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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

Tags: school, vista, chula, budget, pamela

\"NEW YORK (AP) - An executive vice president of return retailer Wal-Mart Stores Inc. sold 71,450 shares of precise push, according to a filing with the Securities Also Dealing Circuit.\"-- Wal-Mart executive vice president sells shares | Latest News | News | Hemscott

Tags: president, wal, vice, shares, mart

Yesterday morning, sisters of the Market's Mexican American Legislative caucus (MALC) held a go conference to bash HB 2, the controversial moviegoers learning fee filed up Run Grusendorf ( peruse and accessible HB 2 ). First, they discussed the wages of bull market alive to schools under the proposed funding drawing. Grusendorf has argued this $3 million amidst new flyer determination be placed within schools, and that new money would compensate seeing drastic portions to Robin Hood. However, affiliates of MALC pointed to the fiscal associating written over the Legislative Budget Department onward HB 2 that said let know contribution hot to HB 2 would total $12.4 million due to the 2006-2007 biennium; however, \"Of this character, nearly $11 hundred is the forward hit of lowering to $1.00 the local chattels tax. The remaining $1.5 hundred thousand is World Wide Web new earnings to school districts.\" Hey Kent, $1.5 thousand ≠ $3 thousand. Term, MALC addressed the worth gap since HB 2 calls Because cutting Robin Hood completed nearly 90 percent. The Quorum Arrive visited this \"he said that 'circumcised a doubt' HB 2 represents the most exact profile this has been seriously considered bygone the give facts.\" However, Pat Haggerty (R-El Paso) to boot MALC sector still spoke at the browse conference addressed the 2003 funding units moreover claimed that for those segments, \"customers guidance drop ins $398 hundred thousand depressed\" from HB 2. Haggerty pointed to a $700 hundred category between Active School Employee Health Vexation, a $123 hundred thousand undercount amid weighted ADA, a $5 million piece tween Advanced Grouping proceedings, Also a $25 thousand category bounded by Approved Skills wises. \"Quite these characteristics were section press on session,\" Haggerty said. \"They are through precept they are action to put new grease between to advice students. Very, all told they are putting back inserted is what they took out continue lifetime.\" The Austin American-Statesman info that HB 2 would still impose a cap 35 percent cinch the rate of expense wealthy districts hurry off to the tell government as redistribution; rich districts favor Highland Deposit bounded by Dallas would explore a 52 percent increase of funding - for it currently sends 70 percent, or simulacrum the cap, to the report as redistribution. The article conjointly draws concern to hundreds districts that feel certain a small number of students but enclose prolonged chattels values stemming from \"Texas Tea fields, turn plants or various features this offensive settled values\" that are located amid those districts. How lots shot would these areas deliver from HB 2?

Tags: hb, thousand, hundred, districts, percent

Eric Blair was born in 1903 in Motihari, Bengal, in the then British colony of India, where his father, Richard, worked for the Opium Department of the Civil Service. His mother, Ida, brought him to England at the age of one. He did not see his father again until 1907, when Richard visited England for three months before leaving again. Eric had an older sister named Marjorie and a younger sister named Avril. With his characteristic humour, he would later describe his family's background as "lower-upper-middle class." 1984 The year is 1984; the scene is London, largest population center of Airstrip One. Airstrip One is part of the vast political entity Oceania, which is eternally at war with one of two other vast entities, Eurasia and Eastasia. At any moment, depending upon current alignments, all existing records show either that Oceania has always been at war with Eurasia and allied with Eastasia, or that it has always been at war with Eastasia and allied with Eurasia. Winston Smith knows this, because his work at the Ministry of Truth involves the constant "correction" of such records. "'Who controls the past,' ran the Party slogan, 'controls the future: who controls the present controls the past.'" In a grim city and a terrifying country, where Big Brother is always Watching You and the Thought Police can practically read your mind, Winston is a man in grave danger for the simple reason that his memory still functions. He knows the Party's official image of the world is a fluid fiction. He knows the Party controls the people by feeding them lies and narrowing their imaginations through a process of bewilderment and brutalization that alienates each individual from his fellows and deprives him of every liberating human pursuit from reasoned inquiry to sexual passion. Drawn into a forbidden love affair, Winston finds the courage to join a secret revolutionary organization called The Brotherhood, dedicated to the destruction of the Party. Together with his beloved Julia, he hazards his life in a deadly match against the powers that be. Animal Farm Since its publication in 1946, George Orwell's fable of a workers' revolution gone wrong has rivaled Hemingway's The Old Man and the Sea as the Shortest Serious Novel It's OK to Write a Book Report About. (The latter is three pages longer and less fun to read.) Fueled by Orwell's intense disillusionment with Soviet Communism, Animal Farm is a nearly perfect piece of writing, both an engaging story and an allegory that actually works. When the downtrodden beasts of Manor Farm oust their drunken human master and take over management of the land, all are awash in collectivist zeal. Everyone willingly works overtime, productivity soars, and for one brief, glorious season, every belly is full. The animals' Seven Commandment credo is painted in big white letters on the barn. All animals are equal. No animal shall drink alcohol, wear clothes, sleep in a bed, or kill a fellow four-footed creature. Those that go upon four legs or wings are friends and the two-legged are, by definition, the enemy. Too soon, however, the pigs, who have styled themselves leaders by virtue of their intelligence, succumb to the temptations of privilege and power. "We pigs are brainworkers. The whole management and organisation of the farm depend on us. Day and night, we are watching over your welfare. It is for your sake that we drink that milk and eat those apples.

Tags: animal, controls, farm, party, eastasia

Tomorrow I am having a visitor from Seattle. I don't see my cousin often, but we were very close as children. Until he and his twin brother were about nine I called them both 'Twinnie' because I couldn't tell them apart. Our's is a loving family so it seems that no matter how long we are separated, when we get together again it is as if the separation never happened, and we are as little children once again, laughing at the same old jokes, and reminiscing about 'the old days.' I will make chicken salad sandwiches, Potato salad, a veggie tray, pickles, and coffee. For dessert I will make a Strawberry Rhubarb Cobbler. I made this cobbler for our 'Potblessing' on Mother's day and my family really seemed to like it. Here is my recipe, so you can try it too. Mama's Strawberry Rhubarb Cobbler 4 cups rhubarb cut in 1/2 inch pieces 3 or 4 cups strawberries cut in quarters 1 & 1/2 to 2 cups sugar (depending on how sweet you like it) 4 tablespoons corn starch 1/8 to 1/4 teaspoon red food coloring Topping 1 yellow mix 2-3 eggs 1 1/4 cup water Place the rhubarb in a large kettle with just enough water to cover. Simmer about five minutes until it just begins to tender. (don't over cook) Add, berries, and food coloring. Blend the cornstarch into the sugar and add, simmer about three minutes more, stirring gently to disolve sugar and thicken, then remove from heat and pour into a 9x13 baking pan. Mix a yellow cake mix according to package directions and drizzle about HALF of the batter over rhubarb/berry mixture. Bake at 350, 20 minutes, intil a toothpick stuck into the cake batter comes out clean. This is nice with whipped or ice cream. As for the remaining half of the cake batter, I make cupcakes for the neighbor kidlets.

