England’s 15-game unbeaten run came to an end on Friday as Spain ran out 2-0 winners in an international friendly in Alicante.After a goalless first half, the hosts opened the scoring with less than 20 minutes remaining, a stunning overhead strike on the turn from Mario Gaspar beating Hart who had rarely been tested beforehand.Their lead was doubled 12 minutes later as Arsenal playmaker Santi Cazorla’s low well-crafted effort beat the Manchester City goalkeeper, after a poor clearance, to bring Roy Hodgson’s side back to earth after easing through qualifying for Euro 2016.Hodgson kept to his word and named an experimental England line-up for the glamour friendly against the European champions.With Wayne Rooney rested and in-form Jamie Vardy sidelined, Harry Kane led the line and was supported by Ross Barkley, Adam Lallana and Raheem Sterling.Hart captained the side in Alicante, where Chelsea’s Diego Costa and Cesc Fabregas started for the hosts.Unsurprisingly, the hosts dominated the early possession, and large amounts of the first half, but England looked defensively sturdy and dangerous on the break.Good moves saw the visitors twice go close – first Sterling blasted a shot over before Barkley dragged an effort wide.Hodgson’s side were often their worst enemy as they played their way into trouble with sloppy play.Sterling’s poor ball in the England half led to a Spanish break, with Phil Jones making a decisive block after striker Costa was found in space.The following corner saw Barcelona star Sergio Busquets volley wide, inches past the post.England’s left-hand side was a promising aspect of the match as Ryan Bertrand got forward well and linked up with Man City man Sterling.Southampton left-back Bertrand put a superb low cross along the six-yard box and Kane could not quite get to the ball to convert.Shortly after the half-hour mark, England passed a significant milestone as they went 400 minutes without conceding.Costa found space on the left-side of the 18-yard box before curling an effort past the post, but Hart had little to do in the first period.Barkley’s solo effort resulted in a good chance for the hosts before Fabian Delph strode into space ahead of the break before drilling a low 20-yard effort into the arms of Porto goalkeeper Iker Casillas, making his 165th appearance for his country.The hosts took the lead to end England’s run of not conceding and what a deserving goal it was. With 72 minutes on the clock, a floated ball to the right-hand side found Mario, who on the spin, struck the ball on the overhead kick, across goal and into the top corner.Spurs duo Eric Dier and Kane combined well when the former’s ball over the top found the striker, who controlled brilliantly before losing his balance and striking wide.The win was confirmed when Cazorla stroked the ball past Hart from the edge of the box. The England goalkeeper was incensed, as he claimed offside, but the goal stood.Rooney struck the bar late on, but England were beaten by the European holders. 1 Mario Gaspar
5.0★ 3.5★ 3.4★ We Asked 750 Hiring Managers What Makes a Candidate Irresistible, Here’s What They Said 23 hours ago 23h N/A Registered Nurse Supervisor RN Waterbury Gardens Nursing and Rehab Waterbury, CT Interior Designer – St. Louis & Dallas Oculus Saint Louis, MO Director, Advanced Technology Policy General Motors United States 3.1★ Pest Control Technician United Pest Solutions Seattle, WA 23 hours ago 23h 23 hours ago 23h Registered Nurse (RN) – Charge Nurse – $7,000 Sign On Bonus EmpRes Healthcare Management Gardnerville, NV 23 hours ago 23h N/A Deli Associate F&M Deli & Restaurant Mount Laurel, NJ 23 hours ago 23h 4.7★ LCPC – Licensed Clinical Professional Counselor Above and Beyond Family Recovery Center Chicago, IL Whether you’re leaving your job on good terms or bad ones, chances are an exit interview will be part of the process. Even in the best of circumstances, these meetings can provoke anxiety about what to say, what not to say, and how to make sure you’re leaving with the best possible impression. In the worst scenarios, it can be tough to balance the desire to be honest about your work experience and the reasons you’re leaving without throwing anyone under the bus. After all, you never know who you might cross paths with again in the future.To make the process easier, we talked to top HR pros to get their best advice on how to stay calm, cool, and