text:
Stating that the Christian church is the embodiment of Jesus's call for His followers to carry out His work, a guide for Christians explains how to obtain a deeper understanding of the church and how to become dynamic representatives of Christ.
"synopsis" may belong to another edition of this title.
Tony Evans is the senior pastor of Oak Cliff Bible Fellowship Church in Dallas, and president of The Urban Alternative, a ministry devoted bringing about change in urban communities through the church. He is the author of many books, including Free at Last, The Battle is the Lord's, Our God Is Awesome, Returning to Your First Love, The Promise, Who is this King of Glory?, What Matters Most, and The Best Is Yet To ComeExcerpt. © Reprinted by permission. All rights reserved.:
All of us are familiar with the story of Humpty Dumpty, the figure from the children's nursery rhyme whose world was shattered after he had a great fall. He called on the best his world had to offer to address his problem-"all the kings horses and all the king's men." But the tragedy of the story is that none of these human powers could put Humpty Dumpty's life and world back together again. Apparently Mr. Dumpty had no biblically functioning church available to help him, because if he had he would not have had to call on the king in the first place. Now its one thing when a nursery rhyme character cannot find the help he needs to repair his shattered world, even when his problem is being attended to by the highest authorities the culture has to offer. But it's another thing altogether when real people in the real world discover that all the king's horses and all the king's men-can't fix society's deepest problems and address the people's deepest needs. This is where the church comes in, because the church is the most important institution on earth. The church, and only the church, has been commissioned by the sovereign Lord to be His representative agency in history.
"About this title" may belong to another edition of this title.
Book Description Moody Pub, 2003. Hardcover. Book Condition: New. book. Bookseller Inventory # M080243939X
Book Description Moody Pub, 2003. Hardcover. Book Condition: New. Never used!. Bookseller Inventory # P11080243939X


Red Hat Enterprise Linux (RHEL) is a GNU/Linux distribution developed by Red Hat and targeted toward the commercial market.
Around 1 week ago the version 7 of Red Hat Enterprise has been released, and there seem to be great and interesting news in this version of the most used Gnu/Linux Enterprise distribution, let’s see some of them:
- Linux Containers
- XFS filesystems
- Performance management
- All the rest
This is in my point of view one of the most interesting thing of this release, and show how much Red Hat want to support this project as they give a lot of support to docker.
Docker is an open source project that automates the deployment of applications inside Linux Containers, and provides the capability to package an application with its runtime dependencies into a container. It provides a Docker CLI command line tool for the lifecycle management of image-based containers. Linux containers enable rapid application deployment, simpler testing, maintenance, and troubleshooting while improving security. Using Red Hat Enterprise Linux 7 with Docker allows customers to increase staff efficiency, deploy third-party applications faster, enable a more agile development environment, and manage resources more tightly.
This open up a lot of possibility to easily and quickly deploy test/qa machine on your server.
The default file system for an Anaconda-based installation of Red Hat Enterprise Linux 7 is now XFS, which replaces the Fourth Extended Filesystem (ext4) used by default in Red Hat Enterprise Linux 6. The ext4, ext3 and ext2 file systems can be used as alternatives to XFS.
XFS is a highly scalable, high-performance file system which was originally designed at Silicon Graphics, Inc. It was created to support file systems up to 16 exabytes (approximately 16 million terabytes), files up to 8 exabytes (approximately 8 million terabytes) and directory structures containing tens of millions of entries. XFS supports metadata journaling, which facilitates quicker crash recovery. XFS file system can also be defragmented and expanded while mounted and active. Note that it is not possible to shrink XFS file system.
“[Use of XFS] opens the door to a new class of data warehouse and big data analytics applications,” said Mark Coggin, senior director of product marketing, in an interview before the announcement.
Tuna is a tool that can be used to adjust scheduler tunables such as scheduler policy, RT priority and CPU affinity. It also allows the user to see the results of these changes.
Threads and IRQ handlers are able to be tuned. It is also possible to isolate CPU cores and sockets, moving all threads away from them so that a new, more important set of threads can run exclusively.
Tuna provides a graphical user interface (GUI). The GUI displays the CPU topology on one screen, which helps identify problems. It also allows changes to made to running threads, and see the results of those changes immediately.
Most Tuna operations can be performed on either the command line, or in the GUI.
Performing tuning tasks using traditional Linux tools can be daunting and complicated. Tuna reduces that complexity and provides powerful tools for getting the most of the MRG Realtime system.
Upgrade from RHEL 6
In the past there was not any upgrade procedure or path to upgrade to a newer RHEL release, and so to move from 5 to 6 the suggested path was something like “backup date, scratch, reinstall and retrieve data” not so handy or useful if compared to other distribution (e.g. Debian) where you can easily upgrade from a release to another, but with version 7 this could change as with version 6.5 there is a feature called “in place upgrade”, I’ve not tested it yet but the fact that there is an official document and procedure it’s a good start for sure.
systemd is a system and service manager for Linux, and replaces SysV and Upstart used in previous releases of Red Hat Enterprise Linux. systemd is compatible with SysV and Linux Standard Base init scripts.
systemd offers, among others, the following capabilities:
- Aggressive parallelization capabilities;
- Use of socket and D-Bus activation for starting services;
- On-demand starting of daemons;
- Managing of control groups;
- Creating of system state snapshots and restoring of the system state.
Wait, this is an enterprise server release, so who cares if it ship the ugly unity (my opinion of course) or the latest Gnome ?
It’s not a windows server, so just go via ssh with your terminal and you’ll be fine.
- None Found


text:
‘Right next door in Sighthill you can clearly see one of the biggest regeneration projects of its type in Europe gathering apace.’
Housing Archives - NewStart
‘This research shows yet another devastating impact of the broken housing market.’
‘There is a disconnect between the services taxpayers expect their local authorities to provide and the level of service possible.’
‘The key findings highlighted a proactive approach from local housing providers, yet distance between their aspirations and the experiences of disabled people.’
The £600 million will help deliver five projects in London, Central Bedfordshire and Essex.
‘These are first-class homes we are proud of and they rightly set a high design benchmark for the private developers we seek to attract.’
‘Middlesbrough people desperately want to see something happen with Gresham and I can promise them we are going to be getting on with it straight away.’
‘This project will change how we manufacture our homes forever.’
Approximately 8,000 households in Cardiff are on Cardiff Council’s waiting list for new homes, with around 400 new applications added each month.
The grant, awarded by Innovate UK, will fund whg’s two-year research and development project into offsite housing construction.

domain: news


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- Kentucky Officer Shot and Killed, Suspect at Large
- U.S. Man Wanted for Czech Murders Arrested by FBI at Dulles
- Lawsuit Claims Deputy Shot Man But Didn't Call Paramedics
- Mother Killed, Kids Hurt, after Shoplifters Crash in Houston
- Washington, D.C. Transit Police Arrest AED Thief
- Suspect in Killing of Utah Officer Found Dead in Cell
- New Jersey Cop Accused of Setting Fire to Captain's Home
(AP) EL PASO, Texas - An 18-year-old U.S. Army soldier and two other men have been charged with capital murder in the contract killing of a midlevel Mexican drug cartel official who was also a U.S. informant.
Pfc. Michael Jackson Apodaca, who was based at Fort Bliss, near El Paso, and Christopher Duran, 17, were hired by 30-year-old Ruben Rodriguez Dorado to carry out the May 15 shooting of Jose Daniel Gonzalez Galeana, police said Tuesday. Gonzalez was shot eight times outside his pricey El Paso home.
The three men were arrested Monday night and were being held on $1 million bond each. It was not immediately clear if any of the men had retained a lawyer. Online court records did not list an attorney for any of the men, and police said they did not know either.
Gonzalez, a lieutenant in the Juarez drug cartel, was also an informant for the U.S. Immigration and Customs Enforcement agency, according to three U.S. officials who spoke on condition of anonymity because they were not authorized to speak about it.
A law enforcement official familiar with the case told The Associated Press on Tuesday that Rodriguez, who police believe orchestrated Gonzalez's killing, is also a lieutenant in the Juarez cartel.
That official spoke on the condition of anonymity because he is not authorized to speak about the case.
Details of Apodaca's military service were not immediately available.
"Anytime someone does something like this, and a soldier in our case, it's terrible," Fort Bliss spokeswoman Jean Offutt said, without commenting directly on the case.
Before the killing, Gonzalez lived what appeared to be a routine life in an upscale east El Paso neighborhood where his neighbors include Allen and El Paso County District Attorney Jaime Esparza. Business records show that he ran a freight company from his two-story stucco house, along with a day care and an auto business.

