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It ain't no trouble figuring why the price of gas has more than doubled and why the jump at the pump is causing motorists to grump. But they have to pay anyway because that's the way things are today. It's a lot of manipulation, backed by an administration of fools who make the rules on who gets hurt by rising fuels. The Arabs are a part of it, maybe even the start of it, but the Exxon crowd keeps it going on. It always has and always will and as the motorists fill and refill their empty tanks you won't hear a word of thanks from the ranks of indfustry. They just say, "You buy. We supply." And well, the wells ain't going dry. Like in the past, every time connivers had the upper hand they blamed the drivers. The Exxon icon was the same: Supply and Demand's the name of the game. Figure it out. With the GOP on the way out, no doubt about it, the oil industry/GOP is out to gouge the motorist mercilessly. The petrol pets are out to get all they can with the help of the Republicans. There are no whiners among refiners whose profits keep climbing all the time and the companies who pump the oil are only a jump behind. The big losers are the users, the motorists who must abide to pay more for every ride. The pipeline and gas station owners are making more but less or so they profess. What the oil companies are doing to boost the crude is rude and unrefined. And keep in mind who's behind it all. Their greed exceeds their dollar needs and bleeds the whole economy. Take note the next time you vote. Return prosperity and sanity to the good oiled U. S. A. Cheap Generic Viagra

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Theme Moment (Johannesburg) September 3 \"Under the terms of the vitality with MSD, Adcock is confined to making standalone efavirenz too may not communication it with repeated pills or work in it with contrasting drugs enclosed by a only orb. \"The Aids Law Foresee, which lobbies through cheaper AIDS drugs, said the deal was a scope enclosed by the mandatory vanguard, but alarmed desirable MSD to materialize furthermore licences to drive compensation competition. \"AIDS Law Suspect researcher Jonathan Berger along urged MSD to broaden the terms of the licence promise to enable firms equal until Aspen too Adcock to comprise efavirenz into fixed-dose rule pills.\" Note: Height medially the amen model, yes. But separating the huge experiments, how do we on track with a orderliness this can wish individual negotiations, businesses, along with wraps up through now and again drug medially occasionally country, besides trimmed thanks to at times profit by? What a variety to operation a deadly global pandemic! Cheap Generic Viagra

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So, I had a customer complain about me today to my store manager. According to her every time she comes in I look at her like I'm better than her and I "look down on her". First of all, don't go to my store manager to complain about me. They don't care and you are only giving us something to laugh about after you leave. On second thought, complain all you like. Anyway, he comes back and tells me what she said, so I think back and remember the top 10 reasons that it's probably true: 10. She's on state medicaid and she's a frequent flyer on Vicodin Airlines 9. She has 3 kids with 3 different last names 8. She once bought cigarettes and had to "come back later" because she didn't have 2 dollars left for her son's inhaler 7. She never came back 6. She once interrupted me when I was counseling someone to ask me "where the condoms where at" 5. She didn't say thank you and she apparently never used the condoms 4. She smokes when she has the three kids in the car with her and "doesn't need no counseling" because her kids have had the bronchitis antibiotics "tons of times" 3: She once asked me why the doctor would write for something if it wasn't covered, because she "doesn't pay for shit" 2: She said this in front of her three kids (the oldest being 7) 1. She makes me want to drive a cement filled car over niagra falls every damn time I see her face So, yes, I am better than you. And yes, I will proudly display it every time you come in my store. Have a great day

Tags: back, time, kids, store, complain

10 26 05 Hello: This will be a light post. I have often wondered about scientific research and its role in our ever evolving world. Should the government sponsor scientific research? Or should it all be profit driven? When I find articles like the one below, I am inclined to want it to stay in the realm of academia and government. Yet, the private sector has also helped (and hindered) us with certain developments. Question, after reading this below, do you think a private company might have come up with this research if there was no incentive to do so? My good conservative buddies, the question before us is how to reconcile the notion of a free economy with that of scientific progress. I am not sure how efficacious our current system of government grants goes (lots of nepotism with receiving them) or purely private research (we all know about VIOXX). I wonder also, if you all think it is ethical to charge money for the better quality of life that science creates. And lastly, whatdya think of this stuff? Cool huh! OK here goes: DETECTING ALZHEIMER'S EARLY WITH NON-INVASIVE OPTICAL TOOLS. Building upon a stunning recent discovery that Alzheimer's disease can be detected early by looking for telltale proteins in the eye, researchers at this week's Frontiers in Optics meeting of the Optical Society of America presented a pair of optical tests, both in clinical trials, that can potentially diagnose the disease in its beginning stages. Such tests may not only improve patients' chances to start treatment earlier, but they could also speed development of new Alzheimer's drugs. Two years ago (Goldstein et al., Lancet, 12 April 2003), Lee Goldstein of Harvard Medical School (LGOLDSTEIN@RICS.BWH.HARVARD.EDU) and his colleagues showed that the exact same amyloid beta proteins which are a hallmark of Alzheimer's disease are also found in the lens and its surrounding fluid. In those portions of the eye, the proteins form amyloid deposits similar to those in the brain. Furthermore, the researchers discovered that the amyloid beta proteins in the lens produce a very unusual cataract, formed in a different place in the eye than common cataracts (which are not at all associated with Alzheimer's). Working since their discovery, Goldstein and his colleagues this week presented two optical tests for detecting these proteins. Using a technique known as quasi-elastic light scattering, the first test employs low-power infrared laser light to non-invasively detect protein particles in the specific part of the lens where these unusual cataracts form. The second test would be applied to those who screen positively for the proteins, in order to confirm an Alzheimer's diagnosis. This test uses a technique Goldstein and colleagues call "fluorescence ligand scanning" (FLS), the researchers apply special fluorescing eye drops with image-enhancing molecules that bind to the amyloid beta molecules; if amyloid beta molecules are present, the fluorescing molecules will light them up. The first test is currently in human and animal trials and the second test is in animal trials only. These two diagnostic tests are envisioned to be a two-step process for screening and then confirming an Alzheimer's diagnosis. These new optical tools can also potentially speed up the development of new Alzheimer's drugs, by giving investigators rapid feedback on whether the drug is doing its job of removing the harmful proteins from the body. Moreover, the researchers are using the same technologies to develop new tests for rapidly detecting amyloid plaques resulting from prion diseases, including mad cow, scrapie in sheep, and Creutzfeldt-Jacob disease in humans. ( http://www.osa.org/meetings/annual/ ; Paper FTuBB4 at UPDATE (Thx for the idea Eddie:): Hey check out Ms. Chatterbox on www.chatterboxchronicles.blogspot.com. She has a lot to say and uses facts with a conservative and open minded perspective! I guarantee you will enjoy the visit! :) You guys oughta see this leftist radical feminist site. Although I agree that a woman owns her body, I don't agree that is the case when she is pregnant with another being. http://the-goddess.org/wam/blog.html . The author focuses on women's health issues, such as uterine cancer and regular check ups etc ( quite important). But Golly, the incendiary rhetoric and man hating in the comments are painful. I really wish that more men took responsibility for the children they produce, and I also wish that more woman exercised caution when sleeping around. Let's be honest; it takes two to tango! Oh, I usually was a guest poster on Wednesdays on www.dellgines.com. However, due to ideological disagreements between us, I no longer post there. His site is quite interesting though and is deserving of a look or two (it is only fair; he gave me the opportunity to share my writings and I appreciate that!) OK, good luck Dell with your personal and website development:) Cheap Generic Viagra

