Tuesday, October 7, 2014


News Clips For The Day


EBOLA – TWO ARTICLES

Why Spanish nurse is such a troubling Ebola case
CBS/AP October 7, 2014, 5:32 AM

NEW YORK -- In a case underscoring the perils of caring for Ebola patients, a nurse in Spain has come down with the disease -- the first time someone has caught the disease outside West Africa during the current epidemic.

The nurse was part of the medical team that treated a 69-year-old Spanish priest, Manuel Garcia Viejo, who died in a Madrid hospital late last month, Spain's health minister said Monday.

Spain's head of public health, Mercedes Vinuesa, told parliament Tuesday that the nurse's husband was also taken into quarantine, according to the Reuters news agency, but it wasn't immediately clear whether he was showing signs of infection himself, or if the move was just a precaution.

Officials at the hospital in Madrid where the nurse was being treated said 22 people she had come into contact with had been identified and were being monitored. Spanish officials said two other people had been admitted to hospital and quarantined with symptoms which raised fears of possible Ebola infection.

The sick priest had been flown home from his post in Sierra Leone; the nurse is believed to have contracted the virus from him. She went to a Madrid hospital with a fever Sunday, 10 days after the priest died, and was placed in isolation. She was transferred early Tuesday to Madrid's Carlos III hospital, where the priest -- and a second missionary priest sick with Ebola -- were cared for until they died.

The World Health Organization confirmed there has not been a previous transmission outside West Africa in the current outbreak.

According to Reuters, an official at the Carlos III hospital said the nurse was being given antibodies via a drip from a previous Ebola patient in the country.

The nurse's illness illustrates the danger that health care workers face not only in poorly equipped West African clinics, but also in the more sophisticated medical centers of Europe and the United States, said Dr. William Schaffner, an infectious disease expert at Vanderbilt University.

"At greatest risk in all Ebola outbreaks are health care workers," he said.

The development came Monday as another American sick with the disease arrived back in the U.S. for treatment and President Obama said the government was considering ordering more careful screening of airline passengers traveling from the outbreak region.

The unprecedented Ebola outbreak this year has killed more than 3,400 people in West Africa, and become an escalating concern to the rest of the world. It has taken an especially devastating toll on health care workers, sickening or killing more than 370 in the hardest-hit countries of Liberia, Guinea and Sierra Leone - places that already were short on doctors and nurses.

In the U.S., video journalist Ashoka Mukpo, who became infected while working in Liberia, arrived at the Nebraska Medical Center in Omaha, where another Ebola patient had been treated. It's not clear how he was infected. It may have happened when he helped clean a vehicle someone died in, said his father, Dr. Mitchell Levy. On Monday, his symptoms of fever and nausea still appeared mild, Levy said.

"It was really wonderful to see his face," said Levy, who talked to his son over a video chat system.

Mukpo is the fifth American sick with Ebola brought back from West Africa for medical care. The others were aid workers - three have recovered and one remains hospitalized.

There are no approved drugs for Ebola, so doctors have tried experimental treatments in a few cases.

The critically ill Liberian man hospitalized in Dallas is also getting an experimental treatment, Texas Health Presbyterian Hospital said Monday. Thomas Eric Duncan is the first person to be diagnosed with Ebola in the U.S.; he was admitted to the hospital Sept. 28, about a week after arriving in Texas.

The hospital said Duncan was receiving an experimental medication called brincidofovir, which was developed to treat other types of viruses. Laboratory tests suggested it may also work against Ebola.

Two other experimental drugs developed specifically for Ebola have been used, though it's unclear whether they had any effect. The small supply of ZMapp was exhausted after being used on a few patients, though government officials say more should be available in the next two months. A second drug, TKM-Ebola from Tekmira Pharmaceuticals, has been used in at least one patient and is said to be in limited supply.

Schaffner noted there are many questions about the experimental medications, but their use is understandable -- especially in a patient like Duncan who may be deteriorating.

"They're trying to do anything they can to benefit the patient," he said.

Meanwhile, Texas Gov. Rick Perry urged the U.S. government to begin screening air passengers arriving from Ebola-affected nations, including taking their temperatures. Perry stopped short of joining some conservatives who have backed bans on travel from those countries.

Federal health officials say a travel ban could make the desperate situation worse in those countries, and White House spokesman Josh Earnest said it was not currently under consideration.

Passengers leaving the outbreak zone are checked for fevers at the airport. Duncan was screened in Liberia, but he had no symptoms then, health officials have said. He also apparently had no symptoms when he arrived the next day, so a screening in the United States would not have detected his infection.

Health officials have said he didn't get sick until four or five days later. The disease's incubation period is 21 days.

Airline crews and border agents already watch for sick passengers, and in a high-level meeting Monday at the White House, officials discussed potential options for screening passengers when they arrive in the U.S. as well.

Obama said the U.S. will be "working on protocols to do additional passenger screening both at the source and here in the United States." He did not outline any details or offer a timeline.




