Helping VA rehabilitate those with multiple wounds of war

Micaela Cornis-Pop oversees more than 110 rehabilitation facilities around the country, helping the Department of Veterans Affairs (VA) stay at the forefront of developments in treating traumatic brain injury and other medical injuries and issues facing injured veterans and military service members.

With the increase in battlefield survival rates of military personnel serving in Iraq and Afghanistan, service members live with more complex casualties, which led the VA to coin the word “polytrauma” to describe multiple injuries to one person, the most prevalent of which is traumatic brain injury, but also can include post-traumatic stress disorder, multiple amputations, burns, auditory and visual impairments and mental health issues.

In 2005, Cornis-Pop helped conceive, develop and implement the VA’s Polytrauma System of Care, an integrated network of facilities that provide specialized programs to help wounded men and women recover, and move from acute care to outpatient rehabilitation and reintegration into the community. She now leads and manages the system, developing policies and procedures and monitoring their implementation.

“We have a direct impact on how health care is delivered and is impacting veterans and service members, and that is tremendously gratifying,” said Cornis-Pop, national program manager of the Polytrauma System of Care at the Veterans Health Administration, Rehabilitation and Prosthetic Services, at the VA.

She also is responsible for providing education opportunities for VA health care providers who treat traumatic brain injuries. And the system works with another 39 VA locations that provide some, but not all elements of comprehensive polytrauma rehabilitation care, to define the care those facilities can provide and help make the decision when to refer patients to another level of care.

In addition, Cornis-Pop was the lead author and editor of a “massive project” to publish a 166-page book that came out in April 2010, which serves as an accredited independent study course on traumatic brain injury for members of VA health care teams around the country, said Joel Scholten, director of Special Projects at the Physical Medicine and Rehabilitation Program Office (PM&R), which manages the Polytrauma System of Care. Nearly 12,000 clinicians have completed the course between April 2010 and July 2012, using either the book or a Web version of it.

Cornis-Pop “has the innate ability to pull people together and get focused on a task and think creatively, and, most amazingly, develop an end product that is useful and veteran-centric,” Scholten said. “She develops programs and projects that have been sustained because they are clinically relevant. It’s not just policy that is developed and sits there.”

Dr. David Cifu, national director of the PM&R office, not only relies on Cornis-Pop to coordinate the care programs around the country but also to respond to outside requests for information, including from Congress. “She’s the person who makes it all happen,” he said. “She doesn’t care about getting credit. She just gets things done. That’s gold.”

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Festive cheer for online shopping sites

SINGAPORE: More shoppers are buying online during the festive period due to its convenience and wide range of products.

Many have skipped the trip to the malls and avoided the crowds by visiting web stores.

One online bookshop said sales for 2012 jumped by about 40 per cent, compared with the year before.

Its customers are mainly between 30 and 50 years old. It also has a mobile application. Customers need only scan bar codes on books to check the price on the web store.

The store has also introduced electronic gift vouchers.

Group-buying websites are also enjoying brisk business.

Customers visit the websites to buy coupons which will be redeemed for items at the store.

One site - Groupon - said its sales increased by about 30 per cent during the festive period and more than 2,000 people go to its shop every day.

Its best-selling items include electronics and branded accessories.

Groupon's chief operating officer Adrian Tan said: "We've increased the manpower by 40 per cent and at the same time, we extended the operating hours from 7.30pm to 8.30pm now. This is to cope with the increased crowd and increased number of people redeeming items."

- CNA/fa

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Sushilkumar Shinde asks parties to give views on reviewing rape laws

NEW DELHI: The government has asked political parties to give their views on reviewing rape laws to Justice J S Verma Committee, set up to suggest amendments in the statute to provide speedier justice and enhanced punishment in cases of aggravated sexual assault against women.

In letters to leaders of all national and state political parties, home minister Sushilkumar Shinde said in the light of gang rape of a 23-year-old girl in Delhi, the government has given its anxious consideration to the need for reviewing the present laws relating to sexual assault of extreme nature against women.

The government had on December 23 constituted the Committee under the chairmanship of Justice (retd) Verma, former Chief Justice of India, to look into the possible amendments of the criminal law so as to provide for quicker trial and enhanced punishment to criminals in such cases.

