FILE - In this May 25, 2011 file photo, Shirley Waits sits outside her mother's home and waits for an insurance adjuster to arrive, in Joplin , Mo., after a massive tornado moved through Joplin three days earlier, leveling much of the city. The tornado that tore through Joplin a year ago already ranks as the deadliest twister in six decades. Now it carries another distinction _ the costliest since at least 1950. Insurance policies are expected to cover most of the $2.8 billion in damage. But records obtained by The Associated Press show taxpayers could supply $500 million. (AP Photo/Jeff Roberson, File)
FILE - In this May 25, 2011 file photo, Shirley Waits sits outside her mother's home and waits for an insurance adjuster to arrive, in Joplin , Mo., after a massive tornado moved through Joplin three days earlier, leveling much of the city. The tornado that tore through Joplin a year ago already ranks as the deadliest twister in six decades. Now it carries another distinction _ the costliest since at least 1950. Insurance policies are expected to cover most of the $2.8 billion in damage. But records obtained by The Associated Press show taxpayers could supply $500 million. (AP Photo/Jeff Roberson, File)
JEFFERSON CITY, Mo. (AP) ? The cost of 30 manhole covers that got sucked away: $5,800. A new concession stand at the destroyed high school: $228,600. Shelter and care for more than 1,300 homeless pets: $372,000.
The tornado that tore through Joplin a year ago already ranks as the deadliest twister in six decades. Now it carries another distinction ? the costliest since at least 1950.
Insurance policies are expected to cover most of the $2.8 billion in damage. But taxpayers could supply about $500 million in the form of federal and state disaster aid, low-interest loans and local bonds backed by higher taxes, according to records obtained by The Associated Press and interviews with federal, state and local officials.
Almost one-fifth of that money was paid to contractors who hauled off debris. Tens of millions more dollars went to individuals for temporary housing and other living expenses in the immediate aftermath of the storm. Additional money could help subsidize construction of a new hospital to replace one that was irreparably damaged.
All told, about two dozen school districts, emergency agencies, public housing authorities, religious groups and other nonprofits could receive taxpayer money through a program run by the Federal Emergency Management Agency.
The outpouring of assistance is nowhere near the scale of Hurricane Katrina, which swamped New Orleans and damaged property along a wide swath of the Gulf Coast in 2005. Yet the Joplin tornado raises questions anew about the government's role in disasters.
For Joplin families still on the long road to recovery, the taxpayer aid generally is appreciated.
The twister killed Danielle Robertson's mother and destroyed the duplex she shared with her teenage daughter and two dogs. After several months of temporary living arrangements, Robertson eventually got one of the FEMA trailers for tornado survivors. No rent or utility payments were required.
"There are just thousands of people who would not have recovered at all had that aid not been there. I mean there's no way," said Robertson, who finally moved into a rebuilt rental home about three weeks ago. "I like to consider myself a survivalist, but there was nothing to survive with."
The Joplin tornado, which killed 161 people, was one of 99 major disasters declared by President Barack Obama in 2011. Other included blizzards, wildfires and hurricanes. Congress responded in December by authorizing an extra $8.6 billion in disaster aid.
Missouri has a rainy day fund with about $500 million that was created for costly emergencies. But the fund hasn't been tapped for Joplin because Gov. Jay Nixon and some lawmakers are reluctant to trigger a constitutional mandate that the borrowed money be replenished within three years.
Some critics of federal disaster aid point to Missouri's rainy day fund as a prime example of how states pass the buck to the federal government for local tragedies.
"It seems to me this indicates the bad incentive problem that comes with federal involvement ? that states would rather tap federal taxpayers before they have to tap their own taxpayers," said Chris Edwards, an economist and editor of downsizinggovernment.org, a website run by the Washington-based Cato Institute, a group that promotes free markets.
FEMA Director Craig Fugate said it takes an especially destructive tornado to trigger federal aid. What made the Joplin tornado so unusual was the intensity of the devastation in such a concentrated area, he said.
"We're talking thousands of families impacted, hundreds of deaths, the trauma to the community alone was overwhelming," Fugate said. "The likelihood of Joplin being able to recover successfully without federal assistance ... warranted the president declaring it" a disaster zone.
Some of the taxpayer-subsidized projects, such as rebuilding St. John's Regional Medical Center, will benefit people well beyond Joplin. The hospital served patients from a wide region extending into southeastern Kansas and northeastern Oklahoma.
Hospital administrators estimate their total cost from the tornado at $950 million, including demolishing the old building, creating temporary facilities and constructing a permanent replacement.
The hospital expects to get more than $345 million from insurance. It's submitted more than $88 million of expenses to FEMA, of which the federal government could pay for 75 percent. The rest will be covered by private donations and the resources of the Sisters of Mercy Health System, which runs the hospital.
"We do hope to get some money from FEMA, but we're not counting on that," said Shelly Hunter, the chief financial officer for Mercy Health of Joplin.
The cost of replacing damaged school buildings will be covered largely by insurance, too. But voters recently approved the largest bond issue in Joplin history ? $62 million ? to help rebuild or repair 10 school buildings. The resulting property tax increase is estimated at $65 a year for the owner of a $100,000 home ? roughly a 10 percent hike.
