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DUBLIN (AP) — United Nations human rights experts said Thursday that Ireland's abortion ban subjects women to discriminatory, cruel and degrading treatment and should be ended for cases involving fatal fetal abnormalities.

 The 29-page report from the Geneva-based U.N. Human Rights Committee accepted a complaint filed by Amanda Mellet, a Dublin woman who was denied a 2011 abortion in Ireland after her doctor informed her that her fetus had a fatal heart defect and could not survive outside the womb.

 Ireland permits abortions only in cases where the woman's own life is endangered by continued pregnancy. Its ban on abortion in all other circumstances requires women to carry a physiologically doomed fetus to full term in Ireland or travel abroad for abortions, usually to England, where thousands of Irish citizens have abortions annually.

 The U.N. Human Rights Committee, constituting experts from 17 nations led by Fabian Salvioli of Argentina, found that Ireland's abortion law violates the U.N. International Covenant on Civil and Political Rights on several points and called for widespread reform.

 The panel wields no power to compel change from Ireland, a predominantly Roman Catholic nation that maintains the strictest laws on abortion in the 28-nation EU. Ireland's government offered no immediate reaction to the findings.

 But human rights watchdog Amnesty International said the U.N. findings should shame Ireland into further action, three years after the country legalized abortions deemed necessary to save a pregnant woman's life. That move followed the 2012 death in an Irish hospital of an Indian woman, Savita Halappanavar, who suffered lethal blood poisoning while doctors refused to perform an abortion of her dying fetus.

 "The Irish government must take its head out of the sand and see that it has to tackle this issue," said Colm O'Gorman, Amnesty's director in Ireland.

 A series of opinion polls since 2013 have recorded majority support for extending abortion access to cases involving fatal defects and pregnancies caused by rape or incest, but anti-abortion activists argue that permitting any further exceptions to the ban would lead eventually to the legalization of abortion on demand.

 The U.N. report said Ireland's law made the rights of inviable fetuses superior to the rights of women and this arbitrary imbalance "cannot be justified," because the unborn child's life cannot be saved. It said Ireland's restrictions on providing clear advice and state-supported medical care to women who receive abortions overseas caused Mellet "intense suffering" and her experience "amounted to cruel, inhuman or degrading treatment."

 The panel called on Ireland to amend its laws to comply with U.N. treaty obligations, provide financial compensation to Mellet and ensure she has access to state-supported counseling services. It said Ireland specifically should amend its laws to ensure that no other women with pregnancies involving fatal fetal abnormalities should be forced to carry them to full term.

 The experts also found that Ireland's underlying criminal law on abortion was "discriminatory because it places the burden of criminal liability primarily on the pregnant woman."

 Mellet testified that Dublin doctors informed her during scans that her child was likely to die inside the womb but could not be aborted, only removed after it perished. After three weeks, she checked with doctors to see if her now 24-week-old fetus still had a heartbeat and, when told it was still alive, traveled with her husband to the English city of Liverpool. There, doctors induced a 36-hour labor that ended in a stillborn baby girl.

 Mellet was denied any access to state-funded bereavement counseling in Ireland because Irish maternity hospitals are permitted to provide such services only to women who agree to carry their fetuses to the point of birth or miscarriage. Her legal complaint was accompanied by expert opinions from a Trinity College Dublin professor in midwifery and a clinical psychologist who found that Ireland's restrictions inflict unnecessary long-term trauma on women carrying fetuses likely to die in the womb or at birth.

 The woman told the panel she had wanted to take her stillborn daughter's remains back with her to Ireland, but the Liverpool hospital didn't permit this. "She received the ashes, unexpectedly, three weeks later by courier, which deeply upset her," the report said.

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 Associated Press reporter Jamey Keaten in Geneva contributed to this story.

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 Report, http://bit.ly/25NrsFz ||||| GENEVA/DUBLIN (Reuters) - An Irish woman forced to choose between carrying her baby with a fatal congenital defect to term and going abroad for an abortion had her rights violated and deserves compensation, a United Nations panel said on Thursday.

 Abortion laws in majority Roman Catholic Ireland are among the most restrictive in the world: a complete ban on terminating a pregnancy was lifted in 2013 after large street protests from both sides. It is now allowed if a mother’s life is in danger.

 The woman known as “AM” complained to the U.N. Human Rights Committee after being told in the 21st week of pregnancy in November 2011 that her baby would die in the womb or shortly after birth, which led her to have an abortion in Britain.

 This meant she had to choose “between continuing her non-viable pregnancy or traveling to another country while carrying a dying fetus, at personal expense and separated from the support of her family, and to return while not fully recovered”, the independent experts said in their findings.

 The woman was subjected to discrimination and cruel, inhuman or degrading treatment prohibited under international law, they said.”Many of the negative experiences she went through could have been avoided if (she) had not been prohibited from terminating her pregnancy in the familiar environment of her own country and under the care of health professionals whom she knew and trusted,” the Committee said.

 In a statement, the U.S.-based Center for Reproductive Rights welcomed the “ground-breaking ruling” as sending “the clear message that Ireland’s abortion laws are cruel and inhumane, and violate women’s human rights”.

 Ireland, which has ratified the International Covenant on Civil and Political Rights, is obliged to provide AM with an effective remedy, including adequate compensation and psychological treatment she may need, the U.N. panel said. Ireland is also obliged to prevent similar violations, it said.

 Amnesty International Ireland’s head, Colm O’Gorman, said in a statement: “The Irish government must take its head out of the sand and see that it has to tackle this issue.”

 The abortion issue is hugely divisive in Ireland and the new minority government resisted calls to directly loosen the laws, instead leaving it to a citizens’ assembly which will be established by year-end to recommend any changes to the law.

 Activists want to abolish the amendment of the constitution which enshrines the equal right to life of the mother and her unborn child, and at the very least allow for abortion in cases such as rape, incest and fatal fetal abnormality.

 Anti-abortion supporters demand that the eighth amendment remains in place to safeguard all life. Abolishing it would require a national referendum. ||||| Ireland's ban on abortion subjected a woman carrying a foetus with a fatal abnormality to discrimination and cruel, inhuman or degrading treatment, the United Nations has found.

 It called for the strict prohibition to be reversed, including reforming the right to life of the unborn in the Constitution if necessary, to allow women to voluntarily terminate a pregnancy safely.

 Independent experts, from the Geneva-based Human Rights Committee, said Amanda Mellet was forced to choose between carrying her baby to term, knowing it would not survive, or travelling abroad for a termination.

 The UN body also hit out at the Government for putting her through financial and emotional suffering.

 Its report said she had to pick "between continuing her non-viable pregnancy or travelling to another country while carrying a dying foetus, at personal expense and separated from the support of her family, and to return while not fully recovered".

 The UN has ordered the Government to compensate Ms Mellet and ensure she gets the adequate psychological treatment she may need and to prevent similar violations from occurring.

 Ms Mellet was 21 weeks pregnant in November 2011 when doctors told her the foetus would die in her womb or shortly after birth.

 She travelled to the UK for an abortion but had to return home 12 hours after the procedure as she could not afford to stay longer.

 The UN committee said the hospital where she was treated did not provide any options regarding the foetus's remains and she had to leave them behind.

 Three weeks later the ashes were unexpectedly delivered to her by courier.

 Ms Mellet filed a complaint with the UN over her experiences.

 The human rights organisation said she was discriminated against by being denied bereavement counselling and medical care available to women who miscarry.

 It said this did not take into account her medical needs and socio-economic circumstances.

 "Many of the negative experiences she went through could have been avoided if [she] had not been prohibited from terminating her pregnancy in the familiar environment of her own country and under the care of health professionals whom she knew and trusted," the committee said.

 The UN also noted the shame and stigma associated with the criminalisation of abortion of a fatally-ill foetus.

 It said Ms Mellet's suffering was aggravated by the obstacles she faced in getting information about the appropriate medical options.

 The UN said the strict rules that support groups in Ireland can provide on information have a chilling effect on healthcare workers.

 It said some struggle to distinguish between support for a woman who has decided to terminate a pregnancy and promoting abortion.

 In its findings the UN said: "The State party should amend its law on voluntary termination of pregnancy, including if necessary its Constitution, to ensure compliance with the Covenant, including effective, timely and accessible procedures for pregnancy termination in Ireland, and take measures to ensure that healthcare providers are in a position to supply full information on safe abortion services without fearing being subjected to criminal sanctions."

 Ireland's stringent rules on abortion are protected under the Eighth Amendment to the Constitution which deals with the right to life of the unborn.

 Last year new rules came into effect under the Protection of Life During Pregnancy Act 2013 to allow for abortion when there is a real and substantial risk to a woman's life - including suicide.

 But the ban remains on termination in cases of rape, incest, inevitable miscarriage and fatal foetal abnormality.

 In a statement this afternoon, Ms Mellet said: "I am profoundly grateful to the Human Rights Committee for its decision and its clear recognition that my human rights were violated as a result of Ireland's prohibition and criminalisation of abortion.