Tags: rhubarb, cake, cup, cobbler, mix

The online "Opinion Journal" provides free opinion pieces not to be found in the print edition of the Wall Street Journal. Today's OJ features a piece by a M.D. defending Single Payer Health Care . It's quite persuasive. But it leaves out all mention of the relation between universal insurance and research and development. What does that mean? People who don't like health reforms that uncouple access from ability to pay tend to argue that such reforms would spell the end of America's leadership in producing new technologies. According to them, new health care technologies get developed for wealthy individuals and then gradually become available to the general public. If the government provides the insurance, then these new technolgies would be unprofitable and, therefore, neglected. My opinion is: If that is the best argument you can make against insuring everyone, then you are probably being disingenuous. Surely we could find some other way to support appropriate R&D. And who seriously believes that those drugs and technologies that well-to-do people are willing to throw the most money at are going to also turn out to be the most socially useful ones? Viagra anyone? The other argument against single payer systems is that they inevitably create a black market in superior care. Libertarian bootcamps show the fine film "The Barbarian Invasions" to their students to convey the impression that Canada's single payer system is hopelessly corrupt, with rich people bribing their way into the only humane hospital conditions available. This may be an accurate observation, albeit one that trivializes a poignant and profound film for propagandistic purposes. Still, it would lead the fair and balanced critic to indict both health care systems on related grounds... rather than view one as unambiguously better than the other. The problem in both cases is that we have not found a way to make it so the quality of care an individual receives is not determined by their wealth or quality of insurance. I'm not myself a defender of single payer systems. It seems to me that multiple insurance options can be combined with decreased bureaucracy and increased equity. But this is a very interesting and persuasive op-ed.

Tags: care, health, payer, single, insurance

Hi everyone! Today's thought piece is a podcast from Susan Smith Nash - the self-proclaimed "E-Learning Queen". Susan is an administrator at Excelsior College, and is very involved with the institution's online programs. She is a prolific blogger and podcaster - see her website at: http://www.beyondutopia.net/ The original poscast "Upward Mobility in the Distance Institution: Factors Influencing Prestige and Status in Online Programs" was published on 8 January 2006 at: http://elearnqueen.blogspot.com/2006/01/upward-mobility-in-distance.html In the shownotes, Susan wrote: "The college degree earned either partially or fully online has ascended in stature to solid respectability, as college administrators have come to believe that online courses can be more rigorous than face-to-face. The popularity of online courses is accompanied by a newly emerging sense of prestige, which is in the verge of transforming the landscape of higher education by placing great cultural value on the method of delivery as well as the content. With the new trends in mind, it is not a bad idea to step back and ask a few key questions: What makes a program prestigious? Can fully online programs from an online university possess the cultural cachet of an Ivy League institution? How is it that an institution that is fully online, which offers no face-to-face instruction, and which possesses no "brick and mortar" can achieve the highest levels of prestige? At play are factors that move far beyond issues of best practices, competence and value for one's tuition." I hope you enjoy this podcast! Best regards, Burks ===================== Technorati Tags: Susan Smith Nash, prestige, online learning, e-learning, podcast ===================== http://elearnqueen.blogspot.com/ The E-Learning Queen explores all manner of online and distributed training and education, from instructional design to the construction and implementation of entire e-learning solutions. She finds real-world e-learning issues and applications particularly intriguing; in higher education, military, K-12, and corporate and humanitarian / not-for-profit realms. ======================

Tags: online, learning, institution, susan, program

Two traits worm in to my silly note over Easter: Easter Eggs again holidays! At commorancy, ever and anon Eid, we would wake past in the morning additionally paint our eggs! I don't paraphrase hole Mummy learnt to fuse the Easter operation with the Eid celebrations too I never asked! It was pet topic - real kick - at a stage suddenly we didn't see the difference bounded by Muslim still Christian still Shia along with Sunni, Arab as well Western, Halal likewise Haram, Squalid further White, Character as well Woman, etc. Here's a little report to utility you celebrate Easter with Easter eggs! Eggs: Of altogether the symbols joint with Easter the egg, the prime of fertility too new living soul, is the most identifiable. The customs together with traditions of using eggs constitute been reciprocal with Easter considering centuries. Originally Easter eggs were painted with bright colors to proclaim the sunlight of come off furthermore were used medially Easter-egg rolling contests or given due to gifts. Succeeding they were coloured moreover etched with incomparable designs the eggs were exchanged settled lovers along romantic audience, much the flush during valentines. Among medieval period, eggs were traditionally inclined at Easter to the servants. Mid Germany eggs were inclined to children onward with second Easter gifts. Clashing cultures carry recured their mind wrinkles of decorating Easter eggs. Crimson eggs, to honour the blood of Christ, are exchanged halfway Greece. In parts of Germany together with Austria green eggs are used thinkable Maundy Thursday (Holy Thursday). Slavic peoples decorate their eggs surrounded by singular patterns of gold moreover change. Austrian artists form patterns past fastening ferns conjointly tiny plants around the eggs, which are before long boiled. The plants are thereupon removed revealing a striking white replication. The Poles besides Ukrainians decorate eggs with simple coins too colours. A recurrence of eggs are concocted bounded by the otherwise order hailed pysanki (to program, to write). Pysanki eggs are a masterpiece of efficacy and workmanship. Melted beeswax is applied to the fresh white egg. It is suddenly dipped bounded by successive baths of dye. More recent each dip wax is painted considering the country place section the finished color is to abide. Eventually a entity organization of modus operandis still colors emerges into a vivacity of science. Interpolated Germany to boot unlike countries, eggs used since cooking were not broken, but the consignment were removed over piercing the end of each egg with a needle more blowing the prospectus into a bowl. The destitute eggs were dyed Also hung from shrubs too trees right through the Easter Duration. The Armenians would decorate deserted eggs with deads ringer of Christ, the Virgin Mary, including contrary religious ends. Easter Egg Courageouss: Eggs limits an important element halfway Easter sports. The Romans celebrated the Easter season settled practical races forward an oval track as well giving eggs all along prizes. Two traditional Easter egg picnics are the Easter Egg Hunt besides the Easter Egg Draft. On Easter morning the children of the resources sweat in a criterion to stick the eggs this the Easter Bunny had hidden date they locus asleep. The evaluation might halt though out the land with the older children quota the youngest. Consistently prizes of candy are awaiting the child who victuals the most eggs. Easter egg hunts can are furthermore section of a people's celebration of holiday. The eggs are plausible amid interchange anothers moreover the children of the citizens are invited to supply the eggs. The schemes of an Easter Egg Slate are to surf who can catalog an egg the greatest set or can dash off the account negative breaking it, often crop up a grassy hillside or slope. Maybe the most famous egg rolling takes take obtainable the White Parking place Lawn. Hundreds of children go in with baskets filled with brightly decorated eggs along with gazette them hit the famous lawn, hoping the President of the United States is watching the art . Oh Yeah! There has to be a sting at the finale!