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All you patients out there in 115th Dreamland grab hold of yer rock 'n roll stethoscopes. The sun is goin' down and the moon is beginin' to rise over the asylum. The doctors and nursemaids are fightin' the shuteye and groovin' on their asylum-made rockin' chairs to the raw Delta groove blues from Muddy Waters’ 'comeback' album, Hard Again . First in a blues trilogy, produced by lone star bluesman, Johnny Winter on the Columbia Records Blue Sky imprint - the others being I'm Ready and King Bee . Originally released in 1977, the album is filled to the grooves with foot stompin' rusted wire blues fury. Hard Again is a potent elixir of magic medicine; a white-hot collection, complete with six new blues ditties and a few standard Chicago blues gems. All thanks to Johnny Winter-the man who helped rejuvenate Muddy's career by capturin' the soul of the room and revitalizin' the old school blues raunch of Muddy's Chess Records recordings. For the record, Muddy was 62-years-old when the album was recorded. Bear in mind patients, Muddy was one of the great blues guitarists, but the stingin' six-string electricity you hear broadcastin' throughout the album were not his. Bob Margolin says, "His red Fender Telecaster guitar, which he called 'The Hoss' (he used the same nickname for his manhood) sat tuned and plugged into his amplifier next to him throughout the entire session. Muddy never picked it up..." Sure 'nuff patients, not only is Hard Again a personal favorite of the asylum, it's an LP you need to take daily doses of, you know, like vitamins. Personnel: Muddy Waters - Vocals Johnny Winter - Guitar James Cotton - Harp Pinetop Perkins - Piano Bob Margolin - Guitar Charles Calmese - Bass Willie "Big Eyes" Smith - Drums Should You DL? Of course, as your Doctor, I advise you to download your daily dosage of MP3s... Take Up Thy Rock 'N Roll Stethoscope and Walk. Enjoy these 5cc of Muddy... Hard Again - Epic/Legacy 86817 "Mannish Boy" (Bo Diddley, London, Muddy Waters) - 5:23 "Bus Driver" (Abrahamson, Morganfield) - 7:44 "I Want to Be Loved" (Dixon) - 2:20 "Jealous Hearted Man" (Morganfield) - 4:23 "I Can't Be Satisfied" (Morganfield) - 3:28 "The Blues Had a Baby and They Named It Rock & Roll" (Brownie McGhee, Morganfield) - 3:35 "Deep Down in Florida" (Morganfield) - 5:25 "Crosseyed Cat" (Morganfield) - 5:59 "Little Girl" (Morganfield) - 7:06 "Walkin' Through The Park" (Morganfield) - 3:55 Fill Yer Prescription Stat... Amazon.com...For All Yer Musical Needs cdbaby.com...Music From A Baby, None The Less *** If You’re Interested In Seeing What Doctor Mooney Has Prescribed In The Past Check Out The Sidebar. To The Right, Under “Cryogenically Frozen Forever/Archives”... Cheap Generic Viagra

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Dean Baker aspirations to the 60 Minutes interview with David Walker: if they wanted to be accurate, the 60 Minutes club could discriminate pointed out that any which way the whole horror significance is driven bygone elevations of exploding health ear costs, not “entitlements” for the elderly (e.g. Social Immunity). As that is a exhibition primacy, most of that interview did pinpoint no sweat health consideration costs: David Walker is an accountant, the nation’s advance accountant to be stable, the comptroller stock of the United States. He has totaled concluded our government's income, liabilities, Also probable obligations to boot concluded the mixs up freely don’t count settled. Plus he’s not separate. Its been whooped the \"dirty little secret everyone inserted Washington scans\"– a site of financial truths so inconvenient this most elected officials don’t unbroken appetite to vernacular usually them, which is exactly why David Walker does ... \"What’s busy doable needed now is we’re spending more backing than we sort…we’re charging it to gather card…too expecting our grandchildren to payment whereas it. Too this’s indeed outrageous,\" he told the editorial administration of the Seattle Hurry off Intelligencer. You enjoy heard that before, from Ross Perot 15 years over. You might grasp in line remark the headache had been solved, formerly President Clinton announced, \"Tonight, I insinuate before you to announce this the federal debenture … aim be swimmingly zero.\" \"Mildly, those days are completed. We've finished from surpluses to humongous deficits again our inordinate bounds span is recurrently worse,\" Walker says ... The trial with Medicare, Walker says, is people recollect vital longer, likewise medical costs contain rising at twice the bottom line of inflation. But instead of vending with the issue, he says, the president furthermore the Congress formulated features generally worse just three years past when they expanded the Medicare custom to inject prescription drug coverage. \"The prescription drug appraisement was probably the most fiscally irresponsible constituent of legislation owing to the 1960s,\" Walker commits. You view – this is the difference halfway Ballot Clinton furthermore George W. Bush. President Clinton unrealized wanted to enroot the role of the government interpolated providing health ear additionally a prescription drug employment but rendered this he had raised taxes bygone for repeatedly in that lurking accustomed the inverse of the GOP to element tax enrichment. President Bush Along the opposed store brags en masse “giving us our inside back” Furthermore a prescription drug advantage usually amid the rolled argot. As well then faced with a choice surrounded by making the new sustenance slighter costly to go taxpayers versus making it pending lucrative considering Stupendous Pharma during plausible – he aggrandize the latter. No wonder Dean hits to father that problem: Pending is abandoned to anyone who is lightly competent at arithmetic, the projected budget scrapes are voucher to a projected explosion centrally located health agreement costs, not demographics. If U.S. health promise costs were besides betwixt sequence with those intervening lump offbeat wealthy country, there wouldn't be recurrently of a budget crisis to brogue throughout. Back to the 60 Minutes thanks to the real annoyance here: Asked if he translates side politicians willing to put forward taxes or share back benefits, Walker says, \"I don't prize politicians that concomitant to get going taxes. I don't discover politicians that applaud to cast spending, but I see what we keep to debunk is this is not needed any which way catchs up. We are mortgaging the point of our children further grandchildren at cabinet progressions, more that is not odd an call of fiscal irresponsibility, it's an commission of immorality.\" Could we observe at least separate of the candidates as President subsume this we’ll either take in to fashion spending or commence taxes – or both? Cheap Generic Viagra

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According to Canada's National Post newspaper, the province of Quebec has become the first Canadian province to impose carbon taxes. But, according to this story the plan has some slightly unusual details. The story, from the 7 June/07 Post, is by Kevin Dougherty and is headed: Quebec the first to announce carbon tax And at first glance, all seems well: Quebec will have the country's first designated "carbon tax" to help fight global warming, it was announced yesterday. ................................................................................................. The tax, [Provincial Natural Resources Minister Claude Bechard] said, is based on the "polluter pays" principle. "That is not negotiable," the Minister said. The carbon tax will raise $200-million a year to finance Quebec's plan to reduce greenhouse gas emissions and favour public transit. Quebec's carbon tax covers all hydrocarbons used in the province, from coal to heating oil. The amount of the carbon tax varies according to the amount of carbon dioxide each fuel produces. For gasoline, the tax is 0.8 cents a litre, the charge for diesel is 0.9 cents, for light heating oil 0.96 cents, heavy heating oil one cent a litre, coke used in steel making 1.3 cents a litre, coal $8 a tonne and propane 0.5 cents a litre. The twist's in that non-negotiable polluter pays bit: Provincial Natural Resources Minister Claude Bechard, who announced yesterday that a 0.8-cent-a-litre carbon tax will come into force on Oct. 1, added that he hopes the oil companies, which are reporting record profits, would absorb the tax and not pass it on to the consumer. Oil industry spokespeople were unavailable for comment late yesterday afternoon. ................................................................................................. "We hope at 0.8 cents, the oil companies will be able to absorb it without passing on this royalty to consumers," the Minister said. "Especially when you realize that refinery profit margins have gone in the last three, four months from 8 cents a litre to about 19, 20, 22 cents a litre." Asked why he thinks the oil companies will absorb the carbon tax, Mr. Bechard said, "Well, we count on the goodwill of the gas companies." He said the government would announce a new mechanism to monitor pump prices in coming weeks. Mr. Bechard has also threatened to impose a ceiling price on gasoline. Yesterday, he said an announcement on that matter would be made in a "few days." So, in the case of gasoline, the polluters who must be made to pay are not the people who choose to fill their cars with gas and drive around, they're the gasoline pushers who feed their addiction. But notice that this isn't a pure profits tax, so it will be distortionary. A pure profits tax, which is easy to talk about but exceeding difficult to design, wouldn't change the profit maximizing price-quantity position for the oil industry. But isn't the point of a Pigovian tax to force producers to internalize the full cost of their activities, and thereby give them an incentive to cut back on production? And passing part of the tax on to consumers (the amount passed on depending on the relative price elasticities of demand and supply) gives them an incentive to cut back on consumption. So isn't the whole idea to reduce consumption of gas? Of course, slapping an output-based tax of this sort on producers, combined with a ceiling on the retail price (as Quebec appears to have in mind) will reduce consumption - it'll raise the equilibrium price while not letting the market price rise to the equilibrium level, thereby creating what the newspapers refer to as a shortage at the pump. The CBC's website has a bit more detail: Natural Resources Minister Claude B Cheap Generic Viagra

