National Data Breach Notice: Ever or Never? | SecurityWeek.Com

In two decades practicing law ? with a majority focus in the information security industry ? I?ve had a front row seat to the meteoric rise in the public discourse on privacy and data loss. Now as a Certified Information Privacy Professional (CIPP) and General Counsel of a company that navigates state breach notice laws, a plethora of sector based federal breach notice laws, and a host of international breach notice laws, I?ve moved in many ways from the front row and into the ring.

In my role, I am asked many questions about everything from the machinations of Federal privacy regulation, to what individual citizens should do to protect their Personally Identifiable Information (PII.) It?s a complex and compelling area of law and business that I will be covering in this space on an ongoing basis.

With recent discussions of Executive Orders and Cyberwar, a good place to begin might be to start at the top. Specifically, the question of whether or not the Federal Government will pass a comprehensive data breach notification law that supersedes all the state laws.

While I don?t rule out a federal law passing at some point, I see it setting a floor of breach response responsibility rather than superseding everything already in place. To understand the hurdles for Federal pre-emption we will look at what these different breach notice laws say, the political challenge with Federal pre-emption, and why disparate state breach laws are not a problem worth solving.

Data breach notification laws are generally laid out like this: What is personal information, what is a breach, who do you have to tell, and what happens if you don?t.

What is personal information?

The laws start with a definition of the information the law pertains to. Generally in the U.S., that means a name and identifying information that could lead to identity theft or bank fraud - like a social security number or a credit card number.

Many breach notice laws in the US are focused on financial loss because they were companion bills to identity theft bills. But states differ in the definitions of personal information. Some have additional identifiers like tribal ID (if you belong to a Native American tribe) that can trigger the definition. One state includes email addresses in its definition. Some have a long list of identifiers while others stick to a short list. Point being, states have decided that different forms of info are worthy of protection based on the nature of people in that state and their priorities.

What is a breach?

Laws then describe what a breach is. This description is where you find ?outs? to notification. For example, if the information was encrypted and the bad guys didn?t get the key, or the loss is unlikely to result in harm to anyone because while you lost it you got the info back from someone you trust didn?t give a copy to someone else. (The legal topic of measuring ?harm? is a rich one and likely warrant its own column down the line) But some states just have an out for no likelihood of financial harm meaning that a loss in that state that could result in humiliation or other non-financial harm doesn?t qualify for the out.

Who do you have to tell?

Next, the law that tells you what to do. In the U.S., they all say you have to give the folks whose info was lost a heads up so they can try and protect their credit and bank accounts. Some say you have to give your state attorney general or federal regulator notice of the loss. And others say you also have to alert the media and credit reporting agencies.

What happens if you don?t?

Some US laws are explicit about the financial penalty for not providing notice. They give a per-person amount so the larger the loss the higher the fine. And many have a cap on the total fine for an individual breach. But these amounts vary widely. Per violation amounts range from $100 to $25,000 and caps go from $10,000 to $750,000. This is obviously an enormous difference.

So with a little knowledge of how current laws work in the US, put yourself in the shoes of a legislator trying to harmonize all the different state laws. That legislator is going to have three big political challenges.

The first challenge is choosing a single standard when states differ so. Changing the rules in dozens of states will cause upheaval with political fallout.

The second challenge will be dealing with state attorneys general and treasurers. State AG?s are becoming more and more active in tracking breaches and cracking down on companies that don?t provide proper notice or have adequate security procedures. Part of that crackdown includes fines collected that go to the state treasury. A federal law will strip those AGs of the rule of privacy protectors and redirect funds to the federal government and away from the states.

The third challenge is that some states go above even Federal notice requirements, For example, California has a health care notice statute that doesn?t provide an out for encrypted data like HIPAA/HITECH does. Virginia?s health care notice statute provides for criminal penalties. What legislator wants to be known as the one who diluted people?s privacy rights by pre-empting strong protections and replacing them with weaker ones?

When trying to solve a problem, the first thing I ask is if I?m dealing with a problem worth solving. Privacy professionals and law firms have become well versed in the different state laws. Solutions also exist that track all the different laws and provide incident response plans that are easy to follow. If the problem here is the complexity involved in dealing with disparate state breach notice laws, then we don?t have a problem worth solving.

The reasons for the disparities in state breach notification laws are the strength of a federation of states. The citizens of different states with different priorities and beliefs have the power to elect representatives who create law reflecting the mores of their respective states. While some may refer to federal pre-emptions as an act of harmonization, others will see it as a federal government willing to ignore the laws and desires of the states.

The legislator who takes on the task to pre-empt a multitude of state laws is sure to create a multitude of folks displeased with their wills being ignored.

Related: Consumers Dissatisfied with Current Breach Notifications

Related: Legislation May Give the SEC's Breach Guidance Some Teeth

Gant Redmon, Esq., is General Counsel & Vice President of Business Development at Co3 Systems. Gant has practiced law for nineteen years; fifteen of those years as in-house counsel for security software companies. Prior to Co3, Gant was General Counsel of Arbor Networks. In 1997, he was appointed membership on the President Clinton?s Export Counsel Subcommittee on Encryption. He holds a Juris Doctorate degree from Wake Forest University School of Law and a BA from the University of Virginia, and is admitted to practice law in Virginia and Massachusetts. Gant also holds the CIPP/US certification.Previous Columns by Gant Redmon:

Source: http://www.securityweek.com/national-data-breach-notice-ever-or-never

laron landry mary j blige burger king islands joe flacco 2013 nissan altima masters par 3 contest google augmented reality glasses

Top UK court rejects bid to free US-held detainee

LONDON (AP) ? Britain's Supreme Court on Wednesday quashed a bid by a Pakistani man held by the U.S. in Afghanistan to force U.K. authorities to secure his release, although it said there was evidence his detention violated international law.

Yunus Rahmatullah, 30, was captured by British forces in Iraq in 2004 and handed over to the Americans, who sent him to a prison at Bagram air base in Afghanistan.

He has not been charged with a crime, but U.S. officials have accused him of being a member of an al-Qaida-linked terrorist group.

Last year a lower court ordered Britain to seek Rahmatullah's release on the grounds that under international law it was responsible for his care and had the power to ask the U.S. to free him.

But the order ? known as a writ of habeas corpus ? was canceled after U.S. officials refused to cooperate.

Habeas corpus is an ancient legal principle ? Latin for "you have the body" ? requiring authorities to bring a prisoner before a court so it can judge the legality of the detention.

The Supreme Court ruled Wednesday that both the original order and the decision to scrap it had been legal.

The judges said Britain had been right to seek Rahmatullah's release, but it was clear U.S. authorities "felt they were holding Mr. Rahmatullah lawfully and were not willing to relinquish control of his detention to the U.K.

However, the seven judges raised concerns about the legality of Rahmatullah's detention. In a written judgment with which a majority of the justices agreed, Lord Brian Kerr said "the presumably forcible transfer of Mr. Rahmatullah from Iraq to Afghanistan is, at least prima facie, a breach of article 49" of the Geneva Conventions on the treatment of war prisoners.

Jamie Beagent, a British lawyer representing Rahmatullah, said the ruling was a victory because the Supreme Court had backed his client's case in principle.

"Sadly, despite the fact that in international law Mr. Rahmatullah remains a British detainee and the United States does not consider him a security threat, our client remains in detention at Bagram," he said.

He said lawyers would continu e to seek Rahmatullah's release on the basis that his detention violated the Geneva Conventions.

Source: http://news.yahoo.com/top-uk-court-rejects-bid-free-us-held-113201388.html

apple dividend snow white and the huntsman snow white and the huntsman rupaul drag race walking dead comic kratom broncos

Post Hurricane Etiquette | Mommy Blog | Celebrity Moms | Parenting ...

As a New Yorker who is lucky enough to not have suffered any damage or lost power due to Hurricane Sandy, I want to just say that I have been pretty amazed by people who don't live in the Northeast who have no clue about how badly people are faring.

I've been watching wall to wall news coverage - much like I did after September 11 and it is truly heartbreaking. From the family who shared their harrowing story of escaping from the burning home in Breezy Point, NY (over 111 homes have burned to the ground so far) to the woman sobbing as she shared with Governor Chris Christie that she had lost her husband and her son and now she lost all the memories of them since everything in her home has been completely destroyed. It was so tragic to see the faces of complete devastation.

