Home » News » Auctions news » A cottage in two halves previous nextAuctions newsA cottage in two halvesThe Negotiator17th December 20190117 Views Owning one property in the sought after coastal area of Bridport is a dream for many, but with this auction lot going under the hammer at the beginning of December, plucky bidders will get a chance to own two distinct halves of a cottage!Network Auctions is listing Sea Breeze, a three-bedroom property guided at £175,000- £200,000 comprises the original stone period cottage along with a two storey extension forming an ‘L’ shape. Old and new combined mean the property offers a decent 1,151 of internal space. Outside the cottage has gardens to three sides with views gently tiered to the valley. There is off street parking and a large outbuilding.The cottage has a large outbuilding and gardens to three sides with views gently tiered to the valley.In need of modernisation and repair, the property is situated in an area where properties change hands for in excess of £400,000. Sea Breeze is located in the popular village of Morcambelake, a quintessential English village with streets called ‘Love’s Lane’, tea rooms, farm shops and a village hall. Sea Breeze will go under the hammer with Network Auctions on 5th December at The Westbury Mayfair Hotel, London.www.networkauctions.co.uk Sea Breeze cottage Network Auctions auction lot Bridport December 17, 2019Jenny van BredaWhat’s your opinion? Cancel replyYou must be logged in to post a comment.Please note: This is a site for professional discussion. Comments will carry your full name and company.This site uses Akismet to reduce spam. Learn how your comment data is processed.Related articles BREAKING: Evictions paperwork must now include ‘breathing space’ scheme details30th April 2021 City dwellers most satisfied with where they live30th April 2021 Hong Kong remains most expensive city to rent with London in 4th place30th April 2021
May 20, 2015 Exercise Shark Hunt Begins in the Norwegian Sea Share this article View post tag: Exercise View post tag: Naval View post tag: Shark Hunt Back to overview,Home naval-today Exercise Shark Hunt Begins in the Norwegian Sea Authorities View post tag: Navy View post tag: Norwegian Sea View post tag: News by topic View post tag: europe Ships, submarines, and maritime patrol aircraft from seven nations commenced the anti-submarine warfare Exercise Shark Hunt in the Norwegian Sea, May 18, 2015.Shark Hunt is a U.S.-led multinational anti-submarine exercise that seeks to enhance interoperability and tactical proficiencies of participating units.During the exercise, participating units will practice detecting and tracking submarines and then share information across a number of maritime operations centers.Maritime patrol aircraft will conduct maritime domain awareness flights from: Andoya, Norway; Lossiemouth, United Kingdom; and Keflavik, Iceland.U.S. units participating in the exercise include USS Jason Dunham (DDG 109), a P-8A Poseidon aircraft from Patrol Squadron (VP) 8, two P-3C Orion aircraft from VP-47, and two submarines.Nations sending forces to participate include Canada, France, Germany, Norway, Italy, the United Kingdom and the U.S.U.S. 6th Fleet, headquartered in Naples, Italy, conducts the full spectrum of joint and naval operations, often in concert with allied, joint, and interagency partners, in order to advance U.S. national interests and security and stability in Europe and Africa.Image: US Navy
So what’s the product?Electrolysed or ’E’ water. It’s basically what is produced by softened (salted) tap water going through an electrolysis process where it is split into both alkaline and acidic water. Alkaline water cleans and acidic water sanitises.How can it help bakers?Bakeries have warm environments where spores of yeasts and moulds are abundant. Other foods that are often present include custards and creams in which bacteria can thrive. By washing hands with E Water, most bacteria and spores are eradicated, drastically reducing the chances of cross-contamination. E water can also be used throughout a bakery for everything from basic sanitising, line cleaning and floor washing.Is it as good as chemical cleaning and sanitising?Yes. The cleaning power of the alkaline water is equal to a mild detergent while acidic water is more potent than traditional bleach-based sanitisers and works faster, so pathogens do not build a resistance to it.Presumably, as no chemicals are involved, it must be very ’green’ and safe?Theoretically, you could drink it but we would never recommend this because of the salt content. Also, it can be safely poured down the sink without any damage to the environment.Is it expensive?No. It works out at approximately 2p per litre, including equipment, installation, salt and electricity. A further bonus is that you only draw off what you need so there’s no wastage.
