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Novant reports lower net profit in 2014
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Novant Health said it had net income of $201.8 million in 2014, down from $273 million in the previous year. That included an investment gain of $28.9 million. Revenues increased 5.4% to $3.79 billion from 2013.
The Winston-Salem-based health care company said it provided $135 million of care to indigent and uninsured patients in 2014. Charity care for indigent patients ranged from providing flu shots to comprehensive cancer treatments.
"Novant Health managed itself with a strong sense of financial responsibility as we prepare for continued changes in the health care industry," CEO Carl Armato said in a prepared statement. "Strong financial results are necessary for us to reinvest in our communities, facilities and team members. I am proud of our organization's efforts to transform, lower costs and find efficiencies in our operations."
Bad debt was $190 million, slightly higher than 2013.
The organization invested more than $266 million in capital for construction projects, equipment replacements and the implementation of electronic health records. Construction of Novant Health Haymarket Medical Center in northern Virginia, which opened in 2014, was a significant expense. Seven medical centers converted to electronic health records as part of a $600 million, multiyear project. Among those converting were Novant Health Charlotte Orthopedic Hospital and medical centers in Huntersville, Matthews, Kernersville, Clemmons and Winston-Salem.
Novant Health boosts the North Carolina economy by nearly $6 billion, according to a 2013 economic impact study. The organization supports more than 44,000 jobs and $2.4 billion in salaries, wages and benefits in the state and generates $623 million in tax revenues, according to the study.
Report: N.C. State offers best value
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For a good education at a good price, N.C. State University offers the best value in the state, according to a recent study by personal-finance website SmartAsset.com.
The state's public university system has a national reputation for its quality and affordability, and seven of the 10 schools deemed as the top values are members of the UNC system. Campbell University in Buies Creek and Davidson College also made the list.
The New York-based company looked at five factors to come up with the rankings: average scholarship and grant funding, starting salary upon graduation, tuition costs, living expenses and retention rate.
Each factor was given equal weight.
UNC Chapel Hill ranked second and Duke University ranked third on the list. Duke graduates had the highest starting salary among the top 10, at $55,900. The Durham-based university also awarded the highest average scholarship and grant money, though its tuition was highest at $43,623.
N.C. State ranked 15th nationally in the survey, while UNC was 34th. The University of Michigan ranked first.
Here is the list of the top 10 best value colleges in North Carolina:
|Affordability index
|N.C. State University
|UNC Chapel Hill
|Duke University
|N.C. A&T University
|Campbell University
|UNC Charlotte
|Winston-Salem State University
|Appalachian State University
|UNC Wilmington
|Davidson College
N.C. tax receipts remain lower than 2007 levels
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Tax revenues collected by North Carolina are 9.5% lower than at their peak in late 2007, adjusted for inflation, according to a report by The Pew Charitable Trusts. That is similar to border states South Carolina and Virginia, which also reported receipts that are about 10% lower than 2007. In Tennessee, revenues are about 1% higher than eight years ago.
North Carolina's tax revenues totaled about $5.8 billion in the third quarter of 2014, compared with a peak of $6.4 billion in the third quarter of 2007. Changes in revenues are affected by economic activity and tax policy. The state's economy has revived since the 2007-09 recession, particularly in the Charlotte and Raleigh-Durham metro areas, according to Wells Fargo economist Mark Vitner and analysts. But revenues haven't rebounded as much as other large U.S. states because North Carolina's Republican-led General Assembly has cut tax rates for both corporations and individuals, reducing the flow of money into state coffers for roads, schools and other expenses.
North Carolina is among 30 states in which tax receipts have not rebounded to pre-recession levels, according to Pew. "Total 50-state tax revenue has hovered above its 2008 high mark— even though most states had below-peak receipts — largely because of the recovery of collections in three states with large tax bases: California, Illinois, and Texas," according to a Pew press release.
The Pew report didn't break down how much of the change is related to corporate tax rate declines versus personal income tax. Critics of North Carolina's tax policy changes say too much of the benefit from lower taxes is going to corporations.
Without adjusting for inflation, 50-state quarterly tax revenue was 12% above peak, and tax collections had recovered in 38 states as of the third quarter of 2014, Pew said.
Pew's report is available here: http://www.pewtrusts.org/en/research-and-analysis/analysis/2015/03/23/since-recession-tax-revenue-lags-in-30-states
Charlotte PE firm adds $125 million fund
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Capitala Group, a Charlotte-based business-development company, said it raised $125 million, marking its fourth private-equity fund.
CapitalSouth SBIC Fund IV, L.P. will invest in the debt and equity of companies with at least $8 million in revenue and $2 million in earnings before interest, taxes, depreciation and amortization. The fund typically invests $2 million to $10 million in its deals.
Capitala Group's managed funds have made more than 100 investments since 1998, totaling about $700 million. The company manages a public capital portfolio through a publicly traded company, Capitala Finance Corp., and a private portfolio that includes the new fund.
"We appreciate the interest expressed in the fund by many long-standing relationships, as well new investors," Chief Executive Officer Joe Alala said in a statement. Investors were not disclosed.
Capitala Finance on March 24 said it formed a joint venture with Kemper Corp.'s Trinity Universal Insurance Co. for a new fund to invest in secured loans. Capitala Finance is putting $20 million of equity into the venture, with Trinity providing $5 million. Capitala Finance went public in September 2013.
3 N.C. hospitals name head of shared-services group
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Former Novant Health executive Mark Tribbett was named president of a new shared-services company owned by Wake Forest Baptist Medical Center, Vidant Health and WakeMed Health & Hospitals.
The new Raleigh-based company, called Socius Health Solutions, aims to reduce costs and improve quality and access to health care at the three large hospital systems, which have a geographic reach across 300 miles across northern North Carolina. Plans for the company were disclosed last year, prompting speculation of a potential merger of the three groups. Wake Forest Baptist is based in Winston-Salem, Vidant is based in Greenville and WakeMed is in Raleigh.
Though the three had combined operating revenue of about $4.7 billion in 2014, only Vidant had an operating surplus — in for-profit terms, profit. Hospitals are grappling with the shift in how they get paid as insurers increasingly contest charges for repeated tests or procedures.
Socius offer services including supply-chain management and information-technology support.
The amount of investment and number of employees weren't immediately available.
Tribbett most recently founded AlphaHealth LLC, a health care consulting firm that has worked on more than 100 projects for 50-plus medical organizations. He previously worked at hospital and health care systems for 17 years, including 10 with Novant Health and Presbyterian Health Care System.
"We will be building on the work of clinical teams from last fall to codify best practices and spread them throughout our health systems," John McConnell, CEO of Wake Forest Baptist Medical Center, said in a statement. "Some of the benefit from this work will come from identifying select specialty patients with the most commonly diagnosed conditions in the specialty across the three systems."
Organizers said Socius is a Latin term that means sharing, associated and allied.
For a deeper look at changes sweeping the North Carolina hospital industry, see Business North Carolina's recent story "Bigger if not better (March 2015)."
ClubCorp adding N.C. clubs
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ClubCorp Holdings Inc., a Dallas-based operator of golf and private clubs, is paying $44 million to buy six golf courses, including two in North Carolina, according to statement from the company. The sellers are Stratford Golf Partners and Accord Golf Capital
The company is buying Bermuda Run Country Club near Winston-Salem, a private club with 36 holes of golf, two clubhouses and a tennis center, as well as Firethorne Country Club in Marvin, near Charlotte, which has 18 holes, a water park with four pools and a tennis center.
Other clubs acquired include:
• Legacy Golf Club at Lakewood Ranch in Bradenton, Fla. — a public golf club featuring an 18-hole, Arnold Palmer-designed championship golf course.
• Temple Hills Country Club in Franklin, Tenn. — a private country club offering 27 holes of championship golf, a clubhouse, junior Olympic-size pool and tennis.
• Brookfield Country Club in Roswell, Ga — a private club with an 18-hole golf course, pool, tennis and fitness facilities.
• Ford's Colony Country Club in Williamsburg, Va. — a semi-private golf club offering three 18-hole courses.
Since 2010, ClubCorp has grown its portfolio of clubs by a third and now includes more than 200 clubs in 26 states, the District of Columbia, Mexico and China. Ten of the clubs are in North Carolina, including the Piedmont Club in Winston-Salem and City Club of Raleigh.
"These clubs fit well with our stated goal to continue consolidating a very fragmented industry," Eric Affeldt, ClubCorp president and CEO, said in a statement.