The Joplin school district has sought disaster aid for dozens of costs not covered by insurance, such as a truck and trailer used to shuttle band equipment between makeshift school buildings, as well as the concession stand, bleachers, flagpoles, fences, outdoor basketball hoops and new mulch for playgrounds. The cost to remove and replace the mulch at just three sites: $7,100.
The city has its own share of tornado costs, like the manhole covers. The tornado also destroyed two sirens that warn people of dangerous storms. Taxpayers paid more than $41,000 for temporary and permanent replacements, according to disaster-aid records.
During the cleanup, 14 fire hydrants and curbs and gutters at 111 locations were damaged by heavy equipment. And tires were punctured on about 125 vehicles, costing almost $57,300.
The American Society for the Prevention of Cruelty to Animals said it spent $1.2 million providing shelter and veterinary care for 1,300 homeless pets after the tornado. The city of Joplin agreed to cover $351,000 of those costs and now is seeking reimbursement from FEMA. It's seeking an additional $21,000 for costs incurred by Joplin Human Society.
Federal disaster aid rules also reward local entities for the charitable work and donations of others. Joplin expects to receive $1 million through FEMA as a partial credit for an estimated $17.7 million worth of volunteer labor and donated supplies and services. That money can be used to offset the city's own expenses for debris cleanup and emergency response.
"The fact that we can basically break even from a tornado of this magnitude is astonishing, and it's in large part due to the donated resources," city Finance Director Leslie Jones said. "Not only did it help us financially, they helped us clean up our community. I don't even have words to describe it."
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Fine Arts Fiesta in Wilkes-Barre celebrates local talent, May 17-20
By Kirstin Cook
Home is where the art is. At least, that?s the opinion of the Fine Arts Fiesta organizers, which is why this year?s event will focus in on local talent. The 57th annual Fine Arts Fiesta will be held on Public Square, Wilkes-Barre, from May 17 to 20. The theme is ?Our Town ? Art Town.? The free event will feature live performances, a juried art show, an artists? market, children?s activities and ethnic foods. Tracey Selingo, chairperson of the marketing committee for the Fine Arts Fiesta, said the event really hones in on the talented artists in our own neighborhoods. ?There are so many performers here, and many different artists, and there?s such a rich culture that you don?t see every day,? she said. Fine Arts Fiesta gives attendees a rare look at all of these artistic abilities together in one place. Pennsylvania?s longest-running art show has been trending toward local artisans and performers in the last two years. Kathleen Godwin, member of the performing arts committee, said many people aren?t aware of the artistic potential of this area. She hopes attendees might be inspired to learn more about local opportunities and perhaps take a class. Another unique part of Fiesta is how different it is every year. ?The very nature of the whole event constantly changes, just because the people are always different and the players are always different,? Selingo said. The changing dynamic is due to the artist selection process, which requires artists to apply every year in order to participate. ?Everybody has to either apply for the first time or reapply, everything is judged and juried to get them in,? Selingo said. Godwin said they strive to showcase variety and appeal to different ethic groups in the selection process. She added that their new website allows artists to submit work online. ?We look at what?s submitted and try to pick a little of this, a little of that,? Godwin said. The resulting pool of artists is a mix of returning stars and first-time performers. Selingo said this variety is one reason Fiesta has become Pennsylvania?s longest-running art show, growing to span 57 years. She said the other part is the thriving arts community. ?I think that the vibrancy, and the fact that it is always different certainly has helped keep it alive,? Selingo said. With that vibrancy comes variety. Fineartsfiesta.org outlines a diverse schedule of performances, with everything from dance, theater and poetry to classical and salsa bands represented. The artists? market features artists from northeastern Pennsylvania, as well as across the country, who will showcase their wares, including photography, paintings, jewelry pottery and more. While your eyes are taking in all the art, your tastebuds won?t be bored. Venders such as Hillside Farms, Nico?s Pizza and Blue Chip Gourmet will offer everything from Philly cheese steaks to potato pancakes. The Fiesta is run by volunteers and funded by community donations. Selingo said the event relies on funds from the public and about 20 volunteer board members who work all year to make it happen. ?It?s an event that is run by and run for the community, which I think makes it so special,? Selingo said.
Fine Arts Fiesta will be held on Public Square in Wilkes-Barre, Thursday, May 17; Saturday, May 18 from 10 a.m. to 8 p.m.; and Sunday May 20 from 10 a.m. to 6 p.m. For more information, visit fineartsfiesta.org.
Fine Arts Fiesta Entertainment
Thursday, May 17 10 a.m. ? West Hazleton Elementary Select Chorus 10-30 a.m. ? West Hazleton Middle School Chorus 11 a.m. ? West Hazleton Band Noon ? Opening Ceremonies 12-30 p.m. ? Lunchtime Celebration Concert with ?Luis Colon Salsa Band? 2 p.m. ? E.L. Meyers High School Jazz Band 5 p.m. ? The Conservatory Choir 5-30 p.m. ? Awards Ceremony Prelude ? Hazleton Area High School Jazz Band 6-30 p.m. ? Awards Ceremony 7-30 p.m. ? ?Musical Theatre Favorites by- ?The Little Theatre of Wilkes-Barre?