From illusion cakes to boozy bakes, there was a host of trends on display at the Cake & Bake Show held at London’s ExCeL last weekend (6-8 October).Some were displayed as part of the impressive cakes entered into the best of British competition – here’s a gallery featuring the standout pieces – while others were visible in the demonstrations and the products available to buy at the show. Here’s our pick of the trends:Illusion cakesFrom sandwiches to suitcases, corgis and even a bust of Queen Victoria, illusion cakes were a big part of the Cake Competition. It even extended to the cupcakes, with many featuring components of a full English breakfast, such as a fried egg complete with crispy edges and baked beans.Need further proof of their trend status? Contestants on the first episode of this year’s Great British Bake Off were tasked with creating an illusion cake in the showstopper.Blood and goreThis is Halloween, this is Halloween! Conveniently, the Cake & Bake Show took place in October meaning spooktacular cakes, such as the above bleeding heart or zombie cake, were not out of place. Gory cakes are gaining popularity, though, as bakers find ways of creating more realistic blood and gore for truly scary, but impressive, centrepieces.Boozy bakesBrits love a boozy bake, from G&T cupcakes to chocolate porter cakes. This is evident from the sheer volume of alcohol brands at the show, such as Aluna Coconut rum, Darnley’s Dry Gin and Mozart Chocolate Liqueurs – great for sipping, but also for baking. The latter even recommends recipes on its website from a chocolate liqueur cupcake to a boozy chocolate cream gugelhupf (a yeasted marble cake made in a Bundt mould).Edible bouquetsWhy send flowers when you can send doughnuts? Or cakes? Say sorry, say I love you, or treat that special someone with an edible bouquet. They’re growing in popularity, with many seen during National Cupcake Week, and are likely to grow further as Valentine’s Day draws near.Cake stencilsThe devil is in the detail, as the old adage goes. Bakers can add detail to their cakes and bakes with stencils, such as the ones pictured above found at the Sugar Vanilla Stencils stand. From spooky spiders to cheerful Christmas designs, beautiful flowers and more, they’re great for adding patterns to cakes with the use of lustre or royal icing.
In Margaret Atwood’s futuristic The Year of theFlood, sex workers wear “Biofilm Bodygloves” toprotect themselves from infection. It turns out,though, that a prototype bodyglove may havealready been invented. We call it the skin. Livinginside the dermis, alongside connective tissue,blood vessels and collagen, are immune system Tcells, armed with the ability to fight off infection.HMS researchers found that the old-fashionedskin-scratching smallpox vaccine generates theseskin-resident T cells, creating an internal bodygloveof smallpox immunity inside the skin—aneffect not seen with injected vaccines. This discoveryruns counter to the longstanding assumption that vaccines trigger thesame immune responseno matter how they are delivered. The findings,led by Thomas Kupper, suggest that it may bepossible to design vaccines that place the strongestimmune defenses at the borders of the body,giving it the power to beat infections before theysneak in.T cells provide immunity by memorizing aviral antigen during vaccination or infection, recognizingit during a later infection and killing theinfected cell. This kind of immunity is differentfrom humoral immunity, in which antibodies recognizeantigens and recruit other immune cells tofight the infection. One additional key differenceis location: antibodies circulate in the blood whileT cells embed themselves in peripheral tissues.More than Scratching the SurfaceKupper, the Thomas B. Fitzpatrick professor ofdermatology at HMS and Brigham and Women’sHospital, first learned in 2006 that skin-scratchingvaccines activate T cells in the skin. T cells triggeredby a skin-scratching vaccine begin theirtravels in skin-draining lymph nodes. Theselymph nodes generate three populations of armedT cells: the front lines that home back to skin,called effector memory T cells; the backup troopsthat flow through the circulatory system, calledcentral memory T cells; and a small cadre of effectormemory T cells that home to other peripheraltissues such as the lungs or the gut.Kupper’s latest work compared different modesof vaccination, including skin scratching, intramuscularinjection, and injection into the gut, tofind out if different vaccination modes stimulatedistinctive types of immunity.He and first authors Luzheng Liu, HMS assistantprofessor of dermatology, and Qiong Zhong,a former HMS research fellow, found that skinscratching provided the most effective protection.Mice vaccinated with this method eliminated thevirus from infected skin within six days while miceimmunized via injection destroyed some but notall viral copies.Cellular ImmunityTo tease out which types of immunity providedthis protection, Kupper systematically eliminatedportions of the immune response. He eliminatedthe antibody response by running the same test inmice incapable of forming antibodies. The skinscratchedmice cleared the virus in six days whileothers did not, showing that antibodies play a keyrole in injected, but not skin-scratching, vaccinations.He then eliminated central memory T cellsby blocking the exits of lymph nodes. Again, theskin-scratched mice cleared the virus completelywhile the viral load for all other immunizationtypes remained high. The work appeared in theFebruary Nature Medicine.“This elegant experimental work shows thatskin scarification is a potent way of activating cellularimmunity,” said Wayne Marasco, HMS associateprofessor of medicine at Dana-Farber CancerInstitute, who is investigating novel approaches tothe influenza vaccine.“This is an important biological observation thatno one recognized before.”It isn’t clear yet how these armed T cells learnto home to the skin, but in 2006 Kupper foundthat different lymph nodes tag T cells with differenthoming molecules. The skin-draining nodecreates T cells with skin-homing molecules afterskin-scratching vaccination. Mesenteric lymphnodes, which drain the gut, create T cells with guthomingmolecules after vaccine injection intothe gut.Taken as a whole, the research suggests that itmight be possible to design vaccines with “anatomicallyflexible protection,” said Kupper. “If wecould come up with the right cocktail of modifiersfor getting T cells to the right peripheral tissue, wecould vaccinate in a sort of physiologically andbiologically relevant way.”For instance, imagine a malaria vaccine thatcould stimulate skin-resident memory T cells thatquash infection from a mosquito bite. Imagine anHIV vaccine that builds a protective barrier of Tcells in genital mucosa. “The idea,” said Kupper,“is to pair the biology of how you get infectedwith the right immune response. It’s a new way ofthinking about vaccination.”“This work shows that the way we are vaccinatingnow is probably completely wrong,” saidRachael Clark, HMS assistant professor of dermatologyat BWH, who, along with Kupper, first discoveredprotective, long-lived, skin-resident T cellsin 2006. “By injecting antigens into muscle, we areignoring millions of years of evolution that havedesigned organisms to produce complex and multifacetedimmunity to agents that come throughepithelial surfaces such as the skin.”Kupper and colleagues are continuing researchto validate their hypothesis that tissue-residentcells provide important protection against infectiousdiseases. “It’s fun to hypothesize about thisidea,” said Kupper, “but we have to demonstrate itfurther in the laboratory.”
