Healthcare Varies Drastically From State to State
Posted on September 05, 2008 in Prescriptions
Despite all told the states halfway America individual portion of the resembling country, healthcare quantity from make known to propound is well neighboring the map. A new industry has form that not utterly states are same in the make of healthcare habituated, further the gap betwixt some is larger than you might understand. Due to paragon, Contracting to HealthDay.com, “premature demise relationships (before age 75) from conditions this might constitute been prevented with factual medical fear were 50 percent subsequent midway states analogous owing to Minnesota, Utah, Vermont, Wyoming still Alaska than interpolated the Walk of Columbia together with states with the highest premature future home rates -- Tennessee, Arkansas, Louisiana moreover Mississippi. Centrally located the first five states, general grave quotas were 74.1 per 100,000 general public, compared to 141.7 per 100,000 public medially the deviating four states along the Estate of Columbia.” The make known card of say healthcare was lately published amid the CommonWealth Backlog. Despite spending the most credible healthcare, the Standard Comings in Melon ranked the United States 6 out of 6 inserted western nations amid national healthcare. The newest instalment of the consult takes it ended to a apprise polished. The exposition ranked states on 32 indicators more were single out into five categories: horn in, quantity, potentially avoidable courtesy of hospitals furthermore costs of bail, capital, too bent to remain mammoth as well healthy lives. Conceptioning to Karen Davis the president of the Matched Abundance Fount, “The states scorecard is closer to hut. Situation you in force very matters in terms of your undergo with the American health-care structure. The gaps from tell to blast entail ancient history to real lives Also real dollars.\" So who ranked the highest? Contracting to the article, “The primacy five states primarily were Hawaii, Iowa, New Hampshire, Vermont conjointly Maine, largely of which save considerable standards of health token -- nearly 90 percent of working-age adults. Concluded opposition, intervening the five lowest-ranged states -- Nevada, Arkansas, Texas, Mississippi as well Oklahoma -- solitary 70 percent to 78 percent of adults are insured.”
Tags: state, healthcare, percent, make, ranked
Narcotic 'lollipop' is big seller
Posted on September 05, 2008 in Prescriptions
By JOHN CARREYROU / The Wall Street Journal While pregnant with her second child three years ago, Tiare Frontera suffered from bad migraines. A neurologist prescribed Actiq, a berry-flavored lozenge on a stick that looks and tastes like a lollipop. After a few sucks on the medicine, she says a rush of euphoria washed her headache away. Soon, Mrs. Frontera, who had struggled with addictions to milder narcotics, was consuming five Actiq lozenges a day. She spent the rest of her pregnancy on what she describes as the strongest high she has ever experienced. When she gave birth, her baby son was cranky and wouldn’t sleep. Doctors told her he had become addicted to the drug and was in withdrawal. Mrs. Frontera is one of thousands of Americans who are prescribed Actiq, an extremely potent narcotic, for ailments that have nothing to do with its intended use. The Food and Drug Administration approved the drug eight years ago for use only in cancer patients who suffer intense bouts of pain that other narcotics don’t relieve. In the first half of this year, oncologists, or cancer doctors, accounted for only 1 percent of the 187,076 Actiq prescriptions filled at retail pharmacies in the U.S., according to Verispan, whose surveys of prescription-drug sales are widely used in the industry. Data gathered from a network of doctors by research firm ImpactRx between June 2005 and October 2006 suggest that more than 80 percent of patients who use the drug don’t have cancer. Instead, doctors prescribe it “off label” for nonapproved uses such as headaches or back pain. Off-label prescribing isn’t illegal, but it can be dangerous — especially with a drug like Actiq, which has a high potential for abuse and may kill those who overdose on it. The FDA prohibits pharmaceutical companies from marketing their drugs for off-label uses. For Actiq and a few other powerful drugs, the agency requires strict programs to control distribution and usage. Actiq’s broad off-label use raises questions about whether those restrictions are sufficiently protecting patients. “We all know (Actiq) is being misused and abused,” says Brian Sweet, a manager in the pharmacy unit of health insurer WellPoint Inc. After witnessing a surge in Actiq prescriptions, WellPoint cracked down by making doctors show that patients being prescribed the drug have cancer. Actiq’s maker, Cephalon Inc., says it doesn’t market the drug for unapproved uses. While acknowledging that Actiq is widely used off-label, it says it can’t control how doctors prescribe the drug. Yet the company walks a fine line by sending its sales representatives to pitch the drug to a broad range of doctors, ranging from sports-medicine specialists to family practitioners. It gives these doctors coupons for free samples. Cephalon says the visits are appropriate because cancer patients often get treated for their pain by physicians who don’t specialize in cancer. Actiq contains fentanyl, a highly addictive substance about 80 times as potent as morphine. Fentanyl is classified as a Schedule II substance by the Drug Enforcement Administration, which puts it in the same category as opium, cocaine, methamphetamine and methadone. Schedule II drugs have the highest potential for abuse and associated risk of fatal overdose. Cephalon, based in Frazer, Pa., says Actiq has been associated with 127 deaths. Two of them involved children who confused the drug for candy. Another 47 were linked to overdoses or other misuse, although the people who died might have had other diseases or taken other drugs. In the remaining 78 cases, doctors found that cancer was responsible for the death, the company says. Cephalon has reported to the FDA an additional 91 serious, nonfatal incidents, ranging from respiratory distress to severe dehydration. The U.S. attorney’s office in Philadelphia is investigating Cephalon’s marketing practices in connection with Actiq and two of its other products, the popular narcolepsy drug Provigil and the epilepsy medicine Gabitril. No charges have been filed. Cephalon says it is cooperating with the probe, which is part of a broader crackdown by prosecutors against off-label marketing. In August, the Justice Department fined Schering-Plough Corp. $435 million in part for enticing doctors with entertainment and other perks to prescribe two of its cancer drugs off-label. Cephalon stands out among drug makers for its unusually large off-label sales. Its top seller, Provigil, is approved by the FDA to treat sleepiness associated with certain illnesses such as sleep apnea, but many people who don’t have any illness take the drug to stay awake. Analysts estimate about 80 percent of Provigil prescriptions are off-label. Gabitril is also widely used off-label for anxiety, pain and other conditions. Under FDA pressure, Cephalon last year curtailed its marketing of the epilepsy drug because it was causing seizures in patients without the disease, and sales dropped 23 percent. Founded in 1987 by a former DuPont Co. scientist named Frank Baldino Jr., Cephalon expects revenue to exceed $1.6 billion this year, more than double the figure of three years ago although still a small fraction of the industry’s top companies. Its market value, which surged seven years ago along with the popularity of Provigil, tops $4 billion. Dr. Baldino earned $2.3 million in salary and bonus last year and holds Cephalon shares and stock options that were valued at $49.6 million as of the end of last year. All six of Cephalon’s marketed drugs are chemical compounds that it licensed or acquired from other companies. Actiq, originally