Bali volcano erupts: Thousands of tourists stranded as ash closes airport

The Indonesian tourist island of Bali closed its international airport on Friday, stranding thousands of travellers, as the Mount Agung volcano gushed an 8,200-feet column of ash and smoke. The National Disaster Mitigation Agency said nearly 450 flights were cancelled, affecting some 75,000 people. The regional Volcanic Ash Advisory Centre in Darwin, Australia, said winds would carry the ash southwest toward Java, Indonesia’s most densely populated island. Volcanic ash is a potentially deadly threat to aircraft that can cause engines to "flame out." The volcano began belching ash and smoke on Thursday and several airlines cancelled inbound and outbound flights scheduled for the evening. "We hadn’t a place to stay for the night so we had to find something else, just took a taxi and stayed at a random hostel," said a stranded German backpacker who identified herself as Louisa. "We hoped we could leave this morning, but the airport is closed," she said. Mount Agung - Bali Two small airports, at Banyuwangi and Jember in eastern Java, also closed because of the ash threat. Agung’s alert level has not been raised and an exclusion zone around the crater remains at 2.5 miles. The disaster agency said the closure of Bali’s airport was in effect until 7 pm.  Australia’s national airline Qantas said in a statement that it’s "currently not safe" to operate Bali flights. A flight information board shows cancelled flights at Ngurah Rai International Airport in Bali Credit: AP It said it was monitoring advice from the ash advisory centre and its own pilots and meteorologists would decide when flights can resume. Australian visitor Rod Bird came early to the airport only to be told his flight back to Perth had been cancelled for the second time. An earlier flight on AirAsia was called off before the airport was shuttered early Friday morning. "They told us the volcano is going off so they rebooked us for this morning and we got here at 5:00 am only to be turned away again. So we've had two cancelled flights," Bird told AFP. "Well it's Bali, these things happen and we are fine with it. We just miss the kids," he added. Tourists rest as Ngurah Rai International Airport is closed due to the eruption of Mount Agung in Bali Credit: AP The volcano, about 45 miles northeast of Bali’s tourist hotspot of Kuta, last had a major eruption in 1963, killing about 1,100 people. It had a dramatic increase in activity last year, forcing the evacuation of tens of thousands of people, but had quietened by early this year. Authorities lowered its alert status from the highest level in February. Indonesia, an archipelago of more than 250 million people, sits on the Pacific "Ring of Fire" and is prone to earthquakes and volcanic eruptions. Government seismologists monitor more than 120 active volcanoes.  

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Senate battles over timing of vote on President Trump’s SCOTUS nominee

Republicans are planning to hold a confirmation vote before the midterm elections, refusing Democrats’ demands for a delay.

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Police called suspect in Capital Gazette newsroom shooting no threat in 2013

The man accused of killing five people at a Maryland newspaper was investigated five years ago for a barrage of menacing tweets against staff members, but a detective concluded he was no threat, and the paper didn't want to press charges for fear of inflaming the situation, according to a police report released Friday. The newspaper was afraid of "putting a stick in a beehive." The 2013 police report added to the picture emerging of Jarrod W. Ramos, 38, as the former information-technology employee with a longtime grudge against The Capital of Annapolis was charged with five counts of first-degree murder in one of the deadliest attacks on journalists in US history. Authorities said Ramos barricaded the rear exit of the office to prevent anyone from escaping and methodically blasted his way through the newsroom Thursday with a 12-gauge pump-action shotgun, gunning down one victim trying to slip out the back. Three editors, a reporter and a sales assistant were killed. "The fellow was there to kill as many people as he could," Anne Arundel County Police Chief Timothy Altomare said. Capital Gazette shooting suspect split Ramos, clean-shaven with long hair past his shoulders, was denied bail in a brief court appearance he attended by video, watching attentively but saying nothing. Authorities said he was "uncooperative" with interrogators. He was placed on a suicide watch in jail. His public defenders had no comment. The charges carry a maximum penalty of life without parole. Maryland has no death penalty. The bloodshed initially stirred fears that the recent surge of political attacks on the "fake news media" had exploded into violence. But by all accounts, Ramos had a specific, longstanding grievance against the paper. President Donald Trump, who routinely calls reporters "liars" and "enemies of the people," said, "Journalists, like all Americans, should be free from the fear of being violently attacked while doing their jobs." Ramos had filed a defamation lawsuit against the paper in 2012 after it ran an article about him pleading guilty to harassing a woman. A judge later threw it out as groundless. Ramos had repeatedly targeted staffers with angry, profanity-laced tweets. "There's clearly a history there," the police chief said. Annapolis shooting Ramos launched so many social media attacks that retired publisher Tom Marquardt called police in 2013. Altomare disclosed Friday that a detective investigated those concerns, holding a conference call with an attorney for the publishing company, a former correspondent and the paper's publisher. The police report said the attorney produced a trove of tweets in which Ramos "makes mention of blood in the water, journalist hell, hit man, open season, glad there won't be murderous rampage, murder career." The detective, Michael Praley, said in the report that he "did not believe that Mr. Ramos was a threat to employees" at the paper, noting that Ramos hadn't tried to enter the building and hadn't sent "direct, threatening correspondence." "As of this writing the Capital will not pursue any charges," Praley wrote. "It was described as putting a stick in a beehive which the Capital Newspaper representatives do not wish to do." The five victims of the Annapolis shooting: (top) Gerald Fischman, Rob Hiaasen, (bottom) John McNamara, Rebecca Smith and Wendi Winters Marquardt, the former publisher, said he talked with the newspaper's attorneys about seeking a restraining order but didn't because he and others thought it could provoke Ramos into something worse. "We decided to take the course of laying low," he said Friday. Later, in 2015, Ramos tweeted that he would like to see the paper stop publishing, but "it would be nicer" to see two of its journalists "cease breathing." Capital Gazette reporter Chase Cook (right) and photographer Joshua McKerrow work on the next days newspaper while awaiting news from their colleagues  Credit:  IVAN COURONNE/AFP Then Ramos "went silent" for more than two years, Marquardt said. "This led us to believe that he had moved on, but for whatever reason, he decided to resurrect his issue with The Capital yesterday," the former publisher said. "We don't know why." The police chief said some new posts went up just before the killings but authorities didn't know about them until afterward. Few details were released on Ramos, other than that he is single, has no children and lives in an apartment in Laurel, Maryland. He was employed by an IT contractor for the US Labor Department's Bureau of Labor Statistics from 2007 to 2014, a department spokesman said.