domain: law


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Sasha Banks, among multiple other WWE superstars have voiced their concern regarding their placement on the WWE WrestleMania poster this year, with Bobby Lashley and Drew McIntyre WrestleMania news upsetting her. WrestleMania 37 is scheduled to take place as a two-night event on April 10 and 11, 2021 at Raymond James Stadium in Tampa, Florida. Banks is upset that her highly anticipated match against challenger Bianca Belair for the WWE Smackdown Women’s Championship. ‘The Boss’ took to social media via Twitter to voice her displeasure as she stated, very simply that her Women’s Championship match should be the main event night one of the ‘Granddaddy of them all’. Alexa Bliss also ‘angered’ Randy Orton backstage at Raw.
The current main event of that particular night is slated to be WWE Champion Bobby Lashley defending his title against former champion, Drew McIntyre. Other scheduled matches for night one of WrestleMania 37 include Bad Bunny Vs The Miz.
Another superstar who is upset about their placement on the WrestleMania 37 poster is none other than ‘The Messiah’ Seth Rollins. However, Rollins has, arguably a bigger grievance over Banks. While Banks is showcased front and center on the advertisement for the ‘Showcase of the Immortals’ Rollins is hardly featured at all. Taking to Twitter himself, the former WWE Champion rectified this by showcasing by blowing up the latest version of the WrestleMania 37 poster where he is featured albeit in very small fashion. It should be noted that in the original, Rollins wasn’t included at all. WWE Wanted Sasha Banks ‘Pulled’ From Smackdown.
Main Event. https://t.co/Q2cApBn9OL
— Mercedes Varnado (@MercedesVarnado) March 23, 2021
FRONT AND CENTER WRESTLEMANIA POSTER SUPERSTAR VISIONARY KING!!!! #ETV pic.twitter.com/rQT1BgeRwo
— Seth “Freakin’” Rollins (@WWERollins) March 23, 2021

domain: sports


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While my hands haven’t been covered in mud this week – I have been accepted into Uni to learn some more about clay, ceramics and art.
Had a beautiful lunch with fellow Revolutionary Ceramicos members Cass and Clare and was very lucky to receive one of Cass’s puppies as a Christmas gift. Woot woot
My Christmas tree is up and with carols resounding in the background, lights tinkling and a tipple of the cheery stuff I had the pleasure of remembering past trips, friends and family as I put the Christmas ornaments around the tree.
This years additions were six beautiful crosses from Hillgrove House in Ireland http://homepage.eircom.net/~hillgroveporcelain/index.html – beautiful porcelain trinkets and a wonderful big red heart from Lyn Gold Coast Potters www.goldcoastpotters.com and a lovely white heart rememberance of the people of Japan that went through the earthquake earlier this year. I was in Japan when my father died and we had to return to Australia – a day later the earthquake hit Japan and my heart goes out to the poeple who are still coping with the after effects.
On a ceramic note – If you are lucky enough to be able to get to Manly -Check out
The Narrative Knot: stories in ceramics Curator and artists talk, 4 December 2011 Exhibition open 2 December 2011 – 22 January 2012 by: The Australian Ceramics Association
And dont forget to check out – ‘Mud Colony’ – a weekly blog for Clayworkers to show us what their up to in the studio
Happy Clay days everyone
Wonderful to have clay rememberances of friends for the holidays. We had a cattle dog named Blue whose since gone to dog heaven, love that blue dog.
Thanks Linda I am going to get onto making some next year. You have inspired me to make a little puppy ornament and name him after my maltese -Dogs are so beautiful
Hi Debby I was lucky enough to visit Belleek Pottery last year – did the studio tour and pondered for ages in the shop before purchasing a little souvenir teapot. The bodies are mostly slipcast except for the baskets which are still completely handbuilt as are the flowers. The shamrocks are all painted on by hand with china paint enamels and then refired along with the decal logo on the base. The women making the flowers were amazing to watch!
Happy clay days to you too
lucky lucky you Anna – It is on my wish list. I have a few Belleek pieces but the baskets are just so beautiful. Maybe next year
Hope you make it there (and maybe the Wedgwood vistors centre in UK?)

domain: artistic


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Light Fall from Bishop Games is an interesting, challenging and tight 2D platformer that you should checj out on Nintendo Switch. Find out why in our Light Fall review!
In Light Fall you explore the land of Numbra by making the most of your Shadow Core, a very handy block that has many uses to help you on your quest to make light prevail over darkness. You’ll be joined in this adventure by Stryx, an old owl that will act as your sidekick on this journey, as well as the game’s narrator.
At first you can only move around with the left analog stick, run by holding down the ZR button and jump with the B button, but you soon earn some new skills. You’ll get a magical cube of sorts, and this will allow you to summon the cube below you to work as a floating platform to stand on. You can trigger this platform up to four times, and if you want to use it again you will need to stand on solid ground before jumping again. You can also press the Y button to project the cube forward as an attack, or press the X button to have the cube materialize above you to move it around with the left analog stick to, say, block a deadly laser from killing you, or to activate some mechanisms you can interact with by pressing the Y and A buttons. You’ll learn other ways to use your abilities as you go, eventually having enough to do some crazy fast speedrunning.
As you play you will sometimes spot yellow crystals which can be destroyed and condensed by holding down the Y button to unlock a memory you need to bring to a checkpoint. Some of them will be along the main path, but others will be a bit more out of reach and will require you to complete some tricky platforming sections in which you’ll use every skill at your disposal. You will also find others trapped within blue crystals, so be sure to use your attack with the Y button to set them free. The first couple of them will be on the main path, but you’ll need to search high and low for the others. You’ll know how many yellow crystals you need to find and how many people you need to set free from the blue crystals by viewing the checkpoints for a level since each slot in the two halves of the checkpoint represent one of these collectibles.
You will learn more about this world’s story as you progress through each area thanks to the owl narrator who will slowly unveil the overall reasons why you’re traversing this bleak 2D world while trying to stay alive. There are a couple of big twists along the way, which I won’t spoil here, and the voice actor for the narrator does a great job, moving the story along at checkpoints in a level or during the cutscenes that break the chapters of every act.
Light Fall is a fun and challenging 2D platformer with more than enough content to offer for its asking price. The difficulty curve feels just right, bumping up the challenge as you go at a steady pace without ever feeling overwhelming or unfair. It’s a solid platformer on Nintendo Switch, and the secret rooms where you will find most of the yellow crystals to collect will test your skills even further as you try to use your cubed to defend from the hazards you find.
This Light Fall review is based on a Nintendo Switch copy provided by Bishop Games.