In the fall of 2003, William R. Fitzsimmons, Harvard’s dean of admissions and financial aid, visited Austin, Texas, on a recruiting trip. After Fitzsimmons spoke, the parent of a prospective student stood up. “Harvard sounds wonderful,” the man said. “But I can send my daughter to the University of Texas for a third of the cost or less.”Fitzsimmons and other Harvard officials already were steeped in the latest research, which said that college was getting too pricey for average Americans. But the question still shook Fitzsimmons, who knew that Harvard, despite providing rising financial aid, was still depriving itself of talented students whose families were strapped for cash — and whose economic diversity could provide a social benefit.“We were concerned about the whole idea of upstairs and downstairs,” he said in an interview. Admissions officials were worried that colleges once again would come to mirror the nation’s economic disparities, and that Harvard in particular “would go back to the old days, when we were mostly a bastion for the affluent.”There was also concern that students saddled by debt and constant worry had to work long hours during the school year, and so “were not getting the full Harvard experience,” said Fitzsimmons.The sting was personal. As a Harvard freshman in 1963, Fitzsimmons had come from a working-class family in Weymouth, Mass., and earned pocket money by pumping gas. Travel was a marker of his socio-economic class back then. The young Fitzsimmons had only gone as far south as New York City and as far west as Niagara Falls. He had gotten the idea of attending Harvard by reading an encyclopedia entry.In 2003, Fitzsimmons knew that the man from Austin, who was of modest means, was right. Although Harvard awarded its first scholarship in 1643, it was still, centuries later, a place that often only the well off could afford. Without “revolutionary changes in our financial aid program,” he remembers thinking, “we certainly would be less and less relevant.”Returning to Cambridge, Fitzsimmons and two other officials spent the following weekend sketching out solutions. One was Sally Donahue, director of financial aid and senior admissions officer. The other was Clayton Spencer, policy adviser to then-Harvard President Lawrence Summers and now president of Bates College. By Monday, all three returned with drafts of financial aid plans that were strikingly similar.“Larry, as an economist, understood instinctively the issue of waste — wasting human talent and human capital,” said Fitzsimmons of Summers, an early backer of broadening financial aid.Good timingThe time was right. In the previous six years, Harvard had boosted its student aid by 49 percent. And in December 2003, Harvard had announced the formation of the Crimson Summer Academy, a program for low-income high school students eager for Harvard summer study and for college advisement.Not long after the Texas visit, the outline took shape of the Harvard Financial Aid Initiative (HFAI), a plan to make the College more accessible to low- and moderate-income students. Harvard would step up recruitment; it would make college free for students from families earning less than $40,000; and it would trim parental contributions from households earning less than $60,000. (Income cutoffs today are higher, for which Fitzsimmons praised President Drew Faust.)Harvard announced HFAI on Feb. 27, 2004, 10 years ago this month. It went into effect that September. The changes in 2004 added about $2 million in costs to the College’s $80 million annual scholarship budget, and quickly benefited about 1,000 students.Patricia “Patty” Rincon ’08, the daughter of Mexican immigrants in California, was a freshman that fall, and one of the first beneficiaries of the expanded aid plan that insiders now call “H-Fi.” She had been accepted at Stanford and into the University of California system, “but I would still have to take out a lot of loans, substantial loans I would still be paying back,” said Rincon, now a second-year law student at the University of Oregon. So the financial aid letter from Harvard came as a shock. Her family’s tab for four years of college would be zero.Back then, said Fitzsimmons, financial aid that generous “was revolutionary for places like Harvard.”In 2003, the last year before HFAI, Harvard parents earning less than $40,000 a year paid an average of $2,300 a year towards tuition, a lot more than zero.Enhanced financial aid eventually had meaning “not just for Harvard,” said Fitzsimmons, since Yale University followed suit the next year with a similar program, as did other schools. “It made a lot of colleges reassess where they were going,” he said. “This was not a competitive move against our peer private institutions. It was a public-policy initiative.”HFAI “is a program that’s been instructive to other schools,” Donahue agreed.The lesson goes bigger too, said Fitzsimmons. Democratizing access offers advantages for elite universities, he said, as well as for “higher education, for America, and