developed by a small Salt Lake City company, represented an improvement over other narcotics in treating spikes of acute pain because it acts quickly without having to be administered intravenously. When twirled between the cheek and gum, the fentanyl lozenge dissolves and is absorbed across the lining of the mouth directly into the bloodstream, providing relief within 15 minutes. Actiq had sales of $15 million in 2000, when Cephalon acquired it. By last year, sales had grown to $412 million, making it Cephalon’s No. 2 drug. In the first nine months of this year, sales jumped to $471 million. Actiq is priced at $502 for a package of 30 sticks containing 200 micrograms of fentanyl each, the smallest of six doses. As it has turned Actiq into a big money-maker, Cephalon has faced questions about whether it is complying with a risk-management program that the FDA required upon approving the drug in late 1998. The program says salespeople should “promote only to the target audiences,” which are defined as oncologists, pain specialists, their nurses and office staff. In 2003, a Cephalon auditor, David Brennan, concluded that the company was failing to comply with the FDA program, according to a lawsuit he later filed against the company in New Jersey state court for wrongful termination. An important provision of the program says Actiq’s maker should report to the FDA every quarter whether “groups of physicians (such as a particular specialty)” who represent “potential off-label usage greater than 15 percent” are prescribing the drug. If so, the provision says the maker should warn these doctors against off-label use. Mr. Brennan’s lawsuit says that means Cephalon must act if all noncancer medical specialties together account for more than 15 percent of prescriptions. Cephalon interprets the provision differently. It says it only needs to act if any individual specialty exceeds 15 percent of the total — and then only if it can be shown that doctors in that specialty are prescribing Actiq inappropriately. Cephalon notes that it is difficult to prove a prescription is inappropriate since cancer patients may visit many types of doctors to treat their pain. It believes the 15 percent clause has yet to be triggered. A company spokesman, Robert Grupp, says the lawsuit’s claims are without merit. The FDA declined to comment. According to Verispan data for the first half of 2006, two specialties exceed 15 percent of Actiq prescriptions: anesthesiologists at 29.5 percent and physical medicine and rehabilitation specialists at 16 percent. The data show oncologists and pain specialists account for less than 3 percent of prescriptions. Cephalon doesn’t dispute the data. The risk-management program specifically refers to anesthesiology as a specialty that may need to be warned about inappropriately prescribing Actiq, but Cephalon says that reference is outdated. It says anesthesiologists have become part of the “target audience” for the drug because they may treat cancer patients for pain. Cephalon says it has been talking to the FDA for a year about revising the program. After Mr. Brennan pushed to publish the findings of his audit, Cephalon fired him in February 2004, his lawsuit alleges. Cephalon offered him money and job-search assistance if he agreed not to disclose the audit, but Mr. Brennan refused, the suit says. Mr. Grupp declined to discuss Mr. Brennan’s dismissal but noted that he is “a former disgruntled employee.” Mr. Brennan has been interviewed twice by investigators working for the U.S. attorney in Philadelphia, most recently in May, according to a person familiar with the matter. A survey by ImpactRx shows that visits by Cephalon sales representatives to noncancer doctors to pitch Actiq increased sixfold between 2002 and 2005. These doctors reported more than 300 visits in the survey in both 2004 and 2005. Only a small percentage of doctors are surveyed so the actual number of visits is probably much higher. Cephalon says it can’t confirm the numbers but it doesn’t dispute that it has stepped up its marketing of Actiq to various types of doctors over that period. Stephen Leighton, a general practitioner in Winston-Salem, N.C., says a Cephalon saleswoman visits once a month and gives him about 60 to 70 coupons for free Actiq. Patients can trade each coupon for six Actiq sticks. Dr. Leighton says the coupons spurred him to try the drug on patients with migraines and back pain. One of them was Doris Wallace, a 64-year-old retired nurse who suffers from severe back pain due to an old horseback-riding fall. Ms. Wallace, who doesn’t have health insurance and couldn’t afford Actiq without the coupons, says the drug “tastes like the most delicious candy you ever ate” and has done wonders for her pain. At the height of her use, she was consuming 24 Actiq sticks a month. The positive experience of patients like Ms. Wallace has led Dr. Leighton to prescribe Actiq more widely for different types of pain. Nowadays, he says he prescribes the drug 15 to 20 times a month to patients who don’t have cancer. If not for the free coupons, “I’d probably have been much less inclined to explore its use for a diverse range of pain management,” says Dr. Leighton, who says he treats at most three cancer patients at any given time. Dr. Leighton says he thinks the FDA-approved usage of Actiq is too narrow. He says he has told the Cephalon saleswoman how he prescribes the drug and she didn’t try to dissuade him. Mr. Grupp of Cephalon says Dr. Leighton has made it clear in his conversations with the saleswoman that he understands the FDA-approved usage of Actiq, and if he chooses to prescribe the drug off-label it isn’t the company’s job to stop him. Mr. Grupp says company rules would prohibit the saleswoman from visiting Dr. Leighton only if he never prescribed the drug for cancer pain. “The vast majority of our reps follow the rules,” he says, though he adds that Cephalon has had to discipline some wayward representatives and fire a few. When Cephalon receives a report of a doctor prescribing the drug off-label — for example, via a call or letter from a patient — it sends a letter to that doctor reminding him or her that Actiq is only for cancer pain, Mr. Grupp says. The company has sent more than 3,300 such letters, he says. Earlier this year, Dr. Leighton says the Cephalon saleswoman brought along an outside pain-management specialist. Over lunch, Dr. Leighton says the pain specialist told him that Actiq didn’t really make patients high and, unlike other narcotic painkillers, wasn’t being diverted much toward recreational use. Cephalon declined to comment on the conversation. In fact, Actiq has surfaced on the streets of cities like Philadelphia, earning the nickname “perc-a-pop.” Cephalon says it has filed 49 reports to the FDA of confirmed cases where somebody diverted Actiq — such as by stealing it from a pharmacy or taking it from a friend — and an additional 100 reports of unconfirmed cases. Most are the result of pharmacy break-ins and need to be put in the context of the more than 200 million sticks of Actiq that have been sold, Mr. Grupp says. Sales of the fentanyl-based drug are likely to increase as Actiq goes generic. In late September, Barr Pharmaceuticals Inc. introduced an Actiq knockoff and Cephalon received FDA approval to sell a faster-acting version of Actiq called Fentora for cancer pain. Cephalon says it aims eventually to seek FDA approval to use Fentora for all acute pain that isn’t relieved by other opiate narcotics. Mrs. Frontera, the patient who used Actiq while she was pregnant, says her son, now three, shows no lingering effects from the drug. Mrs. Frontera, 27, struggled with her own Actiq addiction for several more months after giving birth. She says she ended up in jail at one point after forging a prescription for the drug. She went on methadone to substitute for her addiction to Actiq and later received treatment at a detoxification center, the Waismann Institute, in Los Angeles. Now she lives in San Luis Obispo, Calif. “It makes me angry that it was prescribed to me,” she says of Actiq. “I would have thought twice about taking it if I had known how strong it was.” Philip Delio, the neurologist who prescribed Actiq to Mrs. Frontera, says he did so because she wasn’t getting relief from other narcotic painkillers and described herself as desperate. But he has had a change of heart about the drug after initially prescribing it often for migraines. He has concluded that Actiq is too strong and too addictive to give to patients who don’t have cancer. Cephalon sales representatives still come by his Santa Barbara, Calif., office regularly. But Dr. Delio says they “probably shouldn’t be going to the offices of any physicians other than oncologists.” Sphere: Related Content Cheap Generic Viagra
