NHS patients dying in hospital corridors, A&E doctors tell Theresa May

Doctors running 68 A&E departments tell PM patients are dying prematurely because staff are too busy to treat them

Patients are dying in hospital corridors during the ongoing winter crisis because the NHS is so underfunded and short-staffed that it cannot cope, senior doctors have warned Theresa May.

A&E units are under such intense strain that patients are at intolerable risk of being harmed by receiving poor care, specialists in emergency medicine from 68 hospitals have told the prime minister in a letter of unprecedented alarm.

In recent weeks some hospitals have become so overloaded that they have been looking after as many as 120 patients a day in corridors, with some dying prematurely as a result, the letter says.

The doctors, consultants who work in or run A&E units in England and Wales, have written to May to highlight the very serious concerns we have for the safety of our patients. This current level of safety compromise is at times intolerable, despite the best efforts of staff.

Conditions in many A&E units are so appalling that they could kill patients, claim the signatories, who work at both major teaching hospitals and smaller district general hospitals. They include Frimley health trust in Surrey, which May visited last week in an attempt to reassure the public that the NHS was coping well this winter.

As you will know a number of scientific publications have shown that crowded emergency departments are dangerous for patients. The longer that the patients stay in [the] emergency department after their treatment has been completed, the greater is their morbidity and associated morbidity, they write.

Their intervention came as new NHS figures showed that the percentage of patients being treated within four hours at hospital-based A&E units in England fell last month to its lowest-ever level 77.3%. The performance of all types of settings offering A&E-type care taken together, including walk-in centres and urgent care centres, was better but still the joint worst ever at 85.1% far below the politically important target of 95%.

Graph

Only three of the NHSs 137 acute trusts hit the 95% target, while 32 were at or below 70%. Blackpool teaching hospitals trust had by far the lowest performance, at 40.1%. The figures reinforced the warning to ministers on Thursday from NHS Providers that it would be impossible to deliver on their pledge that all hospitals would be achieving 95% by March.

Our emergency departments are not just under pressure, but in a state of emergency, said Dr Taj Hassan, the president of the Royal College of Emergency Medicine, which represents A&E doctors.

The NHS undertook unprecedented planning to help services cope with the annual spike in demand in December and January. Despite that, hospitals had a record number of emergency admissions last month 520,163, a 4.5% rise on the numbers admitted in December 2016.

A drive to free up 2,000-3,000 beds by 1 September, to avoid hospitals becoming dangerously full, appears to have failed. Separate NHS figures for last week show that 19 trusts were on 99% or 100% bed occupancy between 1 and 7 January. Three were completely full.

Average bed occupancy shot up last week to 95%, far higher than the 85% that experts say, and the NHS accepts, hospitals need to maintain in order to stop patients getting hospital-acquired infections such as MRSA or Clostridium difficile, or experiencing poor care.

Bed occupancy as high as 95% is a danger to patient safety, with around 7,000 fewer beds open than in the same period last year, said Hassan.

Drawing on their own experiences in recent weeks ,the doctors who signed the letter painted a stark picture of conditions inside A&E units. Common situations include over 50 patients at a time waiting beds in the emergency department [and] patients sleeping in clinics as makeshift wards.

A Department of Health and Social Care spokeswoman said in response to the letter: There has been a 68.7% increase in the number of A&E consultants since 2010, and the NHS was given top priority in the recent budget with an extra 2.8bn allocated over the next two years.

But we know there is a great deal of pressure in A&E departments, and we are grateful to all NHS staff for their incredible work in challenging circumstances. Thats why we recently announced the largest single increase in doctor training places in the history of the NHS a 25% expansion.

May stressed on Thursday that flu was a key factor in the intense strain that NHS services were facing. We have seen the extra pressures that the NHS has come under this year. One of the issues that determines the extent of that pressure is flu and we have seen in recent days an increase in the number of people presenting at A&E from flu, she said.

Q&A

Why is the NHS winter crisis so bad in 2017-18?

A combination of factors are at play. Hospitals have fewer beds than last year, so they are less able to deal with the recent, ongoing surge in illness. Last week, for example, the bed occupancy rate at 17 of Englands 153 acute hospital trusts was 98% or more, with the fullest Walsall healthcare trust 99.9% occupied.

NHS England admits that the service has been under sustained pressure [recently because of] high levels of respiratory illness, bed occupancy levels giving limited capacity to deal with demand surges, early indications of increasing flu prevalence and some reports suggesting a rise in the severity of illness among patients arriving at A&Es.

Many NHS bosses and senior doctors say that the pressure the NHS is under now is the heaviest it has ever been. We are seeing conditions that people have not experienced in their working lives, says Dr Taj Hassan, the president of the Royal College of Emergency Medicine.

The unprecedented nature of the measures that NHS bosses have told hospitals to take including cancelling tens of thousands of operations and outpatient appointments until at least the end of January underlines the seriousness of the situation facing NHS services, including ambulance crews and GP surgeries.

Read a full Q&A on the NHS winter crisis

Hours after she spoke, new figures from Public Health England confirmed that flu was putting a sharply increased burden on GP surgeries as well as hospitals.

Last week 758 peple around the UK were hospialised because of flu, up from 421 the week before. Of those, 240 were so sick they had to be admitted to an intensive care or a high dependency unit, up from 114. The number of people consulting a GP with flu-like symptoms almost doubled.

A further 27 people died of flu-related symptoms last week, three more than the week before, taking the toll of deaths this winter to 85.

Read more: https://www.theguardian.com/society/2018/jan/11/nhs-patients-dying-in-hospital-corridors-doctors-tell-theresa-may

Donald Trump defended his mental stability and Twitter has some thoughts on that

Image: Jabin Botsford/The Washington Post via Getty Images

2018 sure is off to a running start in Trumpland.

The 45th President of the United States kicked off a busy weekend of meetings at Camp David on Saturday with a brief, fiery tweetstorm that — even at this early point in 2018 — is already a surefire candidate for the year’s most memorable.