People have been on gas lines for hours. Beach communities like Long Beach have no power and are about to have their water turned off because it has been contaminated. And a lot of our friends are without power and have no idea when it's going to be turned back on because telephone poles with transformers attached to them fell, crashed to the ground and blew up.

So what do you do if you don't live near here and can't relate to what people are going through? Don't dismiss it as if everything is fine. Unfortunately, it's not. The aftermath of this storm is continuing - fires are starting due to gas leaks, water is still being pumped out of subways, tunnels and homes and you can't even drive into Manhattan unless three or more people are in your car.

Did I mention that over 50 people have died -- including the children of a poor mother whose babies were swept away when she tried to protect them from the storm? Another couple died while they were walking their dog. And two young boys were killed when a tree hit the home they were seeking shelter in.

This storm is not a laughing matter and shouldn't be taken lightly. Homes and businesses have been destroyed. Lives have been lost. It will take billions of dollars to repair the damage. So please, take a moment and think about the people who have been directly affected by this tragedy. You may be safe and sound in your home but unfortunately, weather is unpredictable and every corner of our globe has experienced devastation in its wake. The northeast and its residents were the latest victim and all I can say is, if you don't live nearby and weren't home hearing the wind, water and fire rip apart neighborhoods, then say a prayer, make a donation and trim your trees!

Posted in: Blog, Role Mommy Confessions, Undercover Mom on 10/31/2012

Source: http://www.rolemommy.com/blog/post-hurricane-etiquette.php

gunner kiel groundhog soulja boy did the groundhog see his shadow punxsutawney phil groundhog day ground hog

High schools with athletic trainers have more diagnosed concussions, fewer overall injuries

ScienceDaily (Oct. 22, 2012) ? High schools with athletic trainers have lower overall injury rates, according to a new study, "A Comparative Analysis of Injury Rates and Patterns Among Girls' Soccer and Basketball Players," presented Oct. 22 at the American Academy of Pediatrics (AAP) National Conference and Exhibition in New Orleans. In addition, athletes at schools with athletic trainers are more likely to be diagnosed with a concussion.

Researchers reviewed national sports injury data on girls' high school soccer and basketball programs with athletic trainers, between the fall of 2006 and the spring of 2009, from the Reporting Information Online (RIO?) and compared it to local Sports Injury Surveillance System (SISS) data on a sample of Chicago public high school programs without athletic trainers for the same sports and time period.

Overall injury rates were 1.73 times higher among soccer players and 1.22 times higher among basketball players in schools without athletic trainers. Recurrent injury rates were 5.7 times higher in soccer and 2.97 times higher in basketball in schools without athletic trainers. In contrast, concussion injury rates were 8.05 times higher in soccer and 4.5 times higher in basketball in schools with athletic trainers.

While less than 50 percent of U.S. high schools have athletic trainers, "this data shows the valuable role that they can play in preventing, diagnosing and managing concussions and other injuries," said Cynthia LaBella, MD, FAAP. "Athletic trainers have a skill set that is very valuable, especially now when there is such a focus on concussions and related treatment and care. Concussed athletes are more likely to be identified in schools with athletic trainers and thus more likely to receive proper treatment.

"Athletic trainers facilitate treatment of injuries and monitor recovery so that athletes are not returned to play prematurely. This likely explains the lower rates of recurrent injuries in schools with athletic trainers," said Dr. LaBella.

Share this story on Facebook, Twitter, and Google:

Other social bookmarking and sharing tools:

---

Story Source:

The above story is reprinted from materials provided by American Academy of Pediatrics.

Note: Materials may be edited for content and length. For further information, please contact the source cited above.

---

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Source: http://feeds.sciencedaily.com/~r/sciencedaily/living_well/~3/tF0U7usyvMA/121022080649.htm

grammy winners obama budget woolly mammoth belize resorts nikki minaj grammy performance shel silverstein niki minaj grammy performance

Banks responding slowly to mortgage demand

By Dan Wilchins and Rick Rothacker, Reuters

Big U.S. banks are hiring mortgage bankers to meet a surge in demand for home loans and refinancings, but they are still struggling to process applications, which could undermine the Federal Reserve's attempts to stimulate the economy.?

Jonathan Ernst / Reuters

Banks are hiring to meet increased demand in the home loan business.

Since the Fed announced its plan in September to buy up to $40 billion of mortgages a month, consumer mortgage rates have fallen more slowly and by less than they would have done in more normal times.?

On average, 30-year home loan rates are down just 0.18 of a percentage point this week from Sept. 13, when the Fed announced its latest stimulus program. Some analysts estimate that in more normal markets, rates would have fallen by roughly 0.31 of a percentage point or more. That could save a home buyer thousands of dollars over the lifetime of a mortgage.

The dysfunction in the mortgage market, which has yet to fully recover after its battering in the U.S. housing bust and subsequent financial crisis, means most benefits from the Fed's new stimulus plan may be accruing to banks instead of consumers.

Banks still committed to the home loan business are hiring to meet increased demand, but fewer banks are committed to the business after the 2007-2009 mortgage crisis pulverized some of the biggest lenders in the United States and wounded many others.

Capacity constraints work in the banks' favor. Profit margins for home lending are more than double their usual level, JPMorgan Chief Executive Jamie Dimon told investors last Friday. The major U.S. banks, including JPMorgan Chase & Co, Wells Fargo & Co and Citigroup Inc, all said mortgage operations boosted third-quarter profits.

Lenders making mortgages say they do not want to hire too many staffers only to lay them off when volume declines. The Mortgage Bankers Association estimates that banks will make $1.47 trillion of home loans this year for home purchases and refinancings, but then just $1.04 trillion in 2013, a decline of nearly a third.

"We are trying to ... not over hire," Andy Cecere, chief financial officer at U.S. Bancorp, said in an interview on Wednesday.

Top U.S. mortgage lender Wells Fargo added about 2,000 people in the third quarter as volume surged. Chief Financial Officer Tim Sloan said in an interview the bank is responding to the impact of the Fed's plan. Chase has increased its number of loan officers by 23 percent over the last year, and expects to keep hiring aggressively, said Kevin Watters, head of mortgage originations at JP Morgan Chase.

But mortgage applications are also jumping, rising nearly 17 percent in the week ended Sept. 28. With demand that strong and no staffers to handle extra business, banks have little reason to cut rates much. In a speech on Monday, New York Federal Reserve President William Dudley acknowledged that difficulty, noting the Fed's efforts to stimulate the economy in recent years would have had a bigger economic impact if consumer mortgage rates were falling more.

Bank staffing issues are a headache for mortgage applicants already struggling with tough appraisals and wary lenders. Many borrowers tell Kafka-esque stories of bureaucracy, where what used to be a 30- to 60-day process has stretched to 90 days or more.

Profit bonanza
The mortgage business has grown much more concentrated. The top two mortgage lenders made 14 percent of mortgage loans in 2000, 29 percent of mortgages in 2006, and 44 percent in the first half of 2012, according to Inside Mortgage Finance data.?

Wells Fargo and JPMorgan Chase are the top two lenders now, and their predecessor companies were the top in 2000.

In 2006, Countrywide Financial Corp ? now owned by Bank of America Corp ??and Wells were the top. Bank of America last year stopped buying loans from other banks after suffering billions of dollars of losses from its exposure to home loans, which has cut its volume in half and limited smaller banks' capacity to lend.

Bankers are unsure how long the refinancing bonanza will last.

JPMorgan Chase CEO Dimon told investors the mortgage boom will continue "next quarter, maybe for a couple of quarters after that but it won't last for that much longer."

Citigroup Chief Financial Officer John Gerspach told investors on Monday that figuring out how long the refinancing boom will last is "one of the big questions facing a lot of institutions at this point in time."

Smaller banks are struggling with the same questions.

Matt Williams, president of Gothenburg State Bank in Gothenburg, Neb., and incoming chairman of the American Bankers Association, said his bank was not adding staff even though its 28 employees were "stressed to the max right now."

Williams said his bank, with $125 million in assets, expects rates eventually will go up, cutting demand for refinancing.

Mortgage demand was rising even before the Fed announced its latest plan to buy home loans, but that announcement immediately lowered bank funding costs. The effect on bank revenues will take longer to show up, because it takes months to process and close mortgage applications.

For consumers, capacity constraints among mortgage lenders mean rates are not falling as much as they theoretically could.

