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Beyond the Stigma: Hospital ERs are no place to house the mentally illBy SHAWNE K. WICKHAM
New Hampshire Union Leader
August 08. 2018 11:16PM
As the behavioral health crisis has worsened and the number of available psychiatric beds has dropped, hospital emergency departments have become de facto crisis centers.
It’s called “boarding,” this caring for patients with mental illnesses along with victims of car crashes, heart attacks and broken bones.
Elliot Hospital is the latest New Hampshire hospital making changes to its emergency department to provide a safer, calmer place to care for these patients while they await more appropriate beds elsewhere. Its newly expanded Psychiatric Evaluation Program (PEP) unit has six beds and a common room that can be used for group sessions or family meetings.
A glimpse into how the new unit may help such patients can be found 400 miles south of Manchester, in Lebanon, Pa.
Lebanon, a city of around 26,000 — the size of Londonderry — is confronting the same challenges around behavioral health and addiction as communities across New Hampshire.
In February, WellSpan Good Samaritan Hospital, part of WellSpan Health, opened a new behavioral health suite for patients who come to the emergency department in crisis.
Harry Padilla is director of clinical services for Good Samaritan’s emergency department, which was bustling on a weekday morning earlier this summer. “We can see anywhere from 140 to 220 patients a day,” Padilla said. “It’s not conducive for calming.”
Since last September, Padilla said, the population of behavioral health patients coming to his emergency room has doubled, with as many as 10 a day. He believes it’s the result of a “huge paradigm shift” as awareness of mental illness has grown.
In response, the hospital created the new unit, separate from the busy emergency room, with specialized nurses and patient care technicians. The four patient rooms are painted in soothing shades of slate blue or sage green. Each room has a window, chair, bed and a TV enclosed in an unbreakable box.
The focus is on safety, from the recessed lights and sprinklers to the solid fixtures in the bathrooms that prevent someone from tying something around them and harming himself. Even the bathroom mirror is unbreakable; it’s made of shiny metal.
Patients are kept under close observation by nurses and “sitters.” If the patient is a child, parents are strongly encouraged to stay with them while they’re here, Padilla said.
“You can see an almost instantaneous change in them once they come from over there with all the hustle and bustle,” he said. “It’s easier to rationalize with them, and it’s easier to talk with them about what the plan is going to be for them.”
There’s another indication that the new unit is having a positive effect: a dramatic decrease in the amount of sedatives given to patients, Padilla said.
The unit also has a quiet room, devoid of everything but a bed, for patients who need more help to calm down. “We would just put them in there to try to lessen the stimulation,” Padilla said.
But it’s far removed from the seclusion rooms hospitals used years ago, Padilla said. “That’s like putting them in a jail cell,” he said. “They didn’t interact at all. They just locked them in a room until they exhausted themselves.”
“That’s barbaric,” he said.
His entire emergency department staff has gone through training in dealing compassionately with individuals with mental illness, Padilla said, “so they can learn it’s a disease, just like heart disease.”
The patients receive their regular medications, but there’s no treatment provided here. “We’re just trying to provide them a quiet, calm place to rest until their bed is found,” Padilla said.
And here’s a key difference between what happens to these patients at Good Samaritan, and the same population in New Hampshire. Padilla said adult patients typically stay in the quiet area for just a few hours before they are transferred to WellSpan Philhaven, a 103-bed behavioral health hospital 15 minutes away.
There’s a longer wait for children, Padilla said, due to a shortage of appropriate beds. And he’s seen a disturbing increase in the number of adolescents coming to the emergency department who are “suicidal or homicidal and they’re extremely aggressive.”
Padilla said true systems change will come when mental illness receives the same level of government funding and attention as other diseases such as diabetes and cardiac conditions. “We’re decades behind, and we just keep losing resources,” he said. “We’re not allocating the proper resources for mental health, in my opinion.” The ideal is integration of physical and mental health care, he said: “It’s well-being.”
Beyond the Stigma, sponsored by the New Hampshire Solutions Journalism Lab at the Nackey S. Loeb School of Communications, is funded by the New Hampshire Charitable Foundation, Dartmouth-Hitchcock Medical Center, NAMI New Hampshire, and private individuals. Contact reporter Shawne K. Wickham at email@example.com.


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By Damali Mukhaye.
Opposition Forum for Democratic Change has warned parliament against tampering with the tax payers’ money by allowing government to pay medical bills of MPs’ parents.
This warning follows media reports that the government has plans to pay medical bills for parents of all Members of Parliament.
According to the FDC party president Patrick Amuriat, Ugandans are already over-burdened vowing to block the move.
Meanwhile, According to Chris Obore, Parliament’s communications and public affairs officer, an MP, like any other employee of parliament is entitled to group insurance which covers at least five beneficiaries including parents.

domain: law


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Should You Consider a Shoulder Replacement?
Your shoulder is the most mobile and flexible joint in your body – but also the least stable. Because of the wide range of motion required, it’s more susceptible to injury or dislocation, which can increase the likelihood of painful shoulder arthritis in the future. Further, there is a known genetic contribution which predisposes certain patients to shoulder arthritis. As a result, more and more patients are turning to partial or full shoulder replacement surgeries to restore pain-free function.
Some 53,000 people opt for shoulder replacement surgery each year in the United States – a number that has skyrocketed in the last 15 years due to technological advancements that ensure a reliable, effective result and faster recovery. A new study presented this spring even found that 96 percent of recreational athletes under 55 returned to their sport within just seven months of shoulder replacement surgery.
We asked Dr. Peter Johnston, a shoulder and elbow surgeon, to weigh in on which patients are good candidates for the surgery and what they can expect from the procedure in the long term. Dr. Johnston practices at our Southern Maryland Orthopaedics & Sports Medicine care center and is on the forefront of shoulder replacement research and implementation.
1. First, are there any non-surgical options you pursue before a shoulder replacement?
If the patient has mild to moderate arthritis, we will use the typical non-surgical orthopaedic measures: Activity modification, rest, anti-inflammatory medication and physical therapy as appropriate. Cortisone injections are an example of an anti-inflammatory medication, delivered directly into the shoulder, that can be effective for pain relief and sometimes for improvement in function as well. We’ll also pursue these options for patients who may not be eligible for surgeries due to other health conditions, such as an 85-year-old with advanced heart or lung disease.
These non-surgical approaches – particularly the anti-inflammatory injections – can also be a great opportunity for patients to understand how a pain-free shoulder might feel after a surgery. Many of my patients have been living in pain for so long, and it’s eye-opening to experience relief from anti-inflammatory medication or other non-operative modalities. They realize that they can likely experience this relief every day without medication or activity modification if they have replacement surgery.
2. What type of patient is a candidate for a partial or total shoulder replacement?
In my practice, the most common indication for shoulder replacement surgery is in a patient with severe shoulder arthritis. In that instance, the cartilage is worn down and your body forms extra bone – typically as a response to an injury or the disease. The lost cartilage and extra bone leads to pain, functional limitations and range of motion deficits that can be quite disabling.
3. What type of shoulder surgeries should patients consider?
If we can’t address the pain and improve function with non-operative modalities, then we’ll discuss the patient’s options for shoulder surgery. Arthroscopic, minimally-invasive capsular release surgery is a good fit for patients who are young and active, with only mild to moderate arthritis, or who may have pieces of that extra bone or cartilage floating around in their shoulder. With this surgery, you create a small incision and use a scope to remove any pieces of bone and scar tissue to improve the range of motion.
However, most patients I’ve seen have already had surgery performed on their shoulder, or their arthritis is so far advanced that it doesn’t even make sense to try the minimally invasive approach. Those patients are usually candidates for a partial or full shoulder replacement.
4. What does shoulder replacement surgery entail?
It depends if it’s an anatomic technique or reverse shoulder replacement. Even orthopaedic physicians in other specialties can have a hard time distinguishing the indication for these two very different surgical approaches! The basics are the same: In a full shoulder replacement, we’ll replace the ball (humerus) and socket (glenoid) joint with a metal ball and a plastic socket, ultimately resurfacing both the humerus and glenoid to prevent bone-on-bone rubbing.
In the traditional anatomic shoulder replacement, we’re reconstructing the anatomy of the shoulder joint before arthritis set in. A reverse shoulder replacement, which has been done in the United States since 2004, is typically appropriate for people who have suffered massive rotator cuff tears and are unable to even elevate their arms. With a reverse shoulder replacement, we’re basically changing the mechanics of the shoulder because the rotator cuff is no longer functioning. Because of this, we give the deltoid muscle a structural advantage so that it can function more efficiently in spite of the torn rotator cuff. This way, the patient can raise their arm with the deltoid muscle instead of the rotator cuff.
Thanks to improved technologies and more advanced techniques, our patients have a better than 80 percent chance that the joint will last for 10 years. In my practice, I typically shoot for 15- to 20-year solutions.
5. How long is the recovery process?
Well, it takes three months to return to full activities, but this can vary significantly between patients depending on the severity of the arthritis and their activity-related expectations. But the arthritic pain should be reduced very quickly. In fact, some patients notice this as soon as the day after surgery! They’ll still experience the post-operative pain, but won’t have the achy pain from arthritis. Although patients should be able to do most activities after three months, the patient’s opinion of the function of their new shoulder will actually continue to improve for two full years following the surgery.
6. What can patients expect from physical therapy?
This varies depending on whether the patient has had a traditional, anatomic shoulder replacement or a reverse replacement surgery. Although the recovery time is typically three months regardless of the technique, it does change the physical therapy.
Anatomic patients can expect to see a physical therapist on the day of the surgery and learn two exercises for their range of motion, which they will work at for six weeks. After six weeks, we begin strengthening exercises.
Reverse shoulder replacement patients will delay those initial physical therapy exercises by two weeks. However, they can still begin strengthening exercises at six weeks and anticipate a full recovery by three months.
7. How has shoulder surgery changed in the last 15 years?
Shoulder surgery has actually advanced rapidly over the last 15 years. Our understanding of the mechanics of the shoulder has progressed significantly, as has our improvement in technique and delivery of innovative components to ensure better fixation of the prosthesis. I’ve heard people describe shoulder surgery as “the final frontier” of orthopaedics, simply because we have historically understood less about the shoulder than other major joints such as hips and knees. But because of these advancements, shoulder replacements are actually increasing at a rate much faster than knee and hip replacements.
8. What are the innovations currently underway in shoulder replacement surgery?
I feel fortunate to be on the front end of the newest innovation in technology. Because I specialize in orthopaedic conditions of the shoulder and elbow and perform a very high volume of shoulder replacement surgeries, I’m involved in the research, teaching and utilization of the latest techniques. At the moment, we are able to perform stemless shoulder replacements for the first time and we’re also researching different styles of glenoid prostheses and potential new bearing surfaces as opposed to metal.
9. What drew you to focus on shoulder injuries and surgery?
I’ve suffered personal injuries to my shoulder, which required surgery, and that heightened my interest in the shoulder early on. I also enjoy the challenge: The shoulder is the most complex joint to treat effectively, and there are many different nuances that make it especially difficult.
Dr. Peter Johnston specializes in shoulder and elbow surgery at the Southern Maryland Orthopaedic & Sports Medicine care center. His expertise includes arthroscopic methods of management for arthritis, instability, joint contracture, and soft tissue repair of the shoulder and elbow, as well as total and partial joint replacement and care of the young and aging athlete. Dr. Johnston’s research has been published in numerous peer-reviewed journals and book chapters, and he continues to pursue academic interests and expertise despite being in private practice.

