Patrick Skerrett By Patrick Skerrett Dec. 22, 2015 Reprints [email protected] The draft guidelines from the USPSTF look a lot like the guidelines published in 2013 from the American Heart Association and American College of Cardiology. Are they better?Patients and providers, including me, were confused by the 2013 guidelines. Why the task force has come out with its own similar — but different — guidelines adds to the confusion. For example, the American Heart Association and American College of Cardiology guidelines recommend starting a statin when the 10-year risk is 7.5 percent. The task force says 10 percent. I don’t think it makes public health sense to have multiple guidelines that don’t completely agree with each other floating around.These guidelines use cardiovascular risk to determine who should take a statin. Does that make sense?Using cardiovascular risk to determine whether to take a statin is definitely reasonable. But if you are going to make a risk-based guideline, the way you calculate risk must be very, very good. I and others have criticized the risk calculator used by the American Heart Association and American College of Cardiology guidelines. It understates the risk in some populations, meaning some people who could truly benefit from a statin wouldn’t be advised to take one, and overstates the risk in others. I don’t understand why the US Preventive Services Task Force would recycle this flawed calculator.advertisement First OpinionExpert view: New guidelines on cholesterol drugs are flawed Paul J. Richards/Getty Images @PJSkerrett Editor, First Opinion Patrick Skerrett is the editor of First Opinion, STAT’s platform for perspective and opinion on the life sciences writ large, and the host of the First Opinion Podcast. About the Author Reprints What would make the calculator better?One thing I must emphasize: Before this calculator was made public in the 2013 guidelines, it had never been published in a peer-reviewed paper. The first time many of us saw it was the day it appeared as part of the guidelines. This calculator needs to be verified in various populations, and adjusted to improve its accuracy. It also excludes family history, one of the most powerful risk factors for cardiovascular disease. Risk calculators that include this information, like the Reynolds Risk Score, do a better job of estimating an individual’s cardiovascular risk.The USPSTF draft guidelines cover only individuals between the ages of 40 and 75. Does that mean older people shouldn’t take a statin?Truncating treatment recommendations at age 75 is not sensible. In an important trial called IMPROVE-IT, published earlier this year in the New England Journal of Medicine, the researchers found something remarkable. People under age 75 who took a statin plus another cholesterol-lowering drug called ezetimibe [a Merck drug marketed as Zetia] got very little benefit from the medications, while those over 75 benefited, meaning they had lower rates of heart attack or stroke or needing artery-opening angioplasty or bypass surgery.Statins aren’t risk-free. How do individuals and their doctors balance benefits and risks?Side effects are always a concern. People at low risk for a heart attack or stroke shouldn’t be taking a statin because they get little or no benefit while shouldering the possibility of harm. These include muscle pain and a possible small rise in blood sugar. But keep in mind that these risks are small, especially for the low and moderate doses of statins the task force is recommending. In addition, if these problems appear, stopping the drug eliminates the problem. These factors make it easier to recommend statins to a wider group of individuals, especially since cardiovascular disease is the leading cause of death in the United States and many other countries.If the guidelines are unclear, what’s the best way for individuals to answer the question, ‘Should I be taking a statin?’Find a thoughtful doctor who is independent and who won’t just parrot back the guidelines. He or she should be willing to talk openly about statin use and the prevention of cardiovascular disease. Nothing beats a conversation like that. Patients have different value systems, preferences, concerns, and issues such as family history that aren’t in the guidelines. Including these in the process known as shared decision-making is very powerful.If your doctor doesn’t really want to talk with you or share the decision making, find another doctor. Some seemingly healthy men and women could benefit from taking a cholesterol-lowering statin, according to draft guidelines published Monday by the US Preventive Services Task Force, an independent panel of clinicians established by Congress to develop federal guidelines for tests and treatments aimed at preventing disease.There’s little question that statins save lives when taken by individuals who have had a heart attack or stroke. Things are a bit murkier for adults without heart disease. The task force is now recommending a low- to moderate-intensity statin for 40- to 75-year-olds who might seem healthy but have a higher chance developing heart disease because of high blood pressure, high cholesterol, diabetes, or smoking.For perspective on the draft guidelines, I talked with Dr. Steven Nissen, chair of cardiovascular medicine at the Cleveland Clinic.advertisement Tags guidelinesheart diseasestatins