Friday, May 18 10-30 a.m. ? Wyoming Valley West Middle School Honors Orchestra Noon ? Friday Afternoon Musicale- Dallas Middle School Jazz Band and Select Chorus 1-30 p.m. ? Coughlin Jazz and Concert Band 2-30 p.m. ? Wilkes Barre Area All-Area Orchestra Featuring members from E.L. Meyers, Coughlin, G.A.R. High Schools and Sullivan Jr. High School 4 p.m. ? Katie Kelly 6-30 p.m. ? Hybrid Sessions 8 p.m. ? Mark DeRose and The Way Home Saturday, May 19 10 a.m. ? Conservatory of Dance 11 a.m. ? Joan Harris Conservatory Dancers Noon ? Lunchtime Concert- ?Doug Smith Dixieland All-Stars 1 p.m. ? Performances by The Mozart Club 1-45 p.m. ? Performances by The Music Box Theatre Co. 2-25 p.m. ? Starring U Kid! 3-25 p.m. ? Dance Theatre of Wilkes-Barre, Gina Malsky 3-45 p.m. ? Without Walls Dance Company 4 p.m. ? Ballet Northeast 5 p.m. ? The George Wesley Band 7 p.m. ? Rogue Chimp featuring Mark Woodyat, Violin
Sunday, May 20 11 a.m. ? Annual Spring Poetry Contest and Reading, The Wyoming Valley Poetry Society, Jim Spock, Poet and Director Noon ? David Blight Dance Studio 1 p.m. ? ?Freilox and Bagels?, Klezmer Band 2 p.m. ? Northeastern Pennsylvania Academy of Dancing and Children?s Ballet Theatre Company 3 p.m. ? XCLUZIVE SOUL, (Motown) 5 p.m. ? The Poets
Every day of Fiesta, enjoy the sounds of strolling musicians Bill Kuklevich, on accordion, and Mary Baker, on guitar. For the most up-to-date schedule, visit fineartsfiesta.org.
Every so often, a product graces the PCMag Labs that will leave more than a few of us scratching our heads in befuddlement. Enter the Sharper Image Cooling Station ($79.99 direct), an item whose main purpose somewhat eludes me. Ostensibly, it's a portable keyboard with a built-in touchpad for your laptop, yet it can only work inches away from the laptop's keyboard. And, as the name implies, it also cools your laptop, but that requires the laptop to be placed in a ridiculously awkward position in order to accommodate the built-in keyboard. And therein lies the main problem with the Sharper Image Cooling Station: while there's obviously nothing inherently wrong with portable keyboards or cooling stations in and of themselves, a combination of the two winds up compromising the utility of both elements to such an extent that the overall product consequently suffers as a whole.
Now, I'm fully aware that Sharper Image isn't a company known for computing prowess. It's more of an entity that specializes in innovative-cum-gimmicky items ranging from foot massagers to automatic tie racks. This lack of focus is apparent with the cooling station. It's a hastily sketched out idea that tries to perform more than one function and winds up doing none of them adequately.
Design
The Sharper Image Cooling Station is constructed out of flimsy plastic and comes in a silver finish. It folds open and close like a laptop, and when it's open and laid out flat, the unit is 17 inches wide and 13.75 inches long, whereas it stands at about 9 inches tall when opened up like a laptop. Opening it up for the first time is a mildly jarring experience because you encounter a keyboard in the lower half but no screen above it, like an incomplete laptop. Instead, you place the bottom of the laptop on this upper portion while tilting your screen upwards. In the end, you wind up with an eye-level screen and the strangely disconcerting, Shining-esque sight of two keyboards staring at you point blank. From an aesthetic angle, the Cooling Station's keyboard is a dead ringer for the MacBook Pro's keyboard, so its keys are in the familiar chiclet style. But while the Cooling Station's keyboard emulates the MacBook Pro's look, the keyboard also has a Windows Start Menu button since it's meant to be compatible with both Windows and Mac operating systems. As a mini keyboard, its size is nearly identical as the Evoluent Essentials Full Featured Compact Keyboard (EKB) ($49.95 direct, 3.5 stars). There's also a touchpad beneath the keyboard which, despite its superficial similarity to the MacBook's touchpad, does not feature any multi-touch capabilities, like two-finger scrolling.
But before you actually mount your laptop onto this thing, you'll notice a few features on the upper half, namely three horizontally arranged cooling fans that the Cooling Station owes its namesake to. There's a rectangular flap beneath the fans that you push out so it sits obliquely on an adjustable plastic panel behind the system, sort of like a picture frame; adjusting the flap's tilt in turn alters the viewing angle of the laptop screen. There's a removable plastic window to the left of the flap that opens up to reveal a built-in USB 2.0 cable that powers the Cooling System's fans.
To the left of the keyboard are three additional ports: there's a micro USB port for connecting the keyboard and touchpad to your laptop (via the included USB 2.0 cable), as well as two available USB 2.0 ports for connecting additional peripherals. Annoyingly, the micro USB port and the built-in USB cable are both located on the Cooling Station's left side, so if there aren't any USB ports on the left side of your laptop, it'll take some patience and creativity to hook the Cooling System to your Laptop; this problem is exacerbated by the fact that both the included USB cable and the built-in cable are only 21 inches long and, consequently, offer very little slack.