In three tweets, Donald Trump addressed his intellect (“being, like, really smart”), his mental stability (“a very stable genius”), and his successful presidential election campaign (“on my first try”). He doesn’t come out and say it, but the tweets are likely a response to Michael Wolff’s upcoming book, in which Trump insiders question the president’s stability on the record, and/or recent meetings on Capitol Hill to discuss the president’s mental state.

In typical Trump fashion, the three-tweet tirade blows past known facts in favor of creating a particular narrative. The “first try” election claim, for one, is hogwash; Trump ran in 2000, and even won a couple of primaries — though only after he left the race, in Feb. 2000. 

He ran under the Reform Party banner, and ultimately blamed his exit on the political organization being a “total mess.” The Reform Party countered at the time with the contention that Trump’s bid had never been serious.

“Donald Trump came in, promoted his hotels, he promoted his book, he promoted himself at our expense, and I think he understands fully that we’ve ended the possibilities for such abuse of our party,” party leader Patrick Choate said at the time.

Predictably, Trump’s tweets drew a disbelieving response from social media. 

By all means, laugh at Trump’s ridiculously transparent feelings of inadequacy if it helps you get through the day. But don’t let it draw you away from staying informed on news items of actual import.

This week alone: G.O.P. legislators asked the Justice Department to investigate Christopher Steele, the former British spy behind the infamous Trump dossier; the White House renewed its demand for a border wall; the U.S. cut off security aid to Pakistan; and the Justice Department moved to imperil the country’s burgeoning marijuana industry.

Among other things.

Read more: http://mashable.com/2018/01/06/donald-trump-very-stable-genius-tweetstorm/

Trump Takes On Amazon Again, Urging Much More in Postage Fees

President Donald Trump said the U.S. Postal Service should charge Amazon.com Inc. more to deliver packages, the latest in a series of public criticisms of the online retailer and its billionaire founder.

The post office “should be charging MUCH MORE” for package delivery, the president tweeted Friday from his Mar-a-Lago estate in Florida, where he’s spending the holidays.

“Why is the United States Post Office, which is losing many billions of dollars a year, while charging Amazon and others so little to deliver their packages, making Amazon richer and the Post Office dumber and poorer?” Trump told his 45 million followers.

Trump regularly criticizes Amazon and its chief executive officer, Jeff Bezos, who also owns the Washington Post newspaper and is currently the world’s richest man. In August, Trump accused the company of causing “great damage to tax paying retailers,” even though the internet giant began collecting sales tax on products it sells directly in April.

As with prior missives targeting the company, Trump’s message appeared to concern investors. Amazon’s stock had gained the past three days, but dropped 0.6 percent to $1,178.68 at 12:41 p.m. in New York.

A sudden increase in postal service rates would cost Amazon about $2.6 billion a year, according to an April report by Citigroup. That report predicted United Parcel Service Inc. and FedEx Corp. would also raise rates in response to a postal service hike.

Amazon didn’t respond to requests for comment.

‘Last Mile’

Amazon regularly uses the Postal Service to complete what’s called the “last mile” of delivery, with letter carriers dropping off packages at some 150 million residences and businesses daily. It has a network of more than 20 “sort centers” where customer packages are sorted by zip code, stacked on pallets and delivered to post offices for the final leg of delivery.

While full details of the agreement between Amazon and the Postal Service are unknown — the mail service is independently operated and strikes confidential deals with retailers — David Vernon, an analyst at Bernstein Research who tracks the shipping industry, estimated in 2015 that the USPS handled 40 percent of Amazon’s volume the previous year. He estimated at the time that Amazon pays the Postal Service $2 per package, which is about half what it would pay UPS or FedEx.

Both shippers were up less than 1 percent Friday. Higher postal service rates would benefit private carriers by making their rates more competitive.

But the postal service’s losses have little to do with Amazon and more to do with its large health-care obligations and the dwindling use of first-class mail. USPS charges some of the world’s lowest stamp prices.

The president’s tweet also assumes that Amazon would be forced to pay if the Postal Service increased its rates for packages. But Amazon has been setting up its own shipping operations in the U.S. and elsewhere in the world to minimize costs.

For more on Trump’s Twitter storms, check out this podcast:

 

$62 Billion Loss

The Postal Service reported a net loss of $2.1 billion in the third quarter of 2017 and has $15 billion in outstanding debt. The service has lost $62 billion over the last decade.

USPS’s chief financial officer, Joseph Corbett, wrote in a post for PostalReporter.com in August that the service is required by law to charge retailers at least enough to cover its delivery costs.

“The reason we continue to attract e-commerce customers and business partners is because our customers see the value of our predictable service, enhanced visibility, and competitive pricing,” he wrote.

He said Congress should pass provisions of legislation introduced last year by former Representative Jason Chaffetz, a Utah Republican, that would allow the postal service to raise some rates and discontinue direct delivery to business customers’ doors.

Amazon is experimenting with a new delivery service of its own that is expected to see a broader roll-out in the coming year. Under the program, Amazon would oversee the pickup of packages from warehouses of third-party merchants and delivery to home addresses.

Despite the occasional anti-Amazon tweet, Trump is unlikely to target Amazon with any action because the company is creating jobs by building new warehouses around the country. It’s also expected to generate 50,000 new positions with its second headquarters, said James Cakmak, analyst at Monness Crespi Hardt & Co.

“The interests of Amazon and the administration are largely aligned – even factoring the dislocation to retail – given the positive headline potential around new job creation with fulfillment centers and HQ2,” he said.

    Read more: http://www.bloomberg.com/news/articles/2017-12-29/trump-says-u-s-post-office-should-charge-amazon-much-more

    Damian Green sacked as first secretary of state after porn allegations

    Green admits he made misleading statements after pornography was found on Commons computer in 2008

    Damian Green has been sacked as first secretary of state after admitting he lied about the presence of pornographic images on his House of Commons computer.

    An investigation by the cabinet secretary, Sir Jeremy Heywood, found that Greens vehement denials after a Sunday newspaper reported that porn had been found on his computer were inaccurate and misleading.