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Here's What Could Happen to Roe v. Wade and Abortion Rights After Justice Kennedy's Retirement

"There’s every reason to believe that Roe v. Wade is on the chopping block"

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Private plane crashes in crowded Mumbai area; 5 people dead

MUMBAI, India (AP) — A small private plane crashed Thursday in a busy area of Mumbai, India's financial and entertainment capital, killing five people including one person on the ground, police said. A former aviation minister said the pilot avoided a much higher toll by hitting an open area at a construction site.

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'Oh God': Melania Trump's horror at being shown picture of young boy left at US border

The Customs and Border Patrol agency (CPD) said that it was the only drink he had and carried no food. Mrs Trump was shown pictures of the boy during a visit to a CPD facility in Tucson, Arizona. In a call to CPD, a spokesperson for the border patrol confirmed to The Independent that the child was no longer in their custody, but would not release where he had been transferred, citing personal protection.

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Democrats Tie Trump Supreme Court Pick To Russia Investigation

Some Democratic senators and their allies are starting to make the argument

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Manslaughter charge: Georgia officer shot fleeing black man

ATLANTA (AP) — A white Georgia police officer accused of fatally shooting a black man had only been on the job a year and a half. But during that time, he'd already earned one suspension for using his personal vehicle in a high-speed chase and — after a black resident complained to the police — parked outside his house, causing the resident to say he feared for his life.

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SoCal parents spread awareness about genetics as kids get same brain cancer diagnosis

A brother and sister received the same cancer diagnosis within a week. Their parents want to let the public know about their children because the cause is thought to be genetic.

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Prosecutor: Suspects in N. Korean death are trained killers

SHAH ALAM, Malaysia (AP) — Two Southeast Asian women on trial for killing the estranged half brother of North Korea's leader are trained assassins who used "criminal force" to rub the toxic VX nerve agent on Kim Jong Nam's eyes and face, prosecutors said in their closing arguments Thursday.

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Trump: Will pick a SCOTUS nominee ‘that’s going to be there for 40 years’

The short list contains all appeals court judges, including Amy Coney Barrett of Indiana, Brett Kavanaugh of Maryland, and Thomas Hardiman of Pennsylvania.

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2019 Dodge Charger SRT Hellcat Gets Some Goodies From The Demon

Dodge also reshuffles the lineup and adds some performance.

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Complete list of every full moon in 2018, including June's Strawberry Moon