 "The decision not only vindicates my rights. It also serves to uphold the rights of many other women in Ireland who have faced and continue to face human rights violations under the current legal regime."

 Mixed reaction to report

 A group opposed to abortion has criticised the UN report.

 Tracy Harkin of Every Life Counts said that the UN had "deliberately ignored the experiences of families who had received great joy and love from carrying their babies to term", and added that it was "shameful for the UN to ignore the fact that these children were alive and kicking in the womb, and deserved equal protection and love".

 She said: "The language used by the UN reflects the appalling attitude of discrimination which is pushing families towards abortion, and denies them time with their sick babies, time that allows them to make memories and provides a pathway to healing.

 "Our experiences with our children, whether their lives spanned hours, weeks or years, has taught us that abortion solves nothing and brings no comfort to either the baby or the family involved."

 The Pro Life Campaign has said the comments were further proof that the committee "is 100% partisan in favour of abortion and never takes account of the hugely damaging effects of abortion on both mother and baby".

 Cora Sherlock of the Pro Life Campaign said: "The UN's Human Rights Committee has become a de facto lobby group for abortion. Every few months they castigate Ireland's abortion laws but are totally silent when it comes to investigating abuses in the abortion industry.

 "It is unbelievable how one-sided they have become and they need to be called out on it. The same committee that is always challenging Ireland on its abortion laws has never once taken countries like Britain and Canada to task over the horrific practice of babies being born alive after failed abortions and left to die in hospital corners."

 Terminations for Medical Reasons welcomed the decision of the committee saying "The Committee has determined that Ireland, by refusing access to safe and legal abortion services, is abusing women by treating them in a cruel, inhuman and degrading manner."

 In a statement the group commended Ms Mellet for the "brave and selfless manner in which she took her complaint against Ireland to the UN, with the assistance of the Center for Reproductive Rights."

 "This UN decision makes it incumbent upon Ireland to act promptly to take measures to prevent further abuse. It is bad enough that our Government is complicit in this, but any delays would make them architects of such abuse" the statement said.

 The Catholic Primate of All Ireland Eamon Martin has said he has some difficulty with outside bodies telling Ireland what to do on abortion law.

 The Archbishop of Armagh said it was a choice for Irish people, adding that the right to life trumped all other rights, including the right to choose, and if that was taken away then everything else crumbled.

 He also cited the thousands who came out last weekend for a ProLife rally celebrating the Eighth Amendment and he questioned why anyone would take that equality away.

 He said the church position remains to respect the life of mothers and unborn children.

 The Irish Council for Civil Liberties said the report "cranks up the pressure" on the Government to reform Ireland's "antediluvian" abortion laws.

 ICCL Executive Director Mark Kelly said: "This latest denunciation of one aspect of Ireland's abortion regime comes as no surprise, as it was already a matter of public record that UN Human Rights Committee considers that Ireland's abortion law violates the UN Covenant on Civil and Political Rights.

 "This latest opinion has no direct legal effect in this State; however, it joins a chorus of expert voices reminding Ireland that its abortion regime is wildly out of kilter with abortion law and practice in the family of civilised nations."

 In the Dáil, Independents4Change TD Clare Daly said she would like to ask how the Government proposes to deal with this morning's "ground breaking international decision issued against Ireland by the UN Human Rights' Commission where Ireland as a state party to the international covenant on civil and political rights was found guilty of violating the human rights of a woman who was denied a determination in the case of a fatal foetal abnormality."

 She said "not only is the Government in the statement obliged to provide her with an effective remedy, including compensation, but obliged to prevent similar violations in the future.

 "So can the minister [Richard Bruton] confirm the Government will be awarding compensation to the woman in question and what steps are you immediately going to take to ensure that human rights are not being violated by addressing the legislative shortcomings, including as suggested by the UNHRC the amendment of our Constitution in relation to the same issue?"

 Sinn Féin's Louise O'Reilly asked; "When are we going to see the Citizens Assembly? When will the membership be known? And will it be mandated to recommend a referendum on repealing the Eight Amendment?"

 Independent TD Catherine Connolly called for an answer to the question posed to Mr Bruton by Ms Daly.

 She read out the UN finding, and said: "I listened to the Taoiseach misquote what has happened in relation to various amendments to the Constitution.

 "It is important that the voices of women are heard in this chamber."

 AAA/PBP TD Joan Collins said she would like the minister to reply to Ms Daly's question and added, "I don't think we should be going through a Citizens' Convention on this issue.

 "We have discussed this in the last Dáil in a lot of detail and we should be moving quite quickly now to repealing the Eight Amendment."

 Labour TD Jan O'Sullivan reiterated that the discussion take place as soon as possible in the convention so the issue of the Eight Amendment can be addressed.

 Responding, Mr Bruton said he has not seen the report from the Committee on Human Rights but he sympathises and understands the concerns of TDs for any woman with a fatal foetal abnormality.

 He said he cannot answer for what action Government will take on foot of this finding.

 He said that change in this area requires an amendment of our Constitution and the Programme for Government has set out that there will be a Citizen's Assembly established within six months.

 Mr Bruton said it will not have a specific mandate and the Oireachtas will have the final decision on this.

 He said that in the last Dáil, the work in holding hearings, bringing in expert advice and allowing deputies to see in a dispassionate way how difficult issues can be handled, was of benefit to the Oireachtas.

 The minister said that it allowed the Dáil to reach conclusions on the issue of constitutional rights being converted into law that no government had broached in the previous years.

 Ms Daly said it is not acceptable to say he cannot answer for the Government on this issue.

 Meanwhile, an independent expert on the UN Committee has said the Irish Government must amend its law and possibly the Constitution in relation to fatal foetal abnormalities.

 Speaking on RTÉ's News at One, Sarah Cleveland said the law is in contradiction with Ireland's obligations under the European Union human rights treaty.

 Ms Cleveland said Ireland must also review and amend laws so that healthcare providers can provide people, who find themselves in such a situation, with adequate information on their choices without fear of legal repercussions.

 She acknowledged that the matter is a sensitive issue in Ireland but said that families should have the right to chose whether they carry to full term or chose to terminate in the case of fatal foetal abnormalities.

 She said the Committee does not have any enforcement mechanisms but added that Ireland can be pressed on the matter at future appearances before the UN committee. ||||| The UN’s human rights committee has called on the Irish government to reform its restrictive abortion legislation, after ruling that it subjected a woman to cruel, inhuman and degrading treatment and violated her human rights.

 The landmark ruling, which is expected to set an international precedent, calls on Ireland to introduce “accessible procedures for pregnancy termination” to prevent similar violations in the future. The judgment marks the first time that an international human rights committee has recognised that by criminalising abortion, a state has violated a woman’s human rights.

 More Irish women seeking help for British abortions, says charity Read more

 A panel of UN human rights committee experts found that Ireland’s prohibition and criminalisation of abortion services subjected Amanda Mellet to severe emotional and mental pain and suffering in 2011, when she was told she could not have an abortion in Ireland even though doctors had discovered that the foetus had congenital defects that meant it would die in the womb or shortly after birth.

 Ruling on Mellet’s complaint, the committee concluded that Ireland’s abortion laws, which are among the most restrictive in the world, meant that she had to chose “between continuing her non-viable pregnancy or travelling to another country while carrying a dying foetus, at personal expense, and separated from the support of her family, and to return while not fully recovered”. This violated her right to freedom from cruel, inhuman and degrading treatment.

 Ireland has signed the international covenant on civil and political rights (ICCPR), which is part of the international bill of human rights. As such, it is obliged to compensate Mellet and to prevent similar violations from occurring in the future, the ruling states.

 Ireland “should amend its law on voluntary termination of pregnancy, including if necessary its constitution, to ensure compliance with the covenant, including effective, timely and accessible procedures for pregnancy termination in Ireland”, the ruling stated.

 Lawyers said the judgment could help trigger reform in other countries with restrictive abortion laws. “The decision is so significant that lawyers who are working with women who have been denied access to abortion across the world will be very encouraged and will be using it in their work to seek justice for their clients and legal change in countries where access to abortion services is criminalised,” Leah Hoctor, the regional director for Europe at the Center for Reproductive Rights, who filed the complaint to the UN human rights committee on Mellet’s behalf, said.

 Prohibited from accessing a termination in Ireland, Mellet chose to travel to the UK and returned 12 hours after the procedure because she could not afford to stay longer. She had to pay for private treatment, and the round trip cost €3,000. Her foetus’s ashes were unexpectedly delivered three weeks later by courier.

 “Many of the negative experiences she went through could have been avoided if [she] had not been prohibited from terminating her pregnancy in the familiar environment of her own country and under the care of health professionals whom she knew and trusted,” the committee wrote in its findings.

 Mellett welcomed the ruling, and said in a statement: “The Human Rights Committee has made it clear that to redress the violations that I suffered, the Irish Government must ensure that other women do not live through similar violations of their rights. This cannot happen until until abortion is decriminalised and legislation is adopted to enable women to access services in Ireland.

