Holiday experiences help travel operator Tui weather the heatwave storm

first_img“This enables us to clearly differentiate ourselves from the competition. With more than 20 million customers, use of state-of-the-art IT and intelligent customer systems, we have considerable potential for new business, turnover and earnings.“We will continue our successful transformation: The next step will transform Tui into a digital and platform organisation.” The positive sales growth was largely driven by strong performances in the group’s holiday experiences division. Tui said its hotel and cruise offerings account for roughly 70 per cent of earnings.This outweighed disappointing results in its markets and airlines division, which the company said was due to prolonged hot weather in Europe over the summer and significant levels of airline disruption.The results come after rival tour operator Thomas Cook reported a loss for the year as the heatwave and strikes took their toll.But Tui, which was formed in 2014 after a merger between British Tui Travel and its German parent company Tui AG, has a more diversified benefited from a more diversified offering.The company said it expects to deliver “superior annual earnings growth” of at least 10 per cent for the next financial year. Thursday 13 December 2018 9:03 am Holiday experiences help travel operator Tui weather the heatwave storm Travel operator Tui has reported double-digit sales growth for the full year, as strong performance in hotels and cruises outweighed the impact of the summer heatwave and airline strikes.The figuresReported core earnings rose 10.9 per cent from €1.10bn (£990m) to €1.14bn. Revenues were up five per cent to €19.52bn.Profit before tax fell to €972m from €1.08bn in 2017.The company saw financial debt rise 26.4 per cent to €2.44bn.Dividend per share increased 10.9 per cent to €0.72.Why it’s interestingTui’s results come after a tough summer for travel operators, who have had to contend with high temperatures and airline strikes. Tui said it had delivered “strong performance in a challenging market environment”. whatsapp whatsapp David Madden, market analyst at CMC Markets UK, said: “The travel sector across the board has had a difficult time as the unusually warm weather encouraged prospective holiday makers to stay at home.“Given what has gone on in the travel sector lately, it was an impressive performance from Tui.”Shares in Tui rose more than four per cent this morning.What Tui saidChief executive Fritz Joussen said: “We are investing, we are growing with Tui’s high-margin products and services and our businesses are increasingly scaling.“Today, our own holiday experiences content account for more than 70 per cent of our earnings: hotels, cruises, excursions and destination activities. James Warrington by Taboolaby TaboolaSponsored LinksSponsored LinksPromoted LinksPromoted LinksYou May LikeBetterBe20 Stunning Female AthletesBetterBeMisterStoryWoman Files For Divorce After Seeing This Photo – Can You See Why?MisterStoryZen HeraldEllen Got A Little Too Personal With Blake Shelton, So He Said ThisZen HeraldFinance Wealth PostTom Selleck’s Daughter Is Probably The Prettiest Woman To Ever ExistFinance Wealth PostTotal PastJohn Wick Stuntman Reveals The Truth About Keanu ReevesTotal PastGive It LoveThese Twins Were Named “Most Beautiful In The World,” Wait Until You See Them TodayGive It LoveCrowdy FanKaley Cuoco Net Worth Left Her Billionaire Husband SpeechlessCrowdy FanMoneyPailShe Was A Star, Now She Works In ScottsdaleMoneyPailNoteableyFaith Hill’s Daughter Is Probably The Prettiest Woman In The WorldNoteabley More From Our Partners A ProPublica investigation has caused outrage in the U.S. this weekvaluewalk.comPolice Capture Elusive Tiger Poacher After 20 Years of Pursuing the Huntergoodnewsnetwork.orgFlorida woman allegedly crashes children’s birthday party, rapes teennypost.comRussell Wilson, AOC among many voicing support for Naomi Osakacbsnews.com980-foot skyscraper sways in China, prompting panic and evacuationsnypost.comNative American Tribe Gets Back Sacred Island Taken 160 Years Agogoodnewsnetwork.orgBiden received funds from top Russia lobbyist before Nord Stream 2 giveawaynypost.comAstounding Fossil Discovery in California After Man Looks Closelygoodnewsnetwork.orgBrave 7-Year-old Boy Swims an Hour to Rescue His Dad and Little Sistergoodnewsnetwork.org Share Tags: Company TUI AGlast_img read more

