News article:

It’s difficult for many of us to imagine a world without the benefits of technology. As mobile providers revolutionize our daily lives with each new gadget and companies tout the simplicity of e-commerce and social networking, it’s all too easy to forget that this technology is simply not accessible for millions of Americans, especially seniors.

 The transformative power of technology is real, but so is the digital divide.

 Across the country, more than 25 percent of Americans lack Internet access, and seniors are especially likely to be without technology. More than 50 percent of Americans over age 65 lack Internet access, while nearly half of them do not even own a computer.

 Seniors make up the lion’s share of the more than 30 million households — a quarter of our population — that are being left behind while the rest of America goes online. While great strides are being made to deliver technology to more Americans, we are not there yet.

 Yet despite this deep digital divide, government agencies are increasingly choosing to eliminate traditional access to paper-based services and information — leaving millions of Americans, especially seniors, behind.

 Federal agencies, from the Treasury to the Social Security Administration, are now forcing Americans — even those who lack Internet and even computer access — to go online to interact with their government. And many of these decisions to go paperless primarily affect seniors, who are nearly twice as likely to be without Internet access.

 The Treasury, for example, ambitiously set a March 2013 deadline to completely phase out paper federal benefits checks. For two years leading up to the deadline, the agency demanded that Social Security beneficiaries either switch to direct deposit or opt into electronic debit cards, which carry steep fees. The March deadline came and went, however, with 5 million beneficiaries — mostly elderly Americans — refusing to give up paper checks.

 Many of these seniors and other federal beneficiaries are uncomfortable with electronic debit cards or the direct-deposit process, or simply do not have a bank account. Others have concerns about privacy and growing cybersecurity threats. They are not ready or equipped for digital banking or online interaction, and our government should not force them.

 Benefits checks aren’t the only paper-based services being eradicated. The Social Security Administration has also eliminated the mailing of annual earnings statements, which offered all workers ages 25-60 a chance to double-check the government’s math and plan for retirement. Now these statements are only accessible online, meaning that low-income earners who most need these earnings statements are unlikely to ever get a copy.

 The Treasury also phased out paper savings bonds, turning an important American tradition into just another click of the mouse. The move also makes it difficult for seniors, who were once the primary buyers of savings bonds, to purchase them.

 Although the government’s rush to go paperless clearly penalizes seniors and other Americans without access to technology, the general public also disagrees with these actions.

 According to a new national poll by the advocacy group Consumers for Paper Options, 73 percent of American adults believe it is wrong to expect Americans to interact with government agencies online.

 Additionally, 85 percent said federal decisions to restrict paper-based services should be overseen by Congress. Right now, these decisions are made behind closed doors — often without congressional oversight or public comment.

 These survey respondents — all of whom have Internet access — also recognized the negative consequences for seniors and others caught in the digital divide. Nearly 90 percent of respondents said the government’s shift to paperless services disadvantages elderly, disabled, low-income and poorly educated Americans.

 The government’s rush to go paperless is disenfranchising millions of seniors and other vulnerable Americans and making the digital divide even deeper.

 The push to make these changes while millions of seniors remain uncomfortable with technology — and even more cannot even access it — should stop. Government agencies shouldn’t be rushing to make these changes, and Congress should have proper oversight of such significant shifts in policy that negatively affect our seniors and all Americans.

 We call on our fellow members of Congress to help us ensure that federal agencies embrace the benefits of a digital world without discriminating against Americans who lack access to technology or the skills to use them.

 Our job is to serve the American people. That means maintaining and protecting access for all.

 Rep. Sean P. Duffy is a Republican from Wisconsin; Rep. Michael H. Michaud is a Democrat from Maine. ||||| Language tucked into last month’s budget deal requires the government to plan for resuming paper delivery of annual Social Security earnings statements to some of the nation’s 150 million future retirees. (Matt Rourke/AP)

 As the Obama administration pushes to do more business over the Internet, finally seeking to close the technology gap with the private sector, the digital makeover is running into a dogged opponent called Consumers for Paper Options.

 The group is working the halls of Congress in closed-door meetings, underwriting research favorable to its position and mounting a news media campaign in an effort to preserve Washington as the capital of paper — and slow the move away from printed checks, forms and other paper communication.

 The lobbying group has had some recent victories, including language tucked into last month’s budget deal that requires the government to plan for resuming paper delivery of annual Social Security earnings statements to some of the nation’s 150 million future retirees. And it’s been claiming these wins in the name of the elderly and low-income Americans the Internet has left behind.

 Except Consumers for Paper Options is a creation of the paper industry.

 The group — which bills itself as “a coalition of individuals and organizations advocating for access to paper-based services and information” — was set up by the Envelope Manufacturers Association (EMA), officials from both organizations said. It receives financial backing from the paper industry’s largest trade group, several of North America’s biggest paper manufacturers and EMA, according to documents and interviews with company and trade association officials. The EMA and other paper companies are also pushing for Congress to pass legislation to help stabilize the Postal Service.

 Consumers for Paper Options is led by a veteran advocate for the industry’s interests on Capitol Hill. His previous posts include head of federal government relations for International Paper, the largest pulp and paper company in the world, and treasurer of its PAC.

 “The glitzy new thing is to be pro-technology,” said John Runyan, Consumers for Paper Options’ executive director. “But a lot of government agencies are saying, �?We’re going electronic and the heck with it.’ ”

 With federal budgets under fire in Congress, the government’s move to the Internet has gained pace. An electronic payment, for instance, costs the government only 9 cents to process, compared with $1.25 for a paper check, the Treasury Department says.

 At Treasury, which last year suspended most paper mailings for all but the very aged and those with “mental impairments,” officials estimate the shift will save $1 billion over 10 years. The move by the Social Security Administration in 2011 to stop mailing paper earnings statements to 150 million Americans is saving $72 million a year.

 For the paper industry, the stakes are high. The digital age has ravaged sales of envelopes, office paper, catalogues and pulp products, with industry analysts saying that demand for paper products dropped 5 percent on average in each of the past five years. Mills have closed, and thousands of employees have been laid off.

 So Consumers for Paper Options and industry officials have raised the banner of the digital divide, warning that putting government services online is creating hurdles for many Americans.

 Runyan said his group is not against technology but rather is for choice: “If there are Americans who can’t use an iPhone to navigate the Internet, there ought to be an option for them.”

 When asked whether Consumers for Paper Options represents consumers or the industry, Runyan said the point is that a quarter of Americans do not have Internet access. He added that its efforts have won support from ordinary Americans.

 Maynard Benjamin, president of the EMA, said the “consumers” in the group’s name are “everybody’s mother and father and sister who care about the way government policy develops.”

 While some traditional consumer groups have also asked the government to make accommodations for the elderly and others who do not use the Internet, it is Runyan’s organization that has been most active on the issue.

 The group’s lobbyists have been meeting with members of Congress and their staffs, concentrating in particular on those from paper-producing states and districts with large elderly populations. Runyan and Benjamin said the goal is to “educate” lawmakers about what advocates describe as the government’s willy-nilly rush to digitize without proper oversight.

 Runyan met with Rep. Susan A. Davis (D-Calif.) and pressed her to get language put into the budget bill requiring the Social Security Administration to develop a plan to restore the mailing of paper earnings statements, said Runyan and the lawmaker’s staff.

 Late last year, Consumers for Paper Options scored another victory when Rep. Michael H. Michaud (D-Maine), working with the American Forest and Paper Association, used his influence to have language removed from a pharmaceutical bill that would have ended the practice of printing prescription information and inserting it into drug packages, instead requiring that it be posted online. The Food and Drug Administration has been pressing for the change, which the agency says would save money and ensure the information is up to date.

 But Michaud warned that the change would put consumers at risk.

 His argument about the dangers of the “rush to go paperless” was highlighted in a December op-ed article in Roll Call signed by Michaud and Rep. Sean P. Duffy (R-Wis.), which said the shift was “disenfranchising millions of seniors and other vulnerable Americans and making the digital divide even deeper.” Consumers for Paper Options helped craft the piece and got it placed in Roll Call, according to officials familiar with the article.

 The group has conducted several studies of consumer preferences, Runyan said, including a poll last year that reportedly found that 73 percent of American adults do not think they should be required to interact with the government online. Those research findings have been repeatedly cited in newspapers and trade publications across the country and attributed to Consumers for Paper Options. In very few instances did they disclose that the group was set up by the paper industry.

 Consumers for Paper Options started in 2010 as the Senate was debating the Dodd-Frank Act, which created new regulations for the financial industry. A little-noticed proposal would have required banks and credit-card companies to put all statements online. That provision was never enacted.

 But the Obama administration had other plans to reduce paper services. The government, for instance, was looking to make use of direct deposit or prepaid debit cards for monthly checks for veterans, federal retirees, disabled Americans and 66 million retirees on Social Security. IRS tax forms and other government “paperwork” were also going online.

 The paper industry was growing alarmed. Consumers for Paper Options stepped up its fundraising and outreach in Washington, arguing, for instance, that using debit cards would saddle the poor with high fees and that electronic tax refunds and checks would lead to stolen identities.

 “I wish we had launched this effort 10 years ago,” said Thomas Howard, vice president of government relations for Domtar, one of North America’s largest paper manufacturers and a financial backer of Consumers for Paper Options. “But we’re on top of things now. Government agencies are in effect slamming citizens by determining how they will receive vital information.”

 In the past year alone, 22 of the largest federal agencies have reduced their spending on paper by about 7 percent, to $64 million a year, according to data from the General Services Administration. With the trend likely to continue, Duffy and Michaud have introduced a resolution calling for government action to ensure that people be provided with “paper-based information” along with electronic. The measure is awaiting a hearing.

 While government purchases of paper are a small share of overall demand, Runyan said that restoring the use of paper in federal transactions could set a precedent for the private sector, where the economic threat of financial firms and retailers going all-digital is far greater.

 He says his group has enlisted many partners in the fight, including Consumer Action and the Gray Panthers, an advocacy group that focuses in part on issues affecting senior citizens. The organizations are not official members but like-minded groups in an “advocacy effort that’s trying to leverage resources. . . . We’re not just advocating on behalf of the industry,” Runyan said.

 Officials from several traditional consumer groups said they had held discussions with Consumers for Paper Options about their shared concerns and ways that it could help them, for instance by conducting research.