for the world.”Paris Woods ’06 performed with the Kuumba Singers during her time at Harvard. Without HFAI-level financial aid, she said, “it would have not been possible for me to go to college.” Woods graduated debt-free, which allowed her to take a first job that paid only $15,000 a year. File photo Stephanie Mitchell/Harvard Staff PhotographerSocial advantagesHaving students of modest means is a social advantage, said Donahue. “They improve the classroom experience” for those Harvard students who may not have seen economic diversity. They embody the pluck and talent that can arise from families lacking financial resources. Such students, Fitzsimmons said, better represent what America looks like demographically. It’s an education in reality for future leaders.Outside the classroom, Donahue added, economic diversity improves the “life discussions” that thread informally through all of College life.“All of these rich experiences,” she said, often reflect upbringings that were solidly modest. In the last decade, parents of Harvard students have been farmers and factory workers from the Midwest, fishermen in Alaska, secretaries, cafeteria workers, and laundromat managers.When she applied to Harvard, Paris Woods ’06, Ed.M. ’08, was living in St. Louis, the daughter of a single mother who worked as a secretary. Without HFAI-level financial aid, she said, “it would have not been possible for me to go to college.” Woods graduated debt-free, which allowed her to take a first job that paid only $15,000 a year. “All of my jobs after Harvard had to do with educational opportunity,” she said. “All are focused on college access. It’s worked its way into my values.” Woods is now an admissions counselor at Cohen College Prep High, a New Orleans charter school.Precious Eboigbe ’07, now a second-year law student at Boston College, left Harvard with the same focus: that higher education should be available to all.“It’s something that’s always been really important to me — access,” she said, and that same drive applies to her future career in the law. “That’s a thing I have carried with me,” she said. In college, she was a four-year fencer, spent three years as an HFAI student coordinator, and three years after Harvard co-directing HFAI itself.Eboigbe entered Harvard knowing the sharp end of the stick, financially. She was born in Nigeria and moved to New Jersey with her mother at age 2. Her stepfather died when she was still in high school. With HFAI, she said, “I was definitely less concerned about money.”“Harvard as possible”Muriel Payan ’08 was the daughter of a single mother who worked at a Costco in Southern California when she entered Harvard in the first year of HFAI. She graduated nearly debt-free, with $2,000 in loans. Payan now has a Wharton School M.B.A. and works in marketing at Ford Motor Co.Harvard admissions is not only need blind, it is passport blind. Part of the economic and ethnic diversity at the College comes from international students, who make up about 12 percent of the undergraduate population. Some of them are from countries where poverty is endemic, like Kenya or India, said Donahue. “It’s very difficult for high-achieving applicants from those countries to even think of Harvard as possible.”Today, because of HFAI, 20 percent of student families pay nothing, a “zero parental contribution,” in the language of admissions. (In 2006, the payment cutoff went up to $60,000; in 2012, it was raised to $65,000.) About 70 percent of Harvard undergraduates receive some kind of need-based aid. Families earning between $60,000 and $80,000 qualify under HFAI for reduced parental contributions.Harvard’s financial aid program asks families earning up to $150,000 a year to pay from zero to 10 percent of their income for college expenses. (Families with incomes above that pay proportionately more.) “These are not rich people,” said Fitzsimmons of families even at the $150,000 mark. They may have more than one child in college at a time, or care for elderly grandparents, or face other financial pressures — “the struggles of real people.”To help ease concerns for middle-class families, home equity and retirement assets are left out of financial aid assessments at the College. No one is required to take out a loan.In the end, the average Harvard family receiving financial aid pays $12,000 a year for tuition, room, and board. Admissions officials calculate that 90 percent of American families would pay the same or less for a Harvard education as for a state school.“Now we can go to Texas,” said Fitzsimmons, and show how things are different. “It puts Harvard on a level playing field with our great public universities.”One line on the Harvard admissions website sums up today’s financial aid. It’s a sentence as vivid as a poem. “This is simple: Anyone can afford Harvard.”Harvard’s broadened financial aid programs were not slowed down by the last recession. In 2007, the year before the global financial crisis, Faust and Dean Michael D. Smith of the Faculty of Arts and Sciences (FAS) launched an initiative to support students from middle-income backgrounds. Since then, funding at the College for financial aid has increased by 88 percent, to a budgeted $182 million.