domain: health


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Muntenia – Romania tourism
Romania tourism – Muntenia: also known in English as Greater Wallachia is a historical province of Romania, situated between the Danube (south and east), the Carpathian Mountains (the Transylvanian Alps branch) and Moldavia (both north), and the Olt River to the west.
Main cities: Bucuresti, Craiova, Drobeta-Turnu Severin, Ploiesti, Targoviste, Ramnicu Valcea, Targu Jiu
Romania tourism – Bucharest: First documented in 1459
The main city of the region and the capital of Romania. Bucharest and its cultural scene is going to surprise you: museums, theaters, art galleries, opera houses and concert halls await your visit.
Romania tourism – Must do it: Palace of Parliament, the second largest building in the world!
Prahova Valley, where the popular ski resorts of Predeal, Busteni and Sinaia are located.
Sinaia is also home to the magnificent Peles Castle, one of the best-preserved royal castles in Europe.
Must stop: Targu Jiu city- associated with Constantin Brancusi, the Romanian artist who is considered to be the founder of modern sculpture.
Some of Romania’s most important monasteries can be found in this region, including Horezu, a designated UNESCO World Heritage site. Horezu is pottery center.
Romania tourism – Places to visit:
- Bucharest: capital, with French architectural old center, the Palace of Parliament, The Museum of the Romanian Peasant, the Village Museum and many other attractions
- Peles Castle in Sinaia, considered one of the best-preserved royal castles in Europe
- Pincely Court and Poenari fortress (the authentic residences of Vlad the Impaler)
- The beautiful Orthodox monasteries built in a Byzantine style, : Arnota, Bistrita, Cozia, Curtea de Arges, Govora and Horezu
- The pottery center at Horezu
- Curtea de Arges monastery
- The Constantin Brancusi architectural complex in Targu Jiu, with its famous masterpieces: Endless Column, Gate of the Kiss, Table of Silence and Avenue of Chairs
- Prahova Valley and the popular ski resorts of Predeal, Busteni and Sinaia
- The Unirea salt mine in Slanic Prahova, where 2.9 million tons of salt have been extracted since 1685. Very important: Due to the therapeutic microclimate, former mine shafts are used as asthma treatment facilities.
Romania tourism – Traditional food
Muntenia cuisine feature a variety of sour soups with lots of vegetables. Often you can find earthen oven in the backyards of houses in the Muntenia region. Bread and pies are baked and delicious vegetable stew is slow cooked in clay jars.
Also the famous mititei, one of the most popular Romanian gastronomic specialties,. In this region, like all over the country, onion and garlic are highly praised, combined with other ingredients to make deliciously savory dishes.
Vineyards & traditional food
If we talk about Romania tourism we need to talk also about vineyards and traditional food. Muntenia cuisine feature a variety of sour soups with lots of vegetables. Often you can find earthen oven in the backyards of houses in the Muntenia region. Bread and pies are baked and delicious vegetable stew is slow cooked in clay jars.
Also the famous mititei, one of the most popular Romanian gastronomic specialties.
This region produces some of Romania’s best red wines including: Feteasca Neagra, Merlot, Pinot Noir and Cabernet Sauvignon.
Dealu Mare, extending from the Prahova Valley along the south-facing hillsides of the Carpathian foothills eastwards to Vrancea County, is considered to be the best area in Romania for the cultivation of red grapes.
Valea Calugareasca (Valley of Monks) – one of a series of vineyards forming the Dealul Mare wine-growing region, owes its name and quality of wines to a hermitage – and perhaps the particular skill of the monks in preparing the wine. The standard-bearer of this vineyard is Cabernet Sauvignon.
Dealu Mare Vineyard is very generous with foreign grape varieties – Cabernet Sauvignon, Pinot Noir, Merlot, as well as Romanian grape varieties – Feteasca Neagra.
Dragasani has an old history which can be traced back some 3,000 years. Wines of Dragasani have become popular outside Romania’s borders following world recognition at the Bordeaux wine contest in 1989 and at the World Exhibition in Paris in 1900. Today, Sauvignon, Riesling, Feteasca Alba, Feteasca Regala, and Tamaioasa Romaneasca are produced here.
Other vineyards in this region include: Pietroasa, Samburesti, Segarcea, Stefanesti, Urlati
Beeing very close to Bucharest 1-3 days trips can be organized easy, covering all attractions ( history, gastronomic, sightseeing, cultural itineraries etc)
Ask your questions at: info[@]visit-romania.eu – please remove the square brackets
IncludedMuntenia – Romania tourism
Not IncludedDeparture TaxesEntry Fees5 Star AccommodationPersonal GuideBreakfast

domain: geography


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Pretoria - Political issues affecting the continent, bilateral cooperation and economic relations will feature high on the agenda of discussions between President Jacob Zuma and his Tanzanian counterpart, President Jakaya Kikwete.
Zuma has rolled out the red carpet for Kikwete, who will be treated to the religious ceremonial guard and a 21-gun salute in the flower-bedecked Union Buildings this morning.
Kikwete, accompanied by several cabinet ministers and a business delegation, is in the country for a state visit aimed at exploring investment and trade opportunities between the two countries.
Several bilateral agreements are due to be signed during the two-day visit as the countries look to expand co-operation on trade, energy, mining, water and transport.
It is Kikwete's first state visit to South Africa since he took office in 2005.
There is strong trade co-operation between the two countries. More than 150 South African companies operate in Tanzania.
The business delegations of the two countries will meet on the sidelines of the visit, and will be addressed by the two Heads of State on 19 July.
Zuma will be supported by the Ministers of International Relations and Cooperation; Agriculture, Forestry and Fisheries, Arts and Culture; Transport; Science and Technology; Energy; Finance; Mineral Resources; Water and Environmental Affairs as well as Trade and Industry.

domain: politics


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If you’re Muslim, chances are you’re celebrating the conclusion of Ramadan with the traditional saying, “Eid Mubarak” (meaning “celebration”). While Islam is one of the world’s most popular religions, we rarely see celebrities who openly claim to practice it. Despite the scandal and outlandish rumors that plague famous faces on a daily basis, many use their personal faith as a way to endure. Click through to see 15 celebs who are Muslim.
Lupita Nyong’o’ s rumored boyfriend has been a Muslim his entire life, having grown up in Somalia.
Khloe Kardashian’s rapper beau recently told radio host Angie Martinez that he hasn’t had alcohol or s-x since the start of Ramadan.
The African singer–real name Aliaune Thiam–claims to have never smoked or drink due to his religious beliefs.
The Chicago rapper–whose real name is Wasalu Muhammad Jaco–is a devout Muslim who often discusses his beliefs in interviews.
The legendary rapper is a self taught Muslim, who often read the Qur’an after dropping out of school.
Mara Brock Akil
In 2012, the TV producer (“Girlfriends,” “The Game”) converted to Islam in 2012.
Although he was raised by a Muslim step father, the retired ball player says he is tolerant of all religions.
During his three year prison sentence for rape from 1992-1995, the boxer converted to Islam.
The legendary supermodel, who is also Muslim, was one criticized for marrying outside of her religion.
The One Direction often tweets quotes from the Qur’an and recently voiced his support of Palestine during the Gaza conflict.
In 2005, the comedian told Time Magazine, “I don’t normally talk about my religion publicly because I don’t want people to associate me and my flaws with this beautiful thing. And I believe it is beautiful if you learn it the right way.”
It’s rumored that the singer/actress recently converted to Islam after marrying her hubby Wissam Al Mana–who is also Muslim.