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Beach front businesses deal with impacts of Fort Myers Beach ‘street preachers’ June 16, 2021 What led up to the Memorial Day shooting on Fort Myers Beach June 9, 2021 RELATEDTOPICS Woman infected with flesh-eating bacteria after swim at Fort Myers Beach June 3, 2021 FORT MYERS BEACH, Fla. — It’s been 10 months since a 22-year-old man was gunned down on Fort Myers Beach, officials said.Investigators need the public’s help with tracking down Johnny Jackson’s murderer. While spending time with friends and family near the Lani Kai Island Resort on Fort Myers Beach, an unidentified shooter shot and killed Jackson.Jackson had five siblings and was raised in Lee County. He worked at a lawn care service in Lehigh Acres and spent plenty of time with his family — especially his nieces and nephews. AdvertisementRecommended ArticlesBrie Larson Reportedly Replacing Robert Downey Jr. As The Face Of The MCURead more81 commentsGal Gadot Reportedly Being Recast As Wonder Woman For The FlashRead more29 commentsDC Young Fly knocks out heckler (video) – Rolling OutRead more6 comments’Mortal Kombat’ Exceeded Expectations Says WarnerMedia ExecutiveRead more2 commentsDo You Remember Bob’s Big Boy?Read more1 commentsKISS Front Man Paul Stanley Reveals This Is The End Of KISS As A Touring Band, For RealRead more1 comments AdvertisementAnyone with information on the murder of Johnny Jackson is urged to call Crime Stoppers at 1-800-780-TIPS (8477). All callers will remain anonymous and will be eligible for a cash reward of up to $3,000 from Crime Stoppers and $10,000 from an anonymous donor.Tips can also be made online at www.southwestfloridacrimestoppers.com or on the P3Tips mobile app. AdvertisementTags: Deadly shootingFort Myers BeachLani Kai Resort Teen arrested in Fort Myers Beach Memorial Day shooting June 4, 2021
SHARE Facebook Twitter News Jong So YongJong So Yong is one of Daily NK’s freelance reporters. Questions about her articles can be directed to [email protected] RELATED ARTICLESMORE FROM AUTHOR Pak Myong Ho, a North Korean vice minister of foreign affairs, was recently punished by a stern warning for disregarding the government’s disease control measures amid the COVID-19 pandemic, Daily NK has learned. A source in Pyongyang told Daily NK on Jan. 29 that “Pak was subject to a severe warning for two months because he abused his power and behaved in an undisciplined manner despite the COVID-19 crisis.”Pak, who is considered a China expert, had previously served as a minister at North Korea’s embassy in China and as a temporary charge d’affaires. He was promoted to vice minister of the Asia department in the foreign ministry in June of last year.According to the source, Pak has received recognition from the state for his accomplishments. The Central Committee reportedly even considered him “a person who was good at his job.” However, Pak was recently criticized by members of the Ministry of Foreign Affairs for “neglecting the pandemic situation” and behaving in an “undisciplined manner” while “taking advantage of the Party’s trust.” A picture of a street in Pyongyang in August 2019. / Image: Daily NK“In accordance with the national quarantine policy, foreign embassies have been designated as emergency quarantine zones and social distancing measures have been imposed,” the source told Daily NK. “Pak nonetheless arbitrarily contacted foreigners in Pyongyang, [and was subsequently] reported to the party committee of the foreign ministry for his violation of national quarantine policy.”As a consequence, he was subject to two months of punishment (in the form of a “severe warning”) – from Dec. 1 to the end of this month – for disobeying the government’s quarantine rules, such as contacting many people while visiting foreign embassies during an emergency quarantine.In their condemnation of Pak, the North Korean authorities pointed out that foreign ministry employees are frequently acting like privileged people. The authorities also condemned trade officials on the Sino-North Korean border for their “undisciplined behavior.” They further emphasized that anyone who acts in an undisciplined manner will not avoid punishment.The authorities also ordered all trade-related workers on the border to return to Pyongyang, saying that they must be strictly controlled because the activities they conduct near the border to earn foreign currency could cause a “major disaster” in the country.Please direct any comments or questions about this article to [email protected] in Korean North Korea Market Price Update: June 8, 2021 (Rice and USD Exchange Rate Only) Hamhung man arrested for corruption while working at a state-run department store News News North Korea hikes “party contributions” Russia-based workers must pay by 30-55%
