Category: tfwouhzt


Wealthy to increase spending

first_imgWednesday 2 February 2011 8:26 pm Ad Unmute by Taboolaby TaboolaSponsored LinksSponsored LinksPromoted LinksPromoted LinksYou May LikeTotal PastThe Ingenious Reason There Are No Mosquitoes At Disney WorldTotal PastUndoLuxury SUVs | Search AdsThese Cars Are So Loaded It’s Hard to Believe They’re So CheapLuxury SUVs | Search AdsUndoSerendipity TimesInside Coco Chanel’s Eerily Abandoned Mansion Frozen In TimeSerendipity TimesUndoBrake For ItThe Most Worthless Cars Ever MadeBrake For ItUndoBlood Pressure Solution4 Worst Blood Pressure MedsBlood Pressure SolutionUndoBetterBe20 Stunning Female AthletesBetterBeUndoBlood Pressure For LifeWhy Doctors May No Longer Prescribe Blood Pressure MedsBlood Pressure For LifeUndoAlphaCute30 Rules That All “Hells Angels” Have To FollowAlphaCuteUndoDefinitionDesi Arnaz Kept This Hidden Throughout The Filming of ‘I Love Lucy’DefinitionUndo whatsapp KCS-content Show Comments ▼ More From Our Partners Kansas coach fired for using N-word toward Black playerthegrio.comNative American Tribe Gets Back Sacred Island Taken 160 Years Agogoodnewsnetwork.orgLA news reporter doesn’t seem to recognize actor Mark Currythegrio.comBrave 7-Year-old Boy Swims an Hour to Rescue His Dad and Little Sistergoodnewsnetwork.orgRussell Wilson, AOC among many voicing support for Naomi Osakacbsnews.comAstounding Fossil Discovery in California After Man Looks Closelygoodnewsnetwork.orgA ProPublica investigation has caused outrage in the U.S. this weekvaluewalk.comFans call out hypocrisy as Tebow returns to NFL while Kaepernick is still outthegrio.comPolice Capture Elusive Tiger Poacher After 20 Years of Pursuing the Huntergoodnewsnetwork.orgInside Ashton Kutcher and Mila Kunis’ not-so-average farmhouse estatenypost.comColin Kaepernick to publish book on abolishing the policethegrio.comSupermodel Anne Vyalitsyna claims income drop, pushes for child supportnypost.comMan on bail for murder arrested after pet tiger escapes Houston homethegrio.comBiden received funds from top Russia lobbyist before Nord Stream 2 giveawaynypost.comPorsha Williams engaged to ex-husband of ‘RHOA’ co-star Falynn Guobadiathegrio.comUK teen died on school trip after teachers allegedly refused her pleasnypost.comFort Bragg soldier accused of killing another servicewoman over exthegrio.comKiller drone ‘hunted down a human target’ without being told tonypost.com Sharecenter_img High earners are determined to spend their way out of recession, a report by HSBC suggests. Spending by people earning over £100,000 per annum is expected to increase by 7.8 per cent this year. Overall spending for this group will increase to £87,380. Spending on one-off purchases will fall by 25 per cent for the £100,000-£150,000 bracket. Yet this group still spends on average over £10,000 a year on one-offs. Areas of increased spending include transport and travel, and home improvements. Affluent consumers are expected to spend an average of £13,946 improving their homes. Wealthy to increase spending whatsapp Tags: NULLlast_img read more

Golden Guinea Breweries Plc (GOLDBR.ng) Q32019 Interim Report

first_imgGolden Guinea Breweries Plc (GOLDBR.ng) listed on the Nigerian Stock Exchange under the Beverages sector has released it’s 2019 interim results for the third quarter.For more information about Golden Guinea Breweries Plc (GOLDBR.ng) reports, abridged reports, interim earnings results and earnings presentations, visit the Golden Guinea Breweries Plc (GOLDBR.ng) company page on AfricanFinancials.Document: Golden Guinea Breweries Plc (GOLDBR.ng)  2019 interim results for the third quarter.Company ProfileGolden Guinea Breweries Plc is a brewery in Nigeria producing Golden Guinea beer. It was shut down in 2003 following a fire outbreak and efforts to restore it to its former capacity are ongoing. The new production line has capacity to produce 48 000 bottles per hour which is double the capacity of both Ama Breweries in Enugu and SAB Miller in Onitsha. Formerly known as Independence Brewery Limited, the company changed its name to Golden Guinea Breweries in 1971. Its brewing plant is located in Umuahia which was chosen due to its location to a good source of water. Golden Guinea Breweries Plc has the rights to produce and market Bergedorf premium lager beer and Bergedorf Malta in Nigeria under license from Holsten Brewery. Golden Guinea Breweries Plc is listed on the Nigerian Stock Exchangelast_img read more

