Tuesday, June 11, 2013

No happily ever after on 'Game of Thrones' finale

TV

7 hours ago

Image: Arya, The Hound

Helen Sloan / HBO

Arya -- with some help from The Hound, sort of -- got a teensy bit of revenge on the season finale.

Does "Game of Thrones" really have a heart after all? After last week's shocking massacre, most fans braced for more tragic deaths in season three's finale. Instead, the blow was softened with poignant reunions and surprising saves, setting the stage for an explosive fourth season.

Body count: No one important died! Unless you count Robb Stark's many bannermen slaughtered at the Twins, that is. But Jon Snow, Theon Greyjoy, Ser Davos, Gendry ... practically all our heroes (and villains) were spared in the aftermath of the Red Wedding.

Headless horseman: One thing viewers were not spared was the sight of Grey Wind, Robb's direwolf, mounted on his body and paraded around the Twins. But the fool who boasted about this unspeakable desecration was silenced by Arya herself, using the knife she stole from the Hound and a little help from Jaqen's silver coin. Valar morghulis!

Image: Cersei and Joffrey

Helen Sloan / HBO

Awww. Did little Joffrey need to be comforted by mommy after his uncle and grandpa put him in his place?

The North remembers: "Killed a few puppies today?" Tyrion quipped when a jubilant Joffrey first summoned him to a special meeting of the king's council -- to gloat, in fact, about the Red Wedding massacre. After Joffrey threatened to serve up Robb's head to Sansa at his wedding feast (coming in season four!), his appalled uncle offered a thinly disguised threat to kill the little monster. His grandfather also delivered a virtual spanking -- or, as Tyrion put it so well, "You just sent the most powerful man in Westeros to bed without his supper." In fact, only Tywin's youngest son recognized that the Lannister patriarch engineered the slaughter -- and warned that they would all suffer the consequences.

Family first! But as usual, Tywin had the last word: When he questioned his loyalty, daddy dearest revealed that he wanted to drown his youngest as an infant -- and should be grateful that he not only spared him but actually acknowledged him as his son. Ouch. Also: Tywin wanted Tyrion to hurry up and impregnate his wife because Roose Bolton will be Warden of the North until he's supplanted by Tyrion and Sansa's son.

Family reunion: Cersei also encouraged Tyrion to have a baby because they bring such happiness. Like Joffrey, for example, whom she said used to be "such a jolly little fellow." Aw. Jolly times are here again, because she was finally reunited with her baby daddy/brother Jaime -- most of him, anyway.

Hickory Farms: Speaking of missing appendages, Theon's castrator was finally revealed as Roose Bolton's bastard son Ramsay. While he taunted the new eunuch -- renamed Reek -- by munching on a pork sausage, the Greyjoys got a look at the genuine article, sent to the Pike in a fancy gift box. Balon disowned his son, but Theon's suddenly loyal sister, Yara, declared that she would rescue him.

You give love a bad name: Ygritte, as it happens, is a card-carrying member of the Fool Me Once Club. She chased the Night's Watch spy, found him alone and aimed her crossbow at him. Jon professed his love and said, "I know you won't hurt me," but he clearly hasn't been paying attention. "You know nothing, Jon Snow," she snapped one last time before drilling him with three arrows.

Dance Party Castle Black: Fortunately for Ned Stark's bastard, his horse had a great sense of direction, delivering his gravely wounded master to the Night's Watch. Fortunately Jon was conscious enough to recognize his welcoming party, including Samwell Tarly! Sam briefly came across Bran too, before reluctantly giving him, the Reeds and Hodor (Hodor! Hodor! Hodor!) directions to cross The Wall.

Reading rainbow: Thank the gods for Ser Davos' literacy program because he managed to read the warning sent by Samwell's ravens about the northern invasion. Instead of killing the Onion Knight for secretly freeing Gendry, Melisandre persuaded Stannis to spare him -- because Davos "has a part to play in war to come." (So winter really is coming?!)

Image: Dany

Keith Bernstein / HBO

Dany is Mother of Dragons, and now, also mother to the Yunkai.

"Mhysa": Let's see, is that everyone? "Game of Thrones" wouldn't say goodbye for the year without one final, victorious send-off from Daenerys Targaryen. When the freed slaves of Yunkai emerged from the city's gates, she refused to command them. "If you want (your freedom) back, you must take it for yourselves," she said before they erupted in shouts of "Mhysa" -- their name for "mother" -- and carried her on their shoulders as her three full-grown dragons soared overhead.

