This past week, I have learned that too many people I know or have know of – are dying of cigarettes.
Yes. That's right. Not lung cancer. Or Chronic Obstructive Pulmonary Disease – COPD. Those are symptoms.
Their cause?
Smoking cigarettes.
"Mary's life ended all too soon. The cause of death was cigarettes, which first addicted her at 14. In lieu of flowers, contributions to the crushing of the tobacco industry would be greatly appreciated-whether in dollars to the Non-Smokers' Rights Association, or by persuading someone you know, in Mary's name, to quit now." Dr. Mary Barrie was an extraordinary person. An educator, years ahead of her time, specializing in Andragogy, the art and science of teaching adults. My husband enormously enjoyed teaching at the University of Toronto's School of Continuing Education under Mary Barrie's watch, when she was its Director from 1994 to 2005.
If you're addicted, as I am, to CBC:Radio One and Andy Barrie, who anchors the morning show. If you wake up with Andy, as I have, for so many years, I cannot remember. (Long before I started waking up with my husband.) If you have missed Andy desperately, as I have, since last November when he took an "indefinite leave" for "family matters" – you know that Dr. Mary Barrie was Andy's wife of 40 years.
She was 64 years old.
At close to 3 a.m. this morning, I was crying at this computer as I read a blog new to me called Life as a hospice patient, written by Judi Chamberlin, a pioneering activist in the psychiatric survivor movement.
"I believe that until people labeled as 'mentally ill' have the same rights as others, we will continue to be marginalized and discriminated against," she states in her Blogger profile.
Judi has COPD but she is not a candidate for a lung transplant. In her first blog post, Trying to make sense of it all, on December 4, 2008, she wrote, knowing that she doesn't "have a very long life expectancy," she hoped to see Barack Obama inaugurated and to be around for the Super Bowl. "After that, I'll set another goal," she said.
Judi is 64 years old.
Last week, I received a note from a woman, a family friend, who found me though this blog. I had not heard from her for many years. She is a friend of my mother's. Brilliant, charismatic. A dynamo. When I was a kid, I babysat for her three children, now grown, with kids of their own.
Superbly accomplished. Anything she tries, she masters. With pizzazz! You never forget her. She's a force. Funny. Fabulous. I adore her.
"I've had two bouts of lung cancer (clean at the moment) and suffer terribly with my emphysema... Mind you, some days I can manage and others simply cannot breathe. That's a trial. However, I AM STILL HERE," she said her in note.
And finally, during a call this morning to my mother who is wintering in Florida and I knew would not yet know of Dr. Mary Barrie's death, she informed me of yet another amazing man I had known, a smoker, who had died recently after battling lung cancer.
I was a smoker. My husband quit 20 years ago. Addictions don't often appear here in "Coming Out Crazy," but they should. Often, addictions are highly complex and comorbid – linked to deeper psychological trauma and pain.
Timing is everything. Who knew nicotine was a highly addictive drug 50 years ago? Toxic. Poisonous. Deadly.
Alcohol is highly addictive, too. The founders of Alcoholic Anonymous knew that back in the 1930s.
Food can be highly addictive. I know. I'm an addict.
The pleasure pathway in the brain is the same for nicotine, alcohol, food – even sex.
We are human. I don't judge anyone. But I applaud the bravery, the integrity, the honesty, the audacity and the leadership of the late Dr. Mary Barrie and her family for stating boldly in her obituary, that the cause of her death was cigarettes.
Graciously and generously, they are giving all of us a unique opportunity to take action – to become activists. By either supporting the Non Smokers' Rights Association, or by helping someone to quit smoking, we can join in honouring and memorializing Dr. Mary Barrie's wonderful life and legacy.
We may make a difference for the Greater Good.
We may help each other choose to "Say yes, to life."
And, finally... Andy, Jess and Wrigley and those grieving with you – please accept my profound sympathy.


Saccharin Removed from EPA’s Hazardous Substance List The EPA has officially removed saccharin and its salts from their list of hazardous constituents and commercial chemical products. In a December 14, 2010 release, the EPA stated that saccharin is no longer considered a potential hazard to human health. Other substances on this list are still considered hazardous.
Saccharin is commonly used as an artificial sweetener in food products such as diet soft drinks, table-top sweeteners, syrups, juices, chewing gums, and jellies. Its white crystalline powder is approximately 300 times sweeter than sucrose. The substance is typically available in the acid form (saccharin) or as salts (sodium saccharin or calcium saccharin). It is also used in personal-care products, such as toothpaste, mouthwash, dental cleaners, lipstick, or for pharmaceuticals such as coatings on pills and electroplating (e.g. brightener in nickel-plating baths).
In response to a petition submitted to EPA by the Calorie Control Council (CCC) requesting removal of saccharin and its salts from RCRA and CERCLA, EPA will no longer list these substances as hazardous within the Resource Conservation and Recovery Act (RCRA) and the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA).
EPA granted CCC’s petition based on a review of the evaluations conducted by key public health agencies concerning the carcinogenic and other potential toxicological effects of saccharin and its salts. In addition, EPA assessed the waste generation and management information for saccharin and its salts, concluding that the wastes do not meet the criteria for hazardous waste regulations.
The proposed removal of saccharin and its salts was first announced in April 2010. Since April, the EPA stated they had not received any comments opposing the proposal, so this is the final rule announcement.
Supporting materials for this final rule are available for public review at www.regulations.gov – docket number EPA-HQ-RCRA-2009-0310.
Read a previous article on the saccharin removal…


Great idea!
I heard at the end of a talk by Thich Nhat Hanh earlier this week, which he gave in Vietnam, a woman asked if we are mindful in everything we do, do we need to meditate? Thich Nhat Hanh told her that those who have a high level of mindfulness, constant mindfulness in everything they do, don't need to sit in formal meditation. Being mindful in everything you do is actually constantly meditating during everything you do.
So I agree with you, mindfulness in daily life and formal sitting practice are equally as important. I think with much formal sitting practice, the effects of meditation can spill over into daily activities, making it easier to be mindful in daily activities, permeating every part of one's experience.
"No tree becomes rooted and sturdy unless many a wind assails it. For by its very tossing it tightens its grip and plants its roots more securely; the fragile trees are those that have grown in a sunny valley." --Seneca the Younger (57 BCE- 65 AD) "Everything is an illusion. Life is like a big dream." --Buddha Shakyamuni


Your firmer and flatter abdomen will enhance your body contour as a result of Abdominoplasty. Wearing certain styles of clothing will be easier and comfortable. You will be more confident about your appearance.
The incisions from the procedure will heal and fade over time. However, one needs to understand that the incision lines will be permanently visible. In a few cases they may eventually be only faint lines. Certain individuals may have incision lines that are more noticeable. Fortunately, the incisions for your Abdominoplasty are usually in locations concealed by most bathing suits and undergarments.
Wearing a support garment for several weeks may be instructed. Your abdomen should remain firmer and flatter for many years subject to your gaining or losing a significant amount of weight or becoming pregnant. However, factors like gravity and the effects of aging will eventually take their toll.
In case, after a few years, you again become dissatisfied with the appearance of your abdomen, you may choose to undergo a second procedure to restore a more youthful body contour.


International Bottled Water Assn. delivers bottled water to Hurricane Sandy victims
The International Bottled Water Assn. (IBWA) is working with its member bottlers to deliver critical supplies of bottled water to victims of Hurricane Sandy.
As with past disasters, IBWA member bottlers began preparing to provide substantial supplies of bottled water as the storm approached. Working in coordination with the Federal Emergency Management Agency; state, county and municipal emergency management agencies; and emergency relief partners, including the American Red Cross and AmeriCares, IBWA’s members are supplying clean and safe drinking water to hurricane victims in New Jersey, New York and other stricken areas in the Mid-Atlantic and Northeast.
“Throughout the years, bottled water companies have immediately responded to the need for clean water after disasters such as hurricanes, earthquakes, tornados, flooding and wildfires; or the terrorist attacks on the Pentagon and World Trade Center,” said IBWA Vice President of Communications Chris Hogan.
“Having access to safe, clean drinking water is important to everyone’s survival, but this becomes paramount during disasters such as this, when municipal supplies may become compromised,” Hogan said. During these times, bottled water is a necessary and reliable option to deliver clean, safe drinking water.
IBWA member companies are working around the clock to get bottled water to affected areas in several ways. For example, as of last week, one company had delivered 12 truckloads of bottled water to Red Cross warehouses in Middletown and Somerset, N.J., for immediate distribution to Jersey Shore towns most in need of clean drinking water. Additionally, through AmeriCares, bottled water has been distributed to the Salvation Army for Nassau County, the Food Bank for New York City and Vermont food banks to help residents affected by the storm.
Other IBWA members are working through Convoy of Hope, which has deployed a rapid response team, complete with emergency relief supplies, to its Long Beach, N.Y., distribution facility. The organization is receiving and distributing daily tractor-trailer loads of supplies, including bottled water, microwaveable meals, trash bags and other basic essentials.


ITFC is designed to maintain children and youth in family settings in the community who otherwise may have been placed into institutional settings. ITFC offers intensified services for foster youth who need extra structure and support not available in other foster settings. Additional support is given to foster families to help care for ITFC foster youth.
Supports and services in this program are highly individualized to target the specific needs of foster children and foster parents:
Special Training for ITFC foster parents Respite for foster parents Support Counselor provides scheduled in-home support to foster youth Intensive in-home case management provided to foster families by social workers Access to mental health professionals and programs Increased stipend - ITFC foster parents receive a higher monthly reimbursement Support Services include family reunification, mentoring, targeted life skills training, liaison with schools, placement stabilization, monthly treatment team meetings and 24/7 crisis response Foster children who have special emotional, social and developmental needs are at greater risk of violent behavior, incarceration, hospitalization, or placement in different forms of group and residential treatment. When given the opportunity to participate in Intensive Treatment Foster Care, the individual attention can positively impact that child’s choices and increase his or her chances of reaching their full potential in life.
This video supplied by our respected colleagues at the Kennedy Krieger Institute in Baltimore will be helpful to anyone wanting to understand what fostering challenging children and youth is all about. This video is used with permission of Kennedy Krieger Institute, Baltimore, MD. The individuals who appear were participants in Kennedy Krieger’s Therapeutic Foster Care program at the time of filming. The video is six minutes, forty-nine seconds long.