City Moves for 4 September – Who’s switching jobs?

first_img Tribe Payments Today’s City Moves includes Cushman & Wakefield, Tribe Payments and BNY Mellon. Cushman & Wakefield More From Our Partners Texas governor said he plans to strip the Legislature’s paybusinessinsider.com whatsapp Share City Moves for 4 September – Who’s switching jobs at Cushman & Wakefield, Tribe Payments and BNY Mellon? Real estate adviser Cushman & Wakefield has appointed Tina Reuter and Louise Bonham as co-heads of its Europe, Middle East and Asia (EMEA) asset services business. Tina, who is based in Frankfurt, has been with Cushman & Wakefield since 2013 and was previously responsible for running the asset services business in continental Europe. Louise joined the firm in early 2018 as head of UK and Ireland asset services, a London-based role she will continue alongside her regional responsibilities. Tina will represent asset services on the firm’s EMEA executive committee, while Louise will continue to do the same on its UK and Ireland executive committee. Both have been promoted to executive partner, the highest grade in Cushman & Wakefield’s EMEA business – given to strategic leaders who drive change and are responsible for governance.center_img Tribe Payments, a team of industry experts dedicated to delivering the future of payments, has announced the appointments of Alex Reddish as chief commercial officer, Fadl Mahmoud as chief information officer, and Vytautas Mickevicius as chief technology officer. Together the hires are a milestone in Tribe’s mission to assemble the best global payment experts in order to deliver payment technology that doesn’t compromise between speed and scale. Alex previously held senior roles at Valitor and Raphaels Bank. Fadl has 15 years’ experience working within payments technology, including the ground-breaking Nets processing platform in Denmark. He will work with Tribe’s technical team to ensure its systems are state of the art. Vytautas previously held roles at Alna and Deutsche Bank and has experience of creating online gaming systems from scratch. His role will be to guide the continued development of Tribe’s technology, building on current innovations to create its short and long-term technical strategy. Greg Kok and Robert Burchett-Coates have been appointed to BNY Mellon Asset Servicing’s Europe, Middle East and Asia private markets team. Greg joins as director, private equity, real estate, debt and infrastructure from Maitland, where he was head of management company services. He has previously worked for Fundrock Group and Franklin Templeton in a wide range of operational, risk and portfolio man­agement roles within the alternatives sector. Robert joins as director, private equity, real estate and infra­structure. He was previously a director at an indep­endent trust, fiduciary and fund service spec­ialist. He previously worked at Deutsche Bank, Man Group and JP Morgan. Main image credit: Getty Wednesday 4 September 2019 12:07 am BNY Mellon City MovesSend your appointments to [email protected] whatsapplast_img read more