collected throughout the process.1. Remember the purpose of an exit interview. In the end, the exit interview isn’t really about you, and it’s important to be aware of that before going into one. “Exit interviews typically take place for the employer’s sake, not the employee’s,” explains Dina Amouzigh, People’s Operations Manager at the online healthcare portal CareDash. “The purpose is to get information and feedback based on the employee’s experience or context for their ultimate decision to separate,” she adds. This is the most important thing to keep in mind heading into the meeting, since ultimately the company you’re leaving stands to benefit from your intel, not the other way around. Remember, you don’t have to share anything you’re uncomfortable talking about, and you definitely shouldn’t use the meeting as an emotional outlet to let out frustrations you feel about your time at the company. 2. If you’re nervous, prepare ahead of time. “I highly recommend writing down notes to plan what you want to say,” advises Jude Miller-Burke, Ph.D., business psychologist and author. “If you expect it to be highly charged, practice out loud. Reinforce to yourself that you will maintain boundaries and not succumb to your strong emotions.” Writing in a journal beforehand is a good way to sort out your thoughts, she adds. “Seeing this meeting as an opportunity for you to practice self-management, a skill critical to success, may decrease your stress. Having a friend to call after the meeting can be a helpful debriefing.”Keep It Classy! How to Quit Your Job With Grace3. Get specific about the good. When it comes to positive feedback, get into the nitty gritty. “You want to be sure to share specifics about what (or who) made the work experience positive,” says Laura MacLeod, LMSW, HR expert and founder of the From The Inside Out Project. Points to highlight include “how you learned and grew as a professional and what you’ll remember and why,” she adds. These topics give the human resources department important information about how they can continue to promote a positive work environment and who is having a beneficial impact on other employees. In other words, you’re paying it forward by highlighting what the company you’re leaving got right. 4. Be general about the bad. Even if you had a horrible experience at a company, experts unilaterally advise against throwing another person under the bus during an exit interview. It’s just not the time or the place. That being said, there are ways to let HR know about the real motive behind your departure. “I believe there are ways to be honest and retain your professionalism,” says Miller-Burke. “Speak in general terms and never identify people you are angry with. It is fine, for example, to express that the workload was more than any one person could handle, if done in the right tone,” she says. It’s also okay to say something like, “I think managers should get more training in active leadership,” but it’s best to avoid statements like, “Tom was the worst boss I’ve ever had.”What Not to Do When You Resign5. Find the silver lining. No matter how awful your experience was, it’s important to mention at least one positive during your final conversation. “Find something that you honestly feel was positive,” recommends MacLeod. “This may be tough, but it is important to demonstrate your professionalism. You are able to see and acknowledge that there were benefits and opportunities there, despite the way things turned out.” 6 Hacks to Save Time During Your Job Search 23 hours ago 23h 23 hours ago 23h 23 hours ago 23h Service Advisor Prime Motor Group Saco, ME 23 hours ago 23h 2.5★ RN, Registered Nurse – OP Chemotherapy CHRISTUS Health Houston, TX QUIZ: Is Your Company Toxic? 4.5★ Also on Glassdoor: Browse Open Jobs 2.8★ Administartive Assistant Sentry Mechanical Pittsburgh, PA 23 hours ago 23h