“Spain's head of public health, Mercedes Vinuesa, told parliament Tuesday that the nurse's husband was also taken into quarantine, according to the Reuters news agency, but it wasn't immediately clear whether he was showing signs of infection himself, or if the move was just a precaution.... Officials at the hospital in Madrid where the nurse was being treated said 22 people she had come into contact with had been identified and were being monitored. Spanish officials said two other people had been admitted to hospital and quarantined with symptoms which raised fears of possible Ebola infection.... According to Reuters, an official at the Carlos III hospital said the nurse was being given antibodies via a drip from a previous Ebola patient in the country.... The hospital said Duncan was receiving an experimental medication called brincidofovir, which was developed to treat other types of viruses. Laboratory tests suggested it may also work against Ebola. Two other experimental drugs developed specifically for Ebola have been used, though it's unclear whether they had any effect. The small supply of ZMapp was exhausted after being used on a few patients, though government officials say more should be available in the next two months. A second drug, TKM-Ebola from Tekmira Pharmaceuticals, has been used in at least one patient and is said to be in limited supply.... Meanwhile, Texas Gov. Rick Perry urged the U.S. government to begin screening air passengers arriving from Ebola-affected nations, including taking their temperatures. Perry stopped short of joining some conservatives who have backed bans on travel from those countries.”

This rundown on the progress so far is given: an experimental antiviral drug which has had some positive results against Ebola, Zmapp and something new called TKM-Ebola “which has been used in at least one patient,” but the results from that use are not given here. The nurse is receiving an antibody drip, which has had good results in some earlier cases. The article mentions one recent patient who may have been exposed by cleaning out a car in which an Ebola victim died. One article a few weeks ago mentioned the possibility that Ebola can be spread by touching surfaces, as can the flu. That car was probably heavily contaminated with bodily fluids, and should not have been touched by anyone who was not in a”space suit.” It also is probably still dangerous to anyone else who decides to drive it, it seems to me. I think it should be burned, or at the very leased absolutely soaked in chlorine bleach.





Firestone Did What Governments Have Not: Stopped Ebola In Its Tracks – NPR
by JASON BEAUBIEN
October 06, 2014

The classic slogan for Firestone tires was "where the rubber meets the road."

When it comes to Ebola, the rubber met the road at the Firestone rubber plantation in Harbel, Liberia.

Harbel is a company town not far from the capital city of Monrovia. It was named in 1926 after the founder of the Firestone Tire and Rubber Company, Harvey and his wife, Idabelle. Today, Firestone workers and their families make up a community of 80,000 people across the plantation.

Firestone detected its first Ebola case on March 30, when an employee's wife arrived from northern Liberia. She'd been caring for a disease-stricken woman and was herself diagnosed with the disease. Since then Firestone has done a remarkable job of keeping the virus at bay. Its built its own treatment center and set up a comprehensive response that's managed to quickly stop transmission. Dr. Brendan Flannery, the head of the U.S. Centers for Disease Control and Prevention's team in Liberia, has hailed Firestone's efforts as resourceful, innovative and effective.

Currently the only Ebola cases on the sprawling, 185-square-mile plantation are in patients who come from neighboring towns.

Long rows of dappled rubber trees cover Harbel's landscape. Prevailing winds cause the adult trees to lean westward. Back when Firestone was still based in Ohio, employees used to joke that the trees are "bowing to Akron."

When the Ebola case was diagnosed, "we went in to crisis mode," recalls Ed Garcia, the managing director of Firestone Liberia. He redirected his entire management structure toward Ebola.

Garcia's team first tried to find a hospital in the capital to care for the woman. "Unfortunately, at that time, there was no facility that could accommodate her," he says. "So we quickly realized that we had to handle the situation ourselves."

The case was detected on a Sunday. Garcia and a medical team from the company hospital spent Monday setting up an Ebola ward. Tuesday the woman was placed in isolation.

"None of us had any Ebola experience," he says. They scoured the Internet for information about how to treat Ebola. They cleared out a building on the hospital grounds and set up an isolation ward. They grabbed a bunch of hazmat suits for dealing with chemical spills at the rubber factory and gave them to the hospital staff. The suits worked just as well for Ebola cases.

Firestone immediately quarantined the family of the woman. Like so many Ebola patients, she died soon after being admitted to the ward. But no one else at Firestone got infected: not her family and not the workers who transported, treated and cared for her.

The Firestone managers had the benefit of backing and resources of a major corporation — something the communities around them did not.

Firestone didn't see another Ebola case for four months. Then in August, as the epidemic raced through the nearby capital, patients with Ebola started appearing at the one hospital and several clinics across the giant rubber plantation. The hospital isolation ward was expanded to 23 beds and a prefab annex was built. Containing Ebola became the number one priority of the company. Schools in the town, which have been closed by government decree, were transformed into quarantine centers. Teachers were dispatched for door-to-door outreach.

Hundreds of people with possible exposure to the virus were placed under quarantine. Seventy-two cases were reported. Forty-eight were treated in the hospital and 18 survived. By mid-September the company's Ebola treatment unit was nearly full.

As of this weekend, however, only three patients remained: a trio of boys age 4, 9 and 17.

"So we have these three," says Dr. Benedict Wollor, coordinator for the Ebola treatment unit at Firestone. "We are concerned because by this morning the four-year-old was just crying."

A team is getting dressed in full body suits, gloves and goggles to enter the ward: a doctor, two nurses and a man with an agricultural sprayer full of disinfectant strapped to his back. Wollor says the team has a lot of work to do before they get overheated in their industrial spacesuits.

"They have to change pampers, bedding, even bathe them," says Wollor. "Make sure they're clean. If someone is dehydrated, open an IV line. Imagine how we maintain an IV line on a kid."

These three boys all came from outside the plantation. So even as the worst Ebola outbreak ever recorded rages all around them, Firestone appears to have blocked the virus from spreading inside its territory.

Dr. Flannery of the CDC says a key reason for Firestone's success is the close monitoring of people who have potentially been exposed to the virus — and the moving of anyone who has had contact with an Ebola patient into voluntary quarantine.