Bitwalking app to let walkers earn digital dollars

first_img Advertisement BBC Click on Bitwalking  87 total views,  1 views today AddThis Sharing ButtonsShare to TwitterTwitterShare to FacebookFacebookShare to LinkedInLinkedInShare to EmailEmailShare to WhatsAppWhatsAppShare to MessengerMessengerShare to MoreAddThis4 Bitwalking app to let walkers earn digital dollars Posted by Bitwalking on Saturday, 21 November 2015 Bitwalking is a mobile app that promises to pay people for walking. Payments are made in digital crypto-currency ‘Bitwalking dollars’. Could this open up a new source of fundraising income for charities?The idea behind Bitwalking is to encourage and reward people for keeping healthy by walking. The more they walk they more they earn. Instead of ‘mining’ Bitcoins by running a computer programme, Bitwalkers will be able to mine or generate income in Bitwalking Dollars simply by walking.For many it is not the route to instant riches: Bitwalking pays 1 BW$ for every 10,000 steps, or about five miles. As a result, it is going to be hard to generate more than a few dollars a day. But in some countries, such a sum represents a life-changing opportunity. In Malawi, for example, one of the countries in which Bitwalking is launching, the average rural wage is just $1.5 (£1) a day.Given the need for many to walk to work or to fetch water, the idea of earning income while walking could significantly boost their income.Who created it?Nissan Bahar and Franky Imbesi are the founders of Bitwalking and they have already secured $10 million in investment, mostly from Japanese investors. Also Japanese electronics manufacturer Murata is developing a wearable wristband for those who do not have a smartphone.They have a track record in the form of Keepod, a USB stick that costs just $7 and yet functions like a computer. Launched last year it is now in use in 87 countries.Fundraising by walking?Will we be able to raise funds just by walking?The app and its crypto-currency currently only let people spend their accumulated Bitwalking dollars in the company’s online store. Alternatively people can buy other people’s Bitwalking dollars, with traditional currency, to boost their total to spend on items in the shop.There are at least three ways in which Bitwalking could be used in a philanthropic manner.1. It is not a large leap to see how this app, if it takes off and works as promised, could let thousands of people generate income and then donate their Bitwalking dollars to charities. Large sums are raised for charity from sponsored walks and runs. Bitwalking could boost the income for charity from those walks.2. Bitwalking could also generate year-round income for charities from supporters walking to work or walking for pleasure throughout the week. It could offer a simple method of regular giving.3. Bitwalking users could donate their Bitwalking dollars to people in developing countries along the lines of Kiva, to offer them a loan to establish or grow a business.Sadly there are no charity partnerships listed as the app is launched in its first tranche of countries. There is talk of partnerships with sportswear brands, health insurance companies, and health companies, plus of course even more advertisers would might like to reach an active and healthy audience. Indeed, the app will likely generate a great deal of data on people’s activity habits, which could similarly be useful to advertisers.That said, Nissan Bahar told the BBC “That won’t be for sale. We may explore offering advertisers the opportunity to focus on different groups depending on how active they are, but we won’t pass on any information relating to individual’s movements.”UK Fundraising asked Bitwalking if it had plans for charity fundraising partnerships but we haven’t received a response. Can it be hacked?No doubt you’ll already have thought – can the app be hacked? Could I give my phone to someone to walk around with all day and maybe share the income? Can I do that with several smartphones? What about jiggling the phone around while stationary?The developers have apparently ensured that these and other misuses of the app will not generate income. At the same time, this might restrict its ability to be used by people in wheelchairs.center_img Where does the money come from?More importantly, will the app be sustainable? It all depends on the crypto-currency being accepted by a range of providers and for start-up funding to continue to enable it to become self-sustaining.While perpetual motion can’t of course exist, Bitwalking might at least for a while help charities raise funds from the perpetual motion of its supporters.Here is BBC Click’s report on Bitwalking from 21 November: AddThis Sharing ButtonsShare to TwitterTwitterShare to FacebookFacebookShare to LinkedInLinkedInShare to EmailEmailShare to WhatsAppWhatsAppShare to MessengerMessengerShare to MoreAddThis4 Howard Lake | 23 November 2015 | News Tagged with: app cryptocurrency Events Finance mobile About Howard Lake Howard Lake is a digital fundraising entrepreneur. Publisher of UK Fundraising, the world’s first web resource for professional fundraisers, since 1994. Trainer and consultant in digital fundraising. Founder of Fundraising Camp and co-founder of GoodJobs.org.uk. Researching massive growth in giving.last_img read more

