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Redrow [4]: Two sites touted for new Cheltenham school near Redrow Leckhampton site
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Possible locations have been revealed for the new £30million school which is being planned for Cheltenham.

The new school would be an all-through school for primary and secondary pupils aged four to 16, and Gloucestershire County Council wants it to open in September 2020.

Cheltenham's Balcarras School announced this week it will team up with three other schools in the town to put a bid together to develop and run the project.

It is believed that two greenfield sites in Leckhampton and Up Hatherley are being considered for the new school.

And Gloucestershire Live understands the trust managing Marling School, in Stroud, is putting together a bid to compete with Balcarras to build Cheltenham's new school.

Where could the new school go?

South of Up Hatherley Lane

One location for the new school could be between Up Hatherley Lane and Shurdington Road, or between Farm Lane and Leckhampton Lane.

(Image: Google)

Redrow have won permission to build 377 homes on the land bounded by Leckhampton Lane and Farm Lane - despite a legal challenge by Leckhampton Green Land Action Group.

Leckhampton Fields

A second possible location for the new school is the Leckhampton Fields - between Shurdington Road and Church Road and off Kidnappers Lane.

(Image: Google.)

Developer Miller Homes plans to build 350 houses and to invest £65million to develop a patch of land off Shurdington Road, known as Northern Fields – creating more than 1,000 jobs in the process.

It is understood school planners at Gloucestershire County Council have not ruled out using Leckhampton Fields land for the new school.

Councillor Iain Dobie (LD, Leckhampton and Warden Hill), said he had no preference at this stage where the school should be, but he has concerns about the possible use of the Leckhampton Fields as there's not enough space or adequate roads.

He said: "What I want is for this new school to be located within easy reach of the community it will be serving.

"I welcome the proposal for a new school to serve the community. I want it to be in this area but the decision on where it's going to be located is going to be made by public authorities - the Department for Education and Gloucestershire County Council."

The Cotswold Beacon Academy Trust, which manages Marling School, has confirmed its interest in bidding for the new school.

Dr Stuart Wilson, chief executive of the trust, said: "Cotswold Beacon Academy Trust has been taking a keen interest in developments in Cheltenham since the Local Authority announced the need for a new secondary and primary school.

"There is some uncertainty at the moment about the exact criteria and process for free school applications in Wave 13 but we hope that clear information will be available from the DfE shortly.

"In the meantime we have been discussing a potential bid for the primary and secondary schools; subject to trustees approval we would look to start formal consultation in the autumn."

Councillor Richard Boyles, Gloucestershire County Council's cabinet member for children and young people (C, Blakeney and Bream), said: “The council has a good track record for planning school places and we know we need more places in Cheltenham, ideally by 2020.

"Our preferred route is a government funded free school and the first step on this path would be for potential sponsors to develop bids for the school.

“No site has been selected and we’re asking for landowners to get in touch if they have any sites for consideration.”

Output: Two greenfield sites in Leckhampton, Cheltenham, are believed to be under consideration for the new £30m primary through secondary school for pupils aged four to 16, which is expected to open in in September 2020. The location between Farm Lane and Leckhampton Lane is near land where Redrow has permission to build 377 homes. The other, between Up Hatherley Lane and Shurdington Road, is near the Northern Fields site earmarked for a £65m development by Miller Homes that is expected to create over 1,000 jobs and 350 houses. Leckhampton Fields has also not been ruled out.


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Morgan Stanley fund firm plan adds to list mulling Ireland move
 Morgan Stanley currently employs about 30 people in the area of fund administration in Dublin’s south docklands, on Sir John Rogerson’s Quay.

Wall Street giant Morgan Stanley is planning to apply for a licence to set up a fund management company in Dublin to maintain access to investors in the European Union after Brexit.

The group, which has $1.3 trillion (€1.13 billion) of assets under management, is planning to apply to set up a company under the Markets in Financial Instruments Directive (MiFID), according to sources.

A number of other companies, including investment group Legg Mason, are planning to set up similar structures in Ireland, which would typically employ between 20 and 50 people to demonstrate that they have substantive operations and the "mind and will" of the entities in Ireland.

Such a move will allow Morgan Stanley to continue to market its funds in the EU. The actual money managers making day-to-day decisions on investments will remain outside of Ireland.

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Dublin’s south docklands

The bank currently employs about 30 people in the area of fund administration in Dublin’s south docklands, on Sir John Rogerson’s Quay. Sources said that it is likely that its existing office accommodation will be able to house the additional staff.

More than $2 trillion of global fund assets are domiciled in Ireland in an industry that employs about 14,000 people.

Meanwhile, Morgan Stanley has selected Frankfurt to set up its new EU trading hub, joining a growing number of international investment banks, from Citigroup to Nomura, that have chosen to establish their European broker-dealer businesses in the German city, home of the European Central Bank and its banking supervision arm.

A spokesman for Morgan Stanley in London declined to comment.

Bloomberg reported on Wednesday that Morgan Stanley will transfer about 200 jobs to Frankfurt under its plan to set up an EU trading centre there.

However, sources told The Irish Times that the choice of Frankfurt was merely taken to ensure that the group had an operation up and running by March 2019, when the UK is scheduled to exit the EU, and that this does not mean that the city will be the long-term location for the broker-dealership.

Output: Morgan Stanley has become the latest financial giant to consider opening an office in Ireland to maintain access to European investors after the UK leaves the European Union. The bank is said to be considering an application to open a fund management company under MiFID II rules. It would follow other companies, including investment manager Legg Mason, in moving away from the UK, a strategy that allows them to continue marketing to EU investors.


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Nasdaq warns EU that MiFID II gives SIs unfair advantage
 Nasdaq has urged the European Commission to re-examine systematic internaliser (SI) rules in MiFID II, saying they will have a significant advantage over other trading venues.

According to a written response to the Commission’s amended MiFID II regulation, Nasdaq said SIs will benefit from lax rules around tick sizes and transparency, giving them an unfair advantage.

The Commission has already made an unprecedented move to clamp down on SIs by issuing revised delegated regulation preventing them from networking together, after rumours emerged earlier this year that several investment banks were planning to link their SIs and make them function in a similar manner to broker crossing networks, which will be banned from January 2018.

In its submission, Nasdaq said: “the ability of SIs to improve prices without respecting tick sizes means SIs will be allowed to offer marginally better prices to clients. In conjunction with best execution requirements, this means SIs are extremely likely to capture significant trading flows.

“Second, control over the timing of trade publication on SIs (up to 1 min) will give SIs a considerable advantage over market makers on public markets.”

It warned that leaving these issues unresolved could have unintended consequences, such as trading shifting to less transparent environments, market makers becoming SIs and not providing liquidity for public markets, and higher levels of risk in the market.

Nasdaq has asked the Commission to make targeted changes to both its level 2 and level 3 regulation.

It wants RTS 1, Article 10 to be amended to specifically state that executions must be at price levels compliant with the tick size regime.

It also asked for clarification on trade publication, which is required to take place “as close to real-time as is technically possible” but must be within one minute. Nasdaq argues a minute is a very long time in modern trading and the rules should set more specific limits to ensure all trade publication happens as soon as possible.

Many investment banks are considering whether to register as an SI or become a multilateral trading facility (MTF) once broker crossing networks are banned next year. It is thought many will prefer to become SIs due to the regulatory burden of running an MTF.

Output: Nasdaq has called on the European Union to reconsider its rules on systematic internalisers (SIs) under new regulations coming online in January. The exchange company has said SIs, investment firms that make large-scale trades away from public markets, would have an unfair advantage under MiFID II rules. SIs "will be allowed to offer marginally better prices to clients", said Nasdaq in a submission to the EU's executive body. It went on to say "this means SIs are extremely likely to capture significant trading flows". It warned that such a situation would lead to trade relocating to less transparent venues and liquidity drying up in public markets.


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ASCO Outlines Solutions for More Affordable Cancer Drugs
 In a recently released position statement, the American Society of Clinical Oncology (ASCO) has outlined a pathway that would address the rising costs of cancer drugs in the United States.

The position statement tackles the urgent issue of the cost of specialty cancer drugs and the financial toxicity that can result for patients. It cites the nuances of the US healthcare marketplace as well as the rapid growth in available drugs as some of the reasons it will require a multifaceted approach to control these rising prices while ensuring patient access to care and innovative drug development.

ASCO has called for raising the standards for drugs to be considered clinically effective, which would ensure that approved drugs yield significant value to patients, relative to their cost. The statement also recommends utilizing value-based pathways to guide drug utilization, and pricing drugs based on the indications they are used for or the outcomes they produce in patients. However, the statement emphatically recommends against using payment bundles in oncology, since they are too homogenous and could push providers to make subpar clinical decisions.

ASCO’s statement also outlines some regulatory steps that could be taken to lower drug pricing, such as shortening the market and data exclusivity windows for biologic drugs and outlawing several tactics that brand-name drug makers use to discourage competition. It cautiously mentions the possibility of importing lower-priced drugs from foreign countries, but notes that there are safety risks associated with this practice that have the potential to increase drug prices in the overseas markets.

The statement included some positions aimed at insurers who cover the cost of cancer drugs:

ASCO strongly opposes tiered formularies, which could put some oncology therapies out of financial reach for patients.

Allowing Medicare to negotiate discounts with drug makers could lower prices, but may have unintended consequences if the program can deny coverage of a costly drug.

Implementing value-based pathways in Medicare may be a feasible way to establish value based on the recommendations of the scientific community, not the government.