The company was started in the 1950s by Robert Dedman. His family expanded the company before selling it to private-equity group KSL Capital Partners in 2006. ClubCorp went public in September 2013 and now has an enterprise value of $2.1 billion, including debt. As part of the sale, the Dedman family retained ownership of Pinehurst Resort & Country Club.
Robeson attracts $139 million poultry investment
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Robeson County, an eastern North Carolina county hard hit by declining manufacturing employment, attracted a $139 million poultry operation that is expected to employ 1,100 people within three years.
Sanderson Farms Inc., a Laurel, Miss.-based company with a stock-market value of $1.8 billion, plans to start construction on the plant near St. Pauls this summer and eventually process 1.25 million chickens a week. About 100 contract farmers will be needed to supply poultry to the plant, Sanderson said in a statement.
"We are very delighted about this announcement," says Steve Yost, president of the Southeastern Partnership, an economic development group representing 14 counties. "They are a first-class food company. They pay good wages and they pay benefits."
Food companies make up more than 40% of manufacturing employment in southeast North Carolina's 14 counties, Yost says. The region has lost thousands of former textile, hosiery and other manufacturing jobs since the North American Free Trade Agreement took effect in 1994.
Poultry is an expanding business for the region, with other new facilities started or planned there by Garner-based Butterball LLC and Delaware-based Mountaire Farms, Yost says. The region provides good transportation access for poultry producers via East Coast interstates and railroads and export potential through the state ports in Morehead City and Wilmington.
The Fayetteville City Council and the Cumberland County Board of Commissioners had courted Sanderson for a site at one of the county's vacant industrial parks. But hundreds of residents of nearby residents opposed the project. Instead Sanderson picked a site 15 miles from Fayetteville.
North Carolina was in competition for the project with a couple of other states, Yost says. Details on incentives provided by local officials weren't immediately available. The state has offered Sanderson $1 million if it meets its job targets.
St. Pauls Mayor Gordon "Buddy" Westbrook told the Fayetteville Observer, "I think it's probably one of the best things we've had in 30 years."
Novant might expand in northern Virginia
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The University of Virginia Health System and Winston-Salem-based Novant Health are talking about forming a regional health system in northern Virginia, the groups said today. The proposed agreement would involve UVA Culpeper Hospital and Novant Health's Virginia facilities, including Novant Health Haymarket Medical Center, Novant Health Prince William Medical Center and Novant Health Cancer Center.
Plans call for creating a joint operating company by June 30. Discussions will include how Novant Health and UVA can coordinate cancer care across northern Virginia. Culpeper is 70 miles southwest of Washington, D.C.
"We believe a joint operating company will help ensure patients throughout northern Virginia receive quality care at the right time and the right place, while also providing care in a more efficient manner," Richard P. Shannon, UVA's executive vice president for health affairs, said in a statement.
UVA Health System includes a 612-bed hospital, the UVA School of Medicine, a level-I trauma center and heart centers and primary and specialty clinics throughout central Virginia. Novant Health was created by the 1997 merger of Winston-Salem-based Forsyth Memorial Hospital and Charlotte-based Presbyterian Hospital. It now operates in four states with more than 1,200 physicians and 26,000 employees who work at nearly 500 locations, including 14 medical centers and hundreds of outpatient facilities and physician clinics.
Top-rated Tar Heel financial advisers
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Thirty financial advisers from North Carolina made Barron's magazine's annual rankings of the nation's 1,200 top stockbrokers, about half of them based in Charlotte.
Barron's criteria includes assets under management, revenues generated, regulatory history and a questionnaire filled out by the advisers.
The top-ranked adviser in the state is R. Mitchell Wickham, part of a 12-person team started by his father Charles, who joined Merrill Lynch in 1960 and is now chairman emeritus of the group. Wickham's team, which includes No. 3-ranked Gregory Cash, now manages $6.1 billion with its clients having an average net worth of $40 million.
Nine Wells Fargo Advisors members are on the list, including No. 2 William Oliver of Charlotte and No. 5 Christopher Davis of Davidson. Four Merrill Lynch advisers were ranked, along with three from UBS Financial Services and three from Carroll Financial Services in Charlotte.
Advisers with the most assets, behind Wickham, are Lee Bryan III and William Spry Jr., who manage $4.2 billion at Deutsche Asset & Wealth Management in Winston-Salem.
Fourteen of the 30 are from the Charlotte area, while seven are from the Triangle and seven from the Triad. Two advisers from non-metro areas made the list: W. Kel Normann of Sanford (No. 8) and Kim Hoffman of Wilson (No. 25).
Money management remains very male-dominated in North Carolina, with just three women named, including Hoffman, who works for Edward Jones. Two work for Wells Fargo Advisors in Charlotte: Kathleen Malone (No. 13) and Angela Ostendarp (No. 18).
Here's the top 10 in North Carolina, according to Barron's:
R. Mitchell Wickham, Merrill Lynch, $6.1 billion
William Oliver, Wells Fargo Advisors, $1 billion
Gregory Cash, Merrill Lynch, Charlotte, $6.1 million
Larry Carroll, Carroll Financial Associates, Charlotte, $796 million
Stephen Thomas, Linden Thomas, Charlotte, $1.2 billion
Christopher Davis, Wells Fargo Advisors, Charlotte, $1.5 billion
Bruce Knott, Wells Fargo Advisors, Chapel Hill, $614 million
W. Kel Normann, Wells Fargo Advisors, Sanford, $609 million
Sam Rankin, UBS Financial Services, Charlotte, $923 million
Lee Bryan III, Deutsche Asset & Wealth Management, Winston-Salem, $4.2 billion
Wilmington's nCino raises $29 million
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Wilmington-based software company nCino Inc. completed a $29 million round of financing led by New York-based private-equity firm Insight Venture Partners. Other investors include former Morgan Stanley Chairman and CEO John Mack, Boston-based Wellington Management Company LLP and Gene Ludwig, founder and CEO of Promontory Financial Group and former U.S. Comptroller of the Currency.
Spun out of Wilmington-based small-business lender Live Oak Bank in 2012, nCino sells cloud-based software that helps banks streamline loan paperwork. Forbes magazine recently ranked nCino 93rd on its ranking of America's Most Promising Companies – the only North Carolina business earning a spot on the list, which is compiled based on revenue growth, employee growth, capital raised and other factors.
The company reported 206% revenue growth in 2014 compared with 2013 and more than doubled its customer list from 36 to 81 banks and credit unions. Three of the banks added in 2014 have assets of more than $68 billion. Earlier this month, nCino celebrated the addition of its 100th employee, Chief Product Officer Tom DiVittorio.
nCino plans to use the funds to expand in the United States, enter international markets, accelerate product development and add new employees.
CEO Pierre Naudé projects nCino will reach $50 million in annual sales by 2018. "We want to build the company long term," Naudé told Business North Carolina in a December article.
Jeff Horing, managing director of Insight Venture Partners, will join nCino's board of directors. "In our view, nCino represents the future of banking, and we are pleased to partner with a company we believe will continue to create significant value for many years to come," Horing said in a press release.
Insight Venture Partners has raised $8 billion and invested in more than 200 companies since 1995, including Twitter and Tumblr.
Best N.C. stock of the decade?
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Raleigh-based Salix Pharmaceuticals, acquired for $14.5 billion by Valeant Pharmaceuticals, may rank as the best-performing North Carolina-based stock in the past decade.
The company traded for $11 when it went public in 2000, then mostly traded between $5 and $23 over the next nine years. The stock finally broke out of its trading range in October 2009 and has risen about sevenfold since then. Shares traded for about $156 today after the bid by Valeant, a Canadian firm that bought eye-care company Bausch & Lomb for $13 billion in 2013.
Salix ranked as North Carolina's 12th most valuable public company when we discussed the company's success in our annual report on the North Carolina's largest public companies in August. Based on Valeant's bid, they would rank ninth, just behind Charlotte-based Nucor, the largest U.S. steelmaker
Salix's key has been its successful introduction of treatments for gastrointestinal illnesses and other health problems, making it a favorite target of the mergers & acquisitions crowd. Salix drew interest from four large pharmaceutical companies over the past several months, The New York Times notes. Spurned suitors included Allergan, Actavis and Shire.
Salix's sale marks another milestone in the career of Thomas D'Alonzo, a key figure in North Carolina's pharma industry for decades who has been the company's chairman since 2010 and became acting CEO on Jan. 30 after the resignation of Carolyn Logan. He was president of Glaxo Inc., the U.S. division of GlaxoSmithKline plc from 1988 to 1993 and later was president of Pharmaceutical Product Development, the Wilmington-based company now owned by private equity companies.