Industry Modification Efforts Have Matured But Loans Are Harder To Get

first_img Data Provider Black Knight to Acquire Top of Mind 2 days ago Related Articles Paul Salfen is the editor at large for DS News. He holds a Bachelor of Arts from Penn State. He co-hosts two television shows and a radio show and is a frequent contributor to several notable publications. Home / Daily Dose / Industry Modification Efforts Have Matured But Loans Are Harder To Get Previous: DS News Webcast: Monday 4/7/2014 Next: TARP Bank Executive Indicted on Bank Fraud Conspiracy April 7, 2014 671 Views Governmental Measures Target Expanded Access to Affordable Housing 2 days ago in Daily Dose, Featured, Headlines, Market Studies, News The Best Markets For Residential Property Investors 2 days ago Black Knight Financial Services credit default Foreclosures 2014-04-07 Paul Salfen About Author: Paul Salfen Industry Modification Efforts Have Matured But Loans Are Harder To Get The Week Ahead: Nearing the Forbearance Exit 2 days ago The Best Markets For Residential Property Investors 2 days agocenter_img Servicers Navigate the Post-Pandemic World 2 days ago Demand Propels Home Prices Upward 2 days ago Demand Propels Home Prices Upward 2 days ago Tagged with: Black Knight Financial Services credit default Foreclosures  Print This Post Governmental Measures Target Expanded Access to Affordable Housing 2 days ago Data Provider Black Knight to Acquire Top of Mind 2 days ago Servicers Navigate the Post-Pandemic World 2 days ago In what seems to be an unfortunate standard in the industry as of late, a smattering of good news is dosed with a helping of bad news. While the report this morning that the U.S. economy added 192,000 jobs in March seems impressive, the nation’s unemployment rate is still sits flat at 6.7 percent.By the same token, Black Knight Financial Service’s Mortgage Monitor Report reports effective loan modification efforts have shown far fewer defaults, which helps those underwater already in homes. However, those looking to get a home that have had some trouble in the past may hit a brick wall, as only 30% of loans last year went to borrowers with credit scores below 720, which isn’t even close to the subprime score of 620.”Far few borrowers are experiencing re-defaults than in the early years post-crisis. Of course, more than 95 percent of the roughly 2.5 million interest rate reduction modifications still face rate resets,” said Herb Blecher, Black Knight’s SVP of their data analytics division.According to the CheckMyCreditScore blog, Quicken’s chief loan economist Bob Walters said, “Many potential homebuyers have the idea that they will need perfect credit to get a mortgage and therefore do not apply for a refinance or purchase loan. They fear being rejected.”Also in Black Knight’s report was an examination of the implementation of the Consumer Financial Protection Bureau’s new rules, which showed that foreclosures are taking longer to get started, much to the relief of those in distress. The CFPB rule states that foreclosure cannot begin until after the loan is 120 days delinquent, slowing down those that typically started at the 90-day point.In the report, New York, New Jersey and Florida had the highest rate of seriously delinquent loans, but Mississippi, Nevada, Rhode Island, Alabama and Louisiana had an alarming number of the same, which are those considered past 90 days late. This does not bode well for those looking to get a home loan in these states, as the banks have already overextended and despite any commentary on lending practices, the outlook is somewhat grim.”Credit standards have shown little signs of easing,” Blecher said, which only shows signs of promise for those who are on the other side of the coin in the situation. As he points out, there is “significant opportunity to expand mortgage origination activity … if risk appetites allow.”With any luck, there will be appetites for other activity as the market turns, which will hopefully show in the next report. Share Save Sign up for DS News Daily Subscribelast_img read more

