeared to be a couple of hostile Fifth Circuit judges who seemed ready to take the extraordinary step of stopping U.S. District Judge Ed Kinkeade of Dallas from moving forward with more bellwether trials. Oral arguments Thursday at the Fifth Circuit proved highly dramatic in a case that is attracting significant legal attention . . .You must be a subscriber to The Texas Lawbook to access this content. Password Lost your password? Remember me Username Not a subscriber? Sign up for The Texas Lawbook.
by, Martin Bayne, ChangingAging ContributorTweet4Share62Share2Email68 SharesHere’s an idea for every residential aging facility that struggles with ambient despair (chronic melancholy, fatigue, pain, sleeplessness and anxiety) that masks itself as “activity indifference” (the resident spends her entire day in her room or a chair in the main lobby avoiding activities and other residents).Historically, such residents have simply been written off, until the day arrives that their Activity of Daily Living (ADL) profile justifies transfer – most go to Skilled Nursing Facilities (SNF) or to a child’s home.In most of these cases, the adult children of these residents are the POAs and advocates. Because most children are never contacted unless there’s an acute medical problem, the child is unaware there’s a problem in the first place. And even when the children are contacted about ambient despair, the child’s attitude is usually, “Hey, this is why we pay you a zillion dollars a month.”In fact, why does the facility administrator even care about these unresponsive residents? The answer is, because after a while, ambient despair creates a “revolving door” syndrome and the cost of filling that bed with a new resident is not insignificant – just ask the Director of Marketing in an eldercare facility.What to do?Create a Platinum Club.A Platinum Club is a Members-Only group whose sole purpose is to create activities that are well-attended. How? Give everyone a monthly discount (X-$5/day) where X is the current rate, to everyone who participates. In this case, that $150 discount off their monthly charge gets the kids excited; they in turn talk to their parent (“Hey dad, why aren’t you attending the Men’s Club and Resident’s Council?”)If either parent or resident balks, no harm done. It’s just a discount.Email Martin Bayne at firstname.lastname@example.orgRelated PostsTen Things You Need To Know About Assisted LivingMartin Bayne has spent the last ten years as an assisted living facility resident and shares the top 10 things to know before moving in.What it Feels LikeIf you are looking for some “real deal” writing by a person who lives in assisted living and knows how it FEELS to live there, check out Martin Bayne. I’ve known Martin for a bunch of years and he always has a thought provoking perspective on issues related to age,…Nursing Homes: Finding the RIGHT OneOn July 16, 2012, one of my favorite bloggers, Ronni Bennett, posted a piece about institutional elder abuseon her excellent “TimeGoesBy” site. While I hope my family never needs to initiate the process of finding senior housing for me (I started doing it for myself — after my Parkinson’s diagnosis…Tweet4Share62Share2Email68 SharesTags: Ambient Despair Assisted Living long-term care Martin Bayne nursing home
Source:https://news.umich.edu/many-at-risk-for-hiv-despite-lifesaving-pill/ Jun 12 2018Multiple barriers may stop high-risk individuals from accessing an HIV drug that can reduce the subsequent risk of infection, according to a new University of Michigan study.Researchers outlined solutions that would help overcome barriers that make it harder for underserved populations to access pre-exposure prophylaxis (PrEP). The Centers for Disease Control and Prevention reported that nearly 40,000 people–about 43 percent of whom were black or Latino gay and bisexual men–received an HIV diagnosis in 2016.The U-M study, published in the journal AIDS and Behavior, includes 47 peer-reviewed scholarly articles reporting data from HIV prevention and care providers, and from individuals at risk for infection. The researchers listed 31 potential solutions to 30 barriers to accessing PrEP at the patient, provider and health-system levels.One striking barrier to accessing PrEP is created by providers’ biases toward those who most need the drug, says lead author Rogério Pinto, associate professor and associate dean for research at the U-M School of Social Work. For example, providers appear to believe that certain patients, such as transgender women and people of color, when given PrEP may be unable to consistently adhere to prescribed regimens or will stop using condoms to prevent HIV transmission.Pinto and colleagues say that perhaps even more concerning than provider-level biased attitudes is a structural barrier referred to as the “purview paradox.” On the one hand, infectious disease specialists are often trained to provide PrEP, but that they seldom actually see HIV-negative patients. On the other hand, primary care physicians, who care for mostly uninfected but sometimes at-risk patients, are seldom trained to provide PrEP.Other pervasive structural obstacles–such as homophobia, transphobia and racism across systems of care–may be helped by interventions to disrupt stereotypes about potential PrEP users.Related StoriesPatients with HIV DNA in cerebrospinal fluid have high risk of experiencing cognitive deficitsScripps CHAVD wins $129 million NIH grant to advance new HIV vaccine approachHIV therapy leaves unrepaired holes in the immune system’s wall of defense”However, patient assistance in navigating the health care system–including accessing health insurance and co-pay assistance–is a sorely needed intervention,” Pinto said.Some of the barriers and recommended interventions include:To combat bias against a patient’s race or sexual behaviors: Develop and deliver training to increase the provider’s “cultural competency,” including trans- and gender-affirming care.In response to limited health budgets to sustain PrEP programs: Advocate among those in the medical field for expanded health insurance.In response to legal constraints to providing PrEP for youth: Expand education, screening and referrals to PrEP services, and find improved methods to identify appropriate PrEP candidates.The researchers note, however, that some interventions have had mixed results, in part due to not being aligned to specific barriers. Many barriers, such as interventions to lessen providers’ biases and breakdowns in the health system, often target the behavior of individual patients instead of targeting providers and health systems, they say.”The key message from this review is that barriers to PrEP implementation cut across patient, provider and health-system levels, and that multiple interventions, mapped onto specific barriers, ought to be used,” Pinto said.In addition, he says that without attention to the ways structural factors affect individuals within health care systems, PrEP implementation “may actually reinforce existing inequities that place the overwhelming burden of the HIV epidemic on more vulnerable groups.”