During Logan's 12 years at Salix, the company went from one product and less than $25 million in revenue to more than 20 products and revenue topping $1 billion, the company said in a Jan. 5 statement.
But she and CFO Adam Derbyshire, who resigned in November, left the company after Salix said it had reported excessive inventory levels of three of its best-selling drugs. That clearly didn't bother Valeant.
North Carolina's higher-ed makes it rain
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It's February, the General Assembly is in session and the state's colleges and universities are scrapping for every nickel from lawmakers. So the education lobby delivered a report this week showing that North Carolina's colleges and universities —which rank among the state's most important selling points — deliver a very strong bang for the buck. Their combined economic impact was $63.5 billion in 2012-2013, according to the study by Economic Modeling Specialists Inc. that was sponsored by public and private higher education systems.
State and local taxpayers paid $4.3 billion to support higher education in North Carolina during the fiscal year, including University of North Carolina System campuses and community colleges. Rankings of top U.S. universities routinely place Duke University, UNC Chapel Hill and N.C. State University among the nation's most important research institutions — assets that would be envied by virtually every other state.
But Gov. Pat McCrory, former state Budget Director Art Pope and the Republican-led legislature have pushed the higher-ed lobby to provide more evidence of the universities' value. That scrutiny has gotten quite detailed, including the Feb. 18 recommendation by a Board of Governors committee that the tiny, liberal-leaning UNC Center on Poverty, Work and Opportunity in Chapel Hill be closed, even though it takes no state funding. Committee members expressed concern that the center, once a platform for former U.S. Sen. John Edwards, was more interested in favoring Democratic politicians than finding solutions to poverty. The proposed closing is infuriating some UNC officials and is certain to create much discussion when the Board of Governors meets in Charlotte on Feb. 27.
But back to the study, which is full of interesting detail about higher-ed systems.
The UNC system's 16 universities enroll nearly 222,000 students and confer more than 70% of undergraduate and graduate degrees in the state. It spent $3.5 billion on payroll and benefits for about 51,500 full- and part-time workers, not including clinical, research and extension activities, the report from Moscow, Idaho-based EMSI noted. UNC system construction spending totaled $173 million.
The 58-member community college system had payroll and operations spending of $2.2 billion in 2012-13, along with a surprisingly low $37 million in construction spending, the report said. The system employs almost 46,000 full- and part-time workers. Forty percent of North Carolina wage earners received education or training at a state community college during the last 10 years, the report said. "This study demonstrates that our students play a significant role in our state's economic success through the skills they attain at our community colleges," NC Community College System President Scott Ralls said in a statement. "
The report also cited the impact of the 36 members of the North Carolina Independent Colleges and Universities association, which together enroll almost 90,000 students. They employ more than 66,000 full- and part-time workers, and spent $4 billion on payroll and benefits expenses in fiscal 2013 — more than the UNC system, according to the report. Construction spending totaled $166 million during the year at the private schools, which include Duke and Wake Forest universities.
"The UNC system is a treasure this state has built over many generations, and it has allowed North Carolina to prosper by producing great talent and attracting new businesses needed to build a strong economy and a better quality of life," UNC President Tom Ross said. "We are working more closely than ever before with the community colleges and the state's private colleges and universities to leverage our respective strengths and resources for the benefit of students and the state."
Ross, of course, won't be working more closely with his peers after next January, when his successor is likely to be named.
Here are places to get more details:
$75 million IPO plotted by Morrisville marketing company
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MaxPoint Interactive Inc. of Morrisville is a digital marketing company that has done a great job of attracting clients with little notice from the mainstream press. That may change now that it has filed for a $75 million initial public offering.
Started in 2006, MaxPoint helps its clients, which include many of corporate America's biggest names, pinpoint the best neighborhoods to sell their products. They call it "hyperlocal advertising." The company's main owners are private-equity investors Menlo Park, Calif.-based Trinity Ventures and Seattle-based Madrona Venture Group, with a combined 56%. CEO Joe Epperson has 10%. He previously worked for eBay, 3Com Corp. and Ford Motor Co.
The company's leadership team includes executives who worked at eBay, ChannelAdvisor Corp. and other Internet businesses.
MaxPoint's accounting is complex, but the IPO filing shows net losses of more than $25 million since January 1, 2011. Revenues during that period top $100 million, after excluding "revenue acquisition costs."
The number of shares to be issued and listing price haven't been determined.
Goldman, Sachs & Co., Deutsche Bank Securities Inc. and Pacific Crest Securities LLC are lead bankers for the offering.
Dan Forest fundraiser attracts notable developers
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With North Carolina's politicians back in Raleigh, the money-raising game for 2016 elections is already picking up. We saw an emailed invitation from Lt. Gov. Dan Forest to a fundraiser on Feb. 11 at the Raleigh home of Jim and Helen Cain. Co-chairs, who were asked to contribute $5,000, are Jim Anthony, Cliff Benson Jr., Pat & Anne Gavaghan, Tom & Mary Vande Guchte , Bob Luddy, Chad Price , Christopher & Michele Stone, Ed White and Steve & Anne Yager. Among the "hosts," asked to put up at least $2,500, include John M. Kane, Joe & Sarah Knott , Julian W. "Bubba" Rawl, Kieran Shanahan , Tim Smith and Steve Stroud . A minimum contribution of $500 is listed.
Legislators stripped most of the powers from the lieutenant governor many years ago, but Forest is on various state boards and clearly has bigger ambitions. He won the lieutenant governor's race in 2012 by only 7,000 votes — Gov. Pat McCrory won by more than 500,000 — so compiling a war chest for 2016 from many of the state's best-known developers and business executives makes sense.
Forest, 47, has an architecture degree from UNC Charlotte and was a senior partner at Charlotte-based Little Diversified Architectural Consulting. His mother, Sue Myrick, spent 18 years in Congress representing the Charlotte area before retiring in 2013.
Up Front: Turning a page
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I started work here two days before Christmas 1985 — which happened to be my son's 16th birthday — but my first Up Front column didn't appear until the May 1987 issue, after I became editor. This will be my last. Ben — now 45 and the magazine's publisher — and I are selling the business. He'll run it for the new owners; I'm retiring.
It's time. I turn 66 this spring, and nearly three decades in a job should be enough for anyone. Plus, this puts Business North Carolina in good hands — and not just because they're the kind that can slide into deeper pockets than the narrow one binding my billfold to my butt. The buyer is Old North State Magazines LLC, formed by the five men who own The Pilot LLC, which publishes the newspaper in Southern Pines and local magazines there and in Greensboro and Wilmington. Three are members of the family that owned the Raleigh News & Observer for 101 years — and this magazine for 13 of those. Talk about meet the new boss, same as the old boss: This, in effect, makes the third time that Frank Daniels Jr., the group's majority investor, has bought BNC.
He was president of The News and Observer Publishing Co. when it acquired the 4-year-old magazine just weeks before I arrived. And not only did he back me when I bought it in 1998, but the wherewithal came from shares in the parent company I got before it was sold to the McClatchy chain three years earlier. He stuck with us until 2006, when we bought out him and another minority partner — retired McClatchy Chairman and CEO Erwin Potts.
Every one of Frank Jr.'s partners also has ties to the magazine. His son, Frank III, was publisher from 1987 to '89, when he returned to Raleigh and that title was added to mine. Nephew David Woronoff — now publisher of The Pilot — worked here from 1991 to '96 in several roles, including special projects manager. Jack Andrews was the N&O's vice president for subsidiaries when we were one. Lee Dirks brokered the sale of the company, including the magazine, to McClatchy.
These guys know their business and, more important, know Business North Carolina. I trust them. They will be good stewards of the magazine, which provides them an established, respected brand and a statewide footprint to build upon. As David, manager of the group's limited-liability companies, notes, "Our core purpose has always been to serve our community, and we accomplish that by producing world-class publications. With the acquisition of Business North Carolina, we're able to expand our community from Currituck to Cherokee and all 98 counties in between."
In closing, let's not forget those, the names too many to mention, who have invested something more precious than capital in this venture. Working for only a paycheck, they provided the labor, talent, creativity and skill that made the magazine the best of its kind anywhere — sweat equity that forever holds title to my respect, admiration and gratitude.
This staff photograph accompanied the first Up Front column in 1987. You're reading the last one under that editor's byline.