FHFA Extends Mortgage Flexibilities

first_img Servicers Navigate the Post-Pandemic World 2 days ago Tagged with: Fannie Mae FHFA Freddie Mac Governmental Measures Target Expanded Access to Affordable Housing 2 days ago Sign up for DS News Daily Servicers Navigate the Post-Pandemic World 2 days ago The Best Markets For Residential Property Investors 2 days ago Demand Propels Home Prices Upward 2 days ago Share Save FHFA Extends Mortgage Flexibilities About Author: Seth Welborn Demand Propels Home Prices Upward 2 days ago The Best Markets For Residential Property Investors 2 days ago Fannie Mae FHFA Freddie Mac 2020-05-05 Seth Welborn Data Provider Black Knight to Acquire Top of Mind 2 days agocenter_img in Daily Dose, Featured, Government, Market Studies, News Home / Daily Dose / FHFA Extends Mortgage Flexibilities Governmental Measures Target Expanded Access to Affordable Housing 2 days ago The Federal Housing Finance Agency (FHFA) extended several loan origination flexibilities currently offered by Fannie Mae and Freddie Mac designed to help borrowers during the COVID-19 national emergency. Those flexibilities are extended until at least June 30 and include:Alternative appraisals on purchase and rate term refinance loans;Alternative methods for verifying employment before loan closing;Flexibility for borrowers to provide documentation (rather than requiring an inspection) to allow renovation disbursements (draws); andExpanding the use of power of attorney and remote online notarizations to assist with loan closings.​“These loan origination flexibilities will continue to facilitate loan closings and go a long way to keeping the market functioning effectively during this national emergency,” said FHFA Director Mark Calabria. “Today’s actions also keep homebuyers, sellers, and appraisers safe.”The FHFA also reiterated recently that borrowers in forbearance with a Fannie Mae or Freddie Mac-backed mortgage are not required to repay the missed payments in one lump sum.“During this national health emergency, no one should be worried about losing their home,” said Director Mark Calabria. “No lump sum is required at the end of a borrower’s forbearance plan for Enterprise-backed mortgages. To help homeowners navigate the forbearance process, FHFA partnered with CFPB on the Borrower Protection Program to provide homeowners accurate information about forbearance and address concerns noted in some consumer complaints. While today’s statement only covers Fannie Mae and Freddie Mac mortgages, I encourage all mortgage lenders to adopt a similar approach.”In response to the COVID-19 national emergency, the GSEs permitted borrowers with financial hardship due to the pandemic a forbearance option, which is a pause or reduction in their monthly mortgage. The missed payments will have to be paid back by the borrower. For those borrowers who opt for forbearance, their mortgage servicer will contact them about 30-days before the end of the forbearance plan to see if the temporary hardship has been resolved and discuss a variety of repayment options. If the hardship has not been resolved, the forbearance plan can be extended. If the hardship has been resolved, the servicer will work with the borrower to:Set up a repayment plan;Modify the loan so the borrower’s payments are added to the end of the mortgage; orSet up a modification that reduces the borrower’s monthly mortgage payment. Seth Welborn is a Reporter for DS News and MReport. A graduate of Harding University, he has covered numerous topics across the real estate and default servicing industries. Additionally, he has written B2B marketing copy for Dallas-based companies such as AT&T. An East Texas Native, he also works part-time as a photographer. Data Provider Black Knight to Acquire Top of Mind 2 days ago The Week Ahead: Nearing the Forbearance Exit 2 days ago May 5, 2020 1,362 Views Previous: Flattening the Curve: Servicing in a Pandemic Next: Disruption in Property Tax Revenue From Forbearance Plans  Print This Post Related Articles Subscribelast_img read more