domain: game


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Physical function declines, and markers of inflammation increase with advancing age,
even in healthy persons. Microbial translocation (MT) is the systemic exposure to
mucosal surface microbes/microbial products without overt bacteremia and has been
described in a number of pathologic conditions. We hypothesized that markers of MT,
soluble CD14 (sCD14) and lipopolysaccharide (LPS) binding protein (LBP), may be a source
of chronic inflammation in older persons and be associated with poorer physical
We assessed cross-sectional relationships among two plasma biomarkers of MT (sCD14 and
LBP), physical function (hand grip strength, short physical performance battery [SPPB],
gait speed, walking distance, and disability questionnaire), and biomarkers of
inflammation (C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis
factor-alpha (TNF-α), TNF-α soluble receptor 1 [TNFsR1]) in 59 older
(60–89 years), healthy (no evidence of acute or chronic illness) men and
LBP was inversely correlated with SPPB score and grip strength (p
= .02 and p < .01, respectively) and positively correlated
with CRP (p = 0.04) after adjusting for age, gender, and body
mass index. sCD14 correlated with IL-6 (p = .01), TNF-α
(p = .05), and TNFsR1 (p < .0001).
Furthermore, the correlations between LBP and SPPB and grip strength remained
significant after adjusting for each inflammatory biomarker.
In healthy older individuals, LBP, a surrogate marker of MT, is associated with worse
physical function and inflammation. Additional study is needed to determine whether MT
is a marker for or a cause of inflammation and the associated functional
Microbial translocation; Inflammation; Physical function; Microbiome
This study compared measures of chronic pain, for example, number of pain sites and overall pain severity, in relation to lower extremity function in the older population.
Six hundred older adults (mean age 77.9 years, 64% female) were queried about presence of chronic pain. Number of pain sites was categorized as none, single site, multisite, or widespread. Pain severity was measured in quartiles of the Brief Pain Inventory pain severity subscale. Lower extremity function was assessed by the Short Physical Performance Battery (SPPB), a composite measure of gait speed, balance, and chair stands.
Many older persons reported multisite or widespread pain (40%). Increased pain sites and pain severity were associated with poorer SPPB performance after adjusting for age, sex, height, and weight. With further adjustment for education, comorbid conditions, and depressive symptoms, multisite pain (p < .001) and most severe pain (p < .05) were associated with poorer SPPB performance, but assessed together in the same model, only the association with multisite/widespread pain remained significant (p < .01). When specific joint pain sites were evaluated together, only knee pain was associated with lower SPPB score. Pain severity was independently associated with slower gait, pain location was associated with poorer balance, and chair stands performance was associated with both pain measures.
Although multisite pain rather than pain severity was more strongly associated with overall lower extremity function, differences emerged with specific SPPB subtests. Longitudinal studies are needed to understand risk for lower extremity function decline related to chronic pain characteristics in older adults.
Pain; Mobility; Aging; Lower extremity function; Epidemiology
Background: HIV-infected individuals may be at increased risk of poor physical function. Chronic inflammation has been associated with decreased physical function in the elderly and may also influence physical function in HIV-infected individuals.
Methods: This cross-sectional study assessed physical function in 65 HIV-infected women aged 40 and older on stable antiretroviral treatment using the Short Physical Performance Battery (SPPB): a standardized test of balance, walking speed, and lower- extremity strength developed for elderly populations. The relationship between low SPPB score, selected demographic and medical characteristics, and high inflammatory biomarker profile was analyzed using Fisher's exact test and Wilcoxon rank sum test.
Results: The median age of subjects was 49 years (interquartile range [IQR] 45–55), and the median CD4 T-cell count was 675 cells/mm3 (IQR 436–828). Thirteen subjects (20%) had a low SPPB score. Subjects with a low SPPB score were more likely to be cigarette smokers (p=0.03), had more medical comorbidities (p=0.01), and had higher levels of interleukin-6 (IL-6) (p<0.05). They also tended to be older (median age 55 vs. 48, p=0.06), more likely to have diabetes (p=0.07), and have higher levels of soluble tumor necrosis factor-1 (p=0.09).
Conclusions: Twenty percent of women aged 40 and older with well-treated HIV had poor physical-function performance, which was associated with the high burden of comorbidities in this population and with increased IL-6. However, it is unclear from this cross-sectional study whether increased inflammation was related to poor physical function or to other factors, such as age and medical comorbidities.
Chronic kidney disease (CKD) is increasingly recognized as a cause of worsening physical functioning in older patients. The Short Physical Performance Battery (SPPB) is highly reliable in older populations, but no data on older hospitalized patients with different degrees of kidney function are available. We aimed at testing the association between estimated glomerular filtration rate (eGFR) and SPPB, either global score (range 0–12) or its individual components (muscle strength, balance, and walking speed, each ranging from 0 to 4), in a sample of older hospitalized patients. Our series consisted of 486 patients aged 65 or more consecutively enrolled in 11 acute care medical wards participating to a multicenter observational study. eGFR was obtained by the Chronic Kidney Disease Epidemiological Collaboration (CKD-EPI) equation. Physical performance was objectively measured by the SPPB. The relationship between eGFR and SPPB was investigated by multiple linear regression analysis. Physically impaired patients (SPPB total score<5) were older, had lower serum albumin and Mini-Mental State Examination (MMSE) scores as well as higher overall co-morbidity, prevalence of stroke, cancer, and anemia compared to those with intermediate (SPPB=5–8) and good physical performance (SPPB=9–12). Fully adjusted multivariate models showed that eGFR (modeled as 10 mL/min per 1.73 m2 intervals) was independently associated with the SPPB total score (B=0.49; 95% confidence interval [CI]=0.18–0.66; p=0.003), balance (B=0.30; 95% CI=0.10–0.49; p=0.005), and muscle strength (B=0.06; 95% CI=0.01–0.10; p=0.043), but not with walking speed (B=−0.04; 95% CI=−0.09–0.11; p=0.107). In conclusion, reduced renal function is associated with poorer physical performance in older hospitalized patients. SPPB is worthy of testing to monitor changes in physical performance in elderly CKD patients.
To assess the validity (convergent and construct) and reliability of the Short Physical Performance Battery (SPPB) among non-disabled adults between 65 to 74 years of age residing in the Andes Mountains of Colombia.
Design Validation study; Participants:
150 subjects aged 65 to 74 years recruited from elderly associations (day-centers) in Manizales, Colombia. Measurements: The SPPB tests of balance, including time to walk 4 meters and time required to stand from a chair 5 times were administered to all participants. Reliability was analyzed with a 7-day interval between assessments and use of repeated ANOVA testing. Construct validity was assessed using factor analysis and by testing the relationship between SPPB and depressive symptoms, cognitive function, and self rated health (SRH), while the concurrent validity was measured through relationships with mobility limitations and disability in Activities of Daily Living (ADL). ANOVA tests were used to establish these associations.
Test-retest reliability of the SPPB was high: 0.87 (CI95%: 0.77-0.96). A one factor solution was found with three SPPB tests. SPPB was related to self-rated health, limitations in walking and climbing steps and to indicators of disability, as well as to cognitive function and depression. There was a graded decrease in the mean SPPB score with increasing disability and poor health.
The Spanish version of SPPB is reliable and valid to assess physical performance among older adults from our region. Future studies should establish their clinical applications and explore usage in population studies.
SPPB; aging; reliability; validity; validation studies; disability; Colombia
Physical function measures have been shown to predict negative health-related events in older persons, including mortality. These markers of functioning may interact with the self-rated health (SRH) in the prediction of events. Aim of the present study is to compare the predictive value for mortality of measures of physical function and SRH status, and test their possible interactions.
Data are from 335 older persons aged ≥ 80 years (mean age 85.6 years) enrolled in the "Invecchiamento e Longevità nel Sirente" (ilSIRENTE) study. The predictive values for mortality of 4-meter walk test, Short Physical Performance Battery (SPPB), hand grip strength, Activities of Daily Living (ADL) scale, Instrumental ADL (IADL) scale, and a SRH scale were compared using proportional hazard models. Kaplan-Meier survival curves for mortality and Receiver Operating Characteristic (ROC) curve analyses were also computed to estimate the predictive value of the independent variables of interest for mortality (alone and in combination).
During the 24-month follow-up (mean 1.8 years), 71 (21.2%) events occurred in the study sample. All the tested variables were able to significantly predict mortality. No significant interaction was reported between physical function measures and SRH. The SPPB score was the strongest predictor of overall mortality after adjustment for potential confounders (per SD increase; HR 0.64; 95%CI 0.48–0.86). A similar predictive value was showed by the SRH (per SD increase; HR 0.76; 95%CI 0.59–0.97). The chair stand test was the SPPB subtask showing the highest prognostic value.
All the tested measures are able to predict mortality with different extents, but strongest results were obtained from the SPPB and the SRH. The chair stand test may be as useful as the complete SPPB in estimating the mortality risk.
Systemic immune activation (inflammation) and immunosenescence develop in some people with advancing age. This process, known as “inflamm-aging,” is associated with physical frailty and sarcopenia. Meanwhile, successful antiretroviral therapy has led to a growing number of older HIV-1-infected individuals who face both age-related and HIV-1-related inflammation, which may synergistically promote physical decline, including frailty and sarcopenia. The purpose of our study was to determine if inflammation during treated HIV-1 infection worsens physical impairment in older individuals.
We determined the severity of HIV-associated inflammation and physical performance (strength and endurance) in 21 older HIV-infected individuals (54–69 years) receiving suppressive antiretroviral therapy, balanced for confounding variables including age, anthropometrics, and co-morbidities with 10 uninfected control individuals. Biomarkers for microbial translocation (lipopolysaccharide [LPS]), inflammation (soluble CD14 [sCD14], osteopontin, C-reactive protein [CRP], interleukin-6 [IL-6], soluble ICAM-1 [sICAM-1] and soluble VCAM-1 [sVCAM-1]), and coagulopathy (D-dimer) were assayed in plasma. Activation phenotypes of CD4+T cells, CD8+ T cells and monocytes were measured by flow cytometry. Physical performance was measured by 400 m walking speed, a short physical performance battery [SPPB], and lower extremity muscle strength and fatigue.
Overall physical function was similar in the uninfected and HIV-infected groups. Compared to uninfected individuals, the HIV-infected group had elevated levels of sCD14 (P < 0.001), CRP (P < 0.001) and IL-6 (P = 0.003) and an increased frequency of CD4+ and CD8+ T cells with an immunosenescent CD57+ phenotype (P = 0.004 and P = 0.043, respectively). Neither plasma inflammatory biomarkers nor CD57+ T cells correlated with CD4+ T cell counts. Furthermore, none of the elevated inflammatory biomarkers in the HIV-infected subjects were associated with any of the physical performance results.
When age-related co-morbidities were carefully balanced between the uninfected and HIV-infected groups, no evidence of inflammation-associated physical impairment was detected. Despite careful balancing for age, BMI, medications and co-morbidities, the HIV-infected group still displayed evidence of significant chronic inflammation, including elevated sCD14, CRP, IL-6 and CD57+ T cells, although the magnitude of this inflammation was unrelated to physical impairment.
In older adults, studies demonstrate an inverse relationship between physical function and individual inflammatory biomarkers. Given that the inflammatory response is a complex system, a combination of biomarkers may increase the strength and consistency of these associations. This study uses principal component analysis to identify inflammatory “component(s)” and evaluates associations between the identified component(s) and measures of physical function.
Principal component analysis with a varimax rotation was used to identify two components from eight inflammatory biomarkers measured in 1,269 older persons. The study sample is a subset of the Health, Aging, and Body Composition study.
The two components explained 56% of the total variance in the data (34%, component 1 and 22%, component 2). Five markers (tumor necrosis factor-alpha [TNF-α], sTNFRI, sTNFRII, interleukin [IL]-6sR, IL-2sR) loaded highest on the first component (TNF-α related), whereas three markers (C-reactive protein [CRP], IL-6, plasminogen activator inhibitor-1) loaded highest on the second component (CRP related). After adjusting for age, sex, race, site, sampling indicator, total lean and fat mass, physical activity, smoking, and anti-inflammatory drug use, knee strength and a physical performance battery score were inversely related to the TNF-α-related component, but not to the CRP-related component (knee strength: β^TNFα = −2.71, p = .002; β^CRP = −0.88, p = .325; physical performance battery score: β^TNFα = −0.05, p < .001; β^CRP = −0.02, p = .171). Both components were positively associated with 400-m walk time, inversely associated with grip strength, and not associated with 20-m walking speed.
At least two inflammatory components can be identified in an older population, and these components have inconsistent associations with different aspects of physical performance.
Inflammation; Physical function; Aging; Principal component analysis
Sarcopenia, the involuntary loss of skeletal muscle with age, affects up to one-quarter of older adults. Evidence indicates a positive association between dietary protein intake and lean muscle mass and strength among older persons, but information on dietary protein’s effect on physical performance in older adults has received less attention.
Cross-sectional observational analysis of the relationship of dietary protein on body composition and physical performance.
Clinical research center.
387 healthy women aged 60 – 90 years (mean 72.7 ± 7.0 y).
Measures included body composition (fat-free mass, appendicular skeletal mass and fat mass) via dual x-ray absorptiometry (DXA), physical performance (Physical Performance Test [PPT] and Short Physical Performance Battery [SPPB]), handgrip strength, Physical Activity Scale in the Elderly (PASE), quality of life measure (SF-8), falls, fractures, nutrient and macromolecule intake (four-day food record). Independent samples t-tests determined mean differences between the above or below RDA protein groups.
Analysis of covariance was used to control for body mass index (BMI) between groups when assessing physical performance, physical activity and health-related quality of life.