    His departure is a personal blow for Theresa May, who brought him into Downing Street after her majority was wiped out in Junes general election to help shore up her authority.

    He is the third cabinet minister to step aside since early November, following the departures of Michael Fallon and Priti Patel.

    In a letter responding to his resignation, the prime minister said she was extremely sad about losing Green from government. May said it was with deep regret and enduring gratitude for the contribution you have made over many years that I asked you to resign from the government and have accepted your resignation.

    In his resignation letter, Green continued to maintain that he did not download or view the pornography, but added that he should have been clear in my press statements, that his lawyers were informed about its presence in 2008 and that he discussed it with the police in 2013.

    Heywood found Green had twice breached the ministerial code, because his misleading comments had fallen short of the seven principles of public life, one of which is honesty.

    He was unable to reach a definitive conclusion on separate allegations, made by the Tory activist Kate Maltby, that Green had behaved improperly towards her.

    The cabinet secretarys report found that Maltbys account of a disputed meeting was plausible, but with competing and contradictory accounts of what were private meetings, it is not possible to reach a definitive conclusion.

    Sir
    The investigation was led by cabinet secretary Sir Jeremy Heywood. Photograph: Press Association

    In his letter, Green said: I deeply regret the distress caused to Kate Maltby following her article and the reaction to it. I do not recognise the events she described in her article, but I clearly made her feel uncomfortable and I apologise.

    Maltby did not comment publicly on Wednesday evening, but her parents, Colin and Victoria Maltby, released a statement: We are pleased that the Cabinet Office has concluded its inquiry into the conduct of Damian Green. We are not surprised to find that the inquiry found Mr Green to have been untruthful as a minister, nor that they found our daughter to be a plausible witness.

    We have received many supportive messages from people near and far who appreciate Kates courage and the importance of speaking out about the abuse of authority. We join with them in admiring her fortitude and serenity throughout the length of the investigation and despite the attempted campaign in certain sections of the media to denigrate and intimidate her and other witnesses. We are proud of her.

    In her letter to Green, May welcomed the fact that he had apologised to Maltby.

    Speaking on Thursday morning, the health secretary, Jeremy Hunt, acknowledged that Green had been sacked for lying, adding: I think lots of people who understand the context would appreciate why that might have happened. But that doesnt make it any more acceptable.

    He told BBC Radio 4s Today programme the episode showed that cabinet ministers were held to the very highest standard of conduct. But, he said: I think we should probably remember that those are standards that would probably not apply in other countries.

    Labours Jess Phillips told the same programme the decision had taken too long and that the allegations made by Maltby were still hanging over Green.

    The investigation said that Kate Maltby was credible and plausible and what they found that they couldnt prove was the sexual harassment charge.

    However, Im not convinced by that. Ive seen all of the evidence thats in the public domain: text messages between Damian Green and Kate Maltby, text messages between Kate Maltby and her friends at the time, saying how uncomfortable shed felt, whether she felt she had to report it.

    She said that, although it was not officially acknowledged, she believed those allegations had contributed to Mays decision to sack Green.

    The prime minister also used her letter to criticise the conduct of police officers who carried out the raid on Greens parliamentary office in 2008, when the pornography was discovered, and revealed aspects of the case to the media in recent weeks.

    I shared the concerns raised from across the political spectrum when your parliamentary office was raided in 2008 when you were a shadow minister holding the Labour government to account, she said. Greens office was raided as police investigated a series of leaks from inside the Home Office.

    The allegations about porn being found on his computer were the latest chapter in a long-running feud between Green and Bob Quick, the former assistant commissioner of the Metropolitan police, who oversaw the raid almost a decade ago.

    Following a Sunday Times report last month claiming there was extreme pornography on his parliamentary computer, which quoted Quick, Green issued a hard-hitting late night statement branding him a tainted and untrustworthy source who had been trying for some time to cause him political damage.

    He dismissed the porn allegations as false, disreputable political smears from a discredited police officer acting in flagrant breach of his duty and little more than an unscrupulous character assassination. Quick subsequently threatened to sue Green for libel.

    May was handed Heywoods report on Monday, and subsequently sought a second opinion from Sir Alex Allan, the prime ministers independent adviser on ministers interests.

    Quick guide

    Damian Green’s comments on the porn allegations

    What Damian Green said:

    4 November

    The police have never suggested to me that improper material was found on my parliamentary computer, nor did I have a private computer, as has been claimed.

    “The allegations about the material and computer, now nine years old, are false, disreputable political smears from a discredited police officer acting in flagrant breach of his duty to keep the details of police investigations confidential, and amount to little more than an unscrupulous character assassination.”

    11 November

    “I reiterate that no allegations about the presence of improper material on my parliamentary computers have ever been put to me or to the parliamentary authorities by the police. I can only assume that they are being made now, nine years later, for ulterior motives.”

    20 December

    I accept that I should have been clear in my press statements that police lawyers talked to my lawyers in 2008 about the pornography on the computers, and that the police raised it with me in a subsequent phone call in 2013.

    “I apologise that my statements were misleading on this point. The unfounded and deeply hurtful allegations that were being levelled at me were distressing both to me and my family and it is right that these are being investigated by the Metropolitan polices professional standards department.

    Photograph: Ben Stansall/AFP

    A summary of the investigation, released by No 10 on Wednesday night, said: Mr Greens statements of 4 and 11 November, which suggested that he was not aware that indecent material was found on parliamentary computers in his office, were inaccurate and misleading, as the Metropolitan police service had previously informed him of the existence of this material.

    As first secretary of state, Green effectively acted as deputy prime minister, standing in for May at prime ministers questions and sitting alongside her on the frontbench in the Commons.

    Green was a friend of Mays from when the pair were at Oxford University together, and one of a handful of older ministers she brought back into government when she arrived in Downing Street in July last year and dispatched many of David Camerons allies to the backbenches.

    May flies to Poland at the start of a two-day foreign trip on Thursday, and is not expected to appoint a replacement for Green until parliament returns from its Christmas recess in the new year.