 Sally Greenberg, executive director of the National Consumers League, said she’s a “big believer in getting a piece of paper sent to you at least once a year” and isn’t opposed to teaming up with others on the same side of the issue. But along with other advocates who held discussions with Consumers for Paper Options, she still wasn’t sure whom that group represents.

 “I don’t know who’s behind them,” she said.

 Alice Crites contributed to this report. |||||
What is a shorter version of the above article?

– In 2011, the Social Security Administration put the kibosh on mailing paper statements to 150 million future retirees, at an annual cost savings of $72 million. But last month's budget contained language that forces the government to plan for restarting these paper mailings. Ridiculous? Not according to a group called Consumers for Paper Options, which lobbied for that change and has since 2010 been "advocating for access to paper-based services and information," as the group puts it. But though the group says it's a "coalition of individuals and organizations," it's actually a product of the paper industry, the Washington Post reports: It was established by the Envelope Manufacturers Association and gets funding from the top paper-industry trade group. The Treasury expects to save $1 billion over a decade following its 2013 move to largely paperless communications, noting that processing a paper check costs $1.25, which is $1.16 cents more than the cost of an electronic payment. (It hasn't stopped paper mailings to the elderly and people with "mental impairments," the Post notes.) But "if there are Americans who can't use an iPhone to navigate the Internet, there ought to be an option for them," says a rep for Consumers for Paper Options, noting that a quarter of the US lacks Internet access. He also cites a study that says 73% of adults don't believe they should have to deal with the government online. That study was run by the group. A recent op-ed in Roll Call signed by a pair of congressmen also pushed for paper; it turns out Consumers for Paper Options was involved in that piece, too. Who are the "consumers"? "Everybody’s mother and father and sister who care about the way government policy develops," says an industry leader.


Article:

The Kansas Highway Patrol said the wreck occurred just before 1 p.m. near Kansas Highway 32. The school bus is seen laying on its side in the grass just off the roadway.

 When Chopper 5 arrived on scene students appeared to already be off the bus and were seen sitting in the grass nearby.

 Authorities said a school bus carrying sixth-grade girls from Pembroke Hill overturned on southbound Kansas Highway 7 and multiple students and the driver were injured.

 Authorities said a school bus carrying sixth-grade girls from Pembroke Hill overturned on southbound Kansas Highway 7 and multiple students and the driver were injured.

 The Kansas Highway Patrol said the wreck occurred just before 1 p.m. near Kansas Highway 32.

 Highway patrol said 36 sixth-graders from Pembroke Hill and a driver were on board when the driver took a turn on the ramp too quickly. Trooper Howard Dickinson said it was a single bus wreck, and the bus slid off of Highway 7 and rolled down an embankment.

 The driver, Elmer Scott Jr., 66, of Kansas City, applied the brakes and tried unsuccessfully get back onto the road, according to a Kansas City Highway Patrol.

 Once the vehicle overturned, motorists and others rushed to the bus.

 A massive effort consisting of officials from Lenexa police, KHP, Bonner Springs police, all neighboring agencies and EMS technicians quickly responded to the scene.

 "The back wheels got close to the edge and slid, and they rolled and it turned. It had to be God with them on that bus," witness Marvin Cawthon said. "I couldn't believe it. And then I saw the kids, and I saw everyone beating on the doors as they were trying to get out."

 Good Samaritans and first responders converged on the bus and started getting the girls out.

 "They got the back door open and they were able to pull them out, one by one. They were real quick with them, getting them out of there," Cawthon said.

 A 40-year-old woman was on board chaperoning the students, and she was not injured. Altogether, 22 girls ages 11 and 12 years old were injured, according to the KHP report.

 People who work in the area said it's not uncommon for vehicles to take the curve too quickly, but highway patrol said it's still too early to say what caused the crash.

 "A lot times maybe when the weather is slick or rainy. I don't know if people take that corner too quick, but it is not unusual to see a car slide off of that ramp," Vivica Ballew said.

 Durham School Services, who operate the bus, said they are working with highway patrol to determine the cause.

 "Our thoughts and prayers are with all of those affected by this accident including our driver. Safety is Durham's top priority and we are taking every step necessary to ensure that this accident is investigated and responded to appropriately."

 Scott was trapped and had to be extricated. He and the students were taken to either Providence Medical Center, Overland Park Regional Medical Center, University of Kansas Hospital and Children's Mercy Hospital with minor injuries.

 Scott is in serious but stable condition at Overland Park Regional. Highway patrol indicates that the bus driver was not wearing a safety restraint.

 The southbound ramp was closed until 3:45 p.m.

 Bonner Springs police said a bus carrying sixth-grade boys was following the first bus, but it wasn't involved in the wreck in any way.

 An administrator who works in the school's admissions office said the sixth-graders were heading to a camp out at Tall Oaks in Linwood, KS. The area is a camp, retreat center and conference center.

 Students who weren't injured were taken to Bonner Springs High School, located at 100 N. McDaniel St., to meet their parents. The field trip was canceled after the crash.

 In order to pick up their child, parents had to present identification to state troopers so they could match it up with the respective children, who were waiting in the school's cafeteria.

 Parents said even though these students weren't injured, it was just as nerve-wracking. One father said he had a difficult time driving past the accident scene, seeing the bus on its side and then trying to get to the high school to see his son.

 School for students at Bonner Springs High was going on as normal when the Pembroke Hill students were brought in. Staff did everything they could to make the sixth-graders as comfortable as possible.

 "They were really amazing from talking to everybody, they brought out drinks for the kids, they took good care of them, they got them all calmed down, they did a wonderful job of handling the kids. These were all sixth-graders, an entire bus load of girls. They were very, very upset and we did the best job. In fact we spent a lot of time at the scene just trying to calm them down," Dickinson said.

 KCTV5's Greg Milota, Amy Anderson, DeAnn Smith, Dave Jordan and Chris Oberholtz contributed to this report.

 Copyright 2013 KCTV (Meredith Corp.) All rights reserved. ||||| Several children are injured after their school bus crashed in northeast Kansas, but officials say no one was seriously hurt.

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 This image from video provided by KMBC-TV shows the scene of a school bus crash Wednesday, Aug. 21, 2013, in Bonner Springs, Kan. A spokeswoman for a private Kansas City, Mo., school says eight sixth-grade... (Associated Press)

 This image from video provided by KMBC-TV shows the scene of a school bus crash Wednesday, Aug. 21, 2013, in Bonner Springs, Kan. A spokeswoman for a private Kansas City, Mo., school says eight sixth-grade... (Associated Press)

 This image from video provided by KMBC-TV shows the scene of a school bus crash Wednesday, Aug. 21, 2013, in Bonner Springs, Kan. A spokeswoman for a private Kansas City, Mo., school says eight sixth-grade... (Associated Press)

 The bus overturned Wednesday afternoon in Bonner Springs while carrying students from Pembroke Hill School, a private school in nearby Kansas City, Mo.

 School spokeswoman Beth Bryant says eight sixth-grade girls were hurt but that no one suffered life-threatening injuries.

 Bryant says the bus was carrying 30 sixth-grade girls to a campout when it crashed along a ramp connecting Kansas 7 and Kansas 32. She says the other 22 girls were being taken to a local high school to be picked up by their parents.

 Television images showed the bus on its side, with paramedics placing children on stretchers.

 Bonner Springs is about 18 miles west of Kansas City, Mo. |||||
What is a summary?

– A school bus carrying about 30 sixth-grade girls overturned in Kansas today when its driver took an on-ramp too quickly, police in Bonner Springs tell KCTV. Eight girls were hurt in the crash, but none of the injuries was life-threatening, a spokesperson for Pembroke Hill School in Kansas City, Missouri, tells AP. According to an administrator, the girls were en route to a camping trip.


Article:
Natasha Exelby has paid a high price for her weekend blooper, after the humorless management at ABC24 banned the newsreader from playing any future on-air role.

 Exelby, who only recently returned from a foreign correspondent and anchor role with Turkish broadcaster TRT World, was told Monday she has been axed from newsreading duties, after being caught off guard during a live news shift Sunday.

 In video that has since gone viral, the former “Wake Up!” co-host is seen looking startled as she suddenly realizes the cameras have returned to her after a prerecorded package has finished.

 It’s a slip-up almost every newsreader in the world has committed, but rarely costs the TV presenter their on-air job.

 The decision to bench the freelance newsreader and producer comes from the same broadcaster widely criticized for the more serious charge of failing to vet the audience of its panel program “Q&A” and allowing one-time terror suspect Zaky Mallah to join the live TV debate.

 The error, described by then-Prime Minister Tony Abbott as “completely incomprehensible” and compounded when it was rebroadcast on ABC24, saw no one from the program sacked.

 Most viewers laughed off Exelby’s innocuous gaffe, posted by the ABC’s own Media Watch program — it sparked waves of support, rather than acrimony, for the “mortified” news professional.

 SBS newsreader Janice Petersen tweeted a screen grab of herself caught putting lipstick on while live, writing in solidarity: “it happens.”

 Sky News political reporter Samantha Maiden celebrated the human error, telling her Twitter followers: “that’s @NatashaExelby and she’s awesome. She’s too much for @ABCmediawatch. Too fabulous.”

 Exelby told News Corp. “it would be inappropriate for me to comment.”

 Exelby was told Monday she would no longer be used in an on-air role, an ABC spokesman said in a statement: “Natasha Exelby is a casual contributor, not a staff member. She has been booked for occasional on-air shifts when needed, and also does other occasional shifts for the ABC News channel.

 “Contributors work out their shifts with managers on a per needs basis. Details of individuals’ shifts are confidential to them and not something the ABC publicly comments on.”

 News Corp. is pursuing ABC management for further comment, addressing directly her removal from newsreading duties, either as a freelancer or otherwise. ||||| This article is over 1 year old

 Freelance journalist Natasha Exelby ‘read the riot act’ and offered more training after series of missteps, but will remain in casual production role

 ‘Slip-ups will happen’: ABC says presenter won’t be fired over TV blooper

 A casual journalist at the ABC, Natasha Exelby, has been taken off air after she missed her cue on live TV and video of her dramatic reaction went viral.

 The ABC director of news, Gaven Morris, has denied Exelby is being punished and said reports she had been fired or banned were untrue.

 “Live television is a demanding art and slip-ups will happen – our presenters are humans, not robots,” Morris said.