By most accounts, this Ebola outbreak remains out of control, with health care workers across West Africa struggling to contain it.

Asked what's needed to turn that around, Flannery says, "More Firestones" — places that have the money, resources and unwavering determination to stop Ebola.




“When it comes to Ebola, the rubber met the road at the Firestone rubber plantation in Harbel, Liberia. Today, Firestone workers and their families make up a community of 80,000 people across the plantation. Firestone detected its first Ebola case on March 30, when an employee's wife arrived from northern Liberia. She'd been caring for a disease-stricken woman and was herself diagnosed with the disease. Since then Firestone has done a remarkable job of keeping the virus at bay. Its built its own treatment center and set up a comprehensive response that's managed to quickly stop transmission. Dr. Brendan Flannery, the head of the U.S. Centers for Disease Control and Prevention's team in Liberia, has hailed Firestone's efforts as resourceful, innovative and effective.... When the Ebola case was diagnosed, "we went in to crisis mode," recalls Ed Garcia, the managing director of Firestone Liberia. He redirected his entire management structure toward Ebola.... The case was detected on a Sunday. Garcia and a medical team from the company hospital spent Monday setting up an Ebola ward. Tuesday the woman was placed in isolation. 'None of us had any Ebola experience,' he says. They scoured the Internet for information about how to treat Ebola. They cleared out a building on the hospital grounds and set up an isolation ward. They grabbed a bunch of hazmat suits for dealing with chemical spills at the rubber factory and gave them to the hospital staff.... Firestone immediately quarantined the family of the woman. Like so many Ebola patients, she died soon after being admitted to the ward. But no one else at Firestone got infected: not her family and not the workers who transported, treated and cared for her.... Then in August, as the epidemic raced through the nearby capital, patients with Ebola started appearing at the one hospital and several clinics across the giant rubber plantation. The hospital isolation ward was expanded to 23 beds and a prefab annex was built. Containing Ebola became the number one priority of the company. Schools in the town, which have been closed by government decree, were transformed into quarantine centers. Teachers were dispatched for door-to-door outreach.”

This is really impressive, and it indicates to me that the real problem in Africa is the lack of control over those who have merely been exposed to the virus and lack of close monitoring for symptoms. What Firestone did was to move comprehensively and rapidly, even to the construction of a treatment unit in a few days time. The doctors there didn't know how to treat Ebola so they went to the Internet for information. Great stuff! Another huge problem in Africa is that there still aren't enough treatment facilities in most parts of Africa with medical personnel. Another article today said that the US army hospitals are going up “slowly.” I wonder what's holding up the progress? Finally drug treatments are too scarce. It's good to know that some 40% or so of patients recover from simple treatment such as replacing bodily fluids. It would be good to know, also, how many people in Africa have actually developed an immunity to it from prior exposure. In an article on the fruit bats that the people love to eat, it said many of those and other types of bats have tested positive for Ebola antibodies over a large territory, so the disease may not be new to bats, and therefore to humans. We only began hearing about it in the last 20 or 30 years, but there are other hemorrhagic fevers common to Africa which resemble Ebola and may have masked the presence of the virus. If there are enough people who are immune it may become a natural barrier which will eventually stop the epidemic from progressing.





Distracted driving may not be entirely your fault
CBS NEWS October 7, 2014, 7:22 AM

A new study from AAA is raising concerns about the modern technology in our cars.
The research examined the level of distraction drivers face using hands-free or voice command features.

If you've ever been frustrated when the voice-activated system in your car can't understand you, that's not your biggest problem, reports CBS News correspondent Wyatt Andrews.

The study documents how distracted drivers can get using voice commands, especially when the system gets the commands wrong.

Researchers questioned if the very latest hands-free, voice-only command systems caused drivers to get distracted.

And the answer is, yes.

One driver in a simulator became so distracted while voice-messaging a Facebook update, she rear-ended the car in front of her.

But the biggest problem is not the driver. The study concludes that errors made by the voice systems cause the greatest distractions.

In one case, the driver asked Apple's Siri to call a restaurant.

"Café Triol," the driver said.

"Sorry, I didn't get that," Siri replied. "Please select a restaurant."

In the driver's frustration she missed a prompt that was measuring her attention to the road.

The study's author, David Strayer of the University of Utah said it can be distracting to talk to your automobile about a phone call.

"In the situations where you have a system that's very difficult to use, is extremely frustrating to use, then, yes, you'll be paying attention to that and not paying attention to traffic lights and pedestrians and other cars," he explained.

The study also ranked the leading car voice systems by levels of mistakes and distractions.

On a chart where 5 is the most distracting, a Chevrolet with GM's MyLink system rated worst at 3.7, while Toyota's Entune system rated best at 1.7.

GM said in a statement, it is committed to hands-free systems and to improving "our in-vehicle systems and verbal interfaces on behalf of our customers."

This study does not link any of these hands-free systems to an increase in car accidents -- the science is not there yet.

But it does say very simply, the more we have a focus on talking to the car, the less we're focused on the road.




“Researchers questioned if the very latest hands-free, voice-only command systems caused drivers to get distracted. And the answer is, yes. One driver in a simulator became so distracted while voice-messaging a Facebook update, she rear-ended the car in front of her.” Nuff said! Why is Facebook, an entirely unnecessary and extraneous system, in a car? We yell at the kids for texting while driving, but try to use our Facebook page ourselves. I would like to see people have only the most essential of such devices in their car, such as GPS. If another person is riding in the car with me, we don't usually argue or act too silly, as emotions can be distracting too. If I am alone I find having the car radio on with a nice talk show like Diane Rehm actually helps me drive, as it overcomes a slight nervousness that I sometimes have, especially at high speed.