It's not exactly a fairy-tale ending, but after the Red Wedding, we'll take it!

After the penultimate episode, did anything in the finale surprise you? Tell us on our Facebook page!

Source: http://www.today.com/entertainment/no-happily-ever-after-game-thrones-finale-6C10261378

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The UNESCO World Heritage Site Selection Process

By Caroline Smith

The term ?Heritage??is not always an easy word for people to define. However, a word that is often used to describe one?s heritage is legacy. It is what we have done in the past, and what we will pass on to the future. The United Nations Educational, Scientific and Cultural Organization, or UNESCO, sums it up well by defining cultural and natural heritages as ?irreplaceable sources of life and inspiration?our touchstones, our points of reference, our identity? (World Heritage 2008). After World War I, demand increased for an international movement to protect the World?s heritage, and in 1972, following the United Nations Conference on the Human Environment in Stockholm, Sweden, UNESCO adopted the Convention concerning the Protection of World Cultural and Natural Heritage?and thus the beginning of World Heritage Site listings. This convention spearheaded the universal desire for balance between human interactions (cultural heritage) and the need to preserve our environment (natural heritage).

The UNESCO World Heritage Emblem stands for the close relationship between the world?s natural and cultural diversity. The circle is meant to celebrate the beauty of nature and the inside square represents the effects of combining human skill and inspiration. The circular inscription represents the global mission for the protection of mankind?s heritage, following the shape of the world itself. Image from UNESCO.

The UNESCO World Heritage Emblem stands for the close relationship between the world?s natural and cultural diversity. The circle is meant to celebrate the beauty of nature and the inside square represents the effects of combining human skill and inspiration. The circular inscription represents the global mission for the protection of mankind?s heritage, following the shape of the world itself. Image from UNESCO.

Today, the Convention has 190 State signatories, each committed to upholding the mission of UNESCO?s World Heritage??to encourage the identification, protection and preservation of cultural and natural heritage around the world considered to be of outstanding value to humanity.? But what exactly qualifies as cultural or natural heritage? As defined by UNESCO, cultural heritage includes monuments, such as architectural structures, art and science pieces, while natural heritage includes formations that are of ?Outstanding Universal Value from the aesthetic or scientific point of view??the point of view of conservation, natural beauty, or science (Operational Guidelines 2012). UNESCO focuses on bringing together unique, irreplaceable, and diverse areas of the world as part of our global heritage, a common good that belongs to each of us regardless of nationality.

The Convention also set up the World Heritage Committee, which oversees a World Heritage Fund that allocates grants to sites in need for the purpose of ?identifying, preserving and promoting? World Heritage sites (World Heritage 2008). The Committee?s most important job, however, is determining which sites get added to the World Heritage List, a list that now consists of 962 areas (745 cultural, 188 natural, and 29 mixed).

As stated before, in order to be deemed a World Heritage site, the location must be of Outstanding Universal Value, demonstrating international significance; it must ?transcend national boundaries and be of common importance for present and future generations of all humanity? (Operational Guidelines 2012). It must also meet at least one of the following six cultural (I-VI) or four natural (VII-X) heritage criteria:

Selection Criteria:

    1. To represent a masterpiece of human creative genius;
    2. To exhibit an important interchange of human values, over a span of time or within a cultural area of the world, on developments in architecture or technology, monumental arts, town-planning or landscape design;
    3. To bear a unique or at least exceptional testimony to a cultural tradition or to a civilization which is living or which has disappeared;
    4. To be an outstanding example of a type of building, architectural or technological ensemble or landscape which illustrates (a) significant stage(s) in human history;
    5. To be an outstanding example of a traditional human settlement, land-use, or sea-use which is representative of a culture (or cultures), or human interaction with the environment especially when it has become vulnerable under the impact of irreversible change;
    6. To be directly or tangibly associated with events or living traditions, with ideas, or with beliefs, with artistic and literary works of outstanding universal significance. (The Committee considers that this criterion should preferably be used in conjunction with other criteria);
    7. To contain superlative natural phenomena or areas of exceptional natural beauty and aesthetic importance;
    8. To be outstanding examples representing major stages of earth?s history, including the record of life, significant on-going geological processes in the development of landforms, or significant geomorphic or physiographic features;
    9. To be outstanding examples representing significant on-going ecological and biological processes in the evolution and development of terrestrial, fresh water, coastal and marine ecosystems and communities of plants and animals;
    10. To contain the most important and significant natural habitats for in-situ conservation of biological diversity, including those containing threatened species of outstanding universal value from the point of view of science or conservation.