Curriculum Summary: Course of Study The program offers a firm foundation in biomedical sciences, epidemiology and biostatistics. The program trains research scientists who are interested in the following areas of cellular and molecular biology: nutritional biochemistry, cardiovascular biology, gene regulation, cell-environmental interactions, pulmonary inflammation, immunology, infections diseases, protozoa, helminths, viruses and bacteria, and genetic approaches to disease mechanisms. It has become increasingly evident that progress in disease prevention is optimally promoted by a close interaction between epidemiologists and laboratory scientists, where laboratory discoveries and epidemiological observations interact in an iterative manner to advance research in both fields.
To realistically evaluate their research interests, suitability of a laboratory and a potential dissertation advisor, students engage in 3-4 laboratory rotations in their first year before selecting a dissertation advisor. Students engage in two years of coursework before taking a preliminary qualifying exam that must be passed prior to beginning dissertation work. The dissertation must be successfully defended prior to the granting of the Ph.D. degree, typically within 5-6 years.


Steven Lasser, M.D. has recently received his certification from the FAA to perform aviation medical exams.An Aviation Medical Examiner (AME), in the United States and other countries, is a physician designated by the local aviation authority to perform physical examinations and issue aviation medical certificates.Physicians apply through their regional flight surgeon's office. If selected and authorized, they are trained through a national process.AMEs are required to complete the Medical Certification Standards and Procedures Training (MCSPT) and the Clinical Aerospace Physiology Review for AMEs (CAPAME) prior to attending a Basic AME Seminar.
Aviation Medical Examiners are a key element in the medical certification process, ensuring that airmen meet the medical standards prescribed in the Federal Aviation Regulations, and are medically fit to perform safety-related duties. AMEs play a vital role in the FAA Office of Aerospace Medicine's goal to promote aviation safety through excellence in aeromedical certification of airmen.


Erikson Institute Psychodynamic Psychopharmacology: Addressing the Underlying Causes of Treatment Resistance Psychiatry has benefited from an increasingly evidence-based perspective and a proliferation of safer, more tolerable, and perhaps more effective treatments during the last two years. Despite these advances, however, treatment outcomes are not substantially better than they were a quarter of a century ago. However, there is currently a small but impressive evidence base that shows that psychological and interpersonal factors play a pivotal role in pharmacological treatment responsiveness.


Many women and even men have great desire for looking beautiful, fresh and strikingly attractive. However, having an oily skin can lead to several problems. People with oily skin normally have persistent shining face. This kind of skin is advantageous in that it retains a youthful look for a long time. However, oily skin also predisposes one to conditions such as pimples, blackheads and acne. A lot of people with oily skin suffer from a variety of unpleasant conditions that makes them determined to treat it. The following are some effective strategies that can be applied to address the problem.


OBJECTIVE: To evaluate the effects of a completely soluble fiber on fasting and postprandial hormone levels, respiratory quotient (RQ) and subjective ratings of satiety during a controlled weight-loss program.
DESIGN: In a five-week prospective, randomized, double-blind study, a 3.3 MJ (800 kcal)/d diet was provided during a two-week wash-in period. Then, during the intervention weeks, separated by a one-week wash-out period, a 3.3 MJ (800 kcal) formula containing either 20 g fiber or placebo daily, was given in a cross-over design and on days 1, 3 and 7 of the intervention weeks (weeks 3 and 5) measurements were taken after an overnight fast.
SUBJECTS: 25 obese but otherwise healthy females (age: 46+/-6 y, body mass index (BMI): 35+/-6 kg/m2) were studied.
MEASUREMENTS: Body weight; hunger/satiety ratings; glucose, insulin, cholecystokinin (CCK) and leptin concentrations; RQ during the intervention weeks.
RESULTS: In the fasting state, the supplement had no effect on any of the measured parameters, including blood concentrations of glucose, insulin, CCK, and leptin, RQ and satiety ratings. In the 2 h postprandial period following the test meal, none of the measured parameters differed significantly from that following the non-fiber-supplemented meal, except for the CCK response. CCK demonstrated an overall higher concentration after the fiber-supplemented meal (P=0.007), even after adjustment for age, weight, height and treatment sequence. The postprandial peak in CCK also occurred earlier (at 15 min vs 30 min) after completion of the fiber-supplemented meal.
CONCLUSIONS: The results indicated that a hydrolyzed guar gum fiber supplement produced a heightened postprandial CCK response, but did not alter other satiety hormones or increase satiety ratings, in either the fasting or the postprandial state.


S-1792 Supplemental aid to districts with significant enrollment growth.
NJEA supports S-1792 (Sweeney). The bill would provide a supplemental appropriation of more than $4 million from Property Tax Relief to the Department of Education to provide additional state aid to school districts that have experienced significant enrollment growth.
The bill is intended to make FY2012 school aid allocated to non-Abbott districts fairer by increasing aid to “super-growth” districts on a per pupil basis that more closely parallels aid to other districts that did not experience rapid enrollment growth. The legislation would apply to districts where the projected resident enrollment for October 2011 exceeds the actual October 2008 resident enrollment by at least 13%. “Super-growth” districts in Gloucester, Bergen, Burlington, Cape May, Monmouth, Ocean, Passaic and Salem counties qualify, with growth of at least 13%.
NJEA supports the bill because it utilizes limited state resources in difficult economic times to provide needed financial support to at least some of the districts hit hard by the current administration’s haphazard distribution of state school aid. The additional aid to these qualifying districts would be used to restore programs and resources—including teachers and support personnel—to maintain the quality of education during difficult economic times.
This bill, unfortunately, does not increase aid for other districts that also experienced significant enrollment growth since October 2008, but which did not reach the 13% growth threshold. NJEA urges the legislature to consider providing much needed assistance to these districts as well.
NJEA urges you to support S-1792.


Why is Population Important? The health of our planet and all its people depends on how we manage our resources. The more people who live on the planet, the more resources we need.
Because our resources are limited and the population is increasing, we need to manage our resources carefully and fairly.
© All copyright including intellectual property remains the property of


Angora Fire The Angora Fire in South Lake Tahoe began in June, 2007, destroyed 254 homes, caused $140 million in property damage, and scorched 3,100 acres. This project, a collaboration among the photography area of the Art Department, the University of Nevada Reno's Academy for the Environment, and the Center for Land Use Interpretation based in Culver City, California, presents a time-based, visual study of post-fire landscape development. Selecting ten sites and digitally photographing the same vantage points over a period of ten months provides investigators and the general public an opportunity to assess post-fire development.
It is surprising how few resources are dedicated to evaluating post-fire landscapes. The visual ramifications of fire are obviously evident, yet rephotographed post-fire landscapes are rarely presented in scientific journals or within the popular media. This project initiates a solution; that is, to present a visual study of post-fire development on the Angora Lake Fire. An important sidebar: It is extremely rare for visual artists to join in the investigative process of landscape management, a domain usually reserved for quantitative scientists. This project, while modest on many levels, initiates a process of including the refined visual language of the visual arts (photography) in evaluating landscape change. The underlying premise of this secondary advantage is that art does, indeed, matter. Scientists are in need of a visual baseline for future analysis. Visual analysis of post-fire landscapes is needed, and there are currently no published dedicated, skilled, professional visual comparative views of post-fire redevelopment in the Tahoe basin. The project is being continued beyond the original grant period due to the importance of the site and data gathered from this area.


The Brain, the Will and the Law This project aims to explore the extent to which a three-way collaboration between philosophers, lawyers and neuroscientists can shed light on questions concerning free will, responsibility and punishment.
Recently there has been a huge amount of academic debate about, and public and legal practitioner interest in, the general question of how or whether neuroscientific discoveries should prompt us to reconsider the theoretical underpinnings of, or the actual practice of, the legal system. Developments in neuroscience increasingly uncover the underlying causal mechanisms in the brain that generate our behaviour, thus raising the question whether it is ‘us’ or instead our brains that are really responsible for what we do. This raises questions both about whether we act freely – something that is central to both the moral and legal notions of responsibility – and about whether the purpose of punishment for criminal acts should be conceived as a matter of retribution or rehabilitation.
However, the academic debate has largely been focussed on specifically philosophical issues (involving neuroscientists and philosophers) or specifically legal issues (involving neuroscientists and lawyers). Philosophy can bring conceptual clarity and a significant body of relevant philosophical discussion to the debate about law and neuroscience; while the law, in turn, brings a practical dimension to philosophical debates about free will, moral responsibility and punishment. This project therefore aims to look at these issues by bringing together philosophers, neuroscientists and lawyers.
The project, running from April until August 2012, is based at the Institute of Philosophy and is funded by an AHRC ‘Exploratory Awards’ grant as part of the ‘Science in Culture’ theme. Participants include Prof Helen Beebee, Associate Director of the Institute of Philosophy and a postdoctoral research assistant, Dr Marion Godman.