The full text of the study is available here but requires a subscription to the Journal of Midwifery and Women’s Health.Share this: ShareEmailPrint To learn more, read: Introduction: Data on attendance at birth by midwives in the United States have been available on the national level since 1989. Rates of certified nurse-midwife (CNM)–attended births more than doubled between 1989 (3.3% of all births) and 2002 (7.7%) and have remained steady since. This article examines trends in midwife-attended births from 1989 to 2009.Methods: The data in this report are based on records gathered as part of the US National Standard Certificate of Live Birth from a public use Web site, Vital Stats (http://www.cdc.gov/nchs/VitalStats.htm), that allows users to create and download specialized tables.Results: Between 2007 and 2009, the proportion of all births attended by CNMs increased by 4% from 7.3% of all births to 7.6% and a total of 313,516. This represents a decline in total births attended by CNMs from 2008 but a higher proportion of all births because total US births dropped at a faster rate. The proportion of vaginal births attended by CNMs reached an all-time high of 11.4% in 2009. There were strong regional patterns to the distribution of CNM-attended births. Births attended by “other midwives” rose to 21,787 or 0.5% of all US births, and the total proportion of all births attended by midwives reached an all-time high of 8.1%. The race/ethnicity of mothers attended by CNMs has shifted over the years. In 1990, CNMs attended a disproportionately high number of births to non-white mothers, whereas in 2009, the profile of CNM births mirrors the national distribution in race/ethnicity.Discussion: Midwife-attended births in the United States are increasing. The geographic patterns in the distribution of midwife-attended births warrant further study. Posted on July 5, 2013August 15, 2016Click to share on Facebook (Opens in new window)Click to share on Twitter (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Reddit (Opens in new window)Click to email this to a friend (Opens in new window)Click to print (Opens in new window)A new study, published last month in the Journal of Midwifery & Women’s Health, shares an analysis of two decades of CDC data showing that midwife-attended deliveries are on the rise in the United States. In fact, the report shows that the rate of midwife-attended deliveries more than doubled between 1989 and 2002 and have remained steady since.A piece in Time Magazine on June 25th discussed the new study and some of the various reasons for the increasing trend of midwife-attended births in the United States:In other developed nations, midwives are routinely tasked with bringing new life into the world. Not so in the U.S., where delivery is largely presided over by obstetricians. But a new study finds that midwives are getting busier, delivering 8.1% of the country’s babies in 2009 — a record high.Slice the data differently and the proportion rises even further. Consider vaginal births only — midwives don’t do cesarean sections — and the figure rises to 12.1%, or about one of every eight deliveries, according to statistics from the U.S. Centers for Disease Control and Prevention (CDC).“If this trend continues, it will bring us more in line with the rest of the world in giving midwives a central role in prenatal care and birth,” says study author Eugene Declercq, professor of community-health sciences at the Boston University School of Public Health. “Given that other countries have lower costs and better outcomes, it would be a positive thing for this country.”Read the full story in Time Magazine’s Health and Family section.More about the study (from the study abstract):
Click here to see a larger, more detailed version of the final SD Times March Developer Madness bracket, and how all the games and rounds shook out from beginning to end.March Developer Madness was a fun way for us to gauge our readership’s interest and fascination with all the established and emerging software development technologies out there, from languages and platforms to development philosophies and methodologies. Thank you to all our readers who participated, voted and engaged with us about the event via social media.Did your favorite seed or preferred technology lose somewhere along the way? Let us know! Tell us what you’re passionate about; what you want to read more about, whether in comments, emails or tweets. SD Times is always listening. The championship game is in the books, and the winner of SD Times March Developer Madness is #4 seed Service Virtualization! After a tournament full of surprises, upsets and all eight top seeds going down, Service Virtualization cruised through the Final 4 with convincing wins over cinderella #8 seed NoSQL and #3 seed APIs in the finals.The final tally of 219 championship votes was 75% in favor of Service Virtualization!