Watch Barbara Kruger’s New Mural Go Up in Hollywood

first_imgArtWatch Barbara Kruger’s New Mural Go Up in HollywoodLAXART director Hamza Walker talks us through the pieceBy Gwynedd Stuart – June 13, 20181392ShareEmailFacebookTwitterPinterestReddItUp and down the stretch of Santa Monica Boulevard occupied by LAXART‘s new Hollywood space, signs and advertisements shout instructions at passersby. Cash checks here. Buy weed there. In that sense, legendary L.A. artist Barbara Kruger’s new mural—with its commands to “Break it. Own it. Steal it. Loan it. Kiss it. Slap it. Hug it. Hurt it,” among other things—is a perfect fit. She even departed from her traditional color palette of red, black, and white to incorporate what I guess could be described as “modern dispensary green,” so it feels even more a part of its environment. Called “Untiled (It),” the mural, which covers the building’s entire facade, never establishes what “it” is, so “it” can be whatever the consumer desires. Does “it” even really matter when our desires change so constantly, as demonstrated by the streetscape?The piece was commissioned by LAXART for the alternative art space’s relaunch, which has been two years in the works under director Hamza Walker. Located in Culver City since 2005, the gallery has taken on a big, new space to go with its sort of readjusted mission. “I was brought on, to be frank, to reboot the joint,” says Walker, who relocated from Chicago where he was a curator at the Renaissance Society. “Alternative spaces, it isn’t just that they have life cycles—there’s that, but that entails their being kind of recast relative to the times.” It’ll still be a place for emerging artists, but the mission has expanded to include “thematic exhibitions that engage with key issues of our time.”When Walker was considering the facade project, it occurred to him that a lot of the key issues of our time aren’t terribly different from what they were in the ’80s. And for him, Barbara Kruger remains conduit that links that era to this one. “Barbara Kruger, Jenny Holzer—these are women artists whose work, scathing in its tone, seemed to really shine against Republican administrations,” Walker says. “So it’s like, welcome back. We had Bush and now it’s a whole other set of circumstances. We need Barbara Kruger now more than ever.”They initially discussed the project in the fall, and in March he gave her the building’s architectural plans so she could go to work on whatever she envisioned.Since “Untitled (It)” went up, it’s bemused and puzzled its share of people. Walker recalls, “A young woman dropped off her resumes looking for a job, and she said, ‘I walked past this place because I didn’t realize it was a gallery. I thought it was the most aggressive pawn shop I’ve ever seen.’”On Thursday, as part of the relaunch festivities, Kim Gordon is joined by cellist Leila Bordreuil for a free improvisational performance.In the meantime, here’s an exclusive video of a crew installing Kruger’s work.Barbara Kruger at LAXART from LAXART on Vimeo.RELATED: Fact and Fiction Collide at This Exhibit Inspired by Beverly Hills CopStay up to date with everything you need to know about L.A. by following us on Facebook and Instagram. TAGSBarbara KrugerLAXartPrevious articleDid a Flagpole on Disneyland’s Main Street Originate on Wilshire Boulevard?Next articleHere’s What’s Being Done to End L.A.’s Homelessness CrisisGwynedd Stuart RELATED ARTICLESMORE FROM AUTHORBerlin’s Sprüth-Magers Opens on Museum Row, but They’re Not Just Following All of the Other International GalleriesMy LA to Z: Julian MorrisEverything You Need to Know About L.A.’s New and Future Museumslast_img read more