"I shall be grateful if you could forward your views on the issue to the committee so that the committee can consider them while making their recommendations. I would urge you to communicate your views as early as possible as the committee has been asked to finalize its recommendations early," he said in the letter, a copy of which was made available today.

The three-member committee has been asked to submit its report to the government in 30 days. The other members of the committee are Justice (retd) Leila Seth, former Chief Justice of Himachal Pradesh high court, and former solicitor general Gopal Subramaniam.

Justice Verma committee has become fully operational and in located in Vigyan Bhavan Annexe in New Delhi and can be contacted at telephone no.- 011-23022031 and through email :- justice.verma@nic.in with suggestions and views.

Under the existing law, the maximum punishment for rape is life term but the nationwide outrage over the December 16 gang rape of the physiotherapy student in a moving bus here has sparked a demand for death penalty to rapists. The girl breathed her last on Saturday in a Singapore hospital.

Congress president Sonia Gandhi has stepped in to make some key suggestions to the government for stricter laws on sex crimes against women and enhanced punishment to the perpetrators.

BJP has favoured death for perpetrators of such heinous crimes and demanded a special session of Parliament for amending the laws.

The government has, however, brushed aside the opposition demand for an immediate special session, saying a decision on the issue could be taken only after the Justice Verma committee gives its report.

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Space Pictures This Week: Ice “Broccoli,” Solar Storm

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  Happy Trails

  Photograph by Alex Cherney, TWAN

  Amateur astronomer Alex Cherney captured these star trails as they blazed above Lake Tyrrell, a salt lake in Victoria, Australia in October 2011 and posted to The World At Night website December 25, 2012.

  (See pictures of another Australian salt lake, Lake Eyre.)

  Published December 31, 2012

  
  











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  Tokyo From Space

  
  Image courtesy DLR

  The sprawling Japanese capital Tokyo looks like a funky computer chip in this image taken by Germany's Earth-observing satellite TerraSAR-X and released December 20.

  Launched in 2007, the satellite's radar sensors map Earth from 319 miles (514 kilometers) up in a near-polar orbit.

  Published December 31, 2012

  
  











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  Extreme View

  
  Image courtesy SDO/NASA

  NASA's Solar Dynamics Observatory snapped this extreme ultraviolet view of an active region on the sun as it rotated into view from December 16 to December 18. Ultraviolet light makes it easier to trace the whorls and loops created by superheated gas, or plasma, and the sun's magnetic field lines.

  Active solar regions such as this create space weather that, when aimed at Earth, can disrupt satellite communications and electronics. (See more pictures of solar activity and space weather.)

  Published December 31, 2012

  
  











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  Saturn’s Dark Side

  
  Image courtesy SSI/Caltech/NASA

  This image of the unlit side of Saturn's S rings, released December 24, was taken with visible light by NASA's Cassini spacecraft.

  The shadow of Saturn's innermost major moon, Mimas, is visible as a black oval south of the rings' shadow. For those with completely dust-free computer monitors, Janus, another Saturnian moon, is visible as a tiny white speck above the planet's north pole. (Learn about Saturn's major moons.)

  Published December 31, 2012

  
  











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  A River Runs Through It

  
  Image courtesy ESA/JAXA

  The European Space Agency released this picture—taken by Japan's satellite ALOS—of Italy's longest river on December 14.

  The Po river and its surrounding fields divide Italy into its northern and southern regions. The Japanese used ALOS, which they lost contact with in late April 2011, to generate precise land maps, monitor disasters, and conduct resource surveys. (Read an excerpt from National Geographic magazine about the Po river.)

  Published December 31, 2012

  
  











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  Glacial "Broccoli"

  
  Image from DigitalGlobe/Getty Images

  The Moshniy glacier, located on the Russian archipelago Novaya Zemlya in the Arctic Ocean, calves chunks of ice and debris into a pattern reminiscent of broccoli in an image released December 20.

  Novaya Zemlya was a sensitive military area during the Cold War, and was also the site of the most powerful nuclear device ever detonated. The energy released by the 50-megaton "Tsar" bomb was ten times that of all the explosions set off during World War II.

  Published December 31, 2012

  
  











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  Image courtesy Caltech/SSI/NASA

  Published December 31, 2012

  
  

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Senate Approves 'Fiscal Cliff' Deal, Sends to House

Two hours after a midnight deadline for action, the Senate passed legislation early New Year's Day to avert the so-called "fiscal cliff" with an overwhelming vote of 89-8.