Pollen Allergies June 11, 2011
Pollen is one of the leading causes of seasonal allergies around the home. Each spring, summer, and fall, tiny pollen particles are released from trees, weeds, and grasses, causing seasonal rhinitis, commonly referred to as hay fever (nasal/sinus allergies). While many other allergens can easily be avoided, it is very difficult to avoid pollen, even indoors! Furthermore, individuals with pollen allergies can develop sensitivities to other allergens such as dust mites, pet dander, and mold spores.
Pollen are microscopic grains, typically round or oval in shape, that are shed by plants, trees, and grasses as part of their reproductive cycle. They can travel enormous distances when carried by winds - often several hundred miles! A single plant may produce millions of pollen grains per day.
Common allergy causing pollens in North America include:
Plants
- Ragweed
- Sagebrush
- Redroot pigweed
- Lambs quarters
- Russian thistle (tumbleweed)
- English plantain
Grasses
- Timothy grass
- Kentucky bluegrass
- Johnson grass
- Bermuda grass
- Redtop grass
- Orchard grass
- Sweet vernal grass
Trees
- Oak
- Ash
- Elm
- Hickory
- Pecan
- Box elder
- Mountain cedar
Most colourful and scented flowers like roses do not cause allergies because their pollen is heavy and waxy, and is transported primarily by insects, not by the wind. In other words, it is less likely to be inhaled in significant quantities.
Pollen is readily transported inside your home by wind and airflow through open doors and windows, and on your clothes, or even on your pets. Once inside your home, it is easily stirred up and breathed into your nose, throat, and lungs, where it causes irritations that lead to a wide range of allergy symptoms including runny nose, sore throat, coughing, sneezing, watery irritated eyes, etc.
The best defence against pollen inside your home is a high quality
High Efficiency Particulate Air (HEPA) filter that is capable of trapping and containing the tiny particles. Such filters will also eliminate other allergens such as pet pander and dust mites that you may be more sensitive to during your hay fever attacks.


Sports Medicine
Our Certified Athletic Trainers (ATC) are highly trained professionals with diverse educational and experiential backgrounds. The National Athletic Trainers' Association Board of Certification (NATABOC) and the Commonwealth of Massachusetts Division of Professional Licensure credential them. The comprehensive healthcare services include injury prevention, recognition and assessment, treatment, disposition, rehabilitation, and healthcare administration and promotion. Additional healthcare services are provided through referral to MACONY Pediatrics and Berkshire Orthopedic Associates.
What is Athletic Training?
The 1999 Role Delineation of the National Athletic Trainers’ Association concludes that the profession is divided into six major areas or domains. These domains are:
1. Prevention of Athletic Injuries 2. Recognition, Evaluation, and Assessment of Athletic Injuries 3. Immediate Care of Athletic Injuries 4. Treatment, Rehabilitation, and Reconditioning of Athletic Injuries 5. Organization and Administration 6. Professional Development and Responsibility
In defining these domains and in attempting to assign the elements of athletic training it is evident that many elements transcend several domains rather than fitting in only one domain. These elements are best reflected in the following Athletic Training competencies and clinical proficiencies.
1. Acute Care of Injuries and Illnesses 2. Assessment and Evaluation 3. General Medical Conditions and Disabilities 4. Health Care Administration 5. Nutritional Aspects 6. Pathology of Injuries and Illnesses 7. Pharmacology 8. Professional Development Responsibilities 9. Psychosocial Intervention and Referral 10. Risk Management and Injury Prevention 11. Therapeutic Exercise 12. Therapeutic Modalities


Globalization, inequality, and the legal services industry
Abstract
Borrowing from sociology, this paper uses a 'commodity analysis approach' to discuss key developments in the legal services industry. The paper argues that globalization may lead to considerable restructuring in the legal business. These changes seem to indicate the likelihood of continued concentration of economic power, a trend that seems to mirror changes in the broader economy.
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The Scottish Government has published a Climate Change Bill which sets mandatory targets to cut greenhouse gas emissions in Scotland by 80% by 2050. Following a significant campaign from Friends of the Earth and other environmental groups it has also proposed annual targets. We welcome this as an opportunity for Scotland to lead the way in climate legislation. The Big Ask Scotland is Friends of the Earth Scotland’s campaign for an effective Climate Change Bill. We are calling for a Bill which – to complement both annual targets and the 80% reduction target – places a scientifically based limit on the cumulative total of all emissions between now and 2050, to enable Scotland to play a fair role in ensuring that the climate does not warm by more than 2ºC. This briefing sets out why such a limit is crucial to the effectiveness and credibility of the Scottish Climate Change Bill.


Southwestern Deserts September, 2004
Regional Report Start Vegetable Transplants Sow seeds indoors to ready cool-season veggies for transplant in October. Start cabbage family crops, such as cabbage, cauliflower, broccoli, kale, and brussels sprouts. Use sterile containers and potting mix to inhibit damping off disease, which causes seedlings to tip over at the base. Wait to sow other cool-season veggies, such as greens and root crops, directly into the garden.
Spray off Spider Mites Check for fine webbing or a rusty coloration on foliage, tell-tale signs of teeny spider mites. They thrive in hot, dusty conditions, so hose off dusty plants with a spray of water after a wind storm.
Plan for Fall Start making plans for fall planting. Determine what you want from a plant, such as food, color, shade, or wildlife attraction. Then determine what sun exposure and space your landscape will provide for the plant. Each plant should have space to reach its mature size without unnecessary pruning to keep it in bounds. Finally, match plants with the characteristics you desire to the conditions your landscape provides.
Chill Bulbs Chill spring-blooming bulbs, such as daffodils, tulips, and grape hyacinths, in the vegetable crisper for six to eight weeks before planting. (Note that tulips are often treated as an annual in the low desert.) Other spring-bloomers don\'t need chilling. Buy bulbs now for planting in October, as supplies of unusual bulbs disappear quickly.
Check Trees for Storm Damage Summer thunderstorms bring strong winds that rip off tree branches like toothpicks. Take a quick walk around the yard to make sure there are no damaged limbs. If there are, prune them out, cutting back to the next largest branch. Do not leave stubs or cut too deeply into the trunk. If damage is significant to mature and valuable trees, consider hiring an arborist to do the work.


We Care - Healthcare Construction Held To A Higher Level In healthcare construction, owners, administration, medical staff, physicians, patients and visitors often have differing viewpoints from which they measure the success of a project. Still, all are critical stakeholders in each and every project and are deserving of a project done well.
In healthcare construction, expectations are typically higher. Healthcare is often technologically advanced and frequently changing. Usually, projects are mechanically and electrically intensive with many complex and redundant systems. More stringent code standards and regulations are encountered. And working in a 24/7/365 functioning healthcare environment adds another level of complexity.
Healthcare Held To A Higher Level To address the intricacies of the highly specialized nature of healthcare construction, we developed a program called "We Care". This proprietary program addresses the issues and establishes guidelines for working in and around occupied healthcare facilities. "We Care" addresses a wide range of topics such as infection control, interim life safety measures, moisture control, protocol for clean ductwork, guidelines for installing finishes, commissioning and much more.
Every JE Dunn employee, contractor and vendor that works on a healthcare project site is required to complete training in the "We Care" program. This ensures complete understanding of the level of quality required and compliance with the rules of the working hospital environment.
To view a clip of the video presentation "We Care", press the play button below.


Why Do We Need Probation?
The unprecedented growth in the nation's prison population has placed a heavy economic burden on taxpayers in terms of the cost to build, maintain and operate prisons. According to the United States Justice Department, over 2 million Americans are behind bars. This represents nearly six times as many inmates as we had in 1970.
Society must incarcerate serious and violent offenders who endanger the community. However, probation is a cost effective alternative that holds nonviolent and controllable offenders accountable for their crimes.


BACKGROUND: A bidirectional relationship between migraine and depression suggests a neurobiological link. Adverse experiences, particularly childhood maltreatment, may alter neurobiological systems, and predispose to a multiplicity of adult chronic disorders. Our objective is to determine, within a headache clinic population of women, if depression moderates the abuse-migraine relationship.
METHODS: At six headache specialty clinics, women with migraine were diagnosed using ICHD-II criteria, and frequency was recorded. A questionnaire regarding maltreatment history, headache characteristics, current depression, and somatic symptoms was completed.
RESULTS: A total of 949 women with migraine completed the survey: 40% had chronic headache (> or =15 headache days/month) and 72% had "very severe" headache-related disability. Major depression was recorded in 18%. Physical or sexual abuse was reported in 38%, and 12% reported both physical and sexual abuse in the past. Migraineurs with current major depression reported physical (p < 0.001) and sexual (p < 0.001) abuse in higher frequencies compared to those without depression. Women with major depression were more likely to report sexual abuse occurring before age 12 years (OR = 2.30, 95% CI: 1.14 to 4.77), and the relationship was stronger when abuse occurred both before and after age 12 years (OR = 5.08, 95% CI: 2.15 to 11.99). Women with major depression were also twice as likely to report multiple types of maltreatment (OR = 2.07, 95% CI: 1.27 to 3.35) compared to those without depression.
CONCLUSIONS: Childhood maltreatment was more common in women with migraine and concomitant major depression than in those with migraine alone. The association of childhood sexual abuse with migraine and depression is amplified if abuse also occurs at a later age.


Value realized from an acquisition depends on how well the newly combined company identifies, manages, and executes on synergy opportunities. Successful integrations follow a sequence of coordinated steps to identify, prioritize, execute, and track the drivers of value across the integration continuum. This framework helps executives capture synergies and confidently communicate performance to their stakeholders.
Explore our other related publications.


This book is part of the series Integrated Sustainable Waste Management - A Set of Five Tools for Decision-makers - Experiences from the Urban Waste Expertise Programme (1995 - 2001 )
It introduces the concept of Integrated Sustainable Waste Management (ISWM). ISWM provides an analytic framework for the assessment of waste management services, which takes into account aspects of the system that are often neglected in traditional municipal waste management.
It looks at institutional, social, environmental, political, technical and financial aspects, while emphasising the critical role that different stakeholders - including waste pickers, women, micro- and small enterprises - play in waste management operations such as collection, treatment, recovery, reuse, recycling and prevention.
This book focuses on the framework for understanding the problems of urban waste management by assessing all the aspects of the baseline situation.
This framework provides the basis for planning of a more sustainable waste management system. This publication also presents the steps suggested to develop an ISWM plan.
Also available in French and Spanish


The 130 million existing homes in the US are responsible for nearly a quarter of our greenhouse gas emissions. Yet, if all new homes were built to net zero energy it would reduce our emissions by zero. Mitigation and adaptation really do start at home.
If we are capable of destroying the planet…


This 1-hour module describes key competency areas and strategies for supervisors of staff, particularly in the areas of supporting and instructing staff, so that excellence is achieved in the workplace. Participants will also learn about the different roles supervisors play in their interactions with their staff.
The heart of supervision presents three motivators and three elements of effective supervision and guides managers to identify two personal priorities for individual supervisory practice.


