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03 Mar 2017 
medicina vip

Considera o imagínate la siguiente situación: son las dos de la madrugada y te levantas con un dolor abdominal terrible, náuseas, vómito y diarrea. Decides llamar a tu doctor de cabecera a su teléfono celular privado y el médico contesta tu llamada. A eso le sigue una conversación de unos 15 minutos y se llega a la conclusión de que tienes que ir a la sala de emergencia. Te vistes, manejas hasta al hospital y tu doctor de cabecera ya te está esperando en la sala de emergencia para examinarte, realizar estudios de rigor y crear un plan de acción. En menos de una hora, se determina que estás sufriendo de una infección gastrointestinal, te recetan las medicinas pertinentes y vuelves a tu hogar antes de las cinco de la madrugada. Tu doctor primario te pide que lo veas al día siguiente sin importar si tienes una cita previa o no. ¿Qué te parece?

Millones de personas que no tienen el teléfono celular de sus doctores, esperan horas para ser atendidos en una sala de urgencias, no ven a su doctor particular cuando van al hospital y jamás pueden verlo sin una cita previa, caracterizaran esta historia como irónica, ridícula, tal vez jocosa. Pero para aproximadamente un millón de personas en los Estados Unidos esto tiene nombre y apellido: Concierge Medicine o Medicina VIP.

En Estados Unidos atravesamos uno de los periodos más críticos en cuanto a cómo los ciudadanos reciben cuidado médico. El sistema actual es uno confuso, redundante, abusivo, politizado y controlado por intereses poderosos muchas veces desalineados con lo que debe ser la esencia del mismo, el paciente. Debido a disminuciones significativas en el rembolso que reciben los médicos por parte de las aseguradoras, incluyendo Medicare, los doctores cada día ven más pacientes diariamente; esto a su vez reduce el tiempo de cada visita, y aumenta las horas de espera en los consultorios; en fin, afecta de manera directa la relación médico-paciente.

Los Demócratas apuestan a Obama Care; los Republicanos, además de querer eliminar la ley (Affordable Care Act), es difícil precisar qué quieren. El resultado en progresión, debido a la inseguridad que ha creado todo esto tanto en doctores como en pacientes, es un sistema de salud estratificado y dual en donde la gente que puede pagar dinero adicional recibe un mejor cuidado y mucho más personalizado.

¿Cómo funciona? A diferencia de un médico tradicional quien usualmente tiene una práctica de varios de miles de pacientes, el "Concierge Doctor" acepta tantos como 600 o tan pocos como 100 o 200. Inmediatamente, esto le permite al galeno poner mucho más atención a cada individuo (exámenes físicos mucho más comprensivos), ofrecer citas el mismo día o en 24 horas y enfocarse más en medicina preventiva. Los pacientes gozan de un acceso completo y directo al doctor, 24/7, a través de su teléfono celular y correo electrónico.

Obviamente todos estos beneficios vienen con un costo, una prima. Este monto varía dependiendo de la práctica pero usualmente se encuentra entre $1,500 a $5,000 anuales. Por supuesto, este dinero que usted pagaría es parte de un contrato adicional con su doctor y no tiene que ver con el dinero que usted paga por su seguro médico.

Para finales del 2011, existían unos 3,500 doctores VIP y la Academia Americana de Doctores Privados estima que ese número se duplicará cada 12-18 meses por los próximos 3-4 años.

Algunos ven esta tendencia como una anti-ética y elitista; otros como una mejoría a la prestación de find out this here servicios de salud. En mi opinión, es simplemente una respuesta, una adaptación, por parte de algunos doctores y pacientes a las restricciones e imposiciones del presente sistema de salud. Si el pago a los médicos por parte de los seguros, incluyendo el recorte en Medicare propuesto por el presidente, continúa disminuyendo, no me cabe la menor duda de que las prácticas médicas tipo Concierge continuarán aumentando. Para aquellos ciudadanos que no puedan pagar el servicio, esto haría que tengan que cambiar de doctor, y por ende, se convierte en un tipo indirecto de racionamiento de servicios.

Dificilísimo predecir qué va a suceder... en que dirección nos vamos a mover. Pero estoy seguro de que la manera en que invertimos nuestro dinero en asuntos de salud y la manera en que recibimos los servicios, continuarán cambiando drásticamente.