The average 30-year consumer mortgage rate was 3.37 percent, Freddie Mac said on Thursday ? about 1.13 percentage points higher than rates investors in mortgage bonds would accept, as measured by the "secondary rate" for mortgages guaranteed by Fannie Mae.

In the second half of 2011, the gap between consumer mortgage rates and the secondary rate averaged closer to about 0.9 percentage point, suggesting lenders could cut rates another 0.23 point. However, Freddie Mac and Fannie Mae boosted fees for guarantees by 0.1 of a percentage point in August, meaning the difference may be only about 0.13 of a percentage point.

Additional reporting by David Henry and Michelle Conlin in New York and Emily Stephenson in San Diego.

More business news:

Follow NBCNews.com business on Twitter and Facebook

Source: http://bottomline.nbcnews.com/_news/2012/10/19/14563232-banks-responding-too-slowly-to-mortgage-demand?lite

allen iverson jr smith chris anderson rondo suspended bay bridge downton abbey season 3 presidents day

France: Iran seems on track for nukes by mid-2013

{ttle}

{cptn}","template_name":"ss_thmb_play_ttle","i18n":{"end_of_gallery_header":"End of Gallery","end_of_gallery_next":"View Again"},"metadata":{"pagination":"{firstVisible} - {lastVisible} of {numItems}","ult":{"spaceid":"84962389","sec":""}}},{"id": "hcm-carousel-587594927", "dataManager": C.dmgr, "mediator": C.mdtr, "group_name":"hcm-carousel-587594927", "track_item_selected":1,"tracking":{ "spaceid" : "84962389", "events" : { "click" : { "any" : { "yui-carousel-prev" : { "node" : "a", "data" : {"sec":"HCMOL on article right rail","slk":"prev","itc":"1" }, "bubbles" : true, "test": function(params){ var carousel = params.obj.getCarousel(); var pages = carousel._pages; // if same page, don't beacon if(("_ult_current_page" in carousel) && carousel._ult_current_page==pages.cur) return false; // keep track of current position within this closure carousel._ult_current_page = pages.cur; return true; } }, "yui-carousel-next" : { "node" : "a", "data" : {"sec":"HCMOL on article right rail","slk":"next","itc":"1" }, "bubbles" : true, "test": function(params){ var carousel = params.obj.getCarousel(); var pages = carousel._pages; // no more pages, don't beacon again // if same page, don't beacon if(("_ult_current_page" in carousel) && carousel._ult_current_page==pages.cur) return false; // keep track of current position within this closure carousel._ult_current_page = pages.cur; return true; } } } } } } })); }); Y.later(10, this, function() {(function() { try{ if (Math.floor(Math.random()*10) == 1) { var loc = window.location, decoded = decodeURI(loc.pathname), encoded = encodeURI(decoded), uri = loc.protocol + "//" + loc.host + encoded + ((loc.search.length > 0) ? loc.search + '&' : '?') + "_cacheable=1", xmlhttp; if (window.XMLHttpRequest) xmlhttp = new XMLHttpRequest(); else xmlhttp = new ActiveXObject("Microsoft.XMLHTTP"); xmlhttp.open("GET",uri,true); xmlhttp.send(); } }catch(e){} })(); }); Y.later(10, this, function() {Y.namespace("Media").ywaSettings = '"projectId": "10001256862979", "documentName": "", "documentGroup": "", "ywaColo" : "vscale3", "spaceId" : "84962389" ,"customFields" : { "12" : "classic", "13" : "story" }'; Y.Media.YWA.init(Y.namespace("Media").ywaSettings); }); Y.later(10, this, function() {if(document.onclick===YAHOO.Media.PreventDefaultHandler.newClick){document.onclick=YAHOO.Media.PreventDefaultHandler.oldClick;} }); }); });

CDC: Death toll rises to 23 in meningitis outbreak

{ttle}

{cptn}","template_name":"ss_thmb_play_ttle","i18n":{"end_of_gallery_header":"End of Gallery","end_of_gallery_next":"View Again"},"metadata":{"pagination":"{firstVisible} - {lastVisible} of {numItems}","ult":{"spaceid":"2145892301","sec":""}}},{"id": "hcm-carousel-350283504", "dataManager": C.dmgr, "mediator": C.mdtr, "group_name":"hcm-carousel-350283504", "track_item_selected":1,"tracking":{ "spaceid" : "2145892301", "events" : { "click" : { "any" : { "yui-carousel-prev" : { "node" : "a", "data" : {"sec":"HCMOL on article right rail","slk":"prev","itc":"1" }, "bubbles" : true, "test": function(params){ var carousel = params.obj.getCarousel(); var pages = carousel._pages; // if same page, don't beacon if(("_ult_current_page" in carousel) && carousel._ult_current_page==pages.cur) return false; // keep track of current position within this closure carousel._ult_current_page = pages.cur; return true; } }, "yui-carousel-next" : { "node" : "a", "data" : {"sec":"HCMOL on article right rail","slk":"next","itc":"1" }, "bubbles" : true, "test": function(params){ var carousel = params.obj.getCarousel(); var pages = carousel._pages; // no more pages, don't beacon again // if same page, don't beacon if(("_ult_current_page" in carousel) && carousel._ult_current_page==pages.cur) return false; // keep track of current position within this closure carousel._ult_current_page = pages.cur; return true; } } } } } } })); }); Y.later(10, this, function() {(function() { try{ if (Math.floor(Math.random()*10) == 1) { var loc = window.location, decoded = decodeURI(loc.pathname), encoded = encodeURI(decoded), uri = loc.protocol + "//" + loc.host + encoded + ((loc.search.length > 0) ? loc.search + '&' : '?') + "_cacheable=1", xmlhttp; if (window.XMLHttpRequest) xmlhttp = new XMLHttpRequest(); else xmlhttp = new ActiveXObject("Microsoft.XMLHTTP"); xmlhttp.open("GET",uri,true); xmlhttp.send(); } }catch(e){} })(); }); Y.later(10, this, function() {Y.namespace("Media").ywaSettings = '"projectId": "10001256862979", "documentName": "", "documentGroup": "", "ywaColo" : "vscale3", "spaceId" : "2145892301" ,"customFields" : { "12" : "classic", "13" : "story" }'; Y.Media.YWA.init(Y.namespace("Media").ywaSettings); }); Y.later(10, this, function() {if(document.onclick===YAHOO.Media.PreventDefaultHandler.newClick){document.onclick=YAHOO.Media.PreventDefaultHandler.oldClick;} }); }); });