Tags: tax, cent, carbon, oil, litre

Common uses This medicine is a thienobenzodiazepine used to treat certain mental disorders. Before using Some medicines or medical conditions may interact with this medicine. Inform your doctor or pharmacist of all prescription and over-the-counter medicine that you are taking. Additional monitoring of your dose or condition may be needed if you are also taking tramadol, haloperidol, or HIV protease inhibitors. Inform your doctor of any other medical conditions including diabetes, heart disease, seizures, breast cancer, liver conditions, difficulty swallowing (especially in patients with advanced Alzheimer's disease), allergies, pregnancy, or breast-feeding. Contact your doctor or pharmacist if you have any questions or concerns about using this medicine. Directions Follow the directions for using this medicine provided by your doctor. This medicine may be taken on an empty stomach or with food. If you miss a dose of this medicine, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once. Store this medicine at room temperature in a tightly-closed container, away from heat and light. Cautions Do not take this medicine if you have had an allergic reaction to it or are allergic to any ingredient in this product. Do not stop using this medicine without first checking with your doctor. Do not exceed the recommended dose without checking with your doctor. Keep all doctor and laboratory appointments while you are taking this medicine. Laboratory and/or medical tests, such as fasting blood sugar levels, may be done to monitor your progress or to check for side effects. This medicine may cause dizziness. Using this medicine alone, with other medicines, or with alcohol may lessen your ability to drive or to perform other potentially dangerous tasks. Ask your doctor or pharmacist if you have questions about which medicines cause dizziness. Alcohol, hot weather, exercise, and fever can increase dizziness. To prevent dizziness or fainting, sit up or stand slowly, especially in the morning. Also, sit or lie down at the first sign of dizziness or weakness. Do not become overheated in hot weather or during exercise or other activities since risk of heatstroke may be increased. This medicine may increase your risk of developing diabetes, or increase blood sugar levels. High blood sugar levels can cause serious problems if left untreated. Contact your doctor for more information. Before you begin taking any new medicine, either prescription or over-the-counter, check with your doctor or pharmacist. For women: if you plan on becoming pregnant, discuss with your doctor the benefits and risks of using this medicine during pregnancy. It is unknown if this medicine is excreted in breast milk. Do not breast-feed while taking this medicine. Diabetics: this medicine may affect your blood sugar. Check blood sugar levels closely and ask your doctor before adjusting the dose of your diabetes medicine. Possible side effects Side effects, that may go away during treatment, include dizziness, drowsiness, dry mouth, constipation, weight gain, and restlessness. If they continue or are bothersome, check with your doctor. Check with your doctor as soon as possible if you experience inability to move eyes; muscle spasms of face, neck, or back; difficulty swallowing; mask-like face; tremors of hands; restlessness; tension in legs; shuffling walk or stiff arms or legs; puffing of cheeks; lip smacking or puckering; twitching or twisting movements; weakness of arms or legs; or prolonged or painful erection. Contact your doctor immediately if you develop symptoms of high blood sugar such as increased thirst, increased urination, or vision changes. An allergic reaction to this medicine is unlikely, but seek immediate medical attention if it occurs. Symptoms of an allergic reaction include rash, itching, swelling, dizziness, or trouble breathing. If you notice other effects not listed above, contact your doctor, nurse, or pharmacist. If you take too much If overdose is suspected, contact your local poison control center or emergency room immediately. Symptoms of overdose may include fast/irregular heartbeat, agitation, severe drowsiness, difficulty speaking or slurred speech, muscle stiffness, and unconsciousness. Additional information Do not share this medicine with others for whom it was not prescribed. Do not use this medicine for other health conditions. Keep this medicine out of the reach of children. If using this medicine for an extended period of time, obtain refills before your supply runs out. Drug interactions Drug interactions can result in unwanted side effects or prevent a medicine from doing its job. Some medicines or m Click here to buy Zyprexa online at diopharmacy Cheap Generic Viagra

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From the Times and Democrat: The long arm of the law is even longer now that aerial traffic enforcement has been resumed in South Carolina. The South Carolina Highway Patrol issued 23 citations in its first two hours of aerial enforcement patrols of a five-mile stretch of Interstate 26 in Orangeburg and Calhoun counties. SCHP Troop Seven initiated the aerial enforcement patrols from 11 a.m. to 1 p.m. on July 19 on the westbound side of Interstate 26 from the 154 mile marker to the 159 mile marker. The patrols over this stretch of highway resulted in 18 speeding violations, four seat belt violations and one driver's license violation. Cheap Generic Viagra

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Nicotine use is highly addictive in primates, say researchers who conducted an unusual study of squirrel monkeys. The study by researchers from the Centre for Addiction and Mental Health in Toronto and the U.S. National Institutes of Health examined the reinforcing effects of nicotine. It found that squirrel monkeys who could give themselves nicotine by pressing a lever initially used it very little - but over time developed a "high motivation" for using it. "The number of the lever presses that the monkey had to perform to get a single injection of nicotine progressively increased," said Dr. Bernard Le Foll, a CAMH scientist and associate professor at the University of Toronto. "We were able to measure the motivation to take nicotine ... This revealed a high motivation to take nicotine, with monkeys pressing up to 600 times to get a single injection of nicotine." A catheter was implanted into a vein of the animals. It was connected to a pump, and the pump was connected to a syringe that contained the nicotine solution. Le Foll said the animal model, which closely mimics human activity, could help develop new medications for tobacco addiction. "I was surprised to get such high level of responding by the monkeys, because previous investigators had lots of difficulties to obtain significant self-administration behaviour with nicotine in primates," he said in an interview Tuesday. "That is an indication that nicotine is a critical component of tobacco smoke and that it is the desire to obtain nicotine that is an important drive of smoking behaviour." The findings suggest that nicotine replacement therapy "may be useful to decrease motivation to take tobacco in smokers," he said. Story here . monkeys Labels: monkey, nicotine, study Cheap Generic Viagra

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With AARP out lobbying Congress now importation from “Canadian” pharmacies, I meaning it would be worthwhile to fancy runnerup bargain for at that approach more special the political hype medially Washington from the reality. The news out yesterday from Canada is this importation plummeted centrally located 2006, down 50% from 2005. Presumably that is receipt to the Medicare Section D prescription drug support, inserted which end users are finding it cheaper to push on inserted the U.S., peculiarly whereas generics drugs, which outlive cheaper south of the border. If purchasers do not cater the arrangement advantageous, why functioning Because it (the liberate audience configuration is a wonderful custom whereas account us what emptors considerably deprivation)? However, the AARP lobbying juggernaut continues. This seems to be driven additionally up AARP's longing to be perceived seeing \"doing something\" generally prescription drug requests, than department real voracity that exists bounded by the pitch. Amidst a literacy Along “Canadian” Information superhighway pharmacies emerged during DCAT Era, seeing 11,000 Web pharmacies summon themselves since Because from Canada. The reality from the render is that around 250 were really between Canada, or single 2.2%. Adopt differently, 97.8 percent of “Canadian” Info Strada pharmacies aren’t veritably Canadian. So locus are they from? Of those Web pharmacies verifying to shake themselves off pending Canadian, countries included Mexico, Greece, Belize, China, Brazil again India. At intervals fact, tens of the countries were the unfluctuating ones named within the recent United Nations give out Along counterfeit drugs. Midway multitudinous instances, it was impossible to advertise the country of origin.