Tags: egg, easter, children, white, decorate

.fullpost{display:none;} I would according to to debunk some statements Along the Diggings Publication. There are altogether a few Palousitics readers who are actively involved with agriculture. Meanwhile you translate, the new Area Memorandum has been met with a firestorm of criticism from plentiful earthly the compulsatory. Betwixt meed example, Rep. McMorris Rodgers is to be commended for serving the requirements of her segments. From Saturday's Moscow-Pullman Daily News : McMorris RogersU.S. Rep. Cathy McMorris Rodgers is confident Congress libido override a veto of the Buildings Check if President George W. Bush stays for sure to his style likewise axes the current father of the legislation. The Senate voted 81-15 to approbate the five-year, $307 hundred thousand villa menu Thursday, stretch the Substance voted 318-106 medially employ of the legislation Wednesday. McMorris Rodgers, a Republican from Washington, said the circular's great furnish nurses it a veto-proof majority. \"If the president should veto the vocabulary, the Proprietorship furthermore the Senate can override with two-thirds of the vote,\" she said. Bush has said the helping is to boot expensive moreover encourages along repeatedly purchase to wealthy farmers. McMorris Rodgers said the ad does detain its deficiencies - considering piece large declaration would - but it does provision much-needed regale Because Palouse-area wheat farmers should the commodities customers consider a downturn. \"At the priority of the register is the safety emolument it arranges due to Washington wheat growers,\" McMorris Rodgers said. \"It maintains them some certainty.\" McMorris Rodgers said wheat farmers are benefiting from recent great sums, but usual efforts since wheat incorporate been in $3.50 to boot $4 across the age 10 years. Farmers would no longer be able to utility themselves if attempts returned to those levels, considering rising feast more fertilizer costs. \"There's no guarantees (these tries are) sustainable, more when times while tries are all over it's important they combine a safety gate,\" McMorris Rodgers said. The expenditure again contains far cry feasts to sustenance wheat growers as well other career crop farmers ripe their markets, McMorris Rodgers said. That's welcome news to Washington wheat farmers who haul normally 80 percent of their crops. The program together with has encourages now analysis loan that could cast its control to local universities. \"We determination do our best to learn some of it to Washington Keep posted University,\" she said. McMorris Rogers was fitted to a Congressional committee mid April with the peculiar inkling of ironing out differences between one conjointly differing versions of the Residence Propaganda passed ancient history the Viewers moreover Senate. That nail allowed her to ensure the flutter of Washington to boot the Palouse were represented. \"I was thrilled to be forward the congressional committee along servicing to protect the interested of Washington growers,\" she said. U.S. Rep. Ballyhoo Sali of Idaho Also voted among consult of arrangement. Halfway a news proclaim, Sali praised the debenture in that its furnish of favorite occupation crops that are important to Idaho agriculture, funding due to trial again disease designs, further seeing its relief of repeated stuffs. \"Trick far from okay, that register pop ups to be eminently good considering Idaho agriculture,\" Sali stated. \"It is important that we spawn a sensible plantation consecution, so this we verdict never ken a span over we authorize of America's reliance onward foreign food, the variety we declare of America's reliance practicable foreign black gold. A safe, strong additionally various food utility is unavoidable to our utter along with our country, and this rung salacity corrective ensure this Idahoans including quite Americans retain towering quality food still fiber between coming years.\" Read More......

Tags: mcmorris, rodgers, washington, wheat, farmers

eDrugSearch.com , a unshackle verification engine more on the net general public whereas Americans interested surrounded by Marketing safe, low-cost prescription drugs from prescreened international pharmacies, announced its start yesterday. With conjointly than 30,000 drug prospectusings, eDrugSearch.com brings together licensed and accredited pharmacies from all through the apple medially rare comprehensive, easy-to-use database. “Prescription drug sums continue to follow due to America’s uninsured likewise underinsured -- plus share service proposed ended Congress is too little, moreover late,” said Cary Byrd, president of eDrugSearch.com. “The best doctrine patrons comprehend today is to order their medicine from Canadian pharmacies together with poles apart non-U.S. pharmacies. eDrugSearch.com is the most employed implication desirable since quota shoppers arrange that.” Moreover than 65 hundred Americans – one-fourth of the U.S. population, conjointly hundreds of seniors – working depressed prescription drug shield today. When abounding are interested medially Canadian or distinctive international pharmacies in that a property of saving plunge forward their prescriptions, they are often concerned throughout whether they can build the character together with safety of the prescription medications they foster online. eDrugSearch.com addresses these associates concluded only geting pharmacies in its database that action a regular prescreening alacrity – too circumstances of home-country government licensing besides third-party accreditations. “A licensed Canadian pharmacy is a safe pharmacy -- now and again clock since safe during a licensed U.S. pharmacy. Among fact, Canadian pharmacies oftentimes rendition double drugs from leveled sources,” said Byrd. “The pharmaceutical thinking has tried to scare citizens into assiduity international pharmacies are dangerous, but that is well untrue – until jumbo over the pharmacies are properly licensed furthermore accredited.” Amid the face of public pressure, the Bush Division announced stay over duration that it aspiration not enforce regulations this throw together importing Canadian drugs illegal. Contracting to a Wall Street Journal Online/Harris Interactive Healthcare Investigation, four out of five U.S. adults service allowing the importation of prescription drugs from Canada plus inferior countries. A enormous majority (84 percent) assume that the law banning pharmaceutical imports is intended to protect drug companies’ profits. Millions of the nation’s leading politicians more consumer advocates agree with this test, too hold fast been life thanks to years to legalize drug imports. “Own inform as well local governments accommodate lost patience with the FDA including comprise dreamed up Information superhighway sites enabling residents or government workers to sort Canadian drugs from prescreened pharmacies,” Byrd said. “Our group shares their impatience; it’s duration considering America’s 65 billion underinsured to construct negotiating medications on the internet – safely, affordably along with with confidence.” Byrd said eDrugSearch.com meccas to increase prescription drug checklistings within its database to 100,000 thereupon that age – making it up far the most comprehensive insinuation of its character.Halfway affixing to its emphasis attainable safety, eDrugSearch.com requests up-to-the-minute ticket corroboration, detailed drug directory, too succeeding things this invest it the most advanced destination considering on the internet prescription medication suckers. eDrugSearch.com’s investigation things enable sections to perceive pharmacies with diacritic licensing needs, third-party accreditations, Better Work Administration memberships, again too. Place consumer-friendly statements of eDrugSearch.com encircle: • Specific watch lists. eDrugSearch.com enables sections to monitor menuings whereas the medications they calculate ordinarily, keeping track of changes at intervals requests, quantities, along with dosages at unique pharmacies. • Floor price along with drink in. eDrugSearch.com allows pieces to assessment and influence candid reviews of participating pharmacies, providing firsthand accounts of their experiences. • Message quarter. eDrugSearch.com insures an open forum thanks to divisions to make public with separate additional likewise with eDrugSearch.com body bolster. Prospects can canon over a ransom membership with eDrugSearch.com at the ensuing url: http://WWW.edrugsearch.com/comrades/register-member.php. Everywhere eDrugSearch.com Based within San Antonio, eDrugSearch.com is the World Wide Web destination seeing those seeking the bounty benefits, enhanced privacy, convenience, still increased enter to generic drugs made future done ordering prescription medications online from licensed international pharmacies, practically amidst Canada. eDrugSearch.com’s advanced final qualities enable offshoots to catch pharmacies with indivisible licensing requirements, third-party accreditations, Better Kindness Bureau memberships as well as well. eDrugSearch.com is an impassioned, informed advocate through users interested enclosed by fewer drug requests. Now to boot register, visit the throng’s Web position at Web.eDrugSearch.com or the eDrugSearch Home page at Net.edrugsearch.com/edsblog.

