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The first 3 rectors of Hungar's Parish were;
1) Wm Cotton, the first minister, from it's inception till his death, in 1640.
2) 1642, Nathaniel Eaton was the 2nd minister...he came from Mass, and left to return to England in 1646.
3) Francis Doughty, my ancestor. became the 3rd minister and is mentioned in many local records, ie....court records and, for instance, as mentioned in wills, such as that of Eleanor Empson, in 1661. Francis married Ann Graves Cotton Eaton, who had also been married to Wm Cotton and Nathaniel Eaton, the first 2 rectors. Francis left Hungar's by April 22, 1661 and by 1665 was referred to in Old Rappahannock Co court papers as the Minister of the parishes of Sittingbourn and Farnam. I know nothing of who served Hungars after my ancestor left in 1661, but do know who was there till that date...Cotton, Eaton and Doughty.
I did a quick google and found quite a few online sites with info about the Rev. Thomas...one that said "Rev Thomas Teackle a clergyman of the Church of Eng b 1624 in Gloucestershire Eng came to America in 1656 and settled at Craddock an estate in Accomac County." Have you tried to contact all the people that have posted info online? There seem to be a good many.
I found this one, too, that seemed to have a lot of info on the Rev. Thomas and many other Teackles.
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Thanksgiving is right around the corner. In the salon, the talk is all about the Thanksgiving dinner. Where are you going? Who's coming? Do you have to make the turkey or do you just get to bring a side dish? Dinner used to be turkey, stuffing, mashed potatoes, sweet potato/marshmallow casserole, carrots, turnip, cranberry sauce, [...]
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A humble man with hundreds of well wishers
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A French study has revealed there's been an increase in the number of women watching pornographic films and videos.
2:58PM, Nov 30
When the study was first conducted in 2006, 73% of female participants said they'd watched an X-rated film at least once before. But when the same study was conducted again recently, researchers found more than 80% of women answered yes to the same question.
And they're not just watching it with their partners. Fifty per cent of respondents said they've viewed porn solo.
"Women are now consuming porn by themselves," one of the study's researchers Francois Kraus said. "That goes hand in hand with a widening of sexual behaviour, and changing attitudes towards sex toys or fellatio for instance."
So what's behind the increase? Sexologist and relationship expert Dr Nikki Goldstein (drnikkig.com.au) said women's access to pornography has risen steadily with the growth of the Internet and technology.
"Watching porn is a pretty safe form of sexual experimentation; it's in the privacy of your own home. You can explore that without anyone knowing," Dr Goldstein explains.
It's also become more socially acceptable for females to explore their sexuality, she says.
"In general, women are taking back their control sexually. In pop culture we had Sex and the City push the boundaries, and then again just recently with Fifty Shades of Grey and the subsequent increase in the popularity of erotic fiction."
Dr Goldstein says the industry has acknowledged the female porn consumer and is catering to the demand.
"If you look at a lot of the porn stars [such as 'the Ryan Gosling of porn' James Deen] and materials that are out there, the market is providing for women. They've acknowledged there are a large number of consumers that are female."
"These days I think the more poignant question is 'why wouldn't women be looking at porn?'"
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I bought this bass combo looking for some quick cheap bass. Thats pretty much all I got for it. The amp does overheat and is entirely too small. For someone that's never installed a system before and this is your first bass system, it would be good and easy to learn on. But as far as power goes, it really doesn't cut it. For the money I paid you can't beat it.
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Broncos' Marshall may reportedly miss 3 months after surgery
ENGLEWOOD, Colo. -- Denver Broncos wide receiver Brandon Marshall has an injured right arm and the NFL Network reported Monday night he could take several months to recover.
In a story published Monday, Marshall told the Rocky Mountain News he had slipped on a fast-food bag while vacationing at a resort with his mother, father and siblings. He said there was nothing more to read into it than that and described his injury as "a little cut on my arm."
He repeated the explanation in an interview on satellite radio Monday.
The NFL Network reported Monday night, citing no sources, Marshall had severed an artery, a vein and a nerve in his forearm along with tendons to five muscles.
The NFL Network also reported Marshall told the team he was wrestling with family members when he got hurt.
Marshall underwent surgery on Saturday and will be in a cast for two weeks, then a splint for a month, the NFL Network reported, but he will be ready for training camp.
Neither Marshall nor his agent, Fletcher Smith, returned a phone message from The Associated Press. Marshall was at Broncos headquarters Monday, when the team's offseason strength and conditioning program got under way, but did not speak to reporters.
Team spokesman Jim Saccomano said Monday night that he had no information on Marshall's injury.
Also on Monday, a jury trial was postponed for Marshall, who is accused of driving under the influence. A new trial date was set for June in Denver District Court after his lawyer asked for a delay.
Marshall was arrested in downtown Denver on suspicion of drunken driving on Oct. 22, hours after he caught six passes for 77 yards in the Broncos' 31-28 victory over the Pittsburgh Steelers at Invesco Field.
Marshall blossomed into the Broncos' best receiver last year, catching 102 passes for 1,325 yards and seven touchdowns.
Copyright 2008 by The Associated Press
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State Highlights: Mass. Town Considers Total Tobacco Ban; Ohio Autism Program Changes
NFL Teams Face Federal Drug Inspections
Obama Uses Saturday Address To Urge Americans To Sign Up For Health Coverage
GOP Readies Strategy To Hobble Health Law
Memo To Gov.-Elect: Include Pain Sufferers As You Seek Opiate Solution
By Cindy Steinberg
Guest contrbutor
Cindy Steinberg is the policy chair for the Massachusetts Pain Initiative and the national director of policy and advocacy for the U.S. Pain Foundation.
"Charlie Baker vows to tackle state opiate problem," was the Boston Globe headline two days after Election Day.
It's good to hear from our newly elected governor that he plans to take steps to curb the ongoing problem with illegal use of prescription medication in our state. There's little doubt that too many lives are being harmed by drug abuse and addiction.
But in a quest to fix one problem, policymakers need to consider the potential unintended negative consequences for the patients for whom these medications are a lifeline.
Gov.-elect Baker said in that Globe interview that he plans to convene a coalition of lawmakers, health care providers and labor leaders to confront the opioid crisis in our state. Representatives of the pain community — an estimated 1.2 million Massachusetts residents live with chronic pain — must be included in these discussions as well.
For many with chronic pain, the right medications mean the difference between a life worth living or not.
But despite these legitimate needs, more and more I'm hearing from residents of our state who are unable to access treatment that their doctors say they need and that they depend on. These are not addicts; these are people who are trying to manage their lives with debilitating conditions such as cancer, diabetic neuropathy, sickle cell, daily migraine, fibromyalgia, severe back pain and many others.
Not including members of the pain community in discussions about how these medications are prescribed, regulated and controlled marginalizes the lives of thousands of Massachusetts citizens who live with pain caused by a myriad of conditions and serious injuries.
There is not a silver bullet solution to solving the abuse of prescription drugs. We need to take a thoughtful, multifaceted approach to ensure that those who need pain medication have access to it, and that those who choose to abuse these medications are stopped. There is no group more invested in making sure that medications are responsibly controlled than members of the pain community.
Last legislative session, Massachusetts lawmakers did take a step forward: they passed legislation on medications specially formulated to deter abuse.
"Abuse deterrent formulations" are opioids with physical and chemical properties that prevent chewing, crushing, grating, grinding, or extracting, or contain another substance that reduces or defeats the euphoria that those susceptible to substance abuse disorders experience. The new law requires insurance companies to provide the same coverage for the new abuse deterrent formulations as non-abuse deterrents, and they are not permitted to shift any additional cost of these medications to patients. It makes doctors more able to prescribe these medications without pushback from insurance companies.
Abuse deterrent formulations are not the only solution, but they are a good first step in balancing the legitimate needs of pain patients with the need to reduce medication abuse.
Other efforts must also include more robust education of medical professionals and of consumers to keep the medication out of the hands of potential abusers in the first place. Government statistics show that 78.5 percent of those who abuse prescription pain medication did not obtain them from a doctor themselves.
As someone who personally suffers from debilitating chronic pain, I have firsthand experience with the myriad challenges faced each day by the millions of Americans with severe chronic pain. I encourage Governor Baker to work to eliminate improper use of prescription medications, while remembering the medical needs of the chronic pain community.
Cindy Steinberg tweets at @CindySteinberg_.