You know the feeling: Faced with many of your favorite dishes and beverages, you overindulged. Now you facing the consequences. Heartburn.
Perhaps prompted by television ads about their effectiveness, or the advice of a friend, you reach for an over-the-counter antacid. But is this the best way to handle your heartburn?
When used properly, antacids are useful in relieving the occasional heartburn and indigestion. The active ingredient in antacids neutralizes stomach acid, which is what is causing the pain. However, it is much better if you prevent the heartburn from occuring in the first place, rather than treating the heartburn after it happens.
Don't eat big meals. After you eat, don't lie down right away. Cut down on caffeine. Sleep with your head and shoulders propped up six to eight inches. If you do take an antacid, it should be used only for occasional relief of mild heartburn or indigestion. If you're taking antacids for longer than two weeks, then the heartburn may be caused by a more serious medical problem. It is important that you consult your doctor for a further evaluation. You should see your doctor even sooner if you're experiencing any symptoms severe enough to interfere with your lifestyle. If you experience any of the following symptoms, you should call your doctor:
Your heartburn presists or becomes more severe. Your heartburn isn't relieved by medication. Your heartburn interfers with your ability to fall asleep or it wakes you at night. Your discomfort interferes with your lifestyle or daily activities You have difficulty swallowing or have pain when swallowing. You have the sensation of food caught in your chest or throat. Pain in the neck, chest or back. Your heartburn is causing you to vomit. You vomit blood or have black stools (from digested blood). You have excessive saliva. You've experienced a drastic weight loss. You have persistent hoarseness or sore throat. You have episodes of choking, coughing or wheezing. If lifestyle changes don't entirely prevent the heartburn, your doctor may suggest using an antacid. If symptoms persist, your doctor can prescribe a different form of treatment, such as proton pump inhibitors. If at any time you have questions about your treatment, or the effectiveness of that treatment, please consult with your doctor.
——————
Examples of Antacids
——————
Sources: Cramer, Tom. "A Burning Question: When Do You Need an Antacid?." Food and Drug Administration (FDA). 6 Dec 2006


…”Recent research has uncovered a trend called ‘boomer bummers,’” notes Michelle Edelman, boomer expert and president of NYCA, a Solana Beach, Calif.-based integrated marketing and ad agency. “As [older] boomers pass into the typical retirement ages — as they get their AARP cards and turn milestones — they start to get depressed.”
Edelman, also a contributing author/editor for two baby boomer-related books, notes that the rates of suicide and clinical depression for these older boomers are rising. After all, they were part of the generation that wanted to change the world, but now are facing realities they cannot alter.
“Much is not controllable,” she adds, “particularly as age affects health and appearance.”
In contrast, younger boomers are still in the “family forming” stage, Edelman says. Many still have children at home; they are actively pursuing careers and were not greatly impacted by the turbulent times of the 1960s…
To read the full article, click here.


Subjective Attributes of Depression, Part 2: The Contribution of Self-Perceived Disability to Depression Following Stroke Abstract This study aimed to evaluate the factors leading to depression following stroke and amputation according to the patients own self-report. Method: Twenty-seven stroke patients and partners, and 28 amputees and partners from a rehabilitation centre completed the Subjective Disability Depression Questionnaire (SDDQ), Hospital Anxiety and Depression Scale, General Health Questionnaire-28, and Emotional and Social Dysfunction Questionnaire. Results: Stroke patients scored higher than amputee patients on all depression measures. Stepwise regression models using the SDDQ scales to predict a Combined Depression score were completed. For the stroke group, the model comprised perceived Cognitive Difficulties and Emotional Dysfunction (R²= .68). For the amputees, the Relationships scale was the only scale to enter the model (R² = .41). Conclusions: This study identified factors contributing to depression following stroke and amputation.
Full text Permanent link Keywords Psychology; stroke; amputation; cognition; emotion; relationships; depression
The content of this journal is licenced under a Creative Commons Licence.ISSN 1832-7931


Abstract Recent advances in nanotechnology have yielded materials and structures that offer great potential for improving the sensitivity, selectivity, stability, and speed of next-generation chemical gas sensors. To fabricate practical devices, the “bottom-up” approach of producing nanoscale sensing elements must be integrated with the “top-down” methodology currently dominating microtechnology. In this letter, the authors illustrate this approach by coupling a single-crystal SnO2 nanowire sensing element with a microhotplate gas sensor platform. The sensing results obtained using this prototype sensor demonstrate encouraging performance aspects including reduced operating temperature, reduced power consumption, good stability, and enhanced sensitivity.


Producer Profiles KSU Arinagata - Koperasi Serba Usaha Arinagata Farmers in the area had been severely affected by the previous armed conflict in the Aceh province, prompting most to leave their farms for years, only returning recently after the signing of a peace agreement in 2005. As a result, some farmers are still in the process of re-cultivating their coffee gardens, a process that has been made difficult by a lack of cash and labor. Finding a good market channel for its coffee has been one of the cooperative’s greatest challenges. The recent increase in demand for coffee from the Gayo Mountains, however, has invigorated business in the area. KSU Arinagata’s Fair Trade certification has combined with this increase to bring improvements to the cooperative’s community.
Programs Education for Children instead of Labor; English Program The cooperative strongly opposes the use of child labor among its members. Part of the premium fund was used to ameliorate the constraints that have forced some families to take their children to the coffee farms instead of letting them attend school. Also, the cooperative has used funds to establish a training/day-care center for children, where the cooperative members’ children can stay and receive education while their parents work in the coffee farms. Additionally, the cooperative has set up an after-hours English-teaching program.
Community: Public Restrooms/Washrooms, Shelters, Improved Roads KSU Arinagata has used premium funds to invest in pressing community needs, such as the construction of public toilets and washing areas and shelters against rain. The cooperative has also rebuilt damaged roads. Additionally, funds have paid for daily necessities in the community, such as rice, oil and sugar.


Are judicial rulings based solely on laws and facts? Legal formalism holds that judges apply legal reasons to the facts of a case in a rational, mechanical, and deliberative manner. In contrast, legal realists argue that the rational application of legal reasons does not sufficiently explain the decisions of judges and that psychological, political, and social factors influence judicial rulings. We test the common caricature of realism that justice is “what the judge ate for breakfast” in sequential parole decisions made by experienced judges. We record the judges’ two daily food breaks, which result in segmenting the deliberations of the day into three distinct “decision sessions.” We find that the percentage of favorable rulings drops gradually from ≈65% to nearly zero within each decision session and returns abruptly to ≈65% after a break. Our findings suggest that judicial rulings can be swayed by extraneous variables that should have no bearing on legal decisions.
Source: “Extraneous factors in judicial decisions” from Proceedings of the National Academy of Sciences
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Sort: publication date | titles A - Z Page: | 1 | Ethical Maturity in the Helping Professions provides a comprehensive overview of the most influential ideas in ethical thinking across the ages. It explores the ethical challenges through an interdisciplinary approach and presents a brand new model for becoming ethically mature professionals in the process. more »
2012, Paperback: £29.99/ $47.95Keywords: careers, carers, counselling, health care, psychiatry, psychoanalysis, psychology, psychotherapy, social care, social work, supervision
For those in the helping professions, communicating with the public can sometimes be a challenge, and different skills are needed to those used when communicating with friends and family. This book addresses these issues by providing hundreds of tips on how to communicate with the public. more »
2011, Paperback: £15.99/ $24.95Keywords: advocacy, augmentative communication, careers, carers, challenging behaviour, communication, counselling, education, educational training, emotions, employment, ethnicity, exposure anxiety, health care, reference, relationships, restorative justice, risk assessment, social care, social skills, social work, supervision
Alcohol misuse is becoming an increasingly significant issue for people aged 55 and over. This practical guide explores the factors that differentiate older drinkers, and introduces an innovative person-centred model that will help counsellors and other healthcare professionals to them the help and support they need. more »
2011, Paperback: £20.99/ $34.95Keywords: addiction, adult protection, adults, alcohol, Alzheimer's disease, anxiety, carers, communication, community care, counselling, dementia, depression, occupational therapy, older people, pastoral care, person-centred, psychiatry, psychology, psychotherapy, residential care, self esteem, social care, social work, substance abuse, supervision, supported living
Social and demographic changes have led to traditional areas of welfare being transformed. The contributors to this book take a critical look at the current situation and assess the implications for future practice. They debate the assumptions and values underlying established welfare programmes and consider the case for change. more »
2001, Paperback: £29.99/ $47.95Keywords: Alzheimer's disease, carers, dementia, health care, older people, residential care, social care, social policy, social work, supervision, supported living
Page: | 1 | (4 titles match the current selection)


Reproductive Health Practice Adaptations This document is part of the network’s series of practice adaptations developed by clinicians working in HCH projects.
This document contains the client education and pregnancy counseling protocols for the San Francisco Department of Public Health, posted with permission.
Healing Hands Articles Pregnant and Homeless (2001)
In this issue of Healing Hands, we examine health risks and barriers to reducing them experienced by homeless women and their children, during and following pregnancy. The lead article addresses the greatest challenge reported by Health Care for the Homeless clinicians in caring for these women: alleviating substance abuse problems, to protect maternal and fetal health and foster normal child development.
This issue explores the public health ramifications of unintended pregnancy and discusses contraception options for women experiencing homelessness. The newsletter also looks at funding sources for family planning programs and includes a toolkit of practical resources for providers and patients.
Supplement: Methods of Contraception


The University of Massachusetts Amherst Center for Research on Families’ Tay Gavin Erickson Lecture Series Presenting: Judith Crowell, MD Professor and Director of Training, Child and Adolescent Psychiatry, Stony Brook University, Senior Scientist, Judge Baker Children's Center, Harvard Medical School
“ Influences of Childhood Adversity on Health in Midlife: First Findings of a Longitudinal Study ” Dr. Judith Crowell is a child psychiatrist and researcher with expertise in family relationships, stress and adversity, and mental health. Her research focuses on attachment relationships, representations of relationships across the life span, and the impact of attachment and childhood adversity on adult physical and mental health. Specifically, Dr Crowell’s work seeks to understand how childhood and adult adversity and relationships contribute to early midlife adult physical health outcomes. She is also working to understand how individuals’ salient demographic characteristics such as ethnicity, race, and socioeconomic position influence specific health outcomes and their predictors. Her multi-method research project uses psychosocial, sociological and metabolic approaches to examine links from early and ongoing adversities to early signs of physical illness that are not yet expressed as impairing symptoms.
The Center for Research on Families (CRF) is an endowed interdisciplinary research center in the College of Social and Behavioral Sciences and College of Natural Sciences at the University of Massachusetts Amherst. The Tay Gavin Erickson Lectures Series brings internationally recognized speakers with expertise in family research to campus each year. The lecture series began in 1999 through an endowment established in memory of Tay Gavin Erickson.