TASTE OF TROY

first_imgSkip You Might Like The Pike County Fair coming to Troy next weekend With the Pike County Fair just around the corner, October 6-10, the sponsoring Troy Shrine Club members are busy making… read more Troy falls to No. 13 Clemson Pike County Sheriff’s Office offering community child ID kits Book Nook to reopen Published 4:00 am Wednesday, September 30, 2015 Latest Stories Conner said payroll deduction is the Pike County United Way’s largest source of funding and encouraged business that are not yet participating to strongly consider it.MESSENGER PHOTO/JAINE TREADWELLThe Pike County United Way board kicked off its 2016 fundraising campaign at the Pioneer Museum of Alabama with 16 of the board’s agencies participating Johnny Barron and Company provided musical entertainment..“By supporting the Pike County United Way, businesses and their employees are supporting local agencies that help friends and neighbors.Conner can be reached by phone at 334-566-0011 or at the United Way office at the Colley Senior Complex Pottery House on Elm Street.Kari Barley, Pioneer Museum of Alabama director, said it was an honor to host the “Taste of Pike County.” Around the WebMd: Do This Immediately if You Have Diabetes (Watch)Blood Sugar BlasterIf You Have Ringing Ears Do This Immediately (Ends Tinnitus)Healthier LivingHave an Enlarged Prostate? Urologist Reveals: Do This Immediately (Watch)Healthier LivingWomen Only: Stretch This Muscle to Stop Bladder Leakage (Watch)Healthier LivingRemoving Moles & Skin Tags Has Never Been This EasyEssential HealthGet Fortnite SkinsTCGThe content you see here is paid for by the advertiser or content provider whose link you click on, and is recommended to you by Revcontent. As the leading platform for native advertising and content recommendation, Revcontent uses interest based targeting to select content that we think will be of particular interest to you. We encourage you to view your opt out options in Revcontent’s Privacy PolicyWant your content to appear on sites like this?Increase Your Engagement Now!Want to report this publisher’s content as misinformation?Submit a ReportGot it, thanks!Remove Content Link?Please choose a reason below:Fake NewsMisleadingNot InterestedOffensiveRepetitiveSubmitCancel TASTE OF TROYcenter_img Email the author By Jaine Treadwell “The ‘Taste of Pike County’ was also a fundraiser for the Pike County United Way and we appreciate all of those who participated as vendors, all of the entertainers who came out and made this a very special event and everyone who came in support of the United Way and the 18 agencies it serves and, of course, the Pioneer Museum of Alabama for hosting the fundraising event.”Conner said “Taste of Pike County” was the board’s first fundraiser of the 2016 campaign and the next fundraiser will be the sale of the Pike County United Way Cookbook.“The cookbook contains recipes from all of the agencies that we serve and recipes from the mayors of Troy, Brundidge, Goshen and Banks. It’s a great cookbook and should be very popular.” MESSENGER PHOTO/JAINE TREADWELLThe Pike County United Way board kicked off its 2016 fundraising campaign at the Pioneer Museum of Alabama with 16 of the board’s agencies participating. dancers from SheBANG entertained the guests.A large gathering of Pike County people took advantage of the opportunity to get a wide and varied “Taste of Pike County” Tuesday afternoon.The Pike County United Way board kicked off its 2016 fundraising campaign at the Pioneer Museum of Alabama with 16 of the board’s 18 agencies participating with informational booths, freebies and opportunities to win great door prizes.Melinda Conner, Pike County United Way director, said “Taste of Pike County” was an opportunity to for United Way agencies, businesses and organizations to showcase the products and services they offer and to network as well. Remember America’s heroes on Memorial Day Print Article “It was a wonderful opportunity for people to visit the museum again or for the first time,” Barley said. “We are extremely proud of the museum and of the educational opportunities it offers to the people of our community and far beyond. We are a hands-on history museum and offer programs for adults and children throughout the year.”For Eunice Rios of “Feathers of Love,” the “Taste of Pike County” was an opportunity to further introduce her new Troy business to the people all around the county.“It was great to have a place where we could come and tell people what ‘Feathers of Love’ is all about and what we have to offer,” Rios said. “There are not many opportunities like this and we appreciate being able to showcase our business at an event like this.”Melissa Boatner, Whaley Pecans, said the “Taste of Pike County” was also an opportunity to introduce new products to the community.“Whaley’s has products that many people don’t know about,” she said. “We have roasted pecan syrup, butter pecan syrup, peach and blueberry pecan preserves, gourmet salts and all natural soaps. We have pecans and a whole lot more.”And, it was more than Emily Roling was hoping to attract at the Pike County 4-H booth.“We have a lot of 4-H’ers and a lot of interest but we need more volunteers,” she said.“The ‘Taste of Pike County’ is an opportunity to show the people of Pike County more of what we do and hopefully get more adults involved.”Entertainment for the “Taste of Pike County” included the First Baptist Church puppets, Johnny Barron and Company, SheBANG! Cloggers and the American Legion Dancers. Plans underway for historic Pike County celebrationlast_img read more