First Edition: November 17, 2014
Insurance Exchanges Launch With Few Glitches
A Los Angeles furniture store worker who had never had health insurance enrolled in a plan for $75 a month that will cover both him and his son.
An unemployed accountant in Charlotte, N.C., who tried and failed to sign up last year found coverage for $11.75 a month.
A self-employed house contractor from West Palm Beach, Fla., found a health plan that will cost him nothing.
They were among more than 100,000 Americans who signed up for coverage Saturday through the Affordable Care Act's online insurance exchanges, which launched this weekend with far fewer problems and less fanfare than last year. Many people qualified for federal subsidies that kept their monthly premiums well under $100.
"The vast majority of people coming to the site were able to get on and do what they were intending to do," Health and Human Services Secretary Sylva Burwell said Sunday on NBC's Meet The Press, adding that 500,000 people had signed onto the website.
By most accounts, the federal marketplace that handles enrollment for 37 states ran smoothly — a far cry from last year's disastrous rollout that turned www.healthcare.gov into an embarrassment for President Barack Obama, spurred several staff departures and made the site virtually unusable for two months.
State exchanges that had encountered big problems last year — including Maryland, Massachusetts and Hawaii—all reported no major issues this weekend.
Still, there were some hiccups, with consumers and enrollment counselors facing sporadic delays accessing the website to set up an account and buy coverage. Some of those who bought coverage last year had trouble getting into their accounts because they had forgotten their passwords.
Meanwhile, the insurance exchanges run by 13 states and the District of Columbia functioned well — with the exception of the one in Washington state, which was shut down Saturday because it was giving out incorrect subsidy information. The site was fixed and back online Sunday morning.This KHN story can be republished for free (details).
To give consumers assistance, enrollment events were held across the country over the weekend, at hospitals, clinics, churches, community centers, malls, libraries – even at the Rock and Roll Hall of Fame in Cleveland.
"It was awesome," said Joy Floyd after she got help buying a plan for $11.75 a month at the Children and Family Services Center in Charlotte, N.C. She had tried and failed to sign up for coverage last year because of website problems.
Like most enrollees, Floyd will face additional cost-sharing as a result of deductibles and co-pays when she sees doctors, gets tests or buys prescriptions.
Uncertainties Ahead
Despite this year's far smoother opening, the enrollment process continues to face plenty of uncertainties, including the response of a confused and still uninformed public, among them 20 million uninsured who did not enroll the first year; a shorter enrollment period and premium increases that many of the 7 million people who bought coverage last year will face unless they shop around.
Recent political and legal developments also cast a shadow, including a hostile GOP taking control of Congress in January and the Supreme Court's decision to hear a challenge to the subsidies that millions of people have relied upon to reduce the cost of their coverage.
Ricot Telcy, 37, a West Palm Beach, Fla., security guard, knew nothing about the legal challenge, but was pleased to learn he and his wife could get coverage for about $300 a month—about the same price his wife had been paying for herself.
Across town, at an event at a medical society office, Rick Pierre, 40, enrolled in about an hour in a plan that will cost him nothing in premiums because he qualifies for a large subsidy. "I'm very excited," he said.
The Obama administration expects about 9 million people to get coverage on the exchanges before open enrollment ends Feb. 15. The marketplaces are a cornerstone of the health law because they help expand health coverage to millions of Americans who do not get health coverage at their jobs. More than eight in 10 people buying policies last year received a government subsidy to lower their premiums.
People must enroll by Dec. 15 if they want their coverage to start in January. In most states, those who bought coverage last year will be re-enrolled automatically if they do nothing by that date – a scenario that could result in higher costs since most premiums and benefits are changing.
The exchanges and the publicity around them also spurred millions of people to sign up for Medicaid, which has expanded eligibility under the health law in 27 states.
Some Wrestle With Higher Premiums, Confusion
In Philadelphia, Joseph Krakauskas, a retired 62-year-old, showed up two hours early at an enrollment event to secure a place at the front of the line. He has just found out that his current premiums were going to triple next year and he needed help finding a new plan. "This is almost like a bait and switch," he said of the rate increase. "I can't believe they're getting away with this."
Krakauskas wasn't able to access his account through the website, however. Still, a counselor found him an HMO plan for $128 a month, higher than he was paying last year, but about half of what his old plan would cost in 2015.
Despite the government's efforts to streamline the application, confusion and difficulty navigating the website also brought in many people, including Sarah White of Philadelphia, a mother of two.
"I have a doctoral degree," she said. "The fact that this is so complicated for even someone with [her education] is ridiculous. But here I am trying to get help and I have hope."
Demand for coverage was particularly high in California, where 1.2 million residents signed up for coverage last year.
By 9 a.m. Saturday, dozens had lined up for a festive enrollment event in Los Angeles sponsored by SEIU-United Healthcare Workers West. Most of the applicants came prepared – holding envelopes with pay stubs, birth certificates and Social Security cards. As each finished signing up, volunteers cheered, applauded and snapped photos.
Alejandro Irigoyen, 45, said he missed the deadline last year and didn't want to risk doing that again. When he injured his foot recently, he paid about $500 for a doctor's visit, X-rays and medicine. With the help of an enrollment counselor, Irigoyen signed up for a plan which will cover both him and his 23-year-old son for about $75 a month.
"I feel much more secure," Irigoyen said.
The enrollment event took place in a heavily Latino neighborhood, and most of the counselors spoke Spanish. California exchange officials had been heavily criticized last year for not doing enough to reach out to the state's large Latino population. Several of the families at Saturday's event said they hadn't previously enrolled in coverage because they have family members who are in the country illegally and feared telling the government too much.
After being reassured their information wouldn't be given to immigration authorities, Crescencio Lorenzo, 48, a legal resident, came to the enrollment event with his daughter, Andrea, a U.S. citizen, and his wife, Susana Lorenzo, 48, who is in the country illegally. He and his daughter enrolled in Medicaid. "They told us not to worry," about jeopardizing his wife, he said.
Weather And Glitches Are Issues In Ohio, Washington
Some enrollment events failed to draw consumers, including the "Rock Enroll" event at Cleveland's Rock and Roll Hall of Fame. Officials blamed snow flurries. By mid-afternoon, Barb Wynveen, a navigator with the Carmella Rose Health Foundation, said she'd had no walk-ins, and all of her half-dozen scheduled appointments had been a bust.
There was more foot traffic at Northeast Ohio Neighborhood Health Services, a community health center primarily serving the poor. Counselor Khalil Ismail met with Prempal Kaur, a woman in her 50s who spoke mostly Punjabi, and her daughter, Ravinder Kaur, who translated.
"She's a citizen. She's a widow, a single mother," explained Ravinda Kaur, who had traveled from Chicago to help her mother apply for insurance coverage. "And she works at the Convenient Food Mart, where she makes minimum wage."
Before she left, Prempal Kaur was enrolled in Medicaid.
In Washington state, meanwhile, the shutdown of the website to fix a glitch led people to start filling out applications the old-fashioned way — with paper and pen.
"It's incredibly frustrating," said Gary Zablocki, a 51-year-old carpenter at an event at the Southcenter Mall in Tukwila, a Seattle suburb.
Joanna Richards at WCPN in Cleveland , Elana Gordon at WHYY in Philadelphia, Ann Doss Helms at The Charlotte Observer, Nick Nehamas at The Miami Herald, Lisa Stiffler and Patrick Marshall at The Seattle Times, Jordan Shapiro at the St. Louis Post-Dispatch, Wes Venteicher at The Chicago Tribune and Robert Calandra at The Philadelphia Inquirer also contributed.
You Paid What? How Negotiated Deals Hide Health Care's Cost
As Americans begin shopping again for health insurance under the Affordable Care Act on Saturday, they'll be wrangling with premiums, deductibles, out-of-pocket costs and other vague and confusing insurance-speak.
Believe it or not, that's the easy part compared to figuring out what the overall cost of health care is.
Sal Morales of Miami bought insurance in March during the ACA's first enrollment period on healthcare.gov.
"I got my cards and it was like amazing," Morales says, "like if I got an American Express Platinum card. That's how I felt."
Morales was unemployed at the time. Money was tight. And he knew he needed regular doctor visits to manage his high blood pressure. He diligently researched what he would get for the price before settling on a plan.
"Instead of me paying $560 [a month] for COBRA, I found out that I would have insurance for $145. I have a network deductible of $500," Morales says. "My first three visits to a primary care physician, they're zero dollars. Then it's $5 out of my pocket."