Related news Many note that Poloz has indicated that interest rate decisions will be data dependent. In addition to a stronger-than-expected jobs report released earlier this month, the central bank’s Business Outlook Survey revealed that sentiment remained positive during the final quarter of 2017. But many economists say a rate hike today doesn’t mean the Bank of Canada is poised to start a rapid tightening cycle. Given high household debt levels, the unknown impact of tighter stress tests for uninsured mortgages that came into effect this year and uncertainty surrounding NAFTA renegotiations, the bank must be cautious about how quickly it raises rates in order to avoid derailing the economy. Bank of Nova Scotia is forecasting 75 basis points of gradual tightening this year spread out throughout 2018, while Toronto-Dominion Bank expects a gradual pace of tightening over the next two years of about 25 basis points every six months. Royal Bank of Canada says it expects the Bank of Canada to raise the overnight rate by 25 basis points to 1.25% today. Facebook LinkedIn Twitter Canadian Press BoE predicts best economic year for the U.K. since 1941 Keywords Interest ratesCompanies Bank of Canada All eyes will be on the Bank of Canada Wednesday morning as it makes its latest scheduled interest-rate announcement. Economists widely believe that based on the economic environment, it’s likely that governor Stephen Poloz will raise the central bank’s benchmark interest rate today for a third time since last summer. Fed warns U.S. financial system remains vulnerable Share this article and your comments with peers on social media Rising interest rates could dampen stimulus impact: PBO
James Langton Household debt-to-income ratio fell in first quarter: Statscan Katarzyna Białasiewicz/123RF Share this article and your comments with peers on social media Related news Keywords Pandemics, Coronavirus, Economic indicatorsCompanies Statistics Canada Leading indicators signal steady rebound: OECD Last year saw a much more disruptive crisis with the onset of the Covid-19 pandemic, but early evidence indicates that government support measures largely mitigated declines in employment and earnings.StatsCan said that its experimental measure of weekly family incomes indicated that between February and June 2020, “a surge in the share of families with low-weekly earnings was more than offset by government pandemic relief benefits.”StatsCan noted that the experimental low-weekly income rate rose during the second half of 2020, but was still below its pre-pandemic level at the end of the year.It remains to be seen just how the pandemic has impacted poverty in Canada, but the report said that the most vulnerable households — singles and single-parent families, which suffered the largest drops in weekly earnings due to the onset of the Covid crisis — received government transfers that offset the decline in income.Prior to the pandemic, singles and single-parent families were much more likely to be living in poverty. For instance, almost a third (29.8%) of children in families headed by a single mother were in poverty, compared with 7.2% of children living in two-parent families, the report said.Single seniors also struggled. Overall, 5.4% of seniors lived in poverty in 2019, but the poverty rate was 11.7% among single seniors, compared with just 2.8% for those living in families.Before the pandemic, income equality had been improving in Canada, StatsCan reported.In 2019, the bottom 40% of income earners accounted for 21% of total after-tax income and the top 10% of earners represented 22.7% of total income.“The share for the lowest four deciles has been slightly increasing since the beginning of the decade, while the share of the highest decile has been edging down, suggesting a decrease in inequality,” StatsCan said. Ontario unlikely to balance budget by 2030: FAO Heading into the Covid-19 pandemic, the poverty rate in Canada was declining and income inequality was falling too. While the pandemic caused large drops in income for many, government support programs offset these losses, according to new data from Statistics Canada.StatsCan reported that the share of Canadians living below the official poverty line dropped from 11.0% in 2018 to 10.1% in 2019, representing 3.7 million people. This continued a trend that has prevailed since 2012, with the exception of a blip in 2015 that was attributed to an oil price shock. Facebook LinkedIn Twitter