2. knowledge integration A program that states it could achieve anything but you do not get anything new out of it.
Knowledge integration is a program at the University of Waterloo.
1. knowledge integration The practice of combining knowledge across disciplinary boundaries and collaborating with diverse specialists in order to tackle complex problems.
There's an unusual and demanding arts and science degree in knowledge integration offered at the University of Waterloo. However, having a piano doesn't make you a musician.
"When a book and a head collide and a hollow sound is heard, must it always have come from the book?" — Georg Christoph Lichtenberg
When I graduate from med school, I will be trained to practice medicine. Whether I'm any good at it depends on me and how I study, work and learn. When I graduate from Knowledge Integration I will be trained to collaborate with peers from many disciplines.


THE REMARKABLE progress made in the control of epilepsy during the past five years has been due, in a large measure, to a handful of drugs with anticonvulsant action. Many of these drugs, such as trimethadione (Tridione)* and phenacemide (Phenurone), have potentially serious side-effects.† A few deaths have been attributed to trimethadione, phenacemide,‡ and Mesantoin.§ Dermatitis medicamentosa,7 the nephrotic syndrome,‖ and bone marrow depression¶ are the serious toxic reactions of these newer anticonvulsants. These have occurred more often when combined with the standard anticonvulsant preparations.# Judicious use, along with frequent clinical and laboratory observations during periods when the drugs are being used, should avoid serious complications in a high percentage of these patients.*
Recently, a report from England of the nephrotoxic effects of drugs used in the treatment of petit mal19 suggested that even minor urinary changes occurring during the administration of trimethadione or paramethadione (Paradione) may indicate


Q: I've suffered from depression for years, and at least twice have come close to committing suicide. Many factors made me hold back. For the past six years, the longest period since I first sought help, I've been on anti-depressant medication and receive regular therapy.
I have no current plans to do myself in and don't want to face that choice again. However, for me, the effects of depression have been so erosive that I believe it can be compared to many long-term physical ailments that are eventually fatal. Thus, it is possible for me to envision taking steps to end the pain on my own terms.
I'm not a religious person and am inclined toward agnosticism and sometimes total atheism, so being told that suicide is a sin doesn't register with me. Be that as it may, I acknowledge the hurt that suicide can cause others, which makes me feel guilty. If I ultimately choose that way out, I will try to prepare myself and my loved ones for the aftermath. In my own inner hell, this is quite a burden, but I sincerely feel it may be the best option for me. I think the notion that suicide is sin contributes to this inner hell for others, too, rather than being a persuasive force in refusing that option. Any thoughts? — Anonymous via godsquadquestion


April 2, 2009 Causation in the Third Restatement In the final panel of today, David Robertson (Texas) and Joe Sanders (Houston) discussed Causation in the Third Restatement. The panel was moderated by Wendy Parker (Wake Forest). Don Cowan (Ellis & Winters) and Steve Gold (Rutgers) provided commentary.
Robertson presented "Causation in the Third Torts Restatement: Three Arguable Mistakes" (pdf).
Robertson noted three disagreements with the R3 in the area of factual causation: (1) the shift from the substantial factor approach of R2's Section 432 to the causal set approach of the R3's Section 27; (2) the move of trivial contribution cases to proximate cause in Section 36; and (3) new comment
d,which Robertson views as "jettisoning" the line of cases based onAnderson v. Minneapolis, St. P. & S.S.M. Ry., 179 N.W. 45 (Minn. 1920).In the Q&A, Jane Stapleton (Texas) was "troubled" by Robertson's approach, and did not believe that rejection of the causal set approach provided a coherent approach where undifferentiated inputs contributed to the one harm.
In the Q&A, Bill Powers (Texas and co-Reporter for the R3) responded to Roberston's point about
Anderson. In his view, causation is not a fact that exists in the world, it is the way we think about the world to handle every day problems. Mike Green (Wake Forest and co-reporter for the R3) likewise expressed his concern that we should not use common every day notion of "cause."Ben Zipursky (Fordham) commented in the Q&A that the R3 does keep the substantial factor standard, but as part of proximate cause in Section 36. As Zipursky explained, "trivial" contributions are really the converse of "substantial:" contributions.
Sanders discussed "The Controversial Comment C" (pdf).
Sanders took on the issue of causation in toxic tort cases. First, Sanders explained the genesis of the controversy as whether to conceptualize specific & general causation as elements of the tort or as indicia of causation to consider. Sanders noted that the R3 takes the position that specific & general causation are not elements, under which each need to be proven. While he noted the truth of the position that there is but one causation element, he argued, that the R3 misleads because, as de facto matter, both need to be proven. Second, Sanders looked at the R3's distinction between admissibility (an evidence question) and sufficiency (a torts question). Disagreeing with the R3, Sanders viewed the issue as a "torts-evidence emulsion," where the two things never come apart. Sanders noted the increasing role of science in decisions on causation.
In his commentary, Gold first addressed Sanders' point on specific vs. general causation. Gold noted that comment
cwas controversial because it obliquely suggested that the plaintiff might not need to prove both specific and general causation. - SBS
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Thanks for the great series of posts on the Restatement Third conference!
Posted by: Andrew McClurg | Apr 3, 2009 9:48:57 AM


Author: Anthony PymElectronic: ISBN: 020386929X 9780203869291 Pages: 200 Price: U.S. $ 40.95Hardback: ISBN: 0415553628 9780415553629 Pages: 200 Price: U.S. $ 140.00Paperback: ISBN: 0415553636 9780415553636 Pages: 200 Price: U.S. $ 40.95Abstract:
Exploring Translation Theories presents a comprehensive analysis of the key traditional and contemporary paradigms of translation theory.
The book builds on Western theories of translation, starting with a survey of the classical twentieth-century linguistic approaches before moving on to more recent models such as cultural translation. Each central paradigm and its associated theories are addressed in turn, including equivalence, purpose, description, uncertainty, localisation and cultural translation. Readers are encouraged to explore the various theories and consider their strengths and implications for translation today and in the future. The book closes with a survey of the way translation is used as a model in postmodern cultural studies and sociologies, extending the scope beyond traditional Western notions.
Each chapter includes a wealth of material for readers, including key concepts, an introduction outlining the main points, illustrative examples with translations, a chapter summary, and discussion points and exercises.
Exploring Translation Theories uses numerous examples from a range of languages, although knowledge of no language other than English is assumed. With a wealth of tasks and activities, it will be ideal both for classroom and self-study use. This comprehensive and highly engaging book is designed for students studying Translation Theory in Translation Studies and Applied Linguistics programmes.
Linguistic Field(s):Applied LinguisticsLinguistic TheoriesTranslation


1. Scope
1.1 This test method covers the determination of the energy required to rupture coatings applied to pipe under specified conditions of impact from a falling weight.
1.2 This test method may involve hazardous operations and equipment. This test method does not purport to address all of the safety problems associated with its use. It is the responsibility of the user of this test method to establish appropriate safety and health practices and determine the applicability of regulatory limitations prior to use.
1.3 The values stated in SI units to three significant decimals are to be regarded as the standard.
2. Referenced Documents (purchase separately) The documents listed below are referenced within the subject standard but are not provided as part of the standard.
ASTM Standards
G12 Test Method for Nondestructive Measurement of Film Thickness of Pipeline Coatings on Steel
G62 Test Methods for Holiday Detection in Pipeline Coatings
SAE Standard
Grade52100 Steel Available from SAE International (SAE), 400 Commonwealth Dr., Warrendale, PA 15096-0001, http://www.sae.org. Keywords
falling weight test; impact resistance; pipeline coatings;
ICS Code
ICS Number Code 87.040 (Paints and varnishes)
DOI: 10.1520/G0014-88R96E01
ASTM International is a member of CrossRef.
Citing ASTM Standards
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Source
Abdominal Organ Transplant Unit, Hospital Israelita Albert Einstein, São Paulo, Brazil.
Abstract
INTRODUCTION:
Since August 2010, The Brazilian National Transplantation System has allowed performance of liver transplantation (OLT) for patients with hepatocellular carcinoma (HCC) beyond the Milan criteria (MC) who have been successfully treated with preoperative downstaging (DS). Herein we sought to compare the clinical profiles and liver explant findings among patients with versus without preoperative DS.
METHODOLOGY:
Prospective cohort of patients with HCC within and beyond the MC undergoing OLT. Patients were considered for DS if they were beyond the MC without evidence of vascular invasion or extrahepatic disease. Transcatheter arterial chemoembolization was used for DS, which was considered to be successful if the MC were achieved at any moment during the follow-up.
RESULTS:
Between May 2006 and May 2010, we performed 130 OLTs in HCC patients, among whom 10 received preoperative DS. Both groups were comparable for gender, age, viral etiology, serum levels of alpha fetoprotein, and Child-Pugh and Model for End-Stage Liver Disease (MELD) scores (P > .05). The liver explants were within the MC in 80% of patients with preoperative DS and 90% of those without preoperative DS. They were comparable for the number of HCC nodules, total tumor size, histologic grade, and presence of microvascular invasion. Patients with pretransplant DS showed larger HCC nodules (33.3 ± 9.65 vs 26.3 ± 9.62 mm; P .029) and more frequent macrovascular invasion (1 vs 1 patient, P = .024).
CONCLUSION:
Preoperative DS for unresectable HCC may provide a curative treatment for patients who would otherwise be candidates for palliative therapy only. The baseline characteristics and liver explant findings were similar in both groups. We have yet to determine whether the differences observed regarding the size of the largest nodule and the higher frequency of macrovascular invasion have an impact on outcome.