Morales understands his end of the health care equation, but what he sees doesn't necessarily reflect what gets paid to doctors and hospitals for his care, says Bruce Rueben, president of the Florida Hospital Association.
Here's how he breaks it down: "There's one party, the hospital who provides the service. There's a second party, the patient, who receives the service. And there's a third party, the insurance, who pays for the service."This story is part of a partnership that includes WLRN, the Miami Herald, NPR and Kaiser Health News. It can be republished for free. (details)
That third part is where health care pricing gets really squirrelly.
Every hospital has its own "master list" of charges for different services. Those charges are different from hospital to hospital.
But insurance companies don't pay those listed charges. The listed charges are almost fiction. Instead, each insurer negotiates for lower prices with each hospital and doctor on every plan. And insurers can have multiple plans with multiple agreements for the same hospitals or doctors.
Even if two patients have the same insurer, if their plans are different, the insurer may pay the doctor differently for the same care for each of the patients.
All of this means there are about as many pricetags for that hypertension checkup as there are insurers and providers.
"For an individual consumer I am completely sympathetic that it's very confusing," says Dr. Ezekiel Emanuel, who was an adviser to the president during the drafting of the health law and is now a health policy expert at the University of Pennsylvania.
"There are at least six different prices for a hospital day. And then there's the cost of actually delivering the service, which, for most of these things, even hospitals don't know what that is. So when you say, 'What's the price?' It's almost a meaningless question, because there [are] all these different prices."
Those negotiated rates—the prices insurance companies really pay hospitals—are treated like trade secrets. Insurers and many hospitals don't want their competitors to know what the payments are
It is only on an individual basis that people can see the prices their insurer paid for their care. And it's after the care has been delivered and only if the person is already insured.
It's buried in a statement called an explanation of benefits. These are the letters from insurers that look like a bill but say "this is not a bill."
Efrain Monzon helps patients interpret those explanations for Florida Blue, the largest insurance company in the state of Florida.
"We're identifying the procedure, we're identifying the provider, the date of service and then making sure the amount, the member responsibility has to be in there," Monzon says.
Wedged into that statement somewhere between the billing code and the member deductible, is a column for the amount paid.
This is the secret number the insurance company and the provider have worked into their contract, says Monzon. The industry terms are usually "adjusted rate" or "negotiated rate."
In Florida Blue's explanation of benefits to patients, it's called simply "amount paid."
To get a clearer sense of what health care costs, someone would have to collect enough of those statements from patients at all different hospitals with all different insurance.
There are companies and crowdsourcing projects trying to do just that around the country. And Massachusetts has a law that says insurers have to disclose some of these prices in a way that is accessible to patients.
But so far, that's not happening in South Florida.
Sculpture in the Courthouse and the Law Library
In 1910, the American Antiquarian Society donated an 8-foot-4-inch-tall plaster cast of Michelangelo's statue of Moses to the Worcester County Law Library Association. Moses assumed a place of honor in the Worcester Courthouse in Lincoln Square. For 97 years thereafter, Moses became the meeting place within the Courthouse for lawyers and their clients. When the Courthouse moved down Main Street to its new location, Moses came along. Ten inch tall replicas of the statue are now for sale by the Worcester County Law Library Trust, initially offered to recoup the cost of repairs to the statue; but the smaller cousins have become coveted artifacts. The replicas are on view at the Worcester Law Library.
Any visitor to the John Adams Courthouse in Boston will be impressed by Domingo Mora's figural representations of sixteen ideas related to Law and Justice in the Great Hall. In the same location, there is a bronze statue of the nineteenth century attorney, Rufus Choate, by Daniel Chester French. A recent cleaning of the work has obscured the fact that practicing attorneys had a habit of rubbing Rufus Choate's left foot for good luck before going into the Courtroom, giving it a particular shine.
Prominent among Daniel Chester French's teachers was a sculptor named Thomas Ball. One of Ball's favorite subjects was orator and attorney Daniel Webster. In 1853, a series of bronze casts were made of Ball's clay statuette of Webster. Examples of these statuettes are currently in the collections of the U.S. Senate and the Metropolitan Museum of Art, and on view at the Berkshire Law Library. In 1876, Ball went on to sculpt a much larger (14') version of the statute that stands today in New York's Central Park. At the Law Library, Daniel Webster has a series of festive hats (several top hats, a straw hat, a sombrero) that he can be seen to sport.
Art appreciation, in the case of the statues of Moses, Rufus Choate, and Daniel Webster, is about looking and recognizing the story that is there waiting to be told.
New Mass. Health Connector Website Works, But Problems Remain
Here's the report as of 2 p.m., six hours after the state launched a new website for residents who want to buy insurance or are signing up for free or subsidized coverage.
- 2,117 enrolled in MassHealth (the state free Medicaid program)
- 1,923 shopped for subsidized or unsubsidized insurance
- 477 people selected a plan
The Connector does not know how many people received error messages and had to start over. But here's a sample of complaints posted to the Connector's Facebook page.[Storify]
The Connector says the average wait time for those who were instructed to call the Connector's help center was 20 minutes this morning, but has been eliminated because the Connector added more customer service reps Saturday afternoon.
Some people were able to enroll with few, if any problems.[Storify]
So the new site works and that, by itself is a success, say some people who've struggled to enroll or help residents do so for the past year. But lots of people are asking why — when the state has spent $254 million between the old, failed site and this new one — they are still having so much trouble signing up for a health plan.
New Health Connector Website Launches
Updated at 1:30 p.m.
The new Health Connector website for Massachusetts launched successfully Saturday morning and was working as designed upon launch.
"All right, everyone ready to see this thing go up live? Let's do it," Maydad Cohen, who oversaw the effort, said to applause just before 8 a.m. Saturday.
The new website allows Massachusetts residents to browse health plans, find out what program they qualify for and complete an application during the open enrollment period between Nov. 15, 2014 and Feb. 15, 2015.
They will also be able to compare plans, including premiums, co-pays and benefits. People who meet income eligibility requirements can get help paying for their coverage through the Health Connector or free coverage through MassHealth.
Nearly a year ago, the former site crashed repeatedly and the state spent millions of dollars to launch the redesigned site.
Deputy Medicaid Director Robin Callahan said the governor's involvement in the redesign meant a lot to the team building the site.
"I think that's one of the things we didn't have the first time around — a real organizing, strong presence," Callahan said.
Jean Yang, executive director of the Health Connector, said she's excited about the new site, compared to last year's.
"A difference of night and day, for the very first time we're going to be seeing people getting determined for qualified health plan, real time," she said.
The state expects more than 400,000 people will get their health insurance through this website.
Clarification: This post's headline was updated to reflect the fact that the website appeared successful upon launch, but more information is forthcoming about its performance.
Tip on Medicare Spurs Insider Trading Investigation
State Health Insurance Exchanges Hope To Woo Urban Minorities
Tomorrow it begins again – open enrollment for Obamacare. Two very successful state health insurance exchanges, Connecticut's and California's, are both intent on reaching people who avoided signing up last year – especially young Latinos and African-Americans.
"The big takeaway for us last year was that the uninsured were really pocketed in a couple of key, large cities," says Jason Madrak, the chief marketing officer of Access Health CT, in Connecticut. In light of that, he says, the exchange has changed its ad strategy.
"We've dialed up some of the more locally-focused efforts while we've dialed down some of the broader efforts," he says.
The uninsured people Madrak's trying to reach tend to be young, male, urban and Hispanic or African American. They also "aren't really consumers of traditional media," he says.
They don't necessarily read the big daily newspapers and they don't watch mainstream TV, so they can be harder to reach. So Madrak is spending his media money on ads in community newspapers and on local television and radio.
Reaching potential customers is the first half of the job. The second half is figuring out what to tell them. One emphasis is on money, like in this TV ad with a barber asking his customer if he has health insurance. When the customer says, "No, I can't afford it," the barber says, "Now, you can, with Access Health CT, since you may qualify for help to pay for your coverage."
Madrak says the messages of ads that appear later in the open enrollment period, as people are starting to think harder about choices, will be more specific about the cost of the insurance.
We need to go from a culture of coping to a culture of coverage.- Peter Lee, executive director, Covered California
"If I say 'affordable,' nobody really knows what that means," he says. "If I say, 'I can get you a plan for 20 bucks a month with tax credits,' that means something to somebody at that point."