Opinion: NC's refusal to expand Medicaid leaves 1.5 million people without coverage
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Healthcare reform affected every citizen in the United States in some way, yet little is understood when it comes to the intricate details of the Affordable Care Act, commonly called Obamacare. The law's intent was to give all Americans access to quality healthcare that's affordable, while slowing the growth of healthcare costs. While the national conversation has trended toward universal healthcare as the ultimate goal, the local conversation has been very different in North Carolina, where about 1.5 million residents remain uninsured—500,000 of whom would qualify for Medicaid.
Over a year since the effective date of ACA and four years since being signed into law, some of North Carolina's neediest residents still lack access to health-care coverage. Many are uninsured because our state legislators refuse to expand Medicaid, the nation's publicly funded health coverage program for low-income Americans and a key component for coverage expansion.
Originally, the ACA required that every state expand their Medicaid program to include everyone earning up to 138% of the federal poverty level. In 2014, that meant an individual with an income of $15,856 or a family of four with an income of $32,499. This would have provided coverage to 19 million of the 48 million uninsured Americans. If states chose not to expand Medicaid, then the law stipulated they would lose all Medicaid funding. As a result, 26 states sued, and the Supreme Court ruled this provision of the law unconstitutional, giving states the option not to expand.
North Carolina remains one of 16 Republican-led states that refuses to expand Medicaid, raising questions as to its partisan agenda to deny coverage. By doing so, it's created a "coverage gap." This includes poor residents who don't earn enough to buy health insurance from the exchange but still make too much to qualify for Medicaid. North Carolina's decision has been made irrespective of the needs of its citizens and the overall health of our communities and nation.
Medicaid expansion provides federal funds for states to finance expanded eligibility options for its citizens. According to a recent Urban Institute study, for every dollar a state invests in Medicaid expansion, $13.41 in federal aid would flow into the state over a 10-year period (2013-2022). In North Carolina, this totals $39.6 billion in lost federal dollars.
Besides the financial consequences, refusing Medicaid expansion is predicted to adversely affect the health of those affected . Low-income women will forego recommended breast and cervical cancer screening; diabetics will forego medications; and all low-income adults will face a greater likelihood of depression, catastrophic medical expenses and death.
The 1.5 million people left without healthcare in North Carolina present ongoing limitations for access to healthcare and an escalating public health burden to the state. While all of North Carolina will be affected by this decision, our rural communities will be hit the hardest. Twenty % of the people in western North Carolina have no form of health insurance. About 110,000 people in western North Carolina would have qualified for Medicaid through the expansion, according the the Carolina Public Press (2013).
For the remaining states without expansion, the Urban Institute reports 6.7 million residents are projected to remain uninsured in 2016 as a result, and these states are losing $423.6 billion in federal Medicaid funds from 2013 to 2022. North Carolina could see revenue from the broader economic effects of the Medicaid expansion, such as increased jobs, state income and tax revenues within the healthcare sector due to spending. Indeed, states that accepted Medicaid expansion have received billions in federal funding and have reported local job and economic growth. The U.S. Department of Health and Human Services projects that hospitals in states with Medicaid expansion would save $4.2 billion in 2015 in uncompensated care costs.
North Carolina needs to reverse its position. Medicaid expansion is needed to preserve the well-being of our working class, to protect the health of North Carolinians, and to promote the growth of our economy. The North Carolina General Assembly's decision to forego Medicaid expansion has led to missed opportunities for the state. It has sent the wrong message to the citizens of North Carolina, Republicans and Democrats alike.
-Contributed by Dr. Yele Aluko, MD, MBA
Dr. Aluko is a Fellow of the American College of Cardiology and Senior Vice President at Novant Health in Charlotte
Wilmington's nCino makes Forbes 'Most Promising Companies' list
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Wilmington-based nCino Inc. was the only North Carolina business to make Forbes' recent list of America's Most Promising Companies. nCino ranked 93rd on the list, which includes private companies generating less than $300 million annually and considers revenue growth, employee growth, capital raised and management, among other factors.
nCino sells software to banks to help them reduce loan paperwork. The company's CEO, Pierre Naudé, projects $50 million in annual sales by 2018, compared with $6.5 million in 2014 (Statewide, December). Employment has climbed to about 100 from 18 two years ago as banks in 19 states have bought nCino's products. It spawned out of Wilmington-based Live Oak Bank, founded by Chip Mahan, who saw the potential for selling the software to other banks. Live Oak specializes in U.S. Small Business Administration loans, a niche that has made it the state's most profitable bank, based on return on assets and equity ("Big Gains for Small Banks," June).
Family Dollar shareholders approve sale to Dollar Tree
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Family Dollar Stores Inc. shareholders voted Thursday to approve the sale of the Matthews-based discount retailer to Chesapeake, Va.-based Dollar Tree Inc. The company's early vote count showed 74% of total shares were in favor of the deal, and 89% of total shares voted.
The vote came after being delayed in December as some shareholders wanted the company to consider a $9.1 billion offer from rival Dollar General Corp., based in Goodlettsville, Tenn. The Dollar Tree deal was valued at $8.5 billion, or $74.50 per share. Family Dollar shareholders are slated to receive $59.60 per share in cash and the remainder in Dollar Tree shares. Dollar General had offered $80 per share.
Family Dollar CEO Howard Levine favored Dollar Tree's lower bid, which he said would protect some of the1,300 jobs at Family Dollar's corporate headquarters and was more likely to receive Federal Trade Commission approval. Levine is expected to stay on under Dollar Tree's ownership. A combination with Dollar General would have led to more store closings, Levine said.
Leon Levine started the discount chain in Charlotte in 1959 and took the company public in 1970. His son, Howard, became CEO in 2003.
Impetus for the sale followed last June's disclosure that New York investor Carl Icahn owned 9.4% of Family Dollar's shares. He demanded that Family Dollar be put up for sale, prompting the takeover fight between the two other dominant dollar-store chains.
The merger still needs approval from the Federal Trade Commission, and the sale could close as soon as March.
State eyeing $2.5 billion debt expansion
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North Carolina may be asking lawmakers and voters to approve as much as $2.5 billion in debt, State Budget Director Lee Roberts told UNC System leaders last week. His comment to the UNC Board of Governors in Chapel Hill was overshadowed by the forced resignation of UNC System President Tom Ross, expected in January 2016.
Roberts said the McCrory Administration will ask the General Assembly for approval to issue up to $2.5 billion in debt for various needs, including transportation and education.
Any general-obligation bond issue must be approved by the legislature and voters, said Melanie Matthews, a spokeswoman for Roberts. The state has authority to issue as much as $2.5 billion, she said. Roberts and McCrory have not discussed the amount publicly because "we are just starting the conversation," she said.
North Carolina had $8.8 billion of outstanding debt as of June 30, 2013, according to a February 2014 report by State Treasurer Janet Cowell. That includes $7.4 billion in debt backed by highway, general-fund and other taxes. Higher education makes up 47% of the total tax-supported debt, with transportation accounting for 16%.
BankNotes: Remaining community
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Banking is an industry that, by nature, experiences a volume of ebbs and flows. Mergers. Acquisitions. Consolidations. Liquidations. As I discussed in an earlier post, the Great Recession that began in December 2007 had an enormous negative impact on banks of all sizes, greatly changing the landscape of community banks in North Carolina – a crushing ebb. Today, we are experiencing steady economic growth, particularly due to the stock market's recovery. Investors have been bullish. The housing market has rebounded. This time is what we consider a welcomed flow.
By all accounts, this economic health is a positive change. For example, according to the U.S. Department of Labor, North Carolina's unemployment rate for November 2014 was 5.8%, down from 10.4% in November 2009. Improvements like this naturally spark spending and expansions, causing an institutional shift within the banking industry. Among the countless opportunities this provides – for both banks and their customers – a significant challenge presents itself. As the growth of the economy fuels the growth of banks, one tough question arises: "How do you remain a community bank as you develop into a larger financial institution?"
As I've learned firsthand, the answer actually lies in the question: community. A bank must always, at its core, be community focused. This can be tougher than it sounds as you factor in the surge of operating branches, employees, and accounts. Additional corporate structure is inevitably required for a bank to function as a smoothly run business. However, taking an active role in the communities in which a bank serves must continue to be the crux of the franchise. And I mean every community it serves. A bank is merely a whole of its parts, with every branch just as important as the next.