Finally, the statement emphasizes the importance of drug pricing transparency, which would let payers and patients examine the relationship between development costs and drug pricing and hold drug companies accountable for any apparent efforts to gouge prices.

In summary, ASCO recognized that the complex problem of cancer drug costs does not have a simple solution, but coordinated efforts to define value, experiment with pricing initiatives, and drive innovation will be crucial.

"Drug pricing is clearly too complex and political to tackle without evidence-based solutions," said ASCO CEO Clifford Hudis, MD, FACP, FASCO, in a press release announcing the release of the position statement. "We're focused on finding out what works and what the potential downsides and unintended consequences might be with each intervention. However, ASCO believes we must develop approaches that will protect patients from rising costs while improving care."

Output: In a recently released position statement, the American Society of Clinical Oncology (ASCO) has outlined a pathway that would address the rising costs of cancer drugs in the United States.


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Sighs of Relief From Health Safety-Net Providers in California After Senate Bill Collapses
 'The threat is still there for our patients'

Tiburcio Vasquez Health Center (TVHC) in Hayward and Union City, and Zuckerberg San Francisco General Hospital have traditionally served low-income patients, regardless of their ability to pay. Before the ACA, the majority of their patients were uninsured, but now that’s reversed, and most patients arrive with Medi-Cal coverage or private insurance purchased with ACA subsidies on Covered California.

Those additional insurance dollars have been the difference between scraping by and being able to make significant improvements.

"Safety-net delivery systems are traditionally very poorly resourced," said Dr. Alice Chen, chief medical officer for the San Francisco Health Network, an affiliate of Zuckerberg SF General. "We've invested the new revenues that have come in for Medicaid patients into improving our systems of care." She says her network has brought in $150 million in new revenues from the Medicaid expansion.

With those dollars, Chen says SF General, where she is based, has been implementing a new electronic health record system, and is working on initiatives to integrate mental and medical health and improve the patient's overall experience. Work like this, she says, wouldn't be possible without the additional resources from Medicaid dollars.

Medical students and residents at the University of California, San Francisco also said they were tentatively happy that it appears the ACA will remain in place. Dr. Emily Thomas is a UCSF resident who has been politically active since the 2016 election. She’s fighting to keep her patients insured through the ACA. She spoke to a crowd of doctors at SF General on Tuesday, explaining why she wanted the advocacy to continue.

“Even though the BCRA has collapsed at the Senate, the threat is still there for our patients,” Thomas said. “Our patients are still relying on everyone in this room to continue to advocate for their expanded access to care.”

Across the bay, at Tiburcio Vasquez Health Center, CEO David Vliet says his clinic has increased the number of patients it can serve due to the Medicaid expansion dollars. In addition to their existing clinics in Hayward, Union City and Fremont, health center administrators have built a $12 million facility with 22 exam rooms.

Regarding the additional Medicaid money, Vliet emphasized that "those dollars really do have a return on investment, in that when we are able to make sure that Mr. Smith or Mrs. Rodriguez doesn't show up in the ER with tooth pain, everyone in the community enjoys lower costs."

Vliet said now that changes to the ACA are on hold, he's temporarily relieved. But he will still continue to monitor what's happening in Washington, D.C. If the increased funding continues to flow through Medi-Cal, Vliet says he would like to continue to expand services over the next few years to even more residents in the East Bay. Even after all the growth, TVHC staffers are working at capacity. There are still patients in the community waiting to be seen.

Adding to his concern, there is a chance Senate Republicans will revive the stalled health plan and push it through, which is what happened this spring in the House of Representatives.

Output: Health care workers at California hospitals and clinics that serve low-income patients are relieved but still wary after the collapse of the Senate Republican health care bill earlier this week.


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With Rise of Diabetes Technology Comes Value-Based Payment
 Wth seemingly everyone having a smartphone and carrying it everywhere, it was only a matter of time before apps took center stage in efforts to prevent and manage diabetes.

But figuring out how to connect health plans with this technology is proving complicated. Medicare’s efforts to launch the Diabetes Prevention Program (DPP) by early 2018 have slowed as it works to include digital providers, which are needed to scale DPP to all who will need the program.1

Even paying for more conventional devices isn’t always straightforward. As diabetes technology evolves, patients want more choices, whereas payers want to hold down costs.

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To delve into these issues, The American Journal of Managed Care® (AJMC® hosted the discussion “Technology in Diabetes Care: From Prevention to Disease Management” during its April Diabetes Stakeholders Summit, a Peer Exchange™.

Moderator Dennis P. Scanlon, PhD, professor of health policy and administration and director for the Center for Health Care Policy and Research in the College of Health and Human Development at Pennsylvania State University, in University Park, Pennsylvania, led the discussion. Joining him were Robert A. Gabbay, MD, PhD, FACP, senior vice president and chief medical officer, Joslin Diabetes Center, Boston, Massachusetts; Mary Ann Hodorowicz, RDN, MBA, CDE, CEC, a Chicago, Illinois—based consultant, dietitian, and trainer; Kenneth Snow, MD, MBA, medical director, Aetna; and Neal Kaufman, MD, MPH, founder and CMO of Canary Health.

The April discussion foreshadowed an important development when Snow said that “without a doubt” the diabetes device world would be moving toward value-based payment models. On June 26, 2017, as this special issue of Evidence-Based Diabetes Management™ went to press, Aetna and Medtronic announced a risk-sharing agreement for patients transitioning from multiple daily insulin injections to Medtronic’s insulin pumps, including the new Medtronic MiniMed 670G. The agreement covers patients with types 1 and type 2 diabetes (T1D and T2D). Medtronic’s reimbursement will be partly based on outcomes-based measures for patient experience, clinical outcomes, and total cost of care.2

Technology and the Diabetes Prevention Program

As the discussion began, Gabbay explained that results from a landmark National Institutes of Health study show that a lifestyle intervention under “very controlled, rigorous conditions” could produce better results than medication (metformin) for preventing diabetes.3 “The challenge of that study [is that] it was done in a very resource-intensive way to ensure that people adhered to their lifestyle,” Gabbay said. “Now, how do you apply that to the broader population?”

That was the early concern for payers, Snow said, even though they were excited about the DPP. Kaufman, who was very involved in the early years of the DPP, weighed in, pointing out that a single trainer could help 30 to 40 people a year because the program required 16 weekly sessions at the start, followed by monthly in-person sessions. Training was done one-on-one.

“The CDC recognized that that was not a scalable or sustainable model and began looking at how to provide it in other ways,” Kaufman said, and then described 2 “threads” of approaches. The first, most common approach involves training to 10 to 15 people at once, with highly trained educators leading the groups. The best example is the YMCA pilot study funded by the Center for Medicare & Medicaid Innovation (CMMI), which provided the evidence to scale the program across Medicare.4

The second approach is to use technology. The question here, Kaufman said, is whether a program offered in person would translate in a digital format, using a cell phone. “I was very much involved back in 2006 to create a digital version of that program,” he said. “At that time, we didn’t know if it was going to work. We didn’t know if people would accept it, but we recognized that people need choice …

“And so, we, and now a number of other companies, have been able to demonstrate that you can take an in-person program, use great design and great approaches to make technology work, and have individuals use it effectively.”

Scanlon asked the panelists to elaborate more on the YMCA study, because it formed the basis for Medicare’s decision to fund DPP, a decision that will bring diabetes prevention to seniors on a widespread basis in 2018. Many DPP providers believe that once commercial payers that administer Medicare Advantage see the value of the program, DPP will become even more embedded in health plans.5 Hodorowicz said that the dynamic of self-monitoring—tracking weight and exercise and keeping a food diary—and having to report to a lifestyle coach increases motivation more than taking these steps alone does.

Scanlon asked if the number of sessions patients must attend helps, as well. Kaufman replied that based on the YMCA study results, it does. The study contributed to the regulations CDC uses for program recognition: 16 weekly sessions, followed by less frequent attendance for a total of 26 sessions.

What about evidence? “This was a big decision for CMS to decide they were going to go ahead and pay for this,” Scanlon said, adding that it has not been without controversy. “Will other payers follow?”

Snow noted the enormous impact: “Any decision by CMS, whatever cost there is has to be multiplied by millions.” But one difference with Medicare, he said, is that beneficiaries don’t leave, so Medicare reaps the rewards of its investment. For other payers, a preventive service may or may not pay dividends if enrollees switch insurers. Still, “some payers have already made decisions regarding continuing coverage similar to CMS,” and Aetna is among them, he said. “Some will be looking at the type of data that comes out in the real world and real-life experience to see if the results that are hoped for are actually achieved.”

Thanks to the YMCA pilot, Gabbay said, it’s no longer theoretical that the DPP saves money. “That, in essence, was exactly what CMMI was set up to do—to be able to do pilot studies that show cost savings or high value, and then spread that more broadly,” he said.

When asked by Scanlon to address the role of diabetes educators in offering the DPP, Hodorowicz said that for years, patients with prediabetes were referred to educators but did not quality for coverage, even though a certified diabetes educator was perhaps the best person to help that patient avoid progressing to diabetes. But now, with some commercial payers offering coverage and » CMS poised to do so, the American Association of Diabetes Educators is training DPP coaches. “It’s an easy fit to include prevention with an existing self-management program run by diabetes educators,” Hodorowicz said. “It’s a perfect marriage.”

Kaufman agreed. If a person is at risk for diabetes, he said, “we need to help them improve their life’s trajectory, to help them so that they don’t add a new chronic condition every 3 to 5 years, as many people do.” That starts with lifestyle intervention. Focusing on the glucocentric requirements of eligibility for the DPP that will help people lose weight and become active is too restrictive, he said.