Yemen forces endanger health care by raiding hospitals :HRW

'},"otherParams":{"t_e":1,".intl":"US"},"events":{"fetch":{lv:2,"sp":"2146372232","ps":"LREC,MON","npv":true,"bg":"#FFFFFF","em":escape('{"site-attribute":"_id=\'2a2865b7-c0b9-376b-b2ed-926cf1b99ffd\' sensitivity=\'1\' rs=\'lmsid:a0770000002GZ5iAAG\' can_suppress_ugc=\'1\' content=\'no_expandable;ajax_cert_expandable;\' ADSSA"}'),"em_orig":escape('{"site-attribute":"_id=\'2a2865b7-c0b9-376b-b2ed-926cf1b99ffd\' sensitivity=\'1\' rs=\'lmsid:a0770000002GZ5iAAG\' can_suppress_ugc=\'1\' content=\'no_expandable;ajax_cert_expandable;\' ADSSA"}')}}};var _createNodes=function(){var nIds=_conf.nodeIds;for(var i in nIds){var nId=nIds[i];var dId=_conf.destinationMap[nIds[i].replace("yom-","")];n=Y.one("#"+nId);if(n)var center=n.one("center");var node=Y.one("#"+dId);var nodeHTML;if(center && !node){nodeHTML=_conf.nodes[nId];center.insert(nodeHTML);};};};var _prepareNodes=function(){var nIds=_conf.nodeIds;for(var i in nIds){var nId=nIds[i];var dId=_conf.destinationMap[nIds[i].replace("yom-ad-","")];n=Y.one("#"+nId);if(n)var center=n.one("center");var node=Y.one("#"+dId);if(center && node){center.set("innerHTML","");center.insert(node);node.setStyle("display","block");};};};var _darla;var _config=function(){if(YAHOO.ads.darla){_darla = YAHOO.ads.darla;_createNodes();};};var _fetch=function(spaceid,adssa,ps){ if (typeof(ps)!='undefined') _conf.events.fetch.ps = ps;if(typeof spaceid != "undefined") _conf.events.fetch.sp=spaceid;adssa = (typeof adssa != "undefined" && adssa != null) ? escape(adssa.replace(/\"/g, "'")) : "";_conf.events.fetch.em=_conf.events.fetch.em_orig.replace("ADSSA", adssa);if(_darla){_prepareNodes();_darla.setConfig(_conf);_darla.event("fetch");};};Y.on("domready", function(){_config();});;var that={"fetch":_fetch,"getNodes":_conf.nodes,"getConf":_conf};return that;}();/* Backwards compatibility - Assigning the latest instance to the main fetch function */YUI.PhotoAdsDarla.fetch=YUI.PhotoAdsDarla.photoslightboxdarla.fetch; }); Y.later(10, this, function() {YAHOO.namespace('Media.Social').Lightbox = {}; }); Y.later(10, this, function() {Y.Media.Article.init(); }); Y.later(10, this, function() {new Y.Media.AuthorBadge(); }); Y.later(10, this, function() {new Y.Media.Branding(); }); Y.later(10, this, function() {Y.on("load", function () { YUI.namespace("Media.SocialButtons"); var instances = YUI.Media.SocialButtons.instances || [], globalConf = YAHOO.Media.SocialButtons.conf || {}, vplContainers = []; Y.all(".ymsb").each(function (node) { var id = node.get("id"), conf = YAHOO.Media.SocialButtons.configs[id], instance; if (conf) { instance = new Y.SocialButtons({ srcNode: node, config: Y.merge(globalConf, conf.config || {}), contentMetadata: conf.content || {}, tracking: conf.tracking || {} }); vplContainers.push( { selector: "#" + id, callback: function(node) { instance.render(); instance = conf = id = null; } }); if (conf.config && conf.config.dynamic) { instances.push(instance); } } }); Y.Global.Media.ViewportLoader.addContainers(vplContainers); YUI.Media.SocialButtons.instances = instances; }); }); Y.later(10, this, function() {if (!Y.Media) { return; } Y.Media.boba_lightbox_module_targets = Y.Media.boba_lightbox_module_targets || {}; Y.Media.boba_lightbox_module_configs = Y.Media.boba_lightbox_module_configs || {}; Y.Media.boba_lightbox_module_dataset = Y.Media.boba_lightbox_module_dataset || {}; Y.Media.boba_lightbox_module_whitelist = Y.Media.boba_lightbox_module_whitelist || {}; Y.Media.boba_lightbox_module_dataset['a7354c9af64e17027cb2155fc1213ad5'] = []; Y.Media.boba_lightbox_module_configs['a7354c9af64e17027cb2155fc1213ad5'] = {"spaceid":"2146372232","ult_pt":"story-lightbox","darla_id":"","images_total":0,"xhr_url":"\/_xhr\/related-article\/lightbox\/?id=2a2865b7-c0b9-376b-b2ed-926cf1b99ffd","xhr_count":20,"autoplay_if_first_item_is_video":true}; }); Y.later(10, this, function() {new Y.Media.RelatedArticle({count:"2",start:"1", mod_total:"10", total:"0", content_id:"2a2865b7-c0b9-376b-b2ed-926cf1b99ffd", spaceid:"2146372232", related_count:"-1" }); }); Y.later(10, this, function() {(function(d){ d.getElementsByTagName('head')[0].appendChild(d.createElement('script')).src='http://d.yimg.com/oq/js/csc_news-en-US-core.js'; })(document); }); Y.later(10, this, function() { if(!("Media" in YAHOO)){YAHOO.Media = {};} if(!("ugcrate" in YAHOO.Media)){YAHOO.Media.ugcrate = {};} if(!("Media" in Y)){Y.namespace("Media");} YAHOO.Media.ugcrate.ratings_2717655e6e7e25ba702a37253933ab32 = new Y.Media.UgcRate({"context_id":"4b73f06a-bc4d-4ef4-826d-338a8c9551c6","sCrumb":"","containerId":"yom-sentimentrate-2717655e6e7e25ba702a37253933ab32","rateDimensions":"d1","appLang":"en-US","sUltSId":"2146372232","sUltProperty":"news-en-US","sUltCampaign":"","sUltPlatform":"ugcwidgets","sUltIntl":"US","sUltLang":"en-US","selfPageUrl":"http:\/\/news.yahoo.com\/yemen-forces-endanger-health-care-raiding-hospitals-hrw-182030790.html?_esi=0","artContentId":"2a2865b7-c0b9-376b-b2ed-926cf1b99ffd","sUltQstnTxt":"Are Social Security and Medicare crucial to your retirement security?","artContentTitle":"Yemen forces endanger health care by raiding hospitals :HRW","artContentDesc":"ADEN (Reuters) - An international rights group has accused Yemeni security forces of endangering health care in the southern city of Aden by forcibly removing wounded activists from hospitals and exchanging fire with gunmen seeking to block the arrests. Yemen, trying to recover from months of political unrest that eventually forced President Ali Abdullah Saleh from power, is grappling with numerous security challenges after last year\\'s uprising, including al Qaeda-linked insurgents, southern secessionists and Shi\\'ite Muslim rebels. ...","sUltBucketId":"test1","sUltSection":"sentirating","sUltBeaconUrl":"","sUltRecordPageviews":"1","sUltBeaconEnable":"1","serviceUrl":"\/_xhr","publisherContextId":"","propertyId":"2fcd79b5-b3a3-333e-b98e-722536a6698f","configurationId":"435db9ee-c55e-3766-b20d-c8ad3ff889d1","graphId":"","labelLeft":"Not at all","labelRight":"Crucial","labelMiddle":"","itemimg":"http:\/\/l.yimg.com\/a\/i\/ww\/met\/yahoo_logo_us_061509.png","selfURI":"","aggregateRatingCount":"251304","aggregateReviewCount":"0","leftBlocksNum":"57717","rightBlocksNum":"193515","leftBlocksPerCent":"23","rightBlocksPerCent":"77","ugcrate_apihost":"api01-us.ugcl.yahoo.com:4080","publisher_id":"news-en-US","yca_cert":"yahoo.ugccloud.app.trusted_proxies","timeout_write":"5000","through_proxy":"false","optionStats":"{\"s1\":22165,\"s2\":7147,\"s3\":6860,\"s4\":10001,\"s5\":11544,\"s6\":193515,\"s7\":0,\"s8\":0,\"s9\":0,\"s10\":0}","l10N":"{\"FIRST_TO_READ\":\"You are first to read this. Share your feelings and start a conversation.\",\"SHARE_YOUR_FEELINGS\":\"You too can share your feelings and start a conversation!\",\"HOW_YOUR_FRIENDS_THINK\":\"Share your opinion with your friends.\",\"PRE_SHARE_MSG\":\"Your Facebook friends on Yahoo! can see how you responded to this question. To share your response on Facebook, click on the Facebook share option.\",\"START_THE_CONVERSATION\":\"Share\",\"THANKS_FOR_SHARING\":\"Thanks!\",\"POLL_HEADER\":\"SOCIAL SENTIMENT\",\"SERVER_ERROR\":\"Oops there seems to be some error, please try again later\",\"LOADING\":\"Loading...\",\"SHARE_AFTER_COMMENT\":\"Your response has been shared on Facebook.\",\"UNDO\":\"Undo\",\"UNIT_PEOPLE\":\"People\",\"NUM_PEOPLE_DISAGREE\":\"disagree with your opinion.\",\"READ_MORE_TEXT\":\"Read what they have to say.\",\"SLIDER_THUMB_WORDING_BEFORE_VOTING\":\"WHAT DO YOU THINK?\",\"SLIDER_THUMB_WORDING_VERB_BEFORE_VOTING\":\"DRAG\",\"SLIDER_THUMB_WORDING_THANKS_VOTING\":\"Thanks for voting\",\"NUM_PEOPLE_ANSWERED\":\" 251,304 people have answered this question\",\"ONE_PERSON_ANSWERED\":\" 1 person has answered this question\",\"TWO_PEOPLE_ANSWERED\":\" 2 people have answered this question\",\"NUM_PEOPLE_RATED__s1\":22165,\"NUM_PEOPLE_RATED__s2\":7147,\"NUM_PEOPLE_RATED__s3\":6860,\"NUM_PEOPLE_RATED__s4\":10001,\"NUM_PEOPLE_RATED__s5\":11544,\"NUM_PEOPLE_RATED__s6\":193515,\"NUM_PEOPLE_RATED__s7\":0,\"NUM_PEOPLE_RATED__s8\":0,\"NUM_PEOPLE_RATED__s9\":0,\"NUM_PEOPLE_RATED__s10\":0}","fbconfig":"{\"message\":\"undefined\",\"name\":\"undefined\",\"link\":\"\",\"source\":\"\",\"picture\":\"http:\\\/\\\/l.yimg.com\\\/os\\\/152\\\/2012\\\/07\\\/12\\\/slidermedi-jpg_181904.jpg\",\"description\":\"There are quite a few things to consider when thinking about retirement.\",\"captionLeft\":\"undefined\",\"captionRight\":\"undefined\",\"app_id\":\"196660913708276\",\"redirect_uri\":\"\\\/_xhr\\\/ugcratefbredirect\\\/\"}","template_id":"LONG_SLIDER_SOUTH","obj_id":"ratings_2717655e6e7e25ba702a37253933ab32","opt_count":"6","opt_color1":"","opt_color2":"","template_html":"