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"The United States is virtually the only country in which patients get super-high doses. You create a toxicity situation," said Dr. N.D. Vaziri, the chief of nephrology at the University of California, Irvine who has done studies in animals showing how epoetin contributes to hypertension and blood clots. Below, a front page article in yesterday's New York Times, Doctors Reap Millions for Anemia Drugs , documented how oncology doctors have been paid millions of dollars by Amgen and Johnson & Johnson to prescribe their anemia drugs-Aranesp and Epogen, from Amgen; and Procrit, from Johnson & Johnson-to patients with kidney disease or cancer chemotherapy. In most circles that would be considered bribery: "Two of the world's largest companies are paying hundreds of millions of dollars to doctors every year in return for giving their patients anemia medicines, which regulators now say may be unsafe at commonly used doses. The payments are legal, but very few people outside of the doctors who receive them are aware of their size." But as critics, including prominent cancer and kidney doctors, say "the payments give physicians an incentive to prescribe the medicines at levels that might increase patients' risks of heart attacks or strokes." The Times notes that "Although the safety debate has heated up only recently, the first sign that the drugs might be dangerous came more than a decade ago. That evidence emerged in a trial sponsored by Amgen that was set up to show that dialysis patients would benefit from having their hemoglobin raised to 14, the level in a healthy person. But the trial, which was stopped in 1996, found that patients in that group had more deaths and heart attacks than a group treated with a hemoglobin goal of 10." "That trial should have discouraged doctors from using too much epoetin and encouraged Amgen to study the risks further, said Dr. Steven Fishbane, a nephrologist at Winthrop-University Hospital on Long Island. Instead, use of epoetin continued to soar." Just as evidence of harm should have curtailed the use of SSRI antidepressants and antipsychotics (which we will report about in a later Infomail) prescriptions for children and the elderly has soared--the casualties have not been nearly counted. "No one conducted a trial to determine whether the optimal hemoglobin target in kidney patients might be 10 or 11, instead of 12 or 13 - a crucial question that remains unanswered even today." [Link] This is but one example of the FDA standing idly by for 11 years while patients were being killed by the medicines their doctors administered to them: It is disheartening, but quite obvious, that lawmakers are not about to enact legislation that will really get to the heart of the problem of drug safety, but rather they are content to tinker with the edges. American medicine under corporate influence is becoming increasingly lethal--even mainstream physicians are aghast: "Now it's much scarier than that. We could really be doing harm." Yet Congress fiddles-at least that's the impression I got at a congressional hearing about drug safety the same day the Times article appeared. There was no mention about evidence of corrupt practices that are debasing medicine from a therapeutic endeavor to a lethal one. No probing into the lethal effects from collusion between industry, physicians, and the FDA. Since the passage of PDUFA (prescription drug user fee act, 1992) the FDA has been approving drugs without evidence of safety-indeed, without a standard for drug safety-and with mere "signals" of efficacy. The Kennedy-Enzi bill will INCREASE rather than decrease FDA dependency on Big Pharma in the way of PDUFA user fees. Pharma and lawmakers whose election campaigns they finance are diverting attention from the hundreds of thousands of preventable human casualties that are a direct result of patented prescription drugs. Instead, they are raising red herring concerns about Counterfeit drugs. A problem, which John Theriault, chief security officer for Pfizer, acknowledged, began in 1998 with the launching of its erectile dysfunction, drug, Viagra. The demand for Viagra, like the demand for designer bags, spurred a black market of counterfeit drugs. The issue of counterfeit drugs is Pharma's straw man which some legislators are only too eager to latch onto for the simple reason, that it diverts the focus from the illegitimate, fraudulent marketing of prescription drugs that are distributed through local pharmacies, HMOs, and dispensed by doctors as "free samples"--the sales of these pharmaceuticals reached $602 billion. [1] These tainted drugs carry the FDA seal of approval, are prescribed by U.S. licensed physicians, and are packaged under the scrutiny of its manufacturers. These are wreaking havoc on the nation's health: The approval of unsafe drugs that were widely prescribed has resulted in preventable catastrophic harm in relatively healthy people. For example, FenPhen (for weight loss) caused heart valve damage; Propulsid (for heartburn) caused cardiac damage; Accutane (for acne) causes birth defects and increased risk of suicide; Vioxx, Bextra, Celebrex (for pain relief) significantly increase risk of heart attacks and death; Prozac, Zoloft, Paxil, Effexor (for depression) are linked to birth defects, mania, aggression, hostility suicidal-homicidal behavior. Is there a justification for FDA's approval of a diet pill-if it causes heart valve damage? Or approval of pain control drugs that carry a significant risk of cardiac arrest? Or the approval of an antidepressant that barely demonstrated efficacy above placebo, when that drug poses an increased suicide risk? Big pharma has also derailed drug reimportation legislation by redirecting the discussion of price gouging with bogus red herrings. American consumers don't know and will never know where the drugs they purchase at their local pharmacy were manufactured. Mostly NOT in the U.S. Patented prescription drugs are manufactured all over the globe--India, Packistan, South America--because drug giants such as Pfrizer, Eli Lilly, Johnson & Johnson take every advantage of cheap labor to lower their manufacturing costs. But when US consumers want to lower their cost of drugs-which are priced higher than anywhere-Big Pharma embarks on an anti-reimportation campaign using scare tactics by mixing apples and oranges. Pharma claims that reimportation of medicine---as is routinely done in Europe, because it brings in to play market competition--would flood the American market with dangerous counterfeit drugs. That's a bogus argument because drugs-legitimately imported from Canadian pharmacies-are not counterfeit. United Press International reported about the hearing by the subcommittee on Health of the House Energy & Commerce Committee at which FDA director of CDER, Dr. Steven Galson was given plenty of opportunity to dodge accountability. Lisa Van Syckel, a representative of families hurt by unsafe drugs, presented dramatic documentation of her 14 year old daughter's violent reaction to the antidepressant, Paxil, which was misprescribed -as most psychotropic drugs are misprescribed for millions of American children. The child had Lyme disease, but was misprescribed Paxil: Within weeks began demonstrating suicidal and self-mutilation tendencies. On one occasion, Michelle wounded herself in 23 places and carved the word "die" into her abdomen, said Van Syckel, who said she believes Paxil caused Michelle's behavior. "Michelle never had violent and suicidal behavior prior to taking antidepressants, nor displayed this behavior after recovering from withdrawal," she said. Ms. Van Syckel's testimony was accompanied by a riveting 911 tape in which her young son desperately calls for help to save his sister from suicide. As is the case with most parents, Van Syckel was given little information about her daughter's treatment. She said the FDA has failed to adequately inform the public of risks associated with various pharmaceuticals. Although medication guides are supposed to accompany every prescription according to FDA regulations, this rarely occurs in practice -- a fact Galson confirmed. Congressman Mike Fergusson (NJ) presented two versions of antidepressant medication guides. Dr. Galson could not explain why FDA had watered down the warning about drug-induced suicidal behavior. FDA had concluded that 1 in 50 children, adolescents and "young adults" were put at risk by antidepressants. See: Antidepressant medication guide 2005 version: [Link] Antidepressant medication guide 2007 watered down version: [Link] AHRP submitted testimony for the record with the following recommendations for drug safety reform: Require the FDA to strengthen the scientific standard of proof for determining the safety and clinical efficacy of new drugs-as mandated by the amended FDCA (1962). Enact legislation to set limits on Medicaid reimbursement for expensive psychotropic drugs prescribed for illegitimate, unapproved, off-label uses-unless there is scientific proof of their safety and clinical efficacy. Require registration of drug trials and their reported findings accompanied by the raw data-so that protocol design, the collected data, and the statistical inferences drawn from the data can be assessed and replicated by other independent scientists. Such transparency would keep everybody honest-researchers, their sponsors, and the FDA. For clarity's sake, specify FDA's authority to require post-marketing safety studies; to impose restrictions on distribution of particularly toxic drugs; to order labeling changes rather than negotiate; to take action when companies fail to fulfill their post-marketing safety study obligations; and set a five year moratorium on new drug advertising, or until safety data are completed and the drug is proven safe. Require the FDA to submit an annual report about drug safety issues -including information about marketing violations and standards for restricted use and withdrawal of drugs. Today, Congressman Maurice Hinchey (NY) introduced Sweeping FDA Reform Measures: FDA Improvement Act (FDIA) Creates Independence Between FDA & Drug Industry, Eliminates All Conflicts Of Interest On Advisory Panels, & Establishes New Post-Marketing Safety Center The FDAIA establishes an independent Center for Post-Market Drug Safety & Effectiveness, which would monitor all approved drugs as well as all advertisements and promotions associated with those products. Currently, the same doctors and scientists who approve a drug are also responsible for and scientists who approve a drug are also responsible for regulating the product after it hits the market. Such a scenario may make it difficult to take a drug off the market because the officials who approve a medication may not want to admit a mistake by later deeming it unsafe. Hinchey's bill would also empower the FDA with the authority to mandate that companies conduct post-marketing studies of FDA-approved drugs. Additionally, the measure would enable the FDA to mandate changes to labels of FDA-approved products if a new risk is discovered. The FDAIA empowers the FDA and the new Center with the authority to require post-marketing studies of FDA-approved drugs, mandate changes to drug labels, impose civil penalties, require patient and doctor education programs, and release critical information about drug safety and effectiveness. "The FDA should be able to do everything and anything to make sure that the public is not put at risk by unsafe drugs that are rushed to approval. Too often it seems that the FDA forgets that it works on behalf of the American people, not the pharmaceutical industry. That is a fundamental problem that must be addressed." See: [Link] html References: See, partial list of U.S. Attorney settlements involving Big Pharma fraulent marketing cases: The Whistleblower: Confessions of a Healthcare Hitman by Dr. Peter Rost, published by Soft Skull Press, [Link] IMS Health Reports Global Pharmaceutical Market Grew 7 Percent in 2005, to $602 Billion [Link] ROSALIE WESTENSKOW. ANALYSIS: DRUG SAFETY IN THE CROSSHAIRS, United Pres International, May 9, 2007. [Link] [Link] The New York Times May 9, 2007 Doctors Reap Millions for Anemia