 “I hope the day will soon come when women in Ireland will be able to access the health services they need in our own country, where we can be with our loved ones, with our own medical team, and where we have our own familiar bed to go home and cry in. Subjecting women to so much additional pain and trauma simply must not continue.”

 As well as confronting the shame and stigma associated with the criminalisation of abortion, Mellet’s suffering was made worse by the difficulties she faced in getting information about how to access an abortion, the committee said. Ireland’s Abortion Information Act allows healthcare providers to give patients information about the circumstances when abortion services can be available in Ireland or abroad, but the law prohibits them from saying anything that could be interpreted as promoting abortion.

 The ruling said Ireland needed to take measures to ensure that healthcare providers are able to supply full information on safe abortion services “without fearing being subjected to criminal sanctions”, the committee said.

 Abortion is permitted in Ireland only when there is a risk to the life of a pregnant woman. In every other circumstance it is a serious crime. Since 1983, the Irish constitution has placed the “right to life of the unborn” on an equal footing with the right to life of the pregnant woman.

 Ireland’s health minister, Simon Harris, said he had read the committee’s report and found “the experience this woman had deeply upsetting. I have met with families who have been through the trauma of knowing their baby will not survive and I have been very moved by hearing of their experiences. I want to see this issue addressed”.

 Hoctor said: “When a woman is denied the right to make decisions about her pregnancy, her health and wellbeing are jeopardised. In recognising that by outlawing abortion Ireland violated the human rights of Amanda Mellet and caused her intense anguish and distress, the committee has issued a landmark ruling confirming that Ireland’s abortion laws are cruel and inhumane, and violate women’s human rights.

 “The Irish government must now comply with this ruling, redress the harm Ms Mellet suffered and reform its laws to ensure other women do not continue to face similar violations.”

 Colm O’Gorman, the executive director of Amnesty International Ireland, said: “The Irish government must act promptly. Ireland’s constitution is no excuse. It must be changed to allow the reforms required by this ruling.” |||||

– The UN's human rights committee says Ireland's effective ban on abortion violated a woman's human rights and must be reformed in what the Guardian calls "a ground-breaking judgment that is expected to set an international precedent." The committee responded to the case of Amanda Mellet, who was denied an abortion during her 21st week of pregnancy in 2011—though doctors said her fetus had a heart defect and would die in the womb or shortly after birth—as a law makes abortion illegal unless a woman's life is at risk, per Reuters. Rather than continue with the pregnancy, Mellet traveled to the UK for an abortion, alone and at her own expense, and returned home 12 hours later, though she wasn't fully recovered, because she couldn't afford to stay longer. The committee says that amounted to cruel and inhumane treatment. "Many of the negative experiences she went through could have been avoided if [she] had not been prohibited from terminating her pregnancy in the familiar environment of her own country," the committee says, calling on Ireland to allow "effective, timely, and accessible procedures for pregnancy termination." Though "the report carries no legal power," per the AP, Ireland must compensate Mellet and move to prevent similar cases under the International Covenant on Civil and Political Rights, per the Guardian. Ireland's government has suggested it won't address the laws directly as a result of the decision—which has infuriated anti-abortion activists, per RTE News—but will ask a citizens' assembly to recommend changes.


Write an article based on this summary:

– One of the reporters who tangles publicly with President Trump the most is himself in a bit of hot water over a tweet. Jim Acosta of CNN has apologized after tweeting "f--- you" (except he spelled it out) to a critic, reports Mediaite. Acosta also maintains that he mistook the person as an old friend, but not everyone is buying that. It all started Thursday night when Acosta tweeted a complaint that the Trump campaign turned up the music so loudly at a Trump rally that it was difficult to work—the implication being that it was deliberate. At that point, a former aide for Melania Trump, Justin Caporale, mocked Acosta with a tweet reading, "Dear Diary ..." That's when Acosta sent his controversial response—he did so in a private direct message, but Caporale then made it public. Acosta also blocked Caporale. As online criticism grew, and Caporale demanded an apology, Acosta responded: "Hey buddy I thought you were an old friend from the campaign days. I’m so sorry. Hope I didn’t offend you. Have a good night and take care." As the Wrap notes, the apology seems a bit odd given that Acosta also blocked Caporale, raising the question of why he would block a friend. Neither Acosta nor CNN has commented further. (Acosta also once tangled memorably with White House aide Stephen Miller.)

Tonight the Trump campaign/WH turned up the music so loud the press risers were vibrating. Nearly impossible to do live TV. I suppose the WH loves those kinds of shenanigans. But I wonder if it’s a security concern for USSS or local law enforcement. They can’t hear either. ||||| CNN White House correspondent Jim Acosta apologized on Friday for saying “F– You” to a Twitter user in a direct message. In a tweet, Acosta said he had confused the person for an old friend.

 “Hey buddy I thought you were an old friend from the campaign days. I’m so sorry. Hope I didn’t offend you. Have a good night and take care,” he said.

 Hey buddy I thought you were an old friend from the campaign days. I’m so sorry. Hope I didn’t offend you. Have a good night and take care. https://t.co/4u9fj1BNPI — Jim Acosta (@Acosta) October 19, 2018

 Also Read: Jim Acosta to Haters: 'I'm Allowed to Care About This Country' (Video)

 The imbroglio began after Justin Caporale, a GOP consultant and former aide to first lady Melania Trump, attempted to troll Acosta after the CNN reporter complained about loud music at a Trump campaign rally he was covering.

 “Tonight the Trump campaign/WH turned up the music so loud the press risers were vibrating,” said Acosta. “Nearly impossible to do live TV. I suppose the WH loves those kinds of shenanigans. But I wonder if it’s a security concern for USSS or local law enforcement. They can’t hear either.”

 “Dear Diary…..” mocked Caporale.

 Dear Diary….. — justin (@justincap_) October 19, 2018

 That resulted in Acosta sending Caporale a private direct message with a blunt two word rejoinder before subsequently blocking him. Daily Caller reporter Peter Hasson, who was allowed access into Caporale’s Twitter account, confirmed that the message was real and offered by Acosta unsolicited.

 And then he blocked me. pic.twitter.com/F5cq84LAF8 — justin (@justincap_) October 19, 2018

 It’s unclear why Acosta would move to immediately block someone he thought was an “old friend.” Acosta did not immediately respond to request for comment from TheWrap. Reps for CNN declined to comment. Reached by phone, Caporale also declined to comment.

 Acosta has long been a lightning rod among Trump-die hards and a frequent jousting partner for the president at press events. Trump has disparaged him to his face on live television as fake news. When Sarah Sanders held more regular press briefings, her sharp exchanges with the CNN reporter also frequently made headlines. ||||| Focused crawls are collections of frequently-updated webcrawl data from narrow (as opposed to broad or wide) web crawls, often focused on a single domain or subdomain. ||||| Tweet with a location

 You can add location information to your Tweets, such as your city or precise location, from the web and via third-party applications. You always have the option to delete your Tweet location history. Learn more ||||| A direct message sent by CNN Chief White House correspondent Jim Acosta was widely mocked by conservatives late Thursday night.

 It all began with a tweet Acosta made from President Donald Trump‘s rally in Missoula, Montana.

 Tonight the Trump campaign/WH turned up the music so loud the press risers were vibrating. Nearly impossible to do live TV. I suppose the WH loves those kinds of shenanigans. But I wonder if it’s a security concern for USSS or local law enforcement. They can’t hear either. — Jim Acosta (@Acosta) October 19, 2018

 And Justin Caporale — identified as the former director of operations for Melania Trump — trolled him with the following response:

 Dear Diary….. — justin (@justincap_) October 19, 2018

 Well, that apparently got under Acosta’s skin since Justin followed up the tweet with a screenshot from his DMs.

 “F**k you,” Acosta told Justin.

 Peter Hasson verified that the DM was real.

 Can confirm that this is a real message: https://t.co/MNHvM5xDcJ — Peter J. Hasson (@peterjhasson) October 19, 2018

 .@justincap_ allowed me to log into his account and view the message. Here’s a screenshot I took pic.twitter.com/r4F6EpbQAH — Peter J. Hasson (@peterjhasson) October 19, 2018

 And conservatives had some fun at the expense of the CNN journalist.

 Jim: Coke please. Waiter: Is Pepsi okay? Jim: pic.twitter.com/KYWUmCFp2C — Matt’s Idea Shop (@MattsIdeaShop) October 19, 2018

 UPDATE (2:15AM): Acosta offered this apology to Justin, telling him he thought he was an “old friend from the campaign days.”