 “We take on-air standards extremely seriously, but we don’t expect perfection. No one would ever be punished for a blooper and, while it isn’t appropriate to publicly discuss confidential details of people’s personal work arrangements, this has not happened to Natasha.”

 Morris said he has assured Exelby the ABC wants her to continue working various shifts she has been rostered for.

 “While she is not currently doing any on-air shifts, this will be subject to normal performance management. I have spoken to Natasha and conveyed our regret that this has attracted such attention.”

 Footage of Exelby playing with her pen then apparently realising she is on air and gasping in horror has endeared her to the public, with calls for her to return to Australia’s TV screens and a petition, which had garnered more than 3,000 signatures by Tuesday morning.

 The ABC has denied Exelby has been banned or sacked.

 Guardian Australia understands that after a series of missteps including Sunday’s high-profile blooper she was “read the riot act” by news management on Monday.

 Sources said Exelby had been offered more training and may be given on-air shifts again at a later stage.

 Natasha Exelby (@NatashaExelby) Thank U all for ur generous support. Not my finest hour. Myself and my mesmerising pen honourably salute you!

 After the Daily Telegraph reported on Monday that the Queensland-born journalist had been “banned”, the opposition leader, Bill Shorten, led calls on Twitter for her reinstatement.

 Bill Shorten (@billshortenmp) It's live TV. This is just ridiculous.https://t.co/xy6dp7nKwi

 Russell Crowe (@russellcrowe) Come on ABC - Australian Broadcasting Commission - talk about an over reaction to an over reaction . Free @NatashaExelby !!! https://t.co/4xALx8V5PN

 Kevin Rudd (@MrKRudd) Don't worry @NatashaExelby. Just a flesh wound. Check out my swearing video if you want a serious #blooper. Australia wants you back on air. pic.twitter.com/RSDTgR1X3U

 Presenters and other journalists shared stories about their embarrassing mistakes while at work.

 Grant Denyer (@grantdenyer) Nothing wrong with a bit of day dreaming at work @NatashaExelby . I fell asleep while on air. #putyourbloopersout pic.twitter.com/10CE3Cqkph

 Sally Rawsthorne (@sallyrawsthorne) I asked for an interview with someone who has been dead since 1962 #putyourbloopersout

 Amelia Gilbert (@ameliagilbert) Sorry @NatashaExelby, but @LeeLinChinSBS had the greatest blooper of all time https://t.co/SqXtA3S9Sd #PutYourBloopersOut

 It’s not the first time Exelby has been caught in an inappropriate reaction on live TV. Several years ago on Ten she giggled repeatedly while reading serious news items about deaths and disasters.

 Facebook Twitter Pinterest Natasha Exelby giggles while reading the news

 The ABC would not be drawn on the circumstances of the blooper and released a statement saying Exelby was a casual contributor and not a staff member: “She has been booked for occasional on-air shifts when needed, and also does other occasional shifts for the ABC News channel. Contributors work out their shifts with managers on a per-needs basis. We don’t comment on the details of people’s work arrangements.”

 Exelby is best known as a co-host of the disastrous breakfast show Wake Up on Ten, which was launched by the former Seven Sunrise executive producer Adam Boland in late 2012.

 She was dumped as co-host after just 13 days on air and rock-bottom ratings. Boland blamed her sudden exit on her “chemistry” with the two other co-hosts, James Mathieson and Natarsha Belling.

 The entire show was axed in May 2014 owing to lacklustre ratings. ||||| "She has been booked for occasional on-air shifts when needed, and also does other shifts for the ABC News channel. Contributors work out their appearances with managers on a per needs basis. Details of individuals' shifts are confidential to them and not something the ABC publicly comments on," the spokesman said. |||||Summary:

– Natasha Exelby lived out every news anchor's nightmare on live TV over the weekend, and to add to that nightmare, some are saying she's been sanctioned for it, per the New York Daily News. A video circulating online shows the Aussie journalist on ABC24 on Sunday, zoning out and staring at a pen while waiting for a prerecorded portion of the show to end, not knowing at first the camera had cut back to her, per the New York Post. Once Exelby realized she was back on the air, she let out a startled gasp, but quickly composed herself and continued with the broadcast. News outlets reported Exelby, a freelance journalist, was yanked from on-air segments for ABC, with some even framing it as a firing. But ABC's news director insists that's not true and that "slip-ups will happen." "Our presenters are humans, not robots," he says, adding Exelby is simply an occasional contributor (not a full-time employee) who only does on-air segments as needed, even though at the moment she hasn't been rescheduled to do more on-air bits, per the Guardian (which cites sources saying Exelby had been "read the riot act" by management). The Australian notes she's been hired to temporarily read the morning news for a Sydney radio station while the regular host is on break. Exelby, who had supporters such as Russell Crowe rushing to her defense, thanked everyone on Twitter, adding, "Not my finest hour. Myself and my mesmerising pen honourably salute you!" (This news anchor reported on horrible news that hit too close to home.)


Article:

Amid a presidential campaign that has been marred by scandal, conspiracy theories, and the spectre of a new far-right leader, disillusioned French voters have called for an outsider to join the race: Barack Obama.

 A petition launched on Monday calls on the former US president to run in this year’s French elections, which will be held in April and May. Called Obama17, the petition aims to garner 1 million signatures by March 15th, and as of Friday morning, it had already gained 30,000, according to one of the people behind the effort. But even the people who launched the website acknowledge that the chances of Obama actually ascending to the Elysée Palace are virtually zero. French law requires presidential candidates to be French, which Obama is not.

 But the impossibility of the campaign is also what inspired it. In a phone interview Thursday night, one of the people behind the petition, who asked only to be identified as “Antoine,” said he and three other friends decided to create the site out of frustration with France’s leading candidates and the campaigns they’ve run so far.

 “We just wanted to say that we’ve had enough of all of these guys.”

 “In a campaign where we only talk about the scandals of [center-right candidate François] Fillon or the rise of [far-right candidate Marine] Le Pen, at a certain moment we told ourselves well, why not?” Antoine said. “We just wanted to say that we’ve had enough of all of these guys.”

 Antoine, who is in his 30s, says that he and his friends are not activists, and he doesn’t align himself with a particular political party. But he says he has grown tired of voting for the lesser of two evils in every presidential race, rather than a candidate who inspires genuine enthusiasm. “The only guy who’s ever made me feel that way is Obama,” he says. This week, he and his friends plastered some 500 Obama posters across Paris, each carrying the slogan: “Oui on peut” (“Yes we can”).

 "Oui on peut" #obama17 #yeswecan #vivelarepublique #presidentielle #barakobama A post shared by McHautbois (@mchautbois) on Feb 22, 2017 at 12:28am PST

 Antoine isn’t the first French voter to call for an Obama presidency; similar petitions were launched last year, as NPR notes. And although Antoine realizes that it may be a long time before France changes its citizenship requirement for presidents, he thinks it’s important to at least put forth the idea of a more globalized government — particularly given the nationalist, inward-looking rhetoric that has characterized Le Pen’s campaign.

 “At a time when Amazon and Facebook and Apple are richer than our country, it’s stupid to think that it’s our nationalism that will make us better governed,” he says. “We would do better to pay people who are competent to fill important positions, rather than getting stuck with the same people we’ve had for 20 years.”

 “The reality, of course, is that it will never happen,” he adds. “But in another world, in 100 years or 200 years, it may not be a problem.” ||||| A Citizens' Petition Calls For A New French President: Barack Obama

 Enlarge this image toggle caption Courtesy of Obama 2017 Courtesy of Obama 2017

 The French presidential campaign has been marked by scandal, surprises and upsets as the April election approaches.

 Now a petition is calling for an even bigger plot twist: the return of President Barack Obama. As in, French President Barack Obama.

 Earlier this week, the Obama 2017 campaign was launched, calling for the former U.S. president to step forward as a candidate in the French election while there's still time.

 "Barack Obama has completed his second term as President of the United States," the site says. "Why not hire him as president of France? ... [He] has the best resume in the world for the job."

 Posters for Obama 2017 have been plastered around Paris. The slogan, of course: "Oui on peut," French for "Yes we can." And a campaign-style website is gathering signatures to persuade Obama to run.

 Europe Emmanuel Macron Emerges As A Front-Runner In French Presidential Election Emmanuel Macron Emerges As Front-Runner In French Presidential Election Listen · 3:43 3:43

 It's not the first time French citizens have expressed longing for Obama's leadership — at least two petitions were started last year — but it's by far the most successful. According to the site's organizers, some 27,000 people have signed the petition so far.

 A group of four friends — "basic 30-year-old guys from Paris" who work in creative industries — came up with the idea "after a drink," according to one of the people behind the site. He asked NPR not to use his name, to avoid possible legal consequences that could damage his career.

 "We were thinking about French politics and saying that we were fed up with the fact that we all the time had to vote against someone," he says, "and how it would be cool to be able to vote for someone we admire. We came up with Obama."

 "I think the whole world would love to have him as president," he says.

 toggle caption Courtesy of Obama 2017

 We should note that in order to run for president in France, Obama would have to be naturalized as a French citizen. Also, he doesn't speak French — although Michelle Obama studied the language in college, according to a biography.

 Anyway, that's not really the point.

 "It's definitely a joke," says the co-creator of the site. "But it could make people think a little bit about what we could do differently in French politics. ... the idea was to make people wake up."

 Obama 2017 isn't meant to rally support for any French candidate or party, he says — it's an expression of frustration about politicians in France in general.

 "Always the same people, here for 20 years, coming up from the same schools, giving ministry [positions] to their friends," the co-creator says.

 "We don't know politics," he says, referring to the group of friends behind the site. "We aren't coming with real stuff. We're just proposing something to make people think."

 NPR has reached out to Obama's personal office for comment; so far, there has been no reply. ||||| Story highlights Organizers hope to get 1 million people to sign a petition

 It's a joke with a serious purpose

 (CNN) Could France elect Barack Obama president? Not really -- but that's not stopping the organizers of Obama17, a guerrilla campaign trying to entice the former U.S. president to head to Paris.

 "It's totally crazy, but the cool thing is that once you get past that, you start thinking that maybe it's possible. Who cares that he's not French? He's Barack Obama," one of the campaign organizers told CNN.

 They've launched a website and they put up 500 posters of Obama around Paris last weekend, said the organizer. He asked to be identified only as Antoine.