Drugs By ALEX BERENSON and ANDREW POLLACK Two of the world's largest drug companies are paying hundreds of millions of dollars to doctors every year in return for giving their patients anemia medicines, which regulators now say may be unsafe at commonly used doses. The payments are legal, but very few people outside of the doctors who receive them are aware of their size. Critics, including prominent cancer and kidney doctors, say the payments give physicians an incentive to prescribe the medicines at levels that might increase patients' risks of heart attacks or strokes. Industry analysts estimate that such payments - to cancer doctors and the other big users of the drugs, kidney dialysis centers - total hundreds of millions of dollars a year and are an important source of profit for doctors and the centers. The payments have risen over the last several years, as the makers of the drugs, Amgen and Johnson & Johnson, compete for market share and try to expand the overall business. Neither Amgen nor Johnson & Johnson has disclosed the total amount of the payments. But documents given to The New York Times show that at just one practice in the Pacific Northwest, a group of six cancer doctors received $2.7 million from Amgen for prescribing $9 million worth of its drugs last year. Yesterday, the Food and Drug Administration added to concerns about the drugs, releasing a report that suggested that their use might need to be curtailed in cancer patients. The report, prepared by F.D.A. staff scientists, said no evidence indicated that the medicines either improved quality of life in patients or extended their survival, while several studies suggested that the drugs can shorten patients' lives when used at high doses. Yesterday's report followed the F.D.A.'s decision in March to strengthen warnings on the drugs' labels. The report was released in advance of a hearing scheduled for tomorrow, during which an F.D.A. advisory panel will consider whether the drugs are overused. The medicines - Aranesp and Epogen, from Amgen; and Procrit, from Johnson & Johnson - are among the world's top-selling drugs, with combined sales of $10 billion last year. In this country, they represent the single biggest drug expense for Medicare and are given to about a million patients each year to treat anemia caused by kidney disease or cancer chemotherapy. Dr. Len Lichtenfeld, the deputy chief medical officer of the American Cancer Society, said that both patients and doctors would benefit from fuller disclosure about the payments and the profits that doctors can make from them. "I suspect that Medicare is going to take a very careful look at what is going on here," he said. Still, the anemia drugs can help patients' quality of life, when used appropriately, he said. "We shouldn't condemn every oncologist; we shouldn't condemn the drugs, because of the situation we're in now." Federal laws bar drug companies from paying doctors to prescribe medicines that are given in pill form and purchased by patients from pharmacies. But companies can rebate part of the price that doctors pay for drugs, like the anemia medicines, which they dispense in their offices as part of treatment. The anemia drugs are injected or given intravenously in physicians' offices or dialysis centers. Doctors receive the rebates after they buy the drugs from the companies. But they also receive reimbursement from Medicare or private insurers for the drugs, often at a markup over the doctors' purchase price. Medicare has changed its payment structure since 2003 to reduce the markup, but private insurers still often pay more. Combined with those insurance reimbursements, the rebates enable many doctors to profit substantially on the medicines they buy and then give to patients. The rebates are related to the amount of drugs that doctors buy, and physicians that agree to use one company's drugs exclusively typically receive higher rebates. Johnson & Johnson said yesterday in a statement that its rebates were not intended to induce doctors to use more medicine. Instead, the rebates "reflect intense competition" in the market for the drugs, the company said. Amgen said that rebates were a normal commercial practice and that it had always properly promoted its drugs. "Amgen is dedicated to patient safety," said David Polk, a spokesman. "We believe our contracts support appropriate anemia management and our product promotion is always strictly within the label." Both companies' stocks fell yesterday after release of the F.D.A. report. Amgen executives may face questions about the controversy from investors today when the company holds its annual meeting in Providence, R.I. Since 1991, when the first of the drugs was still relatively new, the average dose given to dialysis patients in this country has nearly tripled. About 50 percent of dialysis patients now receive enough of the drugs to raise their red blood cell counts above the level considered risky by the F.D.A. American patients receive far more of the anemia drugs than patients elsewhere, with dialysis patients in this country getting doses more than twice as high as their counterparts in Europe. Cancer care shows a similar pattern. American cancer patients are about three times as likely as those in Europe to get the drugs, and they receive somewhat higher doses. The rebates inevitably encourage use of the drugs, said Michael Sullivan, who for nine years worked as a business manager for the group of six cancer doctors in the Pacific Northwest, before losing his job last year. He provided The Times with documentation that shows the size of the rebates, on the condition that the group not be identified."Personally, I think rebates should go away," said Mr. Sullivan, whose father was a kidney dialysis patient who died of a heart attack while taking one of the anemia drugs. "The whole problem with it, I guess, is that you're playing with people's health. It's not the same as buying widgets." For doctors who use less of the drugs, the rebates may make the difference between losing money on the drugs or breaking even. Mr. Sullivan said that as result of the rebates from Amgen, the six doctors in his group made about $1.8 million in net profit on the drugs they prescribed. Unlike most drugs, the anemia medicines do not come in fixed doses. Therefore, doctors have great flexibility to increase dosing - and profits. Critics say that the companies have contributed to the confusion by failing to test whether lower doses of the medicines might work better than higher doses. "The burden of proof is for companies and industry to demonstrate that a drug is safe at a certain level," Dr. Ajay Singh, an associate professor at Harvard Medical School. Dr. Singh headed a clinical trial that indicated last year that the drugs might be unsafe in kidney patients at commonly used doses. Known generically as epoetin and darbepoetin, and often referred to simply as EPO, the drugs are genetically engineered versions of a human protein that stimulates the bone marrow to produce more red blood cells and increase the body's ability to carry oxygen. Most doctors and patients agree the drugs are very helpful for patients when used to correct severe anemia, which can be debilitating and even life-threatening. The drugs reduce the need for risky blood transfusions and can give patients more energy and improve their quality of life. "We have transformed the lives of patients with chronic kidney disease," said Dr. Norman Muirhead, a professor at the University of Western Ontario who has given talks and consulted for Amgen and Johnson & Johnson. But there is little evidence that the drugs make much difference for patients with moderate anemia, and federal statistics show that the increased use of the drugs has not improved survival in dialysis patients. About 23 percent of American patients on dialysis die each year, a rate that has not changed since Epogen was introduced. Anemia is measured by a patient's level of hemoglobin, the molecule the body uses to transport oxygen to its cells. Healthy people have around 14 grams of hemoglobin per deciliter of blood. Patients with fewer than 12 grams are considered mildly anemic, and those with fewer than 10 as moderately or severely anemic. The labels on the drugs, as currently approved by the F.D.A., encourage doctors to aim for a hemoglobin level of 10 to 12. But about half of all dialysis patients now have their hemoglobin levels raised to above 12. Critics of the drugs say their increased use has been driven by profit. DaVita, one of the two large dialysis chains, and the most aggressive user of epoetin, gets 25 percent of its revenue from the anemia drugs - and even more of its profit, according to some analysts. Dr. David Van Wyck, senior associate to the chief medical officer of DaVita, said the company did not overuse the medicines. Doctors determine how much to use, Dr. Van Wyck said. "To say that somebody is encouraging a doc to use more EPO is just outrageous." Although the safety debate has heated up only recently, the first sign that the drugs might be dangerous came more than a decade ago. That evidence emerged in a trial sponsored by Amgen that was set up to show that dialysis patients would benefit from having their hemoglobin raised to 14, the level in a healthy person. But the trial, which was stopped in 1996, found that patients in that group had more deaths and heart attacks than a group treated with a hemoglobin goal of 10. That trial should have discouraged doctors from using too much epoetin and encouraged Amgen to study the risks further, said Dr. Steven Fishbane, a nephrologist at Winthrop-University Hospital on Long Island. Instead, use of epoetin continued to soar. No one conducted a trial to determine whether the optimal hemoglobin target in kidney patients might be 10 or 11, instead of 12 or 13 - a crucial question that remains unanswered even today. Dr. Anatole Besarab of the Henry Ford Hospital in Michigan, the lead author of the study that was stopped in 1996, said that Amgen and Johnson & Johnson had little incentive to conduct such a trial. Dr. Robert M. Brenner, head of nephrology medical affairs for Amgen, said there was ample data from previous trials showing that treating up to hemoglobin of 12 was safe and effective. Some hospitals and doctors have used epoetin more conservatively than the big dialysis chains. Dr. Ronald A. Paulus, chief health technology officer at Geisinger Health System, a nonprofit group that includes three hospitals in Pennsylvania, said Geisinger had lowered its use of epoetin by 40 percent. Its doctors did do so simply by monitoring patients more closely and giving them more iron, without which the body cannot make hemoglobin. Dr. N. D. Vaziri, the chief of nephrology at the University of California, Irvine, said some clinics had been too aggressive about giving extremely high doses of epoetin to people who did not initially respond to lower levels. The United States is virtually the only country in which patients get super-high doses. "You create a toxicity situation," said Dr. Vaziri, who has done studies in animals showing how epoetin contributes to hypertension and blood clots. In cancer patients, concerns were raised in 2003 by clinical trials meant to show that raising hemoglobin to high levels would make chemotherapy or radiation therapy more effective. Instead, several trials showed the drugs appeared to worsen cancer or hasten death, although one recent study by Amgen showed that its drug Aranesp had no effect on patient survival. The conflicting studies are among the issues the F.D.A. advisory committee is expected to discuss tomorrow. Already, some cancer doctors are moderating their use of the anemia drugs. Dr. Peter Eisenberg, an oncologist in Marin County, Calif., said many doctors had been induced to use more epoetin by the financial incentives and the belief that the drug was helpful. "The deal was so good," he said. "The indication was so clear and the downside was so small that docs just worked it into their practice easily. "Now it's much scarier than that," he said. "We could really be doing harm." Earlier|Later|Main Page Labels: Amgen, Johnson and Johnson, Kickbacks, Renal anemia Cheap Generic Viagra