Performance
Although the Sharper Image Cooling Station's three cooling fans performed decently and succeeded in lowering my laptop's temperature by 2 degrees Celsius after a few minutes, its built-in keyboard and touchpad must also be considered since the three are inextricably linked and, in appraising the item holistically, the good must also be evaluated in addition to the bad. And, man, there's plenty of that going on here.
Despite Sharper Image's claims that the Cooling Station increases productivity, I found the opposite to be true in actual practice. The combination of a tiny palm rest that forces your hands off the edges and flimsy plastic material made typing on the Cooling Station's built-in keyboard an exceedingly difficult and frustrating endeavor. While the Cooling Station's keyboard succeeds in emulating the MacBook Pro's aesthetic, it doesn't come anywhere near the latter in terms of quality and performance. The Cooling Station's stiff and clacky keys are almost entirely devoid of springiness. Unlike the better, equally portable Evoluent Essentials Keyboard (EKB), there are no hot keys whatsoever. Only the most basic keys are here. Even standard, fairly ubiquitous function keys like screen brightness and volume control haven't been included. These omissions paradoxically force you to return to your laptop's now-vertically positioned keyboard to access these keys even while another keyboard sits directly in front of you, thus begging the question: why even bother using this keyboard at all, especially when your laptop almost invariably comes equipped with a better one? Those looking for a portable keyboard to use in addition to their laptop's would be much better served by the significantly cheaper Verbatim Mini Wireless SlimBoard Keyboard & Mouse ($30 street, 3 stars), which also boasts wireless connectivity, or the Evoluent Essentials (EKB) since it's practically the same size as the Cooling Station's built-in keyboard and also sports hot keys that would actually succeed in increasing productivity.
It doesn't help that the keyboard lacks rigidity and give off an overwhelming sensation of cheapness. The shallow area where the keys are located feels disconcertingly hollow, and typing on it with a normal level of intensity yielded a noticeable amount of bending beneath the weight of rapid keystrokes. Overall, the Cooling Station made for an unpleasant typing experience. The cramped keyboard served as a prelude to the even more cramped and equally limited touchpad. Its responsiveness was average at best and its left- and right- click buttons were stiff and clunky. As mentioned earlier, there aren't any multi-touch capabilities on the touchpad. As was the case with the Cooling Station's keyboard, you'd very likely be better off using your laptop's touchpad, or with a mouse-keyboard combination like the Verbatim Mini Wireless SlimBoard Keyboard & Mouse or its full-sized counterpart, the Verbatim Wireless Slim Keyboard and Mouse ($63.00 direct, 3 stars).
In the end, the Sharper Image Cooling Station's lack of focus seals its fate. It's a cooling system that harbors aspirations of being a keyboard, and it consequently performs poorly as whole. Even if it didn't come with an inflated price tag, its odd design and lackluster keyboard and touchpad make for a strange, entirely half-baked product you're better off avoiding.
Go for the automated tie rack instead.
Compare the Sharper Image Cooling Station with several other keyboards side by side.
More keyboard reviews: ??? Sharper Image Cooling Station ??? Corsair Vengeance K60 ??? Logitech Ultrathin Keyboard Cover (for New iPad, iPad 2) ??? Evoluent Essentials Full Featured Compact Keyboard (EKB) ??? Corsair Vengeance K90 ?? more
CHICAGO (AP) ? The famous skyline is etched with distinctive buildings. The downtown boasts a vibrant cultural district. And the stunning lakefront and art-filled parks attract thousands of visitors every day.
The Chicago of 2012 is a sparkling, fast-globalizing financial-services center and a cradle for high-tech startups. Yet in much of the world, the nation's third-largest city is more likely to conjure images of long-dead mobsters, demolished steel mills or a red-faced Mayor Richard J. Daley defending how police cracked protesters' heads at the 1968 Democratic National Convention.
So it's difficult to overstate the importance of this weekend's NATO summit to business and tourism leaders ? or how critical it is for the event to unfold smoothly, despite the potential for large protests.
"We ought to be known for something more than the old stockyards, smog or Al Capone, but we aren't," said Richard Longworth, a senior fellow at the Chicago Council on Global Affairs. "People are surprised when they visit, and that's why" Mayor Rahm Emanuel wanted the summit.
"We have to stop being a surprise," Longworth added.
Twenty-first century Chicago depends more than ever on its international reputation in the quest for jobs, investment from abroad and markets for its exports. Yet it still struggles with familiar problems, such as subpar schools, segregation and corruption. And in its last attempt to draw world attention, a bid for the 2016 Olympics, the city was embarrassed to be eliminated in the first round.
Chicago has changed profoundly since the 1968 debacle. Back then, the steel mills still belched smoke. The stockyards, while a shadow of what they had once been, were still a couple of years from closing altogether, as anyone with a nose could tell you when the wind shifted.