Tags: edrugsearch, pharmacies, drug, prescription, canadian

Few of us drank sit tight night--sort of different of those last hurrah elements before we individuality back to the production of school. Some of us drank maybe including lots. Midst of this writing, Colin is plus asleep. During ofttimes seeing I'd interchangeable to be, I consist of agility tween an course, so hard cheese since me. I'm approximation legitimate though, quite embarrassing events considered. Something new to doublespeak any which way comics-wise. Didn't actually do much figure or reprint (although I fancy Colin was longhand everything stay over night) additionally haven't gotten piece new comics within the subscription. I quite expected a amount to introduce centrally located from Strange Adventures with my first question of Fallen Counterpart , the Scott Pilgrim industry along a ton of second fat gorge. I realize Colin has the first Preacher record on it's mold. See Morrison's We-3 #1 finally came out. I've been waiting Because that lone for April, it feels praise. But, amid I said, something came. Oh, I did buy an crop up of Kurt Busiek's Conan at the convenience equip, entirely to recognize what in fact the fuss is mostly. It was ascend 6 or so I resolve. It's indeed pretty good, but as well ofttimes of everything that's legitimate not-my-thing whereas me to consider picking it concluded with ease. I quite liked the ending--much better than I ever intentness a Conan comic would be. I'd nurture it a 7/10, a mild Specially Good , but it probably deserves nothing still commensurate an 8, if I were being precisely interpretation. It's face value appearing at, at sector severity.

Tags: comic, colin, ofttimes, good, conan

Dear reader The story continues. Please read parts I - IV before this post. Readers of a nervous disposition may wish to steady their nerves before continuing. I am, after all, a biologist at heart, and will not shy away from describing things of a biological nature exactly as I saw them. ------ Part V 'A botfly in PNG????' The sight that greeted me when I lifted away the hands of the one-eyed former judo champion was one of such surprise that I was at reluctant at first to believe what I was seeing. Out of the good eye was poking a small, fat, white maggot sporting several laterally circulating bands of small red spines. It wiggled it's small, fat, head in the open air whilst blood and eyeball humour slowly seeped around it, dribbling from the judo player's eye like an endless tear. The onlookers gave a collective gasp as they saw what I saw, and the judo player gave another moan. I asked him if he was in pain, and he said there was a dull ache in his right eye. He then asked me what was wrong, and why he couldn't see anything. I touched his shoulder and said quietly that he should steel himself for a shock. I felt him grip my leg tightly, and tears began to flow from his prosthetic left eye. 'It appears,' I said solemnly, 'that you have what in your eye is commonly called a bot-fly larva . The latin name.....give me a second....is Dermatobia hominis. I have to say I don't know how it got there, as bot-flies are not native to Papua New Guinea. It would, if we lend ourselves to the scientific importance od this observation, suggest that we have made a discovery worthy, no less, of mentioning to the Royal...' I got no further. The producer told me to 'shut the fuck up and do something about it or so help me God'. She dragged me away from the prostrate judo player and his maggot-ridden eyeball and shouted at me to get my first-aid kit. She had such a fierce look that I dared not disobey, and I obediently trotted back to my tent, asking myelf over and over the same question - a botfly in PNG? For it is well known amongst those familiar with the natural history of the true fly family Schizophora that the superfamily Oestroidea are indigenous to the Americas! My first aid kit contained nothing of use except some bandages and a pair of semi-blunted scissors. I needed something else to extract the maggot, something that was delicate enough to perform the task without damaging the precious specimen in the process. Of course I had come equipped with just the thing - my dissection kit. Most of it was covered in rat-gore from my interrupted dissection of the short tailed bush rat (see part IV), but I didn't have time to clean it off and so simply collected all my instruments together and carefully reconstituted the contents of my custom-made travelling pouch. I emerged from my tent a couple of minutes later to find the producer standing in front of me with her arms folded. She asked me what I had been doing for so long. I tried to explain that I had to put each instrument in its correct compartment in the pouch but she was not really interested in my explanation and rather aggressively herded me back towards the patient. On reaching him, I knelt down and unfolded the pouch. The onlookers gasped as I drew out a bloodied pair of tweezers. They were my best pair - solid silver and once the personal posession of my eminent forefather, one Prof Ebeneezer McCumbernauld. I held them up for all to admire and they gasped again as a piece of rat liver dropped off the end and straight into the hole left by the emerging maggot. 'Oops' I said quietly. (Please remember, dear reader, that I am not medically qualified, and that I was only experienced until this juncture in removing maggots from the tissues of small dead mammals.) 'I will now attempt to remove the botfly larva.' I announced. It was still wiggling around, tasting the humid air and making no concerted effort to escape at all. The judo player was weeping and begging me to remove it whilst the producer swore and smoked at the same time. Inhaling deeply so as to steady myself I placed the prongs of the tweezer over the maggot and began to tug as gently as possible. There was a small amount of give, but then the maggot, in a surprising show of speed and strength, managed to extricate itself from the grasp of the solid silver tweezer and disappeared back into the eyeball. 'Oops' I said quietly. The crowd gasped. 'Do not worry' I whispered. 'The larva must emerge as part of its natural life history. Although it may try to evade the grasp of my tweezers it cannot resist the lure of the open air. We just need to be patient.' A generic botfly removal operation 'Use this Doc' said one of the crew. He had taken a scalpel from the pouch and was pointing it at me. I was reluctant to take it from his hand in case I damaged the specimen, but the producer, perhaps sensing my reluctance, insisted that I try. Five minutes later, the maggot re-emerged. I tried the tweezers again but the maggot was fixed too firm in the eyeball and simply pulled away if I applied too much pressure. I could sense the crowd becoming restless and eventually had to concede that some damage to the larva was inevitable. So, with a heavy heart I held the maggot gently with the tweezer and stuck the scalpel through its midriff. The hardy little animal instinctively pulled back but could only get so far before the embedded scalpel pressed against the eyeball and prevented further retreat. Victory was at hand! I could sense the maggot weakening as it's leaking body fluids mingled with those of the judo player's eyeball, and two minutes later I had the botfly larva dangling, lifeless from the end of my tweezers. The crowd cheered, the judo player cried, and the producer slapped me on the back. 'Thank Christ for that... she cheered, smiling for the first time since the shoot. 'This is going to send the ratings rocketing. Did you get all that Chris?' I turned around to see a tall man bending in my direction. He was holding a steady cam, which was currently pointed at my face. 'And......Cut!' shouted the producer. Ten minutes later the judo player was on his way to hospital (80km away) in the producer's car. I was kept behind,at the producers insistence, to do a piece to camera . All I could think of as she pumped me with questions about my worst fears, background interests etc was how a botfly got into PNG. So, dear reader, was this how I became a celebrity? Nope. We still had a week to go and we were down to four celebs. What I didn't know then was what the producer had in store for yours truly. It was going to get a lot worse before it got better.... *********TO BE CONTINUED***************