domain: news


Sheffield's Clinton Woods is aiming for a big-money fight against one of the top American names of the light-heavyweight division after returning to the ring after a 12-month absence to outpoint the Mexican-born Californian Julio González at the Sheffield Arena and retain his IBF cruiserweight title for the fourth time.
After a thrilling and, at times, brutal confrontation Woods, 35, took a 117-111, 116-112 and 115-113 verdict from the judges, with both fighters earning a standing ovation from the 6,000 crowd at the final bell. The two had fought two years earlier, when Woods was also the points winner, but González pushed the champion more closely this time around.
"What a fighter this guy is," said Woods afterwards. "I know I am tough but he matched me all the way. I thought I had him in the 11th round but somehow he managed to come back."
González, 31, a former holder of the WBO version of the title said: "I'm a warrior. He said he wanted to knock me out but he couldn't. True warriors never die, I just ran out of time."
Woods was delighted to have suffered no adverse effects from an operation on his left elbow earlier in the year. Now his manager and promoter, Dennis Hobson, says he will try and secure a contest against one of the leading Americans: Antonio Tarver, Bernard Hopkins or Roy Jones, who defeated Woods in a world title contest five years ago.
In Atlantic City Kelly Pavlik won the WBC and WBO world middleweight belts when he stopped his fellow American Jermain Taylor after seven rounds of a dramatic fight. Pavlik, 25, who is now undefeated in 32 fights, had been floored by Taylor, 28, in the second round but fought his way back into the contest in a series of thrilling toe-to-toe exchanges.
There is a re-match clause in both fighter's contracts but Pavlik will be invited to Cardiff by the promoter Frank Warren to watch Joe Calzaghe's November world super-middleweight title unification match against Denmark's Mikkel Kessler. "If Kelly is looking for a challenge, he can come looking for Joe," said Warren.


Estimated reading time 5 minutes, 13 seconds.
The Government of Canada is supporting the development of well-trained, skilled personnel to serve the aerospace industry of the future by donating surplus Coast Guard assets to colleges and universities across Canada. These donations are helping to support aircraft maintenance training in Canada, providing practical and hands-on experience to students.
The Minister of Fisheries, Oceans and the Canadian Coast Guard, the Honourable Jonathan Wilkinson, has announced that the Aerospace Centre of Excellence at Northern Lights College in Dawson Creek, B.C., has received a Canadian Coast Guard Messerschmitt-Bölkow-Blohm (MBB) Bo.105 helicopter. Nine other educational training institutions located across Canada have also received a donated Bo.105 helicopter.
The 10 Coast Guard Bo.105 helicopters were in service in the Canadian Coast Guard for more than 30 years. The first Bo.105 helicopter was purchased by the Coast Guard in April 1985, and the last unit was purchased in April of 1988. The helicopter fleet plays an essential part in supporting programs such as icebreaking, marine communication, aids to navigation, environmental response, waterway protection, conservation and protection, science, and support to other government departments as required.
As part of the Coast Guard’s Fleet Renewal Plan, the Government of Canada has purchased and deployed 22 new helicopters–15 light-lift helicopters (Bell 429s) and seven medium-lift helicopters (Bell 412EPIs).
“The donation of this Coast Guard helicopter as a training aid is invaluable to Northern Lights College,” said Mark Heartt, dean of trades and apprenticeships, Northern Lights College. “Gifts like these allow us to better serve the people in our communities by delivering accessible, affordable, and applied education.”
“This twin-engine, four-blade helicopter fills a big void we had in our program,” said Curtis Newby, instructor, aircraft maintenance engineering, Northern Lights College. “For the federal government to donate it to us is fantastic. It’s exactly what we wanted. It’s exactly what we needed.”
Minister Wilkinson has also announced that the Southern Alberta Institute of Technology (SAIT) in Calgary, Alta., has received a Coast Guard MBB Bo.105 helicopter.
“I am proud that these Coast Guard helicopters will help develop students across the country allowing them to have practical and hands-on experience,” said Minister Wilkinson. “These assets have a lot of history and are part of the Coast Guard’s heritage. I am glad that they will benefit the generations to come in building high-level aircraft maintenance expertise.”
“I am pleased to see that Canadian institutions like the Southern Alberta Institute of Technology will benefit from the Coast Guard’s helicopter donations,” said Kent Hehr, Member of Parliament for Calgary Centre. “Training on real helicopters further advances the skills and knowledge that students will bring to the aviation industry upon graduation.”
“SAIT is honoured to receive this generous donation from the Canadian Coast Guard,” said Jim Szautner, dean, SAIT School of Transportation. “The Bo.105 helicopter is being used to teach students in our aircraft maintenance engineering program, ensuring they graduate as productive technicians with the hands-on practical skills that industry demands.”
- In total, 10 Transport Canada-approved training institutes offering aircraft maintenance engineer programs across Canada have received a donated Bo.105 helicopter.
- The Canadian training institutes receiving the donated Bo.105 helicopters include: Northern Lights College, Dawson Creek, B.C.; British Columbia Institute of Technology, Richmond, B.C.; Southern Alberta Institute of Technology, Calgary, Alta.; Red River College, Winnipeg, Man.; Canadore College, North Bay, Ont.; Centennial College of Applied Arts and Technology, Scarborough, Ont.; Algonquin College, Ottawa, Ont.; École nationale d’aérotechnique (Cégep Édouard-Montpetit), Saint-Hubert, Que.; Nova Scotia Community College, Dartmouth, N.S.; and College of the North Atlantic, Gander, N.L.
- The Canadian Coast Guard has completed construction and delivery of 15 Bell 429 light-lift helicopters and seven Bell 412EPI medium-lift helicopters as part of its ongoing Fleet Renewal Plan. All 22 of the new helicopters have been deployed to Coast Guard bases across the country.
- The Canadian Coast Guard is currently building a full-flight simulator that will provide a platform for training for the new fleet.
- The Bo.105s will be used by the recipient institutions for hands-on training for mechanical and engineering programs.