Once payers have the data, Snow said, they will look beyond the issue of diabetes: Does helping at-risk patients lose weight also help avoid issues such as joint damage or back problems? “[These] are clearly not glucocentric but still related to the same population,” he said.

“The real secret sauce is, how do you get people to sign up and show up?” Kaufman asked. “Once you can get them to the program, we can almost predict for 1000 people or 10,000 people what’s going to happen. But how do you get the right person to the right program at the right time to engage them, to activate them, to get them to see that there is a benefit?”

Gabbay agreed that for some patients, in-person programs such as the YMCA will be best, but for others, digital solutions will work well. Hodorowicz said she believes that for the younger generation, digital solutions will be more popular, and Snow noted that Medicare enrollees are more accepting of technology than people realize.

It’s important to distinguish between a digital tool, such as a text, which acts as a reminder, Kaufman said, and an intervention, which is a full program of health improvement. Gabbay said he regularly uses the smartphone, such as to show patients that they are walking less than they think. By contrast, he said, “if you want to do something to prevent diabetes, you need a whole intervention, based not only on counting steps but also [on] dietary changes and other behavior change approaches.”

The Clinical Rationale for Continuous Glucose Monitoring

Scanlon moved the discussion to the importance of continuous glucose monitoring (CGM), now considered the standard of care for those with T1D and becoming more common for those with advanced T2D. A 2011 study6 in AJMC® was the first to quantify the cost of a hypoglycemic admission to the hospital and was cited by JDRF and others in their successful effort to convince the FDA and Medicare to change policies that will ultimately allow beneficiaries to have coverage for the Dexcom G5, although there have been some implementation issues.7,8

There’s evidence that—particularly for patients with T1D willing to use CGM technology—it shows a benefit, Snow said, both in terms of improving glycemic control and lowering hypoglycemia risk. “Once you get outside of that, causation data becomes very thin,” he said, “so you see observational data, where there’s clearly a relationship between hypoglycemia and…if you can give them the message that prevents the hypoglycemia event, well, then that is optimal.”

The challenge is to make sure that patients have access to both the CGM and the right education, which Hodorowicz said is key, because when patients know how to use the data the device provides, educators can more easily instruct them on how to “embed lifestyle changes.” “The good news is that Medicare is starting to cover [CGM],” despite strict criteria, she said.

“It’s fantastic news,” Gabbay agreed. “At Joslin, we have a large type 1 population, and for them, they reach Medicare age and they have to go off their continuous glucose monitor, which is a big problem,” he said. “But I think you’ll see, in the not-too-distant future, this spreading to more use in the type 2 [population] based on the kind of evidence that people who are on multidose insulin can clearly benefit.”

From a payer perspective, Snow said, the fact that the FDA approved the Dexcom G5 for dosing was reassuring—this was a key step in Medicare’s reversal of its longstanding refusal to pay for CGM. “Once you have that FDA stamp of approval, there’s significant advantage, not the least of which is it usually means that there’s legitimate scientific evidence,” he said. “And that scientific evidence is what supports the use.”

CGM data will be more reliable than patient logs, which could be helpful with older patients. “That helps diabetes educators and physicians with medication adjustments and lifestyle changes,” Hodorowicz said. “With the pediatric population, it’s wonderful because parents are so involved with their children’s control, especially of type 1.”

Audible alerts can help patients or caregivers avert an approaching hypoglycemic event. “Payers are starting to recognize that,” Hodorowicz said, “and it’s not just for the type 1s, it’s also for the type 2s on multiple daily insulin doses.”

Devices help, but it’s essential that patients already be engaged in their own care, Kaufman said. He pointed to a program developed by Stanford University, the Chronic Disease Management Program, which is decades old and has been highly successful with patients with T2D.9 “If your A1C was above 9%, it went down by 0.93% at 6 months, and 1.27% at 12 months with a 6-week intervention,” he said. “How does it work a year later? Because people change their lives, change their emotions; they change their sense of well-being, and, therefore, they were able to follow doctor’s orders better, follow nurse’s orders better.”

“And that becomes crucial in anything that has to do with self-management,” Kaufman added. Scanlon noted that this was work pioneered by Katie Lorig, DrPH, and remains foundational in chronic disease management.

Scanlon and Kaufman discussed the need for peer-to-peer support, either in person or in digital formats. Gabbay noted that vast potential for the latter is “just beginning to be tapped.” “Continuous glucose monitoring certainly helps, and even the simple ability of downloading blood glucose meter data and looking at that with the patient is really helpful,” he said. Providers don’t want too much data, however, and decision support tools help manage it all, which he called the next revolution.

“The next revolution after that,” Kaufman said, “is being able to assess it in the moment and give feedback to the individual in the moment.” The challenge, he noted, is that managing diabetes requires patients to constantly make micro decisions. No single decision is hugely important; it’s the sum of them that determines the outcome. The perfect device would require no interaction.

It’s hard to balance the desire for tools without overloading patients to the point of “alarm fatigue,” when they tune out the efforts to help them, Snow said, “because it just gets in the way of living.”

Payer Coverage, Patient Choice in Insulin Pumps

In this rapidly evolving area, Gabbay said, the FDA appears to be open to approving devices more quickly that it had been. “The floodgates are about to open because there are a whole series of iterative changes that can be made to push forward semiautomated insulin delivery,” he said.

As Scanlon noted, however, the issue is figuring out for whom is the device appropriate. “And how do we determine appropriateness?” he asked.

“That’s one of the great challenges, because there’s not a lot of good data that identifies who makes a good pump user,” Snow said. “We can extrapolate [whom] we believe that might be, but there’s not really a lot of data that [are] going to predict for the person sitting in front of you, whether they are likely to succeed or fail.”

Gabbay said that this is changing with the movement toward semiautomatic delivery; the bar is no longer as high for patients’ carb-counting and insulin-adjustment skills. “You could take patients with poor glycemic control and maybe not terribly adherent and [put them] on semiautomated insulin delivery, and that would at least improve their blood sugars overnight, and they would benefit,” Gabbay said.

CMS approved external insulin pumps for T1D and T2D Medicare patients who had been on multiple daily injections (and who have less control as they learn to use the pump in the first year), Hodorowicz noted. “The cost benefit has to be there for CMS to approve coverage for such an expensive item,” she said.

When asked about the differences between models and patient preferences, Hodorowicz said that a waterproof device is important to many patients. Some devices are disposable; some offer wireless infusion versus manual control. Different types of alarms matter to patients, as does ease of calibration. “I think the ease factor is critical,” she said.

CGM devices are on the verge of becoming much smaller and cheaper, Gabbay said, although pumps may remain relatively expensive and complex. Snow noted a possible disconnect between what makes sense from an individual’s point of view versus the population perspective. Giving an expensive device to a patient with a high glycated hemoglobin who seems unmotivated and unengaged may not make sense, but if a person’s A1C of 10% drops by 1.5%, then the population has become healthier overall.

A person with T2D with poor control could benefit from a continuous glucose monitor, Kaufman said, by identifying personal patterns and seeing the connection between certain foods and spikes in blood glucose. “The question becomes, can it become a behavior-change incentive to allow you to become even better at managing your own condition?” he said.

The panel discussed an agreement that will require most adult UnitedHealth patients with diabetes to transition to Medtronic pumps and CGM devices as warranties expire.10 “Sadly,” Gabbay said, “it’s somewhat inevitable because there will be competition around price, the same kind of things that happen in the pharmacy world—I don’t see why it won’t happen in the device world.”

Snow said that historically, if 2 drugs have equal efficacy but 1 is cheaper, the savings are passed down the line and ultimately result in lower premiums. “Clearly, there can be a benefit without a detriment of care,” he said.

Scanlon asked if payment models would change in this area, too. “Without a doubt,” Snow said. “It is the direction of the payer industry.” Many pharmaceutical companies have entered these agreements, “and the device companies are looking that way, as well,” he said.

“The idea of just paying for your treatment is one that was there in the past, but more and more the question is: is there a value from your drug, from your device? Regardless of what it is, is it adding value in terms of either less expensive care or better care? And it doesn’t have to be both.”

Gabbay added that A1C is no longer the only measure of success. “If you reduce hypoglycemic episodes, well, that’s probably a good thing, and that should be a metric, as well.”

The field of diabetes technology has entered an exciting era, Kaufman said. “A paradigm shift is happening,” he said. “We’ve got consumerism, where individuals are taking more control and responsibility for many things, including their health and health care. We’ve got technology being able to deliver something in the moment. You have it in your pocket at all times.

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ajmc.com/conferences/ada-2017/medicares-diabetes-prevention-program-is-coming-but-cmmi-has-work-to-do

“We’ve got the concept of population health, the concept of value-based care coming to a health system that wasn’t set up that way. If the patient is at the center, we always think of them as what’s most important and their needs, that we, as healthcare providers and payers and employers and health systems, will make it so that we’ll help patients have those outcomes that they need.”1. Caffrey M. Medicare’s Diabetes Prevention Program is coming, but CMMI has work to do. The American Journal of Managed Care® website . Published June 11, 2017. Accessed June 27, 2017.

2. Caffrey M. Medtronic announces outcomes-based agreement with Aetna for diabetes patients. The American Journal of Managed Care® website. www.ajmc.com/newsroom/medtronic-announces-outcomes-based-agreement-with-aetna-for-diabetes-patients. Published June 26, 2017. Accessed June 27, 2017.

3. Knowler WC, Barrett-Connor E, Fowler SE, et al; Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346(6):393-403. doi: 10.1056/NEJMoa012512.