What had long been one of the most racially divided cities in the nation was also angry, on edge. Big chunks of it were still smoldering from the rioting that followed the assassination of Dr. Martin Luther King Jr. And nobody had forgotten the mayor's still-famous order to shoot to kill arsonists and shoot to maim looters.
In the years since, a second Mayor Daley has come and gone. Richard M. Daley, who took over the city 10 years after his father died and retired in 2011 after 22 years in office, is largely credited for leading the transformation from a gritty industrial center to a booming hub of international commerce.
Chicago is now headquarters of Boeing Co. and United Continental, corporations he lured with millions in financial incentives. Donald Trump's 98-story tower is among the newest additions to the skyline. And dozens of startup companies have taken root here, including Groupon, a web sensation that has served to anchor the tech culture.
"Ten years ago, you wouldn't have mentioned Chicago" when talking about Internet and high-tech companies, said venture capitalist Eric Lefkofsky, a co-founder of Groupon Inc. and several other Internet startups.
"Today it's mentioned all the time" in the same sentence as Silicon Valley or New York. "When people come here ... they're blown away. They have no idea we have an amazing theater district, an amazing restaurant district and great shopping. They just had no idea."
Those attractions will be on full display when delegations from about 60 countries, including 50 heads of state, attend the meeting of the North Atlantic Treaty Organization on Sunday and Monday. More than 2,000 journalists will be here, too, to cover the summit, where the alliance of the U.S. and European countries will discuss issues such as the war in Afghanistan and European missile defense.
Although the visits will be brief, the potential payoff is enormous, officials said.
"From a marketing standpoint, to have that many opinion leaders from that many nations" offers an unprecedented opportunity to promote business "and the fact that we really truly are a global city," said Rita Athas, president of World Business Chicago, a group of powerful executives working with Emanuel to promote the city and attract investment.
The summit also carries potential risks, especially if the police department, which never completely shed its reputation for brutality, has violent confrontations with the thousands of expected demonstrators.
Obama took a gamble by announcing that both the G-8 and NATO summits would be held in his hometown during a presidential election year. His later decision to move the G-8 meeting of leading industrialized nations to Camp David may have been an acknowledgment of those risks.
"If there were a major clash in Chicago (at the NATO summit) and the police ended up acting with a heavy hand ... I think it would seriously undermine Chicago's reputation as an enlightened world city," said Todd Gitlin, a sociology professor at Columbia University who has written extensively about the 1968 convention, where Chicago police violently clashed with an estimated 10,000 protesters. "There is a lot riding on it."
For all of its progress, the city's global reputation has remained largely mired in the past. Even Russian President Vladimir Putin recently took a dig at Chicago when asked about possible plans to attend the NATO summit.
"Yes, they say (Chicago is) good. Al Capone lived there," Putin said.
And the city is bedeviled by longtime demons. Corruption still makes the front page, years after lawsuits and prosecutions put an official end to the infamous Chicago political machine. It's one of the most segregated metropolitan areas in the country, and it's wrestling with a budget deficit of more than $600 million. Half of public high school students drop out before graduating.
Timuel Black, a veteran civil rights activist and history professor on the South Side, said the NATO summit might be a boon for Chicago's downtown and for businesses and residents who are already successful.
But he doubts it will do anything for the most impoverished neighborhoods that have only become poorer and more violent with the loss of jobs and the widening of the gap between rich and poor.
"They're concerned about schools, health care, jobs for themselves and their kids, and they just don't see the benefit" of a NATO summit, said Black, who is 93.
Longworth, from the Council on Global Affairs, said a successful summit could attract more development and tourists.
"It is not going to solve the city's problems in one stroke," he said. "But the city really does need this exposure."
___
Associated Press Writer Don Babwin contributed to this report.
Genetic testing may not trigger more use of health services Public release date: 17-May-2012 [ | E-mail | Share ]
Contact: Rebecca Hughes hughes.r@ghc.org 206-287-2055 Group Health Research Institute
Personal genetic test results didnt drive overuse of expensive medical care
SEATTLEPeople have more and more chances to participate in genetic testing that can indicate their range of risk for developing a disease. Receiving these results does not appreciably drive up or diminishtest recipients' demand for potentially costly follow-up health services, according to a new study in the May 17, 2012 early online issue of Genetics in Medicine.
The study was done by researchers with the Multiplex Initiative, a multi-center collaborative initiative involving investigators from the National Institutes of Health's Intramural Research Program, Group Health Cooperative in Seattle, and the Henry Ford Health System in Detroit.
The tests are available from a growing number of commercial producers, and health care providers have been uncertain whether people who received information only about risk would follow up by demanding diagnostic testing to check for predicted illnesses.
The study is the first to use electronic health recordsrather than self-reported behaviorto measure the impact of genetic testing on the subsequent use of health services by commercially insured, healthy adults. Self-reports, which can be affected by memory lapses and other problems, tend to be less accurate.
"Our study was a best-case scenario, because we chose 15 genes reliably associated with relatively small risks for eight common diseases that health behaviors can affect," said the study's first author Robert J. Reid, MD, PhD. Dr. Reid is Group Health's associate medical director of research translation and an associate investigator at Group Health Research Institute. Those diseases were type 2 diabetes, coronary heart disease, high blood cholesterol, hypertension, osteoporosis, lung cancer, colorectal cancer, and melanoma. "We hope that testing positive activates patients to make behavior changes that could lower their risk, such as quitting smoking," he added, "without causing them to make many extra visits to their doctors."