Early this morning the seventh full moon of the year – dubbed the Strawberry Moon – lit our skies, peaking at 05:53. The first blue moon of the year was a spectacular sight, dubbed the 'super blue blood moon'. Falling on January 31, it was the product of three different phenomena: it was a supermoon, a blue moon and a blood moon. While many said it was the first to be seen in 152 years, other contested the fact, leading to a division among scientists. Stargazers were also treated to two full moons in March: as well as the first full moon on the night of March 1, we saw another full moon on March 31. As it was the second full moon of the month, it was a blue moon – the second of 2018. July will see will see the longest total eclipse of the 21st century, expected to last one hour 43 minutes – just four minutes shy of the longest amount of time an eclipse can last for. The lunar eclipse, which will occur on July 27, will also be a full moon, a micro moon (meaning it is the smallest full moon of the year) and potentially a blood moon. The view from Parliament Hill in Hampstead of the full moon rising over the City of London on JUne 28 2018 Credit: John Stillwell/PA Wire The moon is the largest and brightest object in our night sky and has enchanted and inspired mankind for centuries. Blue moons are a rare breed, but full moons can be admired every month. Here is everything you need to know about Earth's only natural satellite, from all its different names to how it was formed. How often does a full moon occur? A full moon occurs every 29.5 days and is when the Moon is completely illuminated by the Sun's rays. It occurs when Earth is directly aligned between the Sun and the Moon.  Super blue blood moon, in pictures Why do full moons have names? The early Native Americans didn't record time using months of the Julian or Gregorian calendar. Instead tribes gave each full moon a nickname to keep track of the seasons and lunar months. Most of the names relate to an activity or an event that took place at the time in each location. However, it wasn't a uniform system and tribes tended to name and count moons differently. Some, for example, counted four seasons a year while others counted five. Others defined a year as 12 moons, while others said there were 13. Colonial Americans adopted some of the moon names and applied them to their own calendar system which is why they're still in existence today, according to the Farmer’s Almanac. January: Wolf Moon This moon was named because villagers used to hear packs of wolves howling in hunger around this time of the year. Its other name is the Old Moon. This January there are two Wolf Moons - and stargazers will be in for a treat as both will be supermoons. When two moons occur in one month, the second is called a blue moon. While blue moons typically occur only once every two to three years, this year we will be treated to two moons - the second appearing at the end of March. The night following the first full moon of the month saw the Quadrantid meteor shower light up the skies. When? January 2 and January 31 February: Snow Moon Snow moon is named after the white stuff because historically it's always been the snowiest month in America. It's also traditionally referred to as the Hunger Moon, because hunting was very difficult in snowy conditions.  However this year there won't be a Snow Moon - with a full moon occurring at the end of January and another at the beginning of March, we won't see one light up the skies during the year's shortest month. When? There will be no full moon this month The full Snow Moon appears red above London's Albert bridge and Battersea Bridge in 2012 Credit: Anthony Devlin March: Worm Moon As temperatures warm, earthworm casts begin to appear and birds begin finding food. It's also known as Sap Moon, Crow Moon and Lenten Moon. There will be two moons this March, one at the start of the month and one at the end. As in January, the second moon of the month is called a blue moon. The second moon of the month is important because it is used to fix the date of Easter, which is always the Sunday after the first full moon following the spring equinox. This year, that moon appears on Saturday March 31, which means Easter Sunday falls the day after, on April 1. When? March 1 and 31 April: Pink Moon April's full moon is known as the Pink Moon, but don't be fooled into thinking it will turn pink. It's actually named after pink wildflowers, which appear in the US and Canada in early spring.  This moon is also known as Egg Moon, due to spring egg-laying season. Some coastal tribes referred to it as Fish Moon because it appeared at the same time as the shad swimming upstream.  When? April 30 A couple watch the Pink Moon rise beside Hartshead Pike on April 29, 2018 in Manchester, England Credit: Anthony Devlin May: Flower Moon Spring has officially sprung by the time May arrives, and flowers and colourful blooms dot the landscape. This moon is also known as Corn Planting Moon, as crops are sown in time for harvest, or Bright Moon because this full moon is known to be one of the brightest. Some people refer to it as Milk Moon. When? May 29 Night sky June: Strawberry Moon This moon is named after the beginning of the strawberry picking season. It's other names are Rose Moon, Hot Moon, or Hay Moon as hay is typically harvested around now. This moon appears in the same month as the summer solstice, the longest day of the year (June 21) in which we can enjoy approximately 17 hours of daylight. When? June 28 The so-called 'Strawberry Moon' rises behind Glastonbury Tor on in June 2016.  Credit: Matt Cardy/Getty Images July: Thunder Moon Named due to the prevalence of summer thunder storms. It's sometimes referred to as the Full Buck Moon because at this time of the year a buck's antlers are fully grown.  When? July 27 August: Sturgeon Moon Tribes in North America typically caught Sturgeon during this month, but also it is when grain and corn were gathered so is also referred to as Grain Moon.  This moon appears in the same month as the Perseid meteor shower. When? August 26 September: Harvest Moon The Harvest Moon is the name given to the first full moon that takes place closest to the Autumn equinox, which this year will come on September 23. The Harvest Moon arrived late last year, on October 5 - it normally rises in September. It was during September that most of the crops were harvested ahead of the autumn and this moon would give light to farmers so they could carry on working longer in the evening. Some tribes also called it the Barley Moon, the Full Corn Moon or Fruit Moon.  