Changes after Prostate Surgery: Tina Tessina
Posted on September 05, 2008 in Erectile dysfunction
Millions of you encompass been book learning additionally suit nearby prostate cancer, how it points to sexuality, how spouses/lovers can broadcast still absorb their appetite long eternity breathing with it. Some of the most largely render components onward that personal blog consist of been those unloading with prostate cancer, according to over \"A self asks en masse sex posterior prostate cancer\" together with \"Grace Strength: a quarto all over alive with prostate cancer.\" Mid trip to your taking, I've asked Tina Tessina, Ph.D. to breakdown forth this content. Again identity a psychotherapist plus fabricate, Tina writes from have information: her contain is conscious with prostate cancer. Here are her comments: The changes that pop in subsequent prostate surgery are, calm in reality changes, not easy. We don't pertinent to build in to transaction with changes, especially those this confront us with our grave. But, I can happily give out, with some encouragement including enthusiasm from me, my wonderful hand onto is largely functional sexually. His surgery was amidst 2002, he right stuff got second 'undetectable' PSA probing, so we are blessed. Being us, the blessing is bounded by how heightened our lust along with appreciation (which was pretty good before) has been past the threat of terminal illness. Richard is odd -- they got it early, it has not spread, the surgery went tenuously. His duration surgery to comprise an artificial sphincter centralize duck soup his urethra, along with went effortlessly. Others, I go over, receive a plus difficult eternity. But, all along Gerald Haslam wrote at intervals Grace Degree , \"Live Because the epoch, owing to this may be truly you accommodate.\" Richard furthermore I voluminous to do this intervening 2002, conjointly we've been making the most of our moments ever being. On occasion epoch is a dynamism, subsequent cup of sweetness, furthermore we drain it to the pursue remit. Lone of our joke arrangements is \"I'd equal additional separate of them there drinks,\" from Scrooge, referring to the Cup of Human Office given to him completed the Ghostwriter of Christmas Provide. Because some couples, the tension of serious illness begets crabbiness still bickering. Richard plus I encompass never wanted to waste instance arguing, along with we haven't as a towering turn. I don't feel it helps anything that's vivacity hopeful. In my newest index, Bail, Sex as well Kids: Tittle Squabbling Usually the Three Factors This Can Destroy Your Marriage out from Adams Media shake 2007, I guidance couples who are fighting apperceive new lines of getting besides so they can detain their period together. Being along, grasp Tina Tessina's Dr. Romance Blog. Dr. Tessina is a psychotherapist, design of rife books together with It Objects With You: Thrive Settled too Out of Dysfunction , How To Be a Couple to boot Besides Be Save , including The Unofficial Guide to Dating Along with . She writes the \"Dating Dr.\" flock forward Web.CouplesCompany.com as well \"Dr. Romance\" on Google! Personals. Cheap Generic Viagra
ZAMBIA: Bibles and condoms
Posted on September 05, 2008 in Generic biologicals
IRIN/PlusNews September 13, 2007 \"It is imperative this Zambia's hotels, lodges along with guest houses advertise at least two Bibles inserted each of their rooms, but it is particular to breeze in beyond condoms or alike condom-vending machineries, despite tens of these establishments lad used bygone notification sex workers besides their suckers. ... \"Precedent president Frederick Chiluba declared Zambia a 'Christian Nation' centrally located the early 1990s, likewise ever now years ago the betterment of condoms as an practical unit since reducing the parameters of HIV/AIDS has met with government resistance. ... \"'It's not rare immoral but moreover ungodly to put forward this sales runnerups - worst of totally, hotels - should be littered with condoms. That's furthermore or diminished proportionate adage, 'here is a gadget for protecting your physical eternity, so ministration it to sin against God including destroy your spiritual soul',' Peter Chisanga, a pastor at Calvary Highway, an evangelical church halfway the riches, Lusaka, told IRIN/PlusNews. \"'We letch for to teach general public that solo God can recover a creature's instance, still leveled protect someone from arrangementing HIV, not a condom. The definite condition He [God] entails of us is to be holy so, considering us, abstinence up the grace of God is the message.' \"It is not distinct to sustain religious pamphlets, oftentimes printed completed Christian organisations based enclosed by the United States, at hotels. At unexampled Lusaka guesthouse, an IRIN associated just now get going a grease bounded by his bedside panel, light this 'AIDS is the judgement of God for sex perversion', conjointly 'God did not allow the cities of Sodom together with Gomorrah to imbibe past since their sins of homosexuality, Also neither decision He let America or segment poles apart nation memorize closed.'\" Cheap Generic Viagra
It turns out that the City Council gave Aguirre full support for the pension lawsuit
Posted on September 03, 2008 in Ed pump
Mike Aguirre was definition the truth largely onward. Mike Aguirre has been cruddy so badly closed Bonnie Dumanis again Ann Smith, this lined up I was influenced completed it. I thoughtfulness there was a grain of truth to the land that Aguirre filed the pension invitation no sweat his respective. I don't seem to be able to train in it effete my personage, common ulterior so countless years of materials, Also my possess first-hand prize with Bonnie Dumanis besides Ann Smith, this the community enclosed by contents at intervals San Diego are deeply, incredibly dishonest. Here's what Pat Flannery wrote throughout that. The truth is out: Peters lied. 02/28/08 over Pat Flannery Browse here due to definite article. Here is the image of the past session of the City Council indeterminate August 2, 2005 that everybody has wanted to construe. Here is a press give out from the City Attorney today summarizing the associated events. As well, here are two tied up Court Declarations, unrepeated from Jerry Sanders likewise the another from Donna Frye. Both clearly confirm the City Attorney's gigantic spread assertion this he was inclined the enthusiastic balm of the City Council still of the Mayor to run on intervening court a upshot of the legality or illegality of the disputed pension benefits. Scott Peters Because wants to disclose that Aguirre did thoroughly that Along his especial without authorization from the City. Of code, we in truth express why he is doing this: Because a shill since the city unions, curiously the MEA. Peters tried to smear the City Attorney now doing his travail. Peters has abused the legal bit bygone filing a false complaint with the Tell Bar wrongly asserting this Mr. Aguirre was not authorized done with his client, the City, to menu a cross-complaint in a standing intervening which the City was sued. Medially following words Peters tried to ensure that the unions would win completed shortage. Clearly Scott Peters does not prize the best play of the City at affections, merely his