John McDonnell at the Labour Party Conference 2015: Here’s what businesses think

first_img Share John McDonnell at the Labour Party Conference 2015: Here’s what businesses think whatsapp Emma Haslett More From Our Partners Russell Wilson, AOC among many voicing support for Naomi Osakacbsnews.comFlorida woman allegedly crashes children’s birthday party, rapes teennypost.comBrave 7-Year-old Boy Swims an Hour to Rescue His Dad and Little Sistergoodnewsnetwork.orgWhite House Again Downplays Fourth Possible Coronvirus Checkvaluewalk.comPolice Capture Elusive Tiger Poacher After 20 Years of Pursuing the Huntergoodnewsnetwork.orgInstitutional Investors Turn To Options to Bet Against AMCvaluewalk.comAstounding Fossil Discovery in California After Man Looks Closelygoodnewsnetwork.orgMatt Gaetz swindled by ‘malicious actors’ in $155K boat sale boondogglenypost.comNative American Tribe Gets Back Sacred Island Taken 160 Years Agogoodnewsnetwork.orgSupermodel Anne Vyalitsyna claims income drop, pushes for child supportnypost.comKiller drone ‘hunted down a human target’ without being told tonypost.comWhy people are finding dryer sheets in their mailboxesnypost.com980-foot skyscraper sways in China, prompting panic and evacuationsnypost.com‘The Love Boat’ captain Gavin MacLeod dies at 90nypost.comInside Ashton Kutcher and Mila Kunis’ not-so-average farmhouse estatenypost.comKamala Harris keeps list of reporters who don’t ‘understand’ her: reportnypost.comBiden received funds from top Russia lobbyist before Nord Stream 2 giveawaynypost.com‘Neighbor from hell’ faces new charges after scaring off home buyersnypost.comcenter_img Newly-appointed John McDonnell made his conference debut as shadow chancellor today – and despite promises of a “stultifyingly boring” speech, it actually turned out to be pretty punchy, with attacks on big business and buy-to-let landlords, as well as a hint that the Bank of England’s mandate might be up for discussion.But what did business make of McDonnell’s appearance? Here are the reactions:CBI: “Strong on intent but not on detail”The shadow chancellor was strong on intent but has not yet provided great detail on how he intends to deliver his plans. The overall impression of this speech was of rather more intervention in the world of business and the economy. What’s clear to us is that you can’t be pro-growth and pro-jobs without being pro-business. And a thriving private sector is essential for raising living standards and paying for high-quality public services. We share the aim of seeing more people getting into higher-paid jobs but pay rises need to be sustainable and affordable – and based on rising productivity. Mr McDonnell talks of working in partnership with businesses and entrepreneurs, and recognises the importance of deficit reduction, infrastructure, and skills. But this is best achieved by liberating entrepreneurs to create wealth and jobs.Read more: Four reasons why Corbyn fails to convince small businesses  BCC: “Don’t prejudge outcome of reviews on Treasury and Bank”There is a difference between an entrepreneurial state – one that supports growth and innovation – and a big state, reaching into and directing every facet of business and national life.  … McDonnell is right to go back to first principles and review the shape of the UK economy. He is right to start fundamental reviews of how the Treasury and the Bank of England work. He is right to engage economic experts to look in detail at how the state can better support economic growth. However, he must not prejudge these reviews – or insist on attacking businesses and wealth creators, when a conversation is what is needed. Labour needs to get the tone right if it wants to build a partnership with business, in the national interest.Louise Cooper: “Economically and fiscally naive”It’s cloud cuckoo land. The job of a chancellor is to live in the real economic and fiscal world. McDonnell does not. A significantly higher minimum wage is likely to reduce demand for labour. More wages, less jobs, classic supply and demand. It is private business that creates long term economic growth and not the government.  It only has money to spend thanks to private business. Extravagant promises on spending but with fiscal responsibility? History suggests this is unachievable.ICAEW: “A new era of politics”Fixing our public finances is dependent on generating sufficient tax receipts, so we are pleased that our calls for more resource for HMRC to concentrate on tax avoidance have been heard. Reviewing the Bank of England’s mandate is perfectly reasonable after 18 years, as is looking at the Treasury. We have suggested that Treasury must be transformed into a modern finance ministry, with responsibility across all parts of Whitehall.  We are in a new era of politics, and the Shadow Chancellor spoke of the need for debate. It will be interesting to see what policies Labour come up with in the months and years ahead. Businesses across the country will welcome the opportunity for debate going forward. Monday 28 September 2015 3:45 pm Show Comments ▼ whatsapplast_img read more

News / Anger as SCA arrests Ever Given and submits $916m compensation claim

first_img The Suez Canal Authority yesterday formally arrested the Ever Given.An Egyptian judge granted permission for the SCA to seize the vessel after it lodged a $916m compensation claim against its Japanese vessel owner, Shoe Kisen.The SCA says it intends to maintain the vessel’s arrest until the claim is paid, a position that has caused fury among the ship’s insurers and ship managers, and led charterer Evergreen to investigate whether it could use a court order to treat vessel and cargo separately.The SCA claim includes $300m for salvage and $300m for “loss of reputation”, which appears set to be rejected by the vessel’s insurer, the UK P&I Club, which revealed it had already made a compensation offer to the SCA this week.It said: “Despite the magnitude of the claim, which was largely unsupported, the owners and their insurers have been negotiating in good faith with the SCA.“On 12 April, a carefully considered and generous offer was made to the SCA to settle the claim. We are disappointed by the SCA’s subsequent decision to arrest the vessel today.“We are also disappointed at comments by the SCA that the ship will be held in Egypt until compensation is paid, and that its crew will be unable to leave the vessel during this time. The SCA has not provided a detailed justification for this extraordinarily large claim.“The grounding resulted in no pollution and no reported injuries. The vessel was re-floated after six days and the Suez Canal promptly resumed its commercial operations.“The claim presented by the SCA also does not include the professional salvor’s claim for salvage services, which owners and hull underwriters expect to receive separately. The P&I aspects of the claim are relatively modest, with the exception of a claim for loss of reputation, which is disputed.”Ian Beveridge, CEO of the vessel’s manager, Bernhard Schulte Shipmanagement (BSM), also voiced his concern over the arrest.“The SCA’s decision to arrest the vessel is extremely disappointing. From the outset, BSM and the crew on board have cooperated fully with all authorities, including the SCA and their respective investigations into the grounding.“This included granting access to the voyage data recorder and other materials and data requested by the SCA,” Mr Beveridge added.Evergreen said it had begun to look at other ways to free cargo trapped on board, adding: “In order to lift the arrest order as soon as possible, Evergreen is urging all concerned parties to facilitate a settlement agreement to be reached.“Meanwhile, Evergreen is investigating the scope of such a court order and studying the possibility of the vessel and the cargo on board being treated separately,” it said.BMS said the Ever Given’s classification society, the American Bureau of Shipping, had completed its inspection following the incident and it had “been declared suitable for onward passage to Port Said, to be assessed again before departing for Rotterdam”. © Cnes 2021, Distribution Airbus DS. By Gavin van Marle 14/04/2021last_img read more