When?September 25 October: Hunter's Moon As people planned ahead for the cold months ahead, the October moon came to signify the ideal time for hunting game, which were becoming fatter from eating falling grains. This moon is also known as the travel moon and the dying grass moon. When? October 24 November: Frost Moon The first of the winter frosts historically begin to take their toll around now and winter begins to bite, leading to this month's moon moniker. It is also known as the Beaver Moon. When? November 23 December: Cold Moon Nights are long and dark and winter's grip tightens, hence this Moon's name. With Christmas just a few weeks away, it's also referred to as Moon before Yule and Long Nights Moon. When? December 22 Clouds clear to allow a view of the final full moon of the year, a so-called 'Cold Moon' on December 13 2016 in Cornwall. Credit: Matt Cardy/Getty Images Once in a blue moon Does this well-known phrase have anything to do with the moon? Well, yes it does. We use it to refer to something happening very rarely and a blue moon is a rare occurrence. It's the name given to a second full moon that occurs in a single calendar month and this typically occurs only once every two to three years. There's lots of other moons, too: Full moon: We all know what these are. They come around every month and light up the night at night. Harvest moon: The full moon closest to the autumn equinox. Black moon: Most experts agree that this refers to the second new moon in a calendar month. The last black moon was at the start of October 2016 and the next one is expected in 2019. Blue moon: A phenomenon that occurs when there is a second full moon in one calendar month. Joe Rao from space.com explains: "A second full moon in a single calendar month is sometimes called a blue moon. A black moon is supposedly the flip side of a blue moon; the second new moon in a single calendar month." Supermoon is seen behind the Christ the Redeemer statue in Rio de Janeiro, in May 2012. Credit: AP Photo/Victor R. Caivano The infrequent nature of this lunar event led to the phrase "once in a blue moon" to signify a rare occurrence. It does not actually mean the moon will be blue. Blood moon: Also known as a supermoon lunar eclipse. It's when the shadow of Earth casts a reddish glow on the moon, the result of a rare combination of an eclipse with the closest full moon of the year.  There was one in the UK in September 2015, and before that in 1982 but the next one won't be until 2033.  Strawberry moon: A rare event when there's a full moon on the same day as the summer solstice. It happened in June 2016 for the first time since 1967 when 17 hours of sunlight gave way to a bright moonlit sky. Despite the name, the moon does appear pink or red. The romantic label was coined by the Algonquin tribes of North America who believed June’s full moon signalled the beginning of the strawberry picking season. The blood micro-moon lunar eclipse Next month will see an incredibly rare occurance grace our skies: a blood micro-moon lunar eclipse, the longest eclipse of the century thus far. It will be visible in large parts of Australia, Asia, Africa, Europe, and South America, although it is only expected to be a partial eclipse in the UK. Its totality will last for 103 minutes, which will make it the longest eclipse of the 21st century. The longest total eclipse of the 20th century occurred on July 16 2000, lasting one hour and 46.4 minutes. There is a possibility that we will be able to see Mars on the night of the eclipse, which will fall on July 27. The fourth planet from the sun will be very close to the eclipsed moon on July 27 and 28, which means it will be easier to see it with naked eyes. What is a supermoon? Ever looked up at the night sky to see a full moon so close you could almost touch it? Well you've probably spotted a supermoon. The impressive sight happens when a full moon is at the point in its orbit that brings it closest to Earth. To us Earth-lings, it appears 30 per cent brighter and 14 per cent bigger to the naked eye.  How a supermoon is generated Supermoon is not an astrological term though. It's scientific name is actually Perigee Full Moon, but supermoon is more catchy and is used by the media to describe our celestial neighbour when it gets up close. Astrologer Richard Nolle first came up with the term supermoon and he defined it as "… a new or full moon which occurs with the moon at or near (within 90 per cent of) its closest approach to Earth in a given orbit", according to earthsky.org. How many supermoons are there in 2018? There are two full moon supermoons this year, both of which took place in the first month of the year. The first appeared on January 2 and the second appeared on January 31. As it was the second moon of the month, the latter moon was also known as a blue moon. There will also be two new moon supermoons in 2018: one on July 13 and another on August 11. Unfortunately, stargazers were unable to see these moons as new moons are generally obscured by the light of the sun. Last year we were lucky enough to have four supermoons. The first three - April 26, May 25, June 24 - were new moons.  The fourth supermoon of 2017 appeared on December 3 and was a full moon supermoon. This will be a full moon supermoon. In fact, it's the first of three full moon supermoons in a row.  Supermoon rises over Auckland, New Zealand in August 2014. Credit: Simon Runting/REX What do I look for? Head outside at sunset when the moon is closest to the horizon and marvel at its size. As well as being closer and brighter, the moon (clouds permitting) should also look orange and red in colour. Why? Well, as moonlight passes through the thicker section of the atmosphere, light particles at the red end of the spectrum don't scatter as easily as light at the blue end of the spectrum. So when the moon looks red, you're just looking at red light that wasn't scattered. As the moon gets higher in the sky, it returns to its normal white/yellow colour.  Will the tides be larger? Yes. When full or new moons are especially close to Earth, it leads to higher tides. Tides are governed by the gravitational pull of the moon and, to a lesser extent, the sun. Because the sun and moon go through different alignments, this affects the size of the tides. Tell me more about the moon The moon is 4.6 billion years old and was formed between 30-50 million years after the solar system. It is smaller than Earth - about the same size as Pluto in fact. Its surface area is less than the surface area of Asia - about 14.6 million square miles according to space.com Gravity on the moon is only 1/6 of that found on Earth. The moon is not round, but is egg-shaped with the large end pointed towards Earth. It would take 135 days to drive by car to the moon at 70 mph (or nine years to walk). The moon has "moonquakes" caused by the gravitational pull of Earth. Experts believe the moon has a molten core, just like Earth.  How was the Moon formed? How the Moon was formed Man on the Moon Only 12 people have ever walked on the moon and they were all American men, including (most famously) Neil Armstrong who was the first in 1969 on the Apollo II mission.  The last time mankind sent someone to the moon was in 1972 when Gene Cernan visited on the Apollo 17 mission. Although Armstrong was the first man to walk on the moon, Buzz Aldrin was the first man to urinate there. While millions watched the moon landing on live television, Aldrin was forced to go in a tube fitted inside his space suit. Buzz Aldrin Jr. beside the U.S. flag after man reaches the Moon for the first time during the Apollo 11 mission on July 20, 1969.  Credit: AP When the astronauts took off their helmets after their moonwalk, they noticed a strong smell, which Armstrong described as “wet ashes in a fireplace” and Aldrin as “spent gunpowder”. It was the smell of moon-dust brought in on their boots. The mineral, armalcolite, discovered during the first moon landing and later found at various locations on Earth, was named after the three Apollo 11 astronauts, Neil ARMstrong, Buzz ALdrin and Michael COLlins. An estimated 600 million people watched the Apollo 11 landing live on television, a world record until 750 million people watched the wedding of the Prince of Wales and Lady Diana Spencer in 1981. One of President Nixon’s speechwriters had prepared an address entitled: “In Event of Moon Disaster”. It began: “Fate has ordained that the men who went to the moon to explore in peace will stay to rest in peace.” If the launch from the Moon had failed, Houston was to close down communications and leave Armstrong and Aldrin to their death.  How the Daily Telegraph reported Neil Armstrong's first steps on the Moon in 1969