 They're hoping to get 1 million people to sign a petition urging Obama to run.

 Yes, it's a joke, he admits -- but one with a serious purpose.

 Read More |||||
What is a summary?

– Barack Obama better get his Broadway fix while he can because if a couple dissatisfied French voters get their way, he'll soon have an important new job: president of France. CNN reports a campaign to elect Obama president of France sprung up in Paris this week featuring a website, petition, and more than 500 posters plastered around the city. The Obama17 campaign bears a familiar slogan to go with its familiar face, "Oui on peut," which translates to "Yes we can," according to NPR. The Verge reports the petition to make Obama the French president had 30,000 signatures by Friday morning despite one major stumbling block toward that goal: He's not a French citizen. Obama17 was started by two friends "after a drink," and while they admit it's a joke, they say it's one with a serious point: They're tired of the same French politicians running for office over and over and getting embroiled in scandals. One Obama17 organizer says he's sick of feeling like he's voting "against" someone instead of "for" someone, and Obama is the only politician who's ever inspired him. He might not be alone. Last year, a poll found 84% of French people trusted Obama to do the right thing on world issues, the Washington Post reports. "Who cares that he's not French? He's Barack Obama," one of the organizers tells CNN. The French begin voting for their next president April 23.


Write an article based on this summary:

– We all know you shouldn't drink and drive. Kenneth Bachman is living proof you probably shouldn't drink and Uber either. He was hit with a $1,635.93 Uber fare after accidentally taking the ride service from near the West Virginia University campus, where he was partying with friends last Friday night, to his home in New Jersey, CBS Philadelphia reports. “We went to a frat party and then went to the bar. I was getting drinks all night; I probably spent like $200 at the bar after already drinking all day,” Bachman says. “Basically, I kinda just blacked out." Needless to say, Bachman doesn't really remember calling himself an Uber. He says he woke up to the driver telling him they were about an hour away from New Jersey. “I was just like, that’s crazy. Why did you agree to take me to New Jersey from West Virginia?” Bachman says. Five hours and 300 miles after ordering the Uber, Bachman was home, the Washington Post reports. The ride would have been a good deal cheaper if Bachman hadn't drunkenly treated himself to a more expensive UberXL. According to NJ.com, surge pricing also doubled the cost. Bachman challenged the fare, arguing he would have told the driver to take him to his friends' place near the university campus—not all the way to New Jersey. "I know I wouldn't send it to my house," Bachman says. "I knew where I was." Uber states Bachman did indeed give the driver his home address, and Bachman agreed to pay the fare after the company contacted him. He gave the driver five stars and cash for paying tolls on the way back to West Virginia.

Have you ever wondered what it would be like — and how much money it would cost — to travel more than 300 miles across four states via Uber?

 Well, a young man from New Jersey can tell you.

 Kenneth Bachman, from Sewell, N.J., was visiting friends late last week near West Virginia University and had been drinking at a fraternity party. Many would argue that he did the responsible thing and ordered an Uber to take him home. The only problem? Home was a five-hour ride away.

 No fear! His driver was up to the task — for the right price: a whopping $1,635.93.

 “We went to a frat party and then went to the bar. I was getting drinks all night. I probably spent, like, $200 at the bar after already drinking all day,” Bachman told CBS Philly of his experience on Friday. “Basically, I kind of just blacked out. The last thing I remember was being at the bar, and then I just woke up in the Uber next to an older dude telling me I was an hour out from Jersey.”

 “I was just like … ‘That’s crazy. Like, why did you agree to, like, take me to New Jersey from West Virginia?’ ” Bachman told the station about the sobering moment when he realized what he had done.

 [First came UberPool. Now there’s an even cheaper option, but it requires some extra effort.]

 It’s unclear who holds the record for the longest trip via a car-sharing service.

 In the summer, three Chinese professionals called an Uber to take them from the Dallas-Fort Worth area to Nashville when their connecting flight was canceled, ABC affiliate WFAA reported at the time.

 That’s more than 650 miles — and the trip took more than 11 hours, according to the station.

 When asked about Bachman’s Uber adventure, a spokeswoman for the ride-hailing company confirmed to The Washington Post that the high-priced trip did occur, and that the driver took the passenger to the destination he requested.

 Uber reached out to the passenger, the spokeswoman said, and he agreed to pay the fare.

 Bachman told CBS Philly that he suspects the ride would have cost about $800 had he ordered a standard Uber — but he ordered the more expensive UberXL.

 Looking back on it, he told the station, “I guess it’s kind of embarrassing.”

 This report has been updated.

 Read more:

 Uber Eats driver charged with murder in the shooting death of a customer, police say

 Why a wealthy Michigan frat boy unleashed an expletive-laden rant against his Uber driver

 ‘She’s getting violent’: Miami doctor suspended after attack on Uber driver ||||| Just about everyone has taken a drunken late-night Uber ride they might regret, or not even remember. But one New Jersey native recently took the blackout Uber ride of a lifetime.

 After a night of partying with buddies in Morgantown, W.V. last Friday, Kenny Bachman thought he had called an Uber to take him back to where he was staying near West Virginia University's campus.

 Instead, he woke up in the passenger seat of a 2011 Toyota Sienna minivan next to an Uber driver that was taking him home. Not where he was staying with friends in West Virginia, but home home.

 Like, where he lives. In Gloucester County. More than 300 miles away.

 "I just woke up," Bachman told NJ Advance Media in a phone interview. "And I'm thinking, 'Why the f--- am I in the car next to some random ass dude I don't even know?"

 The price? A hefty $1,635.93.

 "Afterwards I had it fully sink in," Bachman said. "Once the ride ended and I saw how much it was when I was like 'Alright, this is insane, that's just crazy.'"

 A $3.94 base fare, a $2.35 booking fee, $696.95 for distance, $115.90 for time. Things were more expensive because Bachman unintentionally ordered an UberXL, which can hold up to six passengers and is exponentially more expensive than the typical UberX. Still, it would have been just $819.14 -- if not for the surge pricing, which doubled every charge except the booking fee.

 Bachman says he passed out in the van and after two hours woke up to the driver telling him they were on their way to New Jersey. Couldn't he just get out of the car once he realized what was happening?

 "No, because what am I, just going to get dropped off on the side of the road?" Bachman says.

 The Uber driver didn't have money for tolls, Bachman says, and was fined at every tollbooth. When they did get back to New Jersey, Bachman went to a CVS in Sewell and got cash back to give him money for tolls on the way back.

 Bachman got back to New Jersey safe and sound. He even gave his driver five stars. But he challenged the charge; he claims he never put in the home address for the Uber. Bachman says the driver had his phone, even having answered a FaceTime call from a friend while he was asleep.

 "Obviously I sent the Uber, I don't know where to, I know I wouldn't send it to my house, I knew where I was," Bachman said. "He was on my phone, without me allowing it."

 Uber confirmed that the ride did indeed occur and that the driver took the rider to the destination he requested. Uber also connected with Bachman and resolved the matter, which ended with him agreeing to pay the fare.

 Correction: An earlier version of this story misidentified the make and model of the Uber car.

 Jeremy Schneider may be reached at jschneider@njadvancemedia.com. Follow him on Twitter @J_Schneider. Find NJ.com on Facebook. ||||| PHILADELPHIA (CBS) — Let’s start with the good news in this story.

 Kenneth Bachman of Sewell made it safely back to his Gloucester County, New Jersey home from a party on Friday.

 The bad news? That party was in Morgantown, West Virginia.

 “I was just like, that’s crazy. Why did you agree to take me to New Jersey from West Virginia?” he said.

 CDC: 1 In 14 Women Smoke Cigarettes While Pregnant

 Kenneth explains that he had been out with buddies near the campus of West Virginia University when he says he wanted to call it a night, so he ordered an Uber ride, which he doesn’t quite recall doing, and then fell asleep.

 “We went to a frat party and then went to the bar. I was getting drinks all night; I probably spent like $200 at the bar after already drinking all day,” said Bachman. “Basically, I kinda just blacked out. The last thing I remember was being at the bar and then I just woke up in the Uber next to an older dude telling me I was an hour out from Jersey.”

 Once he made it home the price tag of the blurry trip became clear: $1,635.93.

 Kenneth adds that he accidentally ordered a more expensive UberXL, and had no choice but to pay the fare.

 ‘This Is Life And Death For Children’: Teachers Sound Off On School Safety

 John Denver sings, “Country roads, take me home,” in West Virginia’s unofficial anthem.

 In Kenneth’s case, they took him home alright but he won’t be here for long.

 “I’m heading back to West Virginia this weekend to pick up my bags so if you guys see me say, ‘what’s up!’” |||||


News article:

Measures of how pain interfered with things like work, sleep, mood and general enjoyment of life were nearly identical in both groups. On a scale of 0 to 10, the average score was 3.4 for those on opioids and 3.3 for those who weren’t. After 12 months, 59% of those in the opioid group and 61% of those in the nonopioid group reported an improvement of at least 30%. ||||| Key Points

 Question For patients with moderate to severe chronic back pain or hip or knee osteoarthritis pain despite analgesic use, does opioid medication compared with nonopioid medication result in better pain-related function?

 Findings In this randomized clinical trial that included 240 patients, the use of opioid vs nonopioid medication therapy did not result in significantly better pain-related function over 12 months (3.4 vs 3.3 points on an 11-point scale at 12 months, respectively).

 Meaning This study does not support initiation of opioid therapy for moderate to severe chronic back pain or hip or knee osteoarthritis pain.

 Abstract

 Importance Limited evidence is available regarding long-term outcomes of opioids compared with nonopioid medications for chronic pain.

 Objective To compare opioid vs nonopioid medications over 12 months on pain-related function, pain intensity, and adverse effects.

 Design, Setting, and Participants Pragmatic, 12-month, randomized trial with masked outcome assessment. Patients were recruited from Veterans Affairs primary care clinics from June 2013 through December 2015; follow-up was completed December 2016. Eligible patients had moderate to severe chronic back pain or hip or knee osteoarthritis pain despite analgesic use. Of 265 patients enrolled, 25 withdrew prior to randomization and 240 were randomized.