So, how does a bank do this? I've previously shared some characteristics of a successful community bank. For one, even with added structure and directive, it must still allow for some decisions to be made at a local level. This empowers bankers, who personally know the communities they live in, to make the best choices for their customers.
Second, a bank must not overlook the influence of customer service. There is no denying we live in a digital world with incredible technology advances that make our daily lives easier. Online and mobile banking certainly provide added convenience and immediacy, but should be used as an extension of services – not a replacement. Face-to-face, personalized service is still arguably the most important factor when choosing a bank. Bankers and staff should be encouraged to treat customers like neighbors because, in many cases, they are.
Lastly, a bank should never underestimate the importance of giving back. Philanthropy is essential for the reputation of any institution. As I recently witnessed during Yadkin Bank's East Meets West campaign, goodwill at the local level is key for a community bank. It's commendable to have worldwide, nationwide, and even statewide causes, however benefiting local foundations and nonprofits ensures that charitable efforts are making a difference in the lives of people within the community a bank serves.
As a bank grows, the additional services and resources now available to customers are of great value. However, the benefits of a larger financial institution must never overshadow the philosophies from which a community bank is built.
Scott Custer is president and chief executive officer of Yadkin Financial Corp.
Biotech Center CEO moves to lobbying job
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E. Norris Tolson, a veteran Raleigh state official who was the CEO of the North Carolina Biotechnology Center for seven years before resigning last year, joined the Williams Mullen law firm's economic-development group in Raleigh.
Before working for the biotech center Tolson served as secretary of three different state agencies, including revenue, transportation and commerce. He also worked for DuPont for more than 25 years and served as a member of the N.C. General Assembly.
Williams Mullen has 220 lawyers at offices in North Carolina, Virginia and Washington, D.C.
Greensboro gaining large spec industrial building
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McConnell Center Two LLC, a joint venture between Greensboro developer Pete Goria and Richardson Properties LLC, plans to build a 300,000-square-foot speculative industrial building in McConnell Center Industrial Park on Interstate 40 in east Greensboro. It will be the third building in the park and is expected to open in July. The existing buildings are occupied by O'Reilly Auto Parts, Dry Storage Corp. and Vistar, a division of Performance Foods Group.
Windsor Commercial LLC is the contractor, while Triad Commercial Properties LLC will lease the project.
Charlotte-based Falfurrias sells Dorsey Wright for $225M
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Falfurrias Capital Partners, a Charlotte-based private-equity firm led by Hugh McColl Jr. and Marc Oken, sold its stake in investment company Dorsey, Wright & Associates to New York trading company Nasdaq OMXGroup Inc.
New York-based Nasdaq is paying $225 million for Richmond, Va.-based Dorsey Wright, which manages $6 billion in addition to providing investment research to financial advisers and investors. Falfurrias bought controlling interest in Dorsey Wright in 2011, though its precise stake was not disclosed.
McColl, former CEO of Bank of America Corp., and Oken, a former CFO of the bank, started Falfurrias in 2006. It is named after a small town in south Texas near some favorite hunting grounds of McColl and Oken.
Dorsey Wright has an exchange-traded fund, the PowerShares DWA Momentum Portfolio, that has attracted $1.6 billion in assets since its inception in 2007. A separate ETF, the First Trust Dorsey Wright Focus 5, gathered $1.2 billion in assets in 2014.
Family Dollar delays Dollar Tree acquisition vote
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Family Dollar Stores Inc. on Tuesday delayed its stockholders' vote on the proposed acquistion by Chesapeake, Va.-based Dollar Tree Inc. after there were insufficient votes at the time of the meeting. The meeting was adjourned until Jan. 22.
The Matthews-based company agreed to an $8.5 billion deal in July with Dollar Tree, which will pay $74.50 per share. Family Dollar has declined an offer from Goodlettsville, Tenn.-based Dollar General Corp. for $9.1 billion, citing potential antitrust issues. Dollar General extended its offer on Tuesday to expire Jan. 30.
Tuesday's delay came a day after a Delaware court denied a request to block the shareholders' vote.
N.C. Medicaid expansion has big benefits, study says
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North Carolina could add 43,000 jobs and boost the economy by more than $10 billion by 2020 if the state expands Medicaid eligibility to as many as 480,000 people over the next two years, according to a report by researchers at George Washington University. The report was funded by Greensboro-based Cone Health Foundation and the Winston-Salem-based Kate B. Reynolds Charitable Trust.
The Republican-dominated North Carolina General Assembly, along with peers in many other states, have thwarted plans to make Medicaid available to people with income of 133% of the federal poverty level because of concerns over the long-term costs once federal support for the program wanes.
Hospital groups have pushed for expansion, contending that enrolling more low-income people in the federal plan saves money by promoting more healthy living and averting emergency room visits.
Cone Health Foundation, affiliated with the nonprofit Cone Health network of hospitals and medical practices, has more than $100 million in assets, according to its website. The Winston-Salem-based Reynolds trust, formed by the wife of a former R.J. Reynolds Tobacco Co. chairman with a mission of assisting financially needy North Carolinians, has assets of more than $550 million.
"We have some of the most restrictive Medicaid eligibility requirements in the country, so hundreds of thousands of low-income North Carolinians will benefit if the program expands," Susan Shumaker, president of Cone Health Foundation, said in a statement. "The decision not to expand the program impacts all of us, not just those who are struggling to access the care they need to stay healthy. It has already also cost jobs and billions of dollars, and will continue to do so."
About 18% of North Carolina citizens lack health insurance. If the state doesn't expand Medicaid, it will be turning down more than $21 billion in federal funds between 2016 and 2020, according to Leighton Ku, a public health expert at George Washington and the lead author of the report. As part of the program North Carolina would need to spend $1.7 billion to cover the newly insured.
Making more people eligible for Medicaid would boost spending on construction, food service and other sectors by tens of billions of dollars, offsetting higher medical costs, Ku said.
The report, which includes the impact on each of North Carolina's 100 counties, is available at www.NCMedicaidExpansion.com.
Brunswick Co. builder named chair of ports board
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Gov. Pat McCrory has named building contractor Tom Adams of Brunswick County chairman of the North Carolina State Ports Authority board of directors. He succeeds Mike Lee, a Wilmington lawyer who left the board this summer after being appointed to the N.C. Senate, replacing Thom Goolsby, who resigned. Lee was elected in November to a four-year term.
Adams is president and CEO of Adams Building and Consulting Company LLC. Former House Speaker Thom Tillis appointed him to the ports authority in January.
Board membership includes N.C. Secretary of Transportation Tony Tata, six members appointed by the governor and four appointed by the General Assembly. The governor selects the chairman and the vice chairman.
Pantry gains as oil slides
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Lower gas prices are great news for drivers and investors in convenience-store operator The Pantry, which gained 4.4% Wednesday a day after reporting soaring profits. The gain came on the same day the Standard & Poor's 500 Index slid 1.6%, its worst daily showing in seven weeks.
Convenience stores benefit when customers spend less on gas, leaving more money to spend on food, beverages, cigarettes and other staples.
Cary-based Pantry reported earnings on Tuesday of $15.4 million for the fourth quarter ended Sept. 25, or 66 cents per share, beating average analyst estimates by 20 cents. (The earnings excluded three cents per share of impairment charges.) A year earlier the company earned $1.4 million, or 6 cents per share.
Revenue declined 3% from a year earlier to $1.96 billion, about $20 million less than estimates.
Pantry shares have doubled in the past year, trading as high as $29.19 this week. They closed Wednesday at $28.47.
Pantry operates about 1,500 stores in 13 states, mostly under the Kangaroo Express brand.
The S&P 500 has declined 2.4% over the past three trading days, but has gained 9.6% so far this year.
North Carolina metro-area unemployment tumbles
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The North Carolina job market has recovered dramatically over the past year, according to new statistics. Twelve of North Carolina's 14 larger metropolitan areas had unemployment rates of 6% or less in October, compared with only three a year ago, according to the North Carolina Department of Commerce. The rates were not seasonally adjusted.
The biggest changes over the past year, with the unemployment rate declining by at least two percentage points, occurred in Fayetteville, Hickory-Lenoir-Morganton and Rocky Mount. Regions with the lowest rates are Asheville, 4.1%, Durham-Chapel Hill, 4.5% and Raleigh-Cary, 4.5%. The highest rates are in Rocky Mount, 8.1%, and Fayetteville, 6.5% – the only metro areas above 6% — according to the department's labor and economic analysis division.
The October rate in Charlotte-Gastonia is 5.6%, compared with 7.3% a year earlier. Greensboro-High Point came in at 5.7%, while Winston-Salem was 5.1%.