    She is then expected to carry out a wider reshuffle, bringing some of the new generation of Conservative MPs into the cabinet in order to refresh the government.

    The allegations about Green emerged as women began to share their experiences of sexual misconduct in political life after the revelations of inappropriate behaviour by media mogul Harvey Weinstein.

    Fallon stepped down as defence secretary after admitting he had not met the standards required of the armed forces of which he was in charge, after the journalist Jane Merrick said he had lunged at her after a lunch.

    Several other investigations are continuing, including that into trade minister Mark Garnier, who admitted asking an assistant to buy sex toys.

    Green has continued to carry out his ministerial duties since the investigation was announced, and colleagues including the Brexit secretary, David Davis supported him in the face of the allegations made by the police officers.

    A retired Met detective, Neil Lewis, went public with claims that thousands of thumbnail images of legal pornography had been found.

    Following Lewis and Quicks interventions, Cressida Dick, the Mets commissioner, said former officers who spoke out about investigations could face prosecution.

    Labour said it was right that May had finally been forced to sack Green. A spokesperson said: The public deserve the highest standards from ministers, which begs questions around the prime ministers judgment and why she delayed this decision for so long. To lose her number two in government in such a way, and so soon after two other ministers, leaves her further weakened.

    Read more: https://www.theguardian.com/politics/2017/dec/20/damian-green-resigns-as-first-secretary-of-state-after-porn-allegations

    Everything You Need to Know About the GOP Tax Bill

    Here are key changes to U.S. tax law for individuals and businesses that have emerged from the final Republican bill that’s headed for votes in the House and Senate next week.

    Individual Tax Rates

    (Note: Individual rate cuts would expire after 2025.)

    Current law:

    • Seven rates, starting at 10 percent and reaching 39.6 percent for incomes above $418,401 for singles and $470,701 for married, joint filers.

    Proposed: 

    • Seven rates, starting at 10 percent and reaching 37 percent for incomes above $500,000 for singles and $600,000 for married, joint filers.
      For joint filers:
      • 10 percent: $0 to $19,050
      • 12 percent: $19,050 to $77,400
      • 22 percent: $77,400 to $165,000
      • 24 percent: $165,000 to $315,000
      • 32 percent: $315,000 to $400,000
      • 35 percent: $400,000 to $600,000
      • 37 percent: $600,000 and above

      For single filers:

      • 10 percent: $0 to $9,525
      • 12 percent: $9,525 to $38,700
      • 22 percent: $38,700 to $82,500
      • 24 percent: $82,500 to $157,500
      • 32 percent: $157,500 to $200,000
      • 35 percent: $200,000 to $500,000
      • 37 percent: $500,000 and above

    Corporate Tax Rate

    Current law: 35 percent

    Proposed: 21 percent, beginning in 2018.

    Corporate Alternative Minimum Tax

    Current law: Applies a 20 percent rate as part of a parallel tax system that limits tax benefits to prevent large-scale tax avoidance. Companies must calculate their ordinary tax and AMT tax, and pay whichever is higher.

    Proposed: Repealed.

    Individual Alternative Minimum Tax

    Current law: Individual AMT can apply after exemption level of $54,300 for singles and $84,500 for married, joint filers, and the exemptions phase out at higher incomes.

    Proposed: Increase the exemption to $70,300 for singles and $109,400 for joint filers. Increase the phase-out threshold to $500,000 for singles and $1 million for joint filers. The higher limits would expire on Jan. 1, 2026.

    Expensing Equipment

    Current law: Businesses must take depreciation, spreading the recognition of their equipment costs for tax purposes over several years.

    Proposed: Businesses could fully and immediately deduct the cost of certain equipment purchased after Sept. 27, 2017 and before Jan. 1, 2023. After that, the percentage of cost that could be immediately deducted would gradually phase down.

    Repatriation

    Current law: The U.S. taxes multinationals on their global earnings at the corporate rate of 35 percent, but allows them to defer taxes on those foreign earnings until they bring them back to the U.S., or “repatriate” them.

    Proposed: U.S. companies’ overseas income held as cash would be subject to a 15.5 percent rate, while non-cash holdings would face an 8 percent rate.

    Pass-Through Deduction

    Current law: Pass-through businesses, which include partnerships, limited liability companies, S corporations and sole proprietorships, pass their income to their owners, who pay tax at their individual rates.

    Proposed: Owners could apply a 20 percent deduction to their business income, subject to limits that would begin at $315,000 for married couples (or half that for single taxpayers).

    Obamacare Individual Mandate

    Current law: An individual who fails to buy health insurance must pay penalties of $695 (higher for families) or 2.5 percent of their household income — whichever is higher, but capped at the national average cost of the most basic, low-premium, high-deductible plan.

    Proposed: Repeal the penalties.

    Standard Deduction and Personal Exemptions

    Current law: $6,350 standard deduction for single taxpayers and $12,700 for married couples, filing jointly. Personal exemptions of $4,050 allowed for each family member.

    Proposed: $12,000 standard deduction for single taxpayers and $24,000 for married couples, filing jointly. Personal exemptions repealed.

    Individual State and Local Tax Deductions

    Current law: Individuals can deduct the state and local taxes they pay, but the value is subject to certain limits for high earners.

    Proposed: Individuals can deduct no more than $10,000 worth of the deductions, which could include a combination of property taxes and either sales or income taxes.

    Mortgage Interest Deduction

    Current law: Deductible mortgage interest is capped at loans of $1 million.

    Proposed: Deductible mortgage interest for new purchases of first or second homes would be capped at loans of $750,000 starting on Jan. 1, 2018.

    Medical Expense Deduction

    Current law: Qualified medical expenses that exceed 10 percent of the taxpayer’s adjusted gross income are deductible.

    Proposed: Reduce the threshold to 7.5 percent of AGI for 2017 and 2018.

    Child Tax Credit

    Current law: A $1,000 credit for each child under 17. The credit begins phasing out for couples earning more than $110,000. The credit is at least partially refundable to qualified taxpayers who earned more than $3,000.