NIH fetal tissue research would be barred under House panel’s spending plan

first_img Daily reporting and analysis The most comprehensive industry coverage from a powerhouse team of reporters Subscriber-only newsletters Daily newsletters to brief you on the most important industry news of the day STAT+ Conversations Weekly opportunities to engage with our reporters and leading industry experts in live video conversations Exclusive industry events Premium access to subscriber-only networking events around the country The best reporters in the industry The most trusted and well-connected newsroom in the health care industry And much more Exclusive interviews with industry leaders, profiles, and premium tools, like our CRISPR Trackr. Politics About the Author Reprints WASHINGTON — A House subcommittee’s draft 2018 spending plan would prohibit federal funds from being spent on research that uses fetal tissue, a symbolic win for conservatives who are also taking aim at money for family planning and public health programs around the country.The proposal from the House Appropriations health subcommittee is unlikely to be enacted, and the restriction would impact a tiny portion of the National Institutes of Health’s roughly $33 billion budget — in 2016, the agency spent roughly $103 million on research involving fetal tissue. NIH fetal tissue research would be barred under House panel’s spending plan Unlock this article — plus daily intelligence on Capitol Hill and the life sciences industry — by subscribing to STAT+. First 30 days free. GET STARTED By Lev Facher July 13, 2017 Reprints [email protected] What is it? The National Institutes of Health James Shannon building in Bethesda, Md. Pablo Martinez Monsivais/APcenter_img Washington Correspondent Lev Facher covers the politics of health and life sciences. @levfacher STAT+ is STAT’s premium subscription service for in-depth biotech, pharma, policy, and life science coverage and analysis. Our award-winning team covers news on Wall Street, policy developments in Washington, early science breakthroughs and clinical trial results, and health care disruption in Silicon Valley and beyond. Lev Facher Log In | Learn More What’s included? GET STARTED Tags Congresspolicylast_img read more