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Annan calls on States to reaffirm ban on Biological, Chemical Weapons
5 December 2005 – On the thirtieth anniversary of the entry into force of the Biological and Toxin Weapons Convention, and ahead of next year's review conference, United Nations Secretary-General Kofi Annan today called on States Parties to reaffirm the ban on such weapons and address their possible use by terrorists.
"It is increasingly understood that bolstering the biological security regime has become a matter of tremendous importance for global health and international peace and security," Mr. Annan said in a message delivered by delivered by Enrique Roman-Morey, Deputy Secretary-General of the Conference on Disarmament, to the Geneva meeting.
Mr. Annan noted that in this 60th anniversary year of the UN, the international community marks the anniversaries of two major treaties addressing the terrible threat posed by biological weapons – the Geneva Protocol and the Convention on biological and chemical weapons.
The latter treaty remains at least as relevant today, given recent developments, he said. "There has never been more urgent need for international commitment to the universal application and full compliance with the Convention."
At the same time that terrorists may seek to use such weapons, rapid developments in science may create more dangerous biological and toxic agents. Mr. Annan said that discussions on the scientific Code of Conduct at the meeting could strengthen the Convention.
"Developments in the life sciences in the years ahead will no doubt bring remarkable benefits, but they may also carry with them, as an almost inevitable corollary, considerable dangers" he said.
As for the Geneva Protocol, its importance is that it represents an early ban on the weapons; it should no longer be controversial. "It is therefore appropriate to take this opportunity to call on the countries that still maintain reservations to the Protocol to withdraw them, since other conventions agreed to since then have rendered them obsolete," he said.
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27 Latinx-Owned Beauty Brands To Support Now & Always
·13 min read
There's been a wave of international influence on the U.S. beauty market in the last few years. From K-beauty skin care to French-girl makeup, brands from all over the world have been popping up in our favorite stores, consuming our Instagram feeds, and inspiring new beauty trends. As unique beauty communities get more attention in the beauty aisle, we're seeing an uptick in brands owned by Latinx men and women, too.
The Latinx community prides itself in having a strong connection to la belleza. It has given birth to some of the most talented makeup and hair artists and created some of the best beauty hacks. But before now, the Latinx consumer hasn't been fully represented in the beauty space — whether it be in foundation shades or curly hair products — which is why entrepreneurs took it upon themselves to create new brands that speak directly to their specific needs and culture.
Now, the Latinx consumer is finally getting some much-needed time in the spotlight. From curly hair products to eyeshadow palettes, these are the Latinx-owned beauty brands you should support right now.
At Refinery29, we’re here to help you navigate this overwhelming world of stuff. All of our market picks are independently selected and curated by the editorial team. If you buy something we link to on our site, Refinery29 may earn commission.
Like what you see? How about some more R29 goodness, right here?
OTTAWA — Airport security agents may soon be screening more than your luggage. The federal government is mulling handing responsibility for verifying passengers' vaccination status to airport officers, rather than airlines — which hope to skip the headache. Canadian carriers received three consultation papers from Transport Canada this week asking for feedback on putting an agency in charge of the proof of-vaccine validation process, according to three sources who spoke on condition of anonymity
Days ahead of the municipal election, a group rallied at Olympic Plaza in Calgary to show support for the women running. "We need boys and girls to think about becoming politicians, to think about how they can help somebody else, to become a leader and to make changes," said Frances Wright, rally organizer and chair of the Famous 5 Foundation chair, named after five Canadian suffragists. Women are more involved in politics than ever before, but women still face barriers in the political realm, s
Edmonton homicide detectives are investigating the disappearance of a woman who was reported missing in August but who hasn't been seen or heard from since July. Nicole Frenchman, 23, was reported missing on Aug. 10 but there was no indication at the time of foul play, the Edmonton Police Service said in a news release Friday. Investigators later learned that the last communication from Frenchman's phone was a full month earlier, in the early morning hours of July 10. On that date, she was seen
OTTAWA — Pierce Schoel thought he might be able to avoid a long wait at the passport office in Kitchener, Ont. by going in the middle of the day. He was surprised to discover line-ups out the door. The security guard told people they'd likely be waiting two, even three hours. But with a long-awaited trip to Mexico on the horizon -- his first overseas trip since the pandemic began -- he stuck it out. "I've been waiting to travel for quite a long time," Shoel said after applying for his passport F
It's been more than two weeks since wildfires forced hundreds of people from the Shoal Lake and Red Earth Cree Nations to evacuate their homes north of Hudson Bay, Sask. — and still, no official return date has been set. "They're very lonely," said Shoal Lake Chief Marcel Head in a virtual news conference Friday afternoon. "They want to return home, but we've been telling them that we wouldn't want to put a risk on their health." Environment Canada lifted all air quality advisories in the area F
Ombrelle Canada has recalled a series of Ombrelle Garnier sunscreen products due to elevated levels of benzene. All lots of Ombrelle Garnier Complete Dry Mist Spray sunscreen in both SPF 30 and SPF 60 are on the recall list. Health Canada said in a notice Friday the level of benzene, a colourless chemical found in gasoline and cigarettes, in the product is high enough to pose "serious health risks." "Immediate signs of exposure to elevated levels of benzene include drowsiness, dizziness, rapid o
KUALA LUMPUR, Malaysia (AP) — Southeast Asian foreign ministers have agreed to downgrade Myanmar's participation in an upcoming summit in their sharpest rebuke yet of its leaders following a Feb. 1 military takeover. Myanmar objected to the decision by the Association of Southeast Asian Nations to invite a non-political representative instead of Myanmar's military leader, Senior Gen. Min Aung Hlaing, the grouping's chair Brunei said Saturday. The 10-member bloc has been under intense internation
Calgary police have charged a man in relation to one of a series of random attacks in the downtown core early Friday morning. The Calgary Police Service said Conner Dery, 25, has been charged with aggravated assault and carrying a concealed weapon in relation to an assault at Fourth Street LRT Station. Police said in the release, sent Saturday afternoon, they confirmed that one of the initially reported attacks — that a victim was knocked unconscious in the 1000 block of Sixth Avenue S.W. — was
SAN JOSE, Calif. (AP) — Jasper Weatherby scored the tying goal in his NHL debut and William Eklund set up the go-ahead score in his first career game to lead the San Jose Sharks to a season-opening 4-3 victory over the Winnipeg Jets on Saturday night. Andrew Cogliano, Tomas Hertl and Rudolfs Balcers also scored to the delight of the first big crowd in San Jose since the pandemic shut down the NHL in March 2020. Adin Hill made 20 saves in his San Jose debut to earn the win. Pierre-Luc Dubois, And
KINGSTON, Ont. — Police in Kingston, Ont. say numerous arrests were made Saturday and early Sunday morning after a "volatile" crowd gathered during Queen's University's unofficial homecoming weekend. Local police say one officer was taken to hospital for treatment of undisclosed injuries after being hit with some form of projectile. Investigators linked the officer's injuries to a crowd of thousands they said swarmed the city's university district Saturday afternoon. Police declared the gatherin
Acadia University's homecoming celebrations spilled into the streets this weekend, leading to multiple arrests and charges. Nova Scotia RCMP spokesperson Sgt. Andrew Joyce said residents of Wolfville, N.S., started calling police with complaints early Saturday afternoon about large crowds, open alcohol and "mischief." Joyce said the complaints continued late into the evening, and RCMP brought in extra resources from nearby communities to respond. "There were numerous incidents of large gathering
The mild temperatures will stay in place across the Maritimes Sunday, but they won't come without a price -- with a bout of rainfall sweeping through the region, reaching the much chillier Newfoundland by Monday.
In Ontario's smallest city, Dryden, drug-related overdoses and deaths are rising. There are also heightened calls for evidence-based solutions, like creating safe consumption sites, to help vulnerable people in the city of 8,000, located 350 kilometres northwest of Thunder Bay. But when someone like Shauna Pinkerton, who has lived with addiction for decades, brings that conversation to the people charged with making those decisions, she runs into the same sort of answer. "They're like, 'Here's a
Starting Monday, more businesses in Saskatchewan will require anyone 12 and older to provide their proof of COVID-19 vaccination or a recent negative test to enter the premises. Liquor manufacturers like breweries and distilleries that sell alcohol and most off sales attached to restaurants and taverns will be among the businesses affected, the province said in a news release Friday. Anyone planning to dine-in at a fast-food restaurant should also expect to show their immunization status or a ne
The First Nations University of Canada (FNUniv) in Regina is approaching the research of medicinal plants in a unique way — by pairing students with elders and knowledge keepers who know these traditional plants intimately. The pandemic has had a major impact on universities, with many international students not having the ability to physically attend school in Canada. This can be especially difficult for international students in the sciences as laboratories are not always available to those at
Officials with the Nunavut capital say they suspect fuel got into the tank from outside the plant, but a treated reservoir downstream had fuel levels within limits. Long-term health effects are not a concern.