Humberts is saved! Holiday firm snaps up ailing agency for undisclosed sum

first_imgAiling estate agency Humberts has been bought lock-stock by an upmarket UK holiday-home lettings and sales company called Natural Retreats.The deal, which is for an undisclosed sum, was brokered by Canary Wharf-based business recovery firm Begbies Traynor and will save all remaining jobs across the UK within Humberts.Wilmslow-based Natural Retreats, which offers both holiday homes in the UK and US to rent and for sale, says it acquired Humberts in order to expand its UK business into a leading rural property company.Natural Retreats specialises in offering upmarket holiday makers a personalised concierge service and off-the-beaten track properties.Humberts went into voluntary administration at the end of April and staff both at its head office and at branches across the UK were told redundancies would follow.The agency has so far failed to file accounts for 2015, Companies House records show, and made a loss of £1.5 million during 2014.The purchase of Humberts by Natural Retreats, which MD Ian Westerling (pictured) was a “competitive” bidding process, is likely to see money injected into the business, although only ‘remaining’ staff will keep their jobs, suggesting a redundancy programme was completed as part of the sale.“We are absolutely delighted that Natural Retreats group of companies and investors has decided to purchase Humberts,” says Westerling, who will remain with the business.“For us, the business is a perfect fit and there will be mutually beneficial crossovers. We have a shared vision of ensuring exemplary customer service, innovative use of prop tech, and already have complimentary business streams.”Business as usualMatt Spence, CEO of Natural Retreats (pictured), stressed that it is ‘business as usual” for Humberts and that it “is a perfect fit and there will be mutually beneficial crossovers. We have a shared vision of ensuring exemplary customer service, innovative use of prop tech, and already have complimentary business streams,” he says.“We’re at a stage in our evolution where Natural Retreats is keen to drive innovation and our aim is to create a leading rural estate agency and holiday lettings business.“We have a vision to preserve the natural economy and this 176 year old brand that has a history and love for looking after beautiful rural lands and homes fits with our vision.”   Ian Westerling Humberts matt spence natural retreats May 22, 2018Nigel LewisWhat’s your opinion? Cancel replyYou must be logged in to post a comment.Please note: This is a site for professional discussion. Comments will carry your full name and company.This site uses Akismet to reduce spam. Learn how your comment data is processed.Related articles BREAKING: Evictions paperwork must now include ‘breathing space’ scheme details30th April 2021 City dwellers most satisfied with where they live30th April 2021 Hong Kong remains most expensive city to rent with London in 4th place30th April 2021 Home » News » Agencies & People » Humberts is saved! Holiday firm snaps up ailing agency for undisclosed sum previous nextAgencies & PeopleHumberts is saved! Holiday firm snaps up ailing agency for undisclosed sumNatural Retreats, which is primarily a vacation firm in the UK and US but also offers property sales, has bought Humberts helping save hundreds of agency jobs across the UK.Nigel Lewis22nd May 201804,804 Viewslast_img read more

O’Briens sets out bold growth plan

Sandwich bar chain O’Briens revealed this week it plans to have 80 more shops and business canteens in the UK bearing its brand by the end of this decade.”We are already the market leader in Ireland and Scotland. Now we plan to be the market leader in England and Wales,” said the chain’s UK franchise director Paul Stanton.The franchise operator, which sells its brand to independent sandwich operators in suitable areas, said it hoped to have 12 new 0’Briens outlets up and running in the UK by this Christmas – followed by 20 next year (2008), 20 in 2009 and 30 in 2010.Stanton said the company was keeping the locations secret for fear of alerting the competition, which includes Marks & Spencer and Pret A Manger.The chain, which has suppliers including Fresh Fare and Nortons, is rolling out an extended menu and a new look, with a focus on more soft seating. A bigger range of pastries, quiches and iced juices is also planned.Already, 70% of the UK’s 142 outlets, which include company canteens, have been refurbished.O’Briens’ new retail and operations director Andrew Moyes, a former Marks & Spencer marketing manager, said: “These days many people have less time than ever to enjoy their lunch or coffee breaks. So we’ve looked at enhancing the speed of our service at peak periods, without compromising on quality.” read more