The subjects consumed an average of 72.2 g protein/day representing 1.1 g protein/kg body weight/day. Subjects were categorized as below the recommended daily allowance (RDA) for protein (defined as less than 0.8 g protein/kg) or at or above the RDA (equal to or higher than 0.8 g protein/kg). Ninety-seven subjects (25%) were in the low protein group, and 290 (75%) were in the higher protein group. Women in the higher protein group had lower body mass, including fat and lean mass, and fat-to-lean ratio than those in the lower-protein group (p <0.001). Composite scores of upper and lower extremity strength were impaired in the group with low protein intake; SPPB score was 9.9±1.9 compared to 10.6±1.6 in those with higher protein intake and PPT was 19.8± 2.9 compared to 20.9± 2.1 in the low and higher protein groups, respectively. The results were attenuated by correction for BMI, but remained significant. The physical component of the SF-8 was also lower in the low protein group but did not remain significant when controlling for BMI. No significant differences were found in hand grip strength or reported physical activity.
Healthy, older postmenopausal women consumed, on average, 1.1 g/kg/d protein, although 25% consumed less than the RDA. Those in the low protein group had higher body fat and fat-to-lean ratio than those who consumed the higher protein diet. Upper and lower extremity function was impaired in those who consumed a low protein diet compared to those with a higher protein intake. Protein intake should be considered when evaluating the multi-factorial loss of physical function in older women.
Protein; body composition; physical performance; frailty
Early detection of mobility limitations remains an important goal for preventing mobility disability. The purpose of this study was to examine the association between the Short Physical Performance Battery (SPPB) and the loss of ability to walk 400 m, an objectively assessed mobility outcome increasingly used in clinical trials.
The study sample consisted of 542 adults from the InCHIANTI study aged 65 and older, who completed the 400 m walk at baseline and had evaluations on the SPPB and 400 m walk at baseline and 3-year follow-up. Multiple logistic regression models were used to determine whether SPPB scores predict the loss of ability to walk 400 m at follow-up among persons able to walk 400 m at baseline.
The 3-year incidence of failing the 400 m walk was 15.5%. After adjusting for age, sex, education, body mass index, Mini-Mental State Examination, number of medical conditions, and 400 m walk gait speed at baseline, SPPB score was significantly associated with loss of ability to walk 400 m after 3 years. Participants with SPPB scores of 10 or lower at baseline had significantly higher odds of mobility disability at follow-up (odds ratio [OR] = 3.38, 95% confidence interval [CI]: 1.32–8.65) compared with those who scored 12, with a graded response across the range of SPPB scores (OR = 26.93, 95% CI: 7.51–96.50; OR = 7.67, 95% CI: 2.26–26.04; OR = 8.28, 95% CI: 3.32–20.67 for SPPB ≤ 7, SPPB 8, and SPPB 9, respectively).
The SPPB strongly predicts loss of ability to walk 400 m. Thus, using the SPPB to identify older persons at high risk of lower body functional limitations seems a valid means of recognizing individuals who would benefit most from preventive interventions.
Mobility; 400 m walk; Incidence of disability; Functional limitation; Aging
Sarcopenia has been associated with systemic inflammation and a range of other biological risk factors. The purpose of this study was to assess the systemic inflammation–muscle strength relationship in a large representative community-based cohort of older adults, and to determine the independence of this association from other biological and psychosocial risk factors. Participants were 1,926 men and 2,260 women (aged 65.3 ± 9.0 years) from the English Longitudinal Study of Ageing, a study of community dwelling older adults. We assessed hand grip strength and lower body strength (time required to complete five chair stands). Biological measures included C-reactive protein (CRP), fibrinogen, cholesterol, haemoglobin, glycated haemoglobin, adiposity, and blood pressure. Approximately 33% of the sample demonstrated elevated concentrations (≥3 mg/L) of CRP. After adjustments for age, smoking, physical activity, education, inflammatory diseases, and all other biological factors, elevated CRP was associated with poorer hand grip strength and chair stand performance in women but only chair stand performance in men. Low haemoglobin levels were consistently associated with poorer performance on both tests in women and men. These results confirm an independent association between low grade systemic inflammation (as indexed by CRP) and muscle strength that appears to be more robust in women.
Inflammation; Muscle strength; Sarcopenia; Community sample
Obesity-related increases in multiple inflammatory markers may contribute to the
persistent subclinical inflammation common with advancing age. However, it is unclear if
a specific combination of markers reflects the underlying inflammatory state. We used
factor analysis to identify inflammatory factor(s) and examine their associations with
adiposity in older adults at risk for disability.
Adiponectin, CRP, IL-1ra, IL-1sRII, IL-2sRα, IL-6, IL-6sR, IL-8, IL-15, sTNFRI,
sTNFRII, and TNF-α were measured in 179 participants from the Lifestyle
Interventions and Independence for Elders Pilot (Mean ± SD age
77 ± 4 years, 76% white, 70% women). Body mass index, waist circumference, and
total fat mass were assessed by anthropometry and dual-energy x-ray absorptiometry.
IL-2sRα, sTNFRI, and sTNFRII loaded highest on the first factor (factor 1). CRP,
IL-1ra, and IL-6 loaded highest on the second factor (factor 2). Factor 2, but not
factor 1, was positively associated with 1-SD increments in waist
circumference (β = 0.160 ± 0.057, p = .005),
body mass index (β = 0.132 ± 0.053, p = .01),
and total fat mass (β = 0.126 ± 0.053, p =
.02) after adjusting for age, gender, race/ethnicity, site, smoking, anti-inflammatory
medications, comorbidity index, health-related quality of life, and physical function.
These associations remained significant after further adjustment for grip strength, but
only waist circumference remained associated with inflammation after adjusting for total
lean mass. There were no significant interactions between adiposity and muscle mass or
strength for either factor.
Greater total and abdominal adiposity are associated with higher levels of an
inflammatory factor related to CRP, IL-1ra, and IL-6 in older adults, which may provide
a clinically useful measure of inflammation in this population.
Aging; Adiposity; Inflammation; Muscle impairment; Factor analysis
The number of older adults living in the U.S. continues to increase, and recent research has begun to target interventions to older adults who have mobility limitations and are at risk for disability. The objective of this study is to describe and examine correlates of health-related quality of life in this population subgroup using baseline data from a larger intervention study.
The Lifestyle Interventions and Independence for Elders–Pilot study (LIFE–P) was a randomized, controlled trial that compared a physical activity intervention to a non-exercise educational intervention with 424 older adults at risk for disability. Baseline data (collected April–December 2004; analyzed in 2006) included demographics, medical history, the Quality of Well-Being Scale (QWB-SA), a timed 400 m walk, and the Short Physical Performance Battery (SPPB). Descriptive HRQOL data are presented. Hierarchical linear regression models were used to examine correlates of HRQOL.
The mean QWB-SA score for the sample was 0.630 on an interval scale ranging from 0.0 (death) to 1.0 (asymptomatic, optimal functioning). The mean of 0.630 is 0.070 lower than a comparison group of healthy older adults. The variables associated with lower HRQOL included white ethnicity, more comorbid conditions, slower 400-m walk times, and lower SPPB balance and chair stand scores.
Older adults who are at risk for disability had reduced HRQOL. Surprisingly, however, mobility was a stronger correlate of HRQOL than an index of comorbidity, suggesting that interventions addressing mobility limitations may provide significant health benefits to this population.
Older adults have the highest rates of disability, functional dependence and use of healthcare resources. Training interventions for older individuals are of special interest where regular physical activity (PA) has many health benefits. The main purpose of this study was to assess the immediate and long-term effects of a 6-month multimodal training intervention (MTI) on functional fitness in old adults.
For this study, 117 participants, 71 to 90 years old, were randomized in immediate intervention group and a control group (delayed intervention group). The intervention consisted of daily endurance and twice-a-week strength training. The method was based on a randomized-controlled cross-over design. Short Physical Performance Battery (SPPB), 8 foot up-and-go test, strength performance, six min walking test (6 MW), physical activity, BMI and quality of life were obtained at baseline, after a 6-month intervention- and control phase, again after 6-month crossover- and delayed intervention phase, and after anadditional 6-month follow-up.
After 6 months of MTI, the intervention group improved in physical performance compared with the control group via Short Physical Performance Battery (SPPB) score (mean diff = 0.6, 95 % CI: 0.1, 1.0) and 8-foot up-and-go test (mean diff = −1.0 s, 95 % CI: -1.5, -0.6), and in endurance performance via 6-minute walking test (6 MW) (mean diff = 44.2 meters, 95 % CI: 17.1, 71.2). In strength performance via knee extension the intervention group improved while control group declined (mean diff = 55.0 Newton, 95 % CI: 28.4, 81.7), and also in PA (mean diff = 125.9 cpm, 95 % CI: 96.0, 155.8). Long-term effects of MTI on the particpants was assesed by estimating the mean difference in the variables measured between time-point 1 and 4: SPPB (1.1 points, 95 % CI: 0.8, 1.4); 8-foot up-and-go (−0.9 s, 95 % CI: -1.2, -0.6); 6 MW (18.7 m, 95 % CI: 6.5, 31.0); knee extension (4.2 Newton, 95 % CI: -10.0, 18.3); hand grip (6.7 Newton, 95 % CI: -4.4, 17.8); PA (−4.0 cpm, 95 % CI: -33.9, 26.0); BMI (−0.6 kg/m2, 95 % CI: -0.9, -0.3) and Icelandic quality of life (0.3 points, 95 % CI: -0.7, 1.4).
Our results suggest that regular MTI can improve and prevent decline in functional fitness in older individuals, influence their lifestyle and positively affect their ability to stay independent, thus reducing the need for institutional care.
This study was approved by the National Bioethics Committee in Iceland, VSNb20080300114/03-1
Physical activity; Functional fitness; SPPB; 6 MW; Strength; Cross-over design
Having a low level of education has been associated with worse physical performance. However, it is unclear whether this association varies by age, gender or the occupational categories of manual and non-manual work. This study examined whether there are education-related differences across four dimensions of physical performance by age, gender or occupational class and to what extent chronic diseases and lifestyle-related factors may explain such differences.
Participants were a random sample of 3212 people, 60 years and older, both living in their own homes and in institutions, from the Swedish National Study on Aging and Care, in Kungsholmen, Stockholm. Trained nurses assessed physical performance in grip strength, walking speed, balance and chair stands, and gathered data on education, occupation and lifestyle-related factors, such as physical exercise, body mass index, smoking and alcohol consumption. Diagnoses of chronic diseases were made by the examining physician.
Censored normal regression analyses showed that persons with university education had better grip strength, balance, chair stand time and walking speed than people with elementary school education. The differences in balance and walking speed remained statistically significant (p < 0.05) after adjustment for chronic diseases and lifestyle. However, age-stratified analyses revealed that the differences were no longer statistically significant in advanced age (80+ years). Gender-stratified analyses revealed that women with university education had significantly better grip strength, balance and walking speed compared to women with elementary school education and men with university education had significantly better chair stands and walking speed compared to men with elementary school education in multivariate adjusted models. Further analyses stratified by gender and occupational class suggested that the education-related difference in grip strength was only evident among female manual workers, while the difference in balance and walking speed was only evident among female and male non-manual workers, respectively.
Higher education was associated with better lower extremity performance in people aged 60 to 80, but not in advanced age (80+ years). Our results indicate that higher education is associated with better grip strength among female manual workers and with better balance and walking speed among female and male non-manual workers, respectively.
Educational status; Aging; Chronic diseases; Muscle strength; Walking; Postural balance
Several studies have reported predictors for loss of mobility and impairments of physical performance among frail elderly people.
To evaluate the relationship between lifetime occupation and physical function in persons aged 80 years or older.
Data are from baseline evaluation of 364 subjects enrolled in the ilSIRENTE study (a prospective cohort study performed in a mountain community in Central Italy). Physical performance was assessed using the physical performance battery score, which is based on three timed tests: 4‐metre walking speed, balance, and chair stand tests. Muscle strength was measured by hand grip strength. Lifetime occupation was categorised as manual or non‐manual work.
Mean age of participants was 85.9 (SD 4.9) years. Of the total sample, 273 subjects (75%) had a history of manual work and 91 subjects (25%) a history of non‐manual work. Manual workers had significant lower grip strength and physical performance battery score (indicating worse performance) than non‐manual workers. After adjustment for potential confounders (including age, gender, education, depression, cognitive performance scale score, physical activity, number of diseases, hearing impairment, history of alcohol abuse, smoking habit, and haemoglobin level), manual workers had significantly worse physical function (hand grip strength: non‐manual workers 32.5 kg, SE 1.4, manual workers 28.2 kg, SE 0.8; physical performance battery score: non‐manual workers 7.1, SE 0.4, manual workers 6.1, SE 0.2).
A history of manual work, especially when associated with high physical stress, is independently associated with low physical function and muscle strength in older persons.
lifetime occupation; physical performance; aging;
Several studies have reported predictors for loss of mobility and impairments of physical performance among frail elderly people.
To evaluate the relationship between lifetime occupation and physical function in persons aged 80 years or older.
Data are from baseline evaluation of 364 subjects enrolled in the ilSIRENTE study (a prospective cohort study performed in a mountain community in Central Italy). Physical performance was assessed using the physical performance battery score, which is based on three timed tests: 4-metre walking speed, balance, and chair stand tests. Muscle strength was measured by hand grip strength. Lifetime occupation was categorised as manual or non-manual work.