    Proposed: Double the credit to $2,000 and provide it for each child under 18 through 2024. Raise the phase-out amount to $500,000, and cap the refundable portion at $1,400 in 2018.

    Estate Tax

    Current law: Applies a 40 percent levy on estates worth more than $5.49 million for individuals and $10.98 million for couples.

    Proposed: Double the thresholds so the levy applies to fewer estates. The higher thresholds would sunset in 2026.

      Read more: http://www.bloomberg.com/news/articles/2017-12-15/everything-you-need-to-know-about-the-gop-tax-overhaul-bill

      A guide to achieving your 2018 self-care resolutions

      Admiring this gorgeous artwork can also be a form of self-care.
      Image: mashable/vicky leta

      Every product here is independently selected by Mashable journalists. If you buy something featured, we may earn an affiliate commission which helps support our work.

      After an October week from hell — when allegations against Harvey Weinstein first began to unravel, Donald Trump threatened to take aid away from Puerto Rico, women boycotted Twitter, and historic wildfires destroyed California — I splurged on a large Blue Raspberry Icee and sat alone in a 12:15 p.m. Saturday showing of Marshall. I turned my phone all the way off, and over the course of the next two hours I ugly cried in the dark.

      Afterwards, I drove to a bookstore and spent $82.47. I went home, applied a face mask and collapsed onto my bed, escaping into the pages of one of my new books for hours. I met my friend for dinner, cherished every single bite of a cheeseburger, rushed back to my pillow, and fell asleep before watching re-runs of The Mindy Project.

      This was my own personal form of self-care.

      For so many, self-care has been the unsung savior of 2017. You’ve probably heard the term thrown around daily, but learning exactly what it means and why it’s so essential will help to better practice it in the new year.

      Am I doing this thing right?

      Self-care methods — personalized rituals that allow people to take a step back from this messy world to prioritize their well-being and preserve their mental health — differ for each individual and in each scenario, so there’s really no right or wrong.

      For Hillary Clinton self-care could mean anything from frantic closet cleaning, long walks in the woods, and playing with her dogs, to yoga or sitting down to enjoy a glass of wine. For Michael Phelps, who’s conquered the pressures of Olympic competition but has struggled with depression and anxiety over the years, it’s working out or heading to the golf course. The only constant is that methods of self-care must benefit and focus on you.

      “A lot of times people will say ‘I spend time with my kids,’ which is great and meaningful but that’s still taking care of somebody else,” said Monnica Williams, Ph.D., a clinical psychologist and associate professor at University of Connecticut’s Department of Psychological Sciences. “When you self-care it’s really about you recharging.”

      Self-care isn’t selfish

      Some people abstain from self-care for fear that their behavior would come across as selfish. They simply can’t resist the urge to put other people first.

      According to a 2017 “Women’s Wellness Report” from Everyday Health, which studied 3,000 women from ages 25 to 65 in the U.S., 76 percent of women said they were were more likely to put their own personal needs after someone else’s. However, more than half of the participants said that taking time for themselves was the greatest factor in achieving wellness. (Disclosure: Mashable and Everyday Health are owned by the same company, Ziff Davis.) 

      “You can’t be the best you in any other contexts if you’re not taking care of yourself.”

      “It’s essential for your mental health and your physical health,” Williams said, noting that self-care is anything but selfish. “You can’t be the best you in any other contexts if you’re not taking care of yourself.”

      “I heard someone say that it’s like putting on your own oxygen mask in an airplane emergency before putting one on a child,” added Crystal Park, another professor at the University of Connecticut’s Department of Psychological Sciences. 

      “The healthier and more resilient we are, the more effective we can be in our lives.”

      Heading into 2018 with some solid self-care guidelines will help you better manage your stress and survive whatever challenges are in store, so here are a few to keep in mind.

      Don’t be afraid to take a mental health day

      Your mental health is important, but it’s also extremely easy to ignore. When your job gets too overwhelming or events in your personal life prevent or distract you from doing your best work in the office it’s time to take a step back.

      For inspiration, look no further than one of 2017’s viral personal tales: the story of Olark CEO Ben Congleton advocating for his employee after learning she’d taken time off for mental health reasons.

      After Congleton’s understanding email sparked discussion about mental health in the workplace, he wrote a post on Medium further emphasizing the need to normalize it.

      When you are at work, take additional steps to make your environment a place of comfort. Personalize your desk with a plant, a framed photo of something that makes you smile, or set the mood with a tiny lamp. 

      And every so often, book a conference room for lunch with your coworkers to share pizza and a cake you buy for the sole reason of craving cake. Work will still be there when your lunch break ends, but taking time to clear your head is crucial.

      Give social media and screens a rest

      Social media usage often starts with the intention of getting caught up on current events and quickly spirals into a black hole of negativity.

      “So many people are plugged in and instantly alerted to everything that is happening in the news in ways that weren’t possible 10 years ago,” said Dr. Carolyn Mazure, director of Women’s Health Research at Yale.

      While platforms like Facebook, Instagram, and Twitter have been proven to take a toll on self-esteem and mental health, social media isn’t all bad.

      Here are a few ways to make online communities safer spaces for you:

      • Follow encouraging accounts like Janelle Silver‘s, who promotes her self-care-themed Etsy store.

      • Unfollow people on Facebook. (This helps you to remain friends with them but hides their posts from your timeline.)

      • Turn off push notifications.

      • Use Twitter’s mute feature to shield yourself from triggering words.

      Self-Care isn’t selfish 💖

      A post shared by Heart + Hands Store (@janellesilver) on

      Transform your cell phone into a self-care hub 

      While it’s healthy to disconnect from technology every so often, when you do have your phone by your side these tips can help make the experience more enjoyable.

      • Make use of your Do Not Disturb function.

      • Free up some storage space by parting with old text messages you have no intention of ever revisiting, deleting unused apps and contacts, and loading all photos and videos onto your laptop so you’re left with an empty album.

      • Download self-care apps related to deep breathing, meditation, list-making, and maybe even a relaxing game or two, likeAnimal Crossing: Pocket Camp.