Source: http://news.yahoo.com/yemen-forces-endanger-health-care-raiding-hospitals-hrw-182030790.html

manny ramirez easter 2012 bachelor jeremy lin espn sassafras mardi gras 2012 the secret world of arrietty

Health Care: Obesity costs employers $30 billion per year ...

{{infobox disease |name

Obesity |Image Obesity-waist_circumference.svg |Alt Three silhouettes depicting the outlines of a normal sized (left), overweight (middle), and obese person (right). |Caption Silhouettes and waist circumferences representing normal, overweight, and obese |DiseasesDB 9099 |ICD10 |ICD9 |MedlinePlus 003101 |OMIM 601665 |eMedicineSubj med |eMedicineTopic 1653 |MeshName Obesity |MeshNumber C23.888.144.699.500 | }}

Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health, leading to reduced life expectancy and/or increased health problems. People are considered as obese when their body mass index (BMI), a measurement obtained by dividing a person's weight in kilograms by the square of the person's height in metres, exceeds 30?kg/m².

Obesity increases the likelihood of various diseases, particularly heart disease, type 2 diabetes, obstructive sleep apnea, certain types of cancer, osteoarthritis and asthma. Obesity is most commonly caused by a combination of excessive food energy intake, lack of physical activity, and genetic susceptibility, although a few cases are caused primarily by genes, endocrine disorders, medications or psychiatric illness. Evidence to support the view that some obese people eat little yet gain weight due to a slow metabolism is limited; on average obese people have a greater energy expenditure than their thin counterparts due to the energy required to maintain an increased body mass.

Dieting and physical exercise are the mainstays of treatment for obesity. Diet quality can be improved by reducing the consumption of energy-dense foods such as those high in fat and sugars, and by increasing the intake of dietary fiber. Anti-obesity drugs may be taken to reduce appetite or inhibit fat absorption together with a suitable diet. If diet, exercise and medication are not effective, a gastric balloon may assist with weight loss, or surgery may be performed to reduce stomach volume and/or bowel length, leading to earlier satiation and reduced ability to absorb nutrients from food.

Obesity is a leading preventable cause of death worldwide, with increasing prevalence in adults and children, and authorities view it as one of the most serious public health problems of the 21st?century. Obesity is stigmatized in much of the modern world (particularly in the Western world), though it was widely perceived as a symbol of wealth and fertility at other times in history, and still is in some parts of the world.

Classification

Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health. It is defined by body mass index (BMI) and further evaluated in terms of fat distribution via the waist?hip ratio and total cardiovascular risk factors. BMI is closely related to both percentage body fat and total body fat.

In children, a healthy weight varies with age and sex. Obesity in children and adolescents is defined not as an absolute number, but in relation to a historical normal group, such that obesity is a BMI greater than the 95th?percentile. The reference data on which these percentiles were based date from 1963 to 1994, and thus have not been affected by the recent increases in weight.

BMI !! Classification
width=50%		underweight
18.5?24.9	normal weight
25.0?29.9	overweight
30.0?34.9	class I obesity
35.0?39.9	class II obesity
? 40.0	??class III obesity??

BMI is calculated by dividing the subject's mass by the square of his or her height, typically expressed either in metric or US "customary" units:

:Metric: $BMI=kilograms/meters^2$

:US customary and imperial: $BMI=lb*703/in^2$

where $lb$ is the subject's weight in pounds and $in$ is the subject's height in inches.

The most commonly used definitions, established by the World Health Organization (WHO) in 1997 and published in 2000, provide the values listed in the table at right.

Some modifications to the WHO definitions have been made by particular bodies. The surgical literature breaks down "class III" obesity into further categories whose exact values are still disputed.

Any BMI ? 35 or 40 is severe obesity

A BMI of ? 35 or 40?44.9 or 49.9 is morbid obesity

A BMI of ? 45 or 50 is super obesity

As Asian populations develop negative health consequences at a lower BMI than Caucasians, some nations have redefined obesity; the Japanese have defined obesity as any BMI greater than 25 while China uses a BMI of greater than 28.

Effects on health

Excessive body weight is associated with various diseases, particularly cardiovascular diseases, diabetes mellitus type 2, obstructive sleep apnea, certain types of cancer, osteoarthritis and asthma. As a result, obesity has been found to reduce life expectancy.

Mortality

||}}

Obesity is one of the leading preventable causes of death worldwide. Large-scale American and European studies have found that mortality risk is lowest at a BMI of 20?25?kg/m² in non-smokers and at 24?27?kg/m² in current smokers, with risk increasing along with changes in either direction. A BMI above 32 has been associated with a doubled mortality rate among women over a 16-year period. In the United States obesity is estimated to cause an excess 111,909 to 365,000 deaths per year, while 1 million (7.7%) of deaths in the European are attributed to excess weight. On average, obesity reduces life expectancy by six to seven?years: a BMI of 30?35 reduces life expectancy by two to four?years, while severe obesity (BMI?>?40) reduces life expectancy by 10?years.

Morbidity

Obesity increases the risk of many physical and mental conditions. These comorbidities are most commonly shown in metabolic syndrome, a combination of medical disorders which includes: diabetes mellitus type 2, high blood pressure, high blood cholesterol, and high triglyceride levels.

Complications are either directly caused by obesity or indirectly related through mechanisms sharing a common cause such as a poor diet or a sedentary lifestyle. The strength of the link between obesity and specific conditions varies. One of the strongest is the link with type 2 diabetes. Excess body fat underlies 64% of cases of diabetes in men and 77% of cases in women.

Health consequences fall into two broad categories: those attributable to the effects of increased fat mass (such as osteoarthritis, obstructive sleep apnea, social stigmatization) and those due to the increased number of fat cells (diabetes, cancer, cardiovascular disease, non-alcoholic fatty liver disease). Increases in body fat alter the body's response to insulin, potentially leading to insulin resistance. Increased fat also creates a proinflammatory state, and a prothrombotic state.

Survival paradox

Although the negative health consequences of obesity in the general population are well supported by the available evidence, health outcomes in certain subgroups seem to be improved at an increased BMI, a phenomenon known as the obesity survival paradox. The paradox was first described in 1999 in overweight and obese people undergoing hemodialysis, and has subsequently been found in those with heart failure and peripheral artery disease (PAD).

In people with heart failure, those with a BMI between 30.0 and 34.9 had lower mortality than those with a normal weight. This has been attributed to the fact that people often lose weight as they become progressively more ill. Similar findings have been made in other types of heart disease. People with class I obesity and heart disease do not have greater rates of further heart problems than people of normal weight who also have heart disease. In people with greater degrees of obesity, however, risk of further events is increased. Even after cardiac bypass surgery, no increase in mortality is seen in the overweight and obese. One study found that the improved survival could be explained by the more aggressive treatment obese people receive after a cardiac event. Another found that if one takes into account chronic obstructive pulmonary disease (COPD) in those with PAD the benefit of obesity no longer exists.

Causes

At an individual level, a combination of excessive food energy intake and a lack of physical activity is thought to explain most cases of obesity. A limited number of cases are due primarily to genetics, medical reasons, or psychiatric illness. In contrast, increasing rates of obesity at a societal level are felt to be due to an easily accessible and palatable diet, increased reliance on cars, and mechanized manufacturing.