California health officials are also deploying a new and (they hope) improved campaign to woo Latinos. Last year, Covered California made a series of missteps. First, the exchange had only a handful of Spanish-speaking counselors at the call centers. And the Spanish advertising campaign was riddled with cultural oversights.
Among the worst gaffes: Some Latinos who worried that signing up would get undocumented relatives in trouble were shown a written promise from President Obama to the contrary – a note that, unfortunately, was printed on letterhead of U.S. Immigration and Customs Enforcement.
Covered California says it has learned from those mistakes. Peter Lee, the executive director, says this year, the agency is doubling down on making sure Latinos get the right messages.This story is part of a partnership that includes WNPR, KQED, NPR and Kaiser Health News. It can be republished for free. (details)
"We're actually spending more money on outreach, education, and marketing this year for a three-month period than we spent for six months last year," he says.
The agency has hired 200 new call center counselors who speak languages other than English, Lee says. It is enlisting more trusted community organizations to allay fears about deportation. And it's rolling out a new ad campaign tailored specifically to Latinos.
"Every person you see [in these advertisements] that is a Spanish speaker is a Latino who got coverage through Covered California this last year, and it made a difference in their lives," says Lee.
This new video commercial shows pages of immigration documents flying into a safety vault – accompanied by verbal assurances that the application process is confidential.
But the main challenge, Lee says, is persuading Latinos to buy something they don't believe they need or is worth the price.
"They've adjusted to a culture of coping," he says. "We need to go from a culture of coping to a culture of coverage."
Still, a woman in a recent focus group in Connecticut showed Madrak that even the best messages might not work.
"She said, 'Listen, I saved everything that you guys sent me,' " Madrak says. " 'I have a box of postcards and letters that you sent me because it has the phone number on it and I wanted to save it.' And we said, 'Did you call?' And she said, 'No, I never called.' And we said, 'But you saved it all!' And she said, 'I know, I knew it was important; I just never got around to actually doing it.' "
That, Madrak says, is the big, continuing challenge.
Open enrollment runs from Saturday, Nov. 15 through Feb. 15, 2015.
This story is part of a reporting partnership that includes WNPR, KQED, NPR and Kaiser Health News.
Yes, Medicare Will Cover Lung Cancer Scans For Longtime Smokers, But…
…to finish the sentence in the headline: But it was not the simple no-brainer that you might think.
Lung cancer is the biggest cancer killer of all, causing 160,000 American deaths a year. But should we use lung scans to screen longtime smokers en masse for it? That question has been vigorously debated of late in medical circles, as Medicare has weighed whether to pay for the scans.
This week, Medicare announced that it did indeed propose to cover annual low-dose CT scans for smokers and former smokers, ages 55 to 74, with a smoking history equivalent to a 30-year pack-a-day habit. (More details here.)
The draft decision now gathers public comment for a month and will still need to be finalized, but cancer activists and some doctors are already hailing it as a victory. Laurie Fenton Ambrose, president of the Lung Cancer Alliance, which had helped lead the push for the coverage, predicted that the scans would save tens of thousands of lives.
So why has screening for lung cancer sparked such hot debate? Why did it even recently trigger a rare point-counterpoint duel in the pages of a major medical journal, JAMA Internal Medicine?
Well, first, the pendulum has been swinging lately towards greater skepticism about routine cancer screening, from mammograms to prostate tests.
At issue is the pivotal question of whether some forms of cancer screening do more harm than good, given that some of the tumors they pick up would never have caused any trouble. Routine blood tests for prostate cancer have fallen out of favor, for example, and the New England Journal of Medicine just published a cautionary tale from Korea about how mass ultrasound scans for thyroid cancer saved no lives.
So that's the broader medical context. Then there's the money. I recently heard a Medicare official say with pained realism at a public forum, "We can't cover everything good." Close to 5 million people on Medicare would be eligible for the screening, NPR reports, and the scans cost an estimated $241 each.
So at a time of greater emphasis on health costs and greater doubts about cancer screening, "We just found ourselves caught in that crossfire," said Fenton Ambrose of the Lung Cancer Alliance.
With lung cancer, there's also the question of special stigma. People say "You deserve this because you brought it on yourself, and thus, suffer the consequences," Fenton Ambrose said. "It has always had that type of stigma, that even carried through in some of the public comments that came forth during the Medicare consideration."
Dr. Chrisopher Lathan, a medical oncologist at the Dana-Farber Cancer Institute, similarly cited stigma as a source of "hesitation" on the coverage. "This is a cancer that's heavily linked to a behavior," he said. "The amount of data needed to convince everyone that this was a good screening tool — that hurdle was much higher. And also, we are in a more skeptical time, academically, when we look at screening. We know that screening is good, but it's good in certain circumstances."
Which circumstances, when it comes to lung scans? This is the moment for the Public Service Announcement that says, "Talk with your doctor."
"At the end of the day, this is about the relationship between doctors and patients," Fenton Ambrose said. And in particular, there are some gray areas that require discussion, she noted. What if, for example, you're a bit younger, or smoked a bit less than the cut-off? Research is now under way on that "second tier" of potential scan subjects, she said.
The Harvard Health Blog offers this guide to risks of lung cancer CT scanning you might want to discuss with your doctor:
•False alarms. In the New England Journal of Medicine study, about a quarter of people who had low-dose CT screening for lung cancer had positive tests, which set them up for additional CTs, bronchoscopies, or biopsies. Ultimately, only about 5% actually had lung cancer. False alarms can be quite stressful, and the additional testing can cause problems.
•Radiation exposure. Although the risk is low, some people develop radiation-induced cancers.
•The test could pick up a cancer that is unlikely to cause problems in your lifetime.
•Availability of quality testing. It's important to have CT screening at a medical center that has experience in lung cancer screening and treatment and that offers follow-up counseling based on your results.
For those who like to delve into the stats themselves, the numbers abound. The one most often cited by scanning supporters comes from a big, gold-standard study called the National Lung Screening Trial, which found that screening cut cancer mortality by 16 percent. From the "pro" paper in JAMA Internal Medicine:
The National Lung Screening Trial (NLST)9 randomized 53 454 patients at high risk of lung cancer to 3 annual screenings with low-dose CT or single-view posteroanterior chest radiography. The trial was stopped early when interim analysis demonstrated a 20% lung cancer mortality benefit. A follow-up analysis recalculated this as an overall 16% benefit, but with a substantially greater benefit in women than in men (27% vs 8% mortality reduction).
But even now, with the new endorsement from Medicare, low-dose CT scans may remain a tricky decision for doctors and patients.
In a recent update in their series, "Slow Medicine," Dr. Pieter Cohen of Cambridge Health Alliance and Dr. Michael Hochman of Altamed Health in Los Angeles expressed their lingering reservations:
In routine practice many things change compared to a carefully done randomized controlled trial — the expertise of the radiologists, the meticulousness of follow-up and carefully ensuring the correct selection criteria (avoiding indication creep). But even when all this was carefully managed in the NLST [National Lung Screening Trial] there was still a 96% false positive rate from the CT scans which would certainly increase in the community…
The key article used to promote this practice — the NLST — has an extremely key flaw: smoking cessation was not offered/provided prior to randomization. No one should be screened for lung cancer using CT or any other test if they haven't already been offered comprehensive, state-of-the-art smoking cessation. But even if smoking cessation is offered first, we are not convinced that the management of abnormal CT scans in the community will be able to live up to what was achieved in the NLST.
Dr. Lathan of Dana-Farber cited another concern: that smokers who get CT scans and check out healthy may become likelier to keep smoking — though there's no data to bear that out, he said.
As the scales tip toward lung-cancer screening, he said, patients should seek out high-quality screening centers — and among other things, that means making sure there's a quit-smoking program included.
"All these screening programs should also be tied to a smoking cessation program," he said, "so that you can use it as a teachable moment for a person who might be smoking. If they're smoking, you can say, 'Whoa, would you like to quit smoking? Yes, we're going to do your CT scan, screen you for lung cancer, but let's address your smoking issue at the same time."
To end on a hopeful note: Dr. Edward Benz, president of the Dana-Farber Cancer Institute, said this week on Here & Now that he thinks many of the controversies over cancer screening — like this one — will soon give way to more targeted strategies.
"I think that the future, and the not-too-distant future, will be that we will be able to use other tests to pull out of the population those people at highest risk, where those screening tests will have the most effect," he said.