Source:https://medicine.wustl.edu/news/eczema-drug-effective-against-severe-asthma/ May 22 2018Two new studies of patients with difficult-to-control asthma show that the eczema drug dupilumab alleviates asthma symptoms and improves patients’ ability to breathe better than standard therapies. Dupilumab, an injectable anti-inflammatory drug, was approved in 2017 by the Food and Drug Administration as a treatment for eczema, a chronic skin disease.Researchers at Washington University School of Medicine in St. Louis and other institutions conducted the studies and were scheduled to present the results May 20 and 21 at the 2018 American Thoracic Society Conference in San Diego. The studies also will be published online May 21 in The New England Journal of Medicine.The more than 2,000 patients enrolled in the studies suffered from moderate to severe asthma. All used standard asthma inhalers, and some also took oral steroids to control their severe asthma symptoms.In one study, the rate of asthma exacerbations was almost cut in half for those taking dupilumab compared with those taking a placebo. On average, patients taking a placebo had close to one exacerbation per day during the year of the study. Exacerbations are periods of sudden worsening of asthma symptoms such as wheezing, coughing, shortness of breath and tightness in the chest.Although the drug significantly reduced asthma symptoms for all patients, dupilumab worked particularly well in patients with high numbers of a specific type of white blood cell, called eosinophils, circulating in the bloodstream. For those patients, asthma exacerbations were cut by two-thirds.”This drug not only reduced severe symptoms of asthma, it improved the ability to breathe,” said Mario Castro, MD, the Alan A. and Edith L. Wolff Distinguished Professor of Pulmonology and Critical Care Medicine. “That’s important because these patients have a chronic disabling disease that worsens over time with loss of lung function. So far, we do not have a drug for asthma that changes the course of the disease. Current drugs for severe asthma help reduce trips to the emergency room, for example, but they don’t improve lung function.”The first study included about 1,900 patients of at least 12 years of age and with moderate to severe asthma requiring they use at least three different inhalers to control their symptoms. One inhaler contained a corticosteroid that reduces inflammation, another contained a long-acting bronchodilator that relaxes airway muscles, and the third was a “rescue” inhaler filled with albuterol, a short-acting bronchodilator that quickly opens up the airway in the event of a more severe asthma attack.Patients taking these inhaled medications then were randomly assigned to receive either dupilumab or a placebo for one year. Patients receiving dupilumab -; an injectable antibody -; also were randomly assigned to a higher or lower dose of the drug. Neither patients nor their doctors knew whether they were receiving the drug or the placebo.Related StoriesTaking vitamin D and E during pregnancy may ‘reduce likelihood’ of asthmaStudy examines differences in genetic risk factors for childhood-onset and adult-onset asthmaWorld Asthma Day: How climate change is increasing cases of asthmaIn addition to reduced symptoms, the patients receiving dupilumab showed improved lung function in a test of “forced expiratory volume.” This test measures the amount of air a person can force from the lungs during a deep exhale. Patients receiving dupilumab, regardless of dose, improved their lung function by approximately 130-200 milliliters greater than those receiving the placebo. In general, there were no significant differences between the patients receiving high and low doses of dupilumab.Rates of emergency room (ER) visits and hospitalizations also were improved for patients receiving the drug. In the placebo group (with 638 patients), on average, 6.5 percent of the patients required an emergency room visit or hospitalization due to asthma during the study. In the dupilumab group (with 1,264 patients), on average, 3.5 percent of patients needed emergency care or hospitalization due to asthma.Based on the second study, Castro said another benefit of the drug could be the ability to wean severe asthma patients off of chronic oral steroids, which can cause debilitating long-term side effects, including stunted growth, diabetes, cataracts and osteoporosis. The second study included about 200 patients using the same inhaled asthma medications as patients in the larger trial, plus additional oral steroids -; usually prednisone -; to control their more severe symptoms. Half of the patients receiving dupilumab in this study were able to completely eliminate prednisone use. And 80 percent of dupilumab-treated patients were able to at least cut their doses in half. Patients on placebo also reduced prednisone use but to a lesser degree, likely because the protocols of participating in a clinical trial help asthma control generally.Castro said doctors would like to help patients rely less on steroids for asthma control because those with severe asthma can be forced to take these drugs for decades to enable them to breathe.”I have patients who have had to stop working and go on disability because their asthma symptoms are so severe they can no longer function in the workplace,” Castro said. “I’m excited about the potential of dupilumab because I have so many patients who have maxed out on available therapies and they still can’t breathe. It can become a very disabling disease.”Patients receiving dupilumab did experience known side effects of the drug, including pain and swelling at the injection site and a short-term bump in the number of eosinophil cells in the blood. Five patients who received dupilumab and three patients who received placebo died during the study period. According to the investigators and descriptions of these patients’ medical histories, all suffered from multiple severe medical conditions, and none of the deaths was deemed related to the study protocol.