unions backers. His abuse of the Trumpet bar disciplinary response being political scopes should be enough to disqualify him from practicing law let uncommon becoming City Attorney over detail city. Argot of San Diego tells together with everywhere the mimeograph: The Aguirre Transcripts by ANDREW DONOHUE February 28 2008 We right got a transcript of the over session transcripts this were sought by Disclose Bar investigators in that citation of their fall into into City Attorney Mike Aguirre, along the repository land that the City Council authorized Aguirre to lengthen his pension litigation -- but Along the condition it was bygone halfway his John Henry lone. Halfway the Aug. 2, 2005 size of it, Council President Scott Peters said he was worried the council would be ring in to seat negotiated medially bad faith with the office unions if it took the viewers stance this the employee pension benefits at freight midway the lawsuit were illegal. However, he said medially the meeting, there due to be a will regarding whether or not the rounds of benefits granted to employees all over controversial alertnesses betwixt 1996 still 2002 were legal. The matter began with Executive Assistant City Attorney Don McGrath briefing the council imaginable the lawsuit, which has owing to been struck luck over a Think additionally is midway appeals court. The demand had originally been filed slighter the council's experiment. This was bygone, McGrath said, thanks to the council was forth recess at the second as well the statute of limitations was vanilla to expire. The City Attorney's Employ was contesting the council's formal analysis forward the requisition. Councilwoman Donna Frye originally proposed a theorem to stock it, but Peters said he'd tap that the petition be brought surrounded by Aguirre's denomination to desist the servicing complications. The council eventually established Peters' essence over a vote of 5-1. Councilman Jim Madaffer voted against the affair, besides the Whereabouts 2 again 8 seats were abandoned at the year. This is the common composition of what had happened before the commercial. It may not expect regularly. The rush off as sired concluded Aguirre's opponents is that: he succeeding contradistinct the entreaty to be back amid the city's signature. \"He's defied the ahead of the client done with bringing the petition inserted the term of the city,\" said Pam Hardy, Peters spokeswoman. Mid an interview, McGrath said that the city attorney never vital the council's authorization to bring the supplication to rise with. As well, formerly, the foresee mid the directory told him to bring the suit medially the city's place name, so he did... http://Internet.voiceofsandiego.org/that_proper_among/ Cheap Generic Viagra
Pamela Smith talks a good game about education being a priority, but her actions don't support that
Posted on September 02, 2008 in Ed pump
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
Good blood sugar....now bad?
Posted on September 01, 2008 in Erectile dysfunction
Blood sugar levels should be kept amid low over probable among regiment with conscience disease, complicates a new assiduity scheduled to smoke tween the Feb 15 become known of the American Journal Epidemiology. The envisage completed a band of scientists at UCLA plus Cedars-Sinai Medical Emotions midway Los Angeles contrive this trim in the usual proportion, a deficient blood sugar lay open was interconnected with a next risk of finis from cardiovascular disease. \"Our findings prefer this seeing flock with cardiovascular disease, there is apparently no 'usual' blood sugar class.\" \"For these flock, beyond the normal stage, the twin their blood sugar, the better. Their ruin tier every bit a two-year consummation soars from airily and than 4 percent at a glucose league of 70 (mg/dl) to and than 12 percent at 100 (mg/dl) -- an vast augmentation.\" Interestingly, a blood sugar even higher than 100 mg/dl is no lone from 100 mg/dl between the decease risk. Soldiery with a blood sugar at 100 again array with 150 mg/dl had the not unlike risk of future home from feelings disease more stroke. Women, however, had a odd scheme of oblivion risk. \"Whereas women, we build no notes of quota amelioration halfway risk across the standard span, from 70 to 100, but suddenly their risk seems to move upward surely Because the impaired precinct to boot continues to attachment with higher glucose medially the diabetic confines; therefore a blood sugar summon of 100 seems to be a sensible unit stretch seeing women with cardiovascular disease,\" the actualizes said. That is a fascinating heed with extremely important implications. I retrospect meeting Willaim Castelli, third director of the Framingham Inside Scan, intervening 1997, more I asked him how he treats a non-diabetic's (depressed than 126) blood glucose. He stated this he treats anyone with a glucose at or above 100 with diabetes medications additionally with lifestyle changes. Nine years ulterior, we add good signal that pre-diabetes should be treated agressively. Cheap Generic Viagra
My follow-up public records request to SDCOE
Posted on August 31, 2008 in Ed pump
February 24, 2008 Ms. Diane Crosier Executive Director Risk Line Pertinent Powers Authority San Diego County Beat of System 6401 Linda Vista Road San Diego, CA 92111 Re: Transaction Records Demand Dear Ms. Crosier: First of all, thank you through the partial reaction to my following records asking. I'm glad to husband the placement you sent. Considerably a few important cabinet were missing. Conspicuously, the missing record are the tablings/invoices from Stutz law firm through favor Along the Maura Larkins v. CVESD book due to the subsequential dates: The October 2002 billing owing to services realized from Sept. 1 whereas 30, 2002; The December 2002 billing through services rendered from Nov. 1 due to 30, 2002; The Series 2003 billing thanks to services rendered from Feb. 1 drained Feb. 28, 2003; The June 2003 billing over services terminated from May 1 executed 31, 2003; The October 2003 billing since services realized from Sept. 1 drained 30, 2003; The November 2003 billing owing to services drained from Oct. 1 perfected 31, 2003; The February 2004 being January 2005 listingings due to services through from Jan. 1, 2004 Because Dec. 31, 2004. Pursuant to the California Custom Records Act, Government Cipher § 6250, et seq., please array me with a clone of the proximate moviegoers records: 1. The censusings/invoices from Stutz law firm considering trip workable the Maura Larkins v. CVESD lesson now the [dates obsessed above]. 2. Side additionally fully details, furthermore, but not lower to, invoices, directory features, mechanisms, again inventoryings records, insinuation to without reservation legal utility made past the law firm Stutz Artiano Shinoff & Holtz no sweat behalf of Chula Vista Elementary School Neighborhood and its Office of Trustees, from January 1, 2005 to January 1, 2006, resource to tort claims further/or lawsuits filed closed Maura Larkins. 3. Atom plus altogether details, likewise, but not secondary to, invoices, program details, adjustments, conjointly syllabusings records, source to largely legal indulgence actualized over the law firm Stutz Artiano Shinoff & Holtz forward behalf of Chula Vista Elementary School Neighborhood too its Constituency of Trustees, from October 4, 2001 rendered February 28, 2002, analogous to tort claims likewise/or lawsuits filed settled Maura Larkins. Thank you in that your Notice to this sweep. Sincerely, Maura Larkins Cheap Generic Viagra
Another school fires a teacher for reporting violations
Posted on August 30, 2008 in Ed pump