 Interventions Both interventions (opioid and nonopioid medication therapy) followed a treat-to-target strategy aiming for improved pain and function. Each intervention had its own prescribing strategy that included multiple medication options in 3 steps. In the opioid group, the first step was immediate-release morphine, oxycodone, or hydrocodone/acetaminophen. For the nonopioid group, the first step was acetaminophen (paracetamol) or a nonsteroidal anti-inflammatory drug. Medications were changed, added, or adjusted within the assigned treatment group according to individual patient response.

 Main Outcomes and Measures The primary outcome was pain-related function (Brief Pain Inventory [BPI] interference scale) over 12 months and the main secondary outcome was pain intensity (BPI severity scale). For both BPI scales (range, 0-10; higher scores = worse function or pain intensity), a 1-point improvement was clinically important. The primary adverse outcome was medication-related symptoms (patient-reported checklist; range, 0-19).

 Results Among 240 randomized patients (mean age, 58.3 years; women, 32 [13.0%]), 234 (97.5%) completed the trial. Groups did not significantly differ on pain-related function over 12 months (overall P = .58); mean 12-month BPI interference was 3.4 for the opioid group and 3.3 for the nonopioid group (difference, 0.1 [95% CI, −0.5 to 0.7]). Pain intensity was significantly better in the nonopioid group over 12 months (overall P = .03); mean 12-month BPI severity was 4.0 for the opioid group and 3.5 for the nonopioid group (difference, 0.5 [95% CI, 0.0 to 1.0]). Adverse medication-related symptoms were significantly more common in the opioid group over 12 months (overall P = .03); mean medication-related symptoms at 12 months were 1.8 in the opioid group and 0.9 in the nonopioid group (difference, 0.9 [95% CI, 0.3 to 1.5]).

 Conclusions and Relevance Treatment with opioids was not superior to treatment with nonopioid medications for improving pain-related function over 12 months. Results do not support initiation of opioid therapy for moderate to severe chronic back pain or hip or knee osteoarthritis pain.

 Trial Registration clinicaltrials.gov Identifier: NCT01583985

 Introduction

 Long-term opioid therapy became a standard approach to managing chronic musculoskeletal pain despite a lack of high-quality data on benefits and harms.1

 Rising rates of opioid overdose deaths have raised questions about prescribing opioids for chronic pain management. Because of the risk for serious harms without sufficient evidence for benefits, current guidelines discourage opioid prescribing for chronic pain.2-4 Systematic reviews cited by guidelines identified no randomized trials of opioid therapy that reported long-term pain, function, or quality-of-life outcomes.4,5

 The Strategies for Prescribing Analgesics Comparative Effectiveness (SPACE) trial was a pragmatic randomized trial that compared opioid therapy vs nonopioid medication therapy over 12 months for primary care patients with chronic back pain or hip or knee osteoarthritis pain of at least moderate severity despite analgesic use. Hypotheses were that opioids compared with nonopioid medications would lead to better pain-related function and pain intensity and more adverse effects.

 Methods

 The Minneapolis Veterans Affairs (VA) institutional review board approved the trial protocol and patients provided written informed consent. Recruitment details and the trial protocol have been published.6 The trial protocol and statistical analysis plan are in Supplement 1.

 Pragmatic Trial Design

 To maximize applicability to primary care, the trial was designed to be pragmatic.6,7 Eligibility criteria facilitated enrollment of diverse patients from primary care. Interventions were delivered with flexibility in medication selection and dosage. Patients were allowed to participate in nonpharmacological pain therapies outside of the study and were encouraged to complete outcome assessments regardless of their participation in the active interventions.

 Participants

 Eligible patients had chronic back pain or hip or knee osteoarthritis pain that was moderate to severe despite analgesic use. Chronic pain was defined as pain nearly every day for 6 months or more. Moderate or greater severity was defined by a score of 5 or more on the 3-item pain intensity, interference with enjoyment of life, and interference with general activity (PEG) scale (range, 0-10).8

 Patients on long-term opioid therapy were excluded. Other reasons for exclusion included contraindications to all drug classes in either group, including class-level opioid contraindications (eg, active substance use disorder), and conditions that could interfere with outcome assessment (eg, life expectancy <12 months).6 Patients with severe depression or posttraumatic stress disorder symptoms were not excluded because these patients often receive opioids in practice.

 Patients were recruited from 62 Minneapolis VA primary care clinicians from June 2013 to December 2015 (Figure). Primary care clinicians were located at multiple clinics affiliated with the Minneapolis VA Health Care System, including clinics in the main medical center building and 4 outpatient clinics in the greater Minneapolis-Saint Paul metropolitan area. Potentially eligible patients were identified by searching the electronic health record (EHR) for back, hip, or knee pain diagnoses at a primary care visit in the prior month. Study personnel screened patients by telephone and then conducted a focused chart review.

 Randomization and Blinding

 To ensure balanced numbers of patients with back and osteoarthritis pain in each group, randomization was stratified by primary pain diagnosis. The SAS (SAS Institute), version 9.4, uniform random number generator was used to produce a computerized randomization table. Approximately 1 week after the enrollment visit, patients met with the study clinical pharmacist, who initiated random group assignment using a programmed study application that automatically assigned the next unused position in the randomization table. This process simultaneously informed the pharmacist and patient of group assignment. EHR documentation informed patients’ primary care clinicians of study participation and group assignment. Study medications were visible in the EHR. Outcome assessors were blinded to group assignment.

 Intervention Delivery

 Medication was delivered using a collaborative pain care model with demonstrated effectiveness.9,10 In both groups, patients received structured symptom monitoring and a treat-to-target approach to medication management delivered primarily by a single pharmacist. After randomization, the pharmacist reviewed past medications and identified individual functional goals. The initial medication regimen was determined by the assigned group and considerations such as patient preference and comorbidities. Follow-up visits were monthly until a stable regimen was established, then visits occurred every 1 to 3 months. Visits were in-person at 6 and 12 months when possible and otherwise mostly by telephone.

 Both interventions used 3 medication steps. Medications were adjusted within the assigned group to achieve targets of improved PEG scores and progress toward individual goals. Study medications were dispensed from the VA pharmacy.

 Opioid Prescribing Strategy

 Per protocol, patients in the opioid group started taking immediate-release (IR) opioids. Step 1 was morphine IR, hydrocodone/acetaminophen, and oxycodone IR. Step 2 was morphine sustained-action (SA) and oxycodone SA. Step 3 was transdermal fentanyl. Single-opioid therapy was preferred, but dual therapy with a scheduled SA opioid and as-needed IR opioid was considered based on patient needs and preferences. Opioids were titrated to a maximum daily dosage of 100 morphine-equivalent (ME) mg. If dosages were titrated to 60 ME mg/d without a response, rotation to another opioid was considered before dosage escalation.11

 Nonopioid Prescribing Strategy

 In the nonopioid medication group, step 1 was acetaminophen (paracetamol) and nonsteroidal anti-inflammatory drugs (NSAIDs). Step 2 included adjuvant oral medications (ie, nortriptyline, amitriptyline, gabapentin) and topical analgesics (ie, capsaicin, lidocaine). Step 3 included drugs requiring prior authorization from the VA clinic (ie, pregabalin, duloxetine) and tramadol. Patients were initially prescribed a step 1 medication, unless all were clinically inappropriate. Subsequent changes included titrating, replacing, or adding medications.

 Intervention Adherence

 Patients were instructed to receive medications for back, hip, or knee pain only from the study. Nonpharmacological therapies were allowed outside of the study. If patients desired discontinuation of all study medications, they were transitioned back to preenrollment pain medications. Medication adherence was monitored by discussion with patients and checking the state prescription monitoring program website.

 Descriptive Measures

 Before randomization, patients were asked to state their preferred treatment group, perceptions of effectiveness and safety of opioid and nonopioid medications, and expectations for improvement on 0 to 10 scales (higher scores = more favorable).12,13 To characterize the study population and provide data required by federal funders, self-identified race/ethnicity was assessed by asking patients to select from 6 categories.

 Main Outcomes

 The primary outcome was pain-related function, assessed with the 7-item Brief Pain Inventory (BPI) interference scale.14 Pain intensity, the main secondary outcome, was assessed with the 4-item BPI severity scale. Both BPI scales yield 0 to 10 scores (higher score = worse function or intensity). A prior study of chronic pain in primary care estimated a minimal clinically important difference (MCID) of 0.7 points for both BPI interference and BPI severity.15 Following consensus guidelines, this trial used a 1-point difference as the MCID for BPI interference and BPI severity, and used a 30% reduction from baseline as MCID for moderate improvement.16 The primary adverse outcome was a patient-reported checklist of 19 medication-related symptoms,17 modified from the original version by adding common analgesic adverse effects (eg, memory problems, sweating).18

 Secondary Health Outcomes

 Secondary outcomes were as follows: the Veterans RAND 12-item Health Survey (VR-12) quality-of-life measure (range, 0-100; higher score = better quality of life, standardized to mean of 50),19 the 11-item Roland-Morris Disability Questionnaire (RMDQ) measure of pain-related physical function (range, 0-11; higher score = worse function, MCID = 2.0),20 the 8-Item Patient Health Questionnaire (PHQ-8) depression measure (range, 0-24; higher score = worse depression, MCID = 5), the 7-Item Generalized Anxiety Disorder measure (GAD-7; range, 0-21; higher score = worse anxiety, MCID = 5)21; the Patient-Reported Outcomes Measurement Information System (PROMIS) sleep disturbance short form (range, 8-32; higher score = worse sleep disturbance)22; the Migraine Disability Assessment (MIDAS) questionnaire (range, 0-270; higher score = worse headache disability),23 the Arizona Sexual Experience Scale (ASEX; range 5-30; higher score = worse sexual function)24; and the Multidimensional Fatigue Inventory (MFI) general fatigue, mental fatigue, physical fatigue, reduced activity, and reduced motivation scales (for each scale: range, 4-20; higher score = worse, MCID = 2).25 Additional secondary outcomes not reported here were the global impression of pain change, the Fullerton Advanced Balance scale, 6-m gait speed, chair stand, grip strength tests, cold pain tolerance, free testosterone, and the Indiana University Telephone-Based Assessment of Neuropsychological Status.

 Assessment for Adverse Events and Potential Opioid Misuse

 At each assessment, patients reported new hospitalizations, emergency department (ED) visits, and falls. VA hospitalizations and ED events were identified by searching EHR databases from enrollment to 13 months after randomization. Two independent raters determined whether events were analgesic-related.26 Discrepancies were resolved by discussion.