Readers, thoughts? What do you think of the Medicare decision?
Bullying Is Ageless: Conflict And Violence Widespread In Nursing Homes, Study Finds
By Nell Lake
Guest Contributor
For Eileen, who is disabled and reliant on a wheelchair to get around, life in a nursing home isn't easy. Particularly when it comes to the other residents: "There's this guy," she says. "He made advances to me all the time. I did not want his advances. Many times I had to take my grabber and actually strike him to get him to leave me alone." Another resident, Eileen says, is a "real bully. She has terrorized quite a few people. She tries to boss people around. She says harassing things."
In coping with this type of hostile behavior, Eileen (who asked not to be identified) has plenty of company. New research released last week shows that aggression among residents in nursing homes is widespread and "extremely high rates of conflict and violence" are common, according to study author Karl Pillemer, professor of gerontology in medicine at Weill Cornell College of Medicine in New York. His stark findings, presented at the annual meeting of the Gerontological Society of America: One in five people living in the nursing facilities studied was involved in at least one "negative and aggressive encounter" with another resident during a four-week period.
"In most environments — say my work environment at a university — someone yelling at me angrily is so unusual that it would keep me up all night worrying about it," Pillemer says. Yet such conflict in nursing homes appears to be routine.
Abuse and Mistreatment
As part of the study, researchers examined patient records at ten nursing homes in New York state, interviewed staff and residents, and recorded incidents through direct observation. In a sample of more than 2,000 residents, 16 percent were involved in incidents of cursing, screaming, or yelling; about 6 percent in physical violence such as hitting, kicking, or biting; one percent in "sexual incidents, such as exposing one's genitals, touching other residents, or attempting to gain sexual favors"; and 10.5 percent in events researchers labeled "other" — residents entering rooms uninvited, for example, or rummaging through others' belongings.
Abuse and mistreatment of the elderly in general — in their homes and in nursing facilities — is a serious and growing problem. The elder population is burgeoning; the number of vulnerable elderly is increasing; more and more people need care—and nursing homes are often understaffed. Because abuse is usually hidden, data on abuse is difficult to gather. The problem is very likely vastly underreported, according to the National Center on Elder Abuse. Surveys tend to miss elders who don't have a phone, who are too frail to answer it, or who can't respond truthfully about their situations because their abusers are present. Research finds that at least one in ten elderly people who live at home experience abuse each year, according to the National Center on Elder Abuse. (This figure does not include financial mistreatment.)
The great majority of abusers in these cases are family members. Rates of abuse are especially high among elders with dementia: as many 50 percent of people with Alzheimer's and other dementing diseases may be mistreated.
Abuse of elders by staff in nursing homes is also pervasive. One survey of certified nursing assistants found that 17 percent of CNAs had physically abused residents, 51 percent had yelled at them, and 23 percent had insulted or sworn at them.
Crowded Conditions and Understaffing
Resident-on-resident aggression has received less study and publicity — but "it happens all the time," says Diane Menio, executive director of the Center for Advocacy for the Rights and Interests of the Elderly in Philadelphia. Pillemer's study found that the residents involved tend to be among the more active and cognitively intact in a nursing home — they're the ones who are more engaged.
Mild to moderate dementia is clearly a factor in much of the aggression, however, because it causes disinhibited behavior. Other factors, Pillemer says, include:
• Crowded conditions: The study found higher rates of mistreatment in more crowded facilities, and in areas within facilities where residents were more densely gathered.
• Understaffing: The study found higher rates of resident-on-resident aggression in nursing homes with lower staff-to-resident ratios.
• Nursing-home workers who are inured to the problem: "Staff can become somewhat blinded to this," Pillemer says, "because of the frequency with which it occurs."
• Conflict's cyclical nature: "The negative behavior and effects are contagious," Pillemer says. "Seeing these incidents causes other residents to be fearful, anxious, concerned—and that can lead to more of the behavior."
The prevalence of such aggression raises questions about how well U.S. nursing homes are meeting the great and growing need for compassionate, skillful long-term care. In many ways, aggression among nursing home residents is more complicated than other forms of elder abuse. When a family member or nursing-home worker abuses a vulnerable elder, the perpetrator is clear. But resident-on-resident aggression is more systemic and much less clear cut.
It needs to be addressed, many experts believe, not by thinking in terms of perpetrator, victim, and punishment, but by looking at causes and prevention — by improving care. Laura Mosqueda, a practicing geriatrician and director of the National Center on Elder Abuse, believes that nursing homes should be seen as responsible for easing aggression. "Let's not forget that the people [in this study] … are some of the most vulnerable members of our society. Even if they're the ones who are 'perpetrating' some of this, they're not the ones who should be held accountable," Mosqueda says.
If, for example, inadequate staffing is linked to the problem, as the study found, then facilities should hire more staff, she says.
Mosqueda, Pillemer, and others say that staff need to better understand the root of the problems. For instance, Pillemer asks, "Is someone being aggressive because they're in pain? Are they being aggressive because they're hungry or bored? Personalizing the care for residents, understanding why they [become aggressive], and looking for individual solutions are very important."
Life Histories
Alison Hirschel, the elder law attorney for the Michigan Poverty Law Program and director of the Michigan Elder Justice Initiative, agrees. She cites cases in which relatively simple adjustments by nursing-home staff eased elders' "difficult behaviors." One man, a former police officer, had worked the night shift for decades before going into a nursing home. Staff expected him to sleep at night; but he found this impossible, and became frustrated and aggressive. Eventually the nursing aides figured out what would help. They gave him a clipboard and allowed him to wander around his unit at night. His frustration and challenging behaviors eased.
Another woman, who'd lived in an abusive orphanage as a child, did better when treated in ways that didn't trigger terrifying memories. And a blind resident needed to hear from staff the steps they'd take as they bathed her.
Such adjustments by staff require knowledge of residents' emotional needs and of their life histories — not just of residents' medical charts. Acquiring such knowledge takes greater effort and skill, but Pillemer says that workers are generally eager to learn how to better address aggressive behaviors. "Staff feel very powerless to deal with this," he says. "They don't quite know how to handle it."
He believes that better training for nursing-home workers is essential to help them deal with aggression more skillfully, to protect residents and to keep themselves safe. "These violent and aggressive and conflictual incidents are extraordinarily stressful for staff," he says. Workers, too, are at risk of being injured.
Hirschel, the lawyer, acknowledges that not all difficult behavior can be solved through simple, compassionate adjustments to residents' treatments and circumstances.
"Residents with these behaviors do have a negative impact on other residents," she wrote in an email, and "sometimes these issues are really intractable and challenging for even the most skilled and thoughtful staff."
Diane Menio, the elder advocate in Philadelphia, tells a story about her own experience with "problem behavior" in nursing homes — her mother's. Menio's mother had Lewy-Body dementia (which can cause hallucinations) and lived in a facility at the end of her life. The staff at the facility loved her mother, Menio says, and saw her as "a sweetheart." But one day, in a dining area, Menio's mother threw water from her glass at a woman sitting at the same table. The woman had been bothering her mother. Not long after, staff sat the same woman next to Menio's mother, who again threw water.
"So they wanted to medicate my mother" with a psychotropic drug, Menio says. This, Menio believed, was misguided. She asked the staff to keep the two women separate, and her mother never threw water again.
Menio's story highlights a tricky issue. In 1987, a federal law declared that residents have "the right to be free" from both physical and chemical restraints when these are not required for treating medical symptoms.
The law was responding, in part, to practices in nursing homes such as tying "difficult" residents to beds or chairs.
No More Bullying
Today antipsychotic drugs are still used in nursing homes, usually therapeutically but sometimes as "chemical restraints" in response to difficult behaviors. With reform, such use has declined. While the Weill Cornell study illuminates the problem of resident-on-resident aggression, Mosqueda says, this shouldn't mean "we end up putting people back in restraints."
As with many complex issues, the first step toward easing resident-on-resident aggression, many experts agree, is greater recognition and understanding of the problem. Pillemer recalls the days when bullying in schools was considered normal — a dynamic that kids needed to tolerate and learn to deal with. "The idea that we'd even tell our parents [about being bullied] was inconceivable," he says.
"Now things have changed, and standards have changed, and schools are taking on no-bullying policies. I think the same thing needs to happen in the nursing home context. The goal of this study was to show that this is a very frequent phenomenon — a disturbing and potentially damaging phenomenon for probably everybody in the nursing home setting. We need to begin the search for good solutions."