Jul 16 2018Memories are formed through long-term changes in synaptic efficacy, a process known as synaptic plasticity, and are stored in the brain in specific neuronal ensembles called engram cells, which are activated during corresponding events. When two memories are associated, cell ensembles corresponding to each memory overlap. However, each memory has its own identity. How the brain stores and defines a specific memory identity when two memories interact and are encoded in the shared ensemble was elusive. Here, a research team led by Dr. Kaoru Inokuchi at the University of Toyama shows that synapse-specific plasticity represents specific memory entities, and that synaptic plasticity between specific engram assemblies is both sufficient and crucial for information storage.Related StoriesStudy offers clues about how to prevent brain inflammation in Alzheimer’sNew therapy shows promise in preventing brain damage after traumatic brain injuryNew shingles vaccine reduces outbreaks of painful rash among stem cell transplant patientsWe exposed mice to auditory fear conditioning, in which a tone was associated with a foot shock. Synaptic plasticity between the auditory cortex (AC) and the medial part of medial geniculate nucleus (MGm) neuron terminals and the lateral amygdala (LA) neurons mediates this association. After complete retrograde amnesia, optogenetic stimulation of the activated ensemble terminals of the AC and the MGm in the LA failed to induce fear memory recall (Figure 1), indicating that the memory engram no longer existed in that circuit. This result was correlated with the resetting of synaptic strength and functional connectivity between engram assemblies.Next, mice were fear conditioned to two different tones, separated by 5 hours. Therefore, the two memory traces interacted and overlapped in LA. Complete retrograde amnesia of a given fear memory did not affect the linked fear memory encoded in the shared ensemble (Figure 2), indicating that memories are stored in specific synapses.Then, we addressed the question of how each memory reserves its individual identity within the shared ensemble. We used optical long-term depression (LTD) to depotentiate the synaptic efficacy in synapses specific for certain memory. Depotentiation of the plasticity at synapses specific to one memory deconstructed the specific connectivity between engram assemblies, thereby affected the recall of only that memory without influencing the linked memory in the same population of neurons (Figure 3). Thus, sharing of engram cells underlies the linkage between memories, while synapse-specific plasticity guarantees the identity and storage of individual memories.Our findings demonstrate that synapse-specific plasticity is necessary and sufficient for associative fear memory storage, and it guarantees uniqueness to the memory trace, advocating the plasticity as a substrate for the fear memory engram. Furthermore, we achieved selective and total erasure of fear memory from an engram network without affecting other memories stored in the shared ensemble by resetting the plasticity in a synapse-specific manner. This leads to better understanding of the mechanisms underlying memory storage, and may give insight into therapeutic ways to treat post-traumatic stress disorder. Source:http://www.jst.go.jp/pr/announce/20180615/index_e.html
Reviewed by James Ives, M.Psych. (Editor)Aug 25 2018Pregnant women with heart disease should give birth at no later than 40 weeks gestation. That is one of the recommendations in the 2018 European Society of Cardiology (ESC) Guidelines for the management of cardiovascular diseases during pregnancy published online today in European Heart Journal, and on the ESC website.”Beyond 40 weeks, pregnancy has no added benefit for the baby and may even have negative effects,” said Professor Jolien Roos-Hesselink, Co-Chairperson of the Guidelines Task Force and Cardiologist, Erasmus Medical Centre Rotterdam, the Netherlands. “Pregnancy is a risky period for women with heart disease because it puts additional stress on the heart, so the guidelines advise inducing labor or a caesarean section at 40 weeks.”Heart disease is the main reason women die during pregnancy in western countries. Compared to healthy pregnant women, those with heart disease have a 100-fold greater risk of death or heart failure. Most women with heart disease have a healthy pregnancy. However, they should be aware that they have a higher risk of obstetric complications including premature labor, pre-eclampsia, and post-partum bleeding. An estimated 18-30% of offspring have complications and up to 4% of neonates die.Heart disease in pregnancy is increasing as more women with congenital heart disease reach adulthood due to