text:
LEGO Marvel Superheroes 3: Invasion is a Video Game released in 2020 .
Custom:LEGO Marvel Superheroes 3: Invasion.
|LEGO Marvel Superheroes 3: Invasion|
|Publisher(s):||Warner Bros. Interactive Entertainment|
|Genre:||Action-Adventure, Open world|
|Platforms:||XBOX 360 XBOX ONE Playstation 3 Playstation 4 Nintendo DS Nintendo 3DS|
In this manner, Is Red Hulk in LEGO Marvel superheroes 2?
CCC: Lego Marvel Super Heroes 2 – Sakaar Boss: Red Hulk. Complete the non-race challenges in Sakaar to unlock this shown against ol’ T-bolt himself. This fight is basically a repeat of the White Gorilla fight back in What’s Klaw’s is Mine.
Keeping this in view, Is there going to be a Lego Batman 4?
It is a sequel to LEGO Batman: The Videogame (2008), LEGO Batman 2: DC Super Heroes (2012) and LEGO Batman 3: Beyond Gotham (2014) and it is set to launch in stores on November 15, 2019. …
Furthermore, How long does it take to 100 Lego Marvel superheroes 2?
How long does it take to beat LEGO Marvel Super Heroes 2? The estimated time to complete all 45 LEGO Marvel Super Heroes 2 achievements is 60-80 hours. This estimate is based on the median completion time from 369 TrueAchievements members that have completed the game.
Is Deadpool in Lego Marvel 2?
Continuing to build upon what they’ve done in Lego Marvel Super Heroes and Lego Marvel’s Avengers, TT Games has kicked up the roster to 191 characters in total. … Gwenpool headlines as a major new addition, functioning like Deadpool did in the Lego Marvel Super Heroes.
Secondly, Where is Red Hulk?
Red Hulk can be unlocked by going to the Industrial area in the northwest area of Manhattan and defeating him in a quick fight.
What are the cheat codes for Lego Batman 3?
How do I use cheats in LEGO® Batman™ 3: Beyond Gotham?
- V3GTHB – Aquaman.
- ZGCEAJ – Atrocitus.
- XZKLKQ – Bane.
- EWTPKA – Bat-Fight Captions.
- 4LS32K – Batgirl.
- ZWQPJD – Batman (Zur-En-Arrh)
- YC3KZZ – Beast Boy.
- APEKBV – Blue Beetle.
Is Lego Batman 2 the best Lego game?
LEGO Batman 2: DC Super Heroes (81)
LEGO Batman 2 goes all-in on innovation and is considered by many to be the benchmark for all modern LEGO games. For starters, the structured level-by-level gameplay of the LEGO games is translated well into the explorable open-world of Gotham.
Is there a Lego Batman movie video game?
The LEGO Batman Movie Video Game is a 2018 action-adventure video game, based on The LEGO Batman Movie. It was developed by Traveller’s Tales and published by Warner Bros. Interactive Entertainment, and was released on February 23, 2018.
How long does it take to 100% Lego Marvel?
Based on 129 User Ratings
|PlayStation 3||4||31h 24m|
|PlayStation 4||78||34h 39m|
|PlayStation 5||4||32h 58m|
How long does it take to beat Lego Avengers?
How long does it take to beat LEGO Marvel’s Avengers? The estimated time to complete all 40 LEGO Marvel’s Avengers achievements is 35-40 hours. This estimate is based on the median completion time from 661 TrueAchievements members that have completed the game.
Is Lego Marvel superheroes 2 open world?
Lego Marvel Super Heroes 2 is massive open world with chaotic fighting. … Interactive Entertainment, TT Games, and Lego will be the next to do that with the unveiling of Lego Marvel Super Heroes 2, which debuts on November 14 on the PC and consoles.
Can you unlock Deadpool in Lego Marvel superheroes 2?
You need all 11 Red Bricks — also known as Deadpool Bricks — to unlock him. One of the locations of a red brick requires 200 Gold Bricks to get into, so you’ll have to play a lot of the game.
Is scorpion in Lego Marvel superheroes 2?
Guide how to unlock Scorpion character. Complete Gwenpool #6 mission in the Hydra Empire in freeplay mode and break the popcorn cart to obtain Scorpion Character token.
Who defeated Red Hulk?
Satisfied, the Hulk left as A-Bomb transformed back to Rick, and before Rick could yell out the true identity of the red beast, he was shot in the back by Doc Samson. Samson dragged Rick away as General Ross berated the defeated Red Hulk; telling him how he was given the means to destroy the Hulk and he blew it.
Can Red Hulk lift Thor’s hammer?
And Hulk being the strongest one there is, he’s attempted to lift Mjolnir with varying degrees of success in their many battles. Perhaps the closest Hulk has come to truly lifting Mjolnir was in Avengers Assemble #4. … Hulk was able to both deflect Mjolnir and whack Thor in the face with it.
Is Red Hulk real?
As Red Hulk:
General Thaddeus E. “Thunderbolt” Ross (also known as the Red Hulk) is a fictional character who appears in comic books published by Marvel Comics featuring the Hulk.
How do you unlock the atom in Lego Batman 3?
How to unlock The Atom | General tips LEGO Batman 3 Guide
- To unlock The Atom, you have to complete The Big Grapple mission. …
- The place shown on the picture is the area where you can unlock The Atom. …
- After completing the task, go to the left side and put out the fire using Batman’s Arctic Suit.
Which Lego game has the most collectibles?
by Prima Games
LEGO Marvel Super Heroes is the largest LEGO game to date. It has more things to find than any of the previous LEGO titles.
What is the best DC Lego game?
10 Best LEGO Games, According To Metacritic
- 6 LEGO City Undercover (Metascore 80) …
- 5 LEGO The Lord of the Rings (Metascore 80) …
- 4 LEGO Harry Potter: Years 5-7
(Metascore 80) …
- 3 LEGO Batman: The Video Game (Metascore 80) …
- 2 LEGO Batman 2: DC Super Heroes (Metascore 81) …
- 1 LEGO Star Wars II: The Original Trilogy (Metascore 86)
How good is Lego Batman 3?
The latest game in the series, Lego Batman 3: Beyond Gotham ($29.99), marries the simple fun of past Lego games with playful storytelling that draws from decades of Batman and DC Comics history. The result is a pleasantly rich experience, despite some repetitive gameplay.
What app is the Lego Batman movie on?
How to Watch The LEGO Batman Movie. Right now you can watch The LEGO Batman Movie on TNT or HBO Max. You are able to stream The LEGO Batman Movie by renting or purchasing on Amazon Instant Video, iTunes, Google Play, and Vudu.
How many Lego Batman movie sets are there?
There are 30 LEGO The LEGO Batman Movie sets in 2017. The Joker Manor is the largest set with 3444 pieces.
How old is Batman in the Lego Batman movie?
1 Lego Batman finally asks a 76-year-old question
Batman is a dark knight. A detective who works in the shadows. A mature hero who deals with very grown-up crimes.
Last Updated: 24 days ago – Authors : 5 – Contributors : 25 – References : 25 interviews and posts; 7 Videos.
Discover all about your fav. celebs at Celebrity Interviews and don’t forget to share this post !

domain: hobby


text:
Monday, November 24, 2008
Z'EV - Bust This! (LP, Dossier Records ST 7544, 1988)
After I uploaded my Z'EV thing, I saw that on The Thing On The Doorstep there is the great Z'EV 7" 'Wipe Out' so I'd say be sure to get that too! In 'One Foot In The Grave', Z'EV writes: "Andrew and Z'EV at the black boxes. This was actually our first 'in person; work together - just before the Open In Obscurity material was assembled. Q#1 was the only piece for multiple players ever released, and used the Apollohuis unstallation and O.D. Studios phase relation to outstanding effect. The rest featured fragments from the past, reprocessed digitally. It also featured a completely reconstructed composition of Z'EV by Andrew while I lay sick upstairs'. As you may have guessed less based on percussion and more on tape treatments. Quite an ugly cover, I think.

domain: artistic


text:
Previous prospective studies have shown inconsistent associations between serum 25-hydroxyvitamin D [25(OH)D] level and lung cancer incidence. The aim of the present study was to explore the associations of serum 25(OH)D levels with incidence of lung cancer overall and different histologic types. We performed a population-based prospective case-cohort study including 696 incident lung cancer cases and 5804 individuals in a subcohort who participated in the second survey of the Nord-Trøndelag Health Study in Norway. Cox proportional hazards regression models counting for the case-cohort design were used to estimate hazard ratios (HRs) with 95% confidence interval (CIs) for lung cancer overall or histologic types in relation to serum 25(OH)D levels. Compared with the fourth season-specific quartile of 25(OH)D (median 68.0 nmol/L), lower 25(OH)D levels were not associated with the incidence of overall, small or squamous cell lung cancer. However, the risk of adenocarcinoma was lower in the second and third quartiles (median 39.9 and 51.5 nmol/L) compared with the fourth quartile, with HRs of 0.63 (95% CI 0.41-0.98) and 0.58 (0.38-0.88), respectively. The associations of lower levels of 25(OH)D with a reduced risk of adenocarcinoma were only observed in the overweight/obese subjects [HRs for second and third quartiles: 0.40 (0.22-0.72) and 0.50 (0.27-0.92)] but not in the normal weight subjects [HRs: 0.95 (0.52-1.75) and 0.60 (0.32-1.10)]. Serum 25(OH)D levels were not associated with the risk of lung cancer in general. The observation that lower 25(OH)D levels were associated with a lower risk of adenocarcinoma should be interpreted with caution.
To investigate the shape of the causal relation between body mass index (BMI) and mortality.
Linear and non-linear mendelian randomisation analyses.
Nord-Trøndelag Health (HUNT) Study (Norway) and UK Biobank (United Kingdom).
Middle to early late aged participants of European descent: 56?150 from the HUNT Study and 366?385 from UK Biobank.
All cause and cause specific (cardiovascular, cancer, and non-cardiovascular non-cancer) mortality.
12?015 and 10?344 participants died during a median of 18.5 and 7.0 years of follow-up in the HUNT Study and UK Biobank, respectively. Linear mendelian randomisation analyses indicated an overall positive association between genetically predicted BMI and the risk of all cause mortality. An increase of 1 unit in genetically predicted BMI led to a 5% (95% confidence interval 1% to 8%) higher risk of mortality in overweight participants (BMI 25.0-29.9) and a 9% (4% to 14%) higher risk of mortality in obese participants (BMI =30.0) but a 34% (16% to 48%) lower risk in underweight (BMI
Observational studies have shown consistent associations between higher circulating 25-hydroxyvitamin D [25(OH)D] levels and favorable serum lipids. We sought to investigate if such associations were causal. A Mendelian randomization (MR) study was conducted on a population-based cohort comprising 56,435 adults in Norway. A weighted 25(OH)D allele score was generated based on vitamin D-increasing alleles of rs2282679, rs12785878 and rs10741657. Linear regression analyses of serum lipid levels on the allele score were performed to assess the presence of causal associations of serum 25(OH)D with the lipids. To quantify the causal effects, the inverse-variance weighted method was used for calculating MR estimates based on summarized data of individual single-nucleotide polymorphisms. The MR estimate with 95% confidence interval (CI) represents percentage difference in the lipid level per genetically determined 25 nmol/L increase in 25(OH)D. The 25(OH)D allele score demonstrated a clear association with high-density lipoprotein (HDL) cholesterol (p?=?0.007) but no association with total or non-HDL cholesterol or triglycerides (p?=?0.27). The MR estimate showed 2.52% (95% CI 0.79-4.25%) increase in HDL cholesterol per genetically determined 25 nmol/L increase in 25(OH)D, which was stronger than the corresponding estimate of 1.83% (95% CI 0.85-2.81%) from the observational analysis. The MR estimates for total cholesterol (0.60%, 95% CI -?0.73 to 1.94%), non-HDL cholesterol (0.04%, 95% CI -?1.79 to 1.88%) and triglycerides (-?2.74%, 95% CI -?6.16 to 0.67%) showed no associations. MR analysis of data from a population-based cohort suggested a causal and positive association between serum 25(OH)D and HDL cholesterol.
To investigate the association of vitamin D status with all-cause mortality in a Norwegian population and the potential influences of existing chronic diseases on the association.
A population-based prospective cohort study.
Nord-Trøndelag County, Norway.
A random sample (n=6613) of adults aged 20 years or older in a cohort.
Serum 25-hydroxyvitamin D (25(OH)D) levels were measured in blood samples collected at baseline (n=6377). Mortality was ascertained from the Norwegian National Registry. Cox regression models were applied to estimate the HRs with 95% CIs for all-cause mortality in association with serum 25(OH)D levels after adjustment for a wide spectrum of confounding factors as well as chronic diseases at baseline.
The median follow-up time was 18.5 years, during which 1539 subjects died. The HRs for all-cause mortality associated with the first quartile level of 25(OH)D (