Restrooms, dumpsters and drain lines are among areas foodservice operators need to pay extra close attention to on hot summer days. Recent record temperatures have made foodservice venues a haven for people dodging the heat. However, higher temperatures can mean more than just oppressive heat and humidity—they can also create malodors.
Cintas a provider of cleaning and sanitation solutions for foodservice operators, today announced the top 10 sources of offensive summer scents.
“Even if the food tastes great and the service is excellent, odors can leave (foodservice) patrons with a bad taste in their mouths,” said Ann Nickolas, senior director of foodservice for Cintas Corp. “Humidity can leave a restaurant ripe with odors, so understanding common odor sources is the first step in combating smells before they start.”
Ranked from most to least offensive, Cintas’ list of the top 10 bad summer scent sources includes:
1. Trash. Dumpsters are a haven for odors, but this can be a particular issue in the summer months. Keep doors closed to prevent the smell of garbage from creeping into the c-store and ensure dumpsters are regularly cleared to limit odors.
2. Restrooms. A common source of malodor in any business, restroom odors can be particularly noticeable in foodservice and restaurant businesses and other facilities where children frequent. Limit odors by implementing a restroom maintenance program to ensure surfaces are regularly deep cleaned, protected and maintained. Time release air fresheners can also help neutralize odors with pleasant fragrances.
3. Drain lines. Food remnants, liquids, sewage and other organic matter can collect in drain lines if left unattended. This creates rancid odors that can permeate throughout the entire store. To keep drain lines free and clear of kitchen waste, implement a drain line maintenance program that uses live bacterium to remove substances and limits environmental impact.
4. Expired food. Rotten eggs and spoiled meat can quickly result in a significant odor issue if not removed from your foodservice prep area. Leaving perishable food items, such as dairy products, at room temperature leads to quicker expiration. Keep a close eye on inventory and ensure perishable items are kept refrigerated at all times to maximize shelf life and reduce opportunities for spoilage.
5. Dirty dish towels. Towels used to clean up spills, counters and table tops absorb a variety of liquids and solid substances that can generate odors over time. Avoid letting dirty towels sit for an extended period of time by implementing a regular pick-up rental laundry program.
6. Grout lines. When organic bacteria such as food or food byproducts spills onto a tiled floor surface, remnants collect in grout lines which can lead to odors over time. Deep clean grouts lines regularly to remove build-up and prevent odors.
7. Mops. Dirty mops can not only lead to cross contamination, they are also a source of rancid odors that can permeate across the store. Regularly launder mops to keep them smelling fresh—and floors clean and safe.
8. Air conditioning units. Over time, coils and filters in air conditioning units can become dirty and circulate bad odors throughout a store. Using a regular deep cleaning service that keeps pans, coils and unit parts free of dirt and bacteria can eliminate the air conditioner as a potential odor source.
9. Mold. Summer thunderstorms and hurricanes can often result in flooding, particularly in stores close to large bodies of water, rivers or low-lying areas. To remove water and the potential for mold growth following a flood, work with an emergency cleanup service provider that uses ozone generators to quickly remove water and potential odor contributors.
10. Carpet. Carpeting in entryways or dining areas can provide an optimal environment for the development of mildew in humid environments if not regularly deep cleaned. Mildew can also develop when carpets are deep cleaned but not thoroughly dried. Reduce the potential for odors and downtime with an ongoing deep cleaning system that uses fast drying techniques.
“Creating a comfortable atmosphere in a restaurant is one key to ensuring repeat customers,” added Frank Morand, Marketing Associate, Cintas. “By implementing regular inventory and maintenance strategies to eliminate waste and promote cleanliness, restaurant owners and operators can ensure a pleasant dining environment for their customers.”


Bribery Newsflash: Serious Fraud Office revises bribery policies
10 October 2012
The UK's Serious Fraud Office (SFO)
has revised its policies on facilitation payments, business
expenditure (hospitality) and corporate self-reporting, it was
announced yesterday. This follows the removal last week of the
previous guidance on these issues from the SFO's website.
In a press release, the SFO stated that its new Director, David
Green, wished 'to re-emphasise that all decisions to prosecute
unlawful activity will be governed by the Full Code Test in the
Code for Crown Prosecutors and the applicable joint SFO/CPS
prosecution guidance'.
All of the new policies state that 'in appropriate cases the
SFO may use its powers under proceeds of crime legislation as an
alternative (or in addition) to prosecution' .
Commentary
Today's press coverage suggests that the new policies represent a
significant shift in stance by the SFO. We do not agree. The new
policies do not replace the
statutory guidance published
by the Ministry of Justice last year, which specifically refers to
facilitation payments and corporate hospitality.
The SFO's previous guidance on self-reporting focussed solely on
overseas corruption. By contrast, the new guidance on
self-reporting applies to all corruption. The previous guidance had
stated that the SFO wanted to 'settle self-referral
cases...civilly wherever possible '. The new guidance is less
explicit in offering the prospect of a civil as opposed to a
criminal outcome to corporates who self-report historic corruption
to the SFO.
However, the ability of the SFO to offer civil settlements has not
changed. The Joint Prosecution Guidance of the Director of the SFO
and the Director of Public Prosecutions on the Bribery Act 2010,
which the SFO will continue to follow, states that 'a genuinely
proactive approach involving self-reporting and remedial
action' will be a factor tending against prosecution.
We believe that, for companies faced with potential corruption
issues, having a dialogue with the SFO is still a viable option,
and is an option which offers the prospect of a company being
treated more leniently.
The revised statements of policy can be found on the SFO's
website:
For commentary and updates on
enforcement see our
Enforcement Trends Table .
You may also be interested in our
SFO Investigations Tracker .
For further information please contact
Tony Lewis , Partner,
Alexandra Underwood , Partner, or
Charlotte Ovans , Associate at
Field Fisher Waterhouse LLP.


Evaluation of Shared Lane Markings
CHAPTER 1. INTRODUCTION
BACKGROUND
Shared lane markings (also referred to as sharrows ) help convey to motorists and bicyclists that they must share the roads on which they are operating. The purpose of the markings is to create improved conditions for bicyclists by clarifying where they are expected to ride and to remind motorists to expect bicyclists on the road. In the absence of bicycle lanes, motorists often neglect to safely share travel lanes with bicyclists, which can compel bicyclists to ride closer to parked motor vehicles. Such a scenario can result in a dooring crash if someone opens a vehicle door as the bicyclist passes. Also, when bicyclists stay to the far right in narrow travel lanes, passing motorists often track too closely to the bicyclists. This can be unnerving for bicyclists, leaving little margin for error, and sometimes leading to crashes.
In 2008, a recommendation was made by the National Committee on Uniform Traffic Control Devices (NCUTCD) to include shared lane markings in the next version of the Manual on Uniform Traffic Control Devices (MUTCD).(1,2) That recommendation was made with limited research conducted on an 11-ft spacing from the center of a shared lane marking to the curb.(3)
A literature review uncovered no additional research on other spacing options. The 2009 edition of the MUTCD includes provisions for shared lane markings, specifically the sharrow design, with guidance that the markings should be placed at least 11 ft from the curb face or the edge of pavement on a street with parallel parking. Further, on streets with no parking and an outside lane less than 14-ft wide, the centers of the sharrows should be placed at least 4 ft from the curb or the edge of pavement.(1)
The purpose of this study was to evaluate the impact of several uses of shared lane markings, specifically sharrows, on operational and safety measures for bicyclists and motorists. The following hypotheses were explored for sharrows:
The markings may help indicate a preferred travel path and thereby improve bicyclist positioning relative to parked motor vehicles when riding in shared lanes with on street parking.
The markings may help to improve spacing or operations when motorists pass bicyclists on streets both with and without parking.
The markings could improve bicyclist positioning relative to the curb or other hazards along the roadway edge including unsafe drain grates or uneven pavement.
The markings could be used in a situation where a bicyclist needs to take control of the lane, such as on a section of steep downgrade where more operating space is needed and there is not enough width to provide a sufficiently wide bicycle lane. Another such situation might be on a narrow lane where bicyclists need to move away from the door zone or other hazards.
The markings may reduce wrong-way and sidewalk riding, which can cause collisions.
The markings may increase the distance of motor vehicles in the travel lane from parked motor vehicles or from the curb or edge of pavement in the absence of bicyclists, thereby providing more operating space for bicyclists.
A technical drawing of the sharrow marking is depicted in figure 1.
Figure 1. Illustration. Specifications for the sharrow from California MUTCD 2010.
EVOLUTION OF SHARED LANE MARKING DESIGNS
The original bike-in-house design that has been used or slightly modified in other locations for some time is shown in figure 2. This design was used in Gainesville, FL, in a wide curb lane situation and was previously evaluated by the Highway Safety Research Center (HSRC). It was found that the markings increased the safety margin for bicyclists riding near the curb. Additionally, sidewalk riding decreased.(4)
Figure 2. Photo. Bike-in-house marking.
The bike-in-house marking was modified to a bike-and-chevron marking, and the two designs were evaluated in San Francisco, CA. Superior results were associated with the bike-and-chevron marking shown in figure 3.(3) Based on feedback from bicyclists and motorists, the pitch on the chevrons was subsequently increased to resemble more of a directional guide. Given the results of the evaluation, the bike-and-chevron marking was added to the existing 2003 California Manual on Traffic Control Devices through a policy directive in September 2005.(5) Additional evaluation detail is provided in chapter 2 of this report.
Figure 3. Photo. Bike-and-chevron marking.
NCUTCD issued a technical committee recommendation in January 2005 that proposed adding a shared lane marking section to part 9 of the MUTCD.(1,2) Afterward, the Bicycle Technical Committee of the NCUTCD recommended that this proposal be sent to the Federal Highway Administration (FHWA) in January 2007. The proposal suggested that shared lane markings should be used to prevent bicyclists from being struck by opened doors of parked motor vehicles (commonly referred to as dooring ). Furthermore, it was recommended that the markings be placed 11 ft from the curb to encourage bicyclists to track over the markings and increase the distance between bicyclists and the door zone.
SITE SELECTION
At the beginning of the project, HSRC staff contacted communities who had expressed interest in evaluating different uses of sharrows. Staff visited Cambridge, MA; Portland, OR; and Seattle, WA, as well as local officials in Chapel Hill, NC. Based on the site visits, they sent a memorandum to FHWA recommending the following sharrow evaluations:
Cambridge, MA: The sharrows would be placed 10 ft from the curb on a four-lane street with parking on both sides to determine if this location would improve spacing of bicycles and motor vehicles and also prevent dooring. The city has many street cross sections where the recommended 11-ft spacing from the curb would not be feasible.
Chapel Hill, NC: The sharrows would be placed near the curb along the corridor of a busy street with a five-lane cross section (four travel lanes and a center two-way, left-turn lane) with no parking. The street had previously been resurfaced, and the outside lanes were marked nominally as 15-ft-wide lanes. Of primary interest would be the spacing of bicycles and motor vehicles from the curb and situations in which motor vehicles pass bicycles.
Seattle, WA: The sharrows would be placed in the center of the lane on a downhill section of a two-lane street with parking on both sides. The placement was meant to encourage bicyclists to take the lane on the downhill section. The centerline of the street would also be repositioned to allow a 5-ft bicycle lane and a parking line to be installed on the uphill section of the street. Sharrows would be used in the downhill direction because there would not be enough space for bicycle lanes on both sides of the streets.
These recommendations were accepted by FHWA, and this report describes the sharrow evaluations for each location.
The actual design of the sharrow has been evolving, and figure 1 reflects the design used in Cambridge, MA, and Chapel Hill, NC. In Seattle, WA, a version that was a few inches longer was created and used in the evaluation. Figure 4 illustrates a generic sharrow as it appears in the 2009 version of the MUTCD.(1)
Figure 4. Illustration. Generic version of a sharrow.