Mean age of participants was 85.9 (SD 4.9) years. Of the total sample, 273 subjects (75%) had a history of manual work and 91 subjects (25%) a history of non-manual work. Manual workers had significant lower grip strength and physical performance battery score (indicating worse performance) than non-manual workers. After adjustment for potential confounders (including age, gender, education, depression, cognitive performance scale score, physical activity, number of diseases, hearing impairment, history of alcohol abuse, smoking habit, and haemoglobin level), manual workers had significantly worse physical function (hand grip strength: non-manual workers 32.5 kg, SE 1.4, manual workers 28.2 kg, SE 0.8; physical performance battery score: non-manual workers 7.1, SE 0.4, manual workers 6.1, SE 0.2).
A history of manual work, especially when associated with high physical stress, is independently associated with low physical function and muscle strength in older persons.
Physical performance and balance declines with aging and may lead to increased risk of falls. Physical performance tests may be useful for initial fall-risk screening test among community-dwelling older adults. Physiological profile assessment (PPA), a composite falls risk assessment tool is reported to have 75% accuracy to screen for physiological falls risk. PPA correlates with Timed Up and Go (TUG) test. However, the association between many other commonly used physical performance tests and PPA is not known. The aim of the present study was to examine the association between physiological falls risk measured using PPA and a battery of physical performance tests.
One hundred and forty older adults from a senior citizens club in Kuala Lumpur, Malaysia (94 females, 46 males), aged 60 years and above (65.77±4.61), participated in this cross-sectional study. Participants were screened for falls risk using PPA. A battery of physical performance tests that include ten-step test (TST), short physical performance battery (SPPB), functional reach test (FRT), static balance test (SBT), TUG, dominant hand-grip strength (DHGS), and gait speed test (GST) were also performed. Spearman’s rank correlation and binomial logistic regression were performed to examine the significantly associated independent variables (physical performance tests) with falls risk (dependent variable).
Approximately 13% older adults were at high risk of falls categorized using PPA. Significant differences (P<0.05) were demonstrated for age, TST, SPPB, FRT, SBT, TUG between high and low falls risk group. A significant (P<0.01) weak correlation was found between PPA and TST (r=0.25), TUG (r=0.27), SBT (r=0.23), SPPB (r=−0.33), and FRT (r=−0.23). Binary logistic regression results demonstrated that SBT measuring postural sways objectively using a balance board was the only significant predictor of physiological falls risk (P<0.05, odds ratio of 2.12).
The reference values of physical performance tests in our study may be used as a guide for initial falls screening to categorize high and low physiological falls risk among community-dwelling older adults. A more comprehensive assessment of falls risk can be performed thereafter for more specific intervention of underlying impairments.
balance; postural sways; agility; mobility; strength; gait speed
To investigate the associations of body mass index (BMI) and grip strength with objective measures of physical performance (chair rise time, walking speed and balance) including an assessment of sex differences and non-linearity.
Cross-sectional data from eight UK cohort studies (total N = 16 444) participating in the Healthy Ageing across the Life Course (HALCyon) research programme, ranging in age from 50 to 90+ years at the time of physical capability assessment, were used. Regression models were fitted within each study and meta-analysis methods used to pool regression coefficients across studies and to assess the extent of heterogeneity between studies.
Higher BMI was associated with poorer performance on chair rise (N = 10 773), walking speed (N = 9 761) and standing balance (N = 13 921) tests. Higher BMI was associated with stronger grip strength in men only. Stronger grip strength was associated with better performance on all tests with a tendency for the associations to be stronger in women than men; for example, walking speed was higher by 0.43 cm/s (0.14, 0.71) more per kg in women than men. Both BMI and grip strength remained independently related with performance after mutual adjustment, but there was no evidence of effect modification. Both BMI and grip strength exhibited non-linear relations with performance; those in the lowest fifth of grip strength and highest fifth of BMI having particularly poor performance. Findings were similar when waist circumference was examined in place of BMI.
Older men and women with weak muscle strength and high BMI have considerably poorer performance than others and associations were observed even in the youngest cohort (age 53). Although causality cannot be inferred from observational cross-sectional studies, our findings suggest the likely benefit of early assessment and interventions to reduce fat mass and improve muscle strength in the prevention of future functional limitations.
This study examined the influence of lower extremity body composition and muscle strength on the severity of mobility-disability in community-dwelling older adults.
Fifty-seven older males and females (age 74.2 ± 7 yrs; BMI 28.9 ± 6 kg/m2) underwent an objective assessment of lower extremity functional performance, the Short Physical Performance Battery test (SPPB). Participants were subsequently classified as having moderate (SPPB score > 7: n = 38) or severe mobility impairments (SPPB score ≤7: n = 19). Body composition was assessed using dual-energy X-ray absorptiometry and provided measures of bone mineral density (BMD), total leg lean mass (TLM) and total body fat. Maximal hip extensor muscle strength was estimated using the bilateral leg press exercise. Multiple logistic regression analysis was utilized to identify the significant independent variables that predicted the level of mobility-disability.
TLM was a strong independent predictor of the level of functional impairment, after accounting for chronic medical conditions, BMD, body fat, body weight and habitual physical activity. In a separate predictive model, reduced muscle strength was also a significant predictor of severe functional impairment. The severity of mobility-disability was not influenced by gender (p = 0.71). A strong association was elicited between TLM and muscle strength (r = 0.78, p < 0.01).
These data suggest that lower extremity muscle mass is an important determinant of physical performance among functionally-limited elders. Such findings may have important implications for the design of suitable strategies to maintain independence in older adults with compromised physical functioning. Additional studies are warranted to assess the efficacy of lifestyle, exercise or therapeutic interventions for increasing lean body mass in this population.
Aging; Sarcopenia; Mobility; Muscle Mass; Strength
Obesity and a sedentary lifestyle are associated with physical impairments and biologic changes in older adults. Weight loss combined with exercise may reduce inflammation and improve physical functioning in overweight, sedentary, older adults. This study tested whether a weight loss program combined with moderate exercise could improve physical function in obese, older adult women.
Participants (N = 34) were generally healthy, obese, older adult women (age range 55–79 years) with mild to moderate physical impairments (ie, functional limitations). Participants were randomly assigned to one of two groups for 24 weeks: (i) weight loss plus exercise (WL+E; n = 17; mean age = 63.7 years [4.5]) or (ii) educational control (n = 17; mean age = 63.7 [6.7]). In the WL+E group, participants attended a group-based weight management session plus three supervised exercise sessions within their community each week. During exercise sessions, participants engaged in brisk walking and lower-body resistance training of moderate intensity. Participants in the educational control group attended monthly health education lectures on topics relevant to older adults. Outcomes were: (i) body weight, (ii) walking speed (assessed by 400-meter walk test), (iii) the Short Physical Performance Battery (SPPB), and (iv) knee extension isokinetic strength.
Participants randomized to the WL+E group lost significantly more weight than participants in the educational control group (5.95 [0.992] vs 0.23 [0.99] kg; P < 0.01). Additionally, the walking speed of participants in the WL+E group significantly increased compared with that of the control group (reduction in time on the 400-meter walk test = 44 seconds; P < 0.05). Scores on the SPPB improved in both the intervention and educational control groups from pre- to post-test (P < 0.05), with significant differences between groups (P = 0.02). Knee extension strength was maintained in both groups.
Our findings suggest that a lifestyle-based weight loss program consisting of moderate caloric restriction plus moderate exercise can produce significant weight loss and improve physical function while maintaining muscle strength in obese, older adult women with mild to moderate physical impairments.
obesity; weight loss; physical function; oxidative stress; inflammation; walking speed
To assess the association between angiotensin converting enzyme inhibitors (ACEis) and improvements in the physical function of older adults in response to chronic exercise training.
Secondary analysis of the Lifestyle Interventions and Independence for Elders Pilot (LIFE-P) study, a multisite randomized clinical trial to evaluate the effects of chronic exercise on the physical function of older adults at risk for mobility disability.
Four academic research centers within the United States.
Four hundred twenty-four individuals aged 70 to 89 with mild to moderate functional impairments categorized for this analysis as ACEi users, users of other antihypertensive drugs, or antihypertensive nonusers.
A 12-month intervention of structured physical activity (PA) or health education promoting successful aging (SA).
Change in walking speed during a 400-m test and performance on a battery of short-duration mobility tasks (Short Physical Performance Battery (SPPB)).
Physical activity significantly improved the adjusted walking speed of ACEi users (P < .001) but did not of nonusers. PA improved the adjusted SPPB score of ACEi users (P < .001) and of persons who used other antihypertensive drugs (P = .005) but not of antihypertensive nonusers (P = .91). The percentage of ACEi users deriving clinically significant benefit from exercise training for walking speed (30%) and SPPB score (48%) was dramatically higher than for nonusers (14% and 12%, respectively).
For older adults at risk for disability, exercise-derived improvements in physical function were greater for ACEi users than users of other antihypertensive drugs and antihypertensive nonusers.
aging; exercise; physical function; LIFE Study; ACE inhibitors
Background and Aims
Falls are a common cause of morbidity and mortality in the elderly, but the consequences of falls on physical function measures are still unclear. The present study explores the association between history of falls and physical function measures in older persons.
Data are from baseline evaluation of the ilSIRENTE study. Physical performance was assessed using the Short Physical Performance Battery (SPPB) and the 4-m walking test. Muscle strength was measured by hand grip strength. Functional status was assessed using the Basic and Instrumental Activities of Daily Living (ADLs and IADLs, respectively) scales. Self reported history of falls occurred during the previous 90 days was recorded. Analyses of covariance and linear regression models were performed to evaluate the relationship between history of falls and physical function measures.
Mean age of participants (n=364) was 85.9 (SD=4.9) years. Fifty participants (15.9%) reported at least one fall event in the previous 90 days. Participants with history of falls had significantly lower adjusted means for the 4-m walking test (0.382 m/s) and the SPPB score (5.602) compared to non fallers (0.498 m/s and 6.780, respectively, all p< 0.05). No statistically significant association of hand grip strength, ADLs and IADLs scales with history of falls was reported after adjustment. Physical activity was the strongest confounder of the association between history of falls and physical function. Physically active participants had a significantly higher physical function compared to sedentary subjects, regardless of history of falls.
Physical performance measures, walking speed and SPPB in particular, are negatively associated with history of falls.
Hospitalization represents a stressful and potentially hazardous event for older persons. We evaluated the value of the Short Physical Performance Battery (SPPB) in predicting rates of functional decline, rehospitalization, and death in older acutely ill patients in the year after discharge from the hospital.
Prospective cohort study of 87 patients aged 65 years and older who were able to walk and with a Mini-Mental State Examination score ≥18 and admitted to the hospital with a clinical diagnosis of congestive heart failure, pneumonia, chronic obstructive pulmonary disease, or minor stroke. Patients were evaluated with the SPPB at hospital admission, were reevaluated the day of hospital discharge, and 1 month later. Subsequently, they were followed every 3 months by telephone interviews to ascertain functional decline, new hospitalizations, and vital status.
After adjustment for potential confounders, including self-report activity of daily living and comorbidity, the SPPB score at discharge was inversely correlated with the rate of decline in activity of daily living performance over the follow-up (p < .05). In a multivariable discrete-time survival analysis, patients with poor SPPB scores at hospital discharge (0–4) had a greater risk of rehospitalization or death (odds ratio: 5.38, 95% confidence interval: 1.82–15.9) compared with those with better SPPB scores (8–12). Patients with early decline in SPPB score after discharge also had steeper increase in activity of daily living difficulty and higher risk of rehospitalization or death over the next year.
In older acutely ill patients who have been hospitalized, the SPPB provides important prognostic information. Lower extremity performance-based functional assessment might identify older patients at high risk of poor outcomes after hospital discharge.
SPPB; Hospitalization; Disability; Mortality; Prognosis
It is known that weakness in the lower limbs is associated with recurrent falls in old people. Among the tests routinely used to assess lower extremity strength, the Short Physical Performance Battery (SPPB) is one of those used most often, but its relationship with recurrent falls is poorly investigated. We aimed to determine if SPPB scores are related to recurrent falling in a sample of 2710 older-aged people, and to ascertain which test in the SPPB is most strongly associated with a higher rate of falls. In this cross-sectional study, we demonstrated that participants scoring 0–6 in the SPPB were more likely to be recurrent fallers than those scoring 10–12 (odds ratio [OR]=3.46, 95% confidence interval [CI] 2.04–5.88 in women; OR=3.82, 95% CI 1.77– 8.52, in men). SPPB scores of 7–9 were only associated with women being more likely to be recurrent fallers (OR=2.03, 95% CI 1.28–3.22). When the SPPB items were analyzed separately, even a lower score in gait speed for women was significantly associated with the presence of recurrent falls (OR=2.11; 95% CI 1.04–4.30), whereas in men only a significant increase in the time taken to complete the five timed chair stands test was associated with a higher rate of falls (OR=2.75; 95% CI 1.21–6.23). In conclusion, our study demonstrated that SPPB scores ≤6 are associated with a higher fall rate in old people of both genders; in females, even an SPPB score between 7 and 9 identifies subjects at a higher likelihood of being recurrent fallers. Among the single items of the SPPB, the most strongly associated with falls were gait speed in women and the five timed chair stands test in men.