The protection, management, authenticity and integrity of properties are also important considerations.

This information was taken from the UNESCO website. A more detailed description of each criterion can be found in the 2012 Operational Guidelines for the Implementation of the World Heritage Convention, Pages 23-24. http://whc.unesco.org/archive/opguide12-en.pdf

The complicated and often long process begins with each of the 190 States making a ?Tentative List??essentially taking stock of any sites within its territory that demonstrate natural and cultural importance. This is a list that each State Party will pull from when nominating a site for inscription. If a State finds that a site within their boundaries qualifies as having Outstanding Universal Value and demonstrates one of the ten criteria, it may choose to present a nomination file for that site. This file is extensive, including items such as maps, thematic studies, property history, and other necessary documentation needed to prove the Outstanding Universal Value of the site. State Parties are encouraged to seek contributions from local inhabitants, governments, Non-Governmental Organizations, and other people who may be interested or have information regarding the site. Once the file is submitted, the Advisory Bodies must approve it, before sent to the World Heritage Committee. This Committee meets once per year and determines which sites meet the Outstanding Universal Value criteria necessary for Inscription. It has the power to reject or defer a decision, and also can remove sites from the list if they no longer meet the mandatory criteria. However, inscription is only the beginning of the story.

The current UNESCO World Heritage List includes 962 sites, all of which are deemed to be of cultural and natural significance and have been judged as having Outstanding Universal Value. The yellow dots signify cultural sites, the green natural sites, and the red dots are sites in danger. Photo from UNESCO.

The current UNESCO World Heritage List includes 962 sites, all of which are deemed to be of cultural and natural significance and have been judged as having Outstanding Universal Value. The yellow dots signify cultural sites, the green natural sites, and the red dots are sites in danger. Photo from UNESCO.

Once Inscribed on the World Heritage List, the State has agreed to an enduring obligation to ensure the management, conservation, and monitoring of its site(s). They must assess the sites every six years, writing reports on the state of the site and the measures established for the purpose of preservation and conservation. This allows the Committee to determine whether or not a site should be placed on the List of World Heritage in Danger, such as the Belize Barrier Reef Reserve System, the Gal?pagos Islands in Ecuador, and the Everglades National Park in the United States. Danger can be caused in many ways, a few of which are listed on the UNESCO Website, including: ?Armed conflict and war, earthquakes and other natural disasters, pollution, poaching, uncontrolled urbanization, unchecked tourist development,? and more recently, climate change (Danger 2012). Inscription on this list allows the Committee to allocate funds from the World Heritage Fund for immediate assistance, and also serves to alert the world to the problems at hand with the hope of encouraging increased conservation and preservation efforts.

Rock Islands Southern Lagoon, Palau. Photo by Steven Alvarez, National Geographic

Rock Islands Southern Lagoon, Palau. Photo by Steven Alvarez, National Geographic

As one of the 26 students selected to participate in the 2013 University of Southern California?s Environmental Studies experiential program entitled ?Integrated Ecosystem Management in Micronesia,? I have spent the past Spring Semester training through full American Academy of Underwater Sciences Scientific Diver training, and am ending the program by travelling to Guam and to one of the most recently inscribed World Heritage Sites: Rock Islands Southern Lagoon, in the Republic of Palau. After studying the stressed reefs and effects of overfishing, runoff, and military presence in the American Territory of Guam, the class is now conducting multiple species surveys within the restricted Ngderrak Marine Protected Area for the State of Koror in Palau, diving in and around the World Heritage Site, with special permission by the Governor of Koror.

The author ?fighting on? during free time after completing her research exercise at the USC Wrigley Institute for Environmental Studies on Catalina Island. Photograph by fellow student Megan Herring.

The author ?fighting on? during free time after completing her research exercise at the USC Wrigley Institute for Environmental Studies on Catalina Island. Photograph by fellow student Megan Herring.

This area is of mixed cultural and natural heritage, and contains 445 volcanically formed islands surrounded by delicate coral reefs. Culturally, the islands contain ruins and remains of small communities whose ?abandonment?illustrates the consequences of climate change, population growth and subsistence behavior on a society living in a marginal marine environment? (Rock Islands 2012). Rich in both natural and cultural heritage, it is no surprise that UNESCO deemed it suitable for their list.