Senate passage set the stage for a final showdown in the House, where a vote could come as early as today.

"While neither Democrats nor Republicans got everything they wanted, this agreement is the right thing to do for our country and the House should pass it without delay," President Obama said in a statement shortly after the vote.

"There's more work to do to reduce our deficits, and I'm willing to do it. But tonight's agreement ensures that, going forward, we will continue to reduce the deficit through a combination of new spending cuts and new revenues from the wealthiest Americans," he added.

The bill extends Bush-era tax cuts permanently for people making less than $400,000 per year and households making less than $450,000.

The steep "sequester" budget cuts scheduled to go into effect with the New Year would be postponed for two months.

The deal also would affect taxes on investment income and estates, and extend unemployment benefits for a year.
Officials also decided at the last minute to use the measure to prevent a $900 pay raise for lawmakers due to take effect this spring.

'Fiscal Cliff': Lawmakers Scramble for Last-Minute Deal Watch Video

The failure of a deal to pass Congress by Jan. 1 technically triggers an income tax hike on all Americans and automatic spending cuts, though lawmakers could still prevent a tax hike by making retroactive any legislation that passes in the weeks ahead, experts said.

The deal at hand will not entirely solve the problem of the "fiscal cliff," however. In fact, it could set up a new showdown over the same spending cuts in just two months that would be amplified by a brewing fight over how to raise the debt ceiling beyond $16.4 trillion. That new fiscal battle has the potential to eclipse the "fiscal cliff" in short order.

In addition to extending current tax rates for households making $450,000 or less, the latest plan would raise the estate tax from 35 to 40 percent for estates larger than $5 million; and prevent the alternative minimum tax from hammering millions of middle-class workers.

Capital gains taxes would rise to 20 percent from 15 percent.

The deal would also extend for one year unemployment insurance benefits set to expire today for two million people, and avert a steep cut to Medicare payments for doctors.

"Working though the night and throughout the day we've reached an agreement with Sen. McConnell," Senate Majority Leader Harry Reid, D-Nev., said early Tuesday morning prior to the vote.

"I've said all along our most important priority is protecting middle class Americans, this legislation does that," Reid added.

He said he is "disappointed" they were not able to make the grand bargain and that more work needs to be done in the future.

"But we tried, if we did nothing the threat of a recession is very real," Reid concluded.

Speaking after Reid, Senate Minority Leader Mitch McConnell, R-KY., called the deal an "imperfect solution" and noted this should not be the model on how things get done in the Senate.

McConnell also thanked Vice President Joe Biden, who visited Capitol Hill late Monday night and brokered the deal with McConnell.

The House Democratic leader Nancy Pelosi issued a statement saying that when legislation clears the Senate, "I will present it to the House Democratic caucus."

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Board changes at STB and IE Singapore

SINGAPORE : The Singapore Tourism Board (STB) has appointed Christina Ong, a partner at Allen & Gledhill, as a new member on its board.

Meanwhile, Lim Kok Hoong, a chartered accountant and non-executive chairman at Parkway Trust Management, will step down from the STB board with effect from Monday.

Three other STB board members have also been re-appointed.

They are Mike Barclay, chief executive officer of Sentosa Development Corporation; Deborah Ong, assurance partner and risk & quality partner at PricewaterhouseCoopers (PwC) Singapore; and Jessica Tan, general manager for the Enterprise & Partner Group (APAC) at Microsoft Operations.

These changes, which take effect from 1 January 2013, were announced in a statement by the Ministry of Trade and Industry (MTI) on Monday.

Meanwhile, MTI also said that Dato' Kho Hui Meng, president of Vitol Asia Pte Ltd, has been re-appointed to the board of International Enterprise (IE) Singapore for a three-year term.

- CNA/ms

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Direct cash transfer scheme rolls out in 20 districts on Tuesday

NEW DELHI: The government will start direct cash transfer of subsidy to bank accounts of beneficiaries in 20 districts from Tuesday, finance minister P Chidambaram said on Monday.

The Direct Benefit Transfer system will be implemented in seven schemes such as scholarships and old age pensions from Jan 1. A total of 26 schemes will be covered under it.

The system will be rolled out in various schemes according to the due date of payment.

Announcing all this at a news conference here, Chidambaram said the government has identified 43 districts in which the scheme will be rolled out by the beginning of March.

"The scheme will be rolled out in 11 more districts on Feb 1 and 12 more districts will join on March 1," said Chidambaram, adding the scheme would be implemented in all the districts of the country by the end of 2013.

Chidambaram said the government has no intention to provide cash subsidy for food, fertiliser and petroleum products.

"At this stage there is no intention to transfer the subsidy on food, fertiliser, diesel and kerosene. The existing system will continue," he said.

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How to Banish That New Year's Eve Hangover

For those of us who enjoy the occasional cocktail, the holiday season would be incomplete without certain treats of the liquid variety. Some look forward to the creamy charms of rum-laced eggnog; others anticipate cupfuls of high-octane punch or mugs of warm, spiced wine.

No matter what's in your glass, raising one as the year winds down is tradition. What could be more festive? The problem is, one drink leads to two, then the party gets going and a third is generously poured. Soon, the music fades and the morning arrives—and with it, the dreaded hangover. (Explore a human-body interactive.)

Whether it's a pounding headache, a queasy stomach, sweating, or just general misery, the damage has been done. So now it's time to remedy the situation. What's the quickest way to banish the pain? It depends who you ask.

Doctors typically recommend water for hydration and ibuprofen to reduce inflammation. Taking B vitamins is also good, according to anesthesiologist Jason Burke, because they help the body metabolize alcohol and produce energy.

Burke should know a thing or two about veisalgia, the medical term for hangover. At his Las Vegas clinic Hangover Heaven, Burke treats thousands of people suffering from the effects of drinking to excess with hydrating fluids and medications approved by the U.S. Food and Drug Administration.

"No two hangovers are the same," he said, adding that the unfavorable condition costs society billions of dollars-mostly from lost productivity and people taking sick days from work.

Hot Peppers for Hangovers?

So what's the advice from the nonmedical community? Suggestions range from greasy breakfasts to vanilla milkshakes to spending time in a steamy sauna. A friend insists hot peppers are the only way to combat a hangover's wrath. Another swears by the palliative effects of a bloody mary. In fact, many people just have another drink, following the old "hair of the dog that bit you" strategy.

Whether such "cures" actually get rid of a hangover is debatable, but one thing's for sure: the sorry state is universal. The only people immune to hangovers are the ones who avoid alcohol altogether.

So for those who do indulge, even if it's just once in awhile, see our interactive featuring cures from around the world (also above). As New Year's Eve looms with its attendant excuse to imbibe, perhaps it would be wise to stock your refrigerator with one of these antidotes. Pickled herring, anyone?

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Hillary Clinton Hospitalized With Blood Clot

(MICHAL CIZEK/AFP/Getty Images)

By DANA HUGHES and DEAN SCHABNER

Secretary Hillary Clinton was hospitalized today after a doctors doing a follow-up exam discovered a blood clot had formed, stemming from the concussion she sustained several weeks ago.

She is being treated with anti-coagulants and is at NewYork-Presbyterian Hospital so that they can monitor the medication over the next 48 hours, Deputy Assistant Secretary Philippe Reines said.

Her doctors will continue to assess her condition, including other issues associated with her concussion. They will determine if any further action is required, Reines said.

Clinton, 65, originally fell ill from a stomach virus following a whirlwind trip to Europe at the beginning of the month, which caused such severe dehydration that she fainted and fell at home, suffering a concussion. No ambulance was called and she was not hospitalized, according to a state department official.

The stomach virus had caused Clinton to cancel a planned trip to North Africa and the United Arab Emirates, and also her scheduled testimony before Congress at hearings on the attack on the U.S. consulate in Benghazi, Libya.

According to a U.S. official, the secretary had two teams of doctors, including specialists, examine her after the fall.  They also ran tests to rule out more serious ailments beyond the virus and the concussion. During the course of the week after her concussion, Clinton was on an IV drip and being monitored by a nurse, while also recovering from the pain caused by the fall.

Medical experts consulted by ABC News said that it was impossible to know for sure the true nature or severity of Clinton’s condition, given the sparse information provided by the State Department. However, most noted that the information available could indicate that Clinton had a deep venous thrombosis,which is a clot in the large veins in the legs.

“A concussion (traumatic brain injury) in itself increases risk of this clot. Likely the concussion has increased her bed rest,” said Dr. Brian D. Greenwald, Medical Director JFK Jonson Rehabilitation Center for Head Injuries. “Immobility is also a risk for DVT. Long flights are also a risk factor for DVT but the recent concussion is the most likely cause.

“Anticoagulants are the treatment,” he said. “If DVT goes untreated it can lead to pulmonary embolism (PE). PE is a clot traveling from veins in legs to lungs which is life threatening. Many people die each year from this.

“Now that she is being treated with blood thinners her risks of PE are decreased,” he said. “Blood thinners carry risk of bleeding but are common and can be safely used.”

Dr. Allen Sills, associate professor of Neurological Surgery at Vanderbilt University Medical Center, said it was most likely that the clot was not located in Clinton’s brain, since she is being treated with anticoagulants.

“This is certainly not a common occurrence after a concussion, and is most likely related to either inactivity or some other injury suffered in the fall,” he said.

Dr. Neil Martin, the head of Neurovascular Surgery at the University of California, Los Angeles, Medical Center, said blood thinners are often given for blood clots in the legs, and it is “very unusual” for anticoagulants to be given for blood clots in the head.

But he cautioned about speculating too much about Clinton’s condition before more information is available.

“If we don’t know where it is, there is the possibility of several different indications,” he said. “I don’t know if there is any connection between what she’s got now and the concussion. All I can tell you is, at this point, it’s almost impossible to speculate unless we know what’s going on there.”

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Senators trade proposals into night to avoid ‘fiscal cliff’

Senate negotiators labored late into Saturday over a last-ditch plan to avert the “fiscal cliff,” struggling to resolve key differences over how many wealthy households should face higher income taxes in the new year and how to tax inherited estates.

As the clock ticked toward a Jan. 1 deadline, the halls of the Capitol were dark and silent. The House and the Senate are shuttered until Sunday afternoon, in part to avoid distractions as the talks over averting sharp tax increases for most American taxpayers entered their final hours.

While Senate Majority Leader Harry M. Reid (D-Nev.) monitored developments by telephone, Minority Leader Mitch McConnell (R-Ky.) arrived at the Capitol shortly after noon. Asked whether he and Reid would be able to strike a deal, McConnell smiled and replied: “I hope so.”

As nightfall approached, top Democratic and Republican aides continued shuttling paperwork with the latest proposals back and forth between the two leaders’ offices, about 60 steps apart.

Under negotiation is a deal that would extend George W. Bush-era tax cuts for nearly all taxpayers but increase rates on top earners. It also would extend unemployment benefits set to expire in January for 2 million people and prevent about 30 million Americans from having to pay the alternative minimum tax for the first time.

McConnell left the Capitol shortly before 7 p.m, revealing few details. “We’ve been in discussions all day, and they continue,” he said. He added, “We’ve been trading paper all day and talks continue into the evening.”

Reid and McConnell have set a deadline of about 3 p.m. on Sunday for cinching a deal. That’s when they’re planning to convene caucus meetings of their respective members in separate rooms just off the Senate floor. At that point, the leaders will brief their rank and file on whether there has been significant progress and will determine whether there is enough support to press ahead with a proposal.

“They both know the clock ends Sunday,” said Sen. Mark Begich (D-Alaska).

If all goes according to plan, the leaders would roll out the legislation Sunday night and hold a vote by at least midday Monday, giving the House the rest of New Year’s Eve to consider the measure.

In the House, Speaker John A. Boehner (R-Ohio) huddled Saturday with his senior staff for two hours but remained on the periphery of the negotiations. Passage in the unpredictable chamber is anything but certain. Boehner told President Obama and congressional leaders Friday that he could commit only to considering a Senate-passed bill and suggested that the House may amend that bill and send it back to the Senate.

House consideration of the measure could become another white-knuckle moment. Boehner would like the eventual deal to be passed by a bipartisan coalition that is roughly equally divided between Republicans and Democrats, GOP aides said. Republicans have not supported tax increases since 1990, and conservative activists were already criticizing any deal to raise taxes on the wealthy.

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