Flesh-eating bacteria: 5 things to know after a hiker’s almost-fatal infection

first_imgHealthFlesh-eating bacteria: 5 things to know after a hiker’s almost-fatal infection By Catherine Caruso July 25, 2017 Reprints Tags antibioticslists Here are five things to know about flesh-eating infections:1. What causes the infection?Multiple types of bacteria can cause so-called flesh-eating infections, also known as necrotizing fasciitis, but Atkins fell victim to Group A Streptococcus, which Dr. Bernard Camins, an infectious disease specialist at the University of Alabama at Birmingham, considers “the quintessential flesh-eating bacteria.”advertisement 4. What are the symptoms?A necrotizing fasciitis infection can develop within a few hours, and is difficult to diagnose, especially early on when patients may have vague symptoms, such as pain or soreness at the injury site. Early symptoms can also include reddish or purplish areas of swelling that spread rapidly, and Camins said one giveaway is when people have “pain that is out of proportion to what the wound looks like.” Later symptoms include fever, chills, or vomiting. Doctors generally treat the infection with a combination of strong antibiotics to knock out the bacteria and surgery to remove dead tissue.5. How can I avoid it?To avoid infection, Camins recommends washing wounds with soap and water, applying antibacterial ointment like Polysporin, and checking wounds on a regular basis. And if you are in huge amounts of pain from a wound that otherwise looks OK, get yourself to a hospital ASAP. Last month, a few minor blisters turned into a flesh-eating nightmare for hiker Wayne Atkins, who developed a dangerous bacterial infection after climbing Mount Garfield, a 4,500-foot peak in New Hampshire. Atkins survived, but barely: He spent 2 1/2 weeks in a medically induced coma while doctors pumped him full of antibiotics and removed chunks of his flesh to get rid of the infection.And Atkins was lucky, relatively speaking: Infection with flesh-eating bacteria is considered a surgical emergency, and can require limb amputation. One in four people with necrotizing fasciitis dies.But is there any reason for the rest of us to be concerned? Or was Atkins’s case a bacterial lightning strike?advertisement Illustration of Group-A Streptococcus bacteria. James Archer/CDC Related: Privacy Policy Newsletters Sign up for Daily Recap A roundup of STAT’s top stories of the day. Forget sharks: 7 things in the water swimmers should actually fear Please enter a valid email address. Leave this field empty if you’re human: Group A strep may sound familiar: It is the same bacteria that causes strep throat.2. Where does a person catch that bacteria?Around 3 percent of healthy adults and 5 to 15 percent of healthy children have Group A strep bacteria colonies in their nose and throat or on their skin. When people develop necrotizing fasciitis, it’s usually because Group A strep already on their skin get inside a wound after an injury or surgery, though a needle prick or blister could be enough. From there, the bacteria quickly start destroying skin, fat and muscle, and eventually work their way into the bloodstream.3. Why does a generally harmless bacteria turn deadly?According to Camins, Group A strep bacteria are very unpredictable, and scientists don’t know for sure. They can turn deadly once they breach the body’s natural barriers and reach the superficial fascia, a layer of connective tissue just underneath the skin. From there, they start spreading rapidly into the surrounding tissues, releasing destructive toxins along the way.This is more common in people with weakened immune systems whose bodies can’t fight off the bacteria as effectively. The Centers for Disease Control and Prevention estimates that only 700 to 1,100 cases of necrotizing fasciitis occur every year in the U.S., and most occur in people with diabetes, kidney disease, cancer, or other conditions that weaken the immune system.last_img read more

Prescribing opioids: Balancing pain relief and addiction prevention haunted my early days in medicine