A 2006 review identified ten other possible contributors to the recent increase of obesity: (1) insufficient sleep, (2) endocrine disruptors (environmental pollutants that interfere with lipid metabolism), (3) decreased variability in ambient temperature, (4) decreased rates of smoking, because smoking suppresses appetite, (5) increased use of medications that can cause weight gain (e.g., atypical antipsychotics), (6) proportional increases in ethnic and age groups that tend to be heavier, (7) pregnancy at a later age (which may cause susceptibility to obesity in children), (8) epigenetic risk factors passed on generationally, (9) natural selection for higher BMI, and (10) assortative mating leading to increased concentration of obesity risk factors (this would increase the number of obese people by increasing population variance in weight). While there is substantial evidence supporting the influence of these mechanisms on the increased prevalence of obesity, the evidence is still inconclusive, and the authors state that these are probably less influential than the ones discussed in the previous paragraph.

Diet

The per capita dietary energy supply varies markedly between different regions and countries. It has also changed significantly over time. From the early 1970s to the late 1990s the average calories available per person per day (the amount of food bought) increased in all parts of the world except Eastern Europe. The United States had the highest availability with 3,654?calories per person in 1996. This increased further in 2003 to 3,754. During the late 1990s Europeans had 3,394?calories per person, in the developing areas of Asia there were 2,648?calories per person, and in sub-Saharan Africa people had 2,176?calories per person. Total calorie consumption has been found to be related to obesity.

The widespread availability of nutritional guidelines has done little to address the problems of overeating and poor dietary choice. From 1971 to 2000, obesity rates in the United States increased from 14.5% to 30.9%. During the same period, an increase occurred in the average amount of food energy consumed. For women, the average increase was 335?calories per day (1,542?calories in 1971 and 1,877?calories in 2004), while for men the average increase was 168?calories per day (2,450?calories in 1971 and 2,618?calories in 2004). Most of this extra food energy came from an increase in carbohydrate consumption rather than fat consumption. The primary sources of these extra carbohydrates are sweetened beverages, which now account for almost 25 percent of daily food energy in young adults in America, and potato chips. Consumption of sweetened drinks is believed to be contributing to the rising rates of obesity.

As societies become increasingly reliant on energy-dense, big-portions, and fast-food meals, the association between fast-food consumption and obesity becomes more concerning. In the United States consumption of fast-food meals tripled and food energy intake from these meals quadrupled between 1977 and 1995.

Agricultural policy and techniques in the United States and Europe have led to lower food prices. In the United States, subsidization of corn, soy, wheat, and rice through the U.S. farm bill has made the main sources of processed food cheap compared to fruits and vegetables.

Obese people consistently under-report their food consumption as compared to people of normal weight. This is supported both by tests of people carried out in a calorimeter room and by direct observation.

Sedentary lifestyle

A sedentary lifestyle plays a significant role in obesity. Worldwide there has been a large shift towards less physically demanding work, and currently at least 60% of the world's population gets insufficient exercise. This is primarily due to increasing use of mechanized transportation and a greater prevalence of labor-saving technology in the home. In children, there appear to be declines in levels of physical activity due to less walking and physical education. World trends in active leisure time physical activity are less clear. The World Health Organization indicates people worldwide are taking up less active recreational pursuits, while a study from Finland found an increase and a study from the United States found leisure-time physical activity has not changed significantly.

In both children and adults, there is an association between television viewing time and the risk of obesity. A review found 63 of 73 studies (86%) showed an increased rate of childhood obesity with increased media exposure, with rates increasing proportionally to time spent watching television.

Genetics

Like many other medical conditions, obesity is the result of an interplay between genetic and environmental factors. Polymorphisms in various genes controlling appetite and metabolism predispose to obesity when sufficient food energy present. As of 2006 more than 41 of these sites have been linked to the development of obesity when a favorable environment is present. People with two copies of the FTO gene (fat mass and obesity associated gene) has been found on average to weigh 3?4?kg more and have a 1.67-fold greater risk of obesity compared to those without the risk allele. The percentage of obesity that can be attributed to genetics varies, depending on the population examined, from 6% to 85%.

Obesity is a major feature in several syndromes, such as Prader-Willi syndrome, Bardet-Biedl syndrome, Cohen syndrome, and MOMO syndrome. (The term "non-syndromic obesity" is sometimes used to exclude these conditions.) In people with early-onset severe obesity (defined by an onset before 10?years of age and body mass index over three standard deviations above normal), 7% harbor a single point DNA mutation.

Studies that have focused upon inheritance patterns rather than upon specific genes have found that 80% of the offspring of two obese parents were obese, in contrast to less than 10% of the offspring of two parents who were of normal weight.

The thrifty gene hypothesis postulates that due to dietary scarcity during human evolution people are prone to obesity. Their ability to take advantage of rare periods of abundance by storing energy as fat would be advantageous during times of varying food availability, and individuals with greater adipose reserves would be more likely survive famine. This tendency to store fat, however, would be maladaptive in societies with stable food supplies. This theory has received various criticisms and other evolutionarily based theories such as the drifty gene hypothesis and the thrifty phenotype hypothesis have also been proposed.

Other illnesses

Certain physical and mental illnesses and the pharmaceutical substances used to treat them can increase risk of obesity. Medical illnesses that increase obesity risk include several rare genetic syndromes (listed above) as well as some congenital or acquired conditions: hypothyroidism, Cushing's syndrome, growth hormone deficiency, and the eating disorders: binge eating disorder and night eating syndrome. However, obesity is not regarded as a psychiatric disorder, and therefore is not listed in the DSM-IVR as a psychiatric illness. The risk of overweight and obesity is higher in patients with psychiatric disorders than in persons without psychiatric disorders.

Certain medications may cause weight gain or changes in body composition; these include insulin, sulfonylureas, thiazolidinediones, atypical antipsychotics, antidepressants, steroids, certain anticonvulsants (phenytoin and valproate), pizotifen, and some forms of hormonal contraception.

Social determinants

While genetic influences are important to understanding obesity, they cannot explain the current dramatic increase seen within specific countries or globally. Though it is accepted that energy consumption in excess of energy expenditure leads to obesity on an individual basis, the cause of the shifts in these two factors on the societal scale is much debated. There are a number of theories as to the cause but most believe it is a combination of various factors.

The correlation between social class and BMI varies globally. A review in 1989 found that in developed countries women of a high social class were less likely to be obese. No significant differences were seen among men of different social classes. In the developing world, women, men, and children from high social classes had greater rates of obesity. An update of this review carried out in 2007 found the same relationships, but they were weaker. The decrease in strength of correlation was felt to be due to the effects of globalization. Among developed countries, levels of adult obesity, and percentage of teenage children who are overweight, are correlated with income inequality. A similar relationship is seen among US states: more adults, even in higher social classes, are obese in more unequal states.

Many explanations have been put forth for associations between BMI and social class. It is thought that in developed countries, the wealthy are able to afford more nutritious food, they are under greater social pressure to remain slim, and have more opportunities along with greater expectations for physical fitness. In undeveloped countries the ability to afford food, high energy expenditure with physical labor, and cultural values favoring a larger body size are believed to contribute to the observed patterns. Attitudes toward body mass held by people in one's life may also play a role in obesity. A correlation in BMI changes over time has been found among friends, siblings, and spouses. Stress and perceived low social status appear to increase risk of obesity.

Smoking has a significant effect on an individual's weight. Those who quit smoking gain an average of 4.4?kilograms (9.7?lb) for men and 5.0?kilograms (11.0?lb) for women over ten years. However, changing rates of smoking have had little effect on the overall rates of obesity.

In the United States the number of children a person has is related to their risk of obesity. A woman's risk increases by 7% per child, while a man's risk increases by 4% per child. This could be partly explained by the fact that having dependent children decreases physical activity in Western parents.

In the developing world urbanization is playing a role in increasing rate of obesity. In China overall rates of obesity are below 5%; however, in some cities rates of obesity are greater than 20%.

Malnutrition in early life is believed to play a role in the rising rates of obesity in the developing world. Endocrine changes that occur during periods of malnutrition may promote the storage of fat once more food energy becomes available.

Consistent with cognitive epidemiological data, numerous studies confirm that obesity is associated with cognitive deficits. Whether obesity causes cognitive deficits, or vice versa is unclear at present.