 Hey buddy I thought you were an old friend from the campaign days. I’m so sorry. Hope I didn’t offend you. Have a good night and take care. https://t.co/4u9fj1BNPI — Jim Acosta (@Acosta) October 19, 2018

 [image via screengrab]

 Have a tip we should know? tips@mediaite.com |||||


Article:
CLOSE Casual-dining restaurants have struggled as more customers have gravitated toward quick-service restaurants like Panera Bread or Chipotle Mexican Grill. USA TODAY

 There are plans to shutter up to 160 Applebee's and IHOP locations, according to parent DineEquity. (Photo: Andrew Burton, Getty Images)

 The parent company of Applebee's and IHOP plans to close up to 160 restaurants, vastly boosting the number of eateries from the two comfort-food chains that it plans to shutter.

 Some 105 to 135 Applebee's restaurants will close, up from the 40 to 60 that parent DineEquity said would close in the first quarter. Also on the chopping block are an estimated 20 to 25 IHOP sites, up from about 18.

 At the same time, the two chains now will open 125 restaurants globally between them in new locations, DineEquity said.

 The casual-dining segment, where both chains are positioned, is experiencing increased troubles as more customers have gravitated to the quick-service restaurants like Panera Bread or Chipotle Mexican Grill, many of which market themselves as offering healthier and more upscale food.

 Analysts say Applebee’s, in particular, has had a hard time.

 Applebee’s "remains out-of-favor with casual-dining consumers....Sister concept IHOP may be feeling the effects of DineEquity’s struggles as well," said Instinet analyst Mark Kalinowski in a report released Friday.

 But DineEquity officials say the painful job of closing restaurants will help in the long run.

 "We are investing in the empowerment of our brands by improving overall franchisee financial health, closing underperforming restaurants and enhancing the supply chain," interim CEO Richard Dahl said in a statement.

 He said Applebee's is in the middle if a "transitional year" and is "making the necessary investments for overall long-term brand health."

 The company declined to release a list of locations that will be shuttered.

 DineEquity reported net income of $20.9 million, or $1.18 a share, in the second quarter, a drop from $26.4 million, or $1.45 a share, compared to the same quarter last year.

 Applebee's domestic system-wide comparable same-restaurant sales declined 6.2% in the second quarter of 2017, while IHOP's declined 2.6% during the same period, according to the company.

 "IHOP remains on solid ground, despite soft sales this quarter. I am optimistic about the growth in both effective franchise restaurants and systemwide sales," Dahl said.

 DineEquity reiterated its plan to open 20 to 30 Applebee’s, mostly abroad, and revised its plan to open 80 to 95 IHOP restaurants, mostly in the U.S. That's up from the 75 to 90 restaurants globally that it announced previously.

 "Restaurant closures are a normal course of business in the industry and when you have a footprint as large as ours," Amy Mason, senior vice president for global communications and consumer insights, said. "They are either older locations in a lapsed trade area, where once vibrant retail, residential and traffic characteristics are no longer present; others are closed when they are underperforming with unsustainable economics. Closing these well-below average restaurants can have a positive brand benefit since guests are no longer experiencing a substandard experience."

 On Thursday, the company also named Stephen Joyce, former CEO of Choice Hotels, as its new CEO. He replaces Julia Stewart, who resigned in February; she was at the helm when Applebee's as acquired in 2007.

 DineEquity CFO Thomas Emrey resigned in March and no permanent replacement has been named.

 The Glendale, Calif.-based company has 3,700-plus restaurants in 19 countries.

 DineEquity stock was trading at $38.7, up $1.42 or 3.81%, in mid-afternoon trading.

 Related:

 Follow USA TODAY reporter Zlati Meyer on Twitter: @ZlatiMeyer

 Read or Share this story: https://usat.ly/2wMoRw5 ||||| On the IHOP side, DineEquity said closures could range between 20 and 25 restaurants, while the company expects to open 80 to 95 new locations, most of which will be in the U.S. That could mean 75 net openings for the chain. |||||Summary:

– Fans of IHOP and Applebee's, take note: It's possible your hometown location will be closing, though it's also possible one will opening there soon. Parent company DineEquity announced a plan to close as many as 160 of the restaurants and to open up to 125 new ones, reports USA Today. The problem is that the company hasn't decided specifics yet in regard to locations. A safe bet when all is said and done: It will be harder to find an Applebee's in the US but easier to find an IHOP. The Los Angeles Times provides more details on that front: 105 to 135 Applebee's restaurants will close, and while that will be offset slightly by 20 to 30 openings, most of those openings will be outside the US. As for IHOP, 20 to 25 restaurants will close, but 80 to 95 will open, mostly in the US. DineEquity operates 1,968 Applebee's locations worldwide and 1,752 IHOP sites.


Walmart and other retailers pulled a home decoration poster of Nazi Germany's notorious Dachau concentration camp sign.

 A phrase on the gate in German states "Arbeit macht frei," which roughly translates to "work makes you free."

 Walmart, Sears and Amazon pulled the item from its website over the weekend, as first reported by Digiday.com

 Walmart apologized for the photo of a gate at Dachau, which held Jewish prisoners during World War II. The item was sold by one of the company's online marketplace sellers and not directly by Walmart.

 “We were horrified to see that this item was on our site. We sincerely apologize, and worked quickly to remove it," a statement from Walmart read. "The item was sold through a third-party seller on our marketplace. We have shared our disappointment with them and have learned they are removing the publisher of this item entirely from inventory.”

 American Apparel Apologizes After Mistakenly Posting Challenger Photo

 Sears pulled the poster from its website, though a description remained that called the poster a "generic Gate with inscription Arbeit Macht Frei, Dachau Concentration Camp, Dachau, Upper Bavaria, Bavaria, Germany Poster Print by Pa."

 It was not immediately known who created and marketed the poster.

 Amazon did not immediately respond to ABC News' requests for comment.

 Sears said this in a statement: "The item, which was listed by an independent third-party on Sears Marketplace, violates our guidelines and was immediately removed." ||||| Walmart, Amazon and Sears came under social media fire from shoppers over the holiday weekend for selling a commemorative poster featuring a photo of one of Nazi Germany’s concentration camps.

 Online shoppers were horrified to learn that an image from Dachau’s main gate was being sold as a piece of home decor. The offending item was listed on the Walmart page with the description: “Gate with inscription Arbeit Macht Frei, Dachau Concentration Camp, Dachau.” Walmart also promised that the poster “would make a great addition to your home or office.”

 The slogan “Arbeit macht frei” is a sinister German expression favored by Nazis that translates to “work makes you free.”

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 The image shocked many and galvanized members of the Facebook group Grandchildren of Holocaust Survivors to complain.

 Walmart, for its part, pulled the item and issued an apology and explanation: “We were horrified to see that this item was on our site. We sincerely apologize, and worked quickly to remove it. The item was sold through a third-party seller on our marketplace. We have shared our disappointment with them and have learned they are removing the publisher of this item entirely from inventory.”

 The sign was similarly pulled from Amazon and Sears. Although Baltimore-based writer Jennifer Mendelsohn tweeted a screengrab of the Sears listing that, even more shockingly, came with a list of “similar items” to the sign, including double wall ovens.

 Perhaps the only thing worse than @sears selling a Dachau sign? Check out the similar products. I can’t even. pic.twitter.com/16aiJiHxMm — Jennifer Mendelsohn (@CleverTitleTK) July 6, 2014

 Ovens were, of course, notoriously used to cremate the remains of thousands of slaughtered concentration camp prisoners at Dachau and elsewhere during World War II. While Sears has pulled the offending sign, it still sells more generic signs to the city of Dachau that also include ovens as “similar items” in the product lising.

 “The item, which was listed by an independent third-party on Sears Marketplace, violates our guidelines and was immediately removed,” a spokesman for the company wrote in an email to Digiday.

 “Regarding the placement of the Sears products at the bottom of the Web page, those are special sale items that currently appear on millions of product pages. While clearly unintentional, we sincerely apologize for the proximity of the positioning.”

 Retailers have been forced to walk an increasingly fine line when it comes to the selling of Nazi-related paraphernalia. Last year eBay came under fierce criticism after it was revealed to be profiting from the trade in Holocaust memorabilia, including the clothes of concentration camp victims.

 The online auction house pulled the items after stoking international outrage, and ultimately refined and re-articulated its policies regarding the sale of World War II and other potentially offensive memorabilia.

 For its part, Amazon sells the Adolf Hitler memoir “Mein Kampf,” which is arguably a historical document. More troubling, though, is that it also allows for the sale of Holocaust denial literature like “Did Six Million Really Die? The Truth At Last.” |||||

Write a summary.

– A decorative poster that would supposedly "make a great addition to your home or office" according to its online listing was quickly pulled from sale by Walmart and other retailers over the weekend after customers pointed out that it featured the front gate of a Nazi concentration camp. Walmart says the poster, featuring the main gate of the Dachau camp with the slogan "Arbeit Macht Frei"—"Work Makes You Free"—was being sold online by one of its third-party sellers. It was "horrified to see that this item was on our site," the company said in a statement, per ABC News. "We have shared our disappointment with them and have learned they are removing the publisher of this item entirely from inventory," Walmart said, though the name of the seller was not disclosed. Sears and Amazon also removed the poster from sale. One Sears customer was shocked to see that a list of "similar products" to the concentration camp poster included double wall ovens, Digiday finds. How Sears explained that one: "Those are special sale items that currently appear on millions of product pages. While clearly unintentional, we sincerely apologize for the proximity of the positioning." (Click to read about another Walmart headache.)