first_img The attorney general of Oklahoma recently charged a doctor with second-degree murder in the overdose-related deaths of five of her patients. In describing these charges, AG Mike Hunter said:“Nichols prescribed patients, who entrusted their well-being to her, a horrifyingly excessive amount of opioid medications. Nichols’ blatant disregard for the lives of her patients is unconscionable.”Horrifyingly excessive. Those words stopped me in my tracks because they could easily have described the first time I prescribed opioids on my own.advertisement Tags opioidspatientsphysicians No one responded. I was surprised.Trial and error. In managing pain, finding that middle ground is all about trying, and possibly failing. When the goal is to treat patients in ways that don’t foster addiction, I’m left wondering: How many patients’ lives have been destroyed and how many medical decisions have been questioned by a mode of practice that is such a shot in the dark?As I begin to treat psychiatric patients exclusively, I’m actually relieved that I won’t have to deal with prescribing opioids that much anymore. But, I’m aware — and sad — that the fallout of the opioid addiction epidemic is what I will face every day. So pain won’t be that far behind me. Columnist, Off the Charts Jennifer Adaeze Okwerekwu is a psychiatrist and a columnist for STAT. Related: About the Author Reprints Mike Reddy for STAT Fatal drug overdoses in US on the rise, CDC says “This seems like an unusually large dose of oxycodone,” said the inpatient pharmacist, who paged me to double check the order.My patient had a long history of opioid abuse, so I knew that she had developed a high tolerance. She needed a higher dose to manage her pain, and my intention had been to help her do that.I remember learning two things about pain in medical school. First: Pain is effectively the fifth vital sign, and needs to be taken as seriously as a spike in temperature or drop in blood pressure. Second: Each opioid medication is metabolized differently. I remember learning the relative strength of each analgesic in terms of its morphine equivalents.This was supposed to help me compare apples to apples when it came to prescribing.I logged onto her records to compare what I had ordered with what I had written down on the patient’s medication list. “Oh, my God,” I said to the pharmacist. “Yeah, this is a lot.” I profusely thanked him and lowered the dose to one I hoped would manage her pain. I’m starting my career as a doctor as the opioid epidemic escalates in the U.S. It puts me in the middle of wanting to honor and treat the pain my patients tell me they feel while sometimes having to count what’s in their prescription bottles to verify they are taking the prescribed dose and not more.Practicing medicine means being part of the opioid police, while, at the same time, having little guidance on how to effectively treat pain. So I worried: Was I underprescribing? Was I overprescribing? And would this trial and error ever get easier?advertisement [email protected] Jennifer Adaeze Okwerekwu I didn’t catch my own mistake because tolerance felt like a moving target — I was still learning how much was too much, and, unfortunately, how little was too little.Soon after, I had a patient who was dealing with addiction and had infections in his legs that required someone to change his dressings every day. He was in such a fragile state of health that I worried about sedating him too much with opioids. Thinking about my overprescribing mistake, I decided to go with 1,000 milligrams of Tylenol, which is equivalent to two extra-strength over-the-counter tablets, hoping it would do the trick.It did not.The next morning when I made my rounds, this patient cursed at me, telling me how much pain I had caused him, asking me if I knew how it felt to have the skin peeled off my legs. I felt horrible that I caused my patient so much suffering.But he was right — I have never experienced that type of pain. I was trying to spare him the sedative and addictive effects of opioids, but in doing so, I made a choice that didn’t address his actual issue: pain. I chose Tylenol because I was in the first few weeks of my residency. I was afraid of hurting my patient. Prescribing an opioid seemed riskier than prescribing Tylenol.My training was to use morphine equivalents, but I’ve never taken morphine. It was like trying to describe the way fruit tastes relative to an apple without never having eaten an apple.This is what I mean when I say I feel like I’m stuck in the middle trying to treat a person in pain while not feeding an epidemic that often leads to death. The guidance for other illnesses is more defined — I’ve never had a heart attack, but feel confident I could treat someone based on what I’ve learned and seen. With pain management, it’s not that clear.I promised to get my patient something a bit stronger for his next dressing change. But what? Looking for assistance I tweeted out : The first time I prescribed opioids, I misread my patient’s medication list and accidentally ordered a dose that could easily have hurt her. Related: Doctors must be honest about their own biases when treating people in pain Off the ChartsPrescribing opioids: Balancing pain relief and addiction prevention haunted my early days in medicine @JenniferAdaeze By Jennifer Adaeze Okwerekwu Aug. 3, 2017 Reprintslast_img read more

Envision Financial names new commercial banking and insurance head

IE Staff Share this article and your comments with peers on social media Facebook LinkedIn Twitter Langley, B.C.-based Envision Financial has named David Lanphear as vice president, commercial banking and insurance. In his new role, Lanphear is responsible for the financial performance, leadership and overall strategic direction of Envision’s commercial banking and commercial insurance teams. Related news TD getting new head of private wealth, financial planning Keywords Appointments PenderFund names new SVP for investments Lanphear has close to 15 years of financial services experience and has held a number of increasingly senior positions over the course of his career including investment advisor, assistant vice president, Envision Investment Services and assistant vice president, Envision Insurance Services. He is a Certified Financial Planner, has been awarded Envision Financial’s CEO’s Award of Excellence in 2008 and 2010. Additionally, Lanphear was the recipient of the National Credit Union Young Leader Award in 2008. Lanphear currently serves as president on the board of directors of Big Brothers and Big Sisters of Langley. “Dave has a proven track record of creating highly engaged teams while still driving results,” says Shelley Besse, Envision Financial president. “His leadership skills and passion for our members and our people are a tremendous asset to our organization — I’m so pleased he has taken on the leadership of our commercial teams.” Envision Financial is a division of First West Credit Union, British Columbia’s third-largest credit union with 37 branches and 29 insurance offices throughout the Lower Mainland, Fraser Valley, Kitimat and Okanagan, Similkameen and Thompson regions. CETFA elects new board leader read more