Infectious agents

The study of the effect of infectious agents on metabolism is still in its early stages. Gut flora has been shown to differ between lean and obese humans. There is an indication that gut flora in obese and lean individuals can affect the metabolic potential. This apparent alteration of the metabolic potential is believed to confer a greater capacity to harvest energy contributing to obesity. Whether these differences are the direct cause or the result of obesity has yet to be determined unequivocally.

An association between viruses and obesity has been found in humans and several different animal species. The amount that these associations may have contributed to the rising rate of obesity is yet to be determined.

Pathophysiology

Flier summarizes the many possible pathophysiological mechanisms involved in the development and maintenance of obesity. This field of research had been almost unapproached until leptin was discovered in 1994. Since this discovery, many other hormonal mechanisms have been elucidated that participate in the regulation of appetite and food intake, storage patterns of adipose tissue, and development of insulin resistance. Since leptin's discovery, ghrelin, insulin, orexin, PYY 3-36, cholecystokinin, adiponectin, as well as many other mediators have been studied. The adipokines are mediators produced by adipose tissue; their action is thought to modify many obesity-related diseases.

Leptin and ghrelin are considered to be complementary in their influence on appetite, with ghrelin produced by the stomach modulating short-term appetitive control (i.e. to eat when the stomach is empty and to stop when the stomach is stretched). Leptin is produced by adipose tissue to signal fat storage reserves in the body, and mediates long-term appetitive controls (i.e. to eat more when fat storages are low and less when fat storages are high). Although administration of leptin may be effective in a small subset of obese individuals who are leptin deficient, most obese individuals are thought to be leptin resistant and have been found to have high levels of leptin. This resistance is thought to explain in part why administration of leptin has not been shown to be effective in suppressing appetite in most obese people.

While leptin and ghrelin are produced peripherally, they control appetite through their actions on the central nervous system. In particular, they and other appetite-related hormones act on the hypothalamus, a region of the brain central to the regulation of food intake and energy expenditure. There are several circuits within the hypothalamus that contribute to its role in integrating appetite, the melanocortin pathway being the most well understood. The circuit begins with an area of the hypothalamus, the arcuate nucleus, that has outputs to the lateral hypothalamus (LH) and ventromedial hypothalamus (VMH), the brain's feeding and satiety centers, respectively.

The arcuate nucleus contains two distinct groups of neurons. The first group coexpresses neuropeptide Y (NPY) and agouti-related peptide (AgRP) and has stimulatory inputs to the LH and inhibitory inputs to the VMH. The second group coexpresses pro-opiomelanocortin (POMC) and cocaine- and amphetamine-regulated transcript (CART) and has stimulatory inputs to the VMH and inhibitory inputs to the LH. Consequently, NPY/AgRP neurons stimulate feeding and inhibit satiety, while POMC/CART neurons stimulate satiety and inhibit feeding. Both groups of arcuate nucleus neurons are regulated in part by leptin. Leptin inhibits the NPY/AgRP group while stimulating the POMC/CART group. Thus a deficiency in leptin signaling, either via leptin deficiency or leptin resistance, leads to overfeeding and may account for some genetic and acquired forms of obesity.

Public health

The World Health Organization (WHO) predicts that overweight and obesity may soon replace more traditional public health concerns such as undernutrition and infectious diseases as the most significant cause of poor health. Obesity is a public health and policy problem because of its prevalence, costs, and health effects. Public health efforts seek to understand and correct the environmental factors responsible for the increasing prevalence of obesity in the population. Solutions look at changing the factors that cause excess food energy consumption and inhibit physical activity. Efforts include federally reimbursed meal programs in schools, limiting direct junk food marketing to children, and decreasing access to sugar-sweetened beverages in schools. When constructing urban environments, efforts have been made to increase access to parks and to develop pedestrian routes.

Many countries and groups have published reports pertaining to obesity. In 1998 the first US Federal guidelines were published, titled "Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults: The Evidence Report". In 2006 the Canadian Obesity Network published the "Canadian Clinical Practice Guidelines (CPG) on the Management and Prevention of Obesity in Adults and Children". This is a comprehensive evidence-based guideline to address the management and prevention of overweight and obesity in adults and children.

In 2004, the United Kingdom Royal College of Physicians, the Faculty of Public Health and the Royal College of Paediatrics and Child Health released the report "Storing up Problems", which highlighted the growing problem of obesity in the UK. The same year, the House of Commons Health Select Committee published its "most comprehensive inquiry [...] ever undertaken" into the impact of obesity on health and society in the UK and possible approaches to the problem. In 2006, the National Institute for Health and Clinical Excellence (NICE) issued a guideline on the diagnosis and management of obesity, as well as policy implications for non-healthcare organizations such as local councils. A 2007 report produced by Sir Derek Wanless for the King's Fund warned that unless further action was taken, obesity had the capacity to cripple the National Health Service financially.

Comprehensive approaches are being looked at to address the rising rates of obesity. The Obesity Policy Action (OPA) framework divides measure into 'upstream' policies, 'midstream' policies, 'downstream' policies. 'Upstream' policies look at changing society, 'midstream' policies try to alter individuals' behavior to prevent obesity, and 'downstream' policies try to treat currently afflicted people.

Management

The main treatment for obesity consists of dieting and physical exercise. Diet programs may produce weight loss over the short term, but maintaining this weight loss is frequently difficult and often requires making exercise and a lower food energy diet a permanent part of a person's lifestyle. Success rates of long-term weight loss maintenance with lifestyle changes are low, ranging from 2?20%. Dietary and lifestyle changes are effective in limiting excessive weight gain in pregnancy and improve outcomes for both the mother and the child.

One medication, orlistat (Xenical), is current widely available and approved for long term use. Weight loss however is modest with an average of 2.9?kg (6.4?lb) at 1 to 4?years and there is little information on how these drugs affect longer-term complications of obesity. Its use is associated with high rates of gastrointestinal side effects and concerns have been raised about negative effects on the kidneys. Two other medications are also available. Lorcaserin (Belviq) results in an average 3.1?kg weight loss (3% of body mass) greater than placebo over a year. A combination of phentermine and topiramate (Qsymia) is also somewhat effective.

The most effective treatment for obesity is bariatric surgery. Surgery for severe obesity is associated with long-term weight loss and decreased overall mortality. One study found a weight loss of between 14% and 25% (depending on the type of procedure performed) at 10?years, and a 29% reduction in all cause mortality when compared to standard weight loss measures. However, due to its cost and the risk of complications, researchers are searching for other effective yet less invasive treatments.

Epidemiology

|alt=A map of the world with countries colored to reflect the percentage of men who are obese. Obese males and females have higher prevalence (above 30%) in the U.S. and some Middle Eastern and Oceanian countries, medium prevalence in the rest of North America and Europe, and lower prevalence (

Before the 20th?century, obesity was rare; in 1997 the WHO formally recognized obesity as a global epidemic. As of 2005 the WHO estimates that at least 400?million adults (9.8%) are obese, with higher rates among women than men. The rate of obesity also increases with age at least up to 50 or 60?years old and severe obesity in the United States, Australia, and Canada is increasing faster than the overall rate of obesity.

Once considered a problem only of high-income countries, obesity rates are rising worldwide and affecting both the developed and developing world. These increases have been felt most dramatically in urban settings. The only remaining region of the world where obesity is not common is sub-Saharan Africa.

History

Etymology

Obesity is from the Latin obesitas, which means "stout, fat, or plump." ?sus is the past participle of edere (to eat), with ob (over) added to it. The Oxford English Dictionary documents its first usage in 1611 by Randle Cotgrave.

Historical trends

The Greeks were the first to recognize obesity as a medical disorder. Hippocrates wrote that "Corpulence is not only a disease itself, but the harbinger of others". The Indian surgeon Sushruta (6th century BCE) related obesity to diabetes and heart disorders. For most of human history mankind struggled with food scarcity. Obesity has thus historically been viewed as a sign of wealth and prosperity. It was common among high officials in Europe in the Middle Ages and the Renaissance as well as in Ancient East Asian civilizations.

With the onset of the industrial revolution it was realized that the military and economic might of nations were dependent on both the body size and strength of their soldiers and workers. Increasing the average body mass index from what is now considered underweight to what is now the normal range played a significant role in the development of industrialized societies. Height and weight thus both increased through the 19th?century in the developed world. During the 20th century, as populations reached their genetic potential for height, weight began increasing much more than height, resulting in obesity. In the 1950s increasing wealth in the developed world decreased child mortality, but as body weight increased heart and kidney disease became more common. During this time period insurance companies realized the connection between weight and life expectancy and increased premiums for the obese.