"Understanding personalized genetic information is important because it is becoming more readily available and we need to figure out how to integrate it effectively and efficiently into the clinical care we provide," said coauthor Eric B. Larson, MD, MPH, Group Health Cooperative's vice president for research and Group Health Research Institute's executive director.
"There are a lot of unanswered questions about how genetic test results can be used to guide people toward making positive lifestyle and health behavior changes," said Colleen McBride, PhD, chief of the Social and Behavioral Research Branch at the National Human Genome Research Institute (NHGRI). "This study goes a long way toward bringing data to these debates and shows that people are not likely to make inappropriate demands of health delivery systems if they are properly informed about the limitations of genetic tests."
Genetic tests, such as those used in this study, can detect common variants of genes associated with modest changes in the chances of developing particular diseases. "Multiplex" means simultaneously performing many genetic tests on one blood sample.
"Good next steps would be to see whether any patients were motivated to make long-term behavior changesand whether those individuals at highest risk went to their doctors more often," Dr. Reid said. "But this study wasn't designed to answer those questions."
The study included 217 healthy people age 25 to 40 who elected to participate in genetic susceptibility testing that their health plan offered. The researchers analyzed the participants' health care use in the 12 months before genetic testing and the 12 months after it. They also compared the test group's health care use with that of about 400 similar plan members who declined the testing offer.
The researchers counted the doctor visits, lab tests, and procedures the people received, particularly those services associated with four of the eight conditions that the multiplex panel tested. Most of the procedures or screening tests that were counted are not among those currently recommended for people in this age group who don't have symptoms. The researchers found that participants in genetic testing did not change their overall use of health care services compared with those not tested.
Each person who chose to undergo the multiplex test was found to carry at least one at-risk genetic marker. Individuals in the population carried an average of nine at-risk variants. Having a risk version of one of the 15 genes on the multiplex genetic test does not mean that a person is certain to get the conditiononly that he or she might have a slightly greater chance of developing the health condition. Many things other than genetics contribute to the risk of common diseases, including such lifestyle factors as diet, exercise, smoking, and sun exposure.
"Much is written about using genetics to personalize health care," said co-author Lawrence C. Brody, PhD, chief of NHGRI's Genome Technology Branch. "Some think this new generation of genetic tests will be a very positive addition to medicine; others believe they have the potential to make things worse." Dr. Brody designed the panel of genetic tests used in the Multiplex Initiative.
The NHGRI Division of Intramural Research and the National Cancer Institute, both at NIH, along with Group Health Cooperative in Seattle and the Henry Ford Health System in Detroit, launched the Multiplex Initiative in May 2007. For the first two years of the study, the investigators accumulated data from 2,000 Detroit area residents who were offered a multiplex genetic test for eight common conditions.
Once enrolled, participants were asked to review information online about the multiplex genetic test and to decide whether they were interested in taking the test. Those who agreed to genetic testing met with a research educator, who provided more information about the risks and benefits of testing and obtained the patient's written consent. Test results were mailed to participants. Trained research educators called the participants to help them interpret and understand their results. The study also included follow-up interviews with participants three months after they received their results.
###
This work was supported by the Intramural Research Program of the National Human Genome Research Institute, National Institutes of Health. The research was also made possible by collaboration with the Cancer Research Network, funded by the National Cancer Institute. Group Health Research Institute and Henry Ford Hospital provided additional resources. Funded through a federal contract from the National Institutes of Health to The Johns Hopkins University, the Center for Inherited Disease Research provided genotyping services.
In addition to Drs. Reid, Larson, McBride, and Brody, the Multiplex Initiative study team included Andy Baxevanis, PhD, an associate investigator in NHGRI's Genome Technology Branch; and Sharon Hensley Alford, PhD, MPH, an epidemiologist at the Henry Ford Health System.
For more information about the Multiplex Initiative, see http://multiplex.nih.gov.
National Human Genome Research Institute
The National Human Genome Research Institute (NHGRI) is one of the 27 institutes and centers at the National Institutes of Health, an agency of the Department of Health and Human Services. The NHGRI Division of Intramural Research develops and implements technology to understand, diagnose, and treat genomic and genetic diseases. For more information, see www.genome.gov.
National Institutes of Health
The National Institutes of Health (NIH), the nation's medical research agency, includes 27 institutes and centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information, see http://nih.gov.
HMO Research Network
Now 19 members strong, the HMO Research Network is a group of research centers associated with health care delivery systems. They collaborate on multi-site studies in real-world settings where people receive everyday care. With the ability to pool information on more than 16 million people, Network researchers gain statistical power and ethnic and geographical diversity. Since 1994, Network studies have been answering pressing questions about what really worksand what doesn'tto keep people healthy and to deliver care effectively. For more information, see http://hmoresearchnetwork.org.