Nell Lake, a journalist and magazine writer, wrote the new book, "The Caregivers: A Support Group's Stories of Slow Loss, Courage And Love" in which she chronicles the lives of family caregivers over two years. She lives in Western Mass.


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"Great book for psychopaths"
The history is great. There's good character development, the reading is adequate, the book is generally well written... Yet, the majority of the book is spent focusing on making life as miserable as possible for the protagonists you care about. Imagine your sister being raped then locked in a dungeon. Now imagine reading a story about it. You would have to be a psychopath to enjoy it, and that is what this book is like.
"Good build up but not a great finale, entertaining"
Yes. History told balanced with fictional and entertaining characters
The build up and the development of the characters were great, however, their influence on the finale failed a bit. I think that keeps this book from becoming an all time classic.
Great performance


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Government criticised for following anti-farmer policies
Melukote MLA and farmers' leader K.S. Puttannaiah has alleged that the government polices have forced farmers to run from pillar to post for just minimum support price for agricultural produce.
He was speaking at a farmers' conference here on Tuesday, organised by the Karnataka Rajya Raitha Sangha (KRRS) and Hasiru Sene.
"Running from one office to another with an application seeking just minimum support price for agricultural produce is an indication of slavery. Our struggle is just against unjust policies," he said.
These anti-farmer policies had pushed farming community out of villages, he said. He demanded that a separate commission be formed to deal exclusively with farmer-related issues. Mr.. Puttannaiah urged the government to come up with a policy of encouraging agriculture-based industries to overcome agricultural distress. He announced that a delegation of farmer leaders would soon meet Chief Minister Siddaramaiah to discuss irrigation-related issues of the Krishna and the Tungabhadra command areas. Earlier, Chamarasa Mali Patil, State president of KRRS, urged the government to encourage export of Sona Masuri with a special policy.
The conference, which was attended by farmers from Raichur, Koppal, Bellary, Yadagir and Davangere districts, took five resolutions, including an MSP of Rs. 2,000, Rs. 6,500 and Rs. 1,500 a quintal each of paddy, cotton and corn, respectively. They demanded withdrawal of new levy policy enforced to ensure supply of rice for Anna Bhagya scheme.


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Frank Miller
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Frank Miller is an American writer, artist and film director best known for his film noir-style comic book stories. He is one of the most widely-recognized and popular creators in comics and is one of the most influential comics creators of his generation. His works include BATMAN The Dark Knight Returns, BATMAN: THE DARK KNIGHT STRIKES AGAIN, ALL STAR BATMAN & ROBIN, THE BOY WONDER, Sin City and 300.
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updated100 BULLETS VOL. 4: A FOREGONE TOMORROW
In the fourth collection of this series, Agent Graves continues to offer immunity to everyday people to carry out their innermost desires of vengeance with the 100 bullets that he supplies. But as these self-serving manipulations take place, pieces of the mystery of the Minutemen and the organization that created them start to come together, and we discover to the research and conspiracy theories of Mr. Branch. As more is revealed about the series' main characters, the true meaning and importance of the conflict between Graves and the Trust starts to emerge.


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CRITICS' CHOICE: Posh People: Inside Tatler
BBC Two, 9.00pm
Stuffed polar bears. Side-saddle races. The Debrett's-approved way to eat a pear (with a spoon, apparently). Welcome to the rarefied universe of Tatler: the world's oldest magazine, which has been reporting on the privileged and powerful for 300 years. The institution not only documents but dictates the social calendar of Britain's upper class. Now this three-parter goes behind-the-scenes at the glossy lifestyle monthly.
Cameras are greeted by editor Kate Reardon (a J K Rowling lookalike and self-confessed "honking great Sloane") and follow new writer Matthew Bell over his first months in the job, as he struggles to go from middle-class outsider to privileged insider. Unfortunately, most of the chinless staffer's duties seem to involve being turned away from places. We watch the team attend sumptuous social events and meet people featured in the magazine: Lord Glasgow, rattling on about his 13th-century Scottish castle, and Nigerian energy magnate Kola Karim, who doesn't know how many cars he owns.
There are debates about the relative merits of labradors, labradoodles, whippets and pugs. There are polo matches, garden parties, catwalk fashion shows, and a visit to Oxford in search of the Bullingdon Club, with cameos for everyone from the Queen to Anna Wintour, Jilly Cooper and Christopher Biggins. Narrated by Laurence Fox, this is fun, frothy and enjoyably nosy — rather like Tatler, in fact. MH
Don't Mess with Me
BBC One, 9.15am
In a new series airing daily this week, Margaret Mountford puts her fearsome glare to good use by imploring the people of Britain to stop littering. With over 30 million tonnes of rubbish dropped every year, Alan Sugar's former aide wants to find out exactly what it would take to keep the country's streets clean — first, a visit to Brighton Beach at sunrise shows the amount of work it takes to reverse a night of drunken debauchery. NV
Discovering: Brigitte Bardot
Sky Arts 2, 7.00pm
Film directors, critics and fashion editors all offer opinions on the impact and legacy of Brigitte Bardot. The film charts the rise of the movie siren, the media frenzy that once surrounded her, and lows such as her failed relationships, depression and suicide attempts. SH
Turner Prize at 30
Channel 4, 7.55pm
Founded in 1984, the Turner Prize has become one of the most valued accolades in the art world. Five short films this week will pay tribute to some of the most significant winners – Damien Hirst, Steve McQueen, Rachel Whiteread and, starting tonight, Grayson Perry. NV
Dispatches: How to Break into Britain
Channel 4, 8.00pm
Venturing deep inside the camps at Calais, reporter Paraic O'Brien meets those who are willing to put their lives on the line for the chance to get into Britain, and exposes the people-traffickers who operate there. NV
Channel 4, 9.00pm
Following last year's spell in Scunthorpe, this sympathetic, eye-opening series returns to tell the stories of those in long-term unemployment. Now in Grimsby, formerly the largest fishing port in the world, part one of three sheds light on former fishermen who after a lifetime working at sea are struggling to make ends meet. NV
Channel 5, 9.00pm
By-the-book Detective Gordon (Ben McKenzie) informs Captain Essen (Zabryna Guevara) of his plans to make big arrests in connection with the Wayne murders. Elsewhere in the fast-paced Batman prequel, Fish Mooney (Jada Pinkett Smith) is incensed to learn that Cobblepot is still alive — and she wants Gordon to pay. NV
Dancing Cheek to Cheek: an Intimate History of Dance
BBC Four, 9.00pm
Len Goodman and Lucy Worsley return for another sally into Britain's relationship with dancing. The pair begin by exploring how the Victorians suddenly embraced faster and freer dances. The episode takes in the arrival of the waltz and the origins of the polka (and explains why such dances were seen by some as debauched), the popularity of clog dancing in factories and mills and why gin palaces were perfect for a "knees-up". SH
WW2 Air Crash Detectives
Yesterday, 9.00pm
Garth Barnard investigates why so many airmen in the Second World War died not in combat but in air accidents. Reports often gave "pilot error" as the reason, but Barnard isn't so sure. He begins by asking why a B-52 bomber crashed into a mountain in Virginia in 1943. SH
CRITICS' CHOICE: The Paedophile Next Door
Channel 4, 9.00pm
This one-off documentary asserts that a quarter of a million paedophiles live in Britain. Steve Humphries, who has previously worked to uncover sex abuse in the Catholic Church, tries to understand how paedophiles continue to operate despite heightened public and legal awareness. Historical cases of child abuse are also investigated and, speaking to survivors, Humphries learns the extent to which institutions for children such as care homes and boarding schools became a sanctuary for those looking to abuse. He also looks at some shocking facts from our past, for instance that the Paedophile Information Exchange – a network which campaigned for the legalisation of child sex in the Sixties and Seventies – was, for a time, taken seriously by the Home Office.
The documentary also turns a critical gaze on received ways of thinking, speaking to experts who believe that our culture is wrong to only engage with paedophiles once they've become offenders. Dr Sarah Goode works to create a non-judgmental environment in which potential paedophiles who have yet to act can receive treatment. One of these men agreed to be filmed in an effort to encourage others to come forward, totally aware of the risks of revealing himself on camera. It's a tense scene to watch, and must surely stoke the outrage it hopes to address.