“I’ve never been prouder of Harvard and its leaders than when they maintained the financial aid program in the face of the economic meltdown,” Fitzsimmons said.Last fall, FAS announced a $2.5 billion capital-campaign drive. Of its six goals, the largest, at $600 million, is for financial aid.This broad focus on financial aid means that every Harvard student has the opportunity to graduate debt-free, just as Rincon did. “HFAI gave me the freedom to do what I wanted to do,” she said.“My family would never be able to afford college without it,” Jasmine Burnett ’16 said of HFAI. “It’s a weight off my shoulders.” Burnett is a government concentrator who attended Atlanta public schools.As a freshman in 2012, Burnett was one of 275 in her class from families with incomes below $65,000; 122 more families that year qualified for HFAI reductions in parental contributions. For freshmen entering in 2013, those numbers went up: 287 families paid zero, and 144 paid reduced contributions. The Class of 2017 has 431 HFAI recipients, more than any other entering freshman class in the last decade.“It’s freeing,” said Burnett, adding, “but I still have financial needs.” So she works up to 10 hours a week as one of six student coordinators doing outreach for HFAI.“When you’re in college, every small expenditure can feel overwhelming,” said Rachel Culley ’07, who qualified for HFAI reduction and who grew up on a back-to-the-land homestead in central Maine. “I wouldn’t have been able to go to Harvard if my parents had to take on massive debt.” Culley, now a law clerk in Brooklyn, wrote her senior thesis on “the money taboo,” the social limits of saying how much you have.Peter Conti-Brown ’05 grew up in a cash-strapped, seven-child household in Oklahoma. He felt the weight of arriving with little money in a place where so many had so much. In freshman year, he agreed to share the purchase of a couch with his four roommates — and was shocked to find that his share came to $120, which was all he had saved. That he had come to College with so little money “didn’t compute” to his roommates, recalled Conti-Brown, who eventually graduated from Stanford Law School, co-edited a book, authored another, and is a Ph.D. candidate in history at Princeton University.“When you’re in college, every small expenditure can feel overwhelming,” said Rachel Culley ’07 (right), who qualified for HFAI reduction. “I wouldn’t have been able to go to Harvard if my parents had to take on massive debt.” File photo Kris Snibbe/Harvard Staff PhotographerFrom generous to amazingConti-Brown provided a sort of corrective to the HFAI success story. Even before 2004, “Harvard financial aid was already extremely generous,” he said of the $2,500 a year he and his schoolteacher mother were asked to pay. “I felt nothing but gratitude at the time. I felt nothing but love for Harvard financial aid.”Eboigbe, the Boston College law student, said the same of her financial aid before and after HFAI: “It was so generous.”Conti-Brown had a job in Widener Library, got money for books from a special fund, and qualified for free cultural tickets through the Student Events Fund. Harvard even “bought me a winter coat,” he said. (The Coat Fund, an artifact of Civil War-era Harvard, still exists for students in need.) He also worked odd jobs. One elderly woman paid him $50 for moving plants around her house once a month.But Conti-Brown said the real story is that Harvard financial aid got even better. He even had a role in making it so. In the fall of 2003, when Fitzsimmons and others were devising the future HFAI, Conti-Brown was invited to a focus group on features of the proposed plan. He was a junior then, having taken two years off after his freshman year to be a Mormon missionary. In February 2004, just before the HFAI launch, he became Harvard’s representative voice and face for students of modest means.He was quoted in The New York Times and other newspapers, and made a speech to donors. By the fall of 2004, said Conti-Brown, “I remember thinking: I can’t believe I’m going to Harvard for free.”He became the first student director of HFAI, and traveled all over the country to speak to low- and middle-income high school students, “explaining that Harvard was within financial reach. We were telling them: It’s cheaper for you to go to Harvard than it is to go to your local junior college.”That year, his last at Harvard, he telephoned about 3,000 prospective students, getting their names by processing a combination of financially pressed ZIP codes, census data on income, and S.A.T. scores.Still, Harvard’s financial aid gave him more than money, said Conti-Brown, repeating a sentiment heard from many HFAI graduates. “It gave me complete confidence, with the realization: I can play on this stage.”To this day, he added, “HFAI stands out as a great shining light.”