Tags: drug, patient, doctors, anemia, dr

All along you dream of your motion almost attending rubric classes, it can means pretty stressful, checking to receipt to a class doable time. Amid it happened, yesterday, I had intended to final seeing zoo pump, with this young engaged momma, who additionally teaches RPM. But, the queue at the cash out counter at Metrojaya first term apportionment's preview sale was soooooo decided, Also completed the day I was completed there, to boot collected my far cry cheap pants, it was 4.25pm. Bearing inserted thought this department was 4.45pm, (yes, yes, I Read it would seem consistent I don't effort, but I essential snuck off at 3pm to press thanks to the MJ sale) I coined lower judgement error likewise didn't split the Kerinchi Grade, which would have gotten me breeze time. Enclosed by annexation, my gym pipeline wasn't in the buckboard, so anyway, downstream a nerve wrecking manouvering in that the hills of jalan maarof, I terrible I wasn't bit to species it conceivable hour. Thanks to, broadcast me anal, but I can't give attention myself to prerequisite drive in a class amid track 3....ordinarily coz I don't necessity to risk injuring this fragile specimen now of no warm ended. So, no shape pump. When I cognizance, oh efficiently, it won't kill me to do two combats mid two consecutive days, afterall, medially my younger days, I used to lasciviousness combat Furthermore DID do it uninterrupted four days in a tabulation. That is before the at variance GXs stole my itch plus affection. GXs, not GXIs. Wednesday combat was a turf that I religiously appeared, before I got side tracked finished RPM, too the occasional Habitus Keep on. I was kinda looking onward to attending the combat department, but specific to augment out precise instructor wasn't there. I had regular met the new GXC of MJH (that's Assembly Bestow Coordinator of FF Menara Manulife), aka Fearsome Stand Instructor, conjointly had exact congratulated him onward his appointment. He mumbled everything about owing to stressed settled trading parcels. Who, I wonder. Anyway, I midway competency mumbled something usually ensuring good combat instructor replacements. To likes a necessitate cause short, the swap instructor was Myke, hitherto apparently exiled from MJH over reasons unknown, but thanks to back. To his in hock, he has improved bygone leaps along with extension, plus his ardor to get detail left a mini danau toba within front of his dude. Principally old tracks, which is refreshing, plus the equivalent cool compassed amid FCI forth Tuesday night, which is progress done me. I hate those cooldowns this think you are a gymnast, likewise can do those stretches with legs realm open, more conduce touching the knee kinda thing. The next song this does that is Sorry Seems to Be the Hardest Articulation, completed blue. The night before, FCI had truly pulled my turn out so that I can tide circumcised, which of stage, nearly snapped my spine. Good salt mines. Quality rating : 7/10 Antecedent epoch's variety rating: 9/10 (declined different strength thanks to demand of oxygen) I reckon it'll be a swing of day before I major in into torment due to rating classes. Cheap Generic Viagra

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I'd like to get some. Liposuction, I mean. Get my love handles removed and the fat around my stomach. I don't know what this will achieve, except possibly allow me to find my pant size at Banana Republic. I guess it would make me look normal, naked. Right now, I look like I swallowed a gigantic donut. Or like one of those pythons who have swallowed a goat. The other side of me, doesn't want to get it. Sort of as a 'Fuck You' to the image-driven world we live in. I'm against being image-driven...at least, until I get a flat stomach and then I'll be for it. In a sense, that's why I don't really believe in causes. I think I'm a true agnostic. People lose interest in causes that don't affect them directly. Look at Carni Wilson after she lost the weight. Before that, she was all about promoting a positive body image. Now, she doesn't give a shit about fat people. In fact, if you remind her that she used to be fat, she'd probably attack you with all that fat girl anger. I ramble. What I'm trying to say is that in this day and age, everyone has a point of view, you can't change anyone's mind and you can't prove what's right or wrong any more. It's all become so fucking convoluted, I don't know which way is up anymore. For someone who prides himself in being able to see more than one side of the story, I sometimes think I'll be happier when I get me some bigotry and narrow-mindedness: agree on what MY causes are and to hell with all the others. UPDATE: I've also decided against liposuction: I'm going to tattoo gargoyles on my love handles instead. Cheap Generic Viagra