Write an article based on this summary:

– Kim Kardashian is "badly shaken but physically unharmed" after being held up by robbers disguised as police officers Sunday night, a spokesperson says. Police in Paris are searching for the robbers, who tied up Kardashian and locked her in the bathroom of a private residence, not a hotel room as initially reported, per the Guardian. Officials tell the AP that five attackers overpowered the building's concierge and two of them entered the apartment. They stole a jewelry box containing valuables worth $6.7 million and a ring worth $4.5 million, police say. Sources tell People that Kardashian's two children, 3-year-old daughter North and 10-month-old son Saint, were not present during the robbery. Police say that after the incident, Kardashian's family was placed under police protection at a Paris hotel. Kanye West abruptly ended his Sunday night concert at the Meadows Festival in New York after learning that his wife had been robbed. CNN reports that he left the stage mid-song after somebody ran on stage to talk to him. He told fans: "I'm sorry, I'm sorry. Family emergency, I have to stop the show."

Millions of pounds worth of jewellery stolen after incident at private residence involving five armed, masked men

 Kim Kardashian robbed at gunpoint by men disguised as police in Paris

 Kim Kardashian West has been robbed at gunpoint in a private residence in Paris by assailants disguised as police who made off with millions of pounds worth of jewellery.

 A spokeswoman for the reality TV star said she was “badly shaken but physically unharmed” after they tied her up in the flat’s bathroom before fleeing the scene.

 Kim Kardashian West's gunpoint robbery sparks manhunt in Paris Read more

 A Paris police official told the Associated Press that five armed men, who were still at large, stole a jewellery box containing valuables worth €6m (£5.2m) as well as a ring worth €4m, and mobile telephones. Police said the robbers escaped on bicycles.

 French media reported that the men, who had masks and were wearing fake police armbands, arrived at about 3am on Monday and threatened the concierge at the building in rue Tronchet, near the Madeleine church and not far from the Elysée Palace, the British embassy and the designer shops of rue du Faubourg-Saint Honoré.

 The robbers handcuffed the concierge before ordering him to show them where Kardashian West was staying. After forcing their way into the apartment they tied her up and locked her in the bathroom.

 “The haul amounts to several million euros, most of which is jewellery. We’re still trying to establish the exact amount stolen,” a police source told Agence France-Presse. He added that Kardashian West had flown out of France on Monday morning after giving a statement to police.

 The 35-year-old had been in Paris since last week for fashion week and had attended the Balenciaga show earlier on Sunday.

 Kim Kardashian West (@KimKardashian) Balenciaga. No make up today. pic.twitter.com/l2WknhHoiy

 The reality star sat in the front row at the Givenchy show, with her sister Kourtney and their mother, Kris Jenner, in a show of support for their sister, Kendall Jenner, who was modelling in the presentation.

 The family has been uncharacteristically silent on social media since the report involving Kardashian West.

 Her husband, Kanye West, had abruptly ended his performance at the Meadows music and arts festival at Citi Field in New York on Sunday night. He stopped midway through his performance of Heartless, citing a “family emergency”.

 This was confirmed by the Meadows on Twitter.

 The Meadows NYC (@themeadowsnyc) Due to an emergency, Kanye West had to end his performance early. Please get home safely.

 Kardashian West is a prolific user of Twitter and Snapchat but, at the time of writing, she had not posted about the incident on social media.

 However, her name was trending on Twitter and Facebook as the report of the robbery spread, with many initially casting doubt on the story.

 The Carpool Karaoke host, James Corden, reminded those making fun of the reality star that she was a “mother, a daughter, a wife, a friend”.

 James Corden (@JKCorden) People making jokes about @KimKardashian tonight would do well to remember that she's a mother,a daughter,a wife,a friend.Be nice or shut up

 In a separate incident in Paris on Wednesday, Kardashian West was rushed by a man while getting out of her vehicle, prompting her security team to step in.

 Vitalii Sediuk, a self-described “entertainment Hollywood reporter” from Ukraine, had attempted to grab the model Gigi Hadid in Milan days earlier.

 Kardashian West tweeted after the incident: “My security [Pascal Duvier] is a G.”

 On Sunday, before the incident reportedly took place, she had joked about Duvier crashing her paparazzi shots.

 Kim Kardashian West (@KimKardashian) This guy is always in my shot! pic.twitter.com/7LC6ewaYPO

 The private apartment where Kardashian West was staying, in a residence called the Hôtel de Pourtalès, was built in 1838 and is now a listed building. Its luxury apartments, in the chic 8th arrondissement of Paris, are popular with the wealthy and famous; past guests include Leonardo DiCaprio, Madonna, Prince and Russian oligarch Roman Abramovich.

 Kardashian West and her husband are frequent visitors to Paris. In May 2014 they celebrated their marriage with several hundred guests at the Château de Versailles.

 France has experienced some spectacular jewellery heists in recent years. In the biggest, items worth €103m were stolen from the Carlton hotel in Cannes in July 2013.

 Nathalie Kosciusko-Morizet, leader of the opposition Les Républicains party in city hall, said the capital’s Socialist administration was to blame for the Kardashian West attack.

 “There’s a great urgency over crime in Paris. You can do all the publicity you want around ‘I love Paris’ … but it’s all been brutally overshadowed by the Kim Kardashian affair that is on a loop on the news,” Kosciusko-Morizet told Europe 1 radio.

 Condemning the attack and vowing that the perpetrators would soon be traced, Anne Hidalgo, the mayor of Paris, also hit back at those who were using the incident to “create controversy” for political ends.

 “This very rare incident, which took place in a private space, does not in any way call into question the work of police officers and security officers of Paris’s public places,” she said.

 Calling on politicians from all sides “to act responsibly” in the period ahead of France’s presidential election next year, she said that as Paris continued to struggle to recover from last year’s terrorist attacks such criticism was unhelpful.

 “When everyone’s priority should be to boost the number of people coming [to Paris], using this incident to create controversy would directly hit the tourism sector and its 500,000 employees in the Île-de-France region [around the capital].” ||||| Story highlights A ring worth $4.5 million and jewelry box worth $5.5 million were stolen

 Kardashian West bound and gagged during an incident in Paris with a gun to her head

 New York (CNN) Reality TV star Kim Kardashian West has reunited with her husband and children in New York after a harrowing incident in Paris where she was held at gunpoint and robbed by men dressed as police officers in a private apartment.

 A spokeswoman for Kardashian West said the celebrity was "badly shaken but physically unharmed" following the incident, which took place early Monday morning local time.

 CNN Map

 Kardashian was staying at an apartment inside a luxury private mansion that can be rented out for days or weeks at a time.

 The French Interior Ministry said five men threatened the mansion concierge with a weapon, handcuffed him and forced him to open the private apartment.

 Two of the men were able to gain entry to Kardashian West's room, according to the Paris prosecutor's office, and a gun was held to her head. ||||| FILE - In this June 24, 2015, file photo, Kim Kardashian poses during a photo call at the Cannes Lions 2015. A spokeswoman for Kardashian West says she was held up at gunpoint inside her Paris hotel room... (Associated Press)

 FILE - In this June 24, 2015, file photo, Kim Kardashian poses during a photo call at the Cannes Lions 2015. A spokeswoman for Kardashian West says she was held up at gunpoint inside her Paris hotel room... (Associated Press)

 PARIS (AP) — Kim Kardashian West was unharmed after being robbed at gunpoint of more than $10 million worth of jewelry inside a private Paris residence Sunday night, police officials said.

 A spokeswoman for Kardashian West said the reality TV star, who was in Paris attending fashion week shows, was "badly shaken but physically unharmed" after masked men dressed as police officers also tied her up in the flat's bathroom before fleeing the scene.

 A Paris police official said five assailants, who were still at large, stole a jewelry box containing valuables worth 6 million euros ($6.7 million) as well as a ring worth 4 million euros.

 In a message to The Associated Press, the Paris prosecutors' office said that only two of the five suspects forced their way into the apartment, located in the chic eighth district of the French capital.

 With France under a state of emergency following terror attacks that left more than 200 people dead in the last 20 months, news of the robbery immediately sparked criticism from political opponents to the Socialist government.

 Nathalie Kosciusko-Morizet, a right-wing member of Paris council and a potential candidate in next year's presidential election, said the robbery was proof that "there is a general emergency on security" in the French capital.

 "Regardless of all the very expensive advertising we do to promote 'I Love Paris,' tourism and the image of Paris, all these ads have been brutally canceled by the Kim Kardashian case," Kosciusko-Morizet told Europe 1 radio.