Lorraine Explains: Are modern car shows irrelevant?Mercedes-Benz and Volvo had already pulled out of most auto shows in 2020, including the Toronto event and January’s Montreal Auto Show, saying they were focusing on other ways to showcase their products. Audi skipped the Montreal show.In the U.S., some automakers have preferred to attend the Consumer Electronics Show (CES), held in January in Las Vegas, rather than traditional shows such as the North American International Auto Show in Detroit — but CES will be online-only for 2021. Partly due to pressure from CES, the Detroit show was moved from January to June, but was then cancelled when the venue became an overflow field hospital for COVID-19 patients. Toronto’s annual Canadian International Auto Show (CIAS) will offer a digital experience for its 2021 edition, but is still deciding if a live event will be held.According to Automotive News Canada, the CIAS’ director of marketing, David McClean, said technology exists “to build a virtual platform” for the public to experience auto brands “in a virtual environment,” and it could be connected to a physical event, either at the same time or later on.The 2020 show, which ran from February 14 to 23, was one of the few auto events in Canada and the U.S. that wasn’t cancelled due to COVID-19 restrictions. It draws around 360,000 spectators and devotes a large portion to displays including antique cars, children’s activities, gamers, and vendors. During media day, the Automobile Journalists Association of Canada (AJAC) announces its Canadian Car and Canadian Utility Vehicle of the Year Awards. The Rolls-Royce Boat Tail may be the most expensive new car ever COMMENTSSHARE YOUR THOUGHTS McClean said digital options were already under development prior to COVID-19. Show organizers are assessing their ability to hold a traditional show that’s safe for the public, while weighing costs to automakers and the event.Mazda Canada has already said it will not appear at any auto shows in 2021, due to the difficulty of presenting its products to consumers while following safety rules.So far it’s the only company to announce that for all of next year, but regarding the Toronto show, Hyundai Canada CEO Don Romano said it “doesn’t seem feasible” to put thousands of people into a show five months away, and “we’re going to plan for it not to happen.”RELATEDvolvo-audi-bailing-out-2rd.jpg?w=400&h=260′);”>Volvo and Audi join Mercedes-Benz in bailing out from Montreal Auto Show PlayThe Rolls-Royce Boat Tail may be the most expensive new car everPlay3 common new car problems (and how to prevent them) | Maintenance Advice | Driving.caPlayFinal 5 Minivan Contenders | Driving.caPlay2021 Volvo XC90 Recharge | Ministry of Interior Affairs | Driving.caPlayThe 2022 Ford F-150 Lightning is a new take on Canada’s fave truck | Driving.caPlayBuying a used Toyota Tundra? Check these 5 things first | Used Truck Advice | Driving.caPlayCanada’s most efficient trucks in 2021 | Driving.caPlay3 ways to make night driving safer and more comfortable | Advice | Driving.caPlayDriving into the Future: Sustainability and Innovation in tomorrow’s cars | Driving.ca virtual panelPlayThese spy shots get us an early glimpse of some future models | Driving.ca RELATED TAGSFlexTorontoCdn Int’l Auto ShowNew VehiclesToronto & GTAToronto CIASFlexOntarioToronto Trending Videos See More Videos First Look: 2022 Lexus NX The sport-cute’s looks have been softened, but its powertrains and infotainment offerings have been sharpened ‹ Previous Next › We encourage all readers to share their views on our articles using Facebook commenting Visit our FAQ page for more information. Trending in Canada The CIAS will decide by mid-October whether to hold a live event in February, but “the virtual show will go on regardless.” advertisement Created with Raphaël 2.1.2Created with Raphaël 2.1.2 Canadian International Autoshow 2020: Day Two Canadian International Auto Show