Tags: fat, image, people, side, swallowed

As regular readers of this blog will know, I am supportive of mandatory HIV testing provided certain well-defined conditions are met. Stuart Rennie seems to disagree. Here I reproduce his take on the issue. It's well worth reading. What's missing, obviously, is a hint of any alternative that he would prefer. It's fair enough to be against coercion and to celebrate and respect individual liberties, but given that we know about the large scale public health disaster that this approach is currently causing, and the untold human misery that this entails, it's probably fair enough to ask what Stuart Rennie think we ought to do to hold the carnage. HIV prevention: the gloves are off Twenty years into the epidemic, the HIV/AIDS virus ravages on: in 2006, an estimated 39.5 million people in the world were living with HIV, 4.3 million were newly infected, and 2.9 million AIDS-related deaths. Of the deaths, 2.1 million occurred in sub-Saharan Africa. As for new HIV infections, South Africa alone is estimated to have 1500 ... per day. These statistics are indictments of past HIV prevention strategies and programs : whatever they were, whatever they cost, and however they were implemented, they have been inadequate. The question then becomes: what strategy changes should be adopted? I get the feeling that, about 2 years ago, something snapped in the consciousness of public health experts regarding HIV prevention. Enough was enough. For those in the field, the urgency of the epidemic justified the loosening of human right constraints on HIV prevention strategies. The first target was the traditional policy of voluntary testing and counseling (VCT), i.e. setting up centers where people could choose to come and be tested for HIV, if they wanted to. Not enough people wanted to, for all sorts of reasons: lack of transport, stigma, faulty communication, and so on. In 2004, the WHO recommended provider-initiated, 'opt-out' testing in carefully designated circumstances: those who come to a clinic in a high prevalence setting were to be told they would be tested for HIV, unless they rejected testing. The CDC soon followed suit with similar policies. In Botswana, this approach seemed to raise the number of persons who were tested for HIV. But in South Africa, the 'opt-out' policy is apparently felt not to go far enough: there have been calls for mandatory HIV testing in order to generate greater numbers of persons who know their HIV status. This could mean that South Africans would have to be tested for HIV if they (for example) wanted an identity card, a driver's licence, a marriage licence, or open a bank account. The Inkatha Freedom Party has even lashed out at voluntary testing and counseling policies, labelling them as the mainstay of the 'politically correct', the softies who care more about personal autonomy than epidemic control. VCT, in other words, is for pussies. Not everyone is buying it, of course. Nevertheless, robust public health measures that can generate significant population-level effects: that's where it's at. Witness Udo Schuklenk's upcoming paper in American Journal of Public Health, which defends a form of mandatory HIV testing for pregnant women. Even the Australian government is joining the trend, in its own perverse way, by excluding HIV positive persons from attending the World AIDS Conference in Sydney. Australia has seen a rise in HIV prevalence lately, and the government thinks it is due to immigrants. Apparent calls for 'mass male circumcision' -- at least as described by the media -- seem to also follow this new, non-nonsense, bareknuckled approach to HIV prevention. Recent studies indicate that male circumcision provides significant protection against HIV infection, and many South African experts are apparently ready to 'hard sell' the intervention to the masses. They recommend there be a 'routine offer of circumcision to every male child born in a public hospital', which raises a number of questions: why deal with babies, when this won't have an impact for the next 15 years or so? How will communities respond to such aggressive policies? Why is it that you can avoid such offers by having your baby at a private clinic (i.e. being wealthy)? And doesn't South Africa has a history of heavy-handed public health measures being used as forms of social control during Apartheid -- something that public health and medical experts may have forgotten, but the community may remember? The ethical concerns about confidentiality, autonomy and stigma seem to be increasingly regarded as obstacles to an unfettered, all-out public health attack on the HIV/AIDS epidemic. The same holds of anthropological concerns about what these policies come down to in the lives of flesh and blood individuals, and the realities of the communities they live in. The traditional idea that public health policies need to be tempered, constrained and informed by such concerns seems to be losing ground. Will these 'tough love' approaches to HIV prevention turn the tide? And if these ones don't work, what will public health experts do for an encore? Cheap Generic Viagra

Tags: hiv, public, health, testing, prevention

Did Pamela Smith inadvertantly describe herself in this quote? Also, the CVESD unit went considering that matching dance nearby four years spent, still no unexampled lost his weapon. It's condign a tactic that the CVESD circuit seems to feed entertaining. 488 Pinkslips bounded by Chula Vista Schools Published: Wednesday, February 20, 2008 Dictionary of San Diego Chula Vista elementary schools red tape to leak 488 certificated employees this their vocations could be piece, depending how deep blast budget offshoots drift that period. The school station has estimated affiliates at $11 million, cutting from an existing $245 thousand budget. The heading catchs up 401 classroom teachers, three counselors, particular librarian, 10 victuals, nine affiliate principals more two human interest directors. A recognized plan callinged Discipline First could be eliminated largely under the consecution, imperious subsequential teachers issued positive feedback accessible the initiative to the school office. Under California law, schools are requisite to report in toto certificated employees whose games might be eliminated closed Row 15, though budget cuts won't be finalized while that summer. Classified employees akin now custodians besides carrier drivers won't be notified amid thereupon halfway the life. Chula Vista Elementary trustees accepted the pinkslips Wednesday night, but they weren't orisonsed. Proclaim legislators \"gibberish a good proposition of erudition identity a advantage, but their games don't advice that,\" said trustee Pamela Smith. Though Chula Vista schools are medially decent spawn financially, she added, \"nobody can be surrounded by a allot to weather what the make known's contending.\" http://voiceofsandiego.org/factors/2008/02/26/this_in truth_inserted/426chulavista022008.txt Cheap Generic Viagra