National Guard program puts dropouts on a new track
By MICHELLE MILLER CBS NEWS October 6, 2014, 7:15 PM

LOS ALAMITOS, Calif. - The 4 a.m. wake-up call was none like these teenagers had ever heard.

"Get up! Move it!" the instructors shouted as they rushed in. "You better hurry up! Toe the line!"

It was July, day one of Sunburst Youth Academy, an academic boot camp that could very well change the lives of the young cadets, all high school dropouts. Sunburst is one of 35 such "Youth ChalleNGe Academies" in 29 states run by the National Guard. The military-style programs are aimed at getting high school dropouts back on track. Of the more than 120,000 dropouts who have gone through the program, nearly 90 percent have gone on to college or a job.

The cacophonous pre-dawn alarm clock kicked off "Shark Attack," a rigorous beginning to a rigorous program, designed to set the tone, establish structure and let the rebellious teenagers know who's in charge.

"Your day starts today -- it's going to be a looong day!" bellowed Staff Sgt. Timothy Edwards, an instructor at the program.

Angel Kay LeMaster, Jeremy Ceasar, Crista Hopkins, Adjekai Stewart, and the 212 other students in the class have trouble in their pasts -- drug abuse, violence, family issues or simply bad luck. They came to Sunburst, 30 miles south of Los Angeles, desperate for help. If you hear their stories, you understand why.

"Me and my mom was homeless pretty much, sleeping in cars, freeways, hotels," 17-year-old LeMaster told CBS News. I was always homeless, on my own, my entire teenage life, that caused me to drop out."

"When I turned 13, I became a careless teenager. When I turned 14, I became a delinquent," said Ceasar, 17. "I got into seven fights my freshman year, three fights my sophomore year. And I was on the thin line of getting arrested and expelled at the same time."

"When someone tells you something so many times, you start to believe it," said 17-year-old Hopkins. "They always tell you that sticks and stones will break your bones, but words will never hurt you. It's so not true. Words hurt more than anything, especially if it's by someone you love."

"I want to make my dad proud," said Stewart, 17. "He hasn't been in my life, so it sounds backward. But I want to make him proud of the young lady he never took the time to ... to learn."

Their last chance at a second chance began in July. Dropped off by parents or guardians, sometimes a friend or a neighbor, each of them volunteered to be here.

Saying goodbye wasn't easy for 16-year-old Francisco Lazo's mother, Cynthia.

"It just breaks my heart. But it's for the best," she said, wiping away her tears. "I'm sure he'll come out a different person. ... He's a good kid, he just needs help."

"It was really tough. It was hard to say goodbye," Francisco said. "I didn't think of it as a sad goodbye. They were tears of joy."

The cadets are split into platoons -- two male, two female. Since July, they have been told when to eat, sleep and go to school, a five-and-a-half month residential phase that ends in December. No access to social media, television or contact with the outside world.

It's all summed up in a call-and-response, instructor Edwards likes to run with the cadets. "All you have to do is what?" he'll yell. "Breathe, Sergeant, breathe!" they yell back. "We are going to think for you," Edwards finishes.

The intended result? As First Sgt. Michael Scott, Sunburst's commandant, told the teens on their first day:

"We will make you faster. We will make you stronger. ... We will make you healthier and wiser than you have ever been in your lives. ... We will help you earn the credits you need to succeed and graduate from high school. ... Most importantly, we will give you the skills you need to go out and get a job and take care of yourselves."

LeMaster came ready for the challenge.

"I didn't come here for my mom or dad," she said. "I don't need to prove anything to anyone but myself. So if I can do this - because this is hardcore - if I can do this, then I can leave here and do what I need to get done."



See this website on the subject of boot camps in general, and the Sumburst boot camp in particular.

http://books.google.com/books –
Gang Redux: A Balanced Anti-Gang Strategy
By James Diego Vigil

Paraphrased: This book discusses boot camps. It describes Sunburst as being publicized in TV news and commentary and run by the US Army National Guard drill instructors. The kids stay in the barracks, training part time and studying part time. They must be unemployed, drug free and “free of legal entanglements.” The training includes life skills, citizenship, GED, service to community, health and hygiene, leadership/fellowship and physical training. It begins with a 22 week residential phase followed by mentoring for a year. The young people must be from 16 to 18 and “willing to commit” It “intervenes with youth who are likely to fall into gang life and become street socialized.” People who do not recognize that they need help and want what the camp offers are not admitted.




"Sunburst Youth Academy, an academic boot camp” is a novel idea which consists of 35 academies in 29 states, and jars the young people out of their complacent existence. It may even serve as a rite of passage to adulthood, but above all, it is effective. “Of the more than 120,000 dropouts who have gone through the program, nearly 90 percent have gone on to college or a job.” I have always thought that the problem with teenagers is that they are biologically ready to bear and raise children and tackle adult level issues, but we don't give them responsibilities early in life in this country anymore, so they aren't responsible and mature. These particular kids also had severe life problems – homelessness, abuse, etc.

When my father grew up parents had themir children working on the farm as soon as they were big enough. That was why farmers liked big families, and girls worked on the farm as well as the boys. That is also why traditionally schools have a summer break – in the old days that was to allow them to be at home and help work the land. May to October are the months north of Georgia when crops can be planted, tended and harvested. Work is not only good for developing health and strength, it gives the individual a sense of achievement, in other words, self-esteem.