India Plans Major Push for Storage, Boosting Renewables FacebookTwitterLinkedInEmailPrint分享The Hindu:The draft National Energy Storage Mission expects to kick-start grid-connected energy storage in India, set up a regulatory framework, and encourage indigenous manufacture of batteries, according to a member of the expert committee set up by the Ministry of New and Renewable Energy (MNRE) last month.The draft sets a “realistic target” of 15-20 gigawatt hours (GWh) of grid-connected storage within the next five years, according to Debi Prasad Dash, director, India Energy Storage Alliance (IESA), an industry body that is a part of the committee. Power grids do not currently use storage options that would help in smoothly integrating renewable energy sources.The draft has been submitted to the ministry, and will be released for public feedback in the next few months, said Dash. He added that the mission will focus on seven verticals: indigenous manufacturing; an assessment of technology and cost trends; a policy and regulatory framework; financing, business models and market creation; research and development; standards and testing; and grid planning for energy storage.Renewable energy sources now make up almost one-fifth of India’s total installed power capacity. However, as power grids increase their share of solar and wind energy, the problem remains that the peak supply of renewable sources does not always meet peak demand, explained P.C. Pant, a senior scientist with MNRE. For instance, solar energy generation may be at its peak at noon, but unless stored, it will not be available when needed to light up homes at night. Moreover, renewable sources are inherently intermittent: there are days when the wind doesn’t blow or the sky is cloudy.Batteries could help store surplus energy during peak generation times, but are more immediately needed to stabilize the grid when shifting between renewables and the baseload thermal capacity. “Once the installed capacity of renewables reaches 100 GW [from the current 65 GW], it will become critical to incorporate storage options,” said Pant.Solar Energy Corporation of India (SECI) expects to issue tenders for grid-connected storage by the end of the year, said its managing director Jatindra Nath Swain. For its own 160 MW plant in Andhra Pradesh, SECI will issue tenders for a storage option by the end of July, he added. “Up to 10% of [solar] power can be injected into the grid without storage,” he said. “After that, storage will become a necessity.”More: Draft Mission To Kick-Start Renewable Energy Storage
Oct 9, 2007 (CIDRAP News) – In quick succession, the view that influenza shots yield life-saving benefits for elderly people has come under serious attack and received fresh support in recent weeks.One group of experts, writing in the October issue of Lancet Infectious Diseases, argued that the mortality benefits of flu shots for the elderly have been greatly exaggerated because of a subtle bias and other methodologic problems in many of the relevant studies.”The remaining evidence base is currently insufficient to indicate the magnitude of the mortality benefit, if any, that elderly people derive from the vaccination programme,” says the analysis by Lone Simonsen, PhD, of George Washington University in Washington, DC, and colleagues.But in the Oct 4 New England Journal of Medicine (NEJM), another team of experts presented a study showing that in the course of up to 10 flu seasons, flu shots reduced the risk of hospitalization for pneumonia and flu by 27% and shrank the risk of death by 48% for elderly members of three health maintenance organizations (HMOs). The study addresses several of the methodologic problems raised by the Lancet authors.”Vaccine delivery to this high-priority group should be improved,” states the report by Kristin Nichol, MD, of the Minneapolis Veterans Affairs Medical Center and University of Minnesota, and four coauthors.The controversy has major policy implications, since the Centers for Disease Control and Prevention (CDC) and other medical groups heavily promote flu shots for elderly people, given their risk for serious complications if they contract the flu. This policy is reinforced by Medicare coverage of flu shots for this age-group.A sharp critique of the evidenceThe Lancet Infectious Diseases authors offer several reasons for questioning the notion that flu immunization saves lives in the elderly population:Vaccination coverage among the elderly has increased from 15% to 65% since 1980, but instead of declining, overall mortality due to pneumonia and influenza in elderly people has increased in that period.Few randomized, placebo-controlled trials have examined flu vaccine effectiveness in elderly people. The largest and best study, done in the Netherlands, showed a 50% reduction in confirmed flu cases among all the volunteers, but the reduction for those older than 70 was only 23%. There was no significant reduction in influenza-like illness.A number of investigators have reported finding evidence of flu vaccination benefits in the elderly by analyzing the records of large healthcare organizations. But these studies typically are flawed in that investigators looked for an effect on all-cause mortality, a nonspecific outcome, rather than on lab-confirmed flu. Further, many such studies may be marred by a subtle selection bias, wherein relatively healthy older people were more likely to be vaccinated than frail seniors were, thereby making vaccination look more beneficial than it really was. A further problem is that cohort studies typically have defined the flu season arbitrarily as December through March, rather than on the basis of flu surveillance.Simonsen and colleagues also write that since 1968, flu has accounted for an average of about 5% of all winter deaths in older people. Yet the results of cohort studies have prompted claims that flu vaccination reduces the risk of winter death from any cause by about 50% for community-dwelling people older than 65. “That influenza vaccination can prevent ten times as many deaths as the disease itself causes is not plausible,” say Simonsen et al.They argue that in view of the “slim” evidence that flu immunization prolongs elderly people’s lives, it may be time to consider doing more randomized, placebo-controlled trials—even though using a placebo would be “ethically unappealing.” In addition, they suggest, other options for protecting the elderly should be pursued, such as developing vaccines that are more immunogenic, using larger vaccine doses, and employing antiviral drugs more aggressively.Meanwhile, the researchers say elderly people should continue to be vaccinated, because “even