Tourism Minister Hails Work of TPDCo TourismFebruary 14, 2013Written by: Douglas McIntosh FacebookTwitterWhatsAppEmail RelatedTourism Minister Hails Work of TPDCo RelatedTourism Minister Hails Work of TPDCo RelatedTourism Minister Hails Work of TPDCo Story HighlightsTourism and Entertainment Minister, Hon. Dr. Wykeham McNeill, has commended the Tourism Product Development Company (TPDCo) for its work in maintaining Jamaica’s tourism product at the highest international standard.Speaking at the entity’s staff awards luncheon, at the Jamaica Pegasus Hotel, New Kingston, on February 12, under the theme: ‘Celebration of Service in Tourism’, Dr. McNeill underscored the importance of tailoring Jamaica’s tourism provisions to fulfill the needs and expectations of target clients.“Without a great tourism product… no doubt this would result in customer dissatisfaction, something we cannot afford. It is part of your responsibility to ensure that the product meets the highest standards, so that visitors will know, once they arrive on our beautiful shores that steps are being taken to bring the product to its highest level. Your impact in this area has been significant and I want to commend you,” the Minister told the staff. Tourism and Entertainment Minister, Hon. Dr. Wykeham McNeill, has commended the Tourism Product Development Company (TPDCo) for its work in maintaining Jamaica’s tourism product at the highest international standard.Speaking at the entity’s staff awards luncheon, at the Jamaica Pegasus Hotel, New Kingston, on February 12, under the theme: ‘Celebration of Service in Tourism’, Dr. McNeill underscored the importance of tailoring Jamaica’s tourism provisions to fulfill the needs and expectations of target clients.“Without a great tourism product… no doubt this would result in customer dissatisfaction, something we cannot afford. It is part of your responsibility to ensure that the product meets the highest standards, so that visitors will know, once they arrive on our beautiful shores that steps are being taken to bring the product to its highest level. Your impact in this area has been significant and I want to commend you,” the Minister told the staff.Dr. McNeill noted that efforts to this end have manifested in TPDCo’s focus on training industry workers, instituting appropriate regulations, and partnering with communities in maintaining, beautifying and facilitating infrastructural development.“Over the last few years, I am advised that TPDCo has completed physical works to the tune of over $450 million annually. It has also trained over 11,000 industry workers and assessed just under 5,000 entities annually,” the Minister said.“However, while we have been doing some good work in spurts, we must now begin to press (ahead) on transformational projects in areas such as Port Royal, Falmouth, Ocho Rios and Spanish Town…that will have a larger impact, and involve and benefit even more Jamaicans,” he added.Citing the country’s current economic challenges, Dr. McNeill said the tourism sector is deemed pivotal in efforts to revitalize the economy, while asserting that, “we (tourism stakeholders) are going to have to lead the growth going forward.”“As we forge ahead to transform our tourism product…only the highest ethical standards, the best technical standards, the utmost professional standards, will be good enough. Success will require prudent planning and the creation of a holistic policy framework to foster the sustainable development and transformation of our tourism product,” the Minister emphasized.In her remarks, TPDCo Chairperson, Maxine Henry-Wilson, also commended the agency’s staff, while pointing out that the institution is cognizant of its “immense” role in the tourism sector, and acknowledges that if its mandate is not properly executed, this could “negatively affect our brand”.“I also believe that we are aware of the changing nature of the highly competitive global economy and the changing nature of our visitors, who are no longer content with enjoying just sun, sea and sand. They are, more than ever, more discerning, more sophisticated, and require higher standards across the board,” she said, while underscoring the need to cater to local communities in facilitating the enhancement of the country’s various assets.“All of these elements are key components which help to differentiate us from other destinations. Things are moving at a rapid pace and we must be nimble in our response to the changes, so that we can assist our stakeholders and, by extension, Jamaica’s tourism industry, in maintaining its competitive advantage,” Mrs. Henry-Wilson said.Just over 80 TPDCo employees were presented with special awards for exemplary and outstanding service.The Tourism Product Development Company is the central agency mandated by the Government to facilitate the maintenance, development and enhancement of Jamaica’s tourism product. Advertisements