 Two police officials said the robbers tied up Kardashian West and locked her in the bathroom before escaping on bikes. They were not authorized to be publicly named speaking about ongoing investigations.

 Kanye West was performing at the Meadows Music and Arts Festival in New York at the time. He abruptly ended his set Sunday night after telling his fans had a family emergency.

 "I'm sorry, family emergency I have to stop the show," West told the audience.

 Kardashian West was also ambushed last week by a serial celebrity accoster who attempted to assault her as she was entering a restaurant. She was also attacked outside of a Paris fashion week show in 2014. She wasn't hurt in either incident.

 Paris has been a special place for Kardashian West and her husband, who spent the weekend there before marrying in Florence in May of 2014.

 Kardashian West was staying in a residence near Paris' Madeleine church. Police said the thieves entered the building after the concierge let them in. Handcuffed and at gunpoint, he then led them to the starlet's flat.

 It's unclear whether the couple's two children, 3-year-old daughter North and 10-month-old son Saint, were with Kardashian West when the robbery happened. Police said the actress' family was placed under police protection at the George V hotel after the incident.

 ___

 AP entertainment writer Sandy Cohen in Los Angeles and Samuel Petrequin in Paris contributed to this story. |||||


– Scientists have been concerned for some time about "Phantom Menace"-type superbugs that aren't fazed by meds. The latest CDC data finds that 2 million people a year in the US are infected with bacteria resistant to antibiotics, and at least 23,000 die directly from those infections. And a new report from the CDC and the Pew Charitable Trusts—the first research to quantify this issue, per the Washington Post—isn't encouraging. A study published Tuesday in JAMA finds nearly one in three antibiotic prescriptions (around 47 million per year) are given needlessly to people with viruses such as bronchitis and the common cold, as well as for ear and sinus infections and sore throats not caused by bacterial infections—meaning the Rx not only won't vanquish their illness, but can potentially build up antibiotic resistance, the St. Louis Post-Dispatch reports. Besides the drug resistance, overuse can up the risk for drug allergies and even an unpleasant-sounding diarrhea that can be fatal. The researchers analyzed 184,032 outpatient visits to ERs and medical clinics in 2010 and 2011 and found that 12.6% walked out with an antibiotic script, per the Pharmacy Times. Out of an estimated annual antibiotic-prescription rate of 506 per every 1,000 people, only about 353 of those who received prescriptions should likely have received them. The Times notes President Obama's initiative to cut down on unnecessary outpatient antibiotic use by 50% by 2020; researchers say that, based on this study, we'll need to slash overall antibiotic use by 15% to meet that. "If we continue down the road of inappropriate use we'll lose the most powerful tool we have to fight life-threatening infections," CDC Director Tom Frieden says. "Losing these antibiotics would undermine our ability to treat patients with deadly infections [and] cancer, provide organ transplants, and save victims of burns and trauma." (Here's hoping teixobactin can help us out with superbugs.)

Expand this summary.

Importance The National Action Plan for Combating Antibiotic-Resistant Bacteria set a goal of reducing inappropriate outpatient antibiotic use by 50% by 2020, but the extent of inappropriate outpatient antibiotic use is unknown.

 Objective To estimate the rates of outpatient oral antibiotic prescribing by age and diagnosis, and the estimated portions of antibiotic use that may be inappropriate in adults and children in the United States.

 Design, Setting, and Participants Using the 2010-2011 National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey, annual numbers and population-adjusted rates with 95% confidence intervals of ambulatory visits with oral antibiotic prescriptions by age, region, and diagnosis in the United States were estimated.

 Exposures Ambulatory care visits.

 Main Outcomes and Measures Based on national guidelines and regional variation in prescribing, diagnosis-specific prevalence and rates of total and appropriate antibiotic prescriptions were determined. These rates were combined to calculate an estimate of the appropriate annual rate of antibiotic prescriptions per 1000 population.

 Results Of the 184 032 sampled visits, 12.6% of visits (95% CI, 12.0%-13.3%) resulted in antibiotic prescriptions. Sinusitis was the single diagnosis associated with the most antibiotic prescriptions per 1000 population (56 antibiotic prescriptions [95% CI, 48-64]), followed by suppurative otitis media (47 antibiotic prescriptions [95% CI, 41-54]), and pharyngitis (43 antibiotic prescriptions [95% CI, 38-49]). Collectively, acute respiratory conditions per 1000 population led to 221 antibiotic prescriptions (95% CI, 198-245) annually, but only 111 antibiotic prescriptions were estimated to be appropriate for these conditions. Per 1000 population, among all conditions and ages combined in 2010-2011, an estimated 506 antibiotic prescriptions (95% CI, 458-554) were written annually, and, of these, 353 antibiotic prescriptions were estimated to be appropriate antibiotic prescriptions.

 Conclusions and Relevance In the United States in 2010-2011, there was an estimated annual antibiotic prescription rate per 1000 population of 506, but only an estimated 353 antibiotic prescriptions were likely appropriate, supporting the need for establishing a goal for outpatient antibiotic stewardship. ||||| MAY 02, 2016

 Allison Gilchrist, Associate Editor

 About 30% of all outpatient oral antibiotic prescriptions written in the United States are inappropriate, a new CDC study suggests.CDC researchers used data from the 2010-2011 National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey to determine the rates of outpatient oral antibiotic prescribing by patient age and diagnosis, as well as the estimated amount of antibiotic use that could be considered inappropriate.Of the 184,032 outpatient visits included in the data, 12.6% resulted in an antibiotic prescription. The researchers estimated that 353 of the 506 antibiotic prescriptions written annually per 1000 population were appropriate.Broken down further, the data revealed that sinusitis diagnoses resulted in the most antibiotic prescriptions per 1000 population (56), followed by ear infections (47), and pharyngitis (43).“Half of antibiotic prescriptions for acute respiratory conditions may have been unnecessary, representing 34 million antibiotic prescriptions annually,” the researchers wrote. “Collectively across all conditions, an estimated 30% of outpatient oral antibiotic prescriptions may have been inappropriate.”Last fall, the President signed an Executive Order on “detecting, preventing, and controlling antibiotic-resistant microbes” as part of the White House’s 5-year National Action Plan for Combating Antibiotic-Resistant Bacteria, which aims to reduce inappropriate antibiotic use in outpatient settings by 50% by 2020. Based on the current study results, a 15% reduction in overall antibiotic use would be necessary in order to meet that goal, the researchers noted.Because antibiotic overprescribing contributes to drug resistance, curbing the practice is a major public health care priority. Failure to do so could have grim consequences, as the CDC already estimates that 2 million individuals are infected with antibiotic-resistant bacteria each year in the United States, and 23,000 of them die from these infections annually.In one of the more notorious examples , UCLA Health indicated that 179 patients might have been infected with “ superbug ” carbapenem-resistant Enterobacteriaceae at the Ronald Reagan UCLA Medical Center during “complex endoscopic procedures that took place between October 2014 and January 2015.”“Health professionals generally know when antibiotics are and are not needed,” lead study author Katherine Fleming-Dutra, MD, a medical epidemiologist with the CDC’s Office of Antibiotic Stewardship, explained to Pharmacy Times. “Often, clinicians are worried about patient satisfaction. They think that a patient wants antibiotics…sometimes leading them to prescribe when they shouldn’t.”Pharmacists can help prevent this by providing patients with information about the potential consequences of unnecessary antibiotic use.“Pharmacists are the last health professional to see a patient when an antibiotic is prescribed,” Dr. Fleming-Dutra said. “When dispensing antibiotics, pharmacists can educate patients about properly taking antibiotics and about potential harms from antibiotics such as allergies, adverse events, and antibiotic resistance.”Beyond treating infections, other studies have found that as many as 1 in 10 health care providers prescribe antibiotics for almost every patient they see with a cold or bronchitis, despite the fact that antibiotics aren’t effective against viral infections.“It is important for all health professionals in all regions seeing patients of all ages to only prescribe antibiotics when they are needed, and if needed, select the right antibiotic at the right dose for the right duration,” Dr. Fleming-Dutra advised.The current study results appeared in the May 3, 2016, edition of JAMA. ||||| WASHINGTON—The Pew Charitable Trusts and the Centers for Disease Control and Prevention (CDC) released today a first-of-its kind analysis of antibiotic use in doctors’ offices, emergency rooms, and hospital-based clinics in the United States. The analysis, conducted in partnership with a panel of leading antibiotic use experts, identifies acute respiratory conditions as key drivers of antibiotic overuse in human health care and establishes data-driven targets for eliminating the approximately 47 million unnecessary antibiotic prescriptions issued in outpatient facilities across the country every year.

 The findings are outlined in two documents released today: Pew’s report “Antibiotic Use in Outpatient Settings” and “Prevalence of Inappropriate Antibiotic Prescriptions Among U.S. Ambulatory Care Visits, 2010-2011,” an article authored by experts from Pew, CDC, and members of the panel, appearing in the current issue of the Journal of the American Medical Association. They outline the baseline analysis and condition-specific targets, as well as practical strategies to improve prescribing.