a partly effective vaccine would be better than no vaccine at all.”Critiquing the critiqueThe review by Simonsen and colleagues drew praise in an editorial in The Lancet, written by two other vaccine experts who have reviewed the case for flu immunization in the elderly. Tom Jefferson and Carlo Di Pietrantonj of the Cochrane Vaccine Fields in Alessandria, Italy, write that Smonsen et al “prove that statistical methods for adjustment for residual bias used in the observational studies of influenza vaccines did not work, largely because of the difficulty of adjusting for frailty with data available in electronic records.”Jefferson and Di Pietrantonj endorse the idea of doing new randomized, placebo-controlled trials of flu vaccination in older people, arguing that such studies are “the only ethical and scientific way” to settle conclusively whether the vaccines are protective. The trials must cover more than one flu season and be large enough to detect rare outcomes, such as deaths due to flu, the pair assert.In an interview, a flu expert with the CDC asserted that the evidence of effectiveness remains strong enough to justify the US policy of promoting flu shots for the elderly. David K. Shay, MD, MPH, a medical officer in the CDC’s influenza division, agreed that better vaccines are needed, but he rejected the idea of doing placebo-controlled trials in the elderly as unethical.Shay said the randomized, controlled trial from the Netherlands that showed a 50% reduction in confirmed flu cases among the elderly provided “gold standard evidence” for a protective effect. The risk was reduced 57% in 60- to 69-year-olds versus 23% in those 70 and older, but because of wide confidence intervals, the difference between the two groups was not significant, he said.The Dutch findings and the high risk of flu-related hospitalization and death in the elderly provide the major underpinnings of the US policy of promoting flu vaccination in the elderly, Shay said, adding, “We’re left with the fact that this study [by Simonsen et al] isn’t going to change policy in the US for the use of these vaccines.”He said it is very difficult to demonstrate a reduction in mortality as a result of vaccination: “No vaccine trial ever done in the developed world has been [statistically] powered to look at a mortality benefit. So we’re going to have to rely on observational data.”As for the suggestion that unmeasured confounding variables have inflated the effectiveness of flu vaccines in observational studies, Shay said, “We also think that’s possible. The CDC is interested in working with HMOs to get a better handle on how to do vaccine effectiveness studies and mortality outcome studies.”But given the existing evidence that flu shots do help protect seniors, he rejected the suggestion of doing placebo-controlled trials. “If you can’t honestly answer, ‘I have no idea’ to the question whether the vaccine is effective, then you have no basis for doing a placebo-controlled trial,” he said.On the other hand, Shay commented, “Everybody would agree that we need a vaccine with greater effectiveness and greater immunogenicity in the elderly. Manufacturers are working on adjuvanted vaccines that hopefully will be more effective.”HMO study addresses methodologic issuesIn the NEJM study, Nichol and associates sought specifically to address the kinds of methodologic problems cited by Simonsen et al. They retrospectively gathered data on flu vaccination, hospitalization for pneumonia and flu, and death from any cause among community-dwelling elderly members of three HMOs. The study covered the flu seasons from 1990-91 through 1999-2000 for one HMO and those from 1996-97 through 1999-2000 for the other two. The HMOs were in Minnesota and Wisconsin, Washington state, and the New York City area.The study included 713,872 person-seasons of observation. Vaccinated subjects were slightly older and had slightly higher rates of most of the underlying medical conditions that were recorded. There were 4,599 hospitalizations for pneumonia or flu and 8,796 deaths.The per-season hospitalization rates for unvaccinated and vaccinated people were 0.7% and 0.6%, and the corresponding death rates were 1.6% and 1.0%. The figures translated into a 27% reduction in hospitalization rate for pneumonia and flu among the vaccinated (adjusted odds ratio, 0.73; 95% confidence interval [CI], 0.68 to 0.77) and a 48% reduction in mortality (adjusted odds ratio, 0.52; 95% CI, 0.50 to 0.55).The vaccine was somewhat less effective in preventing death—a 37% compared with 48% reduction—in the two seasons when the vaccine was a poor match for the circulating viral strains. For the seasons in which there was a good match, the vaccine yielded a 52% reduction in mortality risk.In an effort to detect any “healthy-vaccinee bias” (better underlying health among the vaccinated than the unvaccinated), the authors compared the risk of hospitalization among vaccinated and unvaccinated subjects during the summers (noninfluenza seasons) of 1999 and 2000. They found that the risks were similar for the two groups.The researchers went a step further by hypothesizing that an unmeasured confounding variable was influencing their findings and then estimating what that influence would be under various assumptions. They picked functional status as the unmeasured variable most likely to affect their subjects’ risk of hospitalization or death.On the basis of studies of functional status, the authors estimated that subjects with poor functional status would be half as likely to get a flu shot and two to three times as likely to be hospitalized or die, compared with those with better functional status. When they plugged these estimates into their data, along with estimates of the prevalence of the confounding variable, they found that the effectiveness of vaccination was reduced but still significant.For example, assuming that the confounder was present in 60% of subjects and that it doubled the risk of hospitalization or death, vaccination still reduced the risk of hospitalization by 14% and the risk of death by 39%. In the most extreme scenario—the confounder was prevalent in 60% and tripled the risk of hospitalization or death—vaccination still lowered the risk of hospitalization 7% and the risk of death 33%.The researchers write that their study “showed multiple benefits across multiple subgroups, a result suggesting that vaccination benefits probably extend to a broad spectrum of elderly persons.” However, they acknowledge that elderly HMO members may differ from elderly nonmembers, and the study did not include the frailest elderly, such as those living in nursing homes, who are likely to have weaker