As you'd imagine, the whole documentary is incredibly upsetting and uncomfortable viewing. And so it should be. JM
MasterChef: the Professionals
BBC Two, 8.00pm
The week's first heat sees five more chefs enter the kitchen, and take on three new challenges. As ever, they ease the chefs in gently, asking them to cook with such familiar ingredients as, erm, cuttlefish. Oh, and they have less than an hour to complete each dish. The competition continues on Wednesday and Thursday. AL
The Body in the Lake: Countdown to Murder
Channel 5, 8.00pm
This bleak documentary examines the events surrounding the killing of Carol Park, whose body was discovered by amateur divers in Coniston Water in 1997 — more than 20 years after she went missing. AL
The Missing
BBC One, 9.00pm
Parallel plotlines — one set in 2006, one in the present day — continue to simultaneously pull the audience in opposite directions in this gripping but heartbreaking drama. This week, in 2006, Tony (James Nesbitt) and Emily's (Frances O'Connor) pleas to reinvestigate a suspect fall on deaf ears; while in the present day, Tony and Julien (Tchéky Karyo) retrace their steps in Paris. AL
Secrets of the Castle with Ruth, Peter and Tom
BBC Two, 9.00pm
Historian Ruth Goodman and archaeologists Peter Ginn and Tom Pinfold continue to get stuck into one of the world's biggest historical experiments: attempting to build a medieval castle from scratch using authentic techniques. This week, they look at defensive features, so expect lots of larking about with catapults and crossbows. AL
The Real Tom Thumb: History's Smallest Superstar
BBC Four, 9.00pm
Michael Grade tells the story of the American entertainer General Tom Thumb, who was just 25 inches tall and yet in his day was a global celebrity who performed in front of Queen Victoria and Abraham Lincoln. Aside from looking back at an extraordinary life, Grade wonders if this is a story of exploitation and asks why even today we are drawn to performers with unusual bodies. SH
Penelope Keith's Hidden Villages
More4, 9.00pm
The conclusion of the series in which actress Penelope Keith tours some of Britain's villages. Tonight she is in Wiltshire, Dorset and Somerset (home of the fictional community in To the Manor Born) and visits Lacock, recreating the first-ever photograph of the village, and Castle Combe, the setting for War Horse. Ultimately, Keith is a spirited advocate for the preservation of village life. SH
Sky Arts 1, 9.00pm
History and psychology are thrown together in Jeremy Dyson's witty returning comedy in which a host of famous female figures (Anne Boleyn, Janis Joplin) seek help from therapist Rebecca Front. The supporting cast includes Frances Barber and Michelle Gomez. SH
Imagine... The One and Only Mike Leigh
BBC One, 10.35pm; NI/Wales, 11.05pm
Following the release of the highly praised Mr Turner, director Mike Leigh talks to Alan Yentob about the struggle to make films on his own terms, while actors including Jim Broadbent and Sally Hawkins offer insights into his distinctive style. AL
CRITICS' CHOICE: Confessions of a GP
Channel 4, 10.00pm
There was a time when the local doctor was the most respected member of the community and his prognosis was treated as gospel. This documentary, which follows a similar format to last week's Confessions of a Copper, shows how times have changed. It looks at the evolution of the job over the past 50 years, and, most importantly, its diminished status within British society.
We see interviews with several doctors who recall their early days in general practice in the Sixties, when sherry parties determined if you were worthy of a position. They discuss the level of trust the job once carried. For example, before the introduction of health and safety legislation and the actions of serial killing GP Harold Shipman, they were allowed to carry and administer powerful drugs. The legalisation of abortion and introduction of the Pill threw some into a moral quandary, mostly due to religious convictions, and they describe how, over time, patients grew less deferential, more demanding and, with the advent of the internet, turned into armchair doctors.
Despite some sombre issues addressed, the film's tone veers between serious and Carry On Doctor — it includes amusing clips of Sixties medics smoking, and in one segment the GPs share some of the abbreviations used in patients' notes, such as PAFO [P----d and Fell Over]. However, the overall feeling you're left with is of GPs' resentment of the box-ticking bureaucracy of today's NHS. VP
The Apprentice
BBC One, 9.00pm
What happens when you take the slickers out of the city? Alan Sugar sets his candidates loose in Somerset for the Royal Bath and West agricultural show, where they must sell specialist rural wares to local customers. Which boardroom bumpkins will need to pull themselves up by their welly-straps? JM
Great Continental Railway Journeys
BBC Two, 9.00pm
North-western Spain, with its wet weather, may not currently be a hit with British tourists. However it was a hugely popular holiday destination in the early 20th century. This week Michael Portillo revisits the land of his fathers, and on his way through the Celtic Galicia region to Portugal he joins a pilgrimage to the famous cathedral in Santiago de Compostela. JM
Liberty of London
Channel 4, 9.00pm
Managing Director Ed Burstell's six-year quest to modernise and Americanise Liberty continues. His latest idea for Regent Street's well-loved Tudor department store is to bring in Liz Silvester, who has recently revamped Kurt Geiger's visual identity. But what will those more sceptical of corporate rebranding make of it? JM
Benefits Britain: Life on the Dole
Channel 5, 9.00pm
The revealing documentary series returns, with the first episode focusing on the impact of the bedroom tax in Liverpool. Mark lives in the council house in which he was raised and cared for by his parents, one of whom was a war hero. But he now struggles to pay taxes almost double his income. JM
Ten Years Old & Living in Poverty: Through a Child's Eyes
Channel 5, 10.00pm
This heart-wrenching two-part documentary follows the plight of very young children who live in deprived conditions. One of these is 10-year-old Lyndsey, whose friends tease her because her possessions are all objects that have been found on the street. JM
The Legacy
Sky Arts 1, 10.00pm
Danish television has delivered high-class murder mystery and political thriller with The Killing, The Bridge and Borgen and now offers something different again with a tautly observed, slow-moving family drama which has shades of Thomas Vinterberg's 1998 film Festen. Set among a dysfunctional artistic family, whose matriarch, Veronika Grønnegaard (Kirsten Olesen), is an eccentric sculptor dying of cancer, Pernilla August and Maya Ilsøe's carefully woven tale delves into the impact her impending death has on her four children. One of them, Signe (Marie Bach Hansen), was adopted, and has only recently discovered that Veronika was her mother but has been bequeathed the family home. Cue sibling rivalry as old secrets and grievances are aired. SH
Forbidden Love: Happily Ever Avatar
Sky Living, 10.00pm
In this continuing examination of love and relationships in the 21st century, the series explains how new research suggests people are more likely to find a happy relationship by looking on the internet. Many couples meet not via dating sites, but through online games while being represented by an avatar. This film interviews couples who hooked up via games such as Second Life and discovers whether they met the expectations suggested by their virtual selves. SH
CRITICS' CHOICE: Life Story
BBC One, 9.00pm
After six episodes and a multitude of jaw-dropping film sequences capturing nature at its most awe-inspiring (who could ever forget the opening episode's tiny, tumbling goslings and their skull-cracking introduction to life's hard knocks?), David Attenborough's latest wildlife wonder series ends by coming full circle. We began with birth, struggled through childhood and adolescence, made it into adulthood and the quest to win a mate; now we come to parenthood and its struggles.
From the outset we are presented with the huge range of parental responsibility in nature: bonobos (pygmy chimpanzees) in the Congo, who play supportive roles in their offspring's lives for upwards of 30 years, are contrasted with female turtles on the Great Barrier Reef whose one act of motherhood is to find a safe place to bury their eggs and depart (though not without stomach-lurching drama along the way, to remind us how even these slow-moving matrons must suffer the ups and downs of nature's rollercoaster).