4. Medicare Diabetes Prevention Program expansion. CMS website. cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2016-Fact-sheets-items/2016-07-07.html. Published July 7, 2016. Accessed June 26, 2017.

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ajmc.com/focus-of-the-week/0316/medicare-to-fund-diabetes-prevention-programs-report-says

5. Caffrey M. Medicare to fund Diabetes Prevention Programs, Burwell says. The American Journal of Managed Care® website . Published March 23, 2016. Accessed June 27, 2017.

6. Quilliam BJ, Simeon JC, Ozbay AB, Kogut SJ. The incidence and costs of hypoglycemia in type 2 diabetes. Am J Manag Care. 2011;17(10):673-680.

7. Centers for Medicare and Medicaid Services (CMS) classify therapeutic continuous glucose monitors (CGM) as durable medical equipment (DME) under Medicare Part B [press release]. San Diego, CA: Business Wire; January 12, 2017. businesswire.com/news/home/20170112006146/en/Centers-Medicare-Medicaid-Services-CMS-Classify-Therapeutic. Accessed June 27, 2017.

8. Caffrey M. Medicare coverage for CGM caught in regulatory limbo. The American Journal of Managed Care® website. ajmc.com/focus-of-the-week/0517/medicare-coverage-for-cgm-caught-in-regulatory-limbo. Published May 9, 2017. Accessed June 27, 2017.

9. Lorig K, Ritter PL, Ory MG, Whitelaw N. Effectiveness of a generic chronic disease self-management program for people with type 2 diabetes: a translation study. Diabetes Educ. 2013;39(5):655-663. doi: 10.1177/0145721713492567.

10. Close K, Brown A. UnitedHealthcare chooses Medtronic as preferred insulin provider starting July 1. diaTribe website. diatribe.org/unitedhealthcare-chooses-medtronic-preferred-insulin-pump-provider-starting-july-1. Published May 3, 2016. Accessed July 27, 2017.

Output: Wth seemingly everyone having a smartphone and carrying it everywhere, it was only a matter of time before apps took center stage in efforts to prevent and manage diabetes.


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Health Care in a Time of Sabotage
 Is Trumpcare finally dead? Even now, it’s hard to be sure, especially given Republican moderates’ long track record of caving in to extremists at crucial moments. But it does look as if the frontal assault on the Affordable Care Act has failed.

And let’s be clear: The reason this assault failed wasn’t that Donald Trump did a poor selling job, or that Mitch McConnell mishandled the legislative strategy. Obamacare survived because it has worked — because it brought about a dramatic reduction in the number of Americans without health insurance, and voters didn’t and don’t want to lose those gains.

Unfortunately, some of those gains will probably be lost all the same: The number of uninsured Americans is likely to tick up over the next few years. So it’s important to say clearly, in advance, why this is about to happen. It won’t be because the Affordable Care Act is failing; it will be the result of Trump administration sabotage.

Some background here: Even the A.C.A.’s supporters have always acknowledged that it’s a bit of a Rube Goldberg device. The simplest way to ensure that people have access to essential health care is for the government to pay their bills directly, the way Medicare does for older Americans. But in 2010, when the A.C.A. was enacted, Medicare for all was politically out of reach.

Output: Is Trumpcare finally dead? Even now, it’s hard to be sure, especially given Republican moderates’ long track record of caving in to extremists at crucial moments. But it does look as if the frontal assault on the Affordable Care Act has failed.


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Inspiring Little Fear in Senators, Trump Struggles to Sell Health Bill
 WASHINGTON — President Trump thought he could sell balky Republican senators like Ron Johnson of Wisconsin on the Senate health care bill through pleasantries, cajoling and, ultimately, some Oval Office muscle.

But Mr. Johnson could not be charmed. He could not be outbargained. And he could not be scared into supporting the measure for the sake of a president whose inability to bend fellow Republicans toward his political will has become a liability for his young presidency.

As the brash Mr. Johnson reminded one associate recently, while Mr. Trump may have stunned the political world in 2016 by winning Wisconsin in the election, Mr. Johnson got 76,000 more votes in the state.

Fear is perhaps the most powerful motivating force in politics, and fear of a powerful president is the surest lever to move a lawmaker from a “no” to a “yes” on a presidential priority. But over the past month, Mr. Trump scared no one into supporting the bill to repeal and replace the Affordable Care Act. He has proved simply too unpopular nationally — polling at 36 to 40 percent approval this week — too weak in many senators’ home states, too erratic and too disengaged from the details of governing to harness his party, as other new presidents have.

Output: President Trump thought he could sell balky Republican senators like Ron Johnson of Wisconsin on the Senate health care bill through pleasantries, cajoling and, ultimately, some Oval Office muscle.


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A Republican Health Care Fix
 These sentiments conflict with recent iterations of Republican health care reform. The “full repeal” bill is nothing of the sort — it preserves the regulatory structure of Obamacare, but withdraws its supports for the poor. The House version of replacement would transfer many from Medicaid to the private market, but it doesn’t ensure that those transferred can meaningfully purchase care in that market. The Senate bill offers a bit more to the needy, but still leaves many unable to pay for basic services. In the rosiest projections of each version, millions will be unable to pay for basic health care. This wasn’t acceptable to Reagan in 1961, and it shouldn’t be acceptable to his political heirs.

It is true, as Republicans argue, that health care costs too much. And it is also true that Obamacare has failed to take care of this problem. But if Republicans fail to accept some baseline provision of care, we’ll find ourselves mired in internal contradictions — arguing, for instance, that a bill that cuts subsidies for the poor somehow makes care more accessible. We’ll rail against the way the government has destroyed our health care market in one breath and resist the support offered to the poor and middle class to navigate this brokenness with the other. This is not conservative; it is incoherence masquerading as ideological purity.

Many problems — the monopolization of provider networks, a regulatory framework that forces Americans to overpay for generic drugs — require both a positive Republican vision and a more robust majority to carry it out.

But devising that vision is impossible when we refuse to accept that the government bears some financial responsibility in solving a problem it helped create.

Output: Imagine a young father stepping into the street. He is alert and conscientious. Then, a government truck speeds around the corner. The man lunges out of the way, but it’s too late: The truck runs him over, causing serious injury. Absent government misconduct, the man would have been just fine.


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Time to End the War on Medicaid
 Politicians in Washington seem hell-bent to cast life-changing votes affecting the health care of nearly every American and negatively impacting our national economy. Of particular concern is the unwarranted attack on Medicaid, the source of health coverage for over 70 million hardworking Americans.

It would be easy to see congressional efforts to repeal the Affordable Care Act as yet another partisan fight over numbers. But this is anything but a routine vote. Despite overwhelming opposition from patients, doctors, nurses, hospitals, employers, unions, safety-net health plans and others who have a direct stake in these decisions, Republican congressmen have been pushing forward dangerous pieces of legislation that will result in millions of Americans going without health insurance, and driving up the costs for those who are still covered.

Many have pointed to the enormous human toll any legislation that makes cuts to Medicaid would have. People without insurance have nowhere to go for preventive care and screenings that could detect illnesses before they become a chronic or deadly condition. Sixty percent of adults with Medicaid coverage are already working. Medicaid helps people manage their chronic illnesses — so they can keep working. People without insurance often forego taking medications that can cure or control their illness and allow them to stay healthy and productive. And people without insurance avoid checking in with their specialist when their conditions demand care; they go, instead, to emergency rooms or don’t go at all and get sicker.

We see the evidence of this every day at Amida Care, New York’s largest Special Needs Health Plan for people with chronic conditions such as HIV. Prior to the ACA, qualifying for Medicaid was a complicated process that weighed how sick a person living with HIV was against how much they earned. By allowing states to expand Medicaid, the ACA extended health insurance coverage to thousands of people living with HIV and greatly streamlined the process of qualifying for Medicaid, helping them afford medication and stay in treatment. Nationally, Medicaid coverage for HIV-positive people rose from 36 percent in 2012 to 42 percent in 2014.

Thanks to improved access to preventive and primary care, over 75 percent of Amida Care’s HIV-positive members have viral loads that are undetectable, meaning that they are healthier and require significantly less costly care. This saved New York state more than $110 million between 2008 and 2015. Reducing patients’ viral load also reduces the possibility of new infections, and preventing just one new HIV infection can save upward of $500,000 in lifetime medical costs.

If the ACA is repealed, all of this progress is at risk. With millions of people losing coverage, access to care will be limited. Without regular, comprehensive health care, people with chronic conditions like HIV are hospitalized and visit the emergency room more frequently, require costly nursing homes, rack up high bills and get pushed into poverty. Those burdensome costs are ultimately passed on to the government, insurers and taxpayers.

Any cuts to Medicaid would be devastating. Changing Medicaid from an entitlement into a state-based per capita grant program will cause permanent and growing damage to people’s health and the ability of our nation to respond to natural or economic disaster. Medicaid is the backbone of health coverage in America. One in two Americans will need Medicaid at some point during their lifetimes. Medicaid provides for healthy births and assistance for older people to be able to remain in their homes. Today, Medicaid is also there to help many thousands of people who lose their jobs in the aftermath of unforeseen disasters like recessions or hurricanes. Similarly, when an outbreak of illness occurs, Medicaid is there to provide coverage for needed care.

The current epidemic of opioid-related addiction is a perfect example of why Medicaid needs to be preserved. In 2014, more than 1.2 million Americans were admitted to a hospital or went to an emergency room for opioid-related conditions, or 3,500 visits a day. Without Medicaid, many of these patients would be unable to get the care they need to survive and recover from their addiction.