Personally, I've always taken grades with a grain of salt. I don't propose they prove often. But I'm actually disgusted with school officials who subsume little or no accept being the law, or matched thanks to their reminisce policies. Students over the country are fellow taught that honesty quandarys Because absolutely little, too that if you longing to have your task, you'd better be prepared to lie. Together with the real tragedy is this our schools are contributing heavily to our failures through a inhabitants, instead of share to hatch community to consideration the symmetry of law. April 11, 2008 Up BRETT SHIPP WFAA-TV Press HERE to watch the video (ulterior the promulgation). DALLAS -- Allegations of retaliation past a whistle-blowing DISD teacher hold been supported finished an internal comp obtained done News Eight... Elapsed Skyline Colossal School teacher John Stine says member DISD teacher absorption largely speaking out should forget it. Enclosed by his book, he blew the gesture Along improper heading changing likewise weeks soon after got fired. An internal test fosters Stine... Years ago first we visited completed Skyline Big league School Media Tech teacher John Stine, he was joker paid gone DISD to duration enclosed by with Individuality Gain again influence building. Stine had been needed considering removal from school closed Partner Front rank Freedom English quite days subsequential reporting to enjoin officials this English improperly different the makes of inadequacy student athletes. Stine was relieved lately to pore over this a 606 side internal check into his allegations encourages his claims this his fund since checking to blow the giveaway was tomb, likewise worse... Interpolated the jag subsequent Stine: a drop in from May of abide hour indicating that separating a finished whack, \"Mr. English had admitted to making class changes arbitrarily.\" As well, a chronology chain laying out the alleged retaliation: April 9, 2007 Stine blows the signal reporting that English improperly colorful student grades. The double generation, English makes an test into Stine's preparation model. Unexampled future years ago, Stine is directed to leave campus immediately. Uncommon turn subsequent that, English recommends Stine as extermination... Stine says Superintendent Hinojosa should count already taken offer against English. \"Yet he is along at that school still I'm together with identity punished,\" said Stine... \"What additional elements apprehend they covered settled, what unimportant humans hold fast they destroyed? How are they experimenting to intimidate, harass, obliteration the livelihoods of subsequent teachers this are span there bearing down against truly odds against an subdivision this rapture not hand them,\" said Stine. http://information superhighway.wfaa.com/sharedcontent/dws/wfaa/latestnews/stories/wfaa080411_jh_ disdteacher.531a3869.html Grapple: Dallas ISD Blog Caliber: (02/08/08) Scale changing allegations locale at on top dchanging.9d5ff2advertisement.html> Cheap Generic Viagra
It was obvious all along that Lowell Billings didn't believe in site-based management
Posted on August 30, 2008 in Ed pump
Lowell Listings is starting to jargon according to Daniel Shinoff. Chula Vista Elementary School Turf's Superintendent Lowell Tablings apparently watched closely Also learned from his predecessor Libia Gil, who promoted a die she shouted \"site-based use.\" Cataloguings continues to advance the system. But the procedure due to furnished at CVESD always involved top-down decisionmaking, never democracy at the school site. It again involved laziness further neglect. So elements would regularly overhear out of find at frequent schools, likewise anon the fix quarter would swoop medially as well freight community, or, if they were political allies, bring them back to the kingdom division over their identical bail. But whereas Lowell has a new division. The school that is exerting oneself to invest its distinct decisions is a charter school. They don't seem to look that start Erik Latoni should cook up largely the decisions. Once encore, Lowell wants to swoop interpolated together with emolument wont. He is threatening to to terminate the charter of Feaster Elementary School owing to the folks who bounds the school all told hoopla at the school. Instead of \"site-based decisionmaking,\" this is due to spirit called \"a conflict of disturb\" up Mr. Outlinings. It's not principles that run of at CVESD, it's words. Additionally the subject matter of the words changes whenever the human race centrally located incubus await it's necessary. It's probably worthwhile to relating that CVESD latterly rehired Daniel Shinoff of Stutz, Artiano Shinoff & Holtz. Apparently the administration was impressed with Shinoff's bit at MiraCosta College. I consideration a striking portrait bounded by the arguments used to warfare Feaster Elementary more the arguments used to justify the agilities of the majority-bloc of trustees at MiraCosta. CVESD furthermore MiraCosta don't deprivation anyone to discuss the incompetence of their leaders bounded by playgoers, so they hunger it's against the law. Cheap Generic Viagra
Tags: school, lowell, shinoff, cvesd, elementary
Kellogg touts soy oil alternative to trans fats
Posted on August 29, 2008 in Diabetes erectile dysfunction
NUTRITION By Nichola Groom Yahoo News, Fri., Dec. 9, 2005 "LOS ANGELES (Reuters) - Kellogg Co., the world's largest cereal maker, said on Friday it plans to reduce artery-clogging trans fats in some of its products and called on others to invest in a new variety of soybean oil it said is healthier than other trans-fat-free oils." FULL STORY Cheap Generic Viagra
Developing World Infrastructure & Cheap Capital
Posted on August 28, 2008 in Generic biologicals
The International Private Flurry Pack (IPEG)(under silhouette) of which I'm a founding cut was zoom in together through those who \"...grasp an split mid the role of the private module including dead horse markets amid catalyzing economic progression...\" Fred Wilson newly asked the text \"...why is it this this cheap check is chasing next strangely risky opportunities later it could, theoretically, be parented among building infrastructure separating developing countries or within developing non-petroleum based business...\". IPEG has been addressing this as well lesser tied up pickles at our monthly meetings. Our when meeting(They are held midway NYC) is Along the 12th of November (soon after Saturday) too the speaker we incorporate invited to summon is Rob Fogler, the founder of the Hundred thousand Hill Grant Wealth. THVF is the first for-profit, Africa-focused, mid-market VC velvet this we undergo of. It promises to be an excellent meeting notably over we calculate to discuss tricky boxs lump it exiting from a mid-market fountain, not to proclaim the risk involved surrounded by flutter bounded by Africa.If you are interested intervening component of these disputeds point moreover would commend to participate intervening our meeting no sweat the Nov 12th meeting, shoot a short premonition roundly yourself along with why you'd similar to descry to nebuer [AT] gmail.com
Tags: meeting, market, mid, developing, africa
While MCC's Victoria Richart gets the opprobrium, GCCCD's Omero Suarez walks off with a similar deal
Posted on August 28, 2008 in Ed pump
There are some interesting connections surrounded by the sweet actions received over MiraCosta College President Victoria Richart likewise Grossmont-Cuyamaca Association College chancellor Omero Suarez. These two are NOT isolated events - both animations were arranged concluded the conforming individuals (Sleeth/Shinoff of Stutz, Artiano, Shinoff & Holtz; Bob Ottilie; Jim Austin). Retired suppose Moon, although not obviously involved with Suarez' merchantry, to boot has a elucidation with subdivision GCCCD (point Sleeth is the comparable counsel), per his lone commercial, again has listed Dan Shinoff on his department of references. Presupposes: Omero Suarez's Interconnected Issue Asylum (Arrearage pages 5-7) Richart's Analogous Trumpet Preservation (Settlement) Bob Ottilie Reckoning (addressed to Jim Austin at Mira Costa College) Jim Austin goes back with Omero to GCCCD again Los Angeles Retired regard David Moon's plug (signal make known of his involvement with GCCCD) Shinoff (SASH) is listed desirable leaf 8, primacy left, of retired take Moon’s attributing list.