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How Alexandria Ocasio-Cortez Caught Fire And Took Down The 'King Of Queens'

Just six weeks ago, when Alexandria Ocasio-Cortez was still campaigning in

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Here's What Could Happen to Roe v. Wade and Abortion Rights After Justice Kennedy's Retirement

"There’s every reason to believe that Roe v. Wade is on the chopping block"

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797-HP Dodge Challenger Hellcat Redeye Ushers In Updated Range

The standard Hellcat gets a power bump too.

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Maxine Waters Cancels Events After 'Very Serious Death Threat'

Rep. Maxine Waters (D-Calif.) has canceled weekend events in Alabama and Texas

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All Eyes on Melania Trump's Fashion as She Takes Second Trip to the Border

This time, she left her controversial jacket at home.

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Even at 'Safe' Levels, Air Pollution May Boost Diabetes Risk

FRIDAY, June 29, 2018 (HealthDay News) -- Add another health harm to air pollution: New research suggests it might increase the risk of diabetes, even at levels considered safe.

Cutting air pollution could reduce diabetes rates in countries with both higher and lower levels of air pollution, the researchers said.

"Our research shows a significant link between air pollution and diabetes globally," said study senior author Dr. Ziyad Al-Aly. He's an assistant professor of medicine at Washington University in St. Louis.

"We found an increased risk, even at low levels of air pollution currently considered safe by the U.S. Environmental Protection Agency and the World Health Organization," Al Aly said in a university news release.

"This is important because many industry lobbying groups argue that current levels are too stringent and should be relaxed. Evidence shows that current levels are still not sufficiently safe and need to be tightened," he added.

But the findings did not prove that air pollution causes diabetes.

In the study, the researchers estimated that air pollution contributed to 3.2 million new diabetes cases worldwide in 2016, or about 14 percent of all new cases that year. They also estimated that 8.2 million years of healthy life were lost worldwide in 2016 due to pollution-linked diabetes.

In the United States, air pollution is linked with 150,000 new cases of diabetes a year and 350,000 years of healthy life lost each year, according to the report.

Diabetes affects more than 420 million people worldwide and 30 million Americans. The main causes of type 2 diabetes include an unhealthy diet, inactivity and obesity, but this study highlights the significance of outdoor air pollution.

It's believed that air pollution reduces insulin production and triggers inflammation, preventing the body from converting blood sugar into energy that the body needs to maintain health, the study authors explained.

The study was published June 29 in The Lancet Planetary Health.

Previous research has linked air pollution with heart disease, stroke, cancer and kidney disease.

More information

The U.S. National Institute of Environmental Health Sciences has more on the health effects of air pollution.

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Human Insulin as Good as Costly Synthetic Versions

FRIDAY, June 29, 2018 (HealthDay News) -- Human insulin is as safe and effective as newer, more expensive insulin analog drugs for people with type 2 diabetes, researchers report.

The new study included people with type 2 diabetes who were followed for an average of 1.7 years after they started using insulin.

"We found that for patients with type 2 diabetes in usual practice, the use of the more expensive insulin analogs did not appear to result in better safety -- at least as defined by hospital or emergency visits for hypoglycemia -- or better blood sugar control," said lead author Dr. Kasia Lipska. She is an assistant professor of medicine at Yale School of Medicine.

"This suggests that many people with type 2 diabetes should consider starting with [human] insulin, instead of insulin analogs, especially if cost is an issue for them," she added in a Yale news release.

About 25 percent of people with type 2 diabetes eventually require insulin to control their blood sugar.

According to study co-author Andrew Karter, "For decades, people initiating insulin treatment were prescribed human insulin. Then in the 2000s, a new generation of long-acting insulin analogs emerged that were designed to mimic human insulin." Karter is a senior research scientist in Kaiser Permanente's division of research.

Lipska explained that "the problem is that insulin analogs are much more expensive" than human insulin.

A vial of insulin analog costs about $200 to $300, compared with $25 for a vial of human insulin. In the United States, the cost of analog insulin tripled between 2002 and 2013, the study authors noted.

Previous research by Karter showed that higher out-of-pocket costs make diabetes patients less likely to take prescribed medicines.

"The cost differential between analog and [human] insulins is huge, up to a 10-fold difference," Karter said. "Some people with type 2 diabetes may find the potential benefits of insulin analogs worth the additional cost. But we found no population-level evidence to suggest that the extra expenditure is warranted for most people with type 2 diabetes, particularly when the high cost could prevent some of them from getting the treatment they need."

The study was published June 23 in the Journal of the American Medical Association.

More information

The University of California, San Francisco has more on types of insulin.

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Close Siblings Can Ease the Pain of Family Conflict

FRIDAY, June 29, 2018 (HealthDay News) -- Good relationships between siblings can help them cope with conflicts between their parents, a new study finds.

The research included 236 families with a mother, father and at least two children who weren't twins. The children were between ages 12 and 14, and most of the families were white and middle-class.

"Most children not only grow up with a sibling, but spend more time interacting with siblings than with any other family member," said study leader Patrick Davies, a professor of psychology at the University of Rochester in New York.

Children in the study observed their parents discussing topics of disagreement, and they reported on their distressed responses then, and one year later. Researchers found that teens who had good relationships with their siblings had less distressed responses, though they only found an association, rather than a cause-and-effect link.

The study was published recently in the journal Child Development.

"We showed that having a good relationship with a brother or sister reduced heightened vulnerability for youth exposed to conflicts between their parents by decreasing their tendencies to experience distress in response to later disagreements between their parents," Davies explained in a journal news release.

The researchers noted that because most of the families in the study were white and middle-class, the findings may not apply to families of other races or levels of wealth.

Still, "relationships with siblings protected teens whether we defined a good bond as one that included warmth and problem-solving skills or one that had low levels of destructive conflict or disengagement," said study co-author Meredith Martin, an assistant professor of psychology at the University of Nebraska-Lincoln.