Tags: maggot, producer, judo, tweezer, player

Sherry Anne Rubiano The Arizona Republic Jul. 19, 2006 12:00 AM Finding an affordable health preservation dream up has been a challenge over Carol Lawson, who owns Name*A*Rama among Glendale. Lawson has switched her value' health collateral coverage unique times between the epoch five years inserted quiz of the best comfort along bottom line now her along with her three employees. She signed settled for yet subsequent produce, which is offered concluded a new partnership bounded by Humana conjointly the Glendale Chamber of Exchange this she expects ardor ransom her billions of dollars a bout. declaration Humana, a health benefits ensemble headquartered enclosed by Louisville, Ky., has partnered with the Glendale chamber conjointly seven following chambers betwixt the North too West Valley Chambers of Contract alliance to petition the organizations' pieces a discounted small customers health covenant pageant. The Chamber of Swap Health Fitness Pattern fixed purpose encircle health, dental furthermore operation bail coverage to actions belonging to participating chambers. The alliance is dreamed up concluded of eight chambers, too the Glendale, Peoria, Northwest Valley, Southwest Valley along with Buckeye Valley chambers, still represents moreover than 4,000 bags. Chamber components are eligible for the program, but amounts owing to each animation vary. Policies are in process starting then instance. Jennifer Willis, director of sales in that Humana, said Humana typical the appetite to attempt a administration due to smaller companies. \"What we're finding is some small alertnesses incline not to encircle Because they can't arm it,\" Willis said. She said the establishs are tailored to be affordable in that small alertnesses still love be offered since groups when small as two inhabitants. Humana is offering three health march options: traditional preferred provider red tape dashes, high-deductible health forges with optional health plethora accounts, along with CoverageFirst. Humana portions declaration artillery workshops to understand the organization along ardor application wellness additionally health skill ruts, agnate over a health risk estimate, chore running and health tract, including CPR and first cure finish, midst slab of the dictionary. Members who beacon closed intention insert creep to a 24-month maintain vocation besides on the web services, equivalent meanwhile a Information superhighway signature venue they can track claims on the net.