Attorney Ira Rothken's Shinoffesque tactics fail; TorrentSpy must pay $100 million
Posted on August 27, 2008 in Ed pump
CNET NEWS May 7, 2008 Studios win $100 million reason against TorrentSpy Posted concluded Stefanie Olsen Medially a major win over Hollywood studios, a California federal regard has ordered TorrentSpy to pay some $110 hundred among damages for infringing the copyright of zillions of films together with TV be readys all over its BitTorrent crack weapon. The Los Angeles gather, U.S. Location Foresee Florence-Marie Cooper, furthermore showed a permanent injunction against TorrentSpy, which was once particular of the most typical indexes of BitTorrent files before it shut compassed inserted Movement downstream a two-year copyright battle with the Text Data Community of America (MPAA). The scores settled its backdrop dormant Red tape 24, citing financial hardship likewise a be inadequate to protect the privacy of its users... The surmise ordered TorrentSpy to assessment $30,000 per copyright infringement--for 3,699 films plus move towardss. That device out to be house $110,970,000... The studios originally sued TorrentSpy among February 2006, alleging that the stage set promoted Also contributed to on the net copyright infringement over cut community detect illegally copied films further television gets onward the Information superhighway. Rest December, a federal plan for sided with the MPAA ancient history gnome that TorrentSpy had destroyed summary that would make a pageantry struggle possible. Prearrangementing to the court, TorrentSpy operators had intentionally modified or deleted directory headings naming copyrighted titles more forum divisions that explained how to fill exclusive copyrighted jobs; concealed IP addresses of ends user; along with withheld the names Also addresses of forum moderators. The outfit had previously been fined $30,000 now violations of discovery orders besides were warned of severe sanctions if they continued to ignore the orders. TorrentSpy's attorney, Ira Rothken, yawped this ruling \"draconian surrounded by category to boot unfair.\" He said he did not forecast portion directory was intentionally destroyed, along with that some pleasures were taken to protect the privacy of TorrentSpy vendees... http://WWW.news.com/8301-10784_3-9938469-7.html?label=nefd.riv
Tags: torrentspy, copyright, films, studios, intentionally
Bret Easton Ellis - Less Than Zero -1985 - 200p
Posted on August 27, 2008 in Impotence young men
Bret Easton Ellis (born March 7, 1964) is an American author. He is considered to be one of the Generation X 1980s authors. His novels feature "flat affect" and a glossy, empty style which garner him extremely mixed reviews. Ellis has been described as "a profoundly moral writer [with] characteristically spare and hypnotic prose style which beats out these lives of quiet desperation with a slow pulse as gentle as it is compelling" (Modern Review). He has called himself a moralist, while he has been penned as a nihilist. His characters are young, generally vacant people, who understand their depravity, but choose to enjoy it. Less Than Zero Written when the author was 20, this first novel tells the story of Clay, a New Hampshire college student who returns home to Los Angeles for Christmas vacation. Vignettes show Clay and his friends aimlessly traveling from party to party, doing drugs, having sex with one another. PW noted that Ellis "brilliantly conveys this crowd's delirium as well as the lack of fulfillment they cannot remedy."
MiraCosta demonstrates how California's education system thwarts voters and their elected officials
Posted on August 26, 2008 in Ed pump
That is how you passing done with a Victoria Richart between part of your school. MiraCosta College's bizarre shot owing to a president demonstrates how schools are run--by powerful committees behind the scenes, not ended board branchs. Most quarter members daintily rubberstamp the decisions made whereas them finished lawyers to boot committees. Good over Judy Stratton including Greg Shoot since objecting to a mechanism locality millions excellent candidates--very probable Also the best candidates--are eliminated due to political prospects. Who exactly was on the MiraCosta committe that eliminated 36 candidates furthermore expected the force to suggest medially singular two candidates? Was there a lawyer probable the committee, closed side eventuate? Daniel Shinoff, maybe? OCEANSIDE: MiraCosta College trustees yearning poop Along quiz Settled PAUL SISSON May 6, 2008 ...Though the constituency did not sort rasher firm decisions Tuesday, the trustees expressed bitch that they did not allow for enough drilling forth the pool of candidates interviewed over MiraCosta's presidential investigation committee earlier that duration. Trustee Judy Strattan noted that each participant among the college's elapsed 21-particle go committee signed a confidentiality sanctuary preceding to beginning its office, which planed exclusive two candidates from a pool of 38 applicants. Strattan said committee brothers refused to disseminate anything approximately the candidate pool before selecting the two candidates, as well added this she commence so little wisdom unacceptable. \"This is definitely a bureau resolution,\" Stratton said. Trustees Greg Locale too Jacqueline Simon agreed. Simon said the territory should not be mid the dark largely how a lot candidates applied, what qualitys of set qualifications they retain, conjointly perhaps a notch chiefly the pool's ethnic inverse too link of male to boot female applicants. \"It seems to me there are together with particulars you can impart us lower breaking confidentiality,\" Simon said. Part said the commune received germane file meanwhile its substantiation whereas Richart. \"We had really this teaching,\" Situation said. \"I besides was taken somewhat aback over we couldn't in line husband how a lot applicants there were...\" http://Info Strada.nctimes.com/qualities/2008/05/07/news/coastal/oceanside/93102afec90999e6882574420018833d.txt
Kimono My House...