 Opioid misuse describes use of prescription opioids in a manner other than as prescribed. This study used multiple approaches to evaluate for potential misuse, including medical record surveillance for evidence of “doctor-shopping” (seeking medication from multiple physicians), diversion, substance use disorder, or death; checking the state prescription monitoring program website at each visit and as needed; and completing the Addiction Behavior Checklist27 at each intervention visit. The Addiction Behavior Checklist measures aberrant medication-related behaviors that may indicate misuse (range, 0-20; higher score = more aberrant behavior; 3 = threshold for opioid misuse). At 6-month and 12-month assessments, patients completed self-report measures and had urine drug testing. Substance use was assessed with the Alcohol Use Disorders Identification Test (AUDIT) and drug use questions from a National Institute on Drug Abuse screening tool.28,29

 Assessment of Study Treatment Received and Nonstudy Co-Interventions

 Pain medication dispensing data were obtained from EHR databases. Total study visit duration was calculated for each patient as the sum of minutes from clinician-entered Current Procedural Terminology (CPT) codes for all intervention encounters; for CPT codes that include a range of minutes (ie, 5-10, 11-20, 21-30), the highest value was used. Nonstudy co-interventions were obtained from patient report and EHR data.

 Statistical Analysis

 Assuming a 2-sided α level of .05 and a standard deviation of 2.7,30 115 patients completing the study per group were required for 80% power to detect a 1-point between-group difference in mean BPI interference at 12 months.16 The initial target was 276 randomized patients, but enrollment was stopped at 265 due to difficulty recruiting and better-than-anticipated retention.

 Analyses were intention-to-treat, with all patients included in their assigned treatment group. Scales were not scored if less than 70% of items were completed. When less than 30% of items were missing, the average of nonmissing items was used for measures scored as an average, and missing “count” data were scored as 0.

 Two-sided t tests and χ2 tests were used for unadjusted between-group comparisons of primary and secondary outcomes at each assessment time point. Main analyses included data from all time points in mixed models (logistic, Poisson, Gaussian) for repeated measures to compare mean scores between treatment groups over 12 months, adjusting for baseline values, with time as fixed effects and intercept as random effects. For medication-related symptoms, groups were compared using a statistical test for treatment × time interaction. Individual patient-level functional response and pain intensity response were defined as 30% or more reduction from baseline to 12-month follow-up in BPI interference and severity, respectively.16 χ2 Tests were used to compare response rates as a secondary measure of effectiveness. The threshold for statistical significance was a P value less than .05. Analyses of secondary outcomes were exploratory and not adjusted for multiple testing. Post hoc treatment group by primary pain diagnosis interaction tests were used to explore possible differential treatment effects. Post hoc sensitivity analyses adjusting for smoking status were conducted to examine potential effects of the baseline group imbalance in current smoking. SAS (SAS Institute), version 9.2, was used for statistical analysis.

 Results

 Of 265 enrolled patients, 25 withdrew prior to randomization and 240 were randomized (Figure). Follow-up rates were 92% at 3 months (106 in the opioid group and 115 in the nonopioid group), 97% at 6 months (116 in each group), 90% at 9 months (108 in the opioid group and 107 in the nonopioid group), and 98% at 12 months (117 in each group). Two patients dropped out before completing follow-up assessments and were excluded; 1 patient randomized to opioids declined to initiate opioid therapy; all others received assigned therapy (Figure).

 Mean age was 58.3 years (range, 21-80) and 32 patients (13.0%) were women (Table 1). For primary pain diagnosis, 156 patients (65%) had back pain and 84 patients (35%) had hip or knee osteoarthritis pain. The opioid group had 25 current smokers (21%) and the nonopioid group had 13 current smokers (11%). Regarding treatment group preference, in the opioid group, 72 patients (60%) had no preference and 25 patients (21%) preferred opioids. In the nonopioid group, 51 patients (43%) had no preference and 44 patients (37%) preferred opioids.

 Pain and Health Outcomes

 There was no significant difference in pain-related function between the 2 groups over 12 months (overall P = .58). At 12 months, mean BPI interference was 3.4 in the opioid group (SD, 2.5) vs 3.3 in the nonopioid group (SD, 2.6); difference, 0.1 (95% CI, −0.5 to 0.7). Pain intensity was significantly better in the nonopioid group over 12 months (overall P = .03). At 12 months, mean BPI severity was 4.0 in the opioid group (SD, 2.0) vs 3.5 in the nonopioid group (SD, 1.9); difference, 0.5 (95% CI, 0.0 to 1.0).

 Functional response (≥30% improvement in BPI interference) occurred in 69 patients (59.0%) in the opioid group vs 71 patients (60.7%) in the nonopioid group; difference, −1.7% (95% CI, −14.4 to 11.0); P = .79. Pain intensity response (≥30% improvement in BPI severity) occurred in 48 patients (41.0%) in the opioid group vs 63 patients (53.9%) in the nonopioid group; difference, −12.8% (95% CI, −25.6 to 0.0); P = .05.

 Health-related quality of life did not significantly differ between the 2 groups (physical health overall: P = .23; difference at 12 months, −1.3 [95% CI, −3.8 to 1.3]; mental health overall: P = .40; difference at 12 months, 0.7 [95% CI, −2.4 to 3.8]). Of the remaining secondary outcomes, only anxiety significantly differed between groups (Table 2; eTables 1-2 in Supplement 2).

 Adverse Outcomes and Potential Misuse

 The opioid group had significantly more medication-related symptoms over 12 months than the nonopioid group (overall: P = .03; difference at 12 months, 0.9 [95% CI, 0.3 to 1.5]) (Table 3).

 There were no significant differences in adverse outcomes or potential misuse measures (Table 3). Two hospitalization or ED visit events were determined analgesic-related: 1 hospitalization in the nonopioid group and 1 ED visit in the opioid group. No deaths, “doctor-shopping,” diversion, or opioid use disorder diagnoses were detected.

 Intervention Adherence and Retention

 Number and duration of study visits were similar in the 2 groups (Table 4). Twenty-three patients (19%) in the opioid group and 10 patients (8%) in the nonopioid group discontinued study medication (eTable 6 in Supplement 2). Most patients in the opioid group received low or moderate dosage therapy (eTables 7-8 in Supplement 2). In each 90-day follow-up period, fewer than 15% of patients in the opioid group had a mean dispensed dosage of 50 ME mg/d or more. In the nonopioid group, tramadol was dispensed to 4 patients (3%), 6 patients (5%), 8 patients (7%), and 13 patients (11%) in the first, second, third, and fourth 90-day follow-up windows, respectively. eTables 9 to 10 in Supplement 2 show nonstudy pain treatments.

 Subgroup and Sensitivity Analyses

 Post hoc tests for interaction of primary pain diagnosis (ie, back pain, osteoarthritis pain) by treatment group on pain outcomes were not statistically significant (P = .25 for BPI interference, P = .34 for BPI severity). For the back pain subgroup at 12 months, BPI interference was 2.9 in the opioid group (SD, 2.1) vs 3.3 in the nonopioid group (SD, 2.6); difference, −0.4 (95% CI, −1.2 to 0.3); BPI severity was 3.7 in the opioid group (SD, 1.8) vs 3.6 in the nonopioid group (SD, 2.0); difference, 0.1 (95% CI, −0.5 to 0.8). For the hip or knee osteoarthritis pain subgroup at 12 months, BPI interference was 4.4 in the opioid group (SD, 2.8) vs 3.4 in the nonopioid group (SD, 2.6); difference, 1.1 (95% CI, −0.1 to 2.3); BPI severity was 4.5 in the opioid group (SD, 2.2) vs 3.4 in the nonopioid group (SD, 1.8); difference, 1.1 (95% CI, 0.2 to 2.0).

 In a post hoc sensitivity analysis, adjusting for baseline smoking status, results did not substantially change (BPI interference adjusted overall, P = .65; BPI severity adjusted overall, P = .05; medication-related adverse symptoms adjusted overall, P = .03).

 Discussion

 Among patients with chronic back pain or hip or knee osteoarthritis pain, treatment with opioids compared with nonopioid medications did not result in significantly better pain-related function over 12 months. Nonopioid treatment was associated with significantly better pain intensity, but the clinical importance of this finding is unclear; the magnitude was small (0.5 points on the 0-10 BPI severity scale) and was less than the MCID of 1.0. Opioids caused significantly more medication-related adverse symptoms than nonopioid medications. Overall, opioids did not demonstrate any advantage over nonopioid medications that could potentially outweigh their greater risk of harms.

 Among the secondary outcomes, only anxiety symptoms were statistically better in the opioid group. This finding is consistent with the role of the endogenous opioid system in stress and emotional suffering.31 The importance of this finding is uncertain because the magnitude of the difference in anxiety was small and the overall level of anxiety was low (9% of patients had moderate severity anxiety symptoms at baseline).

 Recent systematic reviews have concluded that opioids have small beneficial effects on pain compared with placebo that may be outweighed by common adverse effects.5,32-34 Observational studies have found that treatment with long-term opioid therapy is associated with poor pain outcomes, greater functional impairment, and lower return to work rates.35-37 In this trial, pain-related function improved for most patients in each group. Poor pain outcomes associated with long-term opioids in observational studies may be attributable to overprescribing and insufficient pain management resources rather than to direct negative effects of opioids.31,38 This trial did not have sufficient statistical power to estimate rates of death, opioid use disorder, or other serious harms associated with prescribed opioids.39-41

 This trial’s pragmatic design has several advantages. First, enrolled patients had characteristics similar to those of patients receiving opioids in VA primary care, including patients with depression and posttraumatic stress disorder.6 Second, flexibility of treatment within assigned groups facilitated high study retention. Third, the treat-to-target approach reflects clinical practice more closely than approaches comparing single drugs or fixed dosages and allowed maximized benefit for patients.9,10 Because individual medications are effective for only a minority of patients with chronic pain,33,42 structured reassessment and adjustment of medications is likely necessary for effective pharmacological treatment.

 Few data are available regarding optimal opioid dosing for pain, function, and tolerability. A meta-analysis of chronic back pain trials found incremental benefits of larger opioid dosages, but concluded benefits were too small “to be clinically important even at high doses.”32 Another meta-analysis of opioid trials for musculoskeletal pain in older adults found no association of dosage with pain or function.34 Recent opioid prescribing guidelines recommend keeping daily dosages low.2-4 This study was designed to identify the medication regimen with the best balance of benefits and tolerability for each patient and allowed treatment with a range of low to moderately high opioid dosages.