TSEM9220 - Ownership and income tax: legal background: joint ownership - tenants in common Property is held in the name of A and B. A and B are the legal owners.
In a tenancy in common, A and B are each entitled to a specific share in the property. The shares in which the property is owned may or may not be equal. For example A is entitled to 50% and B to 50%; or A is entitled to 75% and B to 25%. When property is held in this way, on the death of one tenant in common the deceased’s share does not pass to the surviving owner. It forms part of the deceased’s estate, and so passes to their successor under the terms of their will or the rules of intestacy.
Words of separation or ‘severance’ are likely to be used. These are words that indicate the property is to be held in shares, for example ‘equally’, ‘in equal shares’, ‘half and half’, ’50/50’, ‘one third/two thirds’, ‘60%/40%’.
Tenancy in common is the way that individuals who are not in a personal relationship are likely to own property. It would be unusual to find that they intended the survivorship rule to apply.


Spatial-temporal complexity of continental intraplate seismicity: insights from geodynamic modeling and implications for seismic hazard estimation
Qingsong Li
Continental intraplate seismicity seems often episodic, clustered, and migrating. The observed seismicity shows both spatial clustering in seismic zones and scattering across large plate interiors; temporal clustering followed by long periods of quiescence; and migration of seismicity from one seismic zone to another. Here we explore the complex spatiotemporal patterns of intraplate seismicity using a 3D visco-elasto-plastic finite element model. The model simulates tectonic loading, crustal failure in earthquakes, and coseismic and postseismic stress evolution. For a laterally homogeneous lithosphere with randomly pre-specified perturbations of crustal strength, the model predicts various spatiotemporal patterns of seismicity at different timescales: spatial clustering in narrow belts and scattering across large regions over hundreds of years, connected seismic belts over thousands of years, and widely scattered seismicity over tens of thousands of years. The orientation of seismic belts coincides with the optimal failure directions associated with the assumed tectonic loading. Stress triggering and migration cause spatio-temporal clustering of earthquakes. When weak zones are included in the model the predicted seismicity initiates within the weak zones but then extends far beyond them. If a fault zone is weakened following a large earthquake, repeated large earthquakes can occur on the same fault zone even in the absence of strong tectonic loading. These complex spatial-temporal patterns of intraplate seismicity predicted in this simple model suggest that assessment of earthquake hazard based on the limited historic record may be biased toward overestimating the hazard in regions of recent large earthquakes and underestimating the hazard where seismicity has been low during the historic record.


If we set our refrigerator thermostat to keep the contents at a reasonable temperature in summer, liquids turn to ice overnight in winter. This has happened with every fridge we have owned. Why doesn't the thermostat react only to the temperature inside the refrigerator? Does something similar occur in electric ovens?
Angus and Puka Henry, Darwin, Northern Territory, Australia
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The disinfection function consists in making materials and premises healthy in terms of bacterial contamination. This is a crucial challenge for the industries, for those who work there and for the protection of the final product and, therefore, for the consumer. An effective and regular disinfection significantly decreases the amount of pathogens. It is essential to disinfect all surfaces, within these industries, to maintain the infectious risk to a strict minimum. The goal of this type of disinfection is to avoid any potential contamination of the final product which could possibly endanger the health of the end consumers. Considering that these environments have to comply to strict hygiene and health standards stated by the relevant regulatory agencies, it is therefore absolutely critical that these industries, and specifically for food and pharmaceutical companies, maintain the germ contamination level at safety minimum levels, beneath the legal thresholds.
Disinfection in pharmaceutical and cosmetic industries is a key and all-important link towards production. Within the pharmaceutical industry, disinfecting the manufacturing equipment is a necessity for the prevention of cross contamination. A disinfecting process following a strict protocol may prevent any potential consumer contamination.
Major clients: List on request
The position of a person in charge of disinfection is a role of the utmost importance in the food processing industry, demonstrating the growing importance of food safety issues in our contemporary society. To conform to these higher requirements, the food processing industry has to develop always safer disinfection policies for its premises and equipment, in order to provide products of good microbiological quality, and protect the end consumer.
Major clients: Recette Générale des Finances, Aubret Laboratoire


Purpose: This study aimed to compare the marginal fit of 2 kinds of metal-ceramic crowns—crowns cast from commercially pure titanium and Procera titanium crowns. Materials and Methods: Ten copings of each type were prepared, veneered with low-fusing porcelain, and bonded with glass-ionomer cement. Marginal fit was assessed before and after cementation, and the data were analyzed statistically. Results: There were significant differences among mean values of marginal fit between the groups. Cementation increases discrepancies in both groups. Conclusion: Casting titanium has resulted in the highest discrepancies in marginal fit of both groups.
Int J Prosthodont 2005;18:390–391.


What is the President's $20 million ADAP Initiative? On June 23, 2004, President Bush announced immediate availability of an additional $20
million in drug therapies for ten states with AIDS Drug Assistance Program (ADAP)
waiting lists as of June 21, 2004. The ten states eligible to participate in this program
are: Alabama, Alaska, Colorado, Idaho, Iowa, Kentucky, Montana, North Carolina, South
Dakota and West Virginia. The Health Resources and Services Administration (HRSA)
within the Department of Health and Human Services is coordinating the program with
the ten states, which is being administered outside of the regular ADAP structure. HRSA
has contracted with a pharmacy benefits manager (PBM) to directly purchase and
distribute the drugs to individuals on the waiting lists in the ten states.
What are the details of the President's ADAP Initiative? As of November 22, 2004, details of the direct purchase program include:
There were 1,738 slots initially available for the program, allocated only to the ten
states by the number of individuals on their respective waiting lists as of June 21,
2004. At time of implementation, in November 2004, 1,349 persons were eligible
for this Initiative (this lower number is a result of some ADAPs enrolling eligible
clients into their ADAPs, some clients becoming ineligible, or some clients unable to
be located, coupled with additional clients presenting for services). It is unclear
whether or not new clients who join waiting lists in the 10 states subsequent to
implementation will be allowed to join this program.
Chronimed Inc., a PBM, is administering this program for HRSA. Their contract runs
from approximately September 29, 2004 to September 28, 2005, or until the money
is expended, whichever comes first.
Drugs are sent directly to the client or the client's physician by the PBM, with the
ADAPs determining initial eligibility for the program.
The PBM will only purchase drugs that were on the ADAP formularly in the client's
state as of June 21, 2004.
The drugs will not be purchased through the 340B program, the standard drug
purchasing mechanism that most ADAPs utilize, or through other cost-saving
mechanisms, although Chronimed has the authority to independently negotiate
lower prices for these medications. It is believed these negotiations are underway
with various pharmaceutical companies. Negotiated discounts, costs of
administering the program and dispensing fees have not been disclosed.
The distribution of the medications to eligible individuals began in November 2004.
As of November 22, 2004, states report that 591 individuals have been processed to
receive medications as part of this Initiative. HRSA reported on November 18,
2004, that 462 individuals had received 917 prescriptions. Chronimed has indicated
a readiness to fill and ship prescriptions once the eligibility process is completed by
the state ADAP and prescriptions are received and verified at Chronimed.
Are ADAPs still in crisis since the announcement of the Initiative? State ADAPs are ever-changing programs due to a variety of factors, including changes in
demand, changes in state Medicaid programs and the variability of state and federal funding.
Since the President's announcement, developments that have implications for this program
include (as of November 22, 2004):
Four states, Arkansas, Hawaii, Nebraska and Wyoming (not eligible for the President's
Initiative), report a total of 55 people on ADAP waiting lists.
Thirteen states (11 of which are not eligible for the President's Initiative) report having
instituted other cost-containment strategies such as capped enrollment, limited formulary,
medication-specific waiting lists, annual or monthly expenditure caps, and cost-sharing
(co-pays).
Six additional states (none eligible for the President's Initiative) report anticipating new or
additional cost-containment strategies during ADAP's FY2004 (ending March 31, 2005).
Colorado, North Carolina, and South Dakota received additional state or federal
appropriations that allowed them to clear or substantially decrease their ADAP waiting lists
after the Initiative was announced. HRSA has directed, however, that unused slots from
the ten states cannot be transferred to ineligible states with severe need in their ADAPs.
What will happen to persons on the direct purchase program in FY2005? HRSA expects states to begin transitioning persons from the direct purchase program to ADAPs
when the FY2005 ADAP fiscal year commences on April 1, 2005. Congress did not, however,
provide states funding to bring these persons onto their ADAP rolls, treating the $20 million as
a one-time-only expense. Therefore, there is no guarantee that individuals receiving
medication through this program will be transitioned into ADAPs when the FY2005 ADAP fiscal
year begins on April 1, 2005.
What does NASTAD recommend for transitioning the clients into ADAPs? Although the $38.7 million increase for ADAPs in the Consolidated Appropriations Act 2005,
signed by President Bush on December 7, 2004, provided some relief to the programs, it does
not solve the long-term ADAP fiscal crisis. In FY2006, it is estimated that at a minimum a $100
million is needed for ADAPs to maintain fiscal solvency and to enroll new clients in state ADAPs.
Supplemental funding during FY2005, through the ADAP earmark, must be provided to the ten
states that are included in the President's Initiative so that the individuals covered by this
program can be enrolled in ADAP programs and avoid costly treatment interruptions.
What challenges are ADAPs facing regarding funding and funding allocations? One-time-only funding for ADAPs may be detrimental to clients as there is no guarantee
that states will be able to cover the cost of medications for these individuals to remain on
treatment in the long term.
The increase in the FY2005 ADAP earmark will be distributed using the current allocation
formula and therefore will be provided to all states. The formula will not translate into the
necessary funding to continue these individuals on therapy as they transition from the
President's Initiative to ADAPs.
What is NASTAD doing to address the ADAP crisis? NASTAD formed the ADAP Crisis Task Force in February 2003 in order to respond to the
nationwide fiscal crisis that ADAPs face. Through negotiations with companies that manufacture
antiretroviral drugs, the Task Force was successful in obtaining significant and multi-year
pricing concessions on HIV/AIDS drugs. NASTAD has reached agreements with ten companies,
collectively saving ADAPs and the federal government over $65 million during FY2003, with
savings of approximately $87 million anticipated during ADAP's FY2004 ending March 31, 2005.