¿TIENES ALGÚN COMENTARIO? OPINA AQUÍ



5 peligrosos químicos en tu their explanation hogar

Champú de alfombras

Yined Ramirez-Hendrix



Los limpiadores de alfombras pueden contener naftalina y percloroetileno, identificados como carcinógenos que pueden afectar el sistema central nervioso con mareos, sueños y náusea. Los niños pueden estar en mayor riesgo, porque suelen jugar en la alfombra.

VIDEO:

http://www.huffingtonpost.com/dr-juan-jose-rivera/medicina-vip_b_2039098.html




Admin · 25 vistas · Escribir un comentario
26 Feb. 2017 
BEIRUT Weddings in Iran have long been an over-the-top affair with families spending thousands of dollars to celebrate a union. But now some couples are splurging on an entirely different sort of nuptial celebration: a divorce party.

Local media outlets and blogs have been abuzz for months about lavish parties, complete with sarcastic invitations and humorous cakes, for couples splitting up. The phenomenon has become so widespread in Tehran and other large cities that one prominent cleric said couples who throw these parties are "satanic".

Still, the divorce parties are a sign of an undeniable trend: divorce in Iran is soaring. Since 2006, the rate of divorce has increased more than one a half times to the point where around 20 percent of marriages now end in divorce.

In the first two months of this Iranian calendar year (late March to late May) alone, more than 21,000 divorce cases were logged, according to official statistics.

The rise in the number of couples choosing to split up has angered conservatives in Iran who see the increase in divorce as an affront to the values of the Islamic Republic.

Last month, Mustafa Pour Mohammadi, the current justice minister who is also a cleric, said that having 14 million divorce cases within the judiciary is "not befitting of an Islamic system," according to the Iranian Students News Agency.

Some of the causes for divorce in Iran, like many other countries, include economic problems, adultery, drug addiction or physical abuse. But the increase in the divorce rate points to a more fundamental shift in Iranian society, experts say.

"There has been a big growth in individualism in Iran, especially among women. Women are more educated and have increased financial empowerment," said Hamid Reza Jalaipour, a sociologist at Tehran University.

"It used to be that a woman would marry and she would just have to get along. Now if she's not happy, she'll separate. It's not taboo," he said.

DIVORCE PARTY

One 41-year-old woman, a chemistry graduate who is now head of public relations at a Tehran factory and who has a teenage daughter, said she divorced her husband because he was an abusive drug addict.

It took four years to deal with the government bureaucracy. "They don't like divorce to come from the side of women," she told Reuters, asking that her name not be used. But in the year since the divorce "I've been in heaven".

While she was married, an aunt had told her not to wash the dishes at a certain time in case it gave her husband a headache.

"I said to hell with the headache, why doesn't he get up and do the dishes himself?"

She had never been to one of Tehran's notorious divorce parties, but added: "The day that I got my divorce finalised I invited some friends over to celebrate too." 



The marriage law in Iran traditionally favors the husband, who has the right to ask for a divorce. But in most cases being brought to court now, the husband and wife have generally come to a mutual agreement to separate, Iranian lawyers say.

In the cases where the husband is unwilling to divorce, the wife must legally prove that the husband is abusive, has psychological problems or is somehow unable to uphold his marriage responsibilities in order to separate.

GOLD COINS

Alternately, the wife could push for the payment of her mehrieh, or dowry, if it was not paid when the couple married. Dowries in Iran, usually in the form of gold coins, have skyrocketed in recent years with families sometimes paying tens of thousands of dollars.

If the husband is not able to pay the dowry, the wife could waive some or all of it as part of a separation settlement. In some cases, the husband can go to jail if he cannot pay the dowry.

"In the past two years the issue of divorce in Iran has reached unprecedented levels," said Mohsen Mohammadi, the head of the Yasa law group in Tehran.

"We didn't even have an interest in family and divorce law. But because of the large number of requests it made sense for us to get into this. The legal side of family and divorce has become a big business in Iran."

And it does not appear that the broader trend partly driving the rise in divorce, the greater number of women being educated and their larger presence in the work force, is going to change, experts say. For the current school year, 60 percent of enrolled university students are female, according to official records cited by the Islamic Republic News Agency.

When these women graduate, their first priority may not be to get married because they can now find jobs. And if they do get married, it will now be easier for them to leave a troubled marriage or to support themselves financially, experts say.