Prior to the trip across the Pacific, we spent a week on Catalina Island off the coast of California finishing up dive training and participating in lectures conducted by our five instructors and two teaching assistants. In these lectures, we studied marine species and the biology of coral reefs, as well as compared the marine governance in Catalina (a top-down approach) to that of Palau. Heavily rooted in tradition, Palau exhibits strong cultural and family ties to their coral reefs and marine areas, and thus demonstrates overwhelming support of the Marine Protected Areas and the regulation of the World Heritage Site. This cultural precedence to maintain and preserve the diverse and fruitful natural environment while still preserving their past traditions is exactly why Palau was chosen as exhibiting Outstanding Universal Value.

The Author (center) standing with instructors David Ginsburg and Kristen Weiss and rangers Princess, Harlan, and Mister at the Koror State Capital building.

The Author (center) standing with instructors David Ginsburg and Kristen Weiss and rangers Princess, Harlan, and Mister at the Koror State Capital building.

Part of maintaining the World Heritage Site requires ?long term protection and management,? and UNESCO encourages the ?constructive use of research on and preservation of traditional knowledge of the marine environment? (Rock Islands 2012). Beginning this year, the Guam and Palau program has added a governance focus to the class, working to map out the ties between the different parties interested in the resources within the area.

On our first day in Palau, I had the opportunity to speak with Harlan, Princess, and Mister, three Rangers for the Koror State Government about their experiences with the UNESCO inscription process. They worked with the past director over the preceding seven years to coordinate and negotiate a nomination file that would meet the UNESCO requirements for inscription. Fortunately, the Koror State Government had previously created a conservation management plan that was comprehensive and already included many of the requirements, including 16 Marine Protected Areas, so the remainder consisted mostly of tweaking and compromising.

?It was a lot of back and forth negotiation with UNESCO,? says Princess, ?even though we had already done a lot to protect the area, there was still so much more we had to do.? They seemed proud of the inscription, but ambivalent about the process, and when I asked if the Palauans viewed it as an accomplishment, they responded by stating that most of the local people are not even aware. Perhaps this communication issue could be investigated in the governance research for future classes.

Classmate Amanda Ungco surveys for indicator species at Short Drop Off Reef in Palau. Photo by the author.

Classmate Amanda Ungco surveys for indicator species at Short Drop Off Reef in Palau. Photo by the author.

Harlan, Princess, and Mister joined our class in the field as we recorded underwater data counts of specific indicator species that would be representative of the health of the reef as a whole. Hopeful that the World Heritage Site will bring awareness to the reefs of Palau, the rangers are determined to restore damaged reefs and protect those that are thriving. They are excited and gracious that us researchers have joined them to provide data that they could use to request funding from UNESCO in case the site needs to be placed on the Danger list as climate change becomes more and more prevalent. The rangers are proud of their Palauan culture, and extremely proud of the natural beauty that surrounds them. I am hopeful that future classes can help breach the communication barriers that often inhibit the Koror State Government?s efforts.

The Rock Islands Southern Lagoon has provided us students with a once-in-a-lifetime opportunity to research the incredible diversity and deep-rooted culture both on land and beneath the sea surface. As one of 26 excited students who are still in shock that the trip is finally here, I have never been more ready to dive on in (pun intended).

Author Bio: Caroline Smith is a rising junior at the University of Southern California pursuing a Bachelors of Science in Environmental Studies from the Dornsife College of Letters, Arts and Sciences. After completing her research as part of the Guam and Palau Program, she plans to study abroad in Queensland, Australia to continue researching the marine governance and regulation structures, as well as participating in further scientific diving research. She intends to pursue a Master?s Degree in Environmental Studies as part of the USC Progressive Degree and to continue on to law school to earn a degree in Environmental Law.

Works Cited:

Alvarez, Steven. Palau?s Rock Isands. N.d. Photograph. National Geographic, Palau. National Geographic. Web. 24 Mar. 2013.

?Rock Islands Southern Lagoon.? UNESCO World Heritage Centre. N.p., 2012. Web. 24 Mar. 2013.

United Nations Educational, Scientific and Cultural Organization.

World Heritage Information Kit. Paris: United Nations Educational, Scientific and Cultural Organization, 2008. 2008. Web. 24 Mar. 2013.

United Nations Educational, Scientific and Cultural Organization. Operational Guidelines for the Implementation of the World Heritage Convention. Paris: Convention concerning the Protection of World Cultural and Natural Heritage, 2012. 2012. Print. 20 Mar. 2013.