Tapping the collective mind

first_imgA 49-year-old man notices a painless rash on his shoulder but doesn’t seek care. Months later, during a routine physical, his doctor sees the rash and diagnoses it as a benign skin condition. More time passes, and during a routine screening test, a nurse points out the spot to another physician, who urges the patient to see a dermatologist. The dermatologist performs a biopsy and the pathology report reveals a noncancerous lesion. The dermatologist seeks a second reading of the pathology slides. This time, a drastically different verdict: atypical invasive melanoma. The patient is immediately started on chemotherapy. Weeks later, a physician friend asks him why he’s not on immunotherapy instead. The man consults his oncologist, who agrees it might work. The man is still in treatment.Though this scenario is hypothetical, real-life versions of it play out hundreds or thousands of times a day across America — not because of negligence, but due to sheer human fallibility and systemic errors.If done right, artificial intelligence could drastically reduce both systemic glitches and errors in the decision-making of individual clinicians, according to commentary written by scientists at Harvard Medical School and Google.The article, published April 4 in The New England Journal of Medicine, offers a blueprint for integrating machine learning into the practice of medicine and outlines the promises and pitfalls of a technological advance that has captivated the imaginations of bioinformaticians, clinicians, and nonscientists alike.The vast processing and analytic capacity of machine learning can amplify the unique features of human decision-making — common sense and the ability to detect nuance. The combination, the authors argue, could optimize the practice of clinical medicine.Machine learning definedMachine learning is a form of artificial intelligence not predicated on predefined parameters and rules, but instead involving adaptive learning. With each exposure to new data, an algorithm grows better at recognizing patterns over time. In other words, machine learning exhibits “cognitive” plasticity not unlike the neural plasticity of the human brain. However, where human brains can learn complex associations from small bits of information, machine learning requires many more examples to learn the same task. Machines are far slower at learning but have greater operational capacity and produce fewer errors of interpretation.“A machine-learning model can be trained on tens of millions of electronic medical records with hundreds of billions of data points without lapses in attention,” said Isaac Kohane, chair of the Department of Biomedical Informatics in the Blavatnik Institute at Harvard Medical School, who co-wrote the commentary with Alvin Rajkomar and Jeffrey Dean of Google. “But it’s impossible … for a human physician to see more than a few tens of thousands of patients in an entire career.”Thus, according to the authors, deploying machine learning could offer physicians the collective wisdom of billions of medical decisions, patient cases, and outcomes to inform diagnosis and treatment. In situations where predictive accuracy is critical, the ability of a machine-learning system to spot telltale patterns across millions of samples could enable “superhuman” performance.To err is human“To Err is Human,” a 1999 report by the Institute of Medicine, now known as the National Academy of Medicine, recognized the imperfections of human decision-making and the limits of individual clinician knowledge. The latter is poised to become a growing problem for front-line clinicians, who must synthesize, interpret, and apply an ever-growing mountain of biomedical knowledge stemming from the exponential rate of new discoveries.“We must have the humility to recognize that keeping up with the pace of biomedical knowledge and new discoveries is humanly impossible for the individual practitioner,” Kohane said. “AI and machine learning can help reduce [or] even eliminate errors, optimize productivity, and provide clinical decision support.”According to the Institute of Medicine’s report, clinical errors encompass four broad categories:Diagnostic: failure to order appropriate tests or properly interpret test results; use of outdated tests; wrong diagnosis or delay of accurate diagnosis; and failure to act on test results.Treatment: choosing suboptimal, outdated, or incorrect therapies; errors in administering the treatment; errors of medication dosing; and treatment delays.Prevention: failures in preventive follow-up and administration of prophylactic therapies such as vaccinations.Errors involving communication or equipment failures, among others.Machine learning has the potential to reduce many of these errors and even eliminate some, the authors of the commentary said. A well-designed system could alert providers when suboptimal medication is chosen; it could eliminate dosing errors; and it could triage the records of patients with vague, mysterious symptoms to a panel of rare-disease experts for remote consults.Machine-learning models hold the greatest promise in the following areas:Prognosis: the ability to identify patterns predictive of outcomes based on vast numbers of already documented outcomes. For example, what is a patient’s likely trajectory? How soon will the patient return to work? How quickly might the patient’s disease progress? Diagnosis: the capacity to help identify likely diagnoses during clinical visits and raise awareness of possible future diagnoses based on a patient’s profile and the totality of previous laboratory and imaging test results and other available data. Machine-learning models could be used as backup intelligence to prod physicians to consider alternative conditions or ask probing questions. This could be particularly valuable in scenarios with high diagnostic uncertainty or when patients present with particularly confounding symptoms. Expanding access to expertise: the ability to improve access to care for patients living in remote geographic locations or regions with a scarcity of medical specialists. Such models could provide patients with nearby care options or alert them when symptoms demand urgent attention or a visit to an emergency room.Deus ex machina … notAI and machine learning are not perfect, nor will they solve all glitches in clinical care.Machine-learning models can only be as good as the data they are provided. “The adage ‘garbage in, garbage out’ very much applies here,” Kohane said.The most significant barrier to developing optimal machine-learning models is the scarcity of high-quality clinical data that includes ethnically, racially, and otherwise diverse populations, the authors said. Other hurdles are more technical in nature. For example, the current separation of clinical data across and within institutions is a significant, yet not insurmountable, barrier to building robust machine-learning models. One solution would be to put the data in the hands of patients to enable patient-controlled databases.Other obstacles include various legal requirements and policies and a mishmash of technical platforms across health systems and tech providers that may not be easily compatible with one another and thus could compromise access to data.AI-optimized M.D.One unintended consequence of machine learning could be overreliance on computer algorithms and a reduction in physician vigilance — outcomes that would increase clinical errors, the authors cautioned.“Understanding the limitations of machine learning is vital,” Kohane said. “This includes understanding what the model is designed and, more importantly, what it’s not designed, to do.”One way to minimize such risks would be to include confidence ranges for all machine-learning models, informing clinicians exactly how accurate a model is likely to be. Even more importantly, all models should be subject to periodic reevaluations and exams, not unlike the periodic board exams physicians must take to maintain certifications in a given field of medicine.If done right, machine learning will act as a backup to targeted human intelligence, enhancing the clinician-patient encounter rather than substituting for physicians.The human encounter — a physician’s sensibility, sensitivity, and appreciation for nuance and the complexity of human life — will never go away, the authors said.“This is very much a case of ‘together with’ and not ‘instead of,’” Kohane said. “This is not about machine versus human, but very much about optimizing the human physician and patient care by harnessing the strengths of AI.”center_img Treatment: Machine-learning models can be “taught” to identify the optimal treatment for a given patient with a given condition based on vast data sets of treatment outcomes for patients with the same diagnosis.Clinical workflow: Machine learning could improve and simplify current electronic medical record keeping (EMR), which places a significant burden on clinicians. A change in efficiency and reduction of time spent on EMR would allow physicians to spend more time in direct contact with patients.last_img read more