Several smaller cities and rural areas have higher unemployment rates, including Laurinburg, 10.2%; Henderson, 8.2%; and Roanoke Rapids, 8.2%.
About 4.42 million workers were employed in the state in October, a gain of about 76,500 from the previous year. The number of unemployed declined by about 82,500.
The statewide rate, which is seasonally adjusted to reflect hiring patterns, was 6.3% in October, compared with a national rate of 5.8%. The November number will be reported on Dec. 19.
Ryan Homes owner Schar donates $12 million to Elon
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Elon University received a record $12 million pledge from Dwight and Martha Schar of Palm Beach, Fla. Dwight Schar is founder and chairman of Reston, Va.-based NVR Inc., which operates Ryan Homes and NV Homes. The couple have a son who is in Elon's class of 2016 and another son who plans to enroll at the Alamance County university next year.
The Schars' donation will be used to build a two-story, 45,000-square-foot building for the School of Communications. Money will also be used for construction of a convocation center.
Schar is a co-owner of the Washington Redskins football team. At his alma mater, Ashland University in Ashland, Ohio, the athletic complex, education school and nursing school are named in his honor, reflecting his philanthropy.
Schar founded NV Homes in 1979 and took the company public in 1986. After acquiring Ryan Homes in 1986, the heavily indebted company filed for bankruptcy reorganization in 1992, according to Forbes magazine.
Schar controls about $88 million of NVR shares, according to Yahoo Finance. The company's shares have advanced 22% this year and NVR has a market capitalization of $5.1 billion.
Elon was founded in 1889 and has about 6,500 students, including 5,800 undergraduates. About 59% of the students are female, according tot he college's website.
Eshelman donates $100 million to UNC
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Fred Eshelman, founder and former CEO of Wilmington-based Pharmaceutical Product Development LLC, pledged a $100 million donation to the Eshelman School of Pharmacy at UNC Chapel Hill, his alma mater. It was the largest individual donation the university has ever received and the largest ever made to a pharmacy school in the United States.
The donation will create the Eshelman Institute for Innovation, which will promote research and encourage entrepreneurship, UNC Chancellor Carol Folt said at a Wednesday announcement. Folt has been leading an effort to increase private funding at UNC.
Eshelman founded PPD in 1985 as a one-man startup. It was sold in 2011 for $3.9 billion to two private equity companies, Washington, D.C.-based The Carlyle Group and San Francisco-based Hellman & Friedman. In 2010, PPD spun off Morrisville-based Furiex Pharmaceuticals Inc., which was sold in July to Forest Laboratories Inc., a subsidiary of Dublin-based Actavis, in a deal valued at about $1.1 billion.
The pharmacy school was named for Eshelman in 2008. He has donated $38 million to the school since 2003.
The school enrolls approximately 650 students in its professional degree program, more than 100 students in its graduate program and has more than 100 full-time faculty members.
"In the past 10 years, the school has generated more than 130 patents and created 15 spin-off companies," said Eshelman, who has been a member of the school's Board of Visitors for more than a decade and has lectured at the school as an adjunct faculty member. "Their success demonstrates the power and the future of drug discovery in academia, and it's a future that I am eager and proud to support."
The UNC pharmacy school is second among the nation's pharmacy schools in total federal research funding and specifically in National Institutes of Health funding, according to a news release about the donation.
Eshelman earlier this year urged North Carolina's political leaders to invest more money in the state's university system. He is president and a key contributor to Wilmington-based RightChange.com, a political group that supports Republican Party candidates.


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Originally published on Tue July 10, 2012 6:52 am
Over a decade ago, Britton Nicholas Newlife bet with a bookmaker that Roger Federer would win Wimbledon seven times. The bet was for $2,300 and the odds were 66-1. Newlife died three years ago, but he left his betting ticket to the international charity Oxfam. On Sunday, Federer won his seventh Wimbledon title. Oxfam will receive more than $150,000 in winnings.


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Cooper & Elliott is the premier Ohio law firm with a focus on wrongful death settlements and serious personal injury. Since 1995, we've achieved justice for thousands of clients. To date, our firm has obtained more than $60 million in jury verdicts and settlements for our clients, including some of the largest jury verdicts in the state of Ohio.
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We're proud that our work has improved our clients' lives, increased public awareness and impacted public safety.


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The Shanklin Hotel enjoys and enviable location with views over Sandown Bay and beyond. The accommodation is well configured and well appointed; a choice of beds is offered to meet the needs of a vari...More about Shanklin Hotel
This delightful house specialises in holistic breaks and enjoys a tranquil yet convenient setting among manicured grounds, close to the seafront and village centre. Care has been taken over the beauti...More about The Grange
Located in the heart of the picturesque village of Godshill, Koala Cottage offers three spacious and comfortably appointed bedrooms, all with external access and on-site parking. Bedrooms and bathroom...More about Koala Cottage
This quietly located hotel is within easy walking distance of the town centre and the lift down to the promenade. Bedrooms are traditionally furnished and guests can enjoy the various spacious public ...More about Melbourne Ardenlea Hotel
A former Victorian villa set on the hillside above Ventnor and with memorable views out to sea, The Hambrough has a modern, stylish interior with well-equipped and boutique-style accommodation. The ki...More about The Hambrough
Blandings is a detached home in the grounds of Horringford Gardens. Set in a small group of farm buildings, it was formerly the piggery and wainhouse, where the farm carts were kept. The guest bedroom...More about Blandings
A warm welcome awaits at this Victorian villa, which is pleasantly and quietly located in an elevated position overlooking the bay. The well-equipped bedrooms are traditionally decorated, while public...More about St Maur
This family-run hotel is located in the heart of Shanklin. Bedrooms are traditional in style yet spacious and all front rooms benefit from balconies with views of Sandown Beach. There is a spacious ba...More about Auckland Hotel
High quality, budget accommodation ideal for both families and business travellers. Spacious, en suite bedrooms feature tea and coffee making facilities, and Freeview TV in most hotels. Internet acces...More about Premier Inn Isle of Wight (Newport)
This country house is situated on an elevated position with panoramic sea views above the historic village of Bonchurch. Luxury bedrooms and suites are spacious and individually styled. Public rooms i...More about The Leconfield


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Adobe Voice: A Free iPad App For Pitching Brilliant Ideas to the World
Everyone with a cool new idea or vision wants a concise and beautiful video to illustrate their story and broadcast it to the world. But oh, right—you suck at all things visual and just learned how to make something move in After Effects. Adobe's new iPad app, Voice, is there to hold your hand in the making of… »


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vegetable partners in containers: cukes + toms?
How large a container is needed to plant a tomato and cucumber (small bush variety) together?
I read that raccoons--who've always taken a liking to my tomatoes--hate cukes. My hope is that by planting the two together I will actually get to eat the tomatoes I've grown.
Sorry. I think you'd need to have a whole cucumber patch around your tomato plant to keep raccoons away. Supposedly they don't like stepping on the vines. How are you going to get through them to care for your tomato?
Raccoons are omnivores but they prefer protein to vegetables. Are you sure they are eating your tomatoes?. I have heard the idea that cucumbers will repel them, but I have never heard someone say it worked for them. On top of that, a single tomato plant needs at least 10-20 gallons to thrive and cucumbers need almost as much. Growing together they would be much more vulnerable to fungal diseases and pests.
Here is a link that might be useful: Here are some other ideas for keeping raccoons away.


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UND's hockey formula likely won't change
GRAND FORKS — The University of North Dakota men's hockey team should have a familiar feel next season: proven goaltending, dynamic defensemen and a group of forwards that will have to put up offense by committee.
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Candy Sagon writes about health topics for AARP. She previously was a reporter with the Washington Post and has written numerous articles on food, health and nutrition for national magazines.