"Strengthening sibling relationships may not only directly foster children's psychological adjustment, but also offer new approaches to counteracting the risks associated with experiencing hostility and unresolved conflicts between parents," she said.

More information

The American Academy of Pediatrics has more on family dynamics.

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Some Salads Are Healthier Than Others

FRIDAY, June 29, 2018 (HealthDay News) -- Not all salads are created equal.

When you're choosing your bowl of greens this summer, you should know that three types contain more calories, sodium and fat than you may want, one dietitian says.

So, if you want to eat the healthiest salads possible, steer clear of taco salads, chef salads and Caesar salads.

Taco salads, especially those that come in shells, typically have 760 calories, 39 grams of fat, 10 grams of saturated fat and 1 gram of trans fat, according to Laura Acosta, a registered dietitian at the University of Florida's Institute of Food and Agricultural Sciences.

"One gram doesn't seem like a lot, but when you consider that organizations like the American Heart Association recommend that even 2 grams of trans fat per day is too much, it helps to put it into perspective," said Acosta.

Not to be outdone, chef salads are loaded with meats and cheeses. The meats are often processed and contain nitrite preservatives that may increase risk for cancer when consumed consistently. While cheese can be a good source of calcium and protein, it is also high in calories, saturated fat and sodium.

Last but not least, Caesar salads can be a problem because most varieties of Caesar dressing are heavy, creamy and high in calories. "Since Caesar salads are usually pre-dressed, you don't have a lot of control over the amount of dressing, and restaurants are usually pretty heavy-handed," Acosta said in a university news release.

When deciding on a salad, read the description or list of ingredients, Acosta suggested.

"As a very general rule of thumb, house salads and garden salads tend to be fairly basic -- lettuce, tomatoes, cucumbers, onions -- and good bets if you're watching your weight or calorie intake," Acosta said.

"If cutting calories is a goal, be aware that the main source of calories in many 'house' or 'garden'-type salads is going to be the dressing, so aim for about two tablespoons of dressing," she recommended.

Most dressings have around 120 to 180 calories per two tablespoons, she said, so you don't want to use more than that.

It's also a good idea to dip your fork in the dressing before each bite, rather than pouring dressing over the salad. That will significantly reduce the amount of dressing you consume, she explained.

If cutting calories isn't a goal, "A simple olive oil and vinegar dressing, for instance, will have roughly the same number of calories as other dressings, but will provide about 10 grams of monounsaturated fat -- one of the 'good' fats that helps to promote cardiovascular health -- per tablespoon of olive oil," Acosta said. "So, the amount of salad dressing may not be as important as the type in many cases."

More information

The American Academy of Family Physicians has more on food and nutrition.

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AHA: Using Electricity to Test Your Risk for Heart Failure

FRIDAY, June 29, 2018 (American Heart Association) -- Imagine stepping onto a scale -- not to measure your weight, but the chance of your heart failing.

That's the potential scenario envisioned by researchers who may have discovered a new risk factor for heart failure: leg bioimpedance.

More frequently used to calculate body fat, bioimpedance uses low electrical currents to measure resistance within tissue. In a study published Friday in the Journal of the American Heart Association, researchers at Stanford University School of Medicine found that people who had lower leg bioimpedance were at higher risk for heart failure. The discovery could potentially lead to earlier diagnosis and preemptive treatment of the condition.

The study's authors examined data on more than 500,000 U.K. patients between the ages of 49 and 69 in a search to find new risk factors for heart failure, a condition in which the heart fails to pump blood efficiently enough to meet the body's needs.

Researchers used computer-assisted techniques to weed through 3,646 variables reflecting lifestyle, health and disease-related factors for each patient. The results did not surprise -- among the top predictors of heart failure were having a previous heart attack, chronic heart disease and a history of diabetes.

But then came leg bioimpedance.

"We homed in on that because the other risk factors are well established for heart failure, whereas [leg] bioimpedance was one of the novel risk factors and one that is easily measurable," said the study's senior author, Dr. Erik Ingelsson, a professor of medicine at Stanford University.

Bioimpedance was measured using a body composition analyzer, which looks like a standard scale but with handlebars. Electrodes beneath each foot send small electric currents and measure impedance, or resistance, met in the tissue.

Water, blood and other fluids easily conduct electricity and have lower bioimpedance than something more solid such as muscle tissue, which has higher resistance.

Ingelsson said it's possible that people who had lower leg bioimpedance in the study had early stages of fluid buildup in their legs, a very common symptom of heart failure. The low bioimpedance may have identified a level of water retention that had yet to be detected by health care providers and before the appearance of other heart failure signs, such as fatigue or shortness of breath.

Dr. Barry Borlaug, a Mayo Clinic cardiologist and medical professor who was not involved in the study, said more research is necessary, but he sees potential for how leg bioimpedance could be used to predict heart failure, particularly among people who lead inactive lifestyles.

"A number of people might have the abnormalities in their hearts and lungs that cause symptomatic heart failure, but they don't experience these symptoms because they are so sedentary," said Borlaug, director of Circulatory Failure Research at Mayo Clinic. "Something like this might function like a canary in the coal mine."

Borlaug said the findings need to be validated within another population to ensure the results can be reproduced, although he admitted that since there were more than 500,000 patients in the study, "the risk that this finding is spurious or due to play of chance is fairly low."

The study's authors suggest that a simple algorithm they developed based on their findings could provide an accurate prediction of developing heart failure within eight years. The formula combines leg bioimpedance with a patient's age, sex and whether the person has had a heart attack or not.