domain: medical


In a bid to pay the salary arrears owed to university lecturers for two months, the Nigerian government has given vice-chancellors of all federal universities till Tuesday, 28th April, to submit the Bank Verification Number (BVN) of the academics.
The Federal Government through the Office of the Accountant-General of the Federation (OAGF) in a memo to the Executive Secretary, National Universities Commission (NUC) dated 22nd April said the completed copy must reach the OAGF office on or before Tuesday, 28th April, to ensure the payment of the two months salaries.
The salaries were not paid to academics who did not register on the Integrated Payroll and Personnel Information System (IPPIS).
This is partly responsible for the indefinite strike embarked upon by the Academic Staff Union of Universities (ASUU) since 23rd March.
The disclosure by the government to pay the arrears last week was welcomed by ASUU leaders.
But the requirement of submitting BVN had been rejected by leaders of the union as a precondition for the February and March salaries to be paid.
ASUU believed that it was an attempt to enrol them on the IPPIS which the union had earlier rejected.
The OAGF in the memo signed by the Director of IPPIS, OJ Olufehinti, said the decision to ask for the lectures’ BVN was based on a presidential directive to pay the February and March salaries for personnel in federal universities enrolled on IPPIS.
“I am directed to please request your assistance in getting the 43 federal universities to forward their nominal roll details of the affected personnel to us.
“The completed format in soft copy should reach the Office of the Accountant-General Office of the Federation on or before Tuesday 28th, April 2020 to enable us effect the salary payment accordingly,” the statement read.
The memo added that the details required from the ASUU members are date of birth, date of first appointment, grade level and step, salary structure, bank number, account number, BVN, phone number, email address, PFA name and PIN.
In its circular to the VCs of federal universities, the NUC acknowledged receipt of the OAGF memo and urged them to take appropriate action to submit the lecturers’ BVN.
The NUC memo dated 23rd April and signed by a director in the office of the executive secretary, Chris Maiyaki said, “there is some degree of urgency attached to the submission deadline of Tuesday, 28th April 2020.”


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domain: finance


text:
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Where and Tips
At around 8400 feet above sea level, this lake nestled between the mountains lies on the border of the Yunnan and Sichuan provinces. The blue colour of the water is going to be unlike any other blue that you have seen before in a lake. The circumference of the lake is 70 kilometres in length which is a challenge to bicycle it in one day. Dotted with small villages all around it is still one of those places which the crowds may have missed but then again maybe because it was early April they were still at home. Lugu lake is home to the Mosuo people, one of China's numerous ethnic minority and the only one with a matriarchal social order. Try to stay in one of the small hostels other the than main island where the bus from Lijiang will drop you off after a six hour ride through beautiful mountainous roads. I stayed in the YHA hostel and the young inn-keeper who knew English very well offered us a level of hospitality that charmed us from the very beginning. He even took us in his van to a place where they cooked the special Lugu lake carp, totally fresh and very delicious. We had planned to stay there for one night but ended up staying for five nights - such was the charm of Lugu Lake. We cycled around the lake and it took us almost ten hours to complete the route and arrive back at the hostel (but then again I stopped at every bend to absorb the calmness and to feast my eyes on the shimmering blue waters that lay before me). There is however an option to take the electric scooters instead of the bicycle and you could complete the entire route in about a little more than two hours but then again its more fun for me on a bicycle. The absence of air pollution is so marked that the colour of the sky, leaves and water overwhelms you with their vividness and makes you want to never leave. There are buses to and from Lijiang, Xichang and Chengdu. We arrived from Lijiang but left for Xichang from where to took the overnight train to Chengdu leaving a part of me in the still waters of Lugu Lake.
PS. There are no lights on that road so be sure to start very early ( 6 AM maybe) and finish your journey before the sun sets.