Story HighlightsThe Governor-General of Jamaica, His Excellency the Most Honourable Sir Patrick Allen and Her Excellency the Most Honourable Lady Allen, made a recent visit to the twin-island Republic of Trinidad and Tobago.Their Excellencies served as patrons of the institution’s 1st Annual Fund Raising Gala: Connections in aid of the Rebuilding from the Ashes campaign. The black tie event was well supported by a cross-section of persons. Advertisements Related24-Year Old Female Footballer is 2016 Rhodes Scholar Governor General Sir Patrick Allen and Lady Allen Visit Trinidad and TobagoJIS News | Presented by: PausePlay% buffered00:0000:00UnmuteMuteDisable captionsEnable captionsSettingsCaptionsDisabledQualityundefinedSpeedNormalCaptionsGo back to previous menuQualityGo back to previous menuSpeedGo back to previous menu0.5×0.75×Normal1.25×1.5×1.75×2×Exit fullscreenEnter fullscreenPlay RelatedJustice Sinclair-Haynes Appointed To Court Of Appeal The Governor-General of Jamaica, His Excellency the Most Honourable Sir Patrick Allen and Her Excellency the Most Honourable Lady Allen, made a recent visit to the twin-island Republic of Trinidad and Tobago from 26th-29th November 2015 at the invitation of the President of the University of the Southern Caribbean (USC), Dr. Clinton Valley and Mrs. Martha Valley. Their Excellencies served as patrons of the institution’s 1st Annual Fund Raising Gala: Connections in aid of the Rebuilding from the Ashes campaign.The main auditorium of the eighty-eight year old institution, nestled in the heart of the picturesque Maracas Valley, was gutted by fire in April 2012. The Gala was one of the main events organized through the USC’s fundraising campaign for the replacement of the auditorium with multipurpose facility which will serve the University community. The black tie event was well supported by a cross-section of persons, including the President of the Republic of Trinidad and Tobago, His Excellency Thomas Aquinas Carmona who was also a special guest, the High Commissioner for Jamaica His Excellency David Prendergast and Mrs. Angella Prendergast, members of the Jamaican community who came out in their numbers to meet Their Excellencies The Governor-General and Lady Allen, members of the University Administration and friends of the University.While in Trinidad and Tobago, The Governor-General and Lady Allen paid a courtesy call on President Carmona and Mrs. Reema Carmona. During the exchange, The Governor-General shared the “I Believe” Initiative with President Carmona and addressed a group of students who were in attendance at the courtesy call.Other activities included visits to the University’s campus where The Governor-General briefly addressed the General Assembly as well as the Divine Hour Service of the University’s Sabbath Education Convention. There was also a Jamaican breakfast hosted by Dr. Clinton Valley and Mrs. Martha Valley, which was followed by a meet and greet session for Their Excellencies with the University Administration, Faculty, staff, students, the Jamaican community and other invited guests. The High Commissioner and Mrs. Prendergast also hosted Their Excellencies at lunch.Their Excellencies returned to Jamaica on 29th November 2015. FacebookTwitterWhatsAppEmail Governor General Sir Patrick Allen and Lady Allen Visit Trinidad and Tobago Governor GeneralDecember 3, 2015Written by: Jamaica High Commission RelatedGovernor-General Appoints the Hon. Donna Parchment-Brown Political Ombudsman Photo: Contributed Their Excellencies the Governor General and Lady Allen, His Excellency David Prendergast, High Commission for Jamaica to Trinidad and Tobago and Mrs. Prendergast and Members of the Jamaican Community at Connections: Gala Fundraising Event on November 28.
Tags :electionvotevote by mailvote centersshare on Facebookshare on Twitteradd a commentSanta Monica Target opensSanta Monica fitness studiosYou Might Also LikeFeaturedNewsBobadilla rejects Santa Monica City Manager positionMatthew Hall5 hours agoNewsCouncil picks new City ManagerBrennon Dixson16 hours agoFeaturedNewsProtesting parents and Snapchat remain in disagreement over child protection policiesClara Harter16 hours agoFeaturedNewsDowntown grocery to become mixed use developmenteditor16 hours agoNewsBruised but unbowed, meme stock investors are back for moreAssociated Press16 hours agoNewsWedding boom is on in the US as vendors scramble to keep upAssociated Press16 hours ago HomeNewsElections11-Day Vote Centers Now Open Oct. 24, 2020 at 6:10 amElectionsFeaturedNews11-Day Vote Centers Now OpenBrennon Dixson8 months agoelectionvotevote by mailvote centersVoters also have the option of casting ballots in one of the County’s officials Ballot Drop Boxes, which are located throughout Santa Monica A pair of 11-Day Vote Centers opened in Santa Monica Saturday, meaning local residents now have the ability to safely cast their ballots in-person.Voters will be welcomed at Santa Monica College’s Corsair Gym and the National Typewriter Company beginning at 10 a.m. Saturday.