These boot camps give them personal achievements, health, fellowship with peers, supervision by adults, planned activities, education and mentoring. It's a win-win. Besides, it's undoubtedly fun for a teenage to do physical training and test themselves. Kids are always looking for excitement, and this gives it. It probably also opens up certain mentally disturbed kids such as the severely shy and under-confident, forcing them to act and participate in life rather than merely observing. Besides, the program is totally voluntary, and they come into it looking to learn and improve. As Jesus said it, they have “ears to hear.”





VA moves to fire 4 senior executives due to scandal
AP October 6, 2014, 10:44 PM

WASHINGTON - The Veterans Affairs Department said it is firing four senior executives as officials move to crack down on wrongdoing following a nationwide scandal over long wait times for veterans seeking medical care, and falsified records covering up the delays.

The dismissals are the first since Congress passed a law this summer making it easier for veterans who experience delays to get care outside VA's nationwide network of hospitals and clinics. The law also made it easier for the agency to fire senior officials suspected of wrongdoing, shortening their appeals process to 28 days.

Among those being fired were a top purchasing official at the Veterans Health Administration, directors of VA hospitals in Pittsburgh and Dublin, Georgia, and a regional hospital director in central Alabama, the VA said.

"VA will actively and aggressively pursue disciplinary action against those who violate our values," Deputy VA Secretary Sloan Gibson said Monday. "There should be no doubt that when we discover evidence of wrongdoing, we will hold employees accountable."

But a Republican congressman challenged the VA, saying that at least one of the employees being fired has already announced his retirement. John Goldman, director of the Carl Vinson VA Medical Center in Dublin, Georgia, said last month he was stepping down. Employees at the hospital have admitted to keeping false records to hide long wait times for veterans.

"Bragging about the proposed removal of someone who has already announced his retirement can only be described as disingenuous," said Rep. Jeff Miller, R-Fla., chairman of the House Veterans Affairs Committee.

Miller called the VA's announcement of Goldman's dismissal a "semantic sleight of hand" that is insulting to veterans and their families hurt by the VA scandal.
Gibson and other VA leaders "must not tolerate this instance of what appears to be blatant deceit," Miller said.

A VA spokeswoman said the VA prepared papers ordering Goldman's removal independent of his retirement announcement.

Miller and other lawmakers said they hoped the VA followed the intent of Congress in firing failing executives.

"What I don't want to see happen is for (senior employees) to retire, resign or find another government job outside of VA without consequence - a pattern that has been emerging in recent weeks," Miller said.

One of the employees being fired is Susan Taylor, the deputy chief procurement officer with the VHA who oversees $15 billion a year in federal contracts. A report by the VA's Office of Inspector General found that Taylor helped steer contracts to a private company that championed so-called reverse auctions, in which sellers compete with each other to offer the lowest bids.

Taylor advocated for the company, Virginia-based FedBid, and worked to discredit a senior VA official who had declared a moratorium on reverse auctions while the government studied them, the report said. She also "misused her position and VA resources" for FedBid's private gain and interfered with the inspector general's investigation, the report said.

Taylor had been offered a job with the Energy Department, but that was rescinded after the DOE learned of the IG's report, officials said.

Terry Gerigk Wolf, director of the Pittsburgh VA Healthcare System, is being fired for unspecified "conduct unbecoming a senior executive."

Wolf has been on paid leave since June after a VA review of a Legionnaire's disease outbreak between February 2011 and November 2012. At least six Pittsburgh VA patients died and 16 were sickened by the bacterial disease that was traced to water treatment problems at the Pittsburgh-area hospitals, which also prompted congressional hearings.

James Talton, director of the Central Alabama VA Healthcare System, is being fired after an investigation by the VA's Office of Accountability Review substantiated allegations of neglect of duty.

Rep. Martha Roby, R-Ala., called Talton's dismissal "a positive sign that the new VA leadership is committed to removing bad actors and improving the health care system."

Talton was placed on administrative leave in August after reports that hundreds of X-rays went unread, patients experienced long delays in getting appointments, patient records were manipulated and one employee took a patient to buy illegal drugs.

Neither Talton nor the other employees could be reached for comment late Monday. The employees have seven days following their dismissal to appeal, with a decision by an administrative judge due 21 days after that.




“The dismissals are the first since Congress passed a law this summer making it easier for veterans who experience delays to get care outside VA's nationwide network of hospitals and clinics. The law also made it easier for the agency to fire senior officials suspected of wrongdoing, shortening their appeals process to 28 days.... 'VA will actively and aggressively pursue disciplinary action against those who violate our values,' Deputy VA Secretary Sloan Gibson said Monday.... 'What I don't want to see happen is for (senior employees) to retire, resign or find another government job outside of VA without consequence - a pattern that has been emerging in recent weeks,' Miller said.”

The Republicans here remind me of a pack of wolves “sharing” a freshly killed deer. They grab a bite and snarl at each other to show who is tops. The Democrats are working on cleaning up the problems. Lets leave them alone and let them do it. One thing the Republicans complained about is not something that I see as a problem – a so-called “reverse auction” held by a company set up to gather the least costly bids. That seems like a smart idea to me, as long as all parties understand that a low bid is necessary to win the contract and the particular bids meet the requirements to get the job done. It sounds like it might do what the Republicans usually want – reduce costs. All Taylor did was “help steer contracts to a private company that championed so-called reverse auctions, in which sellers compete with each other to offer the lowest bids. Taylor advocated for the company, Virginia-based FedBid, and worked to discredit a senior VA official who had declared a moratorium on reverse auctions while the government studied them, the report said.” I can see how working to discredit a senior official might be a problem. Why did he declare a moratorium on the “auctions?” I thought competition was good.