This is not only a trend among the top tier of Iranian society.

"We're not talking about a middle class anymore or the northern Tehran elite. This is not the upper crust becomes Western and gets divorced," said Kevan Harris, a sociologist and associate director at Princeton University's Center for Iran and Persian Gulf Studies.

"This is because of internal change in society. We balance the power of women through the kind of credentials and experience that they have. Because otherwise it can't be so huge. If this were just happening in the upper crust you wouldn't see these kinds of numbers."

The rise in the divorce rate worries government officials in Iran because it comes as the birth rate is plunging.

Last year, parliament's social affairs committee proposed that $1.1 billion be dedicated to facilitating marriages but the motion did not pass in parliament. "If the representatives and officials are sympathetic to the youth of the country, it would be better if they approved these kinds of plans," said the head of the committee, Abdul Reza don't miss this link Azizi, according to Mehr News.

A more controversial proposal has been to create a Ministry of Marriage and Divorce, which some officials have criticized on the grounds that a new ministry would create more bureaucracy rather than address the overall issue of rising divorce.

Whatever the government does, it will be hard to change a new tolerance for divorce.

"It's not because somebody asks 'Please, I want to get divorced' and you convince a conservative society that divorce is ok. That's not the way it works," said Harris. "People have to do it. And the other side can't take it back."

(Reporting by Babak Dehghanpisheh; Editing by Giles Elgood)

http://www.reuters.com/article/us-iran-divorce-idUSKCN0IB0GQ20141022




25 Feb. 2017 
Warning: This story contains graphic photos and video.

Three people were stabbed Saturday during a Ku Klux Klan rally in Anaheim, California, including one person who was in critical condition after apparently being stabbed with a flagpole, police said. 

Thirteen people were arrested after counterprotesters clashed with participants in a planned KKK rally.

The violence erupted at about noon, an hour and a half before the KKK rally was scheduled to begin at Pearson Park, the Los Angeles Times reported. Several dozen counterprotesters had gathered at the scene that morning to face off against the Klan.

Two vehicles with Klansmen pulled up to the scene, and counterprotesters began attacking them, said Sgt. Daron Wyatt of the Anaheim Police Department. Counterprotesters could be seen kicking a member of the KKK on the ground, he said. The Times reported the man on the ground was wearing a shirt that read "Grand Dragon."

Brian Levin, director of the Center for the Study of Hate & Extremism at California State University, San Bernardino, told the Times he browse around this website was able to push the Klan leader out of the way. 

When police got to the scene, they found a counterprotester bleeding on the ground. Wyatt said the counterprotester had apparently been stabbed with the ornamental end of a flagpole by at least one Klansmen. The unnamed victim was transported for treatment with critical injuries.

Photos taken at the scene show a man lying on a bloody sidewalk.

Following the stabbing, several other skirmishes broke out over a city block. Police found another counterprotester on the ground with apparent stab wounds, and nearby a Klansman holding a knife. The victim was in stable condition, Wyatt said.



RINGO CHIU via Getty Images

Another member of the Klan was being transported for possible broken ribs after he was kicked by counterprotesters.

In all, 13 people were taken into custody -- one female and five male members of the KKK, and one female and six male counterprotesters.

A video apparently from the scene shows a person being treated on the ground and police working to secure the area. (Warning: Video contains graphic material.)

Wyatt encouraged anyone who had witnessed the incident to file a report with Orange County Crime Stoppers.

The KKK has historically been a force of some prominence in Anaheim, according to the Times:

The Klan has a long and troubling history with the city. Klansmen were once the dominant political force in Anaheim, holding four of five City Council seats before a recall effort led to their ouster in 1924.

At the height of the group's power in Orange County, nearly 300 Klansmen lived in Anaheim, patrolling city streets in robes and masks. A large KKK rally once attracted 20,000 people to the city.



RINGO CHIU via Getty Images

http://www.huffingtonpost.com/entry/kkk-rally-anaheim-stabbing_us_56d20f95e4b03260bf770ffe


17 Feb. 2017 

There have been extradition requests, emergency motions and gag orders, and yet the four year old child - "Baby Veronica" - is still living in legal limbo.

Sotomayor anticipated the anguish when she wrote, "However difficult it must have been for [Veronica] to leave Adoptive Couple's home when she was just over 2 years old, it will be equally devastating now, if, at the age of 3 1/2 , she is again removed from her home and sent to live halfway across the country."