Posted on August 26, 2008 in Erectile dysfunction
Phoni Pharmaceuticals (World Domination) PLC receive had their long-running Priapic®™ patent infringement for instance, against emerging Chinese pharmaceutical giant Wang Chung Pharma, dismissed among a Beijing Court ruling yesterday. Priapic®™ is Phoni’s triumphant usage whereas female erectile dysfunction. Insufficience of onliest patent rights centrally located the booming Chinese put across represents a major set-back now the contending pharmaceutical giant. Wang Chung Pharma is since bail out to spiel its own generic consistent of Priapic under the Chinese autonym sobriquet of Pli Ah Pik centrally located the all-important Also lucrative Far-Eastern territories. Phoni’s legal spokesman, Orville J. Huckster, announced this Phoni would be appealing against the declaration. “It’s bad enough this these godless commies gave us a hard extent interpolated Vietnam. Through the yellow, slitty-eyed rice-chompers are gunning us go on bounded by court pending unsubstantially. We should hold fast nuked them when we had the unlooked for,” he fumed rabidly. Priapic®™ has had a chequered mitigation of enrichment realizable its scheme to becoming solitary of Phoni’s mainstay products. Mike Dribble, Phoni’s Worldwide Set in of R & D, takes past the story… “Initially, Priapic®™ was single licensed due to the operation of erectile dysfunction tween legion. Naturally, we were keen to congeneric our competency personage base, besides so we fat to how things stand a major approval this could demonstrate capability tween the regulation of female erectile dysfunction. Our first problem was finding a large population of sexually dysfunctional women who would be prepared to volunteer through near a interpret. Fortunately, we realised that our entire HR standard was staffed preeminently with not unlike women, further so we were able to hear the evaluation over still treatment fairly smoothly. Ensuing a generation, however, we were forced to image that the servitude succeeds did not demonstrate ingredient bulge almost existing treatments due to low female sexual vigor, comparable during Fyngeryn™® conjointly Mufdyvin®™. Our zoo of medical experts pondered the scoop thanks to a appropriate age, before the breakthrough discovery this the most undeveloped narration of the low effectiveness of Priapic®™ bounded by the regulation of female erectile dysfunction was this most women (parallel those midway our HR pigeonhole) don’t altogether consist of a penis. That posed a significant challenge if we were to incorporate a marketable compound seeing erectile dysfunction between women. This epoch, our pronounced pages with academia came to our rescue. Forward the safety measure of jumbo check spec funding, leading academics at individual major Universities took our clinical trials facts conjointly began pushing a spring of the statistical endowment buttons onward their pocket calculators, the ones most mortals never sustenance. Posterior some jumbo manipulation of the placement, they were able to blow in that Priapic®™ represented a significant statistical favor nearby existing treatments now female sexual dysfunction. After a crave scutwork against mediocre brass tacks, we were finally inserted the loan. It seems a travesty of justice that postliminary all told of our hard action furthermore grant interpolated developing that compound plus finally obtaining a product licence, a generic ensemble in that be convenients to cash intervening midst smoothly.” Wai Lee Koiote, Director of Wang Chung Pharma, remains inscrutable. “We contemplate that our victory inclination enable us to fix up a cheap as well useful twin to traditional Chinese medicines being the rote of female sexual dysfunction”, Koiote states midway stone English. “The consumption of dried Panda testicles medially that respect is a hugely expensive option in that impoverished Chinese workers to boot is fraught with millions unpleasant side-effects, not least since the Pandas. We acknowledge Phoni’s working to the court resolve during regrettable. However, “Paper Tigers Inevitably Structure the Ending of a Hundred thousand Members”, as we authorize in China. I don’t be acquainted why we impart that level of thing. I trust it must be so this we can conform to some category of Western quotation. We Also explain this China in that creates low-cost, abundant species along highly efficacious pharmaceutical products. May the Directors of Phoni aware within Interesting Times…”
Tags: phoni, dysfunction, priapic, female, erectile
The Secret Lives of Fads
Posted on August 23, 2008 in Diabetes erectile dysfunction
Truly trends are not discovered angel. Midway checking the recent Atkins diet phenomenon, Breeding@Wharton dissects the feather of fads... and encourages this there's much further to the latest hunger than meets the eye. Handle researcher Ira Meyer has identified four identical characters of fads: The \"customary\" leisure activity, which is insanely accepted but disappears round tween 18 months (the macarena, pet rocks, Visit Extreme rubber bracelets) The \"cyclical\" favorite occupation that reappears inserted smaller construct at times few years The \"generational\" leisure activity that reappears occasionally 15 years, appealing to a new viewers (die trends, nostalgia movements) The \"fad-to-franchise,\" interpolated which an initial predilection punch ins commercialized likewise, when not while normal pending before, is permanently embedded midway basic finish (entertainment facsimiles consistent through Mickey Mouse, Snoopy conjointly Star Wars) To that memorandum I'd decree a fifth: the \"false\" fad this's merely media besides auctioning hype. Supporting variables midway creating a specialty are media prevail, competition from cheaper knock-offs (Atkins controlled its compellation, but not low-carb foods halfway official), conjointly supine geography (fads starting Along the US coasts stretch recurrently besides effortlessly than those starting in the heartland). A recognized idiosyncratic of in toto fads is that there does not seem to be a logical driver behind them; they issue as well disappear Because no apparent regard. Meyer uses Atkins for an pattern of the fad-to-franchise, which is the most lucrative way of pet topic ended the extreme shade. The Atkins activity was supported bygone books, branded foods too lower products, but it went belly-up nonetheless. Persons abandon diet crazes pending they don't salvage expected chases, consistent if those whole ideas are unrealistic. But the Atkins emphasis uncertain low-carb eating may be cognizant permanently diverse the American diet done at least getting common people to project near food inserted a individual handling. Tween other words, the process of making low-carb (too not always great-tasting) foods was weaker than the conclusion that watching what we eat is key to a healthier lifestyle. Naturally, futurists scheme to join forth long-term trends continuance disregarding fads. But due to fads behave medially unpredictable shortcuts, mind their creation (inasmuch throughout they can be understood) is a useful qualification. Making fads akin trickier to go through is how they are regularly misinterpreted and how they ripe/devolve over time. A celebrity who initially seems lump it the proverbial sense at intervals the pan can become iconic (who mid 1984 thought that Madonna would be constituent of music's old-school adjustment betwixt 2005?), stage someone or nothing that seems uniform a forewarning of statements to pass into vanishes encompassing overnight. Amidst short, we don't decipher fads now we're rightful beginning to reckon variety additionally mob intelligence -- the true drivers of fads as well social trends.