There are many affecting moments: a Canadian bison's valiant efforts to protect her calf from a wolf attack, a North African drongo's blindness to a first hatchling's ruthless determination to rule the roost. Most intriguing of all is an African elephant herd's response to coming across the sun bleached bones of a former family member – shedding a strange and quietly beautiful new light on the notion that elephants never forget. A stirring finish to a superb series. GO
The Great Interior Design Challenge
BBC Two, 7.00pm
As the semi-finalists fight it out to make it as the next big name in British interior design, they are each given neighbouring Victorian tenements in Edinburgh, and have four days to reimagine the reception rooms. Who will designer Daniel Hopwood and interior stylist Sophie Robinson put through to the final? JM
The Fall
BBC Two, 9.00pm
We are halfway through the second series of this controversial and well-crafted thriller. DSI Stella Gibson's (Gillian Anderson) search for the abducted Rose Stagg and serial killer Paul Spector (Jamie Dornan) continues at an ever heightening pitch. As the two nemeses move towards each other in ever-closing circles, Spector begins to taunt the obsessive detective. JM
24 Hours in A&E
Channel 4, 9.00pm
St George's Hospital in Tooting, south London, treats up to 400 patients a day. In tonight's episode of the award-winning observational documentary series, the medics have a race against time to save the sight of Iain, a 60-year-old who injured his eye in a work related fall. JM
Britain's Bloodiest Dynasty
Channel 5, 9.00pm
Fantasy writer George R R Martin based the shocking action in Game of Thrones on the real acts of our Plantagenet monarchs. This new documentary series, presented by historian Dan Jones, explores the true extent of the family's blood-lust and treachery. The first episode looks at Henry II. JM
Nigel Slater's Icing on the Cake
BBC Four, 9.00pm
Affable chef Nigel Slater goes on a nostalgic journey to chart the history of cake, showing that even Neolithic man snacked on the stuff, in the form of compacted handfuls of grain. He explains how the Elizabethans saw the benefits of using egg white in baking, why buns were once considered too risqué for "common" tastes and asks whether a love of cakes is a matter of mind over substance. SH
The Knick
Sky Atlantic, 9.00pm
Racial tensions rears its head in Steven Soderbergh's grimly intense period medical drama. After a series of racial attacks in New York by white thugs, Thackery (Clive Owen) takes the victims to the hospital. When they come under attack there, he and fellow surgeon Algernon Edwards (André Holland) hatch a plan. SH
South Bank Show Originals: Merce Cunningham
Sky Arts 1, 9.30pm
Recalling their 1980 interview, Melvyn Bragg explores why so many dancers chose to work with avant-garde choreographer Cunningham. The interview explores his work with John Cage, how he found inspiration from watching animals at Central Park Zoo and why he detests teaching, describing it as a necessity that is "the bane of existence". SH
Channel 4, 10.00pm
Commissioner Richard Miller (James Nesbitt) takes PR guru Liz Garvey (Brit Marling) into his confidence and decides to back the "Metwork": a police-run news division. But is this because he wants her to protect skeletons in his own closet? Meanwhile the Met deals with a bomb threat. JM
CRITICS' CHOICE: Alan Carr: Chatty Man / The Graham Norton Show
Channel 4, 10.00pm / BBC One, 10.35pm; NI, 11.05pm
Chatshows are often dismissed as cynical exercises in shameless plugging and celebrity backslapping. Indeed they are. Yet they're also an underrated artform and deceptively tricky to get right. Witness those who've tried and failed to get their own version off the ground: casualties over the last few years include Davina McCall, Lily Allen, Rob Brydon, Sharon Osbourne and, most recently, Michael McIntyre. So the current UK stalwarts of the genre — Jonathan Ross, Alan Carr and Graham Norton — deserve some credit. Ross has been at it for 27 years and gets his turn tomorrow night. Meanwhile, Carr and Norton — relative rookies at five and 16 years respectively — form a Friday double bill.
First off the blocks is bespectacled quipster Carr. His headline guest is comedian, actor, activist and column-inch-gobbling controversy magnet Russell Brand, who talks (no doubt using long words and Dickensian flourishes) about his new book Revolution. Mega-selling French DJ David Guetta also drops in.
Norton, as is usually the case these days, pulls in more heavyweight guests. His banquette of badinage will be filled by three A-list actors in Nicole Kidman, Julie Walters and Downton Abbey's Hugh Bonneville – who are all co-starring with a certain marmalade-loving bear from Darkest Peru in the new Paddington film. There's also music from Take That, now a three-piece in the wake of Jason Orange's departure two months ago. MH
Levitated Mass
Sky Arts 1, 6.00pm
Can a giant slab of rock be considered art? It's a question you might ask when watching the story of Michael Heizer's monolithic sculpture for the Los Angeles County Museum of Art. Doug Pray's film explores how Heizer found the rock he wanted for the installation (it weighed 340 tons) – and the public's reaction to it. SH
The Home that Two Built
BBC Two, 7.00pm; not NI/Scot/Wales
Mel Giedroyc, jaunty as ever, continues her foray into the BBC Two archive, looking at how the channel has influenced British homes for the past 50 years. With the help of vintage clips, she gives a light-hearted account of how, through their multitude of cookery, gardening and home makeover shows, BBC Two have long been trendsetters for the nation. NV
The Martin Lewis Money Show
ITV, 8.00pm
Today marks Black Friday, the unofficial start of the Christmas shopping season — and in timely fashion, the master of personal finance returns with a series chock-full of money-saving tips. Along with predicting when high-street stores will hold their festive flash sales, Martin and reporter Saira Khan show one family how much money can be made by selling unused clothes and mobile phones. NV
Marvel's Agents of SHIELD
Channel 4, 8.00pm
This episode of the superhero spy drama sees the world turn against SHIELD when enemy agency Hydra impersonate members of their team and launch an attack at the United Nations — however, Coulson (Clark Gregg) and co are surprised to learn who is leading the charge against them. NV
Citizen Khan
BBC One, 8.30pm
When self-professed "community leader" Mr Khan (Adil Ray) misses out on a reception with Prince Charles, he tries to use Mrs Khan's (Shobu Kapoor) farm as a way to rub shoulders with the future king. Despite being old-fashioned, this sitcom has its heart in the right place. NV
Channel 4, 9.00pm
In 2015, wine enthusiasts Steph and Dom Parker will share a tipple with Ukip leader Nigel Farage for a Channel 4 debate documentary. Until then, they'll continue to give boozy commentary on the best of the week's TV. NV
Acting Funny: Pioneers of Television
PBS America, 9.00pm
America's TV funny men and women take over tonight's episode of Pioneers with the late Robin Williams explaining the improvisational style he used for Mork & Mindy, while Tina Fey explains her highly prepared approach to Saturday Night Live and 30 Rock. SH
Play It Loud: The Story of the Marshall Amp
BBC Four, 10.00pm
The "father of loud" was the apt nickname of London drum shop owner Jim Marshall, who turned up the volume on rock music when he designed his own amp in the early Sixties. Looking back at Marshall's contribution to rock, the film shows how he gave a distinctive new sound to the electric guitar and how his amp was avidly taken up by the likes of Pete Townshend, Jimi Hendrix and Eric Clapton. It also points to the role of the rock spoof movie This Is Spinal Tap in the Marshall's fortunes. SH
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Posts by Zac Jackson
5 posts • joined 8 Nov 2007
iTunes, and Sting, banned from China
Cheers Fella, confirmation that I'm not going nuts!!! If I remember correctly, I was saying how I preferred living in China - go figure! I'm not entirely sure how this all works, but something's amiss.. Guess it serves me right for checking El Reg from work (government owned company). If you don't hear from me again, tell my parents I love them..... LOL!
Paris, because she's an innocent dear too...
Missing link....
Whoah!!! My comment that actually made it onto this forum last night (from inside China - I work over here), has mysteriously disappeared, and after my 'net connection's been down all evening...
China pardons iTunes (but not Sting)
Fallen foul...
... of this myself. Been in China for 2 years now (UK expat). I couldn't get on iTunes Store last week for some unknown reason, but my pre-subscribed pod casts all downloaded no problem. Yet still I couldn't access iTunes store - just got a network access error. I even went as far as re-installing iTunes but to no avail. Then I read on El Reg about the *ahem* "outage" of iTunes in China and all fell into place! I still wouldn't swap China for the UK. I feel less observed and free over here than I feel I would be in the UK. I was always jealous of those that had the bottle to leave cctv.tax.p1sstake.gov.uk, but now I'm out, living the dream. In the land of the free (!)....
Mine's the 'copter with patented tech from the US... :o)
Filesharing teen gets damages reduced in ignorance claim
US can't have it both ways...
She can't decide it's OK to sip on a Coors until she's 21... poor innocent child.
Paris, because she gargles Coors.
Babbling net software sparks international incident
Babelfish brilliance
I won't hear a word said against babelfish! Working over here in China it's an essential tool. I'd be lost without being able to understand my e-mails from Shiny Happy Jade like Budda delegating responsibility in his absence to steam riding urinating sheeps all...
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