?World Heritage in Danger.? UNESCO World Heritage Centre. N.p., 2012. Web. 22 Mar. 2013.

Previously in this series:

The 2013 Guam and Palau Expedition Begins
A New Faculty Member on the Team
An Analysis of Sargassum Horneri Ecosystem Impact
Marine Protected Areas and Catalina Island: Conserve, Maintain and Enrich
Northern Elephant Seals: Increasing Population, Decreasing Biodiversity
The Relationship Between the Economy and Tourism on Catalina Island
Guam and Palau 2013: New Recruits and New Experiences
Bringing War to the ?Island of Peace? ? The Fight for the Preservation of Jeju-do
Dreading the Dredging: Military Buildup on Guam and Implications for Marine Biodiversity in Apra Harbor
Is the Commonwealth of the Northern Mariana Islands Doing Enough?
The Status of Fisheries in China: How deep will we have to dive to find the truth?
The Philippines and Spratly Islands: A Losing Battle
The Effects of Climate Change on Coral Reef Health
The Senkaku/Diaoyu Island Dispute in the East China Sea

Editor?s note: Scientific Research Diving at USC Dornsife is offered as part of an experiential summer program offered to undergraduate students of the USC Dana and David Dornsife College of Letters, Arts and Sciences through the Environmental Studies Program.?? This course takes place on location at the USC Wrigley Marine Science Center on Catalina Island and throughout Micronesia. Students investigate important environmental issues such as ecologically sustainable development, fisheries management, protected-area planning and assessment, and human health issues. During the course of the program, the student team will dive and collect data to support conservation and management strategies to protect the fragile coral reefs of Guam and Palau in Micronesia.

Instructors for the course include Jim Haw, Director of the Environmental Studies Program in USC Dornsife, Assistant Professor of Environmental Studies David Ginsburg, Lecturer Kristen Weiss, SCUBA instructor and volunteer in the USC Scientific Diving Program Tom Carr and USC Dive Safety Officer Gerry Smith of the USC Wrigley Institute for Environmental Studies

Source: http://www.scientificamerican.com/blog/post.cfm?id=the-unesco-world-heritage-site-selection-process

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Franken said he was unsurprised by NSA revelations (Star Tribune)

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Monday, June 10, 2013

BofA could still put Countrywide into bankruptcy, executive says ...

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By Karen Freifeld NEW YORK (Reuters) - Bank of America Corp could put its Countrywide Financial unit into bankruptcy if it fails to win court approval for an $8.5 billion settlement with mortgage investors, a bank executive said on Monday. Chief Risk Officer Terrence Laughlin was testifying at a hearing in New York state court on whether to approve the deal, which would settle claims by investors who said Countrywide misrepresented the mortgages underlying bonds they bought. ...

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Source: http://www.financeroom.net/?p=109788

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Thursday, May 16, 2013

Flamboyant Texas swindler Billie Sol Estes dies

LUBBOCK, Texas (AP) ? Billie Sol Estes, a flamboyant Texas huckster who became one of the most notorious men in America in 1962 when he was accused of looting a federal crop subsidy program, has died. He was 88.

Estes, whose name became synonymous with Texas-sized schemes, greed and corruption, died in his sleep at his home in DeCordova Bend, a city about 60 miles southwest of Dallas, his daughter said Tuesday. A local funeral home confirmed it would be handling the services.

Estes reigned in the state as the king of con men for nearly 50 years. At the height of his infamy, he was immortalized in songs by Allan Sherman (in "Schticks of One and Half a Dozen of the Other") and the Chad Mitchell Trio (in "The Ides of Texas"). Time magazine even put him on its cover, calling him "a welfare-state Ponzi ... a bundle of contradictions and paradoxes who makes Dr. Jekyll seem almost wholesome."

"He considered dancing immoral, often delivered sermons as a Church of Christ lay preacher," the magazine wrote. "But he ruthlessly ruined business competitors, practiced fraud and deceit on a massive scale, and even victimized Church of Christ schools that he was supposed to be helping as a fund raiser or financial adviser."

Estes was best known for the scandal that broke out during President John F. Kennedy's administration involving phony financial statements and non-existent fertilizer tanks. Several lower-level agriculture officials resigned, and he wound up spending several years in prison.

"I thought he would meet a very violent end. We worried about him being killed for years," his daughter, Pamela Estes Padget, said Tuesday, adding that her father died peacefully in his recliner, with chocolate chip cookie crumbs on his lips.