Cancer Research Network
The HMO Cancer Research Network (CRN) consists of the research programs, enrolled populations, and data systems of 14 health maintenance organizations nationwide that are part of the HMO Research Network. The overall goal of the CRN, and the National Cancer Institute initiative under which it was funded, is to use this consortium of delivery systems to conduct research on cancer prevention, early detection, treatment, long-term care, surveillance, and cancer communication and dissemination and implementation research. A portfolio of research studies encompasses cancer control topics ranging from modification of behavioral risk factors such as smoking to cancer care at the end of life. Through this expansive program of research, the CRN seeks to improve the effectiveness of preventive, curative, and supportive interventions for both major cancers such as breast, colon and lung, and rare tumors. The CRN is also uniquely positioned to study the quality of cancer care in community-based settings. As a reflection of its commitment to improving quality of care, the Agency for Healthcare Research and Quality is cooperatively supporting the CRN with the NCI. For more information, see http://crn.cancer.gov.
Henry Ford Health System
Henry Ford Health System is a not-for-profit corporation comprising hospitals, medical centers, and one of the nation's largest group practices. Researchers across multiple research centers within Henry Ford Health System participate in the HMO Research Network. The health system is an integrated health care system serving more than 800,000 patients and health plan members in Southeast Michigan. Approximately 35 percent of the HFHS patient population is African American, creating special opportunities for research and quality improvement in the area of health care disparities. For more information, see http://henryford.com.
Group Health Research Institute
Group Health Research Institute is the research arm of Seattle-based Group Health Cooperative, a consumer-governed, nonprofit health care system. Founded in 1947, Group Health Cooperative coordinates health care and coverage. Group Health Research Institute changed its name from Group Health Center for Health Studies in 2009. Since 1983, the Institute has conducted nonproprietary public-interest research on preventing, diagnosing, and treating major health problems. Government and private research grants provide its main funding. For more information, see http://grouphealthresearch.org.
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Genetic testing may not trigger more use of health services Public release date: 17-May-2012 [ | E-mail | Share ]
Contact: Rebecca Hughes hughes.r@ghc.org 206-287-2055 Group Health Research Institute
Personal genetic test results didnt drive overuse of expensive medical care
SEATTLEPeople have more and more chances to participate in genetic testing that can indicate their range of risk for developing a disease. Receiving these results does not appreciably drive up or diminishtest recipients' demand for potentially costly follow-up health services, according to a new study in the May 17, 2012 early online issue of Genetics in Medicine.
The study was done by researchers with the Multiplex Initiative, a multi-center collaborative initiative involving investigators from the National Institutes of Health's Intramural Research Program, Group Health Cooperative in Seattle, and the Henry Ford Health System in Detroit.
The tests are available from a growing number of commercial producers, and health care providers have been uncertain whether people who received information only about risk would follow up by demanding diagnostic testing to check for predicted illnesses.
The study is the first to use electronic health recordsrather than self-reported behaviorto measure the impact of genetic testing on the subsequent use of health services by commercially insured, healthy adults. Self-reports, which can be affected by memory lapses and other problems, tend to be less accurate.
"Our study was a best-case scenario, because we chose 15 genes reliably associated with relatively small risks for eight common diseases that health behaviors can affect," said the study's first author Robert J. Reid, MD, PhD. Dr. Reid is Group Health's associate medical director of research translation and an associate investigator at Group Health Research Institute. Those diseases were type 2 diabetes, coronary heart disease, high blood cholesterol, hypertension, osteoporosis, lung cancer, colorectal cancer, and melanoma. "We hope that testing positive activates patients to make behavior changes that could lower their risk, such as quitting smoking," he added, "without causing them to make many extra visits to their doctors."
"Understanding personalized genetic information is important because it is becoming more readily available and we need to figure out how to integrate it effectively and efficiently into the clinical care we provide," said coauthor Eric B. Larson, MD, MPH, Group Health Cooperative's vice president for research and Group Health Research Institute's executive director.
"There are a lot of unanswered questions about how genetic test results can be used to guide people toward making positive lifestyle and health behavior changes," said Colleen McBride, PhD, chief of the Social and Behavioral Research Branch at the National Human Genome Research Institute (NHGRI). "This study goes a long way toward bringing data to these debates and shows that people are not likely to make inappropriate demands of health delivery systems if they are properly informed about the limitations of genetic tests."
Genetic tests, such as those used in this study, can detect common variants of genes associated with modest changes in the chances of developing particular diseases. "Multiplex" means simultaneously performing many genetic tests on one blood sample.
"Good next steps would be to see whether any patients were motivated to make long-term behavior changesand whether those individuals at highest risk went to their doctors more often," Dr. Reid said. "But this study wasn't designed to answer those questions."
The study included 217 healthy people age 25 to 40 who elected to participate in genetic susceptibility testing that their health plan offered. The researchers analyzed the participants' health care use in the 12 months before genetic testing and the 12 months after it. They also compared the test group's health care use with that of about 400 similar plan members who declined the testing offer.
The researchers counted the doctor visits, lab tests, and procedures the people received, particularly those services associated with four of the eight conditions that the multiplex panel tested. Most of the procedures or screening tests that were counted are not among those currently recommended for people in this age group who don't have symptoms. The researchers found that participants in genetic testing did not change their overall use of health care services compared with those not tested.