I hope they do more than fire people. Look at procedures even more strongly, enforcing them in all cases. The problems at the VA were so widespread that it seems to me a few firings can't be a complete solution. They need to build more hospitals, I understand, and hire more doctors. Above all, the business of cheating on the statistics of how many people were on waiting lists for an appointment, and actually dropping some of them from the list, was the most egregious to me, and the outbreak of legionnaire's disease due to contaminated water.





How Justice Sotomayor Is 'Busting' The Supreme Court's Steady Rhythms – NPR
by NINA TOTENBERG
October 07, 2014

What do salsa dancing and the Supreme Court have to do with each other? A lot, according to author Joan Biskupic, whose new book about Justice Sonia Sotomayor is now out in bookstores.

Sotomayor, of course, has written her own best-selling autobiography. But it ends, for all practical purposes, when she becomes a judge in 1992. Biskupic's volume, entitled Breaking In: The Rise of Sonia Sotomayor and the Politics of Justice picks up where Sotomayor left off. It is also different from her two previous Supreme Court biographies.

"I wanted to make this a political history," Biskupic said in an interview with NPR. "I was intrigued by the fact that her life, the arc of her life, was actually the same trajectory of the rise of Latinos in America."

Latinos have grown from an estimated 2% of the population when Sotomayor was born to 17% today.

Underlining those astonishing numbers is the fact that, as Biskupic puts it, Sotomayor is not someone who "happened to be Puerto Rican." Her heritage is central to her identity. True, her odyssey in the legal profession was a cautious one; even after winning appointments to two lower federal courts, Sotomayor avoided controversy and continued to build alliances. But at the same time, she made no attempt to tamp down on her unreserved personality or her Latina sense of style. And, says Biskupic, by the time Sotomayor got to the Supreme Court, her "unvarnished approach sometimes discombobulated" fellow justices, while at the same time conveying to others outside the court "an authenticity, even a vulnerability that they could identify with."

Biskupic opens her book with a scene illustrating the point. At the end of Sotomayor's first year on the court, the justices are having their annual party. It's in one of the most ornate and beautiful rooms at the court, with painted portraits of past chief justices decorating the walls. It is a very private event, and by tradition, the featured entertainment is a set of skits put on by the law clerks to gently parody their bosses. On this occasion, however, after the skits, something unexpected happens.

Justice Sotomayor "springs from her chair," and tells the law clerks that while their skits were fine, "they lacked a certain something." With that, "she gets her clerks to cue salsa music and she goes one by one and gets the justices" — some of them extremely reluctant—"to dance with her." Justice Anthony Kennedy "did a jitterbug move." Others were less willing; 90-year-old Justice John Paul Stevens "felt as if he had two left feet" and quickly sat down.

The scene is telling in many ways. As Biskupic observes in her book, "It had been a difficult term, and Sotomayor's enthusiasm was catching. [Justice Antonin] Scalia, who could shake things up in his own way," joked as he left the room at the end of the program, "I knew she'd be trouble."

But some justices were "not amused." As Biskupic said in our interview, "I cannot overstate how much of a clash this represents in a place where everyone knows his or her place. There are certain steady rhythms that control the court. She was just busting those."

The salsa scene is of a piece with Sotomayor's sometimes confrontational style, according to the author. Sotomayor "can get in their faces" during oral arguments, she can "cut off" fellow justices, and when the court convenes in its private conferences to discuss cases, she doesn't "soft pedal anything," Biskupic says.

It's a style quite different from that of President Obama's other appointee to the court, Justice Elena Kagan.

"The way I characterize Elena Kagan is as someone who always has her antenna up for where her colleagues are," says Biskupic. "She's always working a game among the nine justices, trying to figure out where common ground might be...Sonia Sotomayor is different...She will break off even from her liberal colleagues to write a separate concurrence or dissent in a way that Elena Kagan to this day still has not done."

But, as Biskupic's book tells us, with a significant scoop, Sotomayor's passion can be effective too, as it was two years ago when the issue was affirmative action in higher education — the very system that initially boosted her from the tenements of the Bronx to the elite Ivy League, and eventually, to the top of the legal profession. The case, which involved the University of Texas affirmative action program, was argued in early October of 2012 but was not decided until late June of 2013. Biskupic reports that it was Sotomayor's scorching dissent, that turned the tide.

"She was furious about where the majority of her colleagues were and what they were going to do in terms of rolling back affirmative action. So she writes this dissent, circulated privately, and it gets the attention of her colleagues" who were "skittish" about the case to begin with. Behind the scenes, inside the court, writes Biskupic, tense negotiations ensued for nine months, with individual justices assuming critical roles. "Among them, Sotomayor as agitator, Stephen Breyer as broker, and Kennedy as compromiser." In the end, the conservatives backed away; the University of Texas affirmative action policy was allowed to stand, at least for the near future; "and there is no public sign of what Sotomayor had wrought."

Indeed, Sotomayor signed on to the court's 7-to-1 opinion, without a public peep. Evidence that she can be a team player, and a discreet one.

For her confirmation hearings, she removed her trademark fire engine red nail polish and hoop earrings. And when Sotomayor learned that Biskupic knew about the internal machinations over the Texas affirmative action case, she was so upset that Biskupic, in a footnote, states specifically that Sotomayor was not the source of her information.