domain: geography


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F-22 Raptor Full PC Game
|Official Name||F-22 Raptor (video game)|
|Platform (s)||Microsoft Windows, PC|
|Release date (s)||1998|
|Genre (s)||Flight simulation|
|Mode (s)||Single player / Multi Player|
F-22 Raptor Full PC Game Overview
F-22 Raptor Download Free Full Game is a Combat flight simulator PC game released by Novalogic in 1998, in which the player flies the USAF's, F-22 Raptor Air superiority Fighter aircraft.
The game involves modern air combat in several campaigns and missions. The campaigns are set around fictional wars in areas such as Angola, Jordan, Russia, Colombia, and Iran, with the player fighting for the USA. F-22 Raptor Free Download.
F-22 Raptor Free Download PC Game
Click on below button to start F-22 Raptor Download Free PC Game. It is a Full Version PC Game. Just download torrent and start playing it.

domain: entertainment


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Nicole LeDonna, LAC is a Acupuncturist in Clovis, CA. She is accepting new patients. Be sure to call ahead with Nicole LeDonna to book an appointment.
Search for your insurance provider
Nicole LeDonna accepts
Accepted insurance can change. Please double-check when making an appointment.
Nicole LeDonna's conditions and procedures:

domain: health


Most recently Wayne has performed the Chief Information Officer position for a tertiary education institution. This was a newly formed position, created to improve the alignment between the Information Technology Services (ITS) department activities and the requirements of the business. This also involved the development of an Information Systems Strategic Plan, the selection of a technology partner and improving the organisation, culture and motivation of the ITS department. Wayne was involved in several strategic initiatives over the 18 month contract.
Business Mechanix was contracted by an Auckland based University to manage and improve a division of the University. This division develops, supports and markets a Student Management System and a Research Management System tailored to the needs of New Zealand Tertiary Institutions. Wayne assumed overall responsibility for the division on an ongoing operational basis and at the same time introduced improved processes to change them into a more commercially focused software development organisation.
Contracted to liaise with a development company on behalf of a financial institution, Wayne was responsible for ensuring that all interests of the finance company were assured throughout a major system change and introduction of new complementary systems.
Wayne designed and implemented an inexpensive, yet fully functional, email solution for an Auckland based non-profit organisation. Business Mechanix arranged the Internet addressing, the setup of multiple email accounts, and configured their computers to share a single dial-up connection to the Internet.
Business Mechanix was contracted by a leading international Internet development company to review a badly performing business unit. The review highlighted significant improvements required. The company then contracted Business Mechanix to implement their recommendations by assuming the role of acting business unit manager. Wayne was able to transform the business unit from significant monthly losses to as significant monthly profits in as little as six months.
Wayne has reviewed the telecommunications of a number of companies, each time able to significantly reduce their expenditure. Wayne has good relationships with the major telecommunications companies that he is able to leverage to obtain the best rates and solutions possible.
Business Mechanix designed and implemented a wide area network solution for a chain of ten retail stores across New Zealand. The solution provided them with remote access by their point of sale system provider to enhance their support ability, connectivity between all stores for data transfer, and gave them the ability to send and receive email between the stores and the Internet. Wayne assisted the company to consider their business case and designed a highly cost effective solution, then utilised his knowledge of routers and firewalls to implement the solution.
Wayne assumed the role of acting IT Director for the New Zealand arm of an international corporate. This assignment provided the company with leadership through a period of change and reorganisation.
Wayne provided project management services to a company establishing in the Auckland CBD. The project spanned the acquisition of a building, the fit-out of their office space, and the launch of their company in Auckland.
Wayne has provided advice to a number of organisations, assisting them to maximise the return on their investment in technology through identifying potential cost savings, then assisting them to achieve those savings. He has assisted companies to develop e-Business strategies designed to take maximum advantage of emerging technologies. He has developed strategies for companies looking at e-Stores, e-Procurement, and general web presences.
Wayne has performed numerous supplier and product evaluations and selections for a variety of technology products and services from photocopiers to personal computer hardware and software to telecommunications systems.


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Head of Business Development at Dukiya Investments, Lukman Shobowale, has said that Nigeria’s rising population and rapid urbanisation will drive demand for housing in 2024.
In an interview with newsmen, he noted that real estate and housing have helped to sustain the contribution of the non-oil sector in 2023.
He said, “2024 is not likely to be any different. Nigeria’s rising population projected to hit 400 million by 2050 and urbanisation are the two critical factors that will drive demand for housing in 2024.
“The sector is also likely to be aided by key government policies, such as the intervention of the government through ongoing mass housing schemes by the national government, while at the sub-national level, the ongoing urban renewal projects already embarked on by several sub-national governments, including Kaduna, Lagos, Kwara and a host of other states will likely attract investment into the sector.”
According to Shobowale, although the budget for housing in the 2024 budget appears insignificant compared to the scale of the investment required if the government shows a will to partner with private sector players, it would significantly address key challenges in the sector.
He projected a bright prospect for the real estate and housing sector this year.
Nigeria is currently said to have a housing gap of 28 million, which the Vice President, Senate Kashim Shettima, recently said would require N21tn to bridge.
In the same vein, an estate surveyor, Olorunyomi Alatise, said the anticipated surge in the country’s population and the current trend of urbanisation cause a challenge in the country’s housing market.
He said, “As more individuals migrate from rural to urban areas in pursuit of improved living conditions and economic opportunities, the demand for housing in urban centres is poised to skyrocket.
“This rapid urbanisation often outpaces the development of adequate housing infrastructure, creating a substantial gap between supply and demand. The consequences of this disparity could include escalating property prices, heightened rental costs, and an increased likelihood of informal settlements characterised by inadequate living conditions.”
The World Bank puts Nigeria’s urban population as a percentage of the population at 53.52 per cent.
Alatise noted that the country’s housing shortage in urban areas could be attributed to a combination of factors, including limited investment in infrastructure, challenges in land use planning, and economic considerations.
“The inadequate development of infrastructure, such as roads and utilities, hampers the timely construction of housing projects, contributing to the widening gap between demand and supply.
“Economic factors, such as low affordability and income disparities, further compound the challenges, making it difficult for a significant portion of the population to access suitable housing options. These issues highlight the urgent need for comprehensive strategies that address both the immediate and long-term aspects of the housing crisis,” he enunciated.
Alatise asserted that addressing the country’s housing shortage required a multifaceted approach, involving collaboration between the government, private sector, and non-governmental organisations.
He added, “Increased investment in infrastructure development, streamlined land use planning processes, and the implementation of policies promoting affordable housing are essential components of a sustainable solution.
“By adopting a holistic strategy, Nigeria can navigate the challenges posed by population growth and urbanisation, ensuring that the housing market can adequately meet the needs of its expanding urban population in the coming decades.”
In this article


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To help Lower Mekong Basin farmers adapt to climate change, USAID Mekong Adaptation and Resilience to Climate Change (USAID Mekong ARCC) is partnering with International Union Conservation of Nature Thailand (IUCN Thailand) to identify and implement adaptation strategies in the under-resourced communities of Thailand.
Community members in Hae Ko, in northern Thailand’s Chiang Rai province, are strengthening their resilience to projected climate change impacts by diversifying their crops in the same plot of land, a process called “intercropping.” On a USAID Mekong ARCC field trip, Hae Ko villagers observed intercropping and other resilient farming practices and learned that integrated farming, such as growing Arabica coffee in the same plot of land with fruit and other fast-growing trees can help reduce soil erosion, reduce reliance on weather patterns and provide a more consistent stream of income.
"By practicing intercropping, the villagers won’t have to destroy the forest area, and we can earn sufficient income throughout the year from different trees,” said Malee Pasae, a Hae Ko resident. USAID Mekong ARCC and IUCN Thailand is working with 196 households in Hae Ko and neighboring Loh Yo and Huai Kang Pla villages to protect their livelihoods and food security from the impacts of climate change.
Source: USAID/RDMA Regional Environment Office Weekly Update

domain: agronomy


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Blooming Hedgehog Applique Quilt Pattern (BQ-14)
This quilt pattern calls for my newest fabric line called, Who let the Hogs Out, and features these adorable Hedgehogs. Inspired by the fabric and these cute critters Desiree has created two new patterns for your consideration. Blooming Hedgehog features one of the Hedgehogs in a flower pot. Easy to assemble and easy to follow directions with full size templates and diagrams help you create your own unique quilt for your Hedgehog Lover! Finishes at approx 39"x 46". Fabric is available now at your favorite quilt shop or on my website.