immune responses.A confidence boosterIn an accompanying NEJM editorial, John D. Treanor, MD, writes that the study by Nichol et al addresses many of the concerns raised about other observational studies “and increases our confidence in the benefits of influenza vaccination in older adults.”Because the evidence of vaccine effectiveness held up well through 10 seasons, the findings “convincingly dispel concerns that the previous studies were artifacts of a specific influenza season or a specific population,” states Treanor, who is a vaccine researcher; professor of medicine, microbiology, and immunology at the University of Rochester; and member of the CDC’s Advisory Committee on Immunization Practices.He also comments favorably on the authors’ efforts to address the concerns about unmeasured confounding variables, including the examination of summer hospitalization rates and the estimate of the effect of a hypothetical difference in functional status.”Overall, this study provides additional support for the current strategy to vaccinate elderly adults,” Treanor asserts. The methodologic issues are important, and the precise magnitude of the benefits of vaccination is not yet clear, but it is clear that vaccination is beneficial and should be used widely, he adds.However, he agrees with Shay that the development of more immunogenic and effective vaccines for the elderly is an important goal.Shay said the CDC is contemplating a special initiative to help resolve the controversy over the value of flu immunization for seniors. “Sometime in 2008 the CDC hopes to get together a panel of consultants to bring about ways to move forward and find ways to resolve this controversy,” he said. By assembling experts from the different camps, the agency hopes to come up with recommendations to guide the next series of studies, he said.Simonsen L, Taylor RJ, Viboud C, et al. Mortality benefits of influenza vaccination in elderly people: an ongoing controversy. Lancet Infect Dis 2007 Oct;7:658-66 [Abstract]Jefferson T, Di Pietrantonj C. Inactivated influenza vaccines in the elderly—are you sure? (Editorial) Lancet 2007 Oct 6;370(9594):1199-1200Nichol KL, Nordin JD, Nelson DB, et al. Effectiveness of influenza vaccine in the community-dwelling elderly. N Engl J Med 2007 Oct 4;357(14):1373-81 [Full text]Treanor JD. Influenza—the goal of control. (Editorial) N Engl J Med 2007 Oct 4;357(14):1439-41 [Full text]
South African Deputy President Cyril Ramaphosa has stressed the need for more cooperation between Africa and the Asin countries saying that infrastructure holds great potential for Asian-African cooperation.He was Speaking at the 60th commemoration of the Asia-Africa conference in Jakarta, Indonesia, Deputy President Cyril Ramaphosa said both the African and the Asian continents have recognised the urgent need to promote economic development both in their respective continents and in south-south relations.The deputy president urged Asian countries with capital and technical expertise to partner with Africa. He also said that in strengthening cooperation a new era in global trade could begin.Many African countries “with inadequate rail, road and port infrastructure, are simply unable to productively exploit their abundant natural resources”, Ramaphosa said.Asian countries, with their skills, capital, and technical and engineering expertise and know-how, can “partner with African countries in developing this critical area”, he stressed.The deputy president, who represents South African President Jacob Zuma in a series of meetings said that a number of Asian countries are participating actively in infrastructure development projects on the African continent. “We say may this continue.”The deputy president also highlighted the importance of intercontinental-cooperation in manufacturing, saying the manufacturing sector is “key to economic transformation in Africa” .Manufacturing is vital to Africa’s economic future as it can contribute quite substantially to improving growth, reducing unemployment and addressing the balancing of payment issues, he underscored.South Africa’s deputy President Cyril Ramaphosa attended the Africa Asia summit in Indonesia after President Jacob Zuma pulled out in favour of staying in SA and dealing with the Xenophobia outbreak. South African Vice President Cyril Ramaphosa
INDIANAPOLIS – Health officials across Indiana are seeing an increase in the number of patients with respiratory illnesses; especially in children.The Indiana State Department of Health cannot confirm the increase is related to the recent surge of enterovirus D68 infections that has been reported in several surround states including Ohio and Kentucky.Health officials say enteroviruses are common with approximately 10 to 15 million cases occurring in the United States annually. There are more than 100 types of enteroviruses. Three people in Northern Indiana have tested positive for enterovirus/rhinovirus (rhinovirus is the common cold) by the State Laboratory. Further testing is needed to determine if the cases are EV-D68.“When evaluating patients with significant respiratory illness, it’s important to test for enterovirus because it helps healthcare providers rule out other treatable illnesses, such as influenza or bacterial pneumonia, and to know what viruses are circulating,” said State Epidemiologist Pam Pontones.“Practices such as washing your hands, covering your cough and staying home when you’re sick are more important than ever to protect yourself and others.”The State Health Department is working with local health departments and hospitals to conduct surveillance for additional cases of enterovirus. The Centers for Disease Control and Protection (CDC) is assisting the State with testing for the EV-D68 strain.Typically, EV-D68 causes upper respiratory illness, such as low-grade fever, cough, runny nose, sneezing and body/muscle aches. Infected individuals generally recover on their own without incident by treating symptoms. However, some individuals, especially those with weakened immune systems or underlying medical conditions, such as asthma, may experience severe complications and require hospitalization with supportive therapy.The department says enteroviruses, including EV-D68, are spread through close contact with infected people. To protect you and your family from becoming infected with enterovirus or other illnesses, follow the three C’s:Clean: Wash your hands frequently with warm soap and water. When this is not available, use an alcohol-based hand-sanitizer.Cover: Cover your cough with your sleeve or a tissue when you cough or sneeze.Contain: Prevent spreading illness to others by staying home if you are sick.