Many congressional Republicans seem determined to vote to tear down the health care safety net, harming our nation’s physical and economic health. Yet some Republican senators have chosen to listen to their constituents and have opposed legislation that will cut Medicaid. Their courage to do the right thing is commendable. With so much at stake and so many unanswered questions, it’s time to end these attacks. It’s time for Congress to reach across party lines to find ways to improve coverage and care. Too much is at stake.

Doug Wirth is president and CEO of Amida Care, a private nonprofit community health plan that specializes in providing comprehensive health coverage and coordinated care to New York Medicaid members with chronic conditions.

Morning Consult welcomes op-ed submissions on policy, politics and business strategy in our coverage areas. Updated submission guidelines can be found here.

Output: Politicians in Washington seem hell-bent to cast life-changing votes affecting the health care of nearly every American and negatively impacting our national economy. Of particular concern is the unwarranted attack on Medicaid, the source of health coverage for over 70 million hardworking Americans.


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Aging Americans enjoy longer life, better health when avoiding three risky behaviors
 Credit: CC0 Public Domain

We've heard it before from our doctors and other health experts: Keep your weight down, don't smoke and cut back on the alcohol if you want to live longer.

Now, research from the University of Michigan School of Public Health shows that people of fairly normal weight who never smoked and drank only in moderation have a life expectancy at age 50 that is seven years longer than the average American. They also are able to delay disability up to six years.

Current life expectancy in the United States is about 78 years for men and 82 years for women but for the low-risk group the ages are 85 and 89, respectively.

"It's important to convince people to improve these behaviors in order, not only to live a longer life, but live a long life free of disability," said Neil Mehta, assistant professor of health management and policy at the U-M School of Public Health. "However, from a societal perspective, caring for individuals with disability is very costly and our study shows that risky behaviors are significantly increasing the burden of early disability."

While previous research has focused on life expectancy impacts from the individual behaviors, the study, released today by Health Affairs, is believed to be the first to show the effect of all three factors combined.

Of course, Mehta said, people who have avoided these unhealthy behaviors are not the norm.

"Eighty percent of Americans in their 50s either have smoked or been obese. That's huge," he said. "Our study speaks to the importance of prevention at whatever level that can occur in community health or in public policy."

The study used data from U-M's Health and Retirement Study of Americans age 50 and older that began in 1992. The research sample in 1998 included nearly 15,000 respondents ages 50–74.

The researchers defined the low-risk category as those who never smoked, drank moderately (at the top end, fewer than 14 drinks per week for men and fewer than 7 drinks per week for women) and had a body mass index that was less than the classification for obese (30+)—in other words, those who would be considered normal and overweight (18.5-29.9 BMI).

Although the study did not set out to look at what happens when people change one or more of the behaviors, the team found that non-obese people who had quit smoking for 10 years prior to the study and who drank moderately had overall and disability-free life expectancies that were only one year shorter than non-obese people who had never smoked and were moderate drinkers.

"There is some evidence that you can still do a lot to improve your health, even if you have these risk factors at some point. We've done a great job with smoking cessation but it's not clear where we're going with obesity," Mehta said, adding that current budget proposals in Washington put federal funds targeted at reducing obesity and other prevention measures in jeopardy.

More information: Neil Mehta et al. The Population Health Benefits Of A Healthy Lifestyle: Life Expectancy Increased And Onset Of Disability Delayed, Health Affairs (2017). DOI: 10.1377/hlthaff.2016.1569 Journal information: Health Affairs

Output: We've heard it before from our doctors and other health experts: Keep your weight down, don't smoke and cut back on the alcohol if you want to live longer.


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For the elderly, physical therapy can help straighten a hunched back
 Credit: University of California, San Francisco

A hunched back affects four out of 10 people over age 65. This extreme forward curvature of the upper back, called hyperkyphosis, increases disability and the risk of falls and fractures, but it's rarely deemed a treatable condition among older people.

A new study by UC San Francisco researchers shows that targeted physical therapy can help straighten the spine and boost a patient's self-esteem.

"Currently, there are some medical providers who say there's nothing you can do about it – there's no treatment," said Wendy Katzman, PT, adjunct professor of physical therapy and lead author of the study published July 8, 2017, in Osteoporosis International. "This is a novel treatment approach for older people who have this condition. There's really been no standard of care to treat this until now."

Historically, hyperkyphosis, which usually progresses with age and is more common in women, has not been seen as a discrete health concern. And although osteoporosis – a condition often associated with hyperkyphosis – is often treated with medication, no medications have been shown to improve hyperkyphosis. Surgery can reduce spinal curvature, but is only considered in extreme cases.

Improving Posture and Well-Being

The study enrolled 99 hyperkyphosis patients over 60 years old to explore if physical therapy is a viable solution for improving hyperkyphosis They had an average upper back curvature, as measured by X-ray, of 57 degrees – well above the average curve of 40 degrees, which is the cutoff for defining hyperkyphosis. The participants were randomly assigned to one of two groups.

One group performed exercises known to target muscle weakness, decreased spinal movement and poor postural alignment with a licensed physical therapist and assistant for one hour, three days a week, for six months. They were also advised to practice ideal posture independently at least three times a day. Katzman and her team compared these patients with those in the second group, which were invited to attend four health education meetings over a period of six months but did not receive physical therapy.

The researchers found that posture improved by an average angle of more than 3 degrees in the group that received physical therapy, and that improvement was greater in those over age 75. There was no significant change in the group invited to the health seminars.

The researchers had hypothesized that the exercises might work by strengthening the back muscles, but they found no significant improvement in patients' spinal muscle strength or quality, or their physical function – illustrated by a test in which they performed a 50-foot floor walk, put on and took off a lab coat and picked a penny up off the floor, among other tasks.

However, the patients that received physical therapy did report better self-image.

"I think it's important for people to feel confident. It's a component of self-efficacy," Katzman said. "What we see is that people who have more self-efficacy are more compliant with physical therapy, so there's potential that self-esteem carries over to other health benefits."

Physical Therapy Meets Technology

Katzman and her team point out that the participants in this proof-of-concept study were relatively healthy and robust: Their walking speed and physical ability was better than average for their age group. This might have limited any improvements to the participants' overall physical function.

Moving forward, the team hopes to recruit people with hyperkyphosis that are less robust and include exercises in the regimen that improve physical function overall. They also plan to push patients harder and enhance postural training with technology.

But even a small improvement can be important, Katzman said. "If you step back and say there was a 3-degree improvement, that doesn't sound like a huge number. However, the progression of hyperkyphosis is very slow. It takes about five years for it to progress 3 degrees."

Output: A hunched back affects four out of 10 people over age 65. This extreme forward curvature of the upper back, called hyperkyphosis, increases disability and the risk of falls and fractures, but it's rarely deemed a treatable condition among older people.


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Swiss robot maker ABB boosts growth by 14%
 ABB Group has recorded a 14 per cent increase in robotics orders with third-party base orders increasing by 10 per cent, it has announced in its latest report.

However, amid ongoing uncertainty in the global market including the impact of Brexit, 2017 is expected to be a transitional year for the company.

According to ABB’s second quarter review, it showed revenue growth by five per cent, including a net income of US$525 million (A$660 million).

Meanwhile, the company’s operational EBITA margin was impacted by product mix, significantly higher commodity prices and under absorption, which more than offset cost-out measures.

“In Q2, ABB continued to build its growth momentum as our targeted initiatives are delivering,” said ABB CEO Ulrich Spiesshofer. “Order growth was broad-based and across all regions,

“Our industry-leading digital offering, ABB Ability, is taking off and starting to contribute to growth.”

Read: Rise of the machine manufacturer

“Operational performance in the Power Grids and Industrial Automation divisions was solid in the quarter.”

Although ABB’s electrification products and robotics and motion improved margins sequentially, they were not able to fully compensate commodity price headwinds and overcapacity during the quarter.

“While we are pleased with the growth momentum, especially the double-digit order growth in Robotics and Motion, we remain firmly focused on further improving operational execution and our cost base,” Spiesshofer said.

“The successful completion of the B&R acquisition and the handover of our last legacy off-shore wind project, Dolwin 2, are solid examples of the disciplined execution of our Next Level strategy.”

Macroeconomic and geopolitical developments are signaling a mixed picture with continued uncertainty, the report added.

“Some macroeconomic signs in the US remain positive and growth in China is expected to continue,” ABB said.

Output: Zurich-based multinational ABB Group has seen a 14% rise in robotics orders, as well as a 10% increase in third-party base orders, according to the engineering and robotics company's Q2 review. The report also showed revenue grew by 5% and the business had a net income of $525m, despite uncertainty in the global market. In addition, the review revealed that, despite improved margins in electrification products and robotics and motion activities, the impact of commodity price headwinds and overcapacity was still felt during the quarter.


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Biomedical robot can power itself without cables or batteries
 Battery-free wireless robots move using memory alloys Technology News | July 21, 2017 By Nick Flaherty

The robots developed by the team at the Harvard John A. Paulson School of Engineering and Applied Sciences (SEAS) and the Wyss Institute for Biologically Inspired Engineering are flat and thin plastic tetrahedrons, with the three outer triangles connected to the central triangle by hinges, and a small circuit on the central triangle. Attached to the hinges are coils made of a shape-memory alloy (SMA) that can recover their original shape by being heated to a certain temperature.

When the hinges lie flat, the SMA coils are stretched out in their “deformed” state; when a current is passed through the circuit and the coils heat up, they move back to their original, relaxed state, contracting like tiny muscles and folding the robots’ outer triangles in toward the centre. When the current stops, the SMA coils are stretched back out due to the stiffness of the flexure hinge, lowering the outer triangles back down.