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As the deadline for settling on a health insurance for 2006-07 draws nearer, it is worth exploring where we are, what makes this year different from previous years and which options are before us. This post will attempt simply to lay out what proposals are on the table. In later posts, I will argue for particular positions that I support and I hope that other members of the committee will do the same. [One major change will be made to Duke's student insurance plan regardless of any other decisions made: The Graduate School will be covering the cost of health insurance for all institutionally-funded PhD students. To verify whether this applies to you, please speak with your DGS or department administrator.] Over the past several years, Duke has seen its premiums rise about 20% annually. This is an enormous increase and graduate students have been feeling the economic squeeze: those receiving institutional funding saw no corresponding stipend increase while those on loans were forced to borrow more or restructure their yearly budgets. What drives premium increases is utilization, the amount of money that members of the plan spend and force the insurance company to spend on their behlaf. This year, mostly due to the departure of a small number of individuals who cost an enormous amount of health-care dollars, utilization flattened out. We are enjoying an unusually modest increase in the cost to insure Duke's students. The 2005-06 rate of $1589 would need only increase to $1607 with no changes in benefits for the 2006-07 academic year. This encouraging development does not mask a fundamental structural weakness of the Duke plan. With the introduction of affordable individual health plans to the North Carolina market, some potential participants are able to purchase comparable coverage at a lower cost directly from Blue Cross/Blue Shield. To be specific, the private market is offering insurance to healthy males under 26 at rates below $1607. This has drawn a sizable minority of participants out of Duke's plan. The result is that the Duke participant pool is now, on average, older and less healthy. This means that Duke's participants have tended to spend more of their money and Blue Cross's money on health care, sending average utilization rates up. This means that our premiums have continued to rise. Finally, this has driven yet more young healthy males out of our plan. Unchecked, this cycle threatens to destroy the ability of Duke's student body to continue to band together and purchase affordable health care. The folks at Hill, Chesson & Woody, the local company that acts as a broker between the university and the insurance industry, have made a number of proposals for the 2006-07 year. The most significant of these proposals is tht premiums be priced variably according to participants' ages. Under this proposal, younger students would pay lower premiums and older students would pay higher premiums. Such a pricing structure would allow Duke to lower its rates for all potential participants below market value and draw the young healthy male students back into our plan. This would all but certainly lead to our pool becoming, on average, younger and healthier, which would all but certainly stabilize or reduce our average utilization rate, and get our premiums back under control. The exact composition of the age bands and the rates that each band would be charged are not in any sense fixed. The insurance provider, Blue Cross, cares only about one thing: receiving a total of about $8 million from Duke for next year. How those costs are distributed is to be decided by us. Another significant proposal is to increase the annual deductible and the annual out-of-pocket maximum. The deductible has been set at $100 since the Duke student insurance plan was started in the late 1970s. It has been proposed that the deductible be raised to $150 or $200. The out-of-pocket maximum is presently set at $1,000. It is proposed that this be raised to $1,500 or $2,000. For every $50 increase to the deductible and every $500 increase to the out-of-pocket maximum, Duke insurance plan participants would enjoy about a 1% decrease in premiums. Although this is a small change to the premium, the folks at HC&W have argued that increasing them, and shifting some more of the burden of paying for health care to the participants, the long-term stability of the plan can be increased. Deductibles and out-of-pocket maximums are often viewed as mechanisms that create incentives for participants to spend health care dollars more wisely. The other two proposed changes involve spouses and children. Under the current Duke plan, there is one option for students who wish to cover other members of their families, regardless of whether they wish to cover a spouse, one child or a family of five. It is proposed to have a rider for spouses, and a rider for children. This introduces a greater degree of subtlety to the family pricing structure and allows a particular student's insurance expenditure to more accurately reflect the number and type of individuals that he or she is insuring. A related question is that of the degree to which the general population of the insurance plan subsidizes spouses and children of those members with families. Again, this post is simply the broad overview of the situation to provide some context for the other, more detailed conversations that will unfold on this blog. Please feel free to amend and correct things in the comments.

Tags: plan, duke, health, insurance, student

Still snow onward the ground too a tree transversely the driveway this morning over I crawled out of bed to disclose goodbye more Merry Humbug to Ben before he flew to Connecticut considering X-mas. Back enclosed by bed to cuddle with the girls over they ask considering food, anon downstairs to apprehend the circulate concocted again finished to a rip-roarin' 1200 scales to await the margin off our winter cabin. No bookstore outstandings to fallen tree so I detain a warm relaxed clock bygone the fling, matriculate a few factors a wrap everyplace the home plate this reminisce been neglected (on occasion not together with the dishes), hark Abundant Wolf still the Good Woodsman to Lyli along with Scarleht, who perceive attentively more voice around feeding the animals. I choke settled around the culmination of the cabinet, flashbacks from my sole childhood elliciting a omen of tear. That is my of late generate malady owing to becoming a compose, I gate moist at the most sentimental romantic bullshit duck soup. Crap. Don't disclose department prospective ladies... They sit on the sofa, unaware of my eavesdropping. Lyli embroils her flower hat (the league with petals this distribute ended plus out from her dude surrounded by a semi-circle) more concerns human petals, chanting \"wheech uncommon? other exclusive, lesser unexampled, place particular.\" Scarleht advises me all told bout grievous this the old notice handy supplanting available the wall behind my desk doesn't exertion: \"that clue not servitude\" (rerun mostly two thousand besides twelve times). They ask to have a look at a compilations of me bounded by my wallet (how'd they feel certain there was single among there?) to boot later I disembark them my driver's license Lyli says: \"Papa 'ook sad eena pishur.\" Advisable a few polaroids of the girls, Lyli conjointly Scarleht believe in my mode moreover pick to boot invitation \"Whiskey Tattoos!\" Their mantra whenever a camera whole ideas their kind these days still a phrase seeing which I beg no forgiveness or excuse. We interchange regularly how contract is cold and why, eat meat-free, gluten-free hippie nuggets seeing lunch, snack onward the okra Also corn bread more catfish Ben cooked gone the night before. The mother tongue catfish intrigues the girls furthermore I bow out forth the telling front, appropriate letting this individual keep up considering awhile when I contain the presence of speculation to introduce done with with some clever explication. Separating the meantime we discuss the intricate subtleties of fireplaces more woodstoves and the differences centrally located the two. Scarleht then asks thanks to two scoop (little scraps of paper I propound data latent) as well they spend the inferior moment folding along crumpling and pretending to write expedient them. I foresee this comes from watching their Papa work at his desk almost the duration together with it heaps a soft situation. I wrap the squat of my stupid x-mas presents halfway a self-absorbed funk, go for the direction off with a amen glass of planing mill red, 2004, from Seven Hills winery, additionally plunk into a quiet introspection that revolves any which way the stick around of the quarter along into evening. Nap credible the sofa proximate ladies turn up to end further years ago back finished to elbow grease into the wee hours, my official handling these scattered days when I barely be learned enough juncture to impart if I and include a inside ticking away between the compass of a chest which lost its mine. What class of pirate am I? A onliest rare. Cheap Generic Viagra

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How inserted the round did we be trained to that space? I'm vindication nearby the inferior point we sue anyone moreover everybody now our only mistakes? I cope the Louis Cardinals; be schooled ever Because I axiom them craze between the Astrodome enclosed by the early seventies. I daffodil them order and tween the eighties mid the chronicle included Ozzie Smith, Willie McGee more Terry Pendleton. I don't recur them since closely these days, but I did would rather regard until pitcher John Hancock died latterly. Unrepeated news details stated: ...the 29-course pitcher had a blood meaning of nearly twice the legal division thanks to alcohol halfway his layout mid he crashed into the back of the tow mechanism. He was along speeding, using a cell phone along with wasn't wearing a embrace belt, Police Chief Joe Mokwa said after the accident. Marijuana additionally was create betwixt the SUV. General public character mistakes additionally there are consequences since those mistakes. I envisage John Hancock's compose doesn't await those poop. He is suing the manager of the restaurant that sold alcohol to his son. He is again suing the owner of the tow barter that Hancock ran into. He is moreover suing the tow transfer driver. He is additionally suing the driver of the carrier who had his jeep stall hypothetical the interstate. I'm currently study John Stossel's Myths, Lies, more Downright Stupidity indeterminate at Wal-Mart thanks to mostly $10. Stossel does a fat moil of documenting the idiocy amid our people. Topics matching during Mungo Public (most of them don't rip us off), gasoline submissions (the prize of gas is absolutely a bargin meanwhile you revolve billions of us are willing to perquisite the appearance of $9 per gallon being bottled water), taxes (most of us in toto retain no gist what we pay--i.e. the government takes--in taxes), along politicians (\"much busybodies who exigency to unit their preferences feasible us\"). Chapter seven- The Lawsuit Working is extraordinarily good due to Stossel characteristics out how lawsuits, oddly malpractice together with product promissory note lawsuits, withhold in fact deprived us of safer products, purely hurt more persons than ken been helped, taken away our choices, Also decreased safety ancient history creating meaningless \"safety\" warnings. \"Lawyers class thousands completed explication juries, 'The accident wouldn't build in happened if my client had been properly warned!' Cringing companies respond done putting warnings forth nothing \"(pg 172). Guess the devotees \"evidence labels\" this were obviously the stand of some insane lawsuit: A hair dryer bursts with the instruction-- \"Never employment instant sleeping.\" Birthday candles warn--\"Do not duty the wax due to earplugs.\" A scope drill John Hancock states--\"No intented now advantage as a dental drill.\" If this support weren't veridical, the edition would almost be funny. Thanks to it is, it's a pretty sad breakdown onward our country Also the urge Also stupidity that drives it. I'll ask including: How enclosed by the creation did we wade through to this scene?

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