 By pragmatic design, this trial did not require high levels of adherence to study medications. This study had high active treatment continuation and study retention rates, so results reflect outcomes across a range of treatment adherence.

 Limitations

 This study has several limitations. First, the complexity of interventions precluded masking of patients. Because primary outcomes were patient-reported, results are subject to potential reporting bias that would likely favor opioids. Second, there was an imbalance in prerandomization treatment preference. Any effect of this imbalance would likely favor opioids. Third, because this study was conducted in VA clinics, patient characteristics differ from those of the general population, most notably in sex distribution. Fourth, patients with physiological opioid dependence due to ongoing opioid use were excluded, so results do not apply to this population.

 Conclusions

 Treatment with opioids was not superior to treatment with nonopioid medications for improving pain-related function over 12 months. Results do not support initiation of opioid therapy for moderate to severe chronic back pain or hip or knee osteoarthritis pain.

 Back to top Article Information

 Corresponding Author: Erin E. Krebs, MD, MPH, Minneapolis Veterans Affairs Health Care System (152), 1 Veterans Dr, Minneapolis, MN 55417 (erin.krebs@va.gov).

 Accepted for Publication: February 2, 2018.

 Author Contributions: Dr Krebs had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

 Concept and design: Krebs, Kroenke, Bair.

 Acquisition, analysis, or interpretation of data: All authors.

 Drafting of the manuscript: Krebs, Jensen, DeRonne, Bair.

 Critical revision of the manuscript for important intellectual content: Gravely, Nugent, DeRonne, Goldsmith, Kroenke, Bair, Noorbaloochi.

 Statistical analysis: Gravely, Noorbaloochi.

 Obtained funding: Krebs, Kroenke, Bair.

 Administrative, technical, or material support: Nugent, Jensen, DeRonne, Goldsmith.

 Supervision: Krebs, Kroenke.

 Conflict of Interest Disclosures: All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Ms Jensen reported that her spouse is employed as a research chemist by Upsher-Smith Laboratories. No other disclosures are reported

 Funding/Support: This trial was funded by the Merit Review Award (I01-HX-000671) from the US Department of Veterans Affairs Health Services Research and Development Service.

 Role of the Funder/Sponsor: The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

 Disclaimer: The views expressed in this article are those of the authors and do not represent the views of the VA or the US government.

 Additional Contributions: We thank the veterans who participated in the trial; our Minneapolis VA Health Care System primary care colleagues; members of the data and statistics monitoring board and institutional review board. We also thank the members of the research team, including Indulis Rutks, BS, David Leverty, BS, Ruth Balk, BA, Erin Linden, MPH, and Andrea Cutting, MA (all from Minneapolis VA Health Care System). They received compensation for their contribution. We also thank Melvin Donaldson, MS (University of Minnesota), for help with recruitment; Preetanjali Thakur, BDS (University of Minnesota), for reviewing adverse events; Elzie Jones, PharmD, Melissa Bell, PharmD, Howard Fink, MD, MPH, and Steven Fu, MD, MSCE (all from Minneapolis VA Health Care System), for providing clinical coverage; and Doug DeCarolis, PharmD (Minneapolis VA Health Care System), for dispensing research medication. They did not receive compensation for their contribution. ||||| (Reuters Health) - Acetaminophen, ibuprofen and other nonsteroidal anti-inflammatory drugs (NSAIDs) are better than opioids at easing the intensity of chronic pain in the back, knees or hips, a U.S. experiment suggests.

 And opioids are no better than these other drugs at reducing how much pain interferes with daily activities like walking, working, sleeping or enjoying life, researchers report in JAMA, online March 6.

 “We already knew opioids were more dangerous than other treatment options, because they put people at risk for accidental death and addiction,” said lead study author Dr. Erin Krebs of the Minneapolis VA Health Care System and the University of Minnesota.

 “This study shows that extra risk doesn’t come with any extra benefit,” Krebs said by email.

 U.S. deaths from opioids including heroin and prescription drugs like oxycodone, hydrocodone and methadone have more than quadrupled since 1999, according to the Centers for Disease Control and Prevention in Atlanta. Today, more than six in 10 drug overdose deaths involve opioids.

 Amid this worsening opioid crisis, the CDC has urged physicians to use opioids only as a last resort. Instead, doctors should talk to patients about the potential for exercise or physical therapy to help ease symptoms and prescribe other, less addictive drugs for pain including acetaminophen (Tylenol) and NSAIDS such as aspirin, ibuprofen (Advil, Motrin) and naproxen (Aleve).

 NSAIDs carry their own risks, especially at high doses, including the potential for internal bleeding, kidney damage and heart attacks. But they aren’t addictive.

 For the current study, researchers randomly assigned 240 patients seeking pain treatment at VA primary care clinics to receive either opioids or alternative medicines like acetaminophen or ibuprofen for one year.

 Participants were 58 years old on average and most were men. Back pain was their most common complaint, affecting 156 patients, or 65 percent, and the rest had either hip or knee osteoarthritis pain.

 People in the opioid group started therapy with fast-acting morphine, a combination of hydrocodone and acetaminophen, or immediate release oxycodone. If that wasn’t successful, patients next got long-acting morphine or oxycodone, and then doctors tried fentanyl patches.

 In the non-opioid group, patients first got acetaminophen and NSAIDs. If those options didn’t help enough, doctors tried options like the nerve pain drug gabapentin (Neurontin) and topical painkillers like lidocaine, followed by the nerve pain drug pregabalin (Lyrica) and tramadol, an opiate painkiller.

 Researchers asked participants to rate how much pain interfered with their lives at the start of the study, and again 12 months later.

 By this measure, both groups improved equally over the course of the year, based on a 10-point scale with higher scores indicating worse impairment.

 With opioids, scores declined from an average of 5.4 at the start of the study to 3.4 a year later. With other drugs, scores dropped from 5.5 to 3.3.

 Patients also rated pain intensity on a 10-point scale with higher scores indicating more severe symptoms, and non-opioid drugs worked slightly better on this measure.

 In both groups, patients initially rated their pain intensity at 5.4, but scores dropped to just 4.0 with opioids and fell to 3.5 on the other drugs.

 One limitation of the study is that people knew which medications they were prescribed, which might affect how patients reported their own pain severity and daily functioning, the authors note.

 Even so, the results offer fresh evidence that opioids may not be worth the addiction risk when treating chronic pain, said Marissa Seamans, a researcher at Johns Hopkins Bloomberg School of Public Health in Baltimore who wasn’t involved in the study.

 “There is increasing evidence that non-opioid pain relievers are just as (if not more) effective than opioids for chronic non-cancer pain,” Seamans said by email.

 Patients should only consider opioids if alternatives like exercise, physical therapy or other medications don’t help, said Dr. Chad Brummett, a researcher at the University of Michigan in Ann Arbor and co-director of the Michigan Opioid Prescribing Engagement Network.

 “Prior to beginning opioids, patients not responsive to these non-opioid medications should ideally be evaluated by a pain specialist before starting chronic opioid therapy,” Brummett said by email.

 SOURCE: bit.ly/2tpquTM |||||
What is a shorter version of the above article?

– Even after overdose and addiction risks became known, opioid prescriptions continued on the belief that the drugs were more effective at relieving pain than other medications. New research suggests that may not be the case. In a study in JAMA, scientists say opioids appear to be no better at treating chronic pain than non-opioids like acetaminophen (Tylenol), ibuprofen (Advil), and lidocaine, which are much less addictive. In a trial of 240 patients—mostly middle-aged white males who'd endured at least six months of pain in their back, hips, or knees—non-opioid users actually experienced more pain relief than patients using morphine, oxycodone, or hydrocodone, though not in a way that was statistically significant, reports the Los Angeles Times. "There was no significant difference in pain-related function between the 2 groups over 12 months," say the researchers. Half of the trial patients at Minneapolis VA Health Care System were given opioids, while the other half were given acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs). Both groups reported an average pain score of 5.4 out of 10 at the start of the trial. But after a year, opioid users reported an average score of 4, compared to 3.5 for non-opioid users, reports Reuters. Study author Erin Krebs blames opioid tolerance. "Your body gets used to that level of opioid, and you need more and more to get the same level of effect," she tells NBC News, adding this might explain why opioid users suffered more side effects like constipation, fatigue, and nausea. Since the added risks of opioids come with no advantage over other drugs, Krebs says people with chronic pain just "shouldn't start opioids." (That goes for kids, too.)


Article:
WASHINGTON (Reuters) - Some 200,000 Salvadoran immigrants allowed to live and work in the United States since 2001 will lose their right to remain in the country in 2019, officials said on Monday, marking the Trump administration’s latest move to tighten immigration enforcement.

 The United States will end the Salvadorans’ temporary protected status (TPS) on Sept. 9, 2019, giving them 18 months to leave or seek lawful residency, and for El Salvador to prepare for their return, administration officials said. The status was granted in the wake of two devastating 2001 earthquakes in El Salvador that left hundreds of thousands in the country homeless.

 The decision to end TPS for Salvadorans is part of the administration’s broader push to tighten immigration laws and expel those living in the United States illegally. The move was heavily criticized by immigrant advocates who said it ignored violence in El Salvador and gave the Salvadorans few options but to leave the United States or remain illegally.

 The Trump administration has faced a series of deadlines over the past year to decide whether to end the protected status of immigrants in the United States whose home countries have been affected by disasters.

 Salvadorans are by far the largest group under TPS, a program administration officials said is supposed to provide a temporary haven for victims, not a permanent right to remain in the United States.

 Critics have complained TPS has allowed participants to repeatedly extend their stays in 6-month to 18-month increments.

 Patricia Hernandez, 53, arrived in the United States in 2000 and applied for TPS after the 2001 earthquakes. She has lived in North Carolina for 18 years and runs a subcontracting construction business with her Honduran husband. The couple have two U.S.-born teenage sons.

 “This is a real blow for everyone,” said Hernandez by telephone. “Most of us pay taxes, we’re not living off the government, we’re not criminals.”

 The family will move to Honduras with their children and the couple do not intend to return north, she said, though they worry about violence and political instability in central America.