Estes' name was often linked with that of fellow Texan Lyndon Johnson, but the late president's associates said their relationship was never as close or as sinister as the wheeler-dealer implied.

Johnson, then the vice president, and Agriculture Secretary Orville Freeman came under fire during the scandal, though the scheme had its roots in the waning years of President Dwight Eisenhower's administration, when Estes had edged into national politics from his West Texas power base in Pecos.

Estes was convicted in 1965 of mail fraud and conspiracy to defraud. An earlier conviction had been thrown out by the U.S. Supreme Court over the use of cameras in the courtroom. Sentenced to 15 years in prison, Estes was freed in 1971 after serving six years.

But new charges were brought against him in 1979, and later that year he was convicted of mail fraud and conspiracy to conceal assets from the Internal Revenue Service. He was sentenced to 10 more years but was freed a second time in 1983.

Former Associated Press correspondent Mike Cochran, who covered Estes' trials and schemes throughout the 1970s and '80s, recalled writing about how Estes made millions of dollars in phone fertilizer tanks ? and noting, "how many city slickers from New York or Chicago can make a fortune selling phantom cow manure?"

"Billie Col was a character's character," Cochran said. "I spent literally years chasing him in and out of prison and around the state as he pulled off all kinds of memorable shenanigans."

A go-getter since he was a boy, Estes was one of the Junior Chamber of Commerce's 10 most outstanding men of 1953 and became a millionaire before he was 30. Many of his deals involved agriculture products and services, including irrigation and the fertilizer products that later led to his downfall.

Before his release from federal prison for a second time in 1983, Estes claimed he'd uncovered the root of his problems: compulsiveness. "If I smoke another cigarette, I'll be hooked on nicotine," he said. "I'm just one drink away from being an alcoholic and just one deal away from being back in prison."

One of the strangest episodes in his life involved the death of a U.S. Department of Agriculture official who was investigating Estes just before he was accused in the fertilizer tank case.

Henry Marshall's 1961 death was initially ruled a suicide even though he had five bullet wounds. But in 1984, Estes told a grand jury that Johnson had ordered the official killed to prevent him from exposing Estes' fraudulent business dealings and ties with the vice president. The prosecutor who conducted the grand jury investigation said there was no corroboration of Estes' allegations, though a judge ruled that it was "clear and convincing" that the death was not self-inflicted.

In 2003, he co-wrote a book published in France that linked Johnson to John F. Kennedy's assassination, an allegation rejected by prominent historians, Johnson aides and family members.

A 2007 search for correspondence between Johnson and Estes found a 1953 form letter and only sporadic correspondence during Johnson's Senate years, said Claudia Anderson, supervisory archivist at the Lyndon Baines Johnson Library and Museum in Austin. In a 1962 memo prepared by longtime Johnson aide Walter Jenkins, Johnson recalled meeting Estes once and said he had never talked to him on the phone.

While he admitted to being a swindler, Estes also portrayed himself as a "kind of Robin Hood" and hoped to be remembered for using his money to feed and educate the poor. He was an advocate of school integration in Texas long before it was fashionable.

Estes' wife Patsy died in 2000. He later moved to Granbury, a picture-postcard town southwest of Fort Worth, and remarried.

Services for Estes are set for 2 p.m. Saturday at Acton United Methodist Church in Acton, east of Granbury.

Source: http://news.yahoo.com/flamboyant-texas-swindler-billie-sol-estes-dies-174736454.html

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Wednesday, May 15, 2013

What Dr. Ashton Wants You to Take Away From Angelina Jolie's Double Mastectomy

May 14, 2013 10:57am

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By DR. JENNIFER ASHTON

By going public with her prophylactic double mastectomy, actress Angelina Jolie has again shone the spotlight on breast cancer and the genetic mutation known to increase the risk of getting it by 60 percent.

(Jolie wrote that her doctor told her she had an increased risk of 87 percent, adding that the risk is different for each woman. An NIH?study?found this number to be too high.)

Although Jolie, 37, has the potential to save lives by raising awareness, facts about testing for the mutation and undergoing preventative care can be confusing. Here?s what you need to know:

The test for the genetic mutation, called BRCA, is a simple blood test, but it?s not for everyone. It?s not always covered by insurance and can cost about $3,000, so you should know whether you?re one of the 2 percent of women who have a family history that makes them more likely to have the BRCA mutation.