      • Create empowering or soothing playlists so you can easily listen to mood-lifting music on-the-go.

      Treat Yo Self, but treat others, too

      No matter how small, make a daily attempt to treat yourself to an experience or a purchase that’ll brighten your mood.

      Get a pedicure or massage, take a hot bath, go for a walk around the block, go out with friends, or cancel plans to stay in on a Friday night to recharge and binge-watch mindless television, if that’s what you need.

      And while being good to oneself is key, Park noted “balance is important” in self-care, and making an effort to give back to others often helps people feel better. Consider volunteering, or clean out your closets and drawers to donate unwanted items to charity.

      Put positivity on display

      One form of self-care can be as simple as not being so hard on yourself all the time. It sounds simple, but it can be a serious challenge at times. Visual reminders can help.

      When in doubt, turn to this handy self-care printable, titled “Everything is Awful and I’m Not Okay.” The checklist presents 16 questions for you to answer and serves as a helpful reminder to stay hydrated, shower, participate in physical activity, and be kind to yourself.

      Keep a copy of the printout in your bag for comfort or hang it somewhere you know you’ll see it.  (Mashable HQ has one on the wall of the women’s restroom.)

      Affirmations are another great way to be kind to yourself and can serve as help. Glancing at inspirational quotes, uplifting doodles, or a few words of positivity can lift your spirits. The Mashable women’s restroom also has a few on display. (Very good restroom.)

      Image: nicole gallucci/mashable

      Don’t be afraid to ask for help

      Though the term self-care sounds like an isolated practice, it doesn’t have to be.

      If you’re someone who struggles to commit to individual self-care routines, or simply takes enjoyment from the company of others, spending time with and opening up to a friend, loved one, therapist, or even reaching out to the Crisis Text Line could be extremely beneficial.

      Just know that you’re not alone in your stress and professionals are out there to help. 

      “Certainly, if possible, try to see a stressful situation as an opportunity to grow, and consider the power of reorienting how you confront a stressful situation when it arrives,” Mazure said.

      “Instead of thinking, ‘Oh no, not again,’ perhaps a good self-care perspective might be, ‘I’ve seen stress before. I’ve got this.'”

      If you want to talk to someone or are experiencing suicidal thoughts, text the Crisis Text Line at 741-741 or call the National Suicide Prevention Lifeline at 1-800-273-8255. Here is a list of international resources. 

      Read more: http://mashable.com/2017/12/16/self-care-guide-2018/

      Senate Passes Tax-Cut Bill in Milestone Move Toward Overhaul

      Senate Republicans narrowly approved the most sweeping rewrite of the U.S. tax code in three decades, slashing the corporate tax rate and providing temporary tax-rate cuts for most Americans.

      The 51-49 vote — achieved just before 2 a.m. Saturday in Washington and only after closed-door deal-making with dissident senators — brings the GOP close to delivering a much-needed policy win for their party and President Donald Trump. 

      After the vote, Trump said on Twitter that he looks forward to signing a final bill before Christmas. Vice President Mike Pence tweeted that a pre-Christmas tax cut would be a “Middle-Class Miracle!”

      Before it goes to Trump, lawmakers will have to resolve differences between the Senate bill and one the House passed last month, a process that could begin Monday. Although both versions share common top-line elements, negotiations on individual provisions inserted to win votes, particularly in the Senate, may be protracted and difficult. The final product will end up being a central issue in the 2018 elections that will determine control of Congress.

      “We’re going to take this message to the American people a year from now,” Senate Majority Leader Mitch McConnell said after the vote.

      Speaking in New York on Saturday, Trump also predicted the tax package would be a winner for Republicans in the 2018 midterm elections. “We got no Democrat help and I think that’s going to hurt them in the election,” Trump said at a fundraising event.

      Read about the sticking points between Senate, House bills.

      Both the House and Senate measures would cut the corporate tax rate to 20 percent from 35 percent — though the Senate version would set that lower rate in 2019, a year later than the House bill would. Also, the Senate bill, unlike the House version, would provide only temporary tax relief to individuals, ending tax cuts for them in 2026. Both bills are expected to add more than $1.4 trillion to the federal deficit over 10 years, before accounting for any economic growth.

      Senator Bob Corker of Tennessee, who had cited concerns over the bill’s effects on federal deficits, was the only Republican dissenter. McConnell rejected revenue scores that suggested the bill’s tax cuts would add to the deficit. He predicted it would be a “revenue producer” by stimulating economic growth. Congress’s official tax scorekeeper this week said otherwise.

      The House and Senate bills also align on the contentious issue of individual deductions for state and local taxes: They’d eliminate all but a deduction for property taxes, which would be capped at $10,000.

      Mortgage Interest

      But they differ on the home mortgage-interest deduction; the House bill would restrict that break to loans of $500,000 or less with regard to new purchases of homes. The Senate legislation would leave the current $1 million cap in place.

      They also differ — narrowly — on the tax rates they’d apply to multinational companies’ accumulated offshore earnings. The House bill would tax those profits at 14 percent for earnings held as cash and 7 percent for less-liquid assets. The revised Senate bill contains a lengthy section that has no direct mention of the rates, but a person familiar with the Senate plan said they’d be 14.5 percent for cash and 7.5 percent for less-liquid assets.

      Senate Republican leaders muscled the sweeping legislation through the chamber less than two weeks after releasing the bill draft. Many GOP lawmakers, including Corker and Lindsey Graham of South Carolina, have expressed concerns that the party has little to show so far before next year’s congressional elections, after the collapse of an Obamacare repeal earlier this year and no action on issues ranging from immigration to infrastructure.

      ‘Working Families’

      Trump expressed gratitude to McConnell and Finance Committee Chairman Orrin Hatch for steering the measure through the Senate.

      “We are one step closer to delivering MASSIVE tax cuts for working families across America,” Trump wrote on Twitter.

      Republicans were able to bring the legislation to a vote using Senate rules that allowed them to approve it with a simple majority, therefore without any Democratic support. The GOP controls just 52 votes in the chamber, eight shy of what’s typically needed to move controversial measures that draw delaying tactics by opponents.