improved treatment and as the age at first pregnancy rises, accompanied by the higher rates of ischemic heart disease in older, compared to younger, women. Cardiovascular risk factors including hypertension, diabetes and overweight are also on the rise in pregnancy as older women become pregnant and women now acquire risk factors at a younger age.The guidelines provide recommendations on in vitro fertilization (IVF), contraception, and termination of pregnancy in women with heart disease. IVF often uses high doses of hormones, which increase the risk of thrombosis and heart failure, so women with heart disease need a cardiologist’s confirmation that the chosen method is safe. Since carrying more than one baby puts more stress on the heart, women with heart disease undergoing IVF are strongly advised to transfer a single embryo. Girls with congenital heart disease need contraception advice to avoid unplanned pregnancy. Some contraception methods are contraindicated in patients with certain types of heart disease.Related StoriesRNA-binding protein SRSF3 appears to be key factor for proper heart contraction, survivalTeam approach to care increases likelihood of surviving refractory cardiogenic shockResearch opens possibility of developing single-dose gene therapy for inherited arrhythmiasFor drugs used to treat heart disease, the guidelines list information on adverse events obtained from human and animal studies. In addition, the guidelines state: “In the case of an emergency, drugs that are not recommended by the pharmaceutical industry during pregnancy and breastfeeding should not be withheld from the mother. The potential risk of a drug and the possible benefit of the therapy must be weighed against each other.”Professor Vera Regitz-Zagrosek, Chairperson of the Guidelines Task Force and Director of the Institute for Gender Medicine, Charité University Medical Centre Berlin, Germany, said: “When drug companies have no data on whether a drug is safe during pregnancy and breastfeeding they tend to say it is not recommended. It may be appropriate to give a drug to a severely ill woman if there are no harmful side effects noted in the databases listed in the guidelines.”Pregnancy is not recommended in patients with certain types of heart disease – for example, pulmonary arterial hypertension, severely dilated aorta, or severely reduced ability of the heart to pump blood.Women with heart disease who want to have a baby need pre-pregnancy risk assessment and counseling. Those at moderate to high risk of complications should be reviewed by a pregnancy heart team with a cardiologist, obstetrician, gynecologist, and anesthesiologist. A delivery plan should be devised at 20-30 weeks specifying vaginal or caesarean delivery, whether an epidural or forceps will be used, and the duration of hospital stay after delivery.Professor Roos-Hesselink said: “The delivery plan should be available 24 hours a day so that when a pregnant woman with heart disease arrives at hospital in labor hospital staff know exactly what to do.”Professor Regitz-Zagrosek: “We hope the guidelines will improve doctors’ awareness of the risks of heart disease in pregnancy but also the therapeutic options that are available to guide pregnancy in these women.”Source: https://www.escardio.org/The-ESC/Press-Office/Press-releases/pregnant-women-with-heart-disease-should-give-birth-at-no-later-than-40-weeks-gestation
Between 400 C.E. and 650 C.E., waves of Germanic invaders swept through the eastern United Kingdom. They conquered territory, set up regional governments, and mingled with a diverse local population that included indigenous British people and migrants from the far-flung reaches of the recently defunct Roman Empire. Modern British genomes are mostly a mix of these populations. But it has been difficult to determine just how much the invaders—Anglo-Saxons from Europe’s North Sea coast—contributed because of the small genetic differences among European groups. Now, researchers may have an answer. Using whole-genome sequencing, they looked at rare genetic variants in modern-day British populations and compared them with variants in the DNA of 10 ancient skeletons. The bodies, seven Anglo-Saxons and three preinvasion peoples, were buried near Cambridge, U.K., between about 100 B.C.E and 800 C.E. Writing in Nature Communications, the researchers report that 38% of the ancestors of people from the eastern United Kingdom were Anglo-Saxons. People from Scotland and Wales, meanwhile, have about 30% Anglo-Saxon ancestry. But if scientists really want to understand Anglo-Saxon genomes, they might be better off looking elsewhere in Europe. The researchers also determined that Anglo-Saxons were genetically similar to modern Danish and Dutch people.