This is cancer.gov?s list of family history to consider before undergoing BRCA testing:

  • For women who are not of Ashkenazi Jewish descent:
    • two first-degree relatives (mother, daughter or sister) diagnosed with breast cancer, one of whom was diagnosed at age 50 or younger;
    • three or more first-degree or second-degree (grandmother or aunt) relatives diagnosed with breast cancer regardless of their age at diagnosis;
    • a combination of first- and second-degree relatives diagnosed with breast cancer and ovarian cancer (one cancer type per person);
    • a?first-degree relative?with cancer diagnosed in both breasts (bilateral?breast cancer);
    • a combination of two or more first- or second-degree relatives diagnosed with ovarian cancer regardless of age at diagnosis;
    • a first- or second-degree relative diagnosed with both breast and ovarian cancer regardless of age at diagnosis; and
    • breast cancer diagnosed in a male relative.
  • For women of Ashkenazi Jewish descent:
    • any first-degree relative diagnosed with breast or ovarian cancer; and
    • two second-degree relatives on the same side of the family diagnosed with breast or ovarian cancer.

In all, between 0.125 and 0.25 percent of women will test positive for the BRCA mutation, and it varies by ethnicity. These women have an increased risk of getting breast cancer and ovarian cancer.

If you do test positive for BRCA, you have options, and you don?t necessarily have to go the Jolie route.

Some women choose not to have surgery. Instead, they increase cancer surveillance with imaging tests. These include regular mammograms to test for breast cancer, and regular pelvic sonograms and blood-tests to watch for ovarian cancer.

It is important to note that surveillance or screening does not reduce risk, but rather potentially improves early detection of cancer should it occur.

Other options include chemo-prevention, or taking certain medications to reduce cancer risk. For example, some women take a drug called tamoxifen to prevent breast cancer and others take birth-control pills to prevent ovarian cancer.? These decisions are individual, highly personal and often times very difficult ones for a woman and her family to make.

Like Jolie, some women choose surgery when they learn they have the BRCA mutation. The decision to surgically remove the breasts and ovaries is an individual one and must take into account the woman?s age, fertility and reproductive wishes, psychological factors and cost. Her general medical condition for undergoing elective surgery should be taken into consideration, too.

Often, the reconstructive process is done in stages for a few months and can cost as much as $50,000. Fortunately, since 1998, women without medical insurance have increased options and mandatory coverage for undergoing breast reconstruction after mastectomy.

Because these decisions are complex, patients can seek consultations with oncologists, general gynecologists, gynecologic oncologists, breast surgeons and reconstructive plastic surgeons.

While studies have shown a significant risk reduction and likely survival benefit in women with a BRCA mutation who undergo preventive surgery, their risk does not drop to zero. There is still a low chance of developing breast cancer in the chest wall, and ovarian cancer in the pelvic cavity.

Men carry the BRCA mutation, too, so if a woman with a mutation has a son, he has a 50 percent chance of being a carrier and having the mutation.? Men with the mutation face increased risks of breast cancer, certain kinds of pancreatic cancer, testicular cancer and prostate cancer.

While the information presented here represents he medical tip of the iceberg, the hope is that? it can begin the process of informing, educating and empowering both women and men about this kind of genetic mutation and cancer risk.

Source: http://abcnews.go.com/blogs/health/2013/05/14/what-dr-ashton-wants-you-to-take-away-from-angelina-jolies-double-mastectomy/

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Detroit emergency manager says city 'clearly insolvent'

By Nick Carey and Steve Neavling

(Reuters) - Detroit is clearly insolvent and could face a possible bankruptcy if talks with labor unions and creditors do not make substantial progress on easing the city's cash crunch, the city's emergency financial manager said on Monday.

In his first official report, Emergency Financial Manager Kevyn Orr presented a grim view of Detroit's problems. The city faces a $162 million cash shortfall because of pension deals that outstrip its ability to pay, and a $60 million operating deficit, all amidst a cityscape of abandoned homes and businesses, broken streetlights and fractured services, the report said.

Orr said talks would begin promptly with unions and creditors, and he told the Detroit Free Press editorial board that he should know by the end of June whether the city's finances can be repaired without a bankruptcy filing.

Speaking to reporters later, Orr was matter of fact about prospects for keeping Detroit out of bankruptcy. "We can achieve what we have to achieve without going in. If we can't, then we have to" file for bankruptcy, Orr said.