 “This report provides the most in-depth picture to date of outpatient antibiotic prescriptions in the U.S. and will serve as a benchmark in measuring progress moving forward,” said David Hyun, M.D., a senior officer with Pew’s antibiotic resistance project, who focuses on research and policy development pertaining to the stewardship of antibiotics in health care settings. “While our estimates of unnecessary antibiotic use are conservative, it is clear that a small number of health conditions constitute the lion’s share of unwarranted antibiotic prescriptions in this country. These detailed data will help health care providers target stewardship efforts where they can do the most good.”

 At least 30 percent of antibiotics prescribed in outpatient settings in the United States are unnecessary, according to the report. The majority are prescribed for acute respiratory conditions such as colds, sore throats, bronchitis, flu, and other viral illnesses that do not respond to antibiotics.

 “The more antibiotics are used, the less effective they become. Reducing the needless use of antibiotics will slow the emergence of antibiotic-resistant microbes, so-called superbugs, which are among the most urgent public health threats of our time,” said Kathy Talkington, director of Pew’s antibiotic resistance project. “Patients and health care providers must work together to understand when antibiotics will help and when they won’t, and help preserve these lifesaving drugs for patients who really need them.”

 Antibiotic use in outpatient settings represents the majority of dollars spent on antibiotics for human health care in the United States, and outpatient providers are often the first place patients go for health care when suffering from a cold, flu, sore throat, or other common condition for which antibiotics are often unnecessarily prescribed.

 The analysis concludes that:

 Approximately 13 percent of all outpatient office visits in the United States, or about 154 million visits annually, result in an antibiotic prescription; about 30 percent of these prescriptions are unnecessary.

 Forty-four percent of outpatient antibiotic prescriptions are written to treat patients with acute respiratory conditions, such as sinus infections, middle ear infections, pharyngitis, viral upper respiratory infections (i.e., the common cold), bronchitis, bronchiolitis, asthma, allergies, influenza, and pneumonia. Half of these prescriptions are unnecessary.

 In 2015, the White House released a national action plan for combating antibiotic resistance, which included the goal of reducing inappropriate outpatient antibiotic use by 50 percent by 2020. Based on the panel’s estimate of unnecessary prescribing, this goal would be reached by reducing outpatient antibiotic use by 15 percent overall, which would result in approximately 23 million fewer antibiotics prescribed annually by 2020.

 The panel outlined actions that health care providers, patients, and the health care industry as a whole can take to reach the targets, including:

 Individual outpatient health care providers can evaluate their own prescribing habits as well as implement stewardship activities in their practices.

 Health systems can provide expertise and resources to offices within their network to aid in stewardship implementation.

 Health plans can assist in data collection and analysis—evaluating the antibiotic prescribing habits of their providers and providing feedback that highlights potential areas for improvement.

 State and local health agencies can help provide outpatient facilities with information on best practices for implementing antibiotic stewardship programs, and help develop regional partnerships between various health care stakeholders, such as providers, health plans, and health systems, in order to better coordinate stewardship activities.

 Federal agencies can track antibiotic prescribing at the national level, identifying areas for further improvement and providing technical assistance to stakeholders interested in implementing stewardship efforts of their own.

 Organizations such as the National Committee for Quality Assurance that develop standards to assess the quality of health care services can establish metrics to assess the antibiotic prescribing habits of health care providers.

 Health care professional societies can provide expert guidance to their members on appropriate antibiotic prescribing and incorporating diagnostics to aid in prescribing decision-making.

 “Prescribing unnecessary antibiotics is just one element of inappropriate use of antibiotics,” said Lauri Hicks, D.O., director of the CDC’s Office of Antibiotic Stewardship in the Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases. “Health care providers can also prescribe antibiotics at the wrong dose or for the wrong duration, amplifying the extent of inappropriate use. Setting a national target to reduce unnecessary antibiotic use is the first step, and we must work together across the health care continuum to reach this goal.”

 Pew, CDC, and the expert panel are preparing a similar report on inpatient antibiotic prescribing. It will set national targets for reducing unnecessary use in hospitals and will be released in 2017.

 The Pew Charitable Trusts is driven by the power of knowledge to solve today’s most challenging problems. Learn more at www.pewtrusts.org. ||||| Antibiotic resistance is one of the biggest public health challenges of our time. In 2013, CDC published a comprehensive analysis outlining the top 18 antibiotic-resistant threats in the U.S., titled Antibiotic Resistance Threats in the United States, 2013 (AR Threats Report). The report sounded the alarm to the danger of antibiotic resistance, stating that each year in the U.S., at least 2 million people get an antibiotic-resistant infection, and at least 23,000 people die.

 The report ranked the 18 threats (bacteria and fungi) into three categories based on level of concern to human health—urgent, serious, and concerning—and identified:

 Minimum estimates of morbidity and mortality from antibiotic-resistant infections

 People at especially high risk

 Gaps in knowledge about antibiotic resistance

 Core actions to prevent infections caused by antibiotic-resistant bacteria, and slow spread of resistance

 What CDC was doing at that time to combat the threat of antibiotic resistance

 The data below is pulled from the 2013 Threats Report. CDC is working towards releasing an updated AR Threats Report in fall 2019. |||||

 iStock

 This post has been updated.

 Nearly a third of antibiotics prescribed in doctors' offices, emergency rooms and hospital-based clinics in the United States are not needed, according to the most in-depth study yet to examine the use and misuse of these life-saving drugs.

 The finding, which has implications for antibiotics' diminished efficacy, translates to about 47 million unnecessary prescriptions given out each year across the country to children and adults. Most of these are for conditions that don't respond to antibiotics, such as colds, sore throats, bronchitis, flu and other viral illnesses.

 Although health officials have been warning for decades about the overuse of antibiotics and its contribution to the development of drug-resistant bacteria, the research from the Centers for Disease Control and Prevention and the Pew Charitable Trust is the first to quantify the depth of the problem.

 "We've all been hearing, 'This is a problem, this is problem,' and we all understood the general concept that there is a lot of antibiotic use," said David Hyun, a senior officer with Pew's antibiotic resistance project and one of the authors of the report published Tuesday in JAMA. Pew also published a companion report using the same data.

 "Why this study is so important: It actually provides concrete numbers," Hyun said.

 [CDC warns that Americans may be overmedicating young children with ADHD]

 The study analyzed data for all antibiotic use in the three settings as collected from two major CDC surveys from 2010 to 2011. Antibiotic prescriptions written there represent the majority of dollars spent on antibiotics in this country.

 “Antibiotics are life-saving drugs, and if we continue down the road of inappropriate use we’ll lose the most powerful tool we have to fight life-threatening infections,” said CDC Director Tom Frieden. “Losing these antibiotics would undermine our ability to treat patients with deadly infections [and] cancer, provide organ transplants and save victims of burns and trauma.”

 [‘Looming catastrophe’: These 7 emergency surgeries account for 80 percent of deaths and costs]

 Among the key findings:

 • About 13 percent of all outpatient visits in the United States -- about 154 million visits annually -- result in an antibiotic prescription.

 • More than four in 10 (44 percent) of antibiotic prescriptions are written to treat patients with acute respiratory conditions, such as sinus infections, middle ear infections, sore throats, colds, bronchitis, asthma, allergies, flu, and pneumonia.

 • Half of these prescriptions are unnecessary because many are for viral illnesses.

 Doctors often wind up prescribing antibiotics because of pressure from patients or parents, said Katherine Fleming-Dutra, a CDC medical epidemiologist and report's lead author.

 "Clinicians are concerned about patient satisfaction and the patient demand for antibiotics," she said. But the majority of individuals do trust their doctors to make the right diagnosis, and better communication by doctors about the dangers of antibiotic overuse can lead to more appropriate prescribing, she said.

 An accompanying editorial in JAMA noted that the numbers provided in the report likely are an undercount because they don't include the times antibiotics are given when patients talk to doctors' offices over the telephone, or when patients seek medical care at urgent care clinics, retail pharmacies and dentists' offices.

 Also not included are prescriptions written by nurse practitioners and physician assistants.

 But even relatively simple steps, such as displaying a poster in patient waiting rooms can cut down on antibiotic prescribing, the editorial said.

 The overuse of antibiotics has led to the frightening rise of drug-resistant superbugs in recent years. The CDC has warned that "nightmare bacteria" are increasingly resistant to even the strongest antibiotics, posing a growing threat to hospitals and nursing homes nationwide.

 Last year, the White House announced an aggressive plan to combat antibiotic-resistant bacteria, which already cause an estimated 2 million illnesses and 23,000 deaths every year just in the United States. The administration set a target of reducing inappropriate antibiotic use in outpatient settings by half by 2020.

 Based on the new report, this goal would be reached by cutting outpatient antibiotic use by 15 percent overall, which would result in approximately 23 million fewer antibiotics prescribed annually by 2020.