State of the World's Forests report 2009 The 2009 edition of the biennial “State of the World's Forests” report was published by the UN Food and Agriculture Organization (FAO) on Monday 16 March 2009.
The report summarizes the outlook for forests and forestry in each region, examines past trends and projected demographic, economic, institutional and technological changes to outline the scenario for 2030 and considers how forestry will have to adapt for the future.
It reveals that world forests face the dual challenge of climate change and the global economic crisis. It also suggests that although the economic slowdown might reduce deforestation rates in the short term, it is also likely to lead to other problems, like a lack of investment in the sector and in forestry management.
However, Mr Nair, one of the report's lead authors and the FAO Forestry Department's chief economist added, the downturn was having some beneficial effects.
"We are seeing a decline in the prices of soya beans, palm oil and rubber etc," he explained while interviewed by BBC. "The prices have fallen drastically, so this means that the incentives for cultivating these crops have also gone down. As a result, the pressure to clear primary forest stands is also declining."


To determine whether elastic compression alters the venous hemodynamics in the postphlebitic limb, we measured venous pressure patterns in 11 postphlebitic limbs with and without elastic compression stockings. Following cannulation of a dorsal vein of the foot, the patients underwent measurements of basal resting pressure, maximum percent decrease in venous pressure with exercise (ΔVPex ), peak systolic venous pressure during exercise (SVPmax ), the amplitude of the pressure swing, and venous return time. Elastic compression did not alter basal resting pressure, ΔVPex , or venous return time. By contrast, SVPmax decreased from 139±0.3 mm Hg to 111±8 mm Hg with elastic compression. If venous ulcers are related to the high pressure developed in the superficial veins during calf muscle systole, then elastic compression may be beneficial by decreasing systolic venous pressure and its subsequent deleterious consequences.
(JAMA 242:2766-2768, 1979)


11/08/2009Aids 2010 24 (1): 17-25 Abstract Objective: Resistance to raltegravir is associated with three genetic pathways defined
bythemutations Y143R/C, Q148H/R/K orN155Hin integrase, which also infer a viral
fitness cost. Additionally, the three major HIV-1 drug-targeted enzymes protease,
reverse transcriptase and integrase mature from the same polyprotein, suggesting the
potential for interaction between them. This study aims to elucidate the relative
contribution of protease-reverse transcriptase, integrase and the rest of the HIV-1
genome to viral fitness and susceptibility to raltegravir.
Methods: Recombinant viruses included integrase, protease-reverse transcriptase or
the complete pol-coding region from three patients whose raltegravir-containing regimen had failed. The first had the mutations G140S+Q148H+S230N, the second had
Y143R+G163R and the third had no evidence of genotypic resistance in integrase.
Primary virus isolates were obtained from peripheral blood mononuclear cells.In-vitro
phenotypic resistance and changes in replication capacity were assessed.
Results: Virus isolates, and integrase-recombinant and pol-recombinant viruses from
the patients harboring integrase resistance mutations showed a decrease in raltegravir
susceptibility, with no differences between them. Defects in viral fitness were modulated by resistance mutations within protease, reverse transcriptase and integrase, which were further compensated by regions outside pol. Moreover, protease-reverse transcriptase rescued replication capacity of viruses containing integrase resistance mutations,although integrase was unable to compensate defects in replication capacity caused by protease-reverse transcriptase resistance mutations.
Conclusion: Susceptibility to raltegravir is driven by resistance mutations in integrase,
whereas other viral genes are involved in restoring defects in viral fitness in patients
whose raltegravir-containing regimen fails, suggesting the existence of epistatic effects on replication capacity.
Buzon, M. J., Dalmau, J., Puertas, M. C., Puig, J., Clotet, B., and Martinez-Picado, J.
Grupos vinculados: Retrovirología y Estudios Clínicos (GREC)
Solicitar documento.


Dilapidations & Terminal Lease Issues Langleybury offers professional advice in respect of disrepair claims during or at the end of the lease term, including the negotiation of the settlement in accordance with current RICS guidance protocols and current legislation. We can assist by ensuring the claim is fair and realistic having regard to the type of property and the terms of the lease.
Irrespective of any dilapidation matters, an expiry of a lease raises many issues for Landlords and Tenants with notices often being required to be served by both parties, within specific timescales, in accordance with the provisions of Landlord and Tenant legislation. We can assist by reviewing leases which are approaching expiry, providing advice on strategy and options and liaising with the client’s solicitors as appropriate.
Landlords and Tenants should ideally seek early advice as thorough preparation is the key to a successful result.


Physical therapy services, owing to their inherent nature, have often been found to be elusive while billing for medical reimbursement. Unless medically deemed fit, these services cannot be billed for reimbursement. Consequently, physicians are apprehensive of undertaking certain services that might deprive them of reimbursement for medical services.
How does medical billing and coding support aid in Physical Therapy reimbursement?
Despite the healthcare providers’ pre-emptive scrutiny in determining eligibility for medical reimbursement, they may not always be successful in segregating ineligible cases due to their preoccupation with focused medical care as well as somewhat uncertain nature of this specialty-specific billing and coding.
Medicalbillersandcoders.com, the largest consortium of medical billers in the US, are known for accurate screening for deciding the eligibility of certain services for reimbursement. Such an efficient screening is indispensible for mitigating adverse impact on revenues from reimbursement. Laying a firm foundation for a comprehensive and efficient billing reimbursement solution, our Physical Therapy billing Specialists establish a well-phased system for an efficient claim submission and realization.
Our local medical billers and coders in Ohio have been offering billing solutions to providers and practices of all specialties and are dedicated to increase the cash flows of your practice.
The biggest advantage that these Ohio billers offer is their presence across all major cities like Columbus, Cleveland, Cincinnati, Toledo and Akron. They can offer you the best consultation to increase your revenue steadily and at the same time speed up the collection process, to reduce the account receivable days. Our medical billers display proficiency across:
Physician credentialing with both commercial and public payers
Patient demographics entry
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Generating claims electronically
Insurance follow up and denial management
Account receivable management
Read more..


India has been free of polio for over one year. This is a remarkable accomplishment, considering that just 30 years ago the country recorded 200,000 cases of the disease annually, or one every three minutes. With polio endemic in two neighboring countries, Pakistan and Afghanistan, and in the more distant Nigeria (figure), can India remain free of the disease?


The cellular response to O2 (oxygen) is a central process in animal cells and figures prominently in the pathophysiology of several diseases, including cancer, cardiovascular disease, and stroke. This process is coordinated by the HIF (Hypoxia-Inducible Factor) and its regulator, the pVHL (Von Hippel-Lindau tumor suppressor protein). HIF1 is a basic helix-loop-helix transcription factor that transactivates genes encoding proteins that participate in homeostatic responses to hypoxia. It induces expression of proteins controlling glucose metabolism, cell proliferation, and vascularization. Several genes involved in cellular differentiation are directly or indirectly regulated by hypoxia. These include Epo (Erythropoietin), LDHA (Lactate Dehydrogenase-A), ET1 (Endothelin-1), transferrin, transferrin receptor, VEGF (Vascular Endothelial Growth Factor), Flk1, FLT1 (Fms-Related Tyrosine Kinase-1), PDGF-Beta (Platelet-Derived Growth Factor-Beta), bFGF (basic Fibroblast Growth Factor), and others genes affecting glycolysis (Ref.1).
HIF1 consists [...]