Who was? Well, Biskupic, a law editor for the Reuters news service, is an incredibly hard-working and thorough reporter, who sources all of her information and makes clear in her footnotes that she talked to many justices in researching her book. Indeed, one of the very unusual things she does is clearly state what she does and does not know. In the affirmative action chapter, for instance, she makes clear that she has not seen any opinion drafts and so is limited to the characterizations of those drafts by other people who did see them.

Throughout her book, Biskupic describes how Sotomayor is different from the other justices when it comes to dealing with the public. While the others may be warm, she maintains, they are far less revealing and thus are less able to personally connect with people.

Sotomayor, for starters, is willing to talk openly about her failures as well as her many successes. Having triumphed in many new worlds, winning top honors first from Princeton and then Yale Law School, she is not shy about noting that throughout her academic and professional life, no matter what her achievements, people who did not know her questioned whether she was smart enough. It's a suspicion that she openly suggests stems from her ethnicity, and not from any lack of achievement.

As Biskupic tells it, Sotomayor "strikes a chord with many, many people and part of it is that she reveals her vulnerabilities, right down to how she looks. She'll say, 'I was a kid with a pudgy nose and my hair was all over and I just have problems looking presentable.' She speaks to the every woman out there in the crowd."

And so people line up for six hours in advance at some of her book signings. And at public events, she can bring the crowd to tears by the way she relates, for instance, to a faltering questioner — in one case, calling a young man up to the stage to give him a hug. Biskupic sees Sotomayor as an "authentic and genuine" personality, but also "shrewd and calculating."

"She's someone who got ahead by standing out. She got ahead by not waiting her turn," the author says.

But there have been times when Sotomayor was startlingly willing to let others wait their turn—even the vice president of the United States. After the 2012 election, Vice President Biden asked Sotomayor to swear him in at both the private, official swearing in January 20, which fell on a Sunday, and again at the public ceremony the next day. As Biskupic reports, Sotomayor said she would be happy to do both, but that Biden would have to move up the Sunday swearing in from noon to 8 a.m. because she had committed to doing a much publicized book signing in New York City that day. Some Biden aides were appalled that the justice would ask that the swearing-in time be rejiggered to suit her needs, but the vice president agreed to the schedule change. The matter passed with little public attention, though a writer on the legal blog Above The Law called the episode evidence of "a not so wise Latina."

In evaluating Sotomayor, Biskupic ultimately returns to the theme of the salsa scene and a rhetorical question.

"Will the same characteristics that got her to the Supreme Court potentially interfere with her effectiveness with her fellow justices? When she asked them to dance, they got up. When she asks them to follow her on the law, I'm not so sure."




“But at the same time, she made no attempt to tamp down on her unreserved personality or her Latina sense of style. And, says Biskupic, by the time Sotomayor got to the Supreme Court, her 'unvarnished approach sometimes discombobulated' fellow justices, while at the same time conveying to others outside the court 'an authenticity, even a vulnerability that they could identify with.'... [Justice Antonin] Scalia, who could shake things up in his own way,' joked as he left the room at the end of the program, 'I knew she'd be trouble.' But some justices were 'not amused.' As Biskupic said in our interview, 'I cannot overstate how much of a clash this represents in a place where everyone knows his or her place. There are certain steady rhythms that control the court. She was just busting those.'.... Sotomayor 'can get in their faces' during oral arguments, she can 'cut off' fellow justices, and when the court convenes in its private conferences to discuss cases, she doesn't 'soft pedal anything,' Biskupic says.... Sotomayor, for starters, is willing to talk openly about her failures as well as her many successes. Having triumphed in many new worlds, winning top honors first from Princeton and then Yale Law School, she is not shy about noting that throughout her academic and professional life, no matter what her achievements, people who did not know her questioned whether she was smart enough. It's a suspicion that she openly suggests stems from her ethnicity, and not from any lack of achievement.”

It's obvious that Sotomayor has some typically Latina characteristics. She is lively, witty, passionate, colorful and intelligent. She is also impulsive, assertive and a progressive. I'm glad to see that she turned around a conservative move on the affirmative action question. She said that “people who did not know her questioned whether she was smart enough,” and she said that affirmative action was why she got into Princeton and Yale. That's a sign that there still is, and perhaps always will be, a need for affirmative action. As long as white protestant people smugly consider themselves to be superior there will be a need. I personally liked her from the first time I saw her. She has an outgoing and friendly personality, looks pretty, speaks well on various subjects and apparently knows the law. It is interesting that Scalia, a conservative, seems to find her amusing. That speaks well for him in my book. I would like to read this biography if it comes to my library.







Did The Supreme Court Just Legalize Gay Marriage? – NPR
by RON ELVING
October 06, 2014

Technically, the Supreme Court Monday did not establish a constitutional right for same-sex couples to marry. It merely declined an opportunity to rule definitely one way or the other on the question.

But in the not-too-long run, the consequences may well be the same. Because the situation the court created — or acknowledged — will almost surely continue trending in favor of same-sex couples who want to marry.

Conversely, the legal ground is eroding for states that want to stop such marriages or deny them legal recognition.

As thousands more same-sex couples marry all over the country, this legal climate change becomes a kind of fait accompli.

For the moment, the court's denial of review means state-enacted bans on same-sex marriage in five states were wiped off the books. The denial meant lower court rulings that spiked those bans will now stand. Let's call them The Five.