Ingelsson said he'd like to see companies that manufacture body composition analyzers incorporate that algorithm into software for their scales.

"The ideal scenario would really be that you stand on the scale, and in addition to getting your body fat percentage, you also get your risk for heart failure within the next eight years," he said.

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Pantry Items That Stay Fresher in the Fridge

FRIDAY, June 29, 2018 (HealthDay News) -- You may know to keep tomatoes out of the fridge to preserve their taste, but did you know which pantry staples actually do better under refrigeration?

While many of the following foods may stay fresh for up to six months under "ideal" conditions -- in a cool, dark pantry -- that's not always possible, especially if your home often gets warm and humid.

Here's what you need to know.

Keep whole intact grains and whole grain flours and meals in the fridge or freezer.

These include:

• Whole grains, such as wheat berries, quinoa, brown rice, cornmeal and barley.
• Whole wheat flour.
• Coconut flour and coconut flakes.
• Wheat germ, wheat bran and rice bran.
• Ground flaxseed.

The good-for-you natural oils in nuts go rancid faster at room temperature. They'll stay tasty for a year or more in the fridge and up to 2 years in the freezer. Nut flours, natural peanut butter, other nut butters like cashew and almond butter, and nut and seed oils, especially walnut and sesame oils, should be refrigerated.

If you don't use up opened bottles of other oils, such as olive and safflower oils, within a month, consider keeping them in the fridge, but definitely away from the heat of your stove. Note that refrigerating oils may cause them to become cloudy, but they'll return to normal at room temperature, and this doesn't affect taste.

More surprising foods for the fridge are maple syrup, vanilla, molasses, instant coffee and active dry yeast.

Before the big chill, place foods in airtight containers or sealed plastic bags so they won't absorb any moisture or pick up odors from other foods. And periodically check the temperature inside your fridge -- -it should always be between 34 and 40 degrees.

More information

Maximize the benefits of your fridge and freezer with these tips from the Institute of Agriculture and Natural Resources of the University of Nebraska-Lincoln.

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Staying With 1 Doctor May Prolong Your Life: Study

FRIDAY, June 29, 2018 (HealthDay News) -- Sticking with one primary care doctor may help you stay healthy and extend your life, according to a new British study.

Researchers reviewed 22 studies from nine countries with different cultures and health systems. Of those, 18 concluded that staying with the same doctor over time significantly reduced early deaths, compared with switching doctors.

"Currently, arranging for a patient to see the doctor of their choice is considered a social convenience," said lead researcher Dr. Denis Pereira Gray. "Now it is clear that it is about improving the quality of medical practice with profound implications for all health systems."

Gray is an emeritus professor at the University of Exeter in England. He is also former president of the Royal College of General Practitioners and former chairman of the Academy of Medical Royal Colleges.

He said this study is the first systematic review of the relationship between continuity of doctor care and death rates.

Not only can seeing the same primary care doctor prolong life, but the same holds true for specialists such as surgeons and psychiatrists, Gray said.

"Patients talk more freely to doctors they know, and doctors can then understand them better and tailor advice and treatment better," he said.

Although technology has brought advances in medical care, Gray said, "this research shows that human factors like continuity of care remain important and are indeed a matter of life and death."

A continuing relationship with one doctor has many benefits that can improve care, said Dr. Marc Siegel, a professor of medicine at NYU Langone Medical Center in New York City.

"The intangible aspect of knowing your patients, knowing their history, knowing their quirks, and knowing who they are can help predict outcomes and help you intervene," said Siegel, who wasn't part of the study.

At a time of increasing consolidation of medical information, communication among doctors is still fractured, he added. For example, patients who get their care in clinics or hospitals might not see the same doctor at each visit.

Plus, doctors today spend less time with each patient. "Less face time is disadvantageous," Siegel said.

The personal relationship between a patient and caregiver should also include nurses, nurse practitioners and physician assistants, he added.

"The whole idea is a personalization of the health care industry and a continuity of care," Siegel said.

That's why it's important to find what has been called a "medical home." A medical home is a team-based approach to care coordinated by a primary care physician. Besides providing care, it's a one-stop location for all your medical data and a place where caregivers know you and your needs, Siegel said.

Knowing you well also helps a primary care doctor refer you to the ideal specialist when needed.

"Once you have a good primary care doctor, follow their suggestions on who else to go to," Siegel said. "Primary care doctors are guides. Good doctors know good doctors."

The report was published online June 28 in the journal BMJ Open.

More information

To learn more about the role of primary care doctors, visit the Harvard Medical School.

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Don't Turn Into a July 4 Highway Statistic

FRIDAY, June 29, 2018 (HealthDay News) -- The National Safety Council has a sobering forecast for this Fourth of July.

It estimates that 18,600 people could be seriously injured on U.S. roads and 164 could be killed -- nearly 4 percent more than the number of deaths (157) that occurred in 2012, the last time July 4 fell on Wednesday.

"Independence Day should be about spending time with loved ones and watching fireworks, not about dealing with the tragic aftermath of a car crash," said council president Deborah Hersman, said in a news release.

The holiday period begins at 6 p.m. Eastern time Tuesday, July 3, and ends at 11:59 p.m. Wednesday, July 4.

In sharing its grim estimates, Hersman said the council hopes to highlight the importance of safe, sober and attentive driving.

During the 2016 Independence Day holiday, 41 percent of road deaths involved an alcohol-impaired driver, the highest percentage among all the major holidays, according to the council.

Road deaths rose 14 percent between 2014 and 2016, the largest two-year increase in 53 years, the group noted.