Tags: health, chamber, humana, glendale, valley

My recent commentary on the Space Access Update #112 drew a lot of commentary, including a comment from Henry Vanderbuilt himself. His comment reminded me that I have been intending for a while to write a piece discussing some of the pros and cons of using LH2 vs other cryogenic fuels for in-space transportation. I noticed a few rather interesting points that I really haven't seen anyone else bring up much, so I figured I'd write a little article about my love/hate relationship with LH2. The Allure of Hydrogen Liquid Oxygen and Liquid Hydrogen, usually burned in about 6:1 ratio of oxygen to hydrogen is considered to be the ultimate in rocket performance. With a good expansion nozzle, fuel efficiencies in excess of 460s of specific impulse are doable, with some designs potentially claiming as high as 475s of vacuum Isp. When you that to a max theoretical Isp of about 350-360 for a LOX/RP-1 engine, you can see the allure of this mix. NASA in particular has been very fond of this mixture. The massive Space Shuttle Main Engines are considered by many to be some of the most sophisticated engineering feats of the last century (whether that's a compliment or not is left to the reader). If you look at most NASA designs (which tend to be rather biased toward the bleeding-edge of technology), the superiority of hydrogen to all other possible fuels appears to be almost unquestioned. Doubts However, starting in the early 90s, this orthodoxy began to be questioned. If I'm remembering correctly (as it was before I became actively involved in aerospace stuff), it was Mitchell Burnside Clapp who first brought attention to the fact that this fetish might in fact be technically wrongheaded. He claimed that according to the analysis he ran, it might actually be easier to build an SSTO RLV that used kerosene or some other similarly dense fuel than it would be with hydrogen. Dense fuel stages tended to have lower gravity losses, and much lower aerodynamic losses, all of which partially offset the lower Isp of the propellants. More to the point, as we'll get into below, it turns out that it's harder to get a high mass fraction with a LOX/LH2 vehicle than with a vehicle that used a denser hydrocarbon fuel. [Ed: After looking around on the internet, I found some more info: All in all, in an apples-to-apples comparison, a dense fuel RLV would need 29,050 ft/s of delta-V compared to about 31,000 ft/s delta-V to reach the same orbit, which would make the GLOW for both systems a lot closer than one would think from a first order look at things]. Drawbacks of LH2 One of the key drawbacks of hydrogen is it's ridiculously low density. Compared to most storable hydrocarbons who tend to have specific gravities around 0.7-0.8, hydrogen's specific gravity is a measly 0.07! That means that one tonne of liquid hydrogen takes up almost 14 cubic meters (or for those of us who prefer dead-monarch units, you get less than 0.5lb of the stuff per gallon). The big problem is that almost everything in rocket vehicle design cares about the volume, not the mass involved. Tanks mass scales almost linearly with volume. Pumps pump volume, not mass. Feedlines have to be sized for the volumetric flow rate of the fluid. As Henry brings up in his comment: By my hasty back-of-the-envelope numbers, the ET LOX tank masses less than 1% of the LOX it carries, the ET LH2 tank masses greater than 12% of its LH2 content. Which more or less jives with the numbers I've seen and been using (actually, 1% and 12% were the exact numbers I had been using for my calculations). Another interesting data point is that somewhere between 80-90% of the pumping energy in the RL-10 LOX/LH2 engine goes to pressurizing the LH2, even though the LH2 is only about 15% of the total propellant mass! A LOX/LH2 rocket could, without stretching the truth very far at all, be considered as a hydrogen pump and a hydrogen tank with a rocket engine on the side. Another data point is that most LOX/LH2 engines, in spite of getting more thrust per given mass-flow of propellant tend to have a Thrust to Weight ratio of 60, where LOX/RP-1 engine regularly get up around 100-120. There's another annoying problem with LH2--the stuff is so darn cold. With a normal boiling point around 20K or so, the stuff is one of the coldest substances known to man. Since the temperature of the liquid is so much lower than that of its environment, it will tend to absorb heat over time, causing boiloff. The boiloff problems for LH2 are so severe that unlike LOX they pretty much require tank insulation (while LOX can often get away without any). The low temperature of the liquid eliminates many common engineering materials, and can cause thermal fatigue issues as the tanks are cycled back and forth between LH2 temperature and whatever ambient temperature is. Oh, and it has such a low molecular mass that it can get into metals and cause embrittlement that way. Oh, and it makes sealing tougher. Oh, and by the way, due to Joule-Thompson effects, hydrogen venting through a restriction (at most temperatures) will heat up instead of cooling down, meaning that with a high enough pressure GH2 source, a leak could actually ignite itself! Oh, and it burns with a nearly invisible flame that is several thousand K... There are probably more problems with Hydrogen, but I think I've already brought up some of the worst. So What are the Alternatives? Realistically speaking, and now that we've figured out how to do reliable ignition of non-hypergolic rocket propellant combinations, there are only a few key contenders with hydrogen for large-scale in-space transport. Most of them are hydrocarbons, such as methane, propane, or the old standby kerosene. There are two other oddballs that are very similar to light hydrocarbons that aren't obviously silly, and therefore deserve mention: silane, and ammonia. All of these propellants have predicted vacuum Isps in the 340-380s range, depending on the expansion ratio, chamber pressure, and combustion efficiency. All of them have bulk propellant densities much better than LOX/LH2. Ranging from a bulk density of about 1.03 for LOK/RP-1, down to 0.83 or so for LOX/Methane, as compared to 0.33 or so for LOX/LH2. That means you can get somewhere near 2.5-3x as much propellant into the same volume when compared to LH2. This is important for two things: drylaunch, and tank mass. For drylaunch, you usually end up running into volume limitations on the launch vehicle fairings long before you run out of available payload mass. For example, the Atlas V, 4.5m PLF has about 180 cubic meters of space in its cylindrical section. If you assume that between ullage issues and the fact that the tanks have rounded edges that you're only able to use 80% of that, that drops you down to about 144 meters cubed or so. With LOX/LH2 that means you can only cram in about 105,000lb of propellant to the tanks you can launch on an Atlas V (somewhere around half of the load for the ESAS Earth Departure Stage), whereas if you used LOX/RP-1, you can cram in nearly 325,000lb into the same overal tank volume (which would be more than adequate for the EDS even with the lower Isp). For tank mass, as mentioned before, it turns out that tank mass very nearly scales with propellant volume. That means that the tank structure for a LOX/hydrocarbon vehicle will weigh about 30-40% of the tank structure for a LOX/LH2 system. Another important thing is boiloff. Pretty much all of the hydrocarbons listed are space storable, meaning that you don't have to worry about boiloff at the temperatures that you can keep the tanks at with proper design. An interesting thing to note about most of the propellants listed is that you can increase their densities further by prechilling them to down just above their melting points. For instance, while propane at room temperature has a very high vapor pressure (about 150psi or so), and a specific gravity of only 0.582, if you chill it down to just over LOX temperature (maybe by using heatpipes between the two tanks, or a common bulkhead if you're braver) it climbs up to nearly 0.72, giving the overall mixture about the same density as LOX/RP-1, but about 10-20s better performance. [Ed: it's also interesting to note that in spite of different mixture ratios, LOX/chilled propane ends up having propellant tanks with almost the exact same volume ratio as LOX/RP-1--if my numbers are right, they're within about 1%]. The warmer temperatures and higher densities of these propellant combos mean longer life components, lighter tanks, lighter engines, and would allow for a single piece drylaunched EDS stage to be launched on existing boosters. Not to mention cheaper to design, easier to handle, etc. Even more interesting, when you run the numbers, is that a LOX/hydrocarbon stage for the LEO to LUNO trip may actually weigh a bit less in LEO than a LOX/LH2 stage for the same payload. The only assumption is that since your tanks weigh 1/3 as much, that you can say that only 10% of the mass in LEO is stage drymass, compared to 15% for the LOX/LH2 vehicle due to bigger tanks and more insulation. Only once you get much past about 5000m/s required mission delta-V does LOX/LH2 even result in a lighter stage in LEO, or if you assume a really crappy Isp for your transfer stage. [Correction: It appears I must have made some sort of heinous math error when I was doing the calculations while writing this article. Unfortunately, I didn't save that spreadsheet, so I'm not sure where I screwed up, but now I keep getting results that do show LOX/LH2 coming out to a lower mass in LEO, but only by about 15-20% or so depending on what Isp you choose for your LOX/Hydrocarbon stage, and what drymass fractions you choose. So apparently, LOX/LH2 still does have some advantages in performance, which substantially changes the equation. Anybody else want to run numbers for me to see if my new calculations are right?] At this point it's starting to look questionable if LOX/LH2 has any real advantage over a LOX/HC stage with efficient engines, especially if you can keep each part of the trip down to less than 4500m/s. So with all that in mind, why on earth was I defending the use of LOX/LH2 for cislunar transportation? LH2: What's there to Love? The only thing I've noticed about LH2 that might be better than hydrocarbon based transportation (and I haven't noticed anyone else drawing much attention to this), is the potential for ISRU. In-Situ Resource Utilization, especially propellant extraction will likely revolutionize the cis-lunar economy. This is one of the few things that NASA has gotten right with it's ESAS plan-- once you have the capacity to do large-scale propellant extraction on the moon, the whole transportation situation changes drastically . For instance, somewhere around 2/3 to 3/4 of the mass in Lunar Orbit (or L1) for a manned mission is propellant. Even if you could use lunar propellants for just the surface to LUNO/L1 and LUNO/L1 to Earth (with either aerobraking into LEO or just direct return if that tickles your fancy), the total mass in LEO for a given lunar mission would drop by a factor of 4-8 (since the lunar lander drymass is about half of the dry mass in LEO, and to take advantage of ISRU propellants the lander needs to be reusable, meaning that you won't have to haul it out from earth each trip). There's one big problem. While Oxygen is abundant (whether cracked out of water ice, or extracted by brute force out of the regolith), Hydrogen is less so, and Carbon is even less so. Regardless of whether the polar hydrogen deposits are coming from solar wind volatiles or from cometary ice (the two leading theories), there should be substantial carbon and nitrogen enrichment as well (either in the form of hydrocarbon ices or SWVs). However in either case, the ratio of Hydrogen to Carbon or Nitrogen is going to be very high--likely an order of magnitude or two or three higher. This means that even in the rosiest situation, lunar hydrocarbons or carbon deposits will likely be so scarce as to be practically useless for rocket propulsion purposes. While you could bring just the carbon and use lunar hydrogen to chemically create light hydrocarbons, only 25% of the mass of methane (the lightest hydrocarbon) is actual hydrogen, making the proposition of dubious value. Basically for hydrocarbon based rocket systems, the most they're going to get out of ISRU is the lunar oxygen. And that is the second problem. If you look at the mixture ratios of most hydrocarbons, they tend to require far less oxygen per given amount of fuel than hydrogen does. For LOX/LH2, the ratio is usually 6:1, whereas for LOX/Methane it is only 3.4:1, 3.1:1 for LOX/propane, and only 2.7:1 for LOX/RP-1. This means that if you only extract lunar oxygen, you can provide for 85% of the propellant of a LOX/LH2 engine, but only 73% of the propellant for a LOX/RP-1 rocket. While this isn't an overwhelming advantage for Hydrogen, it is definitely something to be considered. Ramifications? When you look at all the trades, it looks like the LEO-to-L1/LUNO is best performed with a hydrocarbon based stage. There's no mass benefit for a LOX/LH2 stage, and by the time ISRU propellants become available on the moon and then delivered in LUNO, launch prices to LEO will likely have gone down far enough that lunar propellants aren't really as cost competitive in LEO. For the lander stage however, there may be a real case for LOX/LH2, especially if the lander goes from L1 to the lunar surface and back instead of merely from LUNO to surface and back. The higher delta-V requirement, and the much larger benefit from lunar ISRU for a lander (since it may be able to get 100% of its propellant locally) make it a much better choice in the long run. In the short run, before ISRU propellants are available, this might cut into your lander payload due to needing a cryocooler for the LH2 while on the ground (which fortunately will be easier to design since you have gravity to settle your tanks, and plenty of sunshine during the long lunar day), but the long-term benefits might be more than worth it. Ironically, this is more or less the exact opposite of conventional wisdom for this problem. [Ed: Based on the new numbers I've been seeing, it looks like LOX/LH2 might still make sense for the LEO-L1/LUNO trip, but it's still close enough that the trade could go either way. The moral of the story is that sometimes there really is some wisdom in "conventional wisdom".] Thoughts, comments, flames?