Home Capital shareholders reject additional Buffett investment

first_img FSRA consults on standards for residential mortgage lending Consumer debt driven by new mortgages, but credit card debt at six-year low That would have been on top of Buffett’s initial Home Capital investment of $153 million in June. Home Capital chairwoman Brenda Eprile said the board was “grateful” to have Berkshire as a major shareholder but it respects the decision made by other shareholders. “To me, this decision on the second tranche is a clear message that the majority of our shareholders believe that Home Capital’s improved deposit inflows and liquidity position diminish the need for additional capital.” Home Capital shares were up 5¢, or 0.36%, to $14.13 in the early afternoon on Tuesday once trading resumed after the announcement. Buffett’s backing and extension of a $2-billion credit facility to Home Capital in June helped restore investor confidence after the alternative mortgage lender faced a partial run on its deposits following regulators’ accusations that the company misled investors. The mortgage lender’s board unanimously recommended that shareholders approve the additional investment. However, Home Capital shareholders were mixed on Buffett’s second tranche, with some arguing that it would be too dilutive and provide few additional benefits. Shareholder Harry Houtman cheered, “Wow, great!” when the results of the vote — which needed a simple majority to pass — was announced. Houtman, who is the founder of Link Charity which holds 20,000 shares but also holds 4,000 shares of Home Capital himself, said he didn’t want another Canadian firm bought by a U.S. investment company. “We would lose control of this company,” said Houtman, who was among the roughly 50 people who attended the meeting at a small Toronto conference room. Buffett and Berkshire Hathaway did not immediately respond to a request for comment on Tuesday. The rejection follows a recommendation by Institutional Shareholder Services that shareholders vote against the proposal. The influential proxy advisory firm said that when it was announced, the second round of equity investment from Berkshire seemed the best available alternative for stabilizing Home Capital. But since then, ISS said, the company has made substantial progress such as board and management renewal, Ontario Securities Commission and class action settlements, asset sale, dividend suspension, repayment of Berkshire’s line of credit and restoration of deposit inflows to historical averages. Still, longtime shareholder Ken Alexander voted in favour of giving Warren Buffet a bigger piece of the company to buy Home Capital more stability. “He’s had such a wonderful track record, over the years,” Alexander said. “I don’t like to see Americans controlling a Canadian company, but I think he’s the best one for it.” Donald Johnson, a member of BMO Capital Markets’ advisory board who initially reached out to Buffett on behalf of Home Capital, said he was surprised at the proportion of voters who turned the deal down. Johnson said the short-term pain for shareholders would be outweighed by the benefits of giving Buffett a nearly 39% stake. “That way, if the company owned that percentage of the company, they would definitely be there in the long term and provide any assistance, support,” he said. Johnson, who met Buffett more than 20 years ago, said he would be surprised if Berkshire attempted to increase its stake in the future after being turned down this time. When asked whether Berkshire could decide to sell off its existing stake, Johnson said it’s a “possibility. Time will tell.” Analysts viewed the vote against Buffett’s second tranche, and its dilutive effects, as positive. “We view this as a favourable development,” said Cormark Securities analyst Jeff Fenwick in a note to clients. “While HCG has faced significant challenges in 2017, a lack of equity was not one of them.” GMP Securities analyst Stephen Boland told clients that it believes Berkshire “remains committed as a long term 20% shareholder, despite having the second tranche voted down.” Keywords MortgagesCompanies Home Capital Group Inc. OSFI proposes new stress test for uninsured mortgages Facebook LinkedIn Twittercenter_img Share this article and your comments with peers on social media Armina Ligaya Related news Shareholders of Toronto-based Home Capital Group Inc. overwhelmingly voted against Warren Buffett upping his stake in the mortgage lender, with some citing a fear of losing control of a Canadian firm to U.S. hands. At a special meeting on Tuesday, 88.79% of shareholders rejected a plan that would have seen Buffett’s Berkshire Hathaway acquire 23.9 million more shares for $246.7 million, at $10.30 per share. last_img read more