There are a number of ways drivers can protect themselves and their passengers:

• Drive defensively: Use seat belts, get plenty of sleep to prevent fatigue, avoid distractions while behind the wheel, and never drive while impaired by alcohol or drugs.
• Maintain your car: Learn about your vehicle's safety systems and how to use them, and fix recalls immediately.
• Pay attention to newbies: Parents need to monitor teens' driving habits.
• Prevent hot car tragedies: Look before you lock your car to ensure a child hasn't been left inside. So far this year, at least 18 children in the United States have died after being left in hot cars.

More information

The U.S. National Highway Traffic Safety Administration has more on road safety.

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Hot Cars, Drowning: Keep Your Family Safe This Summer

FRIDAY, June 29, 2018 (HealthDay News) -- Along with sun and fun, there's unexpected danger lurking during the summer.

More accidental deaths occur in the United States during July and August than during any other two-month period of the year, according to the National Safety Council.

"Unfortunately, when we look at accidental deaths, summer is not the carefree period we'd like it to be," said Ken Kolosh, manager of statistics at the council.

"The numbers underscore the need for public awareness. We hope [we] can help people understand the biggest risks to their safety and take the steps needed to ensure no one gets hurt," he said.

To help with that, the council has an online interactive database called Injury Facts, which provides numbers and details about a range of risks.

For example, it shows that in July 2016, there were 656 drownings while swimming, playing or after falling in the water -- a 108 percent increase over the yearly average and the highest level that year. In 2016, there were a total of 3,786 drownings.

That number does not include drownings while boating.

And so far this year, 18 children have died after being left in a hot car. On average, 37 children under the age of 15 die this way each year.

Pedestrian deaths also start to rise in late summer, and continue to increase until the end of the year. There has been a sharp jump in pedestrian deaths since 2009, with 7,330 such deaths in 2016.

In terms of natural disasters, there were 44 deaths due to excessive heat in July and August of 2016.

Accidental gun-related deaths have remained steady in recent years, accounting for about 1 percent of all gun-related deaths. However, gun-related homicides increased 7 percent between 2015 and 2016, and July and August are peak months for such deaths.

In 2016, there were more than 2,600 gun-related deaths during July and August.

More information

The U.S. Centers for Disease Control and Prevention offers injury prevention advice.

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The European Union embraced a new hardline agenda to defend its borders against illegal migration last night as Angela Merkel warned that the fate of the bloc depended on addressing the three-year crisis over migration. Europe’s growing crop of populist leaders claimed victory for their “Fortress Europe” agenda which saw the European Council summit in Brussels putting deterrence and the protection of EU borders at the forefront of its migration policy. “Europe has many challenges but migration could end up determining Europe's destiny,” Mrs Merkel told the German parliament before the summit, with her own political future hanging in the balance following a rebellion against her softer migration policies by her Bavarian coalition partners. The draft summit conclusions showed the German leader’s long-standing calls for an inclusive approach to migration playing second fiddle to the need to secure Europe's borders and process illegal migrants off-shore so they could be returned to their countries of origin. In a sign of the high stakes at the table Italy took the highly unusual step of blocking the entire summit conclusions in order to extract concessions on migration. The move forced Jean-Claude Juncker the EU Commission president to cancel a planned press conference.  Senior Brussels sources said that Italy was demanding that the EU agreed that every migrant arriving in Italy was “arriving in Europe” in a bid to force other EU states to share the burden of migration.  Italy was also demanding urgent reforms to the Dublin regulation and a European wide commitment to rescuing migrants in the Mediterranean.  “We’re willing to work through the night to get this,” said an Italian source involved in the talks.  Emmanuel Macron the Fench President posted a photograph on Twitter of him and his Italian counterpart working on drafts of the conclusions as all sides worked to broker a late-night compromise.  Sebastian Kurz, the conservative Austrian chancellor who is in coalition with the far-right Freedom Party, said the shift to a harder line was a victory for those states who have argued that the EU’s soft approach is creating ‘pull factors’ for migration.   Merkel's migration tensions | Read more “It seems as if today we will manage a shift in migration policy,” he said, adding that being rescued in the Mediterranean “must not automatically become a ticket” to central Europe. “That’s important because we have asked for a systemic change for years. For years we have demanded reductions in the number of people coming to Europe illegally. I think that is possible today.” Viktor Orban, the Hungarian prime minister who put up fences on Hungary’s border with Serbia in 2015 after Mrs Merkel threw open Germany’s border, said the change was a victory for the concerns of Europe’s voters. “The main issue is not migration, the issue is democracy in Europe ... it is about what the people believe, what should be done," he said before claiming the people wanted migrants to be sent back to where they came from. He added that the move heralded the start of a “new period when we try to reconstruct the European democracy.” Mr Orban’s claims of a victory for ‘democracy’ will send shudders through liberal Europe which believes that the Hungarian leader is using the consensus for a harder line over migration as a Trojan horse for a broader illiberal agenda. Donald Tusk, the European Council president, warned on the eve of the summit that failure to address the migration question risked handing ammunition to populists and those with “a tendency towards overt authoritarianism” - which was widely taken as a reference to the likes of Mr Orban. But Mr Tusk said that the EU’s measures - which include beefing up Europe’s border force to 10,000, forging return deals with African states and investigating setting up so-called hotspot camps in north Africa - were necessary to avoid something worse. “Some may think I am too tough in my proposals on migration. But trust me, if we don't agree on them, then you will see some really tough proposals from some really tough guys," he said. 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