      Narrow Majority

      That narrow majority made it important for Senate leaders to try to hold every member’s vote; moderate Senator Susan Collins of Maine used that leverage to secure various concessions, including an agreement to enhance an individual deduction for large unreimbursed medical expenses through the end of next year. The House bill would eliminate that tax break.

      Democrats decried the bill’s deficit impact and complained they were shut out of the process to help draft the measure. They cited research showing that the legislation primarily benefits the nation’s highest earners and business owners, and will bleed federal revenues in a way that hurts domestic programs.

      “At a time of immense inequality, the Republican tax bill makes life easier on the well-off and eventually makes life more difficult on working Americans, exacerbating one of the most pressing problems we face as a nation — the yawning gap between the rich and everyone else,” said Minority Leader Chuck Schumer of New York during debate on the bill.

      ‘Back of a Napkin’

      Schumer noted that a set of last-minute revisions to the bill changed it in ways that had yet to be analyzed by the Joint Committee on Taxation, Congress’s official scorekeeper for the effects of tax legislation. “Is this really how Republicans are going to rewrite the tax code? Scrawled like something on the back of a napkin?”

      McConnell said the bill, the first text of which was introduced on Nov. 20, went “through the regular order.” He dismissed complaints like Schumer’s. “You complain about process when you’re losing,” McConnell said.

      Attention now shifts to a House-Senate conference committee — a specially appointed, temporary panel that will be charged with hashing out the differences in the bills and preparing a final version for both chambers to consider. Party leaders will select a small group of lawmakers, likely from the House and Senate tax-writing panels in each chamber, who would then be approved by each chamber.

      That work could start as early as Monday, with many high-stakes issues to be worked through. The deadline of Dec. 31 is an artificial one, though — aimed partly at securing a victory well in advance of the 2018 congressional elections. Republicans would have until the end of 2018 before they lose their ability to clear final passage in the Senate without a filibuster.

      Expensing Provision

      Both bills share some key central elements: They both almost double the standard deduction for individual taxpayers while eliminating personal exemptions. They both allow companies to fully and immediately deduct the cost of their spending on equipment for five years. But the Senate version would slowly step down the expensing provision after the five-year period — a feature that the House bill doesn’t provide for.

      Yet there are many differences — ranging from the taxation of business income to the amount set for the child tax credit — and Senate negotiators may have the upper hand during talks. That’s because the wafer-thin two-vote majority in the Senate will make it harder to usher a final bill back through that chamber.

      The House bill would consolidate the current seven individual tax brackets to four, leaving the top tax rate at 39.6 percent. The Senate bill would have seven brackets — with lower rates, and a top rate of 38.5 percent. Studies have shown that many of the tax bill’s benefits would go to the highest earners — and some middle-class taxpayers might actually pay more — a finding that could impact the House-Senate talks.

      The Senate bill includes a repeal of Obamacare’s mandate that most Americans have health insurance or pay a penalty. The House bill does not.

      Pass-Through Businesses

      Senators approved a 23 percent tax deduction — subject to certain limitations — on business income earned from partnerships, limited liabilities and other so-called pass-through businesses. The House version would create a 25 percent tax rate for such business income — with restrictions on which businesses could qualify. Small businesses would get extra relief under the House legislation as well.

      The House bill would also eliminate the estate tax, while the Senate version would limit the tax to fewer multimillion-dollar estates, but leave it in place. And after 2025, the limits would lift.

      Under current law, the estate tax applies a 40 percent levy to estates worth more than $5.49 million for individuals and $10.98 million for married couples. The Senate bill would temporarily double the exemption thresholds. The House bill would double the exemption thresholds, and then repeal the tax entirely in 2025.

        Read more: http://www.bloomberg.com/news/articles/2017-12-02/senate-passes-tax-cut-bill-in-milestone-move-toward-overhaul

        Senators share photos of GOP tax bill pages, and they’re pretty illegible

        Senate Majority Leader Mitch McConnell walks to his office in the Capitol as he awaits the vote on his party's tax plan.
        Image: alex wong/Getty Images

        We’ve all been there. You have your assignment printed and ready to go, but are frantically scribbling down last minute additions in the desperate hope that you’ll get a passing grade.

        This was OK in high school English class, but what about in the U.S. Senate? 

        After several failed attempts to repeal and replace Obamacare, Senate Republicans are really doing everything they can get a legislative win once and for all with their tax plan—including making hasty and nearly illegible handwritten notes and straight up crossed out sections of the bill. 

        Their Democratic counterparts have been sharing photos of the absurdity, and they’re not too happy about it. 

        Sen. Jon Tester of Montana posted an angry video calling out his Republican counterparts and their scribbled legislative notes on Twitter. He said he had received his copy of the bill 25 minutes earlier, just a few hours before the Senate vote. 

        Just an hour before she had to report to the Senate floor for a vote, Sen. Elizabeth Warren also posted a video of her trying to read the messy bill. She couldn’t. 

        If passed by the Senate and the House and signed into law, the tax plan would make a massive cut to the corporate tax rate, give several tax cuts and benefits to the wealthiest Americans, and get rid of the individual health insurance mandate, among many, many other things. 

        With so many changes to the way our tax system works on the line, representatives should at least be able to know what decisions they’re making on behalf of their constituents, because, you know … democracy.

        Read more: http://mashable.com/2017/12/01/senators-gop-tax-plan/

        Woman who flipped off Trump says she was fired for it

        Washington (CNN)The woman who gave President Donald Trump’s motorcade the finger in late October is speaking out after she said she was fired for the incident that went viral.