Many cultures throughout history have viewed obesity as the result of a character flaw. The obesus or fat character in Greek comedy was a glutton and figure of mockery. During Christian times food was viewed as a gateway to the sins of sloth and lust. In modern Western culture, excess weight is often regarded as unattractive, and obesity is commonly associated with various negative stereotypes. People of all ages can face social stigmatization, and may be targeted by bullies or shunned by their peers. Obesity is once again a reason for discrimination.

Public perceptions in Western society regarding healthy body weight differ from those regarding the weight that is considered ideal ?? and both have changed since the beginning of the 20th century. The weight that is viewed as an ideal has become lower since the 1920s. This is illustrated by the fact that the average height of Miss America pageant winners increased by 2% from 1922 to 1999, while their average weight decreased by 12%. On the other hand, people's views concerning healthy weight have changed in the opposite direction. In Britain the weight at which people considered themselves to be overweight was significantly higher in 2007 than in 1999. These changes are believed to be due to increasing rates of adiposity leading to increased acceptance of extra body fat as being normal.

Obesity is still seen as a sign of wealth and well-being in many parts of Africa. This has become particularly common since the HIV epidemic began.

The arts

The first sculptural representations of the human body 20,000?35,000?years ago depict obese females. Some attribute the Venus figurines to the tendency to emphasize fertility while others feel they represent "fatness" in the people of the time. Corpulence is, however, absent in both Greek and Roman art, probably in keeping with their ideals regarding moderation. This continued through much of Christian European history, with only those of low socioeconomic status being depicted as obese.

During the Renaissance some of the upper class began flaunting their large size, as can be seen in portraits of Henry the VIII and Alessandro del Borro. Rubens (1577?1640) regularly depicted full-bodied women in his pictures, from which derives the term Rubenesque. These women, however, still maintained the "hourglass" shape with its relationship to fertility. During the 19th?century, views on obesity changed in the Western world. After centuries of obesity being synonymous with wealth and social status, slimness began to be seen as the desirable standard.

Society and culture

Economic impact

In addition to its health impacts, obesity leads to many problems including disadvantages in employment and increased business costs. These effects are felt by all levels of society from individuals, to corporations, to governments.

In 2005, the medical costs attributable to obesity in the US were an estimated $190.2?billion or 20.6% of all medical expenditures, while the cost of obesity in Canada was estimated at CA$2 billion in 1997 (2.4% of total health costs). The total annual direct cost of overweight and obesity in Australia in 2005 was A$21 billion. Overweight and obese Australians also received A$35.6 billion in government subsidies. The estimate range for annual expenditures on diet products is $40?billion to $100?billion in the US alone.

Obesity prevention programs have been found to reduce the cost of treating obesity-related disease. However, the longer people live, the more medical costs they incur. Researchers therefore conclude that reducing obesity may improve the public's health, but it is unlikely to reduce overall health spending.

Obesity can lead to social stigmatization and disadvantages in employment. When compared to their normal weight counterparts, obese workers on average have higher rates of absenteeism from work and take more disability leave, thus increasing costs for employers and decreasing productivity. A study examining Duke University employees found that people with a BMI over 40 filed twice as many workers' compensation claims as those whose BMI was 18.5?24.9. They also had more than 12?times as many lost work days. The most common injuries in this group were due to falls and lifting, thus affecting the lower extremities, wrists or hands, and backs. The US state of Alabama Employees' Insurance Board approved a controversial plan to charge obese workers $25 per month if they do not take measures to reduce their weight and improve their health. These measures started in January 2010 and apply to those with a BMI of greater than 35?kg/m² who fail to make improvements in their health after one year.

Some research shows that obese people are less likely to be hired for a job and are less likely to be promoted. Obese people are also paid less than their non-obese counterparts for an equivalent job. Obese women on average make 6% less and obese men make 3% less.

Specific industries, such as the airline, healthcare and food industries, have special concerns. Due to rising rates of obesity, airlines face higher fuel costs and pressures to increase seating width. In 2000, the extra weight of obese passengers cost airlines US$275?million. The healthcare industry has had to invest in special facilities for handling severely obese patients, including special lifting equipment and bariatric ambulances. Costs for restaurants are increased by litigation accusing them of causing obesity. In 2005 the US Congress discussed legislation to prevent civil law suits against the food industry in relation to obesity; however, it did not become law.

Size acceptance

The principal goal of the fat acceptance movement is to decrease discrimination against people who are overweight and obese. However, some in the movement are also attempting to challenge the established relationship between obesity and negative health outcomes.

A number of organizations exist that promote the acceptance of obesity. They have increased in prominence in the latter half of the 20th?century. The US-based National Association to Advance Fat Acceptance (NAAFA) was formed in 1969 and describes itself as a civil rights organization dedicated to ending size discrimination. However, fat activism remains a marginal movement.

The International Size Acceptance Association (ISAA) is a non-governmental organization (NGO) which was founded in 1997. It has more of a global orientation and describes its mission as promoting size acceptance and helping to end weight-based discrimination. These groups often argue for the recognition of obesity as a disability under the US Americans With Disabilities Act (ADA). The American legal system, however, has decided that the potential public health costs exceed the benefits of extending this anti-discrimination law to cover obesity.

Childhood obesity

The healthy BMI range varies with the age and sex of the child. Obesity in children and adolescents is defined as a BMI greater than the 95th?percentile. The reference data that these percentiles are based on is from 1963 to 1994 and thus has not been affected by the recent increases in rates of obesity. Because childhood obesity often persists into adulthood and is associated with numerous chronic illnesses, children who are obese are often tested for hypertension, diabetes, hyperlipidemia, and fatty liver. Treatments used in children are primarily lifestyle interventions and behavioral techniques. In the United States, medications are not FDA approved for use in this age group.

In other animals

Obesity in pets is common in many countries. Rates of overweight and obesity in dogs in the United States range from 23% to 41% with about 5.1% obese. Rates of obesity in cats was slightly higher at 6.4%. In Australia the rate of obesity among dogs in a veterinary setting has been found to be 7.6%. The risk of obesity in dogs is related to whether or not their owners are obese; however, there is no similar correlation between cats and their owners.

Notes

;References Jebb S. and Wells J. Measuring body composition in adults and children In: Kopelman P., Caterson I. An overview of obesity management In: Puhl R., Henderson K., and Brownell K. Social consequences of obesity In: Seidell JC. Epidemiology ? definition and classification of obesity In:

Further reading

Category:Bariatrics Category:Body shape Category:Nutrition ar:???? an:Obesidat ast:Obesid? az:K?kl?k bn:?????????? bjn:Awak lamak zh-min-nan:To?-kho? be:?????????? be-x-old:???????????? bg:???????????? bar:Iwagwichd bs:Gojaznost ca:Obesitat cs:Obezita sn:Kufuta da:Overv?gt de:Adipositas dv:???????? et:Rasvumus el:?????????? es:Obesidad eo:Trodiki?o eu:Gizentasun fa:???? fr:Ob?sit? ga:Murtall gl:Obesidade ko:??? hi:?????? hr:Pretilost id:Obesitas is:Offita it:Obesit? he:????? ??? ?????? jv:Obesitas kk:?????? sw:Kunona la:Obesitas lv:Aptauko?an?s lt:Nutukimas hu:Elh?z?s mk:???????? ml:????????? mr:????????? arz:??? ms:Obesiti my:??????????? nl:Obesitas ne:?????? new:??????? ja:?? no:Fedme nn:Overvekt oc:Obesitat pnb:????? pl:Oty?o?? pt:Obesidade ro:Obezitate qu:Wirakaray ru:???????? sa:??????? si:???????? simple:Obesity sk:Obezita sl:Debelost sr:????????? sh:Gojaznost fi:Ylipaino sv:Fetma tl:Katabaan ta:???? ?????? te:????? ???? th:??????? tr:Obezite uk:???????? ur:?????? vi:B?o ph? fiu-vro:Lihon?min? wa:Fornourixhaedje war:Pagkamatambok yi:???? zh-yue:? zh:???

Source: http://article.wn.com/view/2012/10/19/Health_Care_Obesity_costs_employers_30_billion_per_year/

julia gillard julia gillard pecan pie the hobbit trailer red velvet cake recipe josh krajcik porphyria