Posted: 02/27/2015 by Candy Sagon | Comments
Actor Leonard Nimoy — Mr. Spock to his legions of Star Trek fans — has died at age 83 from a destructive lung disease called COPD, telling his fans in a poignant tweet last month: "Don't smoke. I did. Wish I never had." His wife confirmed his death to the New York Times, saying the cause was end-stage COPD, or chronic obstructive pulmonary disease. He had been hospitalized earlier in the week. COPD is one of the most common lung diseases …
Posted: 02/27/2015 by Candy Sagon | Comments
OK, we know you're smirking. This is not about how a man's finger size is related to the size of his junk. (Not that there's anything wrong with that — in fact, one study says it's true.) No, there's another reason women might want to check the length of a man's ring finger: It may be an indication of how nice he'll be toward the opposite sex. A new Canadian study says it has to do with the size ratio …
Posted: 02/17/2015 by Candy Sagon | Comments
Up to 80 percent of menopausal women suffer hot flashes, but doctors have typically reassured women that these embarrassing, uncomfortable bursts of heat and sweat won't last long. You know, maybe six months. Two years, tops. Ha-ha. Try up to 14 years. A new study — one of the first to look at a large, multiracial group of women — found that hot flashes typically last for seven years or more and that some women have reported suffering with them …
Posted: 02/16/2015 by Candy Sagon | Comments
The government's new dietary guidelines, due to be released in the coming months, may contain an about-face on decades of advice not to eat cholesterol-rich food. As the Washington Post put it, the move by the nation's top nutrition advisory panel "could undo almost 40 years of government warnings" about eating foods high in cholesterol, like eggs and shellfish. A preliminary report by the panel, released in December, stated for the first time that "cholesterol is not considered a nutrient …
Posted: 02/11/2015 by Candy Sagon | Comments
Just how big of an effect did movie star Angelina Jolie have on women getting tested for the BRCA breast cancer gene? A hefty 40 percent jump, according to the first study to look at the impact of Jolie's announcement that she had undergone testing. The study by the AARP Public Policy Institute analyzed more than 6.5 million health insurance claims for women 35 and older during 2013. Researchers found that testing rates increased from about 350 a week prior …
Posted: 02/09/2015 by Candy Sagon | Comments
For a moment last week, research offered all of us slow, plodding exercisers a moment of revenge. According to a new Danish study, those hard-charging runners who blow by us on the jogging trail — or pound away for a sweaty hour on the treadmill several times a week — are ruining their health as much as sluggish, non-exercising couch potatoes. In fact, the researchers said, it was really the twice-a-week, sedate joggers who were going to live the longest. …
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Originally written on WZR Online | Last updated 11/13/14
WWE did an interview earlier this week to talk about his advice for frustrated younger wrestlers. Below are some highlights: Big Show about young talent needing time to develop: "There's a lot of great talent there that just needs time to develop and grow. Dolph's one of the best heels we have right now, Dolph is going to continue to develop, and he's one of those guys that everybody loves to work with because he's so amazing to work with. Over time, these guys are going to have brilliant careers. The only advice I can give them is don't get short-sighted, don't get frustrated on what's going on now. Like Cody (Rhodes) and (Damien Sandow), those kids are so talented, not to be frustrated about what's going on, but understand that through perseverance, everything has a time and place in this company." Big Show on if he sees younger wrestlers getting frustrated: "Sure I do. Sure I do. I see it all the time. They get frustrated: 'Why aren't we doing this? Why don't get this opportunit
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Meir Panim delivers warmth, special care to families in need.
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There was no question that when Mrs. Cohen entered the room to meet the teacher she was hostile from the outset.
Szold was among the founders and leaders (she served on its executive committee) of Ichud ("Unity"), a political group that campaigned against the creation of an independent, sovereign Jewish state in Eretz Yisrael.
My friend is a strong and capable Jewish woman, but she acted with a passivity that seemed out of character.
First, sit down with your helpers and a pen and paper and break the jobs down into small parts.
Kitchen surfing is a unique concept that brings professional chefs to your home to prepare a meal in your own kitchen.
A lot of people have heard about dyslexia, a learning disability that concerns reading.
I believe that Hashem will only bring Moshiach when we finally achieve achdus.
He always impressed me with his brilliance and erudition. But it was his warm remarks and his sincere concern that made me want to please him.
Often I open Haggadot and find depictions of the Makos or slavery that I find troubling for a young audience.
Because birth order can affect most children in similar fashion, there are things you can do to help your children overcome weaknesses that birth order has thrown their way.
When one is blind one learns to use Braille to read. When one cannot walk, a wheelchair gives mobility. Sign language allows a mute person to speak and ocular implants assist in hearing when one is deaf. These are all compensatory strategies that help a person function despite his disability. But compensatory strategies are not just for physical problems. Understanding our psychological weaknesses and setting up our lives to ensure that we are not tempted to repeat our past mistakes, is as necessary as any aid to the disabled.
Well spouses have often discovered that their friends and relatives, despite their closeness to the situation, often don't realize the tremendous emotional impact living with chronic illness has on the family. With the best intentions, suggestions, ideas and criticism are offered, based on the non-experience of those with healthy families. Even when the good intentioned get a taste of the difficulties, it is sometimes not enough for them to then identify and understand what the family of the chronically ill must face on a constant basis.
Over the past two weeks I have shared letters from a therapist and a well spouse. Both of the letters gave personal insights into the process of losing hope, how we react when that happens and some ways of coping when test scores, diagnosis and just simple repetitive behavior indicate that change for the better is impossible.
Dear Ann,
I've read your last few articles on psycho-neurological testing (Oct.8-22) with interest. As a therapist who has counseled couples dealing with chronic illness, I'd like to give you another perspective.
Dear Ann,
Your articles on the Neuro-Psychological Testing were right on (October 8-22). My husband underwent testing twice and your articles explained it things exactly the way they were. Besides the test, we also tried therapy.
Very often when we can't face our big hurts or big loses we focus on the little ones. We can discuss those. We can cry over the small loses, be angry at the smaller hurts even though it may look trite and sound ridiculous to others.
Over the last two weeks we have been discussing one way in which well spouses can determine whether behavior displayed by their ill partners is caused by their illness or is a way they have chosen to act. We have focused on Psycho-Neurological testing, what it can tell us, as well as its pros and cons.
Last week I discussed a question that haunts many well spouses: not knowing if the difficult and often inappropriate behavior frequently displayed by their partners are caused by the disease and therefore not-controllable, or if the behavior is a choice the spouse makes and can therefore be changed. This doubt can be the source of much frustration and many marital disagreements. One way of alleviating this doubt is by having a psycho- neurological work up done. But that path is not so simple.
Printed from: http://www.jewishpress.com/sections/magazine/the-need-to-acknowledge-death/2008/02/20/
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"Working on this film has definitely put an end to a lot of cocktail party conversations." Martha Shane, along with co-director Lana Wilson, talk with Doc Soup Man ahead of the release of After Tiller, a documentary about late-term abortion doctors.Continue reading this entry »
Independent journalist Tom Roston checks in and writes about the world of documentaries in his column, Doc Soup.
You can follow Tom on Twitter @DocSoupMan.
You can follow Tom on Twitter @DocSoupMan.
martha shane
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Normally, revolvers are cheaper than semi-autos.
Everyone should have at least one .357.
Amendment II:
"A well regulated Militia, being necessary to the security of a free State, the right of the people to keep and bear Arms, shall not be infringed."
Life Member NRA
Life Member NAHC
Former President of the ECPT (Eifel Combat Pistol Team)
Comparing the two calibers, is like trying to decide on buying a convertible or an SUV.
My first store purchase handgun was a Ruger Security Six. Someone had modified the grip to accept Police Six grips. Gun was built like a brick SH.
"You know what happens to men who go looking for blood? They find it." - Kind Old Man
I'm going to go against the grain here, and recommend
the 9mm. A very sensible, economical round.
The 357 is fraught with over-penetration, recoil, generally
too much power, additional cost, and limited magazine space.
Unless you have a need for a round, of the same general radius
as a 9mm, which is propelled by 3 times as much powder.
Always have clean socks.
The point wasn't to parse words, argue technical terms, but just an
opinion. Now, instead of lurking your every thread, and picking
every technical gaff apart, I'll merely state that in the comparison
of the semi-357s, (as in DE357, for instance, although I'm given
to understand there are a couple new ones) the mags are limited,
compared to the substantially higher capacity mags of a 9MM
auto, but if it will make you happy, I'll waste the extra time,
and space, to needlessly say "limited round space a five or
six shot revolver offers."
There. NOW you can sleep peacefully, tonight, JW357.
Something to keep in mind. The original question was not just 9mm vs. .357 mag. It was a S&W SD9 vs. an EAA Windicator.
From what I know of both weapons, I'd rather have the Windicator even though in general I'd rather have a 9mm auto.