Detroit had $64 million in cash on hand on April 26, but only because it has deferred $226 million in payments on pensions, loans and other obligations. Orr's report projected the city could get through the end of December without running out of money.

"If we keep going the way that we're going, we're going to hit some bumpy ground in December," Orr said.

In issuing his report to the state Treasurer, Orr declared Detroit is far from solving the problems that caused Governor Rick Snyder in mid-March to appoint him as emergency manager.

"The City of Detroit continues to incur expenditures in excess of revenues despite cost reductions and proceeds from long?term debt issuances," Orr wrote. "In other words, Detroit spends more than it takes in - it is clearly insolvent on a cash flow basis."

Legal experts indicated the declaration of insolvency is important because the city cannot make a bankruptcy filing without an official declaration of insolvency.

Some matters will immediately press on Orr. For example, investors who hold $377 million in interest-rate swap contracts obtained the right to demand immediate payment the moment Snyder appointed Orr to the job, Orr disclosed.

James Spiotto, an expert in municipal restructuring and partner at Chapman and Cutler in Chicago, said Detroit could avoid bankruptcy if Orr could work with the state and other parties to address deeply entrenched problems.

"Obviously, there is an urgency, but it's not time to panic," Spiotto said. "You need a sustainable, affordable recovery plan."

In the past, New York City, Philadelphia and Cleveland avoided bankruptcy with loans and grants designed to keep the cities afloat while a long-term recovery plan was worked out.

Orr said it was important to put out facts so all parties know what they were facing.

Operating expenditures have exceeded revenues by about $100 million a year since 2008, Orr's report found, bringing the accumulated unrestricted deficit to $326.6 million. Payments of Detroit's long-term debt are eating up nearly 20 percent of Detroit's budget.

Orr is looking to renegotiate or restructure Detroit's $8.65 billion in long-term debt. He may reschedule payments, reduce the principal, renegotiate interest rates or issue new debt guaranteeing bondholders payment on Detroit's existing obligations, the report stated.

Patrick O'Keefe, chief executive of turnaround specialists O'Keefe and Associates Consulting, based in suburban Bloomfield Hills, said Orr likely intends to use Detroit's fiscal distress as a weapon in negotiating with unions and debt holders.

"My guess is they (Detroit) don't have the money so they are not that worried," O'Keefe said. "It's a little bit like fighting the ugly kid in the school yard in that he can't get any uglier."

Pension payments to city workers are one of the largest drains on the city's finances. Detroit will make $31 million in pension payments this year, but will defer another $108 million. The city also has $5.7 billion in unfunded retiree benefit obligations, more than previous estimates, the report found.

To catch up on pension and health benefits to retirees, the city would need to spend $339 million, about a third of its fiscal 2013 revenues, Orr estimated. Orr said a city task force was reviewing actuarial assumptions Detroit uses to estimate its obligations.

Detroit has liabilities totaling $9.4 billion from special revenue bonds, revolving loans, pension obligations and other financial instruments.

At investment firm BlackRock in New York, Orr's report was only a small step toward addressing Detroit's major problems.

"The identification of these items are still far from the resolution of these items, and that is ultimately what has to take place here", said Peter Hayes, head of BlackRock's municipal bonds group, which has $114 billion in assets under management.

Labor is among the city's largest challenges. Noting that state law authorized him to "reject, modify or terminate" any of the city's 48 collective bargaining agreements, Orr said he was considering all options.

"This power will be exercised, if necessary or desirable, with the knowledge and understanding that many City employees already have absorbed wage and benefit reductions," the report said.

The report also noted that a review of police, fire and other emergency services was ongoing and that Detroit's "infrastructure and public safety fleet are aged and decrepit, which, in turn, increases the City's operating and repair costs and decreases its productivity."

The Detroit NAACP on Monday filed a federal lawsuit against Snyder and other state officials calling for reversal of the state law that allows emergency managers like Orr.

Emergency managers in Benton Harbor, Pontiac and other Michigan cities have attracted controversy with their turnaround plans, and Rev. Wendell Anthony, head of the Detroit NAACP, said the law was applied unevenly by focusing primarily on cities and school districts with black residents.

(Reporting by Nick Carey and Steve Neavling.; Additional reporting by Bernie Woodall and Deepa Seetharaman.; Editing by David Greising, Sofina Mirza-Reid, Leslie Gevirtz, Toni Reinhold)

Source: http://news.yahoo.com/detroit-emergency-manager-says-city-clearly-insolvent-202324348.html

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