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Focused crawls are collections of frequently-updated webcrawl data from narrow (as opposed to broad or wide) web crawls, often focused on a single domain or subdomain. ||||| by Maria Owings, Ph.D.; Sayeedha Uddin, M.D., M.P.H.; and Sonja Williams, M.P.H., Division of Health Care Statistics

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 This report provides estimates of male newborn circumcisions performed during the birth hospitalization. Using data from the National Hospital Discharge Survey (NHDS), annual rates of newborn circumcision are presented for 1979–2010. National and regional rates are shown in both tabular and graphical form, and trends across the 32-year period are discussed. Note that these estimates do not include circumcisions performed outside the hospital setting (e.g., ritual circumcisions) or those performed at any age following discharge from the birth hospitalization. Thus, these rates cannot be used as prevalence estimates for all male circumcisions in the United States.

 National trends

 Across the 32-year period from 1979 through 2010, the national rate of newborn circumcision declined 10% overall, from 64.5% to 58.3% (Table and Figure 1). During this time, the overall percentage of newborns circumcised during their birth hospitalization was highest in 1981 at 64.9%, and lowest in 2007 at 55.4%.

 However, rates fluctuated during this period, generally declining during the 1980s, rising in the 1990s, and declining again in the early years of the 21st century. These changes occurred during a period of changing guidance on routine newborn circumcision. For example, American Academy of Pediatrics’ (AAP) task force reports during the 1970s (1,2) stated there was no medical indication for routine circumcision of the newborn; AAP revised its position in 1989 (3), stating there were potential medical benefits to newborn circumcision; and then in 1999 (4), an AAP policy statement said that, despite potential medical benefits of newborn male circumcision, there was insufficient evidence to recommend routine circumcision of newborns.

 Regional trends

 Newborn circumcision rates for the four U.S. census regions showed distinctly different patterns (Table and Figure 2). For newborns in the Northeast, the overall trend was flat across the 32 years, and no discernible patterns were evident, although annual rates varied between 60.7% (in 2007) and 69.6% (in 1994). In the Midwest, fluctuations in newborn circumcision rates generally mirrored trends in the national rate: declining until the mid-1980s, increasing until 1998, and then declining again through 2010. Rates ranged between 82.9% in 1998 and 68.8% in 2009. In the South, rates of newborn circumcision generally increased from 1979 until 1998, after which they declined. These rates ranged between 53.8% (in 1988) and 66.1% (in 1995). In marked contrast was the trend for the West. Over the 32-year period, the percentage of newborns receiving circumcision at birth decreased 37%, from 63.9% in 1979 to 40.2% in 2010. Most of this decrease occurred in the 1980s, with the rate dropping to 41.0% in 1989. Rates continued to decrease through 2010, with a low of 31.4% in 2003.

 Data sources and methods

 This report is based on data from NHDS, conducted by the Centers for Disease Control and Prevention’s National Center for Health Statistics (NCHS) from 1965 through 2010. Data on newborn circumcision performed during the birth hospitalization have been collected in NHDS since 1979, when the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD–9–CM) (5) was instituted. NHDS is the only source of reliable, national, historical data on male newborn circumcision performed during the birth hospitalization.

 Circumcision rates for male neonates, based on NHDS data for 1999–2008, were reported and compared with those based on other data sources (i.e., the Nationwide Inpatient Sample from the Agency for Healthcare Research and Quality, and the Charge Data Master from SDI Health, Plymouth Meeting, PA) (6). Observed decreases in the incidence of the procedure differed among the data sources, but the maximum absolute difference for any given year was less than 6%.

 NHDS employed a stratified, clustered, multistage sampling design that produces unbiased national and regional estimates of hospital utilization in the United States. Data were collected from a sample of discharges selected from a national probability sample of nonfederal, short-stay hospitals. This analysis focused only on male newborn infants born during the sampled hospitalization. Circumcision was identified by the presence of ICD–9–CM procedure code 64.0 on the discharge record.

 Newborn circumcision rates over the 1979–2010 period were analyzed using JoinPoint (7), a statistical software program that detects discontinuities in trend lines and tests whether apparent changes in the slope of the trend line are statistically significant. Separate joinpoint models were fitted for the national newborn circumcision rate, as well as for each of the four census regions (Northeast, Midwest, South, and West). The best fit was determined by a series of permutation tests that attempt to fit the data to the smallest number of joinpoints. Statements made about differences, including those referring to increasing or decreasing trends, have been tested and found to be statistically significant. Statistical significance was determined based on an alpha level of 0.05.

 Additional NHDS publications on a range of topics are available from the NCHS website. Public-use electronic data sets are downloadable from the Web, and restricted-format data files are accessible only through the NCHS Research Data Center to authorized users.

 References

 Table

 Figures

 Figure 1. Rates of circumcision performed on male newborn infants discharged from short-stay hospitals: United States, 1979–2010

 NOTES: Rates represent circumcisions performed during birth hospitalization. Circumcision is

 identified by International Classification of Diseases, Ninth Revision, Clinical Modification

 (ICD-9-CM) Procedure Code 64.0.

 SOURCE: CDC/NCHS, National Hospital Discharge Survey.

 Figure 2. Rates of circumcision performed on male newborn infants discharged from short-stay hospitals, by region: United States, 1979–2010

 NOTES: Rates represent circumcisions performed during birth hospitalization. Circumcision is

 identified by International Classification of Diseases, Ninth Revision, Clinical Modification

 (ICD-9-CM) Procedure Code 64.0.

 SOURCE: CDC/NCHS, National Hospital Discharge Survey.

  ||||| Male circumcision has been heavily debated in Denmark in recent years. Photo: Colourbox

 A poll showing 74 percent support for banning male circumcision comes as parliament prepares for a new round of political discussion on male circumcision.

 Nearly three fourths of Danes are in favour of banning male circumcision, a new poll revealed.

 In a survey of over 1,000 Danes conducted by YouGov for Metroxpress newspaper, 74 percent of respondents wanted a full or partial ban on the practice while just ten percent supported giving parents the right to circumcise their sons.

 The poll results come as parliament prepares to hold a hearing on the practice of circumcision on Wednesday. Left-wing party the Red-Green Alliance (Enhedslisten) and libertarian party Liberal Alliance are in favour of a ban, while other parties report internal disagreement on the issue.

 The debate about circumcision is a frequent topic in Denmark. Following extensive media coverage in both 2012 and 2013, the Danish Health and Medicines Authority (Sundhedsstyrelsen) carried out a study on the potential health risks and benefits of circumcision. In June 2013, the agency determined that there was neither enough risk to justify outlawing circumcision nor enough documentation of its benefits to generally recommend the practice.

 Despite the health authorities’ findings, Wednesday’s hearing in parliament may be the first step toward an eventual ban.

 “We will handle this topic politically within a few years. As I see it, it goes against the [UN’s] Convention on the Rights of the Child to circumcise children. I’m leaning toward a ban until the person is of legal age,” Venstre MP Hans Christian Schmidt, a former health minister, told Metroxpress.

 According to Sundhedsstyrelsen, somewhere between 1,000 and 2,000 circumcisions are performed in Denmark each, primarily on Jewish and Muslim boys. Male circumcision is almost universal in the Muslim world and highly prevalent in many African countries. It is also a popular practice in the United States where more than half of all boys are circumcised and in Canada, where a 2007 survey put the percentage at 31.9 percent.

 Jair Melchior of the Jewish faith group Mosaisk Troessamfund cautioned politicians to not let opinion polls affect their stance on circumcision.

 “The problem is that there are so many assertions in the debate on circumcising boys. If it was so dangerous, the Jewish community would have been the first to stop it. But it’s not,” Melchior told Metroxpress. ||||| Focused crawls are collections of frequently-updated webcrawl data from narrow (as opposed to broad or wide) web crawls, often focused on a single domain or subdomain. |||||

Write a summary.

– "To be circumcised should be an informed, personal choice," or so thinks the Danish Medical Association, which on Friday issued its recommendation that no boy under age 18 in the country be circumcised. Going that route then leaves the door open for the male to make a decision of his own "when he has come of age," says Lise Moller, the head of the association’s ethics board. That's not to say the doctors' group is calling for a ban, which it says it weighed and decided against due to cases where male circumcision is medically necessary and for the potential for clandestine botched procedures, says Moller. Had they wanted a ban, they'd possibly face a steep slope. In a June report to the UN, Denmark agreed with Egypt's stance that it is a parental right to circumcise one's male child, reports the Copenhagen Post. Still, the Local reports that 74% of respondents to a 2014 survey said they'd support a full or partial ban. An estimated 1,000 to 2,000 circumcisions take place in Denmark each year, and the country should have a firmer idea of that number as of Jan. 1, after which all circumcisions must be logged in Denmark's national patient registry, reports the Local. Doctors who fail to do so will be fined, reports the Post. The CDC reports that in 2010, an estimated 58% of male newborns were circumcised in the US. (This mom went into hiding and then to jail in an attempt to avoid circumcising her son.)