“This system requires only basic, passive electronic components on the robot to deliver an electric current – the structure of the robot itself takes care of the rest,” said Je-sung Koh who is now an Assistant Professor at Ajou University in South Korea.

The current is generated by coupling to an external coil. In order to control which coils contract, the team built a resonator into each coil unit and tuned it to respond only to a very specific electromagnetic frequency. By changing the frequency of the external magnetic field, they were able to induce each SMA coil to contract independently from the others.

“Not only are our robots’ folding motions repeatable, we can control when and where they happen, which enables more complex movements,” said Mustafa Boyvat, a Postdoctoral Fellow at the Wyss Institute and SEAS.

By changing the frequency of the magnetic field generated by the external coil, the team was able to control the robot’s movements independently.

The team built a variety of robots – from a coin-sized flat tetrahedral robot to a hand-sized version made of folded paper – to show that the technology can accommodate a variety of circuit designs and successfully scale. “There is still room for miniaturization. We don’t think we went to the limit of how small these can be, and we’re excited to further develop our designs for biomedical applications,” said Boyvat.

The research is reported in Science Robotics.

www.seas.harvard.edu

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Output: Researchers at the Wyss Institute for Biologically Inspired Engineering and the Harvard John A Paulson School of Engineering and Applied Sciences have developed robots which are able to move within a magnetic field without using batteries or power cables, according to an article in Science Robotics. The plastic devices are made of a shape-memory alloy which contracts when heated and expands when cool, with the temperature changes controlled by an external coil. The team built several sizes of robot to demonstrate ease of scalability.


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MRI for newborns gains FDA approval
 The U.S. Food and Drug Administration yesterday approved the first magnetic resonance imaging (MRI) device that can be specifically used in neonates or newborn babies. These MRI devices would be used for imaging of the brains and head in neonates who are admitted to the neonatal intensive care units (NICU) where they are necessary.

MRI or magnetic resonance imaging is a form of radiological imaging technique where the scanners use strong magnetic fields to produce the images of the inner structures. The protons in fat and water molecules in the body help form an image of the insides of the body. MRI brain is indicated in several conditions some of which are life threatening and MRI can help detect these conditions. Newborns admitted to the NICU may also require an MRI scan as part of their investigations whereby important decisions may be made.

Embrace Neonatal MRI System. Image Credit: Aspect Imaging

Vasum Peiris, chief medical officer for pediatrics and special populations at FDA’s Center for Devices and Radiological Health, said that till date whenever MRI brain was indicated for neonates in the NICU, the babies had to be taken to the MRI units. Traditional MRI images thus were possible but the challenges of moving a sick newborn out of the NICU to the MRI suite would often be a challenge. This new system is exclusively for neonates and now it would be safer and more convenient for imaging the brains of these ill newborns. He said that this approval ensures “safer imaging for this vulnerable patient population”.

The newly approved MRI system for neonates is called the Embrace Neonatal MRI System. It can measure the heads of the neonates only. Babies with a head circumference up to 38 centimeters and weight between 1 and 4.5 kilograms can be imaged in this machine. Larger babies and children cannot be imaged in this machine. Those with metallic implants within their bodies also cannot be imaged using this system much like traditional MRI machines.

To make the transition from the NICU cots to the MRI machine comfortable as well as less risky for the ill newborn, this new system also has a temperature-controlled incubator inside the MRI system. This makes the baby comfortable and ensures that the baby moves less. In case of an emergency where the baby needs immediate attention, the baby can be removed from the machine within 30 seconds and resuscitated. The system can be placed inside a NICU safely.

The machine is safe with no risk of radiation release and thus need not be in a radiation-safe room. Further the Embrace Neonatal MRI System is completely enclosed and thus it does not mandate what is around it. Most MRI machines cannot allow metallic elements around or within them. The objects that can be allowed inside traditional MRI machines are termed “MR safe” and those less safe are termed “MR conditional”.

The approval of the machine comes from non-clinical testing and the system has not yet been tried on actual neonates. This was done to avoid putting the vulnerable patients at risk. Electrical and mechanical safety of the system was thoroughly examined before approval. The Embrace Neonatal MRI System clearance was granted to Aspect Imaging Ltd. by the FDA.

Output: The US Food and Drug Administration has granted approval to the Embrace Neonatal magnetic resonance imaging (MRI) system following non-clinical testing. The MRI is the first of its kind to be designed exclusively for neonates and newborn babies up to 4kg in weight. The Embrace system can be located in a neonatal intensive care unit, as it neither has to be kept away from metallic objects nor requires a radiation safe-room. This eliminates the need to move ill babies from the ward.


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InsideTrack launches re-enrollment programme for adult learners
 Recruitment & Retention

New Tools Help Adult Students Come Back to Complete Their Degrees

Student success coaching services provider InsideTrack has come up with a new suite of Re-Enrollment & Re-Entry offerings designed to help colleges and universities get former students back on track to complete their degrees.

Targeting adults with some college credit but no degree or certificate, Re-Enrollment & Re-Entry combines InsideTrack's uCoach technology and analytics platform with executive-style coaching to "directly engage former students and help them navigate the enrollment process, define long-term goals and plan to overcome potential barriers to completion," according to the company. "Coaches conduct multi-channel outreach campaigns, using the platform's voice, e-mail, text and other communication capabilities, then work with re-engaged students to design plans for graduating prepared for meaningful careers."

"Fulfilling our mission means ensuring that all of our students graduate prepared for global citizenship and individual excellence, including those who have had their education disrupted by life's many competing demands," commented Michael Cottam, associate vice president for academic affairs and director of the Online Learning Center at Webster University, in a statement. "That is why we're working with InsideTrack to provide tailored support to students who have stopped out, so they can resume their studies and achieve their full potential."

InsideTrack has more than a decade of experience supporting institutions such as Penn State World Campus, Brandman University and Webster University in re-enrolling former students and preparing them to overcome the obstacles to postsecondary education success, the company said. "In a recent effort with the online division of a major public university, 997 of the 2,078 former students contacted re-enrolled, at an average cost of $216 per student."

"Adults with some college, but no credential represent one of America's greatest untapped resources," said Pete Wheelan, CEO of InsideTrack, in a statement. "Unlocking their potential by supporting them in finishing what they started benefits those individuals, their families and communities, and our nation as a whole. It also supports colleges and universities in fulfilling their missions, while providing much needed revenue in a time of great fiscal uncertainty."

For more information, visit the InsideTrack site.

Output: Oregon-based InsideTrack has launched a Re-Enrollment & Re-Entry suite of tools, aimed at helping older college and university students restart their education. The tools combine with InsideTrack's uCoach technology and analytics platform to engage former students, help them navigate the enrollment process and design plans for graduating ahead of taking on meaningful careers. The company cited a recent campaign with a major public university, in which 997 of 2,078 former students re-enrolled, at an average cost of $216 per student.


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Insurtech incubator Plug and Play reaches 50-member milestone
 SUNNYVALE, Calif., July 20, 2017 /PRNewswire/ -- Plug and Play Insurtech continues expansion of its innovation startup platform, signing its 50th participant only a year after opening its doors for business. Arch Insurance Group Inc., based in New Jersey, signs as its 50th participant shortly after it's 45th partner joined the program in May.

Mark Lange, Senior Vice President, P&C Programs of Arch Insurance said, "We are very excited to team up with a dedicated organization that sits at the forefront of innovation within the industry. We are confident that our collaborative efforts will build a long lasting and successful relationship between Arch Insurance Group and Plug and Play."

Over the past year, the Plug and Play Insurtech team has grown to over 50 participants with a global presence in three continents. Plug and Play Insurtech Batch 2 recently presented at Plug and Play's Summer Summit to an audience of over a thousand people. Plug and Play Insurtech's startup innovation platform introduced some of the hottest startups in the insurtech space to the rest of its ecosystem of thousands of corporate partners, investment firms, and universities. "Increased engagement from carriers and traditional corporations in the industry has encouraged entrepreneurs and investors to enter the Insurtech space. This trend can only improve processes, distribution, risk management, and increase efficiency for many of our corporate participants. We are moving in the right direction, however, for us to reach our goal of building the 'ultimate startup ecosystem', we still have a long way to go. We believe by providing value to the Insurtech space, we will reap the benefits in return as an investor." said Ali Safavi, Director of Plug and Play Insurtech.