"For every problem there is always a solution that is simple, obvious, and wrong." - Mark Twain


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Brief summary This experiment is carried out to show the differing effects of axial and mid-span loading. The experiment highlights how theoretical buckling characteristics differ from actual results observed and from analysis of the results one can attempt to account for these differences. The experiments consists of three tests (as described in the procedure section) Test A) shows how a beam would behave with 'normal' mid-span loading. Test B) is similar to Test A) however it incorporates axial loads. By comparing the results with Test A) one can see how a single non-varying axial load affects the mid-span loading. Test C) investigates the effect of eccentricity on axial loading. Axial loads are applied with different eccentricities. Purpose of experiment The aim of this experiment is to investigate the buckling characteristics of a slender beam under axial and mid-span loading. The experiment can be used to predict how the properties of a beam in a real life application will differ from a theoretical beam. The experiment aims to answer the following 1. What are the effects of mid-span and axial loading? 2. How do mid-span and axial loads effect each other? 3. How close to theory are real life beams. (i.e. % error) 4. What is the effect of axial eccentricity 5. What needs to be considered when designing beams for 'real-life' applications? Procedure The apparatus is set-up as above. Three tests are performed; Test A) Investigate the characteristics of mid-span loading (W). Axial loading (Q) is set to zero (therefore Eccentricity (ε), is 0). The lateral mid-span load is varied. Increments of 0.2 LB are used. The lateral deflection δ is measured for every value of W. Care must be taken to calibrate the ruler to zero before the start of the experiment. Test B) Investigate the characteristics of mid-span loading, with different values of Q. Four values of Q are used (3,6,9,12 LB) and W is varied. Increments of 0.2LB (W) are used for Q = 3LB Increments of 0.2-0.05LB (W) are used for Q = 6LB Increments of 0.2-0.05LB (W) are used for Q = 9LB Increments of 0.05-0.01LB (W) are used for Q = 12LB The lateral deflection δ is measured for every value of W and Q. I.e. there are four sets of results, one for each value of Q. Care must be taken to calibrate the ruler to zero before the start of the experiment. Test C) Investigate the relationship between lateral mid-span deflection and eccentric applications of axial load. Three different eccentricities (0,3.18,6.35mm) are used and P( 'true' axial load) is varied P is calculated with the following formula; P = 0.75Q + 3.56 Increments of 0.1-0.05 are used for an eccentricity of 0 Increments of 0.1-0.02 are used for an eccentricity of 3.18mm Increments of 0.1-0.02 are used for an eccentricity of 6.35mm The lateral deflection δ is measured for every value of P and ε. I.e. there are three sets of results. Care must be taken to calibrate the ruler to zero before the start of the experiment. Observations Test A) The graph W Vs δ shows that up until a certain point a load W, causes a deflection that increases linearly with increasing weight. Then after a certain point a small increase in W causes a much larger deflection. Fig 1 shows how the mass of the scale pan can be calculated by the offset of the linear portion of the graph from zero. The y-intercept occurs at –2.4 therefore the mass of the scale pan is 2.4. This mass is added to Test B). 2.4N / 4.45 = 0.54 LB - added Test B) The beam behaves similarly to Test A). The W Vs δ graphs show that with addition of an axial load Q the beam buckles at a lower weight. As Q is increased the force W required to make the beam buckle is lessened. Test C) Again the beam has the same behaviour as in Test A), the beam deflection is proportional to the weight up until a point when it buckles. Then a large deflection is induced by a small increase in weight. By comparing the different eccentricities on a W Vs δ graph one can see that an eccentric load makes a beam buckle at a much lower weight and increasing eccentricity increases the effect. Error analysis 200 Identifiable sources of error include but are not limited to; Weights being dropped – causing swinging and resulting moments Weights not accurate (chipped and broken) Friction in the system particularly the pulley The beam not being supported by pin joints Movement in the notches and its associated friction Loading point Q does not represent a true axial load The theoretical Buckling load is Pc = π2EL(2L)-2 = π2EI/(4L)2 Where Pc = Critical buckling load E = Young's modulus of elasticity (=200Gpa) L = Length I = Second moment of area = db3/12 When the assumption is made that; there is one free end and one supported round end Pc = π2EI/4L2 Pc = π2EI/4L2 Pc = (9.87 * 200*109 * I )/( 0.61)2 where I = ( (0.0254 * 0.00162 3) / 12) Pc = (9.87 * {200 *109}* {9*10-12} )/( 0.3721) I = 8.9991 *10-12 Pc = 47.75N From Test C) with zero eccentricity one can see that the Actual Pc = 50.0N (using P value, which represents true axial load) %error = (Theoretical – Experimental)/Average) *100 %error = [(47.75 – 50) /48.875] *100 %error = 4.6% Discussions Mid span and axial loading can both cause a beam to fail. However a single beam can support a much higher axial load then mid span load. It is easier to make a beam fail by mid-span loading then axial loading. The max deflection is going to be in the centre of the beam. The mid-span load acts directly at the point of max deflection whereas the axial load does not. The axial load is compressing the beam. The mid- span load acts parallel to the resulting deflection. After a critical point an axial load will induce failure much faster then a mid-span load. This effect is caused by moments. In the case of axial loading a small deflection of dx, causes a moment equal to dx multiplied by the distance to the force(which is perpendicular to the deflection), as the deflection increases so does the moment so the beam fails 'quickly'. Mid span loading doesn't have this induced moment since the force is in the same direction as the deflection (i.e. perpendicular distance =0). Any eccentricity in the axial load causes the beam to fail at lower weight, this is again due to moments. The load is not through the central axis of the beam. The eccentricity itself is a small distance perpendicular to the axial force being applied and therefore a moment is created. The mass of the scale pan is calculated in the observation section. The weight of the scale pan (2.4N) is not added in Test C) because it is insignificant compared to the weight required to buckle the beam i.e. it is less then the errors present in the experiment. There are errors associated with calculating the mass of the scale pan by this method too. It can be seen that there are errors in Test A) & Test B) since when the mass of the scale pan is added to Test B) it still does not go through the origin. The % error in Test C) is calculated = approx. 4.6% Conclusions One can see that this type of experimentation is prone to error. There is a proven error of 4.6% and this is not necessarily the max possible error, as positive and negative errors may have cancelled each other out. When designing beams for 'real-life' applications, if possible it is very important to ; Avoid eccentricity Use axial loads instead of mid-span loads Incorporate a safety factor This series of test demonstrates that real life situations cannot be predicted 100%accurately so it is important to make sure that a real life beam can withstand more then the design load. This safety factor insures that the beam is not going to buckle unpredictably. Theoretical buckling loads should be used as a guide. To model a real life system more accurately the following steps should be taken. Move Q to make it a true axial load Ensure that better more accurate weights are used Take measurements electronically Make sure the weights are not dropped and there is no swinging Avoid eccen Use axial loads Real life apps safety factor Refer to beginiing Imprve exp 14 12 10 8 6 y = 0.4802x - 2.4625 4 2 0 -10 -2 0 10 20 30 4 -4 -6 Series1 Series2 Linear (Series1)
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Dr. William Atkinson reviews medical content for Healthwise, a
nonprofit organization with a mission to help people make better health
decisions. He has worked in public health his entire professional career, first with the Louisiana State Health Department in New Orleans, and since 1989 with the Centers for Disease Control and Prevention in Atlanta, Georgia. Dr. Atkinson is on the Medical Advisory Board for the Centers for Disease Control; serves as Liaison Member for the Immunization Action Coalition, St. Paul; and is a Commissioned Officer of the United States Public Health Service. Dr. Atkinson is the head of the National Immunization Program at the Centers
for Disease Control and Prevention in Atlanta.
MD: University of Missouri-Kansas City, Kansas City, MO, 1977
Resident in Internal Medicine: Kern Medical Center, Bakersfield, CA, 1978–1981
Chief Medical Resident: Kern Medical Center, Bakersfield, CA, 1980–1981
Fellowship in Infectious Disease: University of California Irvine Medical Center, Irvine, CA, 1981–1983
Epidemic Intelligence Service Officer: Centers for Disease Control Division of Field Services, New Orleans, LA, 1983–1985
General Preventive Medicine Residency: School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, 1983–1986
Masters of Public Health: Epidemiology School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, 1986
American Board of Internal Medicine
American Board of General Preventive Medicine
Tulane University, New Orleans, LA:
No financial report received from reviewer.
Healthwise Staff
This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use.
How this information was developed to help you make better health decisions.
To learn more, visit Healthwise.org
© 1995-2014 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.
Donations to UW Health are managed by the University of Wisconsin Foundation, a publicly supported charitable organization under 501(c)(3) of the Internal Revenue Code.


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