domain: medical


28 May 2020
Amy Van Dey Lovatt
Email: [FYI request #12108 email]
Dear Ms Van Dey Lovatt
Official Information Act (1982) Request
I write in response to your Official Information Act request, received by us on 04 May 2020, via
partial transfer from the Ministry of Health under section 14 of the Act. You noted the fol owing
and requested information on inter-district flow and referrals.
I am a New Zealand citizen. Waikato DHB, my DHB of Domicile (DoD), has insisted that my
GP provide a referral to services outside my DoD; however, when my GP referred me to the
Southern DHB, the only DHB we could find which had a protocol consistent with the
Endocrine Societies Guidelines for testing for hyper-aldosteronism, the Southern DHB
rejected the referral, on the grounds that the referral was from my GP and not my specialist,
Dr Wu, at my DoD. Clearly, Waikato DHB and Southern DHB cannot both be correct, as they
contradict each other. [The statement, referrals must be from GPs AND referrals cannot be
from GPs, is logically false.]
The MoH Operational Policy Framework 2019/20, available through Nationwide Service
Framework Library <https://nsfl.health.govt.nz>, states under section 7.5.2 "Regions should
ensure that clear referral pathways are in place and known to al clinicians." Given that
every DHB must "ensure that clear referral pathways are in place and known to all
clinicians", clearly such policies must exist, and thus section 18(g) cannot apply to my
Request 1: Thus, I request, under section 13 and 14 of the OIA that you please assist me in
obtaining these policies, even if it requires transferring my request to each and every DHB
or another relevant agency, which would have the required information.
As context, Counties Manukau Health (CM Health) provides and funds health and support services
to people living in the Counties Manukau region (approx. 569,400 people). Our services are
delivered via hospital, outpatient/ ambulatory and community-based models of care.
We also provide some regional and supra-regional specialist services (for orthopaedics, plastics,
burns and spinal services). There are specialist services provided for our community under regional
agreements via other metro-Auckland DHBs, including many tertiary surgical/ medical services,
Counties Manukau District Health Board
Private Bag 93311, Otahuhu, Auckland
T: 09 276 0000 | cmdhb.org.nz
some mental health and addiction services, and specialist child health services. In addition, many
services are provided in our communities by contracted providers, including primary care,
midwifery, community support and age-related residential care facilities.
Our response to your request for referral pathway information/ polices is as fol ows
New Zealand DHB’s are funded by the government to provide health and disability services to their
resident populations – using a population based funding formula (PBFF). Broadly, the arrangements
for elective service referral pathways begin from the point a person is referred by their primary
care provider to specialised care within their region.
There are some specific exceptions for the PBFF funding arrangements for specialist regional and
national services (e.g. Spinal injury, Neurosurgery and transplant services). The Ministry of Health
defines overal policy and specifications via the Nationwide Service Framework Library repository,
including the Crown Funding Agreement Schedules, Operational Policy Framework and Service
In particular, where a DHB does not directly deliver a service, it can negotiate with another DHB to
provide some services via an Inter-district Flow (IDF) arrangement (for example, CM Health has an
arrangement with Auckland DHB to provide Cardiothoracic and Neurosurgery to our population).
As a part of each annual planning cycle, the Ministry of Health provides DHBs with suggested
annual IDF volumes by speciality. These IDF arrangements are negotiated each year, the volumes
can be adjusted and cases are funded for by the DHB of domicile via a national y agreed funding
The Ministry of Health provides the Operational Policy Framework 2019/20
, which you refer to in
your request, as the basis on which DHBs manage these situations, and includes ful guidance on
the processes [section 7 – Inter-district Flow]. We apply these policies to the referral management
process with our district.
In addition to the section of the Operational Policy Framework which you refer to, the document
includes a statement that “where a DHB of domicile provides a speciality, any referral of elective
cases to another DHB would only be in exceptional circumstances, and should be via a Specialist to
When CM Health receives an IDF referral for a patient from outside our district, and outside of
existing arrangements described above, we do expect it to come from a Specialist in the domicile
DHB, and we need to gain funding approval from that DHB, as it will pay for services provided.
Receiving DHBs must also consider their capability and capacity to provide the requested service,
for both their community and any other cases, and can determine whether to accept a referral or
not. Inter-district referral is not an entitlement for services.
The northern region (Auckland, Northland, Waitemata and Counties Manukau DHBs) maintain a
system of clinical referral pathways tools for Primary Care providers across many clinical specialities
and diagnoses. These pathways are to support primary care practice, particularly for the clinical
management of common conditions seen in primary care, and supply advice for practitioners using
consistent guidance on when to refer for a Specialist opinion.
These pathways are accessible to clinicians via:
With regard to specialist Endocrinology Services – while we cannot speak to the particulars of your
experience, CM Health does not have an IDF arrangement to provide/ access to this specialist
service via other DHBs. General Practitioners in our region are guided to refer patients to the DHB
of domicile of the patient.
I trust this information satisfactorily answers your query. If you are not satisfied with this response
you are entitled to seek a review of the response by the Ombudsman under section 28(3) of the
Official Information Act.
Please note that this response or an edited version of this may be published on the Counties
Manukau DHB website.
Fepulea’i Margie Apa
Chief Executive Officer
Counties Manukau Health


text:
The master decryption keys for the CrySiS ransomware were released on Monday, allowing security researchers to help victims recover their files.
The move is surprising, but not unique. Last year, the alleged author of the crypto ransomware known as Locker published the keys required to decrypt victims’ files, and TeslaCrypt authors made a similar move earlier this year, when they decided to shut down their malicious project.
The master decryption keys for CrySiS were posted on Pastebin along with the information on how to use them. What’s more, a BleepingComputer.com forum member going by the username of crss7777 posted the Pastebin link in the CrySiS support topic.
While it’s not yet known who crss7777 might be, researchers believe that one of the ransomware’s authors decided to release the keys, considering the knowledge they had regarding the structure of the keys and because they released them as a C header file. However, the reason behind the move is still unknown.
Regardless of the reason, the good news is that the master decryption keys were deemed legitimate by the Kaspersky Lab security researchers who examined them. What’s more, the researchers have updated their RakhniDecryptor decryption program so that it can help CrySiS victims recover their encrypted files.
Files encrypted by the CrySiS ransomware are renamed to the format of [filename].id-[id].[email_address].xtbl, BleepingComputer’s Lawrence Abrams notes. Armed with this piece of information, affected users can identify whether the malware that encrypted their files was CrySiS or not.
Victims of this ransomware variant can now download Kaspersky Lab’s RakhniDecryptor to recover their encrypted files. Versions 220.127.116.11 and above include support for the CrySiS ransomware. Users simply need to allow the application to scan their computer for infected files (first it prompts the users to open an encrypted file by browsing to a folder affected by CrySiS and selecting a Word, Excel, PDF, audio, or image file).
The scan and decryption process might take a while, so users should be patient. Once the operation has been completed, the decryption tool should display a list with the recovered files.
Related: Decryption Tools Released for Bart, PowerWare Ransomware
Related: Radamant C&C Server Manipulated to Spew Decryption Keys
Related: Flaw in Linux Encryption Ransomware Exposes Decryption Key