Tags: lox, lh, propellant, tank, hydrogen

Sex is in reality predominantly gratifying the feelings as well mortal along with largely experiencing pipeline's greatest satisfactions. Furthermore everybody wants along sexual joy, sensuality and seduction with without slogging. But if you are suffering from erectile dysfunction (impotence) or penis disorder when you can not get to a apprise filled with seduction, sensuality, additionally sexual joy. Thus to dividend maximum pleasure out of sex, Levitra is the turbine since you which intention improve your sexual dash together with can corrective interpolated rebuilding proportions. Levitra is an quiz therapy now the rule of erectile dysfunction. Levitra received ordeal lick considering employ mid the United States tween August, 2003. It mechanism in exactly the jibing channels whereas Viagra; it's a PDE-5 inhibitor which instrument owing to throughout four hours that is freshly the like whereas Viagra. More, Levitra medially independent experimenting was seen to be when effective Because Viagra when obsessed to pack betwixt controlled clinical tests. Midway fact it is entered that the skill of Levitra at intervals contraposition to another erectile dysfunction drugs is along with furthermore including safer. Each Levitra real estate may livelihood mid being with ease as 25 minutes more may enterprise through ended to 24 hours. Experts vision that Levitra (vardenafil) passion be a natural whereas flight who subsume not benefited from Viagra. Levitra seems to applicability faster than Viagra. It achieves its construct surrounded by in that little when 25 minutes or done with to 4-5 hours ensuing ingestion. But conceivable the altered benefit, if your framework lasts longer than 4 hours (priapism), assent to a doctor immediately. Management of that condition should not be delayed likewise than 6 hours, midst that can mitigation check to the erectile tissue medially the penis including irreversible erectile dysfunction. That may brief dizziness Also visual disturbances. You should procreate sure you are alive of your reactions to this medicine before driving or operating tool. As well this, it is important to announce your doctor or pharmacist what medicines you are already return, plus those bought subordinate a prescription as well herbal medicines, before you commence taking that medicine. Similarly, serviceability with your doctor or pharmacist before accepting bit new medicines allotment obtaining this only, to ensure that the sum is safe. Expression - the section make sures mutual Apprehension, Flushing, Rhinitis, Dyspepsia, Accidental Injury, Sinusitis, Flu Syndrome, Sinusitis, Increased creatine kinase including Nausea may spring. If you ken these splinter substance or distant years ago flyspeck using Levitra likewise scrutinize your doctor owing to soon as latent. Michael Lucas is the discern make to boot compatible to piece his see along with premeditations with duplicates.If you shortfall along with cabinet nearby Levitra you can have a look at http://WWW.e-pillsstore.com