The arguments before the Justices concerned the fact that the child is a member of the Cherokee Nation. Justice Anthony Kennedy had pity for lower court judges. "If we could appoint King Solomon, who was the first domestic relations judge as a special master, we would do it," he said. "But we can't," he said at oral arguments.

Back in 2008 the child's biological mother, Christy Maldonado, who is predominately Hispanic, was briefly engaged to Dusten Brown, the biological father, who is a member of the Cherokee Nation and lives in Oklahoma. By May 2009, four months before the baby was born, the relationship had soured and the mother texted Brown asking him if he would rather pay child support or relinquish his parental rights. Brown responded via text message that he relinquished his rights.

The birth mother worked with a private adoption agency and selected a non-Indian South Carolina couple , Matt and Melanie Capobianco, to adopt the baby. They were present at birth, and when the child was four months old, the Capobiancos served Brown with a notice of the pending adoption, which they believed he had a right to under federal law.

Some facts in the case are disputed, but Brown later testified that he thought he had relinquished his rights to the birth mother, not to the Capobiancos. He eventually sought custody with the help of lawyers from the Cherokee Nation.

In September 2011, when the child was two years old, a South Carolina Family Court awarded custody to Brown. At the age of 27 months the child was handed over to Brown, whom she had never met.

The decision was later affirmed by the South Carolina Supreme Court. Lawyers for Brown had argued that a federal law, the Indian Child Welfare Act of 1978, barred the adoption of Baby Veronica.

The law was passed to halt the depletion of the tribal population at a time of rising concern that Indian children were facing child welfare practices that lead to the separation of Indian families and tribes through adoption.

The Capobiancos appealed the decision to the Supreme Court.

Justice Samuel Alito, writing for a 5-4 Court, ruled in favor of the couple in June. Alito noted that Veronica was classified as an Indian because she is 1.2% (3/265) Cherokee Indian on her father's side. But he said that Brown should not have been able to invoke the federal law in part because "he never had legal or physical custody of" Veronica. Alito noted that Brown had abandoned the child before birth.

In dissent, Justice Sotomayor said the majority "transforms a statute that was intended to provide uniform federal standards for child custody proceedings involving Indian children and their biological parents into an illogical piecemeal scheme." Sotomayor was joined in full by Justices Elena Kagan and Ruth Bader Ginsburg and in part by Justice Antonin Scalia.

On July 17, the South Carolina Supreme Court cited the Supreme Court's decision and approved an order finalizing the Capobiancos' adoption of Veronica.

The Cherokee Nation released a statement saying it was "gravely disappointed" that the South Carolina Supreme Court had refused a request to hold a new "best interests" hearing for Veronica.

"This child has been living in a healthy, loving and nurturing home with her father and stepmother for more than a year and a half. She is surrounded by a loving extended family, which includes her grandparents, sister and cousins. Dusten has always been found to be a fit and loving father, yet the South Carolina Supreme Court considered none of these factors, including the father/daughter bond they have developed over the last 19 months," said Cherokee Nation Assistant Attorney General Chrissi Nimmo in a statement on the Cherokee Nation website.

As Brown and his attorneys continued to fight the decision on jurisdictional issues, South Carolina Gov. Nikki Haley signed a warrant for Brown's extradition to face custodial interference charges in South Carolina. Oklahoma's Gov. Mary Fallin signed the request on Sept. 4.

In a statement, Fallin said that she didn't sign the request immediately because her goal had been to encourage Brown and the Capobianco family to reach a quick settlement.

"Unfortunately, it has become clear that Dusten Brown is not acting in good faith," Fallin said. "He is acting in open violation of both Oklahoma and South Carolina courts, which have granted custody of Veronica to the Capobiancos. Finally, he has cut off negotiations with the Capobiancos and shown no interest in pursuing any other course than yet another lengthy legal battle."

Pursuant to the extradition request, Brown gave himself up to authorities at Sequoyah County jail, but a judge released him on bond. His lawyers told local reporters at the time that Fallin misunderstood the facts.

It has at times been difficult to follow the case because motions have been filed in different jurisdictions, many filings are under seal and there has been a gag order imposed on certain aspects of the case.

For now, according to a one-line sentence in the docket, the Oklahoma Supreme Court is allowing Brown to keep the child.