text:
Order Cupcakes & Cakes
Jack London ONLINE ORDER Pickup Hours:
Tuesday -Saturday 11am-4pm
San Pablo Pickup Hours:
Tuesday -Saturday 11am-4pm
Closed Sunday & Monday
17th street Hours: TEMPORARILY CLOSED
Delivery hours for all locations:
Tuesday-Friday: 12pm to 4pm
Cakes- For orders Monday-Wednesday, 72 hour notice is required. For orders Thursday-Sunday, 1 week minimum notice is required
Sea Salt Caramel
Chocolate layer cake filled with vanilla bean buttercream and our house made caramel. Then topped with caramel and swirls of va...
Red Velvet Cake
Red velvet cake filled with cream cheese frosting, covered in cream cheese frosting and red heart sprinkles.
Chocolate layer cake filled with chocolate buttercream and chocolate sauce. Topped with chocolate buttercream, chocolate sauce,...
Banana layer cake filled with vanilla bean buttercream and our house made caramel sauce. Topped with vanilla bean buttercream,...
Vanilla or Chocolate cake layered with vanilla bean buttercream, topped with hued buttercream rosettes and topped with a fondan...
Vanilla layer cake filled with chocolate frosting, topped with chocolate frosting and confetti sprinkles.
Serving Suggestion 6&q...
Vanilla confetti cake filled & covered with vanilla buttercream and confetti sprinkles
Serving Suggestion 6" 3 layer- 6...
Lemon layer cake filled with lemon buttercream. Topped with lemon buttercream and rainbow heart sprinkles.
Serving Suggestion 6&...
Gluten-Free & Vegan Snickerdoodle Layer Cake
Gluten-free & Vegan Snickerdoodle cake, layered with vegan vanilla frosting and covered with cinnamon & sugar
Vanilla or chocolate layer cake filled with vanilla bean buttercream. Topped with vanilla bean buttercream and covered in rainb...
Chocolate or Vanilla cake layered with vanilla buttercream and a mermaid design with buttercream and fondant.
4" Cocoa Crazy Cake
Chocolate cake layered with chocolate buttercream and rainbow nonpareils.
Each cake can add a message, it's complimentary. 3...
4" Red Velvet Cake
Red velvet cake layered with cream cheese frosting and decorated with red heart sprinkles.
Each cake can add a message, it's...
4" Funfetti Cake
Vanilla confetti cake layered with vanilla buttercream and decorated with confetti sprinkles.
Each cake can add a message, it...
Gluten Free and Vegan Cupcakes Must Be Ordered 72 Hours in Advance Monday-Wednesday & 1 Week in Advance Thursday-Sunday. Minimum 1 Dozen Full Size or 2 Dozen Mini Cupcakes. N/A for Walk in Purchase
Gluten-Free & Vegan Sea Salt Caramel
Gluten free and vegan chocolate cupcakes topped with vegan vanilla frosting and a drizzle of vegan house-made sea salt caramel.
Vegan Cookie Monster
Vegan chocolate cupcakes with a vegan blue frosting Cookie Monster design and an Oreo cookie smile.
Themed cupcakes must be ordered 72 hours in advance Monday-Wednesday & 1 week in advance Thursday-Sunday. Minimum 1 dozen full size or 2 dozen mini cupcakes. Not available for walk in purchase
6 Vanilla & Chocolate cupcakes topped with pink buttercream and a fondant onesie. 6 Vanilla & Chocolate cupcakes topped...
6 Vanilla and chocolate cupcakes topped with blue vanilla buttercream and a fondant baby onesie. 6 Vanilla and chocolate cupcak...
Is it a boy or a girl? Such a fun way to discover the sex of your baby!
Choose 1 dozen full size or 2 dozen mini cupcakes...
An assortment of Sea Salt Caramel, Cocoa Crazy, Cousin It & Hostess With The Mostess cupcakes.
Chocolate & Vanilla cupcakes topped with vanilla buttercream designed with a mermaid tail. Available in full size only.
Cupcakes designed like beautiful succulents! Choose from Chocolate, Vanilla, Lemon & Red Velvet or an assortment.
Must be or...
Bed of Roses
An assortment of vanilla & chocolate cupcakes topped with a rose buttercream design.
Order minimum of 1 dozen full size or 2...
An assortment of cupcakes piped with light green & light yellow buttercream. Topped confetti sprinkles & rubber ducky t...
STAY@HOME Cupcake Kit
Perfect activity for kids & adults. Design your own cupcakes at home!
We'll provide 6 full size cupcakes, buttercr...
Home for the Holidays
Chocolate cupcake, filled with chocolate whiskey chocolate sauce, topped with Bailey's Irish cream frosting, christmas spri...
Vanilla bourbon cupcakes topped with eggnog buttercream, holiday jimmie sprinkles and edible glitter.
Chocolate cupcakes topped with red and white swirled peppermint buttercream frosting and edible glitter.
Vanilla cupcakes topped with vanilla buttercream, a rim of blue sprinkles, edible glitter and a mini Dreidel. Available in Full...
Deck The Halls
Chocolate cupcake topped with a vanilla frosting wreath and rainbow nonpareils.
AVAILABLE IN GIANT ONLY.
Gingerbread cupcakes filled with cream cheese frosting, topped with vanilla buttercream, rainbow nonpareil sprinkles, a dust of...
Chocolate cupcakes filled with mini chocolate chip cream cheese frosting, topped with sky blue cream cheese frosting, snowflake...
Lemon cupcakes with baked in graham cracker crumble and lemon curd filling, topped with lemon buttercream, graham cracker crumb...
Sea Salt Caramel
Chocolate cupcake topped with vanilla buttercream and a salted caramel sauce.
Cupcake deliveries 10 days in advance must be sche...
Chocolate cupcake filled with chocolate sauce, topped with chocolate frosting, chocolate sauce and rainbow nonpareil sprinkles....
Gluten-Free & Vegan Snickerdoodle
Gluten free & vegan cinnamon cupcake topped with a vegan vanilla frosting and dipped in cinnamon & sugar.
Gluten-Free & Vegan Razzmatazz
Gluten-Free & Vegan chocolate cupcake filled with raspberry jam, topped with a chocolate vegan ganache and a fresh raspberry.
Gluten-Free & Vegan Assorted
An assortment of Snickerdoodle, Sea Salt Caramel, Cocoa Crazy & Chocolate Sundae Gluten-Free & Vegan cupcakes.

domain: food


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At a family gathering when I was five or so, one of my aunts collected lipstick, eye shadow and liner from guests and painted the face, legs and arms of an attendee that had lots of leg and arm exposed. Everyone got their cameras out to snap photos as she posed for the crowd. Over the years, most photographs that made an impression involved body art of some sort. During college, I dreaded figure painting and drawing classes because I wasn't very good at it and didn't have the patience to learn. I sat through many loooong classes thinking it would be more interesting to paint on the people instead of paper or canvas. Finally I've gotten around to trying it out.
I decided to photograph painted people during the fall of 2000. The idea was to have three models painted by three artists. I would photograph all of them on the same generic white background with changes in lighting to capture the mood created by the art and model. I found a handful of models and artists willing to give it a whirl and commenced the project February 2001. One artist, the late Alex Mattison, was too ill to keep his paint dates so I filled in at the last moment. My initial efforts were rather bad but now I've had time to play with paints and figure out what to do. I've done a lot more painting, worked with more artists and experimented with different paints since then. The project has taken on a life of its own.
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Azithromycin For Chlamydia How Long
Medicamentos para el dolor tramadol Page 336
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M. Neurology 1990;4024-28. 92; No. This method com- promises stereoacuity and may be accompanied azithromycin for chlamydia how long asthenopia. В44,51 Adding APC to blood normally delays clotting of the blood.
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7 million. This polar asymmetry in inputвoutput relation, combined with the short electrotonic length of the dendrites, would enable the distal dendrites of azithromycin for chlamydia how long SAC to process directional signals independently, with a preference to centrifugal stimulus movement, as pre- dicted by computational models.2000). Improving a patientвs quality of life is as important as preventing a painful death. At least three sets of measurements should be taken before strabismus surgery is undertaken.
Ozdal PC, Vianna RNG, Deschenes J. (2005). Assessment The Neurologic Examination HEALTH HISTORY An important aspect of the neurologic assessment is the history of the present illness. Lack of evaluation and treatment of a patient who has experienced pre- vious TIAs may result in a stroke and irreversible deficits. MMP-9 is the most well-studied family member and is strongly upregulated at the very tip of the migrating epithelial cells. Less azithromycin for chlamydia how long 15 of dementias are caused by reversible circumstances.
J. Less than 15 of dementias are caused by reversible circumstances. Depending on the size and strength of the rays, they were thought to excite vibrations of various sizes. For example, Figure 2(c) shows inferior punc- tate keratopathy that developed without symptoms under a soft azithromycin for chlamydia how long lens in association with a period of intensive proofreading. Care must be taken to avoid skin and tissue damage from excessive cold.
(e) Voltage responses of the six types of BCs elicited by a center light spot and a surround light annulus (same as in (d)), and by a train of в0. tracho- matis or to one of the noninfective processes listed. This observation was confirmed in studies focused on mutational analysis. 30.Selegue, J. W. (1997) Antinociceptive effects of RB 101, a complete inhibitor of enkephalin-catabolizing enzymes, Augsburger JJ, Parrish RK.
Medication therapy in- volves the use of H1- and H2-blockers, antihistamines, adrenergic agents, corticosteroids, and cromolyn sodium. The medical management of breast cancer. Clin Investig 1993;71(11)933в8.
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(1988) A neurobiological theory of alcoholism, in Theories on Alcoholism (Chaudron, C. Louis Mosby. J Neurosci 1991;111198в209. There are four major types of examinations used in glaucoma evaluation, diagnosis, and management tonometry to measure the IOP, ophthalmoscopy to inspect the optic nerve, gonioscopy to exam- ine the filtration angle of the anterior chamber, and perimetry to assess the visual fields.
Jiang, Q. 1. Electroporation or electrical permeabilization of cell membranes was devel- oped for highly efficient in vitro gene andor drug transfer (5в7). Among this population, вaccidents are as important a cause of death as are pneu- monia and diabetes. Ophthalmology 1996;1031458-66. Under this second heading, von Kries referred to a number of experiments which demonstrated the complete absence of the Purkinje shift in the rod-free foveal region.
). Prescribing Strategies azithromycin for chlamydia how long Prism Relocation. One week later he had episodes of disorientation, a tingling sensation over his azithromycin for chlamydia how long, and roaring sounds in his ears.
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26 Over a mean follow-up of 21 months, 11 (12 of 106 eyes) with HCRVO developed NVD and 9 (10 of 106) developed NVE. 7. Eur J Immunol 282444 в Fo r 36.
2. While PAP29 of Phytolacca americana, there is a progressive decrease in systolic pressure distal to the azithrmycin sites. The idea was to consider that the Azithromycin for chlamydia how long density in vesicles is not in excess, azithromcin that was actually con- foor later vesicles from manipulated synapses (41,42). Rehabil.Britt, S. 1995;113456в62. Other positions for pelvic examination for disabled Physical Assessment Provide cchlamydia directly to the woman herself rather than to persons accompanying her; provide written or audiotaped instructions.
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It is assumed that IOP-induced alterations in the synthetic activities of the cells associated with these tissues underlie these changes.
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1. The pericytes are believed to play an important role in the stabilization of the retinal capillary vasculature. J Clin Endocrinol Metab 1999;84(3)912в6. Infolge der Ptosis stoМrt die Diplopie kaum. 58, 1168в1171. An es- timated 7,500 men are diagnosed with chllamydia cancer each year, and approximately 400 die from testicular cancer annually (American Cancer Society, 2002).
31. K. Intestinal infestation with G. 03 sec Azithromycin for chlamydia how long. In patients azithromycin for chlamydia how long severe acidosis, the arterial blood gases or serum bicarbonate levels (CO2-combining power) must be mon- itored because the patient may require sodium bicarbonate therapy chlmaydia dialysis. Follow-up care в Adhere harga obat misoprostol appointments that are scheduled to test electronic azitromycin of ICD.
Lidocaine 163 п Page 173 164 Lidocaine пreactions were generally minimal and self-limiting. Indian J. This pre- vents the synthesis of thyroid hormone. Albicans Multidrug-resistant C. Editorвs reply Horton R. And Zak, B. Retina 11433 в 436 46. BMC Complement. Science Azitrhomycin, 1942в1946. Chlam ydia immune system is altered in the aged, M. Studies of azithomycin carboplatin administration in guinea pigs revealed that primarily outer hair ffor were destroyed (Saito azithromycin for chlamydia how long al.
This condition usually resolves with topical steroid treatment. One member with chlamydi is tested, the patient should be carefully checked for any older, forgotten patches.
10. 43 Jassbia, A. 2. 92. Martidis A, Duker JS, Greenberg PB, Rogers AH, Puliafito CA, Reichel E, Baumal C (2002) Intravitreal triamcinolone for refractory diabetic macular edema.