This second batch was hand selected by the majority of corporate partners who have been with the program for over the past six months and widely varies from the previous batch, in both digital solutions and innovation. From their first batch, approximately 30% of the startups that participated in the program are engaged in proof of concept (POC) pilots with corporations, and from the second batch, 69% of their startups are in talks around POCs. Plug and Play Insurtech released their year in review, giving a glimpse into the performance of their first two batches. View the infographic here: http://bit.ly/insurtechinfo

Earlier this week Plug and Play Insurtech kicked off Batch 3 with its top 150 list including focus areas such as Data Analytics, Chatbots, Cybersecurity and Wearables. The list includes applicants from Asia, Europe and Africa. Plug and Play Insurtech's Selection Day for Batch 3 will be located at Plug and Play's headquarters on August 30-31st. Startup applications for this next batch close July 24th. For inquires or to apply, please visit: www.plugandplaytechcenter.com/startup-application/

About Plug and Play Insurtech

Established in 2016, Plug and Play Insurtech is one of Plug and Play's largest industry-specific programs. This 12-week business development program is headquartered in Silicon Valley. The program currently has over 50 corporate participants including Farmers Insurance, Munich Re, Nationwide, SOMPO Digital Lab, and Travelers, and has worked with hundreds of startups to date. Plug and Play Insurtech runs three separated tracks throughout the program: General Insurtech, Property & Casualty, and Life/Health/Group. For more information, visit http://plugandplaytechcenter.com/insurance/

About Plug and Play

Plug and Play is a global innovation platform. We connect startups to corporations and invest in over 150 companies every year. Since inception in 2006, our programs have expanded worldwide to include a presence in 22 locations globally giving startups the necessary resources to succeed in Silicon Valley and beyond. With over 6,000 startups and 180 official corporate partners, we have created the ultimate startup ecosystem in many industries. We provide active investments with 200 leading Silicon Valley VCs, and host more than 365 networking events per year. Companies in our community have raised over $6 billion in funding, with successful portfolio exits including Danger, Dropbox, Lending Club, PayPal, SoundHound, and Zoosk. For more information, visit www.plugandplaytechcenter.com

Contact:

Hadiyah Fain

1-408-524-1662

hadiyah@plugandplaytechcenter.com

View original content with multimedia:http://www.prnewswire.com/news-releases/plug-and-play-insurtech-signs-its-50th-partner-300491321.html

SOURCE Plug and Play

Output: Plug and Play Insurtech, a business development platform, is extending its start-up incubator with the addition of its 50th participant, Arch Insurance Group. The programme has been running for only a year, but already boasts a presence on three continents, providing its start-up partners with a platform from which to launch to its network of investors, universities and corporate partners.


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House sold after Facebook Live stream with 20,000 viewers
 The first ever home to have a viewing staged over Facebook Live has sold after it received three offers as a result of the experiment.

In June we reported that online agency Housesimple was aiming to sell the three bedroom semi-detached bungalow in Rainham, east London, valued at between £470,000 and £475,000.

The owner, Shanty Helim, staged the Facebook Live viewing herself, and viewers were encouraged to make an offer on the home via the Facebook Messenger application during and following the streaming.

Over 20,000 people viewed the property via Housesimple’s Facebook page and the deal has now gone through with the purchaser paying £467,000.

“I’m over the moon that my house has been sold for such as competitive price and so quickly. Housesimple’s livestreaming service has made the sale of my home as simple and convenient as possible, and I would urge other homeowner sellers to go online as a way of saving time and money” says the vendor.

Output: The former owner of a semi-detached bungalow in east London has become the first ever person to sell their home via Facebook Live, after receiving three offers and attracting than 20,000 viewers. Rainham resident Shanty Helim staged the event herself, and invited interested buyers to make their offers via the Facebook Messenger application. The eventual buyer payed £467,000 for the property, originally valued between £470,000 and £475,000.


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Venezuela paralysed as millions join general strike
 Venezuela is bracing for an escalation of the confrontation between the government and the opposition as the country awoke to near paralysis on Thursday at the beginning of a general strike.

Caracas, the capital, was littered with roadblocks of burning rubbish and tyres, and wires stretched from lamppost to lamppost to stop traffic, as opponents of the president, Nicolás Maduro, try to block his plan to consolidate power.

Near Plaza Altamira, in the upscale eastern part of the city, young men manning the barricades turned away any cars that tried to pass, including a bus stamped with the logo of the government tax agency.

“We are seeing empty streets and most shops closed,” said opposition leader Henrique Capriles while touring the city on foot.

Maduro has called for a vote on 30 July to elect a constituent assembly charged with rewriting the constitution. Opposition and human rights groups say the move is aimed at bypassing the National Assembly, which has been under opposition control since 2016, further consolidating the ruling Socialist party’s grip on power. Maduro argues a new constitution would promote dialogue in a country deeply polarised and crippled by widespread shortages of food, medicine and basic services, and unbridled violent crime.

The strike holds the threat of increasing repression from government forces and paramilitary militias, which have been blamed for more than 90 deaths during nearly four months of street demonstrations across the country. “There is a grave danger of violence on a scale so far unseen,” the International Crisis Group warned in a report.

The strike comes as the Trump administration in the US weighs up imposing “swift economic actions” if Maduro goes ahead with the election. “The United States will not stand by as Venezuela crumbles,” Trump said in a statement. The United States is Venezuela’s largest trading partner, and the country is the third largest crude oil supplier to the US.

People pass by a street blocked by security forces during the strike in Caracas. Photograph: Marco Bello/Reuters

Colombia, France, Spain, and the EU have also urged the Venezuelan government to cancel the election.

The last time Venezuela’s opposition attempted a strike of this scale was in 2002. The stoppage lasted two months in an attempt to topple Maduro’s predecessor, the late Hugo Chávez, who set the country on a path of “21st century socialism” before his death in 2013.

Mismanagement and plunging oil income under Maduro have left that project in tatters, driving hundreds of thousands of Venezuelans to flee the country and leading the political opposition to try to increase pressure on the president to step down or call a general election.

On 16 July the opposition orchestrated an unofficial “consultation” of voters ordered by the National Assembly in which more than 7 million Venezuelans voted to reject the constituent assembly, mandate parliament to appoint a new supreme court and electoral authority and to form a government of “national unity”. While symbolic and non-binding, the vote turned up the pressure on the government and emboldened the opposition to call the strike.

The country’s federation of business groups, Fedecamaras, which played a pivotal role in the 2002 strike, has not fully endorsed the action this time around but businesses have said their employees won’t be punished for not turning up for work.

Labour minister Néstor Ovalles said that private companies that close as part of the strike would be punished. “We won’t allow it, and we’ll be watching closely,” he warned.

Carmen Duque, who works at an insurance company, headed to work early on Thursday despite her desire to join the protest strike. “It looks like it’s a success,” she said as she manoeuvred through the blockaded streets of Altamira. “I wanted to join but I’m on call,” she said.

A woman dressed in a red T-shirt most often worn by government supporters, called strikers “puppets and zombies”. “The ones supporting this strike don’t understand anything,” said the woman, who declined to give her name.

Output: The Venezuelan crisis is escalating as a general strike organised by the opposition looks set to paralyse the country, with some fearing the strike will ignite further repression from the government's forces and paramilitary militias, which have been blamed for over 90 deaths in the past four months. “There is a grave danger of violence on a scale so far unseen,” warned the International Crisis Group. Protesters object to President Maduro's plans to amend the constitution to increase his power.


Instruction: create a high quality summary of the given input

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Royalty Exchange lets musicians sell rights to songs
 If your clients have a song in their hearts, they might be able to buy the royalties to it.

Royalty Exchange helps owners of music royalties find buyers. Since March 2016, the company has auctioned off royalties from 150 songs, including:

• Barry White’s “You’re the First, the Last, My Everything”

• Kanye West’s “Mercy”

• A collection of “Sesame Street” musical themes and segments

Many times – as with the Barry White and Kanye West works – the seller isn’t the recording artist, but someone else who collaborated on the song. And what’s being sold represents only his or her portion of the royalties. With “You’re the First,” the auctioned royalties, which went for $73,000, represented 25% of the 1974 hit’s total royalties.

In the case of the Sesame Street collection – which included “Elmo’s World” and music from other classic childrens’ movies – the songwriter, Tony Geiss, bequeathed his share of the royalties to charity. His estate auctioned them off for $580,000, distributing them to his designated causes.

Music royalties last 70 years beyond the longest living participant’s life, which, if all goes well, makes a very long-lived income stream. Just how long that stream lasts and how much it pays is very much an open question, however, and one of the key determinants of a royalty’s return on investment.

The auctioned-off portion of the Barry White song had earned $6,705 in royalties in the previous 12 months. At the auction price of $73,000,a purchaser would need to collect that amount every year for 11 years to recoup his or her investment – a rough equivalent of a price-to-earnings ratio for a stock.

And that’s where things get tricky. Earnings depend on how long you think a song will remain popular worldwide. “Voir La Nuit S’Emballer,” performed by French artist Matt Pokora, for example, generated $8,843 in royalties in the 12 months before it was auctioned. The royalties sold for $16,500. “I’ve seen multiples as low as 1,” said Jeff Schneider, president and CFO of Royalty Exchange.

Should a song be used in a movie soundtrack, or sampled on another artist’s record, royalties could increase. The death of the original recording artist usually increases sales, and thus royalties, too. The movement towards streaming music subscriptions could also mean higher royalties in the future, Mr. Schneider said.

Why invest in royalties? In an era when stocks and bonds look expensive, royalties represent an unappreciated asset class, Mr. Schneider argued. “It’s not correlated to the stock market in general,” he said. “We’re at the tail end of a nine-year stock market run, and uncorrelated assets seem more interesting compared to something that’s bound to correct at some point.”

But as with any alternative asset, due diligence is essential before plunging into a royalty investing, advisers caution. “I would want to see three or five years’ royalty payments and see if they are steady or declining – and if they are declining, at what rate they are declining,” said Ray Ferrara of ProVise Investment Group. “Then I’d do a discounted cash value over time to see how it’s valued.”

Of course, there are other factors – such as your ability to find timeless songs up for auction. “I’d also think that the older the song, the less likely it is to be picked up in something new: Getting a large spike in royalty is less of a possibility as time goes by and tastes change,” Mr. Ferrara said.

And,while alternative investments are appealing as bargains when the stock market keeps hitting new highs, investors should keep in mind that stocks have produced 9% annual gains over the long term – which means that long-term investors might not have to worry about alternatives, he added.

Output: Musicians are selling their royalty rights to investors in alternative assets. Purchase of the rights is a gamble on the track's popularity, with big potential rewards. The return on investment is determined by the song's popularity, with hits selling in greater volume and recouping costs in a shorter period of time. The Royalty Exchange enables composers to cash in their future earnings early. The growing demand for streaming services such as Spotify is rejuvenating the earnings potential of older tracks, while a song's use in an advertisement or film can also bolster its sales.


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South African household debt a major risk to banking: S&P Global
 Ratings agency S&P Global yesterday flagged the high indebtedness of South African households as posing a major risk to the country's banking sector. In its Banking Industry Country Risk Assessment (Bicra) for South Africa, S&P said it estimated the country’s per capita gross domestic product at about $6000 (R78000) for this year, which in US dollar terms was still lower than in 2010.

The National Credit Regulator (NCR) said about 10million South Africans were over-indebted, which meant they were unable to meet their financial obligations timeously. Matthew Pirnie, an analyst at S&P, said the rating agency expected very modest growth in retail lending over the next 18 months as the low economic growth, rising unemployment, and political uncertainties continued to confine consumer confidence. “We continue to believe that domestic households pose the most significant source of risk for the banks because of their relatively high leverage and low wealth levels compared with other emerging markets,” Pirnie said.

In testimony before South Africa’s legislators last year, Nomsa Motshegare, NCR chief executive, said as at the end of September 2015 the country’s gross debtors’ book stood at a whopping R1.6trillion, while the total credit rand value of new credit granted to consumers was close to R124bn. Macro-economic statistics website Trading Economics said household debt-to-income in South Africa averaged 57.28percent from 1969 until last year, reaching an all-time high of 86.4percent in 2008 and a record low of 40.3percent in 1980.

Other weaknesses S&P flagged about the country's banking sector included multiple development needs, supply and skill shortages, including infrastructure bottlenecks, as well as labour market rigidities that constrained economic growth potential. The rating agency also said the financing of the country's current account deficit hinged on potentially volatile portfolio flows, while the sector relies on concentrated short- to medium-term funding from institutional investors, but the risk was mitigated by the closed rand system.

S&P found that in the year to March, credit impairments improved to 1.2percent of total loans from 1.4percent, at the same time the sector’s total capital adequacy increased to 16.05percent from 13.88percent and return on equity improved to 17.33percent from 16.31percent. Pirnie said a positive for the sector was that South African households and corporates had somewhat prepared for long-term economic and political instability by minimising leverage over the past few years. “We see the trend for banking industry risk as stable because we consider the significant deterioration of South African banks’ profitability or funding profiles as unlikely. If the banks become more reliant on more volatile funding or change to a net debtor position, we could lower our assessment,” he said.

Easing Earlier in the year, S&P said its outlook for the big South African banks remained negative but that pressure was easing. However, it said the rest of Africa operations would represent a drain on some of the country's banks' profitability over the next 12 months. Among the positives noted in the Bicra was that the country's regulation was in line with international best practices, while it had top-tier banking stability and good risk management. Ernst & Young’s analysis of the major South African banks earlier this year found the banks had produced credible results against economic headwinds, with the four major banking groups having posted combined profits of R72.3bn in the year to December, up 8.4percent on an annualised basis from 2015.

Output: Rising South African household debt is a severe risk to the nation's banking sector, according to S&P Global. It predicts South Africa's per capita GDP at around $6,000 in 2017. Approximately 10 million South Africans are over-indebted, according to The National Credit Regulator. Modest growth in retail lending is expected in the coming months while political uncertainty, a stagnant economy and growing unemployment continue to damage consumer confidence, said S&P analyst Matthew Pirnie.


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Lloyds compensates only five HBOS fraud victims
 Lloyds Banking Group has paid compensation to only five of the 67 victims of the HBOS Reading fraud scandal almost a month after its own deadline for making redress offers for the “utterly corrupt scheme” that left small business owners “cheated, defeated and penniless”.

The bank, which was until recently part-owned by the government, said on Friday that just five of its customers had accepted its offers of compensation. It has failed to make any offer to more than half of the victims and the bank’s bosses confirmed that some of the customers were threatening to take the company to court rather than accept any deal.

Lloyds, which owns HBOS, had pledged to agree compensation deals worth £100m before the end of June. The bank said on Friday that it had made final offers to just 16 customers and only five of these had been accepted. It said a further 14 cases were in “the final stage of assessment” by the bank and Prof Russel Griggs, an independent reviewer.

Adrian White, Lloyds’ chief operating officer for commercial banking, said: “We are continuing to make progress in getting offers to victims of the HBOS Reading fraud. We have now either made offers or are in the detailed assessment stage for nearly half of the victims in the review. It is important we get the fullest possible information from victims to ensure we can factor in everything that could contribute to their compensation offer.”

Lord Cromwell, the chair of the all-party parliamentary group on fair business banking, said he was very concerned about the progress of the compensation scheme, which he described as a “running sore”.

“Colleagues in both Houses of Parliament are very concerned, and are increasingly raising formal questions, about how this matter is being conducted” he said. “In particular there appears to be a lack of transparency, and therefore a lack of public confidence, in the processes set up unilaterally by Lloyds for assessment and settlement of claims. Inevitably this creates suspicion and we are hoping that Lloyds will now accept our repeated invitations to make the processes – including the nuts and bolts of valuing claims – far more open to assessment by victims and their advisers. Without that it is hard to see how this matter can end other than in bitterness and litigation.”

Lloyds had denied that there was any wrongdoing at its Reading branch until two of its former employees were convicted of fraud in February. A group of six bankers dubbed “Britain’s Wolves of Wall Street” were jailed for combined 47 years and six months for a complex scam at HBOS’s Reading branch between 2003 and 2007.

Lynden Scourfield (right) with David Mills (centre) and Michael Bancroft, who were convicted of fraud. Photograph: Thames Valley Police

At the sentencing, Judge Beddoe said Lynden Scourfield, a former senior HBOS manager, had “sold your soul, for sex, for luxury trips with and without your wife – for bling and for swag”.

Scourfield had pleaded guilty to the extensive scheme, which drained the bank and small businesses of around £245m and left hundreds of people in severe financial difficulties.

The judge described Scourfield as an “utterly corrupt bank manager” who, driven by “rapacious greed”, had “got his tentacles into the businesses of ordinary and honest people and ripped them apart without a thought for those affected”.

The Thames Valley police commissioner, Anthony Stansfeld, has criticised Lloyds for failing to accept that the scam took place despite “overwhelming evidence”, which he said amounted to a cover-up.

Some of the victims lost their companies, livelihoods and even their homes as a result of the scam. Paul and Nikki Turner, from Cambridge, were ignored for years when they tried to report what was going on after their publishing company, Zenith, was run into the ground in the scam.

“They defrauded us, denied for 10 years that the fraud had happened, ignored the debt from the fraud and tried to evict us 22 times in order to cover up the fraud,” Nikki Turner has said.

The Turners have said they will not negotiate compensation with Lloyds and will take the company to court.

Lloyds has issued one-off payments of £35,000 each to victims to cover their costs as they wait for compensation. The bank said the total offers and payments to victims total £10m so far.

Output: Lloyds has compensated just five of the 67 victims of the HBOS Reading fraud scheme, which saw six bankers jailed for a combined 47 years. The bank, which owns HBOS, had promised to agree compensation deals of £100m ($130m) before the end of June. However, offers have been made to only 16 customers, five of whom have accepted. An additional 14 cases are “in the final stage of assessment”. Lloyds has failed to offer compensation to over half of the victims, many of whom lost companies and livelihoods. Some customers are threatening legal action.


Instruction: create a high quality summary of the given input

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YouTube adds 'Redirect Method' for combating extremism
 Expanding the new YouTube product functionality to a wider set of search queries in other languages beyond English.

Using machine learning to dynamically update the search query terms.

Working with expert NGOs on developing new video content designed to counter violent extremist messaging at different parts of the radicalization funnel.

Collaborating with Jigsaw to expand the “Redirect Method” in Europe.

A month ago, we told you about four new steps we’re taking to combat terrorist content on YouTube. One of our core areas of focus is more work to counter online violent extremism. As a first step we’re now rolling out features from Jigsaw’s Redirect Method on YouTube.Over the past years, Jigsaw partnered with Moonshot CVE to conduct extensive research to understand how extremist groups leverage technology to spread their message and recruit new members. From there, they created the Redirect Method , which uses curated video content to redirect people away from violent extremist propaganda and steer them toward video content that confronts extremist messages and debunks its mythology. Today, YouTube is rolling out a feature using the model proven by the Redirect Method: when people search for certain keywords on YouTube, we will display a playlist of videos debunking violent extremist recruiting narratives.This early product integration of the Redirect Method on YouTube is our latest effort to provide more resources and more content that can help change minds of people at risk of being radicalized. Over the coming weeks, we hope to build on this by:This work is made possible by our partnerships with NGOs that are experts in this field, and we will continue to collaborate closely with them to help support their research through our technological tools. We hope our work together will also help open and broaden a dialogue about other work that can be done to counter radicalization of potential recruits.As we develop this model of the Redirect Method on YouTube, we’ll measure success by how much this content is engaged. Stay tuned for more.

Output: YouTube is working to combat terrorist content by introducing Jigsaw's "Redirect Method". The method redirects users who search for or click on extremist propaganda to other videos which challenge those ideologies. The platform aims to expand the functionality to include searches made in other languages, work with NGOs to create new video content to act against extremist messages throughout the radicalisation journey and partner with Jigsaw to introduce the "Redirect Method" throughout Europe.