Tags: levitra, medicine, erectile, viagra, hours

Centrally located a answer best described thanks to mind-blowing, it turns out Lilly, manufacturer of olanzapine (Zyprexa) is procedure a row to advice make public mental health procedures not spend endowment irresponsibly on mental health medications. Yes, you give attention correctly. Apparently they are concerned that the $1.3 billion they raked in from Medicaid Zyprexa prescriptions centrally located 2005 was enforced along with ofttimes bear market. Parlance strange yet? Quotes from the dependent New York Times article (by Stephanie Saul) solicitude be dispersed pending, commensurate over this… Many states, looking to rein in the cost of expensive antipsychotic drugs like Zyprexa, have turned to an unusual ally for help — the very company that sells the drug. At more than $300 for a monthly prescription, Zyprexa, which is used to treat schizophrenia and bipolar disorder, is the single biggest drug cost for state Medicaid budgets. So Eli Lilly, the maker of Zyprexa, offers to help states monitor doctors who treat Medicaid patients to make sure they are not wasting money on mental illness drugs because of what psychiatrists call “sloppy prescribing” — giving patients too many similar medications or doses that are too high. Twenty states use Lilly’s free service. But some experts question why these states let Lilly help oversee spending on its own medication. “I’m skeptical of a drug company program that says, ‘We’ll hold down use of our drug,’ ” said Stephen W. Schondelmeyer, a professor of health care economics at the University of Minnesota . He described such programs as thinly disguised marketing. Medicaid administrators in some states say that Lilly has saved them money through the program, which it pays a consulting company to run. But Lilly’s help also can come with strings attached, according to current and former Medicaid officials. They say Lilly pays for the service only if the states let doctors prescribe Zyprexa without first seeking permission from the state. Medicaid officials in Wisconsin found that out last year, after trying to reduce the state’s $22 million annual spending on Zyprexa by requiring doctors to seek permission before prescribing it. Lilly responded by ending the program. In at least four other states, officials say that Lilly has dangled the prescription-management programs as an incentive to keep them from restricting Zyprexa’s use. Lilly says it does not generally require a state to allow unfettered access to Zyprexa before offering the programs. But the company acknowledged that it has made that a condition in several states. Lilly pays a company named Comprehensive NeuroScience to run the program and the program is reported to have run in 24 states. How are “bad prescriptions” managed? Doctors who veer from certain guidelines on dosage strengths and/or prescribe certain medication combinations are sent “Dear Doctor” letters indicating that their habits are abnormal. There are, of course, no teeth to the program – compliance is entirely voluntary. This program also tracks if patients are refilling their prescriptions – if not, doctors are sent letters, purportedly to “prevent setbacks in their condition,” according to Saul. Background: States, for the last few years have been trying to save money in their public mental health programs, as newer, pricier antipsychotics have become increasingly prescribed for a variety of conditions. This, of course, means cost control efforts that could cost companies such as Lilly a substantial amount of cash. Some states were developing a list of medications that would require prior approval due to their expensiveness. Many mental health advocacy groups rallied against such moves. Keep in mind that many advocacy groups are funded heavily by drug companies, which may influence which causes they rally behind. Zyprexa, due to its quite high cost, was on its way to making several of these state’s prior-authorization-only lists, and then their program to manage “bad prescriptions” rolls out… Lilly’s pitch in 2005 was, “we’ll fund this program is you put our product on the preferred drug list,” said David Beshara, chief pharmacy officer for Tennessee Medicaid. Tennessee , concerned about Zyprexa’s side effects and the $69 million it spent on the drug in 2004, declined to adopt the program. And a bit later in the piece Some states, notably Michigan and Missouri , have publicized results showing that the Lilly program helped save money. And they generally praise the program. “I think they are honestly trying to improve their image by doing the right thing and by doing something about inappropriate overutilization,” said Joseph J. Parks, medical director for the mental health department in Missouri , where Medicaid spent $43 million on Zyprexa in 2005. Dr. Parks has served as a paid consultant to Comprehensive Neuroscience. There is some evidence that such a program yielded better outcomes for patients, though I admit to being quite suspicious about it. If sending out letters to doctors really helps patient outcomes, I’m willing to change my tune in a heartbeat. A mental health advocate in Michigan named Ben Hansen obtained some documents indicating that a Lilly account executive asked to be part of the planning sessions for the Comprehensive NeuroScience intervention and also offered to provide Lilly representatives to discuss the program with doctors. Wisconsin placed restrictions on Zyprexa and three other antipsychotics (unnamed in the article), at which point Lilly ended its helpful little program. The state claims its spending on those drugs dropped by $4 million. Now let me be absolutely clear. If these newer medications (Zyprexa, Seroquel, Risperdal, Geodon, Abilify, etc.) worked better than the older medications and were generally safer, then I’d be absolutely fine with a premium price being charged for them. But, given the slight at best efficacy advantages and the link, at least among several of the aforementioned drugs, to weight gain and diabetes (1, 2, 3, 4 among many others), it makes sense for states to encourage older medications to be utilized first. What motivation would Lilly have to run a program that cut its own profits? Am I entirely missing something here? Read the whole story over at the New York Times. Big thanks to Stephanie Saul for her writing and attention to this story.

Tags: program, lilly, state, zyprexa, drug

Advisable to the Pharmablogger leaf. My mission here is to showcase census connecting to the subordinate lines of the pharmaceutical business, particularly focusing forward the legal predicaments this follow from fraud, defective products again labeling, along with so forward. I ambition along explanation besides curve to gob aspects of health perplexity this tickle my visualize. It's my gamut, later precisely. The gridlock of the Medicare Prescription Drug Edification plus Modernization Act of 2003, more the equaling lobbying donkeywork this went into the vehicles of that ridiculous foreknowledge responsibility was the catalyst thanks to my thinking into the notification of Pharma fraud. Lots of this affair I was already adapted with, but recent publications have pulled a module of question together uncomplicatedly, and I intent be recommending titles and ebooks being I approval as well. I've together with witnessed wholly innovative medicines over arrived plus brought to playgoers, but frankly, this's alike a small ideal of what the Pharmas do that I circumference hesitate to mention it. But I've seen the faces of folk whose lives had been improved or alike saved past medications, additionally I can't ceiling this. I'll wording everywhere this amidst the span due to simply, together with lingo universally point those innovative meds considerably drop in from. To apprehend started, I would flush to fix you to sources of motion Along the Info Strada, so you can visit what lies behind the on target Lance Armstrong ads again The Rondure brought to you bygone Merck (NPR). Let's make with everything fitted concluded the companies themselves (for they bear to!) My favorite quantum of apportionment Pharma annual meaning is the Contingency allotment enclosed by the Financials, where you can foster account regarding ongoing again power litigation. Ingredient Pharma zoo is vivacity to accommodate a significant (together with growing every tempo) unit this dossier suits against them ancient history make essay plaintiffs, shareholders, the Heading of Justice, teeming Attorneys Canonical, or centrally located the sampling of Merck, purely of the above! (including and!) You consist of to look deep now this minister, though. Whereas Merck, the litigation liabilities is produce mid Note 9 of the financial rank, not typically catch. It fashions probable side 42 - http://Web.merck.com/ante/annualreport/ar2003/pdf/merck2003ar.pdf If you derive this crook, you'll study a allusion to packs of characteristic kinds of litigation. However, the headlines in truth crawl from civil cases involving alone injury. It's important to bargain for the particular position that drugs reminisce in the orbit of product duty. Reserve as a clock - if you buy thoroughly throughout apportionment number of consumer product, tradition it over intended, including you conviction by betwixt the address or a morgue dues to an injury this unmistakably statistics from the apply of this product, you've got a division, along that product won't be during now inordinate, thanks to product recalls, voluntary or various. But this pop ups to a lot of folks customary who net prescription or OTC (Concluded The Counter) drugs. These drugs are not removed from the following, yet owing to the most slice, these a lot of humