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Newly insured to deepen primary care doctor gap

Written By Unknown on Sabtu, 22 Juni 2013 | 22.26

COLUMBUS, Ohio — Getting face time with the family doctor could soon become even harder.

A shortfall of primary care physicians in some parts of the country is expected to worsen as millions of newly insured Americans gain coverage next year when the federal health care law goes into full effect.

Patients could find it difficult to get quick appointments. Doctors could face a backlog.

Providers in impoverished inner cities and rural areas across the country say it already takes many months, years in some cases, to hire primary care doctors.

Many states have proposed expanding the medical duties of nurses and other health care professionals to help fill the gap.

As lawmakers struggle for answers, the shortage of primary care doctors is estimated to grow to almost 66,000 by 2025.


22.26 | 0 komentar | Read More

Southwest cancels 57 flights after computer glitch

CHICAGO — Southwest Airlines expects some lingering delays Saturday morning after a system-wide computer failure caused it to ground 250 flights for nearly three hours late Friday night.

Full service was restored just after 2 a.m. EDT Saturday, but the Dallas-based airline is still working to clear a backlog of flights and reposition planes and crew.

The airline — the country's largest domestic carrier — canceled 43 flights Friday night and another 14 Saturday morning.

Southwest is the latest airline to ground flights because of a large computer outage. But its problem was minor compared to those experienced by two competitors — thanks in part to its late-day timing.

In April, American Airlines grounded all of its flights nationwide for several hours due to computer problems. The airline ultimately canceled 970 flights. And last year, United Airlines had two major outages: one in August delayed 580 flights; another in November delayed 636 flights.

The problem was detected around 11 p.m. EDT Friday, Southwest spokesman Brad Hawkins said. It impaired the airline's ability to do such things as conduct check-ins, print boarding passes and monitor the weight of each aircraft. Some flights were on the taxiway and diverted back to the terminal, Hawkins said. Flights already in the air were unaffected.

Most of Southwest's cancelations Friday night were in the western half of the country, according to airline spokeswoman Michelle Agnew. Saturday's cancelations were scattered across the U.S. They included planes leavings from Minneapolis, Chicago, Phoenix, Denver and San Diego, according to flight tracking service FlightAware.

Southwest flies an average of 3,400 flights each day.

Agnew said in an email Saturday morning that the airline's technology team is "still working to confirm the source of the issue."

Shortly after 2 a.m., Southwest posted on its Twitter page that "systems are operating and we will begin work to get customers where they need to be. Thanks for your patience tonight."

Agnew said the computer system was "running at full capacity" by early Saturday. Before that, though, officials used a backup system that was much more sluggish.

______

AP Airlines Writer Scott Mayerowitz in New York contributed to this report.


22.26 | 0 komentar | Read More

Small farmers turn to creative projects to survive

DEL REY, Calif. — Farmer David Mas Masumoto knows his small peach orchard can't compete with the giant agribusinesses that dominate the nation's produce aisles.

So as he walks through his central California grove at harvest time, showing his two workers which trees to pick, his wife and daughter, Marcy and Nikiko, work a different side of the operation, preparing a recipe from the family's newly published cookbook.

They saute fresh peach slices in butter and brandy, then whip heavy cream and pour wholegrain batter into a waffle iron, creating one of the dozens of dishes from "The Perfect Peach."

"The cookbook," says Nikiko Masumoto, 27, who co-authored the book with her parents, "is a natural extension of what we've been trying to do for years on the farm: to use creative ways to share our story and galvanize people about our fruit."

Like the Masumotos, small-scale growers throughout the U.S. are looking for creative ways to set themselves apart as they find that survival requires more than just selling crops. Experts say these practices are shifting notions of how small farms operate. Since the little guys can't beat corporate giants on price or production, they're cashing in on something the big shots can't provide: an intimate, personal experience.

Across the nation, family businesses are capitalizing on small farm culture by selling products such as jam, olive oil and lemonade. They're also writing books, hosting dinners and renting rooms. The ventures allow the public to share the experience and flavor of small farm life.

"The opportunities for farmers are significant today, because many of us as eaters want to make the connection to the food system, the land and the farmer," says Craig McNamara, founder and president of the Center for Land-Based Learning in Winters, Calif., which trains and mentors new farmers.

In industry terms, it's called value-added agriculture, and statistics show the practice is growing. According to the most recent data available, farm operators generated $10 billion in 2007 from farm-related activities other than crop or livestock wholesale, an increase of nearly 80 percent from 2002.

Value-added agriculture projects are "a way to have a product to sell year-round, even during winter months," says Shermain Hardesty, leader of the small farm program at the University of California, Davis.

"It reinforces farmers' connection to consumers," says Hardesty, who teaches a popular class on the specialty food business. "And by getting involved in marketing their identities, they can expand their profitability."

The examples abound. Just south of Hood River, Ore., Draper Girls' Country Farm lets people pick their own fruit or rent a room, in addition to selling jams and jellies and cinnamon-sugar dried apples. The 40-acre farm also makes fresh non-pasteurized apple cider in its own mill.

The Free Spirit Farm in Winters, Calif., grows produce on 7 acres and delivers it directly to over 40 restaurant chefs in the San Francisco Bay Area.

And the 40-acre Green Mountain Girls Farm in Northfield, Vt., which raises pastured goats, chickens, pigs and turkeys and grows vegetables and fruit trees, offers farm stays, cooking classes and workshops on how to milk goats and make cheese and yogurt.

"Contemporary people are fairly distant from farms, so we're trying to reconnect them directly with family scale faming and rebuild their skills, so they can use them on a daily basis," said farm co-owner Mari Omland. "We offer something deeply personal, highly authentic, hands on."

For the Masumotos, who have worked California's fields for four generations, it took time to figure out how to best sustain their operation as giant agribusinesses swallowed other family farms.

The corporations that produce millions upon millions of pounds of fruit in the San Joaquin Valley take up massive tracts of land. Gerawan Farming, for example, controls 9,000 acres. And nearby Wawona Packing Co. grows stone fruit on 6,000 acres.

The Masumotos, by comparison, run just 25 acres.

David Mas Masumoto switched to organics in the 1980s, but found that selling sustainably-farmed fruit proved challenging in an era of perfectly uniform supermarket peaches.

He wrote a book, "Epitaph for a Peach," about the struggle to save his heirloom peaches and way of life. And over the years, the family turned that unlikely crop and uncommon lifestyle into a hip, profitable business by involving consumers in the farm through stories.

Each year, people from Los Angeles, San Francisco and beyond come to the farm to pick their own ripe fruit and spend the day interacting with the farmers. Masumoto writes a farming column for the local paper, and Nikiko Masumoto uses Twitter and Facebook to update the public about the harvest.

The family hopes the cookbook adds to those efforts.

In addition to recipes ranging from peach gazpacho to peach shortcake, the book includes essays that provide glimpses into a small farm's life and vulnerabilities — the sweat, the mistakes, even death. It's an intentional effort, says Masumoto, because artisanal agriculture is highly personal and transparent when compared with the anonymity and homogeneity of corporate farming.

"The new agriculture is about story-based farming. It cares about the community, the farmworkers and the environment," Masumoto says. "The more we can differentiate from corporate farms, the more we can gain a new identity and be financially successful."

---

Follow Gosia Wozniacka on Twitter at https://twitter.com/GosiaWozniacka


22.26 | 0 komentar | Read More

No word from China on leaker's possible return

WASHINGTON — Edward Snowden, the former government contractor who says he revealed that the National Security Agency collects Americans' phone records and Internet data from U.S. communication companies, now faces charges of espionage and theft of government property.

Snowden is believed to be in Hong Kong, which could complicate efforts to bring him to a U.S. federal court to answer charges that he engaged in unauthorized communication of national defense information and willful communication of classified communications intelligence information.

In addition to those charges, both brought under the Espionage Act, the government charged Snowden with theft of government property. Each crime carries a maximum sentence of 10 years in prison.

Hong Kong was silent Saturday on whether Snowden should be extradited to the United States now that he has been charged, but some of China's legislators said the decision should be up to the Chinese government.

The one-page criminal complaint against Snowden was unsealed Friday in federal court in Alexandria, Va., part of the Eastern District of Virginia where his former employer, government contractor Booz Allen Hamilton, is headquartered, in McLean.

The complaint is dated June 14, five days after Snowden's name first surfaced as the person who had leaked to the news media that the NSA, in two highly classified surveillance programs, gathered telephone and Internet records to ferret out terror plots.

It was unclear Friday whether the U.S. had yet to begin an effort to extradite Snowden from Hong Kong. He could contest extradition on grounds of political persecution. In general, the extradition agreement between the U.S. and Hong Kong excepts political offenses from the obligation to turn over a person.

Hong Kong had no immediate reaction to word of the charges against Snowden.

The Espionage Act arguably is a political offense. The Obama administration has now used the act in seven criminal cases in an unprecedented effort to stem leaks. In one of them, Army Pfc. Bradley Manning acknowledged he sent more than 700,000 battlefield reports, diplomatic cables and other materials to the anti-secrecy website WikiLeaks. His military trial is underway.

Sen. Bill Nelson, D-Fla., a member of the Senate Armed Services Committee, welcomed the charges against Snowden.

"I've always thought this was a treasonous act," he said in a statement. "I hope Hong Kong's government will take him into custody and extradite him to the U.S."

But the Government Accountability Project, a whistle-blower advocacy group, said Snowden should be shielded from prosecution by whistle-blower protection laws.

"He disclosed information about a secret program that he reasonably believed to be illegal, and his actions alone brought about the long-overdue national debate about the proper balance between privacy and civil liberties, on the one hand, and national security on the other," the group said in a statement.

Michael di Pretoro, a retired 30-year veteran with the FBI who served from 1990 to 1994 as the legal liaison officer at the American consulate in Hong Kong, said "relations between U.S. and Hong Kong law enforcement personnel are historically quite good."

"In my time, I felt the degree of cooperation was outstanding to the extent that I almost felt I was in an FBI field office," di Pretoro said.

The U.S. and Hong Kong have a standing agreement on the surrender of fugitives. However, Snowden's appeal rights could drag out any extradition proceeding.

The success or failure of any extradition proceeding depends on what the suspect is charged with under U.S. law and how it corresponds to Hong Kong law under the treaty. In order for Hong Kong officials to honor the extradition request, they have to have some applicable statute under their law that corresponds with a violation of U.S. law.

Hong Kong lawmakers said Saturday that the Chinese government should make the final decision on whether Snowden should be extradited to the United States.

Outspoken legislator Leung Kwok-hung said Beijing should instruct Hong Kong to protect Snowden from extradition before his case gets dragged through the court system.

Leung urged the people of Hong Kong to "take to the streets to protect Snowden."

In Iceland, a business executive said Friday that a private plane was on standby to transport Snowden from Hong Kong to Iceland, although Iceland's government says it has not received an asylum request from Snowden.

Business executive Olafur Vignir Sigurvinsson said he has been in contact with someone representing Snowden and has not spoken to the American himself. Private donations are being collected to pay for the flight, he said.

"There are a number of people that are interested in freedom of speech and recognize the importance of knowing who is spying on us," Sigurvinsson said. "We are people that care about privacy."

Disclosure of the criminal complaint came as President Barack Obama held his first meeting with a privacy and civil liberties board and as his intelligence chief sought ways to help Americans understand more about sweeping government surveillance efforts exposed by Snowden.

The five members of the little-known Privacy and Civil Liberties Oversight Board met with Obama for an hour in the White House Situation Room, questioning the president on the two NSA programs that have stoked controversy.

One program collects billions of U.S. phone records. The second gathers audio, video, email, photographic and Internet search usage of foreign nationals overseas, and probably some Americans in the process, who use major Internet service providers, such as Microsoft, Google, Apple, and Yahoo.

___

Associated Press writer Jenna Gottlieb in Reykjavik, Iceland, contributed to this report.


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Voters in Mass. city weigh in on Wynn casino plan

EVERETT, Mass. — Voters in Everett headed to the polls Saturday in the state's first binding referendum on a casino plan since the expanded gambling law was enacted.

The outcome will determine whether Las Vegas casino mogul Steve Wynn's proposal to develop a $1.2 billion resort casino on a site along the Mystic River that once housed a chemical plant can move forward and eventually be submitted to the Massachusetts Gaming Commission.

Voters are deciding whether to approve a host community agreement Wynn signed with city officials that called for his company to make $30 million in advance payments to Everett and more than $25 million in annual payments if and when the casino opens for business.

In the agreement, Wynn also promised to mitigate traffic impacts in the city and complete a multimillion-dollar cleanup of pollution at the site.

He also promised to give hiring preference to Everett residents for the estimated 8,000 temporary and permanent jobs that would be created by the project and to make a "good faith effort" to use contractors and suppliers for the city.

Wynn turned his focus to Everett, a city of about 42,000 residents just north of Boston, after an earlier proposal to build a casino in Foxborough ran into opposition from many residents and officials.

In Everett, Mayor Carlo DeMaria and other top city officials have embraced the proposal.

Sandy Guliano, president of the pro-casino group Everett United, said that the host community agreement is "fair and generous" to Everett and that she was encouraged by Wynn's commitment to clean up the former Monsanto Chemical Co. site.

"It's highly polluted," she said. "We don't know how else this will be cleaned up if it wasn't for a project like this."

No organized group formed to oppose the plan, but some residents are wary that a casino will lead to traffic gridlock.

"The traffic is a nightmare already," said Evmorphia Stratis, who also worries about the potential for increased crime and residents falling victim to gambling addiction.

The 2011 casino law that allows for up to three regional resort casinos in Massachusetts requires that voters approve a host community agreement in a binding referendum before a casino developer can apply for a license from the gaming commission.

Wynn's plan could be in competition for the sole eastern Massachusetts casino license with proposals from Suffolk Downs and Foxwoods Resorts, which is backing a proposed casino in Milford.

Polls in Everett close at 8 p.m.


22.26 | 0 komentar | Read More

Tokyo court backs Apple against Samsung on patent

Written By Unknown on Jumat, 21 Juni 2013 | 22.27

TOKYO — Apple Inc. has won a patent infringement lawsuit against Samsung Electronics Co. in a Japanese court, one of dozens of legal battles around the world between the technology giants.

The Tokyo District Court issued a partial verdict Friday in favor of Apple. Damages were not announced.

The court said in a summary that further examination is needed to determine if Samsung must pay compensation, and if so, how much. A final verdict is expected later.

Apple and Samsung are embroiled in similar battles in the U.S., South Korea, Germany, Italy, the Netherlands, Britain, France and Australia.

The latest was over "bounce-back" technology for scrolling on devices. Samsung was found to have infringed Apple's patent on previous models of the Galaxy phone and tablet series. Samsung has since changed its smartphone design to show a blue light, instead of bouncing back.

The two companies are competing fiercely in global markets, and accuse each other of illegally using various technologies.

Samsung said it will study the ruling before deciding whether to appeal.


22.27 | 0 komentar | Read More

Some immigrants excluded from health care overhaul

PHOENIX — President Barack Obama has championed two sweeping policy changes that could transform how people live in the United States: affordable health care for all and a path to citizenship for the 11 million immigrants illegally in the country.

But many immigrants will have to wait more than a decade to qualify for health care benefits under the proposed immigration overhaul being debated by Congress, ensuring a huge swath of people will remain uninsured as the centerpiece of Obama's health care law launches next year.

Lawmakers pushing the immigration bill said adding more recipients to an already costly benefit would make it unaffordable.

Health care analysts and immigration proponents argue that denying coverage will saddle local governments with the burden of uninsured immigrants. They also fear a crisis down the road as immigrants become eligible for coverage, but are older, sicker and require more expensive care. Those placed on provisional status would become the nation's second-largest population of uninsured, or about 25 percent, according to a 2012 study by the Urban Institute.

"All health research shows that the older you get, the sicker you become, so these people will be sicker and will be more expensive on the system," said Matthew O'Brien, who runs a health clinic for immigrants in Philadelphia and researches health trends at Temple University.

The Affordable Care Act will make health insurance accessible for millions of uninsured people starting in January through taxpayer-subsidized private policies for middle-class families and expanded access to Medicaid, the program for low-income people funded by federal and state dollars. The proposed immigration overhaul explicitly states immigrants cannot receive Medicaid or buy coverage in new health care exchanges for more than a decade after they qualify for legal status, and only after certain financial and security requirements have been met.

Immigrants with provisional status may obtain insurance through employers once they have legal status to work, but many are unskilled and undereducated, and tend to work low-wage jobs at small businesses that don't have to provide the benefit under the health care law. Immigrants illegally in the country also can access community health centers, but the officials who run those clinics said they are overwhelmed by the demand.

"We can't help everybody," said Bethy Mathis, executive director of Wesley Community Center in Phoenix. The clinic serves 7,000 patients a year who seek everything from vaccinations and relief from minor medical problems to care for long-term health conditions such as diabetes.

Debate over whether immigrants illegally in the country should be eligible for federal benefits nearly sank Obama's health care reform before it was passed by Congress in 2010. For lawmakers pushing immigration reform, there was no question that immigrants would continue to be excluded.

"That's one of the privileges of citizenship," said Republican Sen. John McCain, one of the so-called Gang of Eight pushing the immigration bill, during a conference call with reporters. "That's just what it is. I don't know why we would want to provide Obamacare to someone who is not a citizen of this country."

The issue has received more attention in recent weeks. Some House Republicans have threatened to kill the immigration bill unless immigrants are required to pay for all their health care costs even after they receive green cards or become citizens. Democratic Sen. Barbara Boxer, meanwhile, said she wants the government to distribute at least $250 million to state and local governments because they are the ones who will feel the financial pain of immigrants being left out of the health care law.

Pregnant women, children, seniors and the disabled are eligible for emergency Medicaid services regardless of their immigration status.

The politics behind the bill offer little solace to immigrant families struggling with growing medical bills.

Isabel Castillo came to the U.S. illegally with her parents when she was a child. She's now 28 and has not gone for an annual physical exam since 2007. Every pain triggers debate over whether it's worth a medical visit or not.

"You are like, 'God, should I go, should I wait? The bill is going to be so high,'" Castillo said. "You just wait until you can't tolerate the pain anymore and then you go to the emergency room."

Immigrants who are U.S. citizens are also affected by the limits on health care access if they provide for family members here illegally.

High school student Jacqueline Garcia of Phoenix works two jobs to support her 13-year-old brother and 52-year-old grandmother, who has severe diabetes. The woman's mobility is limited, her vision and memory are fading and she sometimes suffers from seizures. The children were born in the United States and are being raised by the grandmother, who does not have lawful status and as a result does not qualify for Medicaid.

"Every time she gets sick, I have to take her to the doctor. It's really expensive," Garcia said. "What if my grandmother doesn't make it for the 10 years? I mean, I am always going to be struggling. That's too long."

Opponents said they understand the concerns of immigrants not getting health care, but it becomes an issue of the added expense.

"We aren't saying people shouldn't get health care. The question is who is going to pay for it?" said Ira Mehlman, spokesman for the Federation for American Immigration Reform, a national group that opposes the immigration overhaul. "They would all be on Medicaid or heavily subsidized in some other way."

Critics of the decision said immigrants are eager to pay for affordable health care insurance and already support federal benefits by paying sales and income taxes. They note that adults unable to overcome health emergencies are less likely to contribute to the workforce and society.

"The risk of them being uninsured if they are in the country illegally is the same risk of anyone else in the country not being insured," said Stephen Zuckerman, a health economist for the Urban Institute. "It's always more expensive to treat people at a more advanced stage of disease."

In North Carolina, Jessica Sanchez-Rodriguez said she has undergone a series of surgeries and medicines to treat her spina bifida, a developmental congenital disorder, and an ailment that leads to brain swelling. Her parents brought her illegally from Mexico when she was 11 months old. As a minor, she received subsidized medical care, but she was cut off when she turned 18 in February.

Her family is trying to raise money for a $55,000 surgery to connect a catheter to her bladder.

"It's terrible," Sanchez-Rodriguez said. "I have to go to school with these pains."


22.27 | 0 komentar | Read More

Chelsea extends deal with Adidas for 10 more years

LONDON — Chelsea and kit manufacturer Adidas have agreed on a contract extension that will see the German brand supply the English Premier League club for 10 more years.

Chelsea says in a statement on Friday it is "the biggest deal to date Chelsea has signed with a partner," though no financial details were revealed.

Adidas has provided the Blues with their football kits since 2006.


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BP calls for independent probe of claims lawyer

NEW ORLEANS — BP is calling for an independent investigation into a lawyer working for the administrator reviewing claims arising from the Gulf oil spill who has been accused of collecting portions of settlement payments from a New Orleans law firm to which he had once referred claims.

The London-based oil giant issued a statement Friday that said only a "comprehensive and independent investigation will ensure the integrity of the claims process."

A BP PLC official who has reviewed a report outlining the allegations, said claims administrator Patrick Juneau delivered a copy of the report to U.S. District Judge Carl Barbier during a meeting in his chambers Thursday. Lawyers for BP and the team of private attorneys who brokered the multibillion-dollar settlement also attended the meeting. The BP official spoke on condition of anonymity because the report hasn't been made public.

The staff lawyer, Lionel H. Sutton III, acknowledged in an email late Thursday that he has been told he was suspended "pending an investigation of an anonymous allegation against me."

"I have not been made aware of the substance of the allegation or the status of the investigation," Sutton wrote. "Once this is resolved, I would be happy to discuss it all with you."

The BP official said the report indicates that Juneau's security head, David Welker, also notified the FBI's New Orleans division about the lawyer's alleged misconduct. Welker until recently was the special agent in charge of the FBI office in New Orleans.

An FBI spokeswoman in New Orleans declined to comment Thursday.

According to the BP official, Juneau told the judge that he had suspended the lawyer and was weighing further disciplinary action. Neither Juneau nor his spokesman responded to calls and emails on Thursday night.

The report says Welker received a complaint that the staff attorney had referred claims to a New Orleans law firm in exchange for portions of subsequent settlement payments, the BP official said. The lawyer allegedly filed those claims before he went to work for Juneau.

The claims at issue were filed on behalf of a single party and involve hundreds of thousands of dollars, the BP official said.

BP PLC has sued to block what could be billions of dollars in settlement payouts to businesses over the spill. The company has accused Juneau of trying to rewrite the terms of the deal and asserts that he has made decisions that expose the company to fictitious losses that were never contemplated in the settlement.

Judge Barbier, who is overseeing the massive settlement, appointed Juneau last year and has upheld his decisions for calculating payments. BP has appealed, and the 5th U.S. Circuit Court of Appeals is scheduled to hear the case in July.

The spill began in April 2010 after the BP-leased drilling rig Deepwater Horizon exploded off the Louisiana coast, killing 11 workers. Roughly 200 million gallons of crude oil were released from the Macondo well a mile under the Gulf surface. Marshes, fisheries and beaches from Louisiana to Florida were fouled by the oil until a cap was placed over the blown-out well in July 2010.

BP set up a compensation fund for individuals and businesses affected by the spill and committed $20 billion. The claims fund initially was handled by lawyer Kenneth Feinberg but Juneau took over the processing of claims after the settlement was reached last year.

It wasn't immediately known how many lawyers work for Juneau, but his office announced in May that it has determined more than $3 billion in claims are eligible for payment through the settlement agreement. More than 162,000 claims were filed and more than $2 billion had been paid to claimants as of May 6.


22.27 | 0 komentar | Read More

New England better on primary care than most of US

PLAINFIELD, Vt. — Ronald Pitkin, 84, remembers the day in the early 1960s when his brother Belmont got a gash in his leg while the two were cutting firewood. They went to the office of the town physician, Dr. Frank Corson.

Corson worked alone, and Pitkin was drafted to be his assistant. "He told me 'You're going to have to scrub up.' I was the operating room nurse that day."

Now Pitkin gets his health care at The Health Center, sleek, modern clinic that houses primary care, dentistry, psychiatry and other specialties under one roof. It's one of eight facilities in small towns around Vermont that charge based on patients' ability to pay. They provide primary care to about 25 percent of the mostly rural state's residents, and experts say they're a key part of the reason why Vermont leads the country in primary care doctors per capita.

"This is a terrific health care center," Pitkin said recently as he waited for a checkup with the center's senior physician, Dr. John Matthew. "It's more care, and help in general, for less dollars than just about anywhere."

With Vermont leading the way, five of New England's six states rank in the top six for primary care doctors per capita, according to data from the Association of American Medical Colleges. The sixth, Connecticut, ranks 12th. As the national shortage of primary care doctors expected to increase after the federal Affordable Care Act takes full effect next year, some are looking to New England's states with an eye to what they've been doing right.

Several factors contribute to New England's relatively strong position. Among them: strong public health programs ensuring that high percentages of residents have health coverage, meaning fewer doctors deliver uncompensated care. Massachusetts, which enacted a universal health care program in 2006, has about 97 percent of its residents carrying health coverage. In Vermont it's about 94 percent.

The high rates of people already insured means "we will not experience the same (influx of newly insured patients) in Vermont as in other states that have very high rates of uninsured people or low Medicaid eligibility," said Mark Larson, commissioner of the Vermont Department of Health Access.

Medical schools in New England, including the University of Vermont College of Medicine and the University of Massachusetts Medical School, have increased their emphasis on educating doctors for primary care in recent years, officials said. Vermont and New Hampshire augment a federal program that offers partial loan forgiveness for doctors willing to work in under-served areas with a similar state program.

In rural northern New Hampshire, Edward Shanshala, executive director of Ammonoosuc Community Health Services, said he tries to use the lifestyle as a lure when recruiting new doctors. "If you like to hike, bike, ski, fish and things like that — great!" he said.

Doctors also have time to see more patients because physician's assistants and nurses deliver some basic care to patients, said Brian Rosman of the Boston-based consumer group Health Care for All.

"The goal is to have everybody working at the top of their license," Rosman said. "Doctors should do things that really need doctors."

Even in New England, though, the picture is "far from rosy," said Dr. Joseph Gravel, president of the Massachusetts Academy of Family Physicians. Starting family physicians at his Lawrence office make $130,000 a year; specialists can make three or four times that much, Gravel said. With many new doctors facing student loan debts in the hundreds of thousands of dollars, the incentives are clear.

A physician workforce study by the Massachusetts Medical Society reported that even a state ranking third in primary care doctors per capita had experienced a shortage for eight consecutive years. Half of all primary care physicians were not accepting new patients, with others reporting long wait times.

MMS spokesman Rick Gulla said the per-capita numbers may overstate access. "Many physicians in the state are teaching, doing research, or other activities. Some of those physicians only see patients a day a month, and this also affects patient access to care."

And the need for care is increasing, too, as the general population ages. Maine has the nation's highest median age; Vermont is second.

"It seems like not only is Maine's general population aging, but a significant percentage of primary care practitioners is also getting to an age of retirement," said Vanessa Santarelli, CEO of the Maine Primary Care Association, which promotes and supports 20 federally qualified health centers across the state.

And sometimes the hiking, skiing and fishing just aren't big enough attractions, Shanshala said. He described some of the lengths to which he's gone to recruit physicians. When doctors in training leave after brief stints, he invites them to return for the company picnic and tries to keep in touch in case they ever want to come back.

Still, the picture New England is better than elsewhere, Gravel said. He cited a 2007 report in the Journal of the American Medical Association saying that among new medical school graduates just beginning their residencies, just 3.3 percent nationwide were going into family practice.

Strong support from the community and from Vermont's political leadership were among the chief satisfactions of Matthew's 40-plus-year career, he said. Good primary care leads to good overall health, he said, noting Vermont has been ranked the healthiest state for several years running — six, according to the United Health Foundation.

"Vermont is a good society," Matthew said. "Everyone is concerned about the least amongst us."

____

AP writers Holly Ramer in Concord, N.H., and David Sharp in Portland, Maine, contributed to this report.


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Ben Bernanke: Bond buys could end next year

Written By Unknown on Kamis, 20 Juni 2013 | 22.26

The Federal Reserve ended weeks of speculation yesterday as it said there would be no immediate changes to the central bank's bond-buying program, but it left open the door for a future slowdown in the purchases that have helped keep interest rates low.

Federal Reserve Chairman Ben Bernanke said if the economy continues to improve, the Fed's bond-buying program could be reduced later this year in "measured steps" and could end sometime next year.

In its updated economic forecast issued after the end of its two-day policy meeting, the Fed painted a moderately positive economic picture, including predicting a drop in the unemployment rate to 7.2 or 7.3 percent by the end of the year.

"The fundamentals look a little better to us," Bernanke said.

The Fed has been buying $85 million in bonds each month, and said it will continue to do so until the outlook for the job market improves substantially. When the Fed does pull back on the bond-buying program, Bernanke said it will be like a driver taking a foot off the gas, rather than slamming on the brakes.

Alan Clayton-Matthews, an economist at Northeastern University, said the news from the Fed was more of the same.

"It doesn't appear to be any different stance," he said. "It's neutral. It's steady as she goes."

Clayton-Matthews said ending the bond-buying program will be a tricky step to navigate.

"That's the whole point of Fed policy, to time it correctly," he said. "The main purpose of the statement was that financial markets would have some idea of what the Fed's policy would be. It plays down the chance of financial markets being surprised."

The Dow Jones industrial average closed down 206 points yesterday, as investors sold off stocks and bonds.

But Clayton-Matthews warned that the effects of the Fed's policy statement would become clearer in 
the coming days.

"Wall Street can respond to this in any number of 
rational or irrational ways," he said.


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AP buys stake in live video service Bambuser

NEW YORK — The Associated Press said Thursday that it has bought a minority stake in the live video service Bambuser, boosting its ability to acquire and distribute video collected by people who have witnessed news events.

Financial terms were not disclosed. As part of the deal, Sandy MacIntyre, AP's director of global video news, will join Bambuser's board as a director.

The deal caps a three-year relationship between the news agency and Bambuser. Last year, the AP signed a deal with Bambuser giving the agency exclusive syndication rights to user-generated content video posted on the service, meaning that if users want to share their video with a news agency, they do it only with the AP, MacIntyre said.

"This investment by the AP is a natural extension of our existing relationship with Bambuser and will ensure that we retain our dominant capability in gathering and verifying UGC video news," he said in a statement.

Bambuser, which was founded in 2007 in Stockholm, allows users to broadcast, watch and share live video through smartphones and computers. The AP said Bambuser's products are designed particularly to cater to the needs of the news industry.

The service is free for individuals and nonprofit groups. To broadcast live, users need to install an app on their smartphones or use a Web browser with Flash technology on regular computers. People can watch videos on Bambuser's website via computers and mobile devices.

Generally, neither AP nor Bambuser pays users to publish the content they post, MacIntyre said.

Access to user-generated content has become increasingly important for media companies like the AP, which has growing demand for live video from its broadcast and online customers.

"Working so closely with the AP over the last year has proven the huge demand for user-generated video content," said Hans Eriksson, executive chairman of Bambuser. "This equity investment is an important milestone in Bambuser's journey, as it not only brings our two organizations closer, but enables us to share our expertise to an even greater extent."

The AP said the deal with Bambuser gives it access to an established community of video contributors around the world. The service also is used by the news agency's own journalists in the field to send video to the AP.

The AP noted that it already uses verified user-generated content regularly, citing the civil war in Syria, the aftermath of the Boston Marathon bombings and recent storms in Oklahoma as examples of recent stories where such content played a role.

MacIntyre said that through its relationship with Bambuser over the past year, the AP has been able to access footage of breaking news it couldn't get any other way. He also noted that user-generated content is poised to grow in both importance and volume.

"Nearly a fifth of the world's population has a smartphone and that is a phenomenal eyewitness resource that Bambuser makes technologically possible," he said.


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Weekly US jobless aid applications rise to 354K

WASHINGTON — Applications for U.S. unemployment benefits rose by 18,000 last week to a seasonally adjusted 354,000. Despite the gain, the level remains consistent with moderate job growth.

The Labor Department said Thursday that the less volatile four-week average increased by 2,500 to 348,250.

Applications are a proxy for layoffs. Since January, they have fallen 6 percent. That suggests companies are cutting fewer jobs.

At the same time, hiring has been steady, despite an increase in taxes on Jan. 1 and steep federal spending cuts that began in March. Solid consumer spending and a rebound in housing have helped the economy weather the fiscal drag.

Jennifer Lee, an economist at BMO Capital Markets, said the increase in applications makes it less likely that hiring will accelerate this month but job growth remains moderate.

"The overall U.S. labor market is improving," Lee said.

Employers added 175,000 jobs in May, nearly matching the average monthly gain for the past year. The unemployment rate ticked up to 7.6 percent from 7.5 percent, but for a good reason: More Americans were confident they could find work and began searching for a job.

The Federal Reserve on Wednesday offered a brighter outlook for the job market and economy. Chairman Ben Bernanke said the Fed is likely to reduce its bond purchases later this year and end them in the middle of next year if the economy continues to strengthen.

The Fed expects the unemployment rate will fall to between 6.5 percent and 6.8 percent by the end of 2014. That's lower than their March forecast of 6.7 percent to 7 percent.

About 4.5 million Americans received unemployment benefits in the week ending June 1, the latest data available. That's 18,000 more than the previous week. But the number of recipients has fallen 28 percent in the past year. Some have likely gotten jobs, but many have used up all the benefits available.

The Labor Department said last week that more Americans quit their jobs in April compared with March. That points to confidence in the job market, since most workers don't quit until they have another job or are sure they can find one. More quits also opens up jobs for other workers, or the unemployed, to take.

Also last week, a survey of chief executives at the largest U.S. companies showed that they are more optimistic about sales in the next six months and plan to add more workers.


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Mass. jobless rate up, but more jobs gained in May

BOSTON — Preliminary estimates show Massachusetts gained 3,500 jobs in May, but revised figures show a steeper loss of jobs in the previous month than originally thought.

Meanwhile, the state office of Labor and Workforce Development says the Massachusetts unemployment rate ticked up two-tenths of a point in May to 6.6 percent.

Different methods are used to calculate the unemployment rate and monthly job growth.

With the estimated gain of 3,500 jobs in May, the federal Bureau of Labor Statistics says Massachusetts has added 14,500 since the beginning of the year.

But the bureau says the state lost 3,300 jobs in April, a downward revision from the earlier estimate of 1,400 jobs lost.

The May jobless rate is just below the 6.7 percent rate recorded in the same month a year ago.


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France threatens Google with privacy fines

PARIS — France is giving Google three months to be more upfront about the data it collects from users — or be fined. Other European countries aren't far behind.

Now it's up to Google to decide whether the relatively small fines are enough of an incentive to rethink its privacy rules — the Internet giant risks a €300,000 euro ($402,180) penalty in France.

Europe's a big market, but one where Google has no serious competition.

However, the company does have a reputation problem when it comes to protecting user privacy. Thursday's legal action puts new pressure on Google, which is smarting from criticism over providing customer data to the U.S. government as part of its fight against foreign terrorists.

The French agency that regulates information technology says that five other European countries are taking similar steps in a staggered offensive against Google's privacy policy between now and the end of July. It says Google largely ignored earlier recommendations from European regulators.

Spain's Data Protection Agency said Thursday that it had initiated sanction proceedings after initial investigations showed Google Spain and Google Inc. may be committing six infractions against the country's data protection law. It said the company could also face fines of up to 300,000 euros.

The French National Commission on Computing and Freedom, known as CNIL, said Britain, Germany, Italy and the Netherlands will join the procedures in the coming weeks.

The legal action accelerates a long-running European fight against Google over privacy, which is more rigorously protected in many European countries than in Google's homeland, the United States.

A spokesman for Google said Thursday that it believes its privacy practices respect European laws.

"We have engaged fully with the authorities involved throughout this process, and we'll continue to do so going forward," said Al Verney.

Paris' formal warning gives the company three months to make changes to its privacy practices. They include specifying to users what it is using personal data for, and how long it's held.

Regulators also want Google to let users opt out of having their data centralized — for example, when data from online searches, Gmail and YouTube are crunched into a single location.

If not, Google risks a fine of up to 300,000 euros by France, which could eventually mean millions of euros in penalties across all six countries. By comparison, Google's revenues were $14 billion in the first quarter of this year, much of that from advertising — which is boosted by the Internet giant's ability to target users based on what they read, watch and buy online.

In Britain, the Information Commissioner's Office said its investigation into whether Google's privacy policy complies with UK law is still underway and it will soon contact Google about its preliminary findings.

The Dutch privacy watchdog, the College for the Protection of Personal Data, said it is investigating Google's "privacy conditions" but spokeswoman Lysette Rutgers declined further comment while the investigation is ongoing.

France's data protection agency led a European investigation last year into Google's privacy policy.

"French law demands that when you're collecting information about someone, you need to collect it for a precise reason," said CNIL president Isabelle Falque-Pierrotin.

She said the outcry about the role of Google and other online players in government surveillance illustrates that users want transparency about where their data goes.

Google's image has suffered since it was identified this month as one of nine U.S. Internet companies that gave the National Security Agency data on its customers, as part of the agency's efforts to track foreign threats to U.S. national security. Revelations about the program, known as PRISM, by a former NSA contractor has opened a debate about the privacy of Americans' communications.

In the European privacy dispute, Nick Pickles of Britain-based watchdog Big Brother Watch said, "There's a real worry that (the European fines) won't be a particularly strong deterrent, that Google may see it as a price of doing business."

"People shouldn't be able to ignore people's rights and the law, make huge profits and then continue acting as if nothing was amiss," he said.

Pickles noted that many European countries are limited by laws on data protection that date from before Google was even born 15 years ago.

EU Justice Commissioner Viviane Reding proposed last year that the maximum penalties for privacy matters be raised from the current €600,000 to 2 percent of a company's global sales.

The legal action could also impact huge trans-Atlantic trade negotiations that President Obama announced on Monday.

In the wake of the NSA data snooping scandal, several EU officials and politicians want data protection issues to be at the heart of the trade talks. The U.S. Ambassador to the EU expressed concern Thursday that privacy issues shouldn't dominate the talks.

___

Raf Casert in Brussels, Ciaran Giles in Madrid, Greg Katz in London and Mike Corder in Amsterdam contributed to this report.


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Miss. AG Hood say he'll subpoena Google on drugs

Written By Unknown on Rabu, 19 Juni 2013 | 22.27

JACKSON, Miss. — Mississippi's attorney general says he still thinks Google has given inadequate responses to allegations that it's not doing enough to prevent illegal online sales of drugs without prescriptions, and says he's sending out subpoenas for company documents to further his investigation.

Attorney General Jim Hood urged fellow attorneys general from other states to do the same at a meeting in Boston Tuesday, even as Google made its fullest response to date to the allegations.

Hood, a Democrat, says the Mountain View, Calif.-based company hasn't adequately responded to requests by himself and the National Association of Attorneys General to discuss sites that sell drugs without prescriptions, as well as that improperly link to copyrighted music, videos and other material.

"We in good faith invited Larry Page, chief executive officer of Google, to have an open, honest and transparent conversation about these important issues that are putting consumers at risk and facilitating wrongdoing, all while profiting handsomely from this dangerous behavior," Hood said in a statement. "Google's lack of response leaves us no choice except to issue subpoenas to Google for possible violations of state consumer protection acts and other state and federal civil and criminal laws."

The move could be the first step toward a criminal or civil prosecution of the company, and Hood has likened the possibility to the blockbuster litigation that a predecessor of his pursued against tobacco companies.

Hood also said he would send evidence of illegal drug purchases to the U.S. Department of Justice. Google paid $500 million to the federal government in 2011 to settle claims over ads sold to pharmacies that were illegally shipping drugs into the United States. Hood said Google has breached the agreement it made with federal officials.

Google, in comments posted Tuesday by Legal Director Adam Barea, says it's making it harder for illegal pharmacies to operate.

"Working together, companies in the private sector, non-profit organizations and law enforcement have made it increasingly difficult for rogue pharmacies to effectively market their illegal products online," Barea wrote, "and operators of these sites are being forced to turn to much less effective marketing techniques from the outskirts of the Internet.

That said, Google still doesn't want to block search results for online drugs, as Hood has demanded.

"We do not remove content from search results except in narrow circumstances (e.g. child sexual abuse imagery, certain links to copyrighted material, spam, malware)," Barea wrote in comments that never mentioned Hood by name.

"It's not Google's place to determine what content should be censored — that responsibility belongs with the courts and the lawmakers."

Hood had said last week that it appeared Google was removing videos on its YouTube site that promoted drugs for sale without prescription, after Hood and a Washington, D.C. group called Digital Citizens Alliance had complained about them.

"Earlier this month YouTube was notified of a number of videos promoting pharmaceuticals that violated its guidelines, and immediately removed them," Barea wrote. "YouTube will continue doing so when notified."

Hood also says that Google still isn't doing enough to stop its auto-complete feature from suggesting sites for online drugs without a prescription and pirated movies, saying the phrases "facilitate known illegal behavior."

Barea wrote that Google is working on the problem: "We're evaluating how to best address this issue, have already started running tests on the subject, and always welcome feedback."

___

Online:

Google statement on pharmacies: http://bit.ly/11K9dK6

Jim Hood's statement on Google: http://bit.ly/18Y6q9U

___

Follow Jeff Amy at http://twitter.com/jeffamy.


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Clark and Thunell join board of Blackstone company

NEW YORK — The Blackstone Group LP said Wednesday that General Wesley Clark and Lars Thunell have joined the board of its newly formed power development company Fisterra Energy.

Clark is former NATO Supreme Allied Commander in Europe and Thunell is the former head of the International Finance Corp., which is the financing arm of the World Bank.

Blackstone, a private equity firm, created Fisterra earlier this year to identify and develop independent power projects. It has a focus on projects in Latin America, Europe and the Middle East.

Clark and Thunell will also serve as senior advisers to Blackstone with a focus on the firm's private equity activities in the energy sector.

Blackstone shares were down 17 cents at $21.42 in morning trading.


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Alcatel-Lucent plans overhaul, big cost cuts

PARIS — Telecommunications equipment manufacturer Alcatel-Lucent launched a major effort Wednesday to boost its fortunes by shedding businesses and jobs as part of a deep cost cutting program.

Shares rose nearly 5 percent on the announcement, as investors hope that the plan brings the solid profits that have eluded the Paris-based company for years.

Alcatel-Lucent, which supplies operators such as AT&T, Verizon and Orange, said it will sell off more than 1 billion euros ($1.33 billion) in assets through 2015, and hopes for 1 billion euros in cost savings. It is also restructuring debt.

The company said it will cut back on research in older technologies and focus on its most promising sectors, such as Internet routing and cloud systems, "to address the explosive growth in bandwidth-hungry data traffic."

Sales at the company nearly stalled in the first quarter at 3.2 billion euros, prompting a wider-than-expected loss for the quarter of 353 million euros.

The company has faced years of nearly uninterrupted losses and successive rounds of cost-cutting and layoffs since the 2006 merger of U.S.-based Lucent Technologies and France's Alcatel.

CEO Michel Combes had promised a turnaround plan for this summer, after restructuring efforts under his predecessor failed to get the company back in profit.

The company said the new plan will include layoffs, site closures and outsourcing of some manufacturing. Combes did not indicate how many jobs would be lost from its global workforce, which included 72,000 employees as of the end of last year.


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Icahn changes tack, seeks $16B Dell stock buyback

NEW YORK — Activist investor Carl Icahn on Tuesday proposed a $16 billion share buyback in his latest effort to thwart Dell Inc. founder Michael Dell's effort to take the struggling computer maker private.

Icahn, now the company's second-largest shareholder after buying 72 million shares from fellow activist investor Southeastern Asset Management Inc., wants the company to buy back up to 1.1 billion Dell shares at $14 apiece to boost shareholders' return on their investment. The price of the buyback would represent about two-thirds of Dell's current market value of about $23.5 billion.

Dell and other personal computer makers have seen their sales crumble because of the growing popularity of smartphones and tablets. In May, Dell posted a 79 percent decline in earnings for the most recent quarter. Michael Dell believes he can turn the company around by taking it private and diversifying into niches, such as business software, data storage and consulting. He and the investment firm Silver Lake Partners are bidding to take the company private for $24.4 billion, or $13.65 per share.

But Icahn and Southeastern say that offer short-changes shareholders and originally proposed that the Round Rock, Texas, company instead give shareholders a special dividend of $12 in cash or stock per share. That would have allowed shareholders to get cash and stay invested in the company.

Dell's board rejected that proposal and has asked shareholders to approve the offer from Michael Dell and Silver Lake in a July 18 vote. In a letter to shareholders on Tuesday, Icahn wrote that he's concluded that Dell's board will never accept his dividend proposal over Michael Dell's offer, and thus is pushing for the buyback to boost shareholder value.

Dell shares rose 7 cents Tuesday to finish at $13.48, a sign that investors aren't taking Icahn very seriously and still expect the buyout deal to go through.

Icahn is now the company's biggest independent shareholder with about 152.5 million shares or an 8.7 percent stake, second only to Michael Dell's 273 million shares, or 15.6 percent stake. Southeastern now holds about 74 million shares, or a 4.2 percent stake.

A special committee of Dell's board said Tuesday that Icahn's latest proposal lacks adequate financing or a commitment from anyone to participate. The proposal "would likely force shareholders to continue to own shares in the highly leveraged company that would result," it added.

Icahn contends that the proposed share buyback would be paid for with $5.2 billion in debt, $7.5 billion in Dell cash and $2.9 billion from the sale of Dell receivables. He said he would make available $2 billion if needed, and said that a major investment bank, which was not named, has agreed to put up $1.6 billion.

Icahn said he and Southeastern would not tender their shares into the $14 per share offer. Other shareholders would be able to sell at least 72 percent of their positions.


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Men's Wearhouse ousts founder, pitchman Zimmer

NEW YORK — Apparently, Men's Wearhouse Inc. doesn't like the way its founder looks anymore.

In terse release issued Wednesday, Men's Wearhouse said it has fired the face of the company and its executive chairman, George Zimmer, who appeared in many of its TV commercials with the slogan "You're going to like the way you look. I guarantee it."

The timing was even odd —the announcement happened the morning the company's annual shareholder meeting had been set to take place. The company delayed the meeting but didn't give a new date.

Men's Wearhouse gave no reason for the abrupt firing of Zimmer, who built Men's Wearhouse from one small Texas store using a cigar box as a cash register to one of the North America's largest specialty men's clothiers with 1,143 locations. The company generated revenue of $2.48 billion in its latest fiscal year ended Feb. 2.

The company said the purpose of postponing the annual meeting is to re-nominate the existing board of directors without Zimmer. It said the board expects to discuss with Zimmer the extent, if any, and terms of "his ongoing relationship" with the company.

The news shocked analysts and corporate governance experts, who tried to speculate what happened.

"This is very rare to fire a founder. Founders are generally entrenched in the company," said Eleanor Bloxham, CEO of The Value Alliance, a board advisory firm.

Zimmer, who handed over his CEO title to Douglas Ewert in 2011, was the company's personable, down-to-earth face, his slogan almost a cultural touchstone.

As of late morning, the company's website still prominently spotlighted Zimmer, calling him "The Man Behind The Brand" and linking to YouTube videos of "the man in action."

The abrupt departure comes a week after Men's Wearhouse reported that its fiscal first-quarter profit increased 23 percent, helped by stronger margins and an earlier prom season.

In 1971, fresh out of college, Zimmer made his first foray into the clothing industry, working in Hong Kong for six months as a salesman for his father's coat manufacturing business, according to the company website.

In 1973, he and his college roommate opened the first Men's Wearhouse store, which sold $10 slacks and $25 polyester sport coats, in Houston. His personal car was a van with the company logo on the side and clothing racks in the back.

The company launched its first TV commercial in the 1970s when commercials for clothing were rare. Zimmer starred in his first TV commercial in 1986, with the line "I guarantee it."

Men's Wearhouse kept expanding, focusing on large markets where business was sluggish to take advantage of lower real estate costs. It also expanded beyond sports coats and trousers to casual sportswear in the 1980s and then went into the tuxedo rental business in 2000.

Zimmer owned 1.8 million shares of Men's Wearhouse as of the company's May 9 proxy filing, a 3.5 percent stake in the company.

Shares of Men's Wearhouse fell more than 2 percent, or 80 cents, to $36.67 in morning trading. The stock has traded between $25.97 and $38.59 in the past 52 weeks, and ended Tuesday up about 20 percent since the start of the year.

The company, based in Fremont, Calif., also runs the Moores and K&G retail chains. It also sells uniform and work wear in the U.S. and U.K.


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