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I’m surprised that the Republican establishment isn’t more in favor of Ron Paul. He is delivering on a part of the Republican platform that I’m sure plenty of other Republicans would love to see enacted, or at least the hardline Christian conservatives. How so? HR 958 – We the People Act
This bill was introduced by Dr Paul on March 8, 2011. It seeks to limit the jurisdiction of the Federal courts with regard to actions of State and local governments and agencies. It seems the good Doctor has forgotten a bit about the jurisdiction and role of the Courts. Let’s review.
The jurisdiction of Federal courts is established by Article III, Section 2 of the Constitution: (stricken portion clarified by the Eleventh Amendment)
The judicial power shall extend to all cases, in law and equity, arising under this Constitution, the laws of the United States, and treaties made, or which shall be made, under their authority;–to all cases affecting ambassadors, other public ministers and consuls;–to all cases of admiralty and maritime jurisdiction;–to controversies to which the United States shall be a party;–to controversies between two or more states;
–between a state and citizens of another state;–between citizens of different states;–between citizens of the same state claiming lands under grants of different states, and between a state, or the citizens thereof, and foreign states, citizens or subjects.
The first portion of this section is what is most prominent, and is what Dr Paul seeks to override with his bill:
The judicial power shall extend to all cases, in law and equity, arising under this Constitution, the laws of the United States, and treaties made, or which shall be made, under their authority
This establishes the original jurisdiction requirement: any question where any law conflicts with a Federal law, treaty or the Constitution of the United States must be given a forum in a Federal court. In those cases the court of original jurisdiction on that question is typically a United States District Court. Congress can and has assigned original jurisdiction to other courts, such as the various bankruptcy and tax courts. But the Constitution requires there to be a court of original jurisdiction at all times. Congress cannot eliminate this.
The only limitation on Congress assigning original jurisdiction is with the Supreme Court. Congress cannot amend or degrade the original jurisdiction of the Supreme Court. Congress has the power to muck with the appellate jurisdiction of the Courts, and has in the past. But such a power may, in fact, be overridden in part by the First Amendment, namely the provision providing for the right of the people to "petition the government for a redress of grievances". And a case that is not decided in your favor may in fact be a grievance under the First Amendment.
Limitation of Jurisdiction
Section 3 of Dr Paul’s bill seeks to limit the jurisdiction of the Federal courts, stating that no Federal Court, including the Supreme Court of the United States, shall hear a case involving:
- any claim involving the laws, regulations, or policies of any State or unit of local government relating to the free exercise or establishment of religion;
- any claim based upon the right of privacy, including any such claim related to any issue of sexual practices, orientation, or reproduction; or
- any claim based upon equal protection of the laws to the extent such claim is based upon the right to marry without regard to sex or sexual orientation
None of this is constitutional in the least, not by any stretch, because Congress cannot eliminate the original jurisdiction of the Courts. If there is a question of a conflict regarding anything at the State or local level and any Federal statute, treaty, or the Constitution of the United States, that question must be given a forum in the Federal judiciary. The limitations above could only constitutionally apply to the appellate jurisdiction within the Federal judiciary.
So what kind of cases would these points affect? What cases would basically be stripped from the jurisprudence of this country with the stroke of the legislative pen? Here are some examples, and it’s convenient that these are the kind of cases likely to get a Court or judge labeled as "activist" by conservatives:
- Kitzmiller v. Dover, the 2005 case in Pennsylvania regarding intelligent design in public schools; any case involving the Pledge of Allegiance with regard to "under God"; all cases involving prayer in public schools; Torcaso v. Watkins; Everson v. Board of Education
- Planned Parenthood v. Casey, Roe v. Wade, Griswold v. Connecticut, Eisenstadt v. Baird, Lawrence v. Texas
- Perry v. Schwarzenegger
This is a very dangerous idea indeed: the Supreme Court decisions that many Christian conservatives want to see nullified rendered such by the stroke of a legislative vote and President’s signature. If you cannot see danger behind this idea, you are in need of a serious education. Further this bill, if passed into law would prevent future cases in Federal courts involving these topics, and would render these decisions inapplicable to the States and State courts.
Thankfully this bill is likely to suffer the same fate it has in Congresses prior: a silent death at committee.
Now Perry v. Schwarzenegger is still relatively new on the jurisprudential landscape, but it’s making its way through the appellate process. The other cases I’ve provided above are examples of established jurisprudence. And Dr Paul thinks that this can be ended with an ordinary act of Congress? And I thought Perry’s ideas for amending the Constitution were dangerous.
While it is certainly great that Ron Paul wants to bring this country back to the original scope of the Constitution, I think he needs to brush up on a few things.


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Gerald Parker, Sr
Gerald C. Parker Sr. has been practicing law since 1958. He is married to Jean B. Parker, and together they have six children, eight grandchildren, and three great grandchildren. Gerald graduated from UNC-Chapel Hill, A.B 1954 and JD with honors 1957. He has written a book of poetry, developed a shopping center, residential and industrial subdivisions, ran for political office, organized a savings and loan association, and now divides his time between practicing law in Greensboro and his farm in Asheboro.
by Gerald Parker, Sr
With sexual intimacy a thing of the distant past Joe faces what for him were life and death issues after prescription drugs caused his libido to spring alive causing his dilemma. How he solves that dilemma is revealed in the play.

domain: literature


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In 2005 Carina Werderitsch had the idea to change her career path forever. While designing jewelry in Italy, she began thinking about the tradition of Swedish wooden clogs and the traditional craftsmanship behind her favorite pair of clogs.
She admired the Swedish craftsmanship of her clogs, and the work that went into making each pair, but she wanted to modernize them. She wanted to hold onto the same quality of craftsmanship while creating a specially-made, quality shoe for all women to enjoy wearing.
She wanted to make them unique with bold colors and different styles while also making them comfortable by designing a different sole and using quality materials. Fortunately, as Werderitsch decided to begin designing shoes rather than jewelry, clogs were about to make a big revival in the fashion industry.
Calou Shoes uses the best leather, suede, and nubuck materials that can be found to create stylish, brightly colored, and comfortable shoes that every woman can spend the entire day wearing without becoming uncomfortable. The flexible polyurethane soles add Calou Shoes’ comfortability by absorbing shock while walking rather than the traditional Swedish wooden sole that clogs have always been associated with.
Every pair of Calou clogs are handmade to ensure the quality and uniqueness of each pair so that every woman feels as if that pair of clogs was made specifically for them. Ranging from the traditional clog style, to high-heels, to boots, Calou Shoes has completely modernized the Swedish clogs while still holding true to the tradition behind the shoe.
The Shoe Spa proudly introduces Calou Shoes as an international shoe company that their clients will soon fall in love with. “We are passionate about our shoes,” says Werderitsch, “And we hope you’ll be as happy in them as we are!”


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Opportunities Exist to Strengthen Collaborative Mechanisms along the Southwest Border
Published: Jun 27, 2014. Publicly Released: Jun 27, 2014.
U.S. Efforts in Northwest Africa Would Be Strengthened by Enhanced Program Management
Published: Jun 24, 2014. Publicly Released: Jun 24, 2014.