So couples in The Five could begin marrying regardless of gender as of today — and some got licenses immediately.

In six other states that had banned the practice, further legal proceedings may be needed to apply the rulings of the relevant federal circuit courts of appeal. But because these six are connected to The Five through the federal circuit system (jurisdictions for the purpose of appealing federal court decisions) the same judgment will apply. Effectuating that judgment in these six states is a short step — and one that is already in motion.

Then they will be just like The Five.

That will bring the number of states where gay marriage has been legalized, either by the state itself or through these federal cases, to 30. And these states are home to the vast majority of the national population.

There are still ways for the Supreme Court to reassert itself in this debate. But the question is, do they want to?

Many legal experts have looked over the landscape and perceived both a trend in the federal system and a signal from the nine justices who sit at its zenith.

Amy Howe, the editor of the highly regarded SCOTUSBlog, told NPR's Nina Totenberg that the justices "are very smart people" and added, "I don't think they're going to be able to put the genie back in the bottle."

The genie got out back in June 2013, when the court decided Windsor v. United States, throwing out the 1996 Defense of Marriage Act, or DOMA. By smacking down this pivotal federal statute, the court threw wide the gates for other challenges to state laws barring gay marriage or otherwise treating gays differently.

Now, as those challenges come in waves, the federal courts at all levels are applying the reasoning from Windsor with great consistency.

If the high court wanted to use that as an occasion to declare a constitutional right, it could have taken one or more of the cases it denied today. But opponents of gay marriage had hoped the court would take such a case for precisely the opposite reason — to uphold the states' right to ban gay marriage.

Instead, Howe observes, the justices instructed their confreres at lower levels of the pyramid to "keep on doing what you're doing."
In other words, there isn't a clear majority of the nine to settle the matter with a landmark ruling one way or the other.

They could choose to re-enter the fray at some later point, perhaps when another circuit court of appeals weighs in with a ruling that supports the state's right to ban gay marriage. That would at least create a conflict for the Supreme Court to resolve.

Or it could revisit the issue later, perhaps when a clear majority has formed either to prohibit gay marriage or to permit it. That might require waiting until Justice Anthony Kennedy, a swing vote on such issues, declares himself. Or it could await the next retirement of a sitting justice and the confirmation of a successor.

But as the number of legal gay marriages skyrockets, and the practice becomes both legal and common across most of the states and most of the population, a future court is less and less likely to rescind it.

Or even take such a case.





“But in the not-too-long run, the consequences may well be the same. Because the situation the court created — or acknowledged — will almost surely continue trending in favor of same-sex couples who want to marry. Conversely, the legal ground is eroding for states that want to stop such marriages or deny them legal recognition. As thousands more same-sex couples marry all over the country, this legal climate change becomes a kind of fait accompli.... That will bring the number of states where gay marriage has been legalized, either by the state itself or through these federal cases, to 30. And these states are home to the vast majority of the national population.... The genie got out back in June 2013, when the court decided Windsor v. United States, throwing out the 1996 Defense of Marriage Act, or DOMA. By smacking down this pivotal federal statute, the court threw wide the gates for other challenges to state laws barring gay marriage or otherwise treating gays differently.... But as the number of legal gay marriages skyrockets, and the practice becomes both legal and common across most of the states and most of the population, a future court is less and less likely to rescind it. Or even take such a case.”

I base most of my opinions on the process of thinking about a subject, reading, and then going with what seems true to me. I don't base them on a religion unless it is the central teaching of Jesus – “God is love,” “Love they neighbor as thyself,” and his parable about a hated group called the Samaritans. He advocated against group judgments over individual evaluation, and “hate” had no place in his teaching. He didn't ever mention gays even by some description of their activities, so it is possible that it was an uncommon condition in that era when women and men were both married off as soon as they were considered to be adult. The Bar Mitzva and Bat Mitzva occur at the ages of 13 for a boy and 12 for a girl, after which they are considered to be adults. They didn't have time to experiment and find out what their real preferences were. “Dating” didn't occur. Their parents picked a partner for them and they were married.

I have thought long and earnestly about this business of gay couples since I first encountered it in my early twenties. At first, I partly understood, but had some hostility toward the couple in question. I didn't feel “liberal” about it. As I saw more cases, and observed how they simply didn't match up successfully with people of the opposite sex, I stopped worrying about it at all. I had no dislike toward them, but little interest in the subject, so no sympathy either.

Personally I have never been gay, but I had been always been “a tomboy” when I was young, and a highly “independent” woman as an adult. I understand the doubts many have about the societally required submissiveness, desire for bodily ornament, and some other “feminine” things that I didn't embody. Also some women can't love and they even fear men because they have been sexually abused, perhaps by a father or brother. Many, though, simply have an affinity for members of their own sex which goes back into their early life. They can't change it anymore than they can explain it. They will never be happy making a sexual union with a man, and they probably won't reach any fulfillment during heterosexual activity. Moreover they make their strongest emotional bonds with women. Why in heaven's name should they have to hide “in the closet,” and never be able to make a permanent bond with another woman – or man, as the case may be. They also shouldn't have to dress in a “feminine” way or do a womanly job (teacher, nurse, cook) rather than being a mountain climbing guide or a paratrooper. The best statement of the way I feel is in the beautiful poem “And Ain't I A Woman?” by Sojourner Truth. The most astounding part of the Declaration of Independence, to me, is its inclusion of “the pursuit of happiness.” It seems to me that the right to marry a person of the same sex fits into that slot. Life is short. Let people be happy if they can without grievously harming someone else.