Each person who chose to undergo the multiplex test was found to carry at least one at-risk genetic marker. Individuals in the population carried an average of nine at-risk variants. Having a risk version of one of the 15 genes on the multiplex genetic test does not mean that a person is certain to get the conditiononly that he or she might have a slightly greater chance of developing the health condition. Many things other than genetics contribute to the risk of common diseases, including such lifestyle factors as diet, exercise, smoking, and sun exposure.
"Much is written about using genetics to personalize health care," said co-author Lawrence C. Brody, PhD, chief of NHGRI's Genome Technology Branch. "Some think this new generation of genetic tests will be a very positive addition to medicine; others believe they have the potential to make things worse." Dr. Brody designed the panel of genetic tests used in the Multiplex Initiative.
The NHGRI Division of Intramural Research and the National Cancer Institute, both at NIH, along with Group Health Cooperative in Seattle and the Henry Ford Health System in Detroit, launched the Multiplex Initiative in May 2007. For the first two years of the study, the investigators accumulated data from 2,000 Detroit area residents who were offered a multiplex genetic test for eight common conditions.
Once enrolled, participants were asked to review information online about the multiplex genetic test and to decide whether they were interested in taking the test. Those who agreed to genetic testing met with a research educator, who provided more information about the risks and benefits of testing and obtained the patient's written consent. Test results were mailed to participants. Trained research educators called the participants to help them interpret and understand their results. The study also included follow-up interviews with participants three months after they received their results.
###
This work was supported by the Intramural Research Program of the National Human Genome Research Institute, National Institutes of Health. The research was also made possible by collaboration with the Cancer Research Network, funded by the National Cancer Institute. Group Health Research Institute and Henry Ford Hospital provided additional resources. Funded through a federal contract from the National Institutes of Health to The Johns Hopkins University, the Center for Inherited Disease Research provided genotyping services.
In addition to Drs. Reid, Larson, McBride, and Brody, the Multiplex Initiative study team included Andy Baxevanis, PhD, an associate investigator in NHGRI's Genome Technology Branch; and Sharon Hensley Alford, PhD, MPH, an epidemiologist at the Henry Ford Health System.
For more information about the Multiplex Initiative, see http://multiplex.nih.gov.
National Human Genome Research Institute
The National Human Genome Research Institute (NHGRI) is one of the 27 institutes and centers at the National Institutes of Health, an agency of the Department of Health and Human Services. The NHGRI Division of Intramural Research develops and implements technology to understand, diagnose, and treat genomic and genetic diseases. For more information, see www.genome.gov.
National Institutes of Health
The National Institutes of Health (NIH), the nation's medical research agency, includes 27 institutes and centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information, see http://nih.gov.
HMO Research Network
Now 19 members strong, the HMO Research Network is a group of research centers associated with health care delivery systems. They collaborate on multi-site studies in real-world settings where people receive everyday care. With the ability to pool information on more than 16 million people, Network researchers gain statistical power and ethnic and geographical diversity. Since 1994, Network studies have been answering pressing questions about what really worksand what doesn'tto keep people healthy and to deliver care effectively. For more information, see http://hmoresearchnetwork.org.
Cancer Research Network
The HMO Cancer Research Network (CRN) consists of the research programs, enrolled populations, and data systems of 14 health maintenance organizations nationwide that are part of the HMO Research Network. The overall goal of the CRN, and the National Cancer Institute initiative under which it was funded, is to use this consortium of delivery systems to conduct research on cancer prevention, early detection, treatment, long-term care, surveillance, and cancer communication and dissemination and implementation research. A portfolio of research studies encompasses cancer control topics ranging from modification of behavioral risk factors such as smoking to cancer care at the end of life. Through this expansive program of research, the CRN seeks to improve the effectiveness of preventive, curative, and supportive interventions for both major cancers such as breast, colon and lung, and rare tumors. The CRN is also uniquely positioned to study the quality of cancer care in community-based settings. As a reflection of its commitment to improving quality of care, the Agency for Healthcare Research and Quality is cooperatively supporting the CRN with the NCI. For more information, see http://crn.cancer.gov.
Henry Ford Health System
Henry Ford Health System is a not-for-profit corporation comprising hospitals, medical centers, and one of the nation's largest group practices. Researchers across multiple research centers within Henry Ford Health System participate in the HMO Research Network. The health system is an integrated health care system serving more than 800,000 patients and health plan members in Southeast Michigan. Approximately 35 percent of the HFHS patient population is African American, creating special opportunities for research and quality improvement in the area of health care disparities. For more information, see http://henryford.com.
Group Health Research Institute
Group Health Research Institute is the research arm of Seattle-based Group Health Cooperative, a consumer-governed, nonprofit health care system. Founded in 1947, Group Health Cooperative coordinates health care and coverage. Group Health Research Institute changed its name from Group Health Center for Health Studies in 2009. Since 1983, the Institute has conducted nonproprietary public-interest research on preventing, diagnosing, and treating major health problems. Government and private research grants provide its main funding. For more information, see http://grouphealthresearch.org.
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AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.
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Public release date: 17-May-2012
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