domain: hobby


Opelousas to build new pavilion in North City Park
Opelousas’ North City Park may become home to a large pavilion for family gatherings, children’s programs and more.
The city has set aside $120,000 in its budget and the board of aldermen voted recently to bid out the project.
Mayor Donald Cravins said the 90-by-120-foot pavilion is in keeping with the city’s Parks Master Plan. As funds become available, he said, it will be expanded into an even larger facility.
“This is just Phase I,” Cravins said. “That park does not have a nice pavilion and this is an important addition that will also help beautify that park.”
Yvonne Normand, head of the Parks Master Plan Committee, said she has also mapped out a one-mile trail for South City Park, where people may walk or jog for exercise or simply enjoy the park.
Normand said she plans to apply for a Rotary Foundation grant that could help with that project. The mayor has given her a letter of endorsement to accompany the grant application.
Because she envisions a smooth track, at least 6feet wide, that can be used by people with wheelchairs or strollers, more money will be needed.
She said if the pavilion project comes in at bid, there should be some money left over in the city’s existing parks grant that it could apply to the project.
The city has north and south city parks. The master plan calls for the creation of a youth sports park on an 80-acre tract of land the city owns on Cherry Street.
Normand said she has been approached by individuals interested in hosting soccer games in the city and that might be a relatively easy and inexpensive way to get the sports park started.
“All you need to play soccer is some stripping for the field is some PVC piping and nets,” Normand said.
The master plan calls for several soccer fields in the proposed sports park. She said the city could at least set up practice fields with minimal investment.
The ground would need to be leveled and proper grass would need to be planted, but she hopes the city’s parks crew could take care of that.
The board of aldermen also recently agreed to spend about $15,000 to create a youth boxing association that would be housed in the former Charter Communications building alongside the proposed sports park.
Cravins said that idea is generating a great deal of interest and the city will begin taking applications in October.
Normand said she is also working with state Rep. Stephen Ortego, D-Carencro, on proposals to create a 4-mile bicycle trail that would link the existing North and South City Parks and the proposed Youth Sports Park.
“The city doesn’t have a cycling trail at this time,” said Normand, who added that Ortego is helping her locate grant possibilities.
In addition to linking the parks in a bicycle-friendly way, she said such a trail would also need a “trailhead” at each of the parks where cyclists could store their bikes, rest and get water.
Should grant money become available, she said Opelousas Police Department Chief Perry Gallow has offered to teach bicycle safety classes and provide other assistance.
Cravins praised the committee’s enthusiasm.
“The committee is very active in promoting our parks system,” he said. “Unfortunately it takes money and in recent years we haven’t had any. We are working together and as the money becomes available we will be building more.”
The next parks master plan committee meeting will be held at 5:15 p.m. Sept. 29 in the South Park Teen Center and Normand invited everyone interested in promoting recreational activities in the city to attend.


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- To establish bicycle transportation/education programs at school sites and community centers in targeted neighborhoods around the East Bay.
- To establish gardening/nutrition education programs at schools and community centers in targeted neighborhoods around the East Bay.
- To promote public policies and community-based partnerships that will facilitate the development of Cycles programs in East Bay neighborhoods.
- To develop work opportunities that provide needed resources to community members while creating a positive impact on ecological systems.
- To further the growth of a network of visionary leaders, linking community members employed in implementing Cycles programs with the many local and global organizations working towards a shared mission.
- To develop an organization whose practices reflect our community agreements and whose actions bring forth the intentions of our mission, vision, and goals in a manner consistent with our organizational values.
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domain: sociology


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Sketchdump #111 – character design
I think it is about time that I stop avoiding to develop my design skills for the sake of practicing pure technical stuff; if I don’t eventually start, I will never get good. So I’ll try to do more design related things from now on. Please bear with me if my influences show too clearly or things just look stupid! I’ll give my best.
Let’s start with two pretty distinct character designs; I’m not entirely happy but… here you go.
(I’m aware that the anatomy is improvable)


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I finally have a new recipe for you! I’ve been such a slacker in the recipe development department, but you understand don’t you? Yesterday I was determined to not only make something new, but to also not spend $200 at the food store.
I’ve said before how I’m a food hoarder and I’ll say it again. After going through my pantry last week and trying to get some organization to it, I realized I just need to stop buying pantry foods until I get it cleaned out. I also have no appetite for beans at ALL (except lentils) and I’ve got PLENTY of grains so I made a plan. Yesterday was just for fresh produce & meat/fish. I buy mostly organic produce, wild fish & organic meat, so I still spent $100, but I felt like I got a good amount (confession: I also had a credit from TJ’s for returning some items). My goal is to cut our food budget to save more money. We’ve been going out to eat/getting take out 1-2 times a week, which we’ll probably stay with.
I’ll keep you posted on my progress at the food store. (Note: we do spend a lot at the food store, but it’s not that much when you break it down to breakfast, lunch, dinner and snacks for 2 people, which is about 40 meals a week.)
When I got home from the food store I went to work right on a quinoa salad. I usually make my own salad dressing but I tend to just make the same balsamic or red wine vinegar over and over again. Yesterday was different. I knew I wanted something creamier.
[print_this]Tri Color Goddess Quinoa Salad
- 1 cup dry quinoa, cooked according to directions (I used tricolor, but any kind will do)
- 10 grape tomatoes, cut in half
- 1 cup lentils (I used TJ’s precooked, but can also use chickpeas or black beans)
- 1/3 cup feta
- 8-10 black olives, chopped
- 1 cup carrots, sliced very thinly (or chopped)
Tahini Goddess Dressing
- 1 garlic clove
- 1/3 cup water
- 1/4 cup apple cider vinegar
- 1 heaping tbsp tahini
- 1/4 cup extra virgin olive oil
- 1 tsp honey
- 2 tsp dried basil
- pinch of sea salt
Combine all ingredients in a blender, food processor or using an immersion blender. [/print_this]
This was delicious. Danny took it for lunch today and he’s not even truly a quinoa lover.
I’m off to enjoy another gorgeous run….when my new Brooks decide to get here!
Don’t forget…if you sign up for my Pure Bliss Eats newsletter, you’ll recieve a coupon for $1.00 off a bag of granola!
Have a great day!
Ultimate Guide to Increasing Your Income As a Food Blogger NOW
Download this guide so you can plan your next source of income without relying on page views or sponsored posts.

domain: food


'West Coast Allstars' from The Hit Sound brings you over 900MB, including 114 Loops influenced by Ice Cube, Dr. Dre, Snoop Dogg, Warren G, Nate Dogg and many more.
Filled with string hits, Acid Bass, Percussion and much more, this will give you the authentic sound of the West Coast.
These Loops are supplied in WAV, AIFF, and REX formats and will give you more than enough West Coast sounds to edit, slice and chop to create your next club banger!
And of course, all loops & samples are 100% Royalty-Free!
Formats (All Included)
BPM and Key Labeled
Size: 1.38GB (Unzipped)


Rashami Desai knows just how to wow her Instafam and her photos from the Maldives is proof of just that.
She is in holiday mode. Rashami Desai is currently vacationing in Maldives. She shared a photo on her Instagram account. She looks stunning in these holiday photos.
Check out the photos below.
Rashami Desai looks like a mermaid in this picture.


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ASHLAND - The City of Ashland is moving forward in its plans to enforce and administer commercial building codes in-house rather than through the Richland County Building Department.
All enforcement and administration of the commercial building code for projects in the city of Ashland is currently done in Richland County, Mayor Matt Miller explained to the city council and attendees of Tuesday's council meeting.
"Our contractors, developers and property owners would go over to Richland County and would interact with their staff and their inspectors as they were competing projects within city limits," Miller said.
Ashland County also contracts with Richland County for commercial building codes enforcement.
Miller said 20 years ago, city and county officials discussed a desire to bring those services to the city of Ashland to make them more efficient for local developers.
"At that time however, we did not have the staff with the right certifications to make it happen. Neither did the county," Miller said.
So over the past year and a half, city leaders have been working to assemble a team that can do the work in-house.
City engineer Shane Kremser has obtained certifications to be a building official and a plans examiner. The city has also redefined positions in the engineering department to make sure new staff coming in have the background and certification to do building inspections. Among the city's newest staff members are an electrical safety inspector and a plumbing inspector.
"We feel we have a good team in place that will be able to create a good culture for the development projects that take place here in the community... I think the team is very excited. They understand the challenges our folks that have been trying to do business have experienced over the last several years, and they want to correct those," Miller said.
City leaders are planning spend about $75,000 to get the building codes office up and running. That money will be advanced out of the general fund to the building and zoning fund and will be reimbursed to the general fund when the office begins collecting fees.
City council members voted Tuesday to approve $48,698 for the purchase of two trucks for the department's inspectors. While that will be the largest equipment expense for the new office and may be the only one that requires approval from council, the city plans to make other purchases including software and iPads for department.
The city has also done some remodeling in the municipal building, taking out walls in the engineer's office area on third floor to accommodate the new department.
Miller said he fully expects the office to pay for itself in fee collection. The city intends to charge the same rates Richland County has been charging, Miller said.
"Truly the only change someone used to working through this process would see is now it will be right here in our own backyard," Miller said. "It will be our own staff that will be carrying out the inspections, and hopefully they will be easier to reach.
"We will be covering one city and one county if the county decides to go with us, whereas Richland County currently covers multiple counties."
Miller told council members he met with Ashland County commissioners earlier Tuesday to discuss whether the county would want to contract with the city for commercial building code enforcement.
"The commissioners are deliberating right now about whether or not to end their agreement with Richland County so they can join our effort," Miller said.
Miller said he hopes to have the office up and running by the end of August. That would require Richland County to allow Ashland to sever its contract without the full 60-day formal notice required in the contract, but Miller said Richland County officials have been aware of Ashland's planned departure for several months.
The mayor said the city regularly gets calls from developers who say they are postponing their building projects until the service is available in Ashland because they expect the process to be easier after the change.
"I do think this will be an important part of future economic development," Miller said.
Council member Dennis Miller praised the upcoming change and said it cannot come soon enough.
"This is huge," he said. "I get a lot of feedback on the current process, and it's very frustrating I think because Richland County is such a big territory, so this is a huge step forward."
Council member Steve Workman said it "makes perfect sense" to bring the service in-house, and council member Dan Lawson agreed the change is "a wise move."


Manufacturer – Winchester Ammunition Company
Bullet – 36 grain copper-plated hollow-point (CPHP)
Casing – Rimfire-primed brass
Manufacturer Item # – 22LR333HP
Winchester’s bulk-pack .22 LR 36 grain copper-plated hollow point ammo is a great value for high-volume plinking and target practice as well as for varmint and small game hunting. This product is designed to be an affordable and reliable choice for shooters who know to trust the quality and reputation of Winchester ammunition.
This product is brand-new, non-corrosive, and brass-cased. It features a copper-plated lead bullet with a hollow point, which is designed for expansion on impact with the target. It features a reliable primer and a clean-burning powder load.
This is a single box of 333 rounds, perfect for an hour or so on the range.