Employees Drive the Total Customer Experience

first_imgDelivering the best Total Customer Experience (TCE) possible is a year round effort. It starts with employees and the amazing work that takes place each day – and often each night – around the world. Working in Human Resources, I see firsthand many of the ways that EMC people help our customers redefine their experiences in the digital world while earning their trust, respect, and loyalty.EMC Colleagues at last year’s TCE Global Celebration in Cairo, EgyptI’ve been fortunate that my EMC career has allowed me to meet the people who design our technology, create it, sell it, deliver it, support it, maintain it and evolve it – and I am humbled by their capabilities. There is a customer-centric mindset in the air here – a current that connects us and unites us, providing the foundation for our culture. You don’t have to look very far for TCE, because it is a key component of who we are.Last year, EMC became one of the Top 25 Global Great Places to Work, joining an impressive list of companies that lead their industries. What makes this honor even more important is that it was determined by the opinions of employees around the world, based on their personal experiences working for EMC. The actions we have taken and investments we have made to be a great place to work represent a ‘Total Employee Experience’ that drives our TCE, and helps it thrive.Customers join EMC team members in Singapore for TCE Global Celebration 2014Company leaders also need to be responsible and accountable for both employee and customer experiences. To that end, EMC’s senior leaders receive detailed employee survey data and have part of their compensation tied to our Customer Net Promoter Score. We not only ask our employees if they would recommend working at EMC, but also ask our customers if they would recommend working with EMC. Continuously tracking this data creates an ongoing pursuit of excellence, ‘inside’ with our employees and ‘outside’ with our customers.Creating the best Total Customer Experience is essential for any company that wants to lead, regardless of industry or geography. I am grateful to all of our employees and customers throughout the world for what we have accomplished together and I look forward to the great work ahead of us.last_img read more