Michael Overall of the Tulsa World estimates the case has spanned three counties, the Oklahoma Supreme Court and the tribal court.

The fact that the tribal court is involved could complicate the claims, according to Robert Anderson, an American Indian law expert at the University of Washington Law School.

"If the birth father and his wife acquiesce in the Oklahoma state court's jurisdiction over the matter, then the Oklahoma court will have the final word with respect to the validity of the South Carolina court's order. On the other hand, if the Cherokee Nation courts were to assert jurisdiction based on the child's domicile in the Cherokee Nation's territory, it's possible that the federal courts would need to get involved to determine the relative bounds of tribal and state jurisdiction as a matter of federal law."

Anderson says, "American Indian law is an exceedingly complex area, and this case is a difficult one within this web of tribal law, state law and federal common law."

On Tuesday, James Anaya, the United Nations Special Rapporteur on the rights of indigenous people, weighed in with a statement.

"Veronica's human rights as a child and as a member of the Cherokee Nation, and indigenous people, should be fully and adequately considered in the ongoing judicial and administrative proceedings that will determine her future upbringing," Mr. Anaya said. "The individual and collective rights of all indigenous children, their families and indigenous people must be protected throughout the United States."

The statement provoked a response from Lori Alvino McGill, a lawyer for the Capobiancos. She said that while Anaya is entitled to his opinion, any further court proceedings about Veronica's custody are "governed by the laws of the United States, including the U.S. Constitution."

"Under those laws, Matt and Melanie are Veronica's parents, period-and she has a right to be returned to their care, custody and companionship," says McGill. She notes that there have been court-ordered visitations occurring recently that have allowed Veronica time with the Capobiancos.

"Our legal system does not permit losing litigants to hop from state to state to relitigate cases that they lose, even when those cases involve the adoption of a small child," McGill said.

http://abcnews.go.com/blogs/politics/2013/09/baby-veronica-custody-case-rages-on/




Admin · 10 vistas · Escribir un comentario
15 Feb. 2017 
A Washington lawyer from a major law firm was wearing a helpful hints wig as a disguise when he was arrested last week trying to sell a copy of a secret lawsuit against a California technology security company for $310,000, according to a criminal complaint.

Jeffrey Wertkin, a former U.S. Justice Department trial attorney who joined Akin Gump Strauss Hauer & Feld LLP as a partner last year, was charged in the complaint filed in federal court why not try here in San Francisco made public on Tuesday.

He was arrested on Jan. 31 at a Cupertino, California, hotel while trying to sell a copy of the lawsuit to an FBI agent posing as a colleague of an employee at the security firm in exchange for a duffle bag full of money, the complaint said.

"My life is over," Wertkin said out loud shortly after his arrest by the Federal Bureau of Investigation, according to the complaint, which did not state where he obtained the lawsuit filed under the False Claims Act.

A lawyer for Wertkin, who was charged with contempt of court, could not be immediately identified. Akin Gump hop over to this site in a statement said it was "shocked and deeply troubled by the conduct alleged in the charges filed against Mr. Wertkin."

"Immediately upon learning of these charges, we took swift action and Mr. Wertkin is no longer with the firm," Akin Gump said.

According to the complaint, the lawsuit was filed in January 2016 under the False Claims Act, which allows whistleblowers to sue companies on the government's behalf to recover taxpayer money paid out based on fraudulent claims.

Those lawsuits are filed under seal to allow the Justice Department to investigate and determine whether it wants to intervene in the cases. Whistleblowers can receive a share of any resulting recovery.

Wertkin joined 920-lawyer Akin Gump in its Washington office in April 2016 from the U.S. Justice Department, where he was involved in pursuing False Claims Act cases and several fraud investigations as a trial attorney, the complaint said.

According to the complaint, in November, someone calling himself "Dan" contacted an employee of the Sunnyvale, California-based security company to discuss providing a copy of the lawsuit for a "consulting fee."



That employee began recording calls with "Dan" at the FBI's request, and negotiated to have a colleague, who was actually an agent, deliver $310,000 in exchange for the lawsuit.





The case is U.S. v. Wertkin, U.S. District Court, Northern District of California, No. 17-mj-70131.

(Reporting by Nate Raymond in New York; Editing by Andrew Hay)

http://www.reuters.com/article/us-usa-crime-lawyer-idUSKBN15N2G5


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