        “My finger said what I was feeling,” Briskman said. “I’m angry and I’m frustrated.”
        She flipped off the motorcade twice, and after the moment went viral, she told her employer.
          “I thought that it would probably get back to my company eventually,” Briskman said in an interview with CNN’s Jeanne Moos.
          She said she was told she had violated the company’s social media policy, and said the company in turn fired her.
          “I said, ‘Well, that was me,'” Briskman told Moos, recalling her conversation with her former company’s HR representative. Akima LLC did not respond to multiple messages seeking comment, and the White House declined to comment.
          Briskman said she had been at the company for about 6½ months before the incident, and was working in the marketing department.
          She added that she’s “really not” the bird-flipping type.
          “Health care doesn’t pass, but you try to dismantle it from the inside,” Briskman said. “Five-hundred people get shot in Las Vegas; you’re doing nothing about it. You know, white supremacists have this big march and hurt a bunch of people down in Charlottesville and you call them good people.”
          This story has been updated to reflect CNN’s repeated outreach to Akima LLC.

          Read more: http://www.cnn.com/2017/11/06/politics/juli-briskman-motorcade-protest/index.html

          The GOP Tax Plan Is Entering Its Make-or-Break Week

          The $1.4 trillion item on President Donald Trump’s wish list — a package of tax cuts for businesses and individuals that he has said he wants to sign before year’s end — is headed into the legislative equivalent of a Black Friday scrum next week.

          Senate Republican leaders plan a make-or-break floor vote on their bill as soon as Thursday — a dramatic moment that will come only after a marathon debate that could go all night. Democrats are expected to try to delay or derail the measure, and the GOP must hold together at least 50 votes from its thin, 52-vote majority in order to prevail.

          Their chances improved this week when Republican Senator Lisa Murkowski of Alaska said she’ll support repealing the “individual mandate” imposed by Obamacare — a provision that Senate tax writers are counting on to help finance the tax cuts. Murkowski had earlier signaled some reservations about the provision; and her support was widely viewed as a positive sign for the tax bill’s chances.

          Trump is scheduled to address Senate Republicans at their weekly luncheon Tuesday afternoon on taxes and the legislative agenda for the rest of the year, according to a statement from Senator John Barrasso, chairman of the Senate Republican Policy Committee. 

          The White House previously announced that the president would talk with Republican and Democratic congressional leaders at the White House the same day about an agreement on spending to keep the government open after funding expires on Dec. 8. David Popp, a spokesman for Senate Majority Leader Mitch McConnell, and Drew Hammill, a spokesman for House Democratic leader Nancy Pelosi, both said that meeting is still on the schedule.

          If the tax bill clears the Senate — a step that’s by no means guaranteed — lawmakers in both chambers would have to hammer out a compromise between their differing bills, a process that presents potential pitfalls of its own. For now, though, much of the Senate’s attention will focus on its legislation’s price tag.

          Three GOP senators — Bob Corker of Tennessee, Jeff Flake of Arizona and James Lankford of Oklahoma — have cited concerns about how the measure would affect federal deficits. Independent studies of the legislation have found that — contrary to its backers’ arguments — its tax cuts won’t stimulate enough growth to pay for themselves. Both the Senate bill, and one that cleared the House earlier this month, would reduce federal revenue over a decade by roughly $1.4 trillion, according to the Joint Committee on Taxation.

          On Wednesday, a report from the Penn Wharton Budget Model at the University of Pennsylvania said the bill would reduce federal revenue in each year from 2028 to 2033. That finding would mean it doesn’t comply with a key budget rule that Senate Republican leaders want to use to pass their bill with a simple majority over Democrats’ objections.

          Budget Rule

          In essence, that rule holds that any bill approved via that fast-track process can’t add to the deficit outside a 10-year budget window. The JCT has already found that the Senate bill would generate a surplus in its 10th year because it has set several tax breaks for businesses and individuals to expire.

          But JCT hasn’t yet weighed in publicly on the revenue effects in subsequent years. Senate GOP leaders have expressed confidence that their proposal will satisfy the rule ultimately.

          Another potential stumbling block stems from the fact that Congress is trying to act on complex tax legislation under a tight, self-imposed timeline in order to deliver on promises from Trump, House Speaker Paul Ryan and McConnell.

          For example, Republican Senator Ron Johnson of Wisconsin has said he can’t support the current Senate bill because it would give corporations a tax advantage — a large rate cut to 20 percent from 35 percent — that other, closely held businesses wouldn’t get.

          ‘Change the Most’

          His concern centers on the Senate’s plan for large partnerships, limited liability companies, sole proprietorships and other so-called “pass-through” businesses. Under current law, these businesses simply pass their earnings to their owners, who pay income taxes at their individual rates — currently, as high as 39.6 percent, depending on how much they earn.

          Read more: A QuickTake guide to the tax-cut debate

          The Senate bill would provide pass-through owners with a 17.4 percent deduction for income — but in combination with other provisions, that would result in an effective top tax rate for business income that’s more than 10 percentage points higher than the proposed corporate tax rate.

          The House bill would use an entirely different approach, setting a top tax rate of 25 percent for pass-through business income, but then limiting how much of a business’s earnings could qualify for that rate.

          Reconciling those differences — and addressing Johnson’s concern — may be a complicated process. “That’s part of the equation that could change the most over the next few weeks,” Isaac Boltansky, senior vice president and policy analyst at Compass Point Research and Trading LLC, told Bloomberg Tax. “No one is planning around it yet. There is uncertainty across the board.”

          Meanwhile, the Obamacare issue looms in the background — threatening at least one GOP senator’s vote. Susan Collins of Maine said earlier this week that tax bill “needs work,” and “I think there will be changes.”

          The 2010 Affordable Care Act — popularly known as Obamacare — contained a provision requiring individuals to buy health insurance or pay a federal penalty. Removing that penalty in 2019, as the Senate tax bill proposes to do, would generate an estimated $318 billion in savings by 2027, according to the Congressional Budget Office. The savings would stem from about 13 million Americans dropping their coverage, eliminating the need for federal subsidies to help them afford it.

          Because many of the newly uninsured would be younger, healthier people, insurance premiums would rise 10 percent in most years, the nonpartisan fiscal scorekeeper found.

            Read more: http://www.bloomberg.com/news/articles/2017-11-24/trump-s-1-4-trillion-tax-cut-is-entering-its-make-or-break-week