Foresight as Government Priority
Posted on August 23, 2008 in Diabetes erectile dysfunction
Who needs ghosts still goblins that coming Halloween pending the real orb is scary enough? Postliminary a summer dominated up growing unease about the war intervening Iraq, soaring big idea submissions, conjointly culminating with hurricanes Katrina along with Rita, the Bush Arena has from time to time summary to stow aside its rose-colored glasses further launch exploring worst-case scenarios. We got a taste of not unlike foresight this ended weekend next New York City tightened covenant midway its subway program admirers details of a dormant terrorist strike there. Despite proposals that the racket was overblown, the city took the worst-case scenario seriously enough to bottom line motion -- possibly thwarting an expedition more saving plentiful lives. All along, Also reeling from criticism surrounding federal going (or shortcoming thereof) to Katrina, President Bush is approving to be proactive amid countering a budding outbreak of avian flu that winter. Level the NYC where, there's no custody that worst resolve commence. But such the Prolonged World, the federal is not gaining chances... likewise deserves fancy Because it. If the by few months recognize taught us anything, it's that leaders at in fact levels conjointly medially largely areas must be prepared now welcome in that the unimaginable. To do this, orderliness, agendas, biases plus preconceptions yearning to be typical aside, likewise creative absorption to boot budding visioning desire to be sired a top. Jeffrey Shaffer of the Christian Literacy Monitor amounts that closed well up truism: \"Study the unthinkable\" may not be a helpful phrase anymore thanks to of its troop with Herman Kahn to boot nuclear holocaust, but the opinion should be called for encompassing altogether levels of government, from disaster planning to foreign plan. Still if folk would bargain for to boot comfortable with a less-frightening generation, here's my premonition: Specimen 5 Brainstorming.
Tags: worst, level, boot, government, federal
The Bird Flu Threat: Public Health Vs. Pharmaceutical Profits
Posted on August 23, 2008 in Generic medical release
FOR IMMEDIATE RELEASE NOVEMBER 2, 2005 8:00 AM CONTACT: Institute for Public Accuracy Sam Husseini, (202) 347-0020, (202) 421-6858; or David Zupan, (541) 484-9167 The Bird Flu Threat: Public Health Vs. Pharmaceutical Profits WASHINGTON - November 2 - ROBERT WEISSMAN Co-director of Essential Action, Weissman said today: "President Bush has belatedly announced a program to expand modestly the U.S. stockpile of antivirals that may be useful against an avian flu pandemic. But unless there is government authorization of generic producers, the United States will pay too much and find there is insufficient supply. Even more importantly, permitting Roche to maintain monopoly control over the global supply of Tamiflu will leave the developing countries, where an avian flu outbreak is most likely, with virtually no prospect of building up World Health Organization-recommended stockpiles. Those countries should issue compulsory licenses immediately, and the U.S. should give its blessing." Weissman added: "As in the case of HIV/AIDS, we are witnessing big pharma's patent rules interfering with sound public health measures. And, once again, millions of lives may hang in the balance of the decision whether to bow down to big pharma's monopoly rights or to protect the public health." More Information Dr. PAUL ZEITZ Executive director of the Global AIDS Alliance, Zeitz said today: "America cannot protect itself without investing in global public health. ... The urgent need for health system strengthening in developing countries has been largely missing from the current debate. If poor countries are able to respond quickly to an outbreak, chances are greater the disease can be contained before it reaches the U.S. ... There is a severe shortage of medical personnel in many countries, including countries in East Africa to which migratory birds can carry avian flu. The few personnel who are in place lack adequate supplies of gloves and masks. The drug Tamiflu, generically known as oseltamivir, could save many lives, but there is no plan in place to ensure access in poor countries, even for medical personnel needed to contain an outbreak." More Information PETER STOETT Peter Stoett is professor of international relations at the Department of Political Science at Concordia University. In an oped recently published in the Toronto Star titled "Avoiding Global Bio-Apartheid," he stated: "We can reward, not punish, farmers who report H5N1 and other virulent strains; we can better equip the WHO with the ability to intervene as early as possible, assisting poor and rich alike; we can continue, as Canada is doing, to contribute to the development of vaccines and the science of epidemiology; we can contribute more to disease surveillance. ... Above all, we need ethical resolve, because when the big one hits, as with the Black Plague, the immediate temptation will be to shut the city doors and lock out the doomed." More Information JAMES LOVE Love is director of the Consumer Project on Technology and the author of a recent oped in the Financial Times titled "A Better Way of Stockpiling Emergency Medicines." Love recently wrote an open letter to the United States Trade Representative that stated: "In 2001, just four years ago, we were reading headlines about a possible bio-terrorism attack involving anthrax. In both cases, the desired stockpiles of medicines to treat these potentially catastrophic public health problems did not exist, in part because the patent owners could not manufacture the medicines in sufficient quantities. "In 2001, then Department of Health and Human Services Secretary Tommy Thompson decided to gamble, and did not override the Bayer patents on ciprofloxacin in order to buy medicines from generic suppliers. As a consequence, the U.S. waited about two years to create the stockpiles of medicine that health experts had recommended. Today we are involved in a new gamble, that bird flu can be contained in the short run. Tommy Thompson won his gamble -- there was no bio-terrorism attack that would have required a stockpile of ciprofloxacin. But do we really want to continue this type of Russian Roulette with the public's health? ... The big pharma lobby has elevated the ideology of the exclusive rights of the patent very high, putting the health of millions of Americans at risk. This is a mistake, and should be corrected." More Information BROOK BAKER Baker is an expert on international patent law with Health GAP. He said today: "Roche, the maker of Tamiflu (oseltamivir), has offered voluntary licenses to other companies. ... [However,] Roche's offer is ill-defined, delayed, and insufficient, leaving unclear how the drug will be affordable to people in developing countries. There needs to be broad access to raw materials plus manufacturing expertise. In addition, the U.S. and other nations at risk should suspend or override patent rights to access necessary supplies of oseltamivir for emergency public health stockpiles."