 Trump administration changes to the TPS program mean that over the next two years approximately 250,000 people who previously had permission to live and work in the United States will be subject to deportation if they remain.

 Haitians and Nicaraguans will lose their protected status in 2019 and Hondurans, the second largest group in the program, could lose their rights later this year.

 Maria Gloria Ceren de Quinonez poses with a picture of her daughter Susana and granddaughters Gabriela and Monica who live in the U.S. under the Temporary Protected Status, in Santa Tecla, El Salvador January 8, 2018. REUTERS/Jose Cabezas

 “The past practice of allowing foreign nationals to remain in the United States long after an initial emergency in their home countries has ended has undermined the integrity of the program and essentially made the ‘temporary’ protected status a front operation for backdoor permanent immigration,” said Roy Beck, president of NumbersUSA, which favors less immigration overall.

 VIOLENCE IN EL SALVADOR

 Advocates of the program say long-term resident Salvadorans and their children should not be sent back to El Salvador, a country struggling with a weak economy and gang violence that has given it one of the world’s highest murder rates.

 “Our (U.S) government is complicit in breaking up families — nearly 275,000 U.S.-born children have a parent who is a TPS holder — and further destabilizing our neighboring countries,” said Oscar Chacon, executive director of Alianza Americas, an immigrant advocacy group.

 There are approximately 1.35 million Salvadorans of any status living in the United States, according to U.S. Census Bureau data analyzed by the Migration Policy Institute, a non-partisan think tank.

 A senior administration official briefing reporters on the decision said it was based on the status of El Salvador’s recovery from the 2001 earthquakes. The country has received millions of dollars in aid and rebuilt schools, homes and hospitals, the official said.

 In the past two years, the United States has repatriated 39,000 Salvadorans, showing the ability of El Salvador to absorb an influx, the official said.

 The government of El Salvador said on Monday that it was glad the administration decided to at least leave the program in place until September 2019.

 “El Salvador’s Foreign Ministry lobbied heavily for the interests of our fellow citizens,” the government said in a statement, adding that it would continue to search for alternatives and seek action by the U.S. Congress to protect the migrants.

 The U.S. Chamber of Commerce had urged the government to extend TPS protections for Salvadorans, Haitians and Hondurans, saying “the loss of employment authorization for these populations would adversely impact several key industries,” including “construction, food processing, hospitality, and home healthcare services.”

 Congressional Democrats on Monday expressed support for finding a permanent solution to help Salvadorans in the United States. But that will be politically difficult at a time when there are rival immigration priorities, including providing permanent protection for “Dreamers” - undocumented immigrants brought to the United States as children.

 That effort has been weighed down by demands from conservatives in Congress to couple any such move with new efforts to clamp down on illegal immigration, especially from Mexico and Central America.

 Slideshow (10 Images) ||||| Trump officials argue that the U.S. has been deporting migrants to El Salvador for years, and that temporary protected status was always supposed to be temporary. Last year, the administration ended the program for two other countries, Haiti and Nicaragua. Recipients from those nations, like those from El Salvador, will have an 18-month grace period to leave the U.S. or apply for other forms of immigration relief, officials said. |||||Summary:

– An estimated 200,000 Salvadorans and their 190,000 US-born children aren't the only people stressed out about the administration's decision to withdraw Temporary Protected Status: The government of El Salvador, which estimates 95% of TPS holders are employed or own businesses in the US, says it will "face a great challenge" if tens of thousands are deported after Sept.19, 2019, when the protection from deportation introduced after two deadly earthquakes in 2001 expires. But Salvadoran officials don't think it will come to that. Foreign Minister Hugo Martinez tells the Washington Post that the government will lobby Congress to find a way for people losing TPS status to remain legal US residents. "We think we have sufficient time and will work hard for this alternative," he says. Congressional Democrats support finding a way for the Salvadorans to stay, though they have multiple other immigration issues to deal with, Reuters reports. Advocates warn that El Salvador has one of the world's highest murder rates, making it a dangerous place to deport people to—and that its economy will be devastated if it loses billions of dollars in remittances from the US. "This is really bad news for our country," Nayib Bukele, the mayor of San Salvador, tells the Los Angeles Times. "Our country doesn't create opportunities for the Salvadorans who live here. Imagine what we're going to do with 200,000 more coming in." Experts say that if there are mass deportations, many former TPS holders are likely to try to move to the US illegally—as will some Salvadorans displaced by the skilled and bilingual new arrivals.


Article:

The FBI says its learned the real secret behind the success of the nasty revenge porn website isanyoneup.com: The site operator, 27-year-old Hunter Moore, was paying a hacker to steal nude photos of innocent people right from their email accounts.

 Moore and alleged hacker Charles Evens, 25, were arrested today on conspiracy and computer intrusion charges for allegedly stealing photos of hundreds of victims.

 Moore’s site began as a revenge porn site, inviting embittered ex-boyfriends and ex-girlfriends to submit explicit photos of their former partners. But to keep populating the site with new images, Moore allegedly instructed Evens to hack email accounts to steal private photos, for which he paid Evens $200 a week via Paypal.

 The two apparently began discussing the arrangement in 2011 via email. By December 2011, with the deal in place, Evens allegedly sent Moore an email seeking $250 for nude pictures of “6 guys and 6 girls.”

 Moore was allegedly so pleased with the transaction that he wrote Evens in January “hack all week for me.” More images poured in, and more money was sent to the Paypal account to compensate Evens, according to the document.

 The two have been charged with 15 counts, including charges for hacking and identity theft.

 Moore has never tried to hide his role in the revenge porn web site, but has defended it in television interviews, blaming victims for taking the photos that his site published.

 “I don’t know how you can point a finger at me; you took the picture,” Moore said in 2012 TV interview defending his site to a victim whose photo was allegedly posted on the site by her boyfriend. “At the end of the day, it started with you and you took these pictures. I don’t know how old you are, but I’m sure you’re smart and go to school. I mean, it’s 2012; what do you expect to happen? Somebody’s going to monetize this and I was the person to do it.” ||||| Two California men – including the creator and operator of a so-called “revenge porn” website -- were charged Thursday with computer crimes and ID theft stemming from an alleged conspiracy to hack into email accounts and steal nude photos that were later posted on the Internet site.

 Agents with the Federal Bureau of Investigation arrested Hunter Moore, 27, of Woodland, Calif., near Sacramento, and Charles Evens, 25, of Studio City, Calif., without incident at their respective homes. They were expected to make initial court appearances later Thursday in the districts in which they were arrested.

 Moore is a notorious character as a result of his creation and operation of the now-defunct revenge porn website isanyoneup.com. The BBC several years ago named him the "most-hated man on the Internet."

 Both men are charged in the 15-count federal grand jury indictment with conspiracy, seven counts of unauthorized access to a protected computer to obtain information and seven counts of aggravated identity theft.

 “The moral of the story is that his revenge porn site wasn’t a good enough business model, and that he had to engage in illegal activity to populate the site with pictures,” said Wes Hsu, assistant U.S. attorney for the Central District of California and head of the office’s Cyber and Intellectual Property Crime Section.

 Neither the defendants nor their attorneys could immediately be reached by NBC News for comment.

 If convicted, Moore and Evens each face a maximum of up to five years in federal prison on the conspiracy and computer hacking counts, prosecutors said. Additionally, the aggravated identity theft carries a mandatory two-year sentence, which would be served consecutively to any other sentence.

 Charlotte Laws' daughter was the victim of photo hacking at the hands of the now-defunct site isanyoneup.com. Laws, who has been called the "Erin Brockovich of revenge porn" discusses how she took down the person who posted pictures of her daughter.

 According to the 13-page indictment, there were least eight primary victims of the conspiracy, described only by their initials. “Nude images of (the victims) … and others” were posted on Moore’s site, isanyoneup.com, it said.

 The indictment also alleges Evens gained access to the email accounts of “hundreds of victims by various means, including by ‘hacking.’”

 Prosecutors said Moore’s site featured “revenge porn,” where “nude or explicit photos of victims (were) submitted by other individuals without the victim’s permission for purposes of revenge.”

 Moore needed more material for his site and conspired with Evens, starting at an unknown date and continuing through May 2, 2012, to illegally gain access to victim’s computers to obtain more photos, prosecutors said.

 Moore allegedly instructed Evens to gain unauthorized access to victims’ email accounts and sent payments to Evens in exchange for nude photos he obtained, according to the indictment. Moore then posted the illegally obtained photos on his website, without the victims’ consent, it said.

 In an interview on "MSNBC Live with Thomas Roberts" in December, activist and mom Charlotte Walls described how a hacker gained access to compromising photos of hundreds of people across the country, including her daughter, first through Facebook and then by getting into her email account.

 “People are being humiliated, hurt,” said Walls, who helped push through a California law banning revenge porn. “The people on the website then harassed the particular individual who is a victim on the site and tried to get her fired from her job, trying to ruin her job essentially. It’s really a horrendous thing that happens.”

 Hsu said the case offers a good lesson for email users.

 “It’s a reminder to everybody that you have to be diligent when you set up your passwords and security questions,” Hsu said. “I think people take for granted that nobody is going to bother trying to get into their email account. I view it is a very important, private thing for most people. Everybody should make themselves as hard a target as possible.”

 More from NBC News Investigations:

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What is a summary?

– The man behind a "revenge porn" site—which encouraged people to post naked photos of their exes to get back at them—allegedly obtained his nude content a second way: via a hacker who grabbed photos from personal email accounts. FBI agents yesterday arrested Hunter Moore, who ran the now-defunct IsAnyoneUp.com; he was charged with conspiracy, hacking, and identity theft. (In case his name sounds familiar, NBC News notes his site once earned Moore the title of the "most-hated man on the Internet.") Charles Evens, the man who allegedly did the dirty work, was similarly arrested and charged. Wired reports the two allegedly began emailing about the idea in late 2011. Evens allegedly sent Moore an email asking for $250 for nude pictures of "6 guys and 6 girls" in December of that year; a month later, Moore allegedly replied with, "hack all week for me." Prosecutors say the hacking ended May 2, 2012. The two face up to 7 years in prison. Wired shares this 2012 quote, from Moore to a woman whose picture reportedly appeared on his site: "I don't know how you can point a finger at me; you took the picture. I'm sure you're smart and go to school. I mean, it's 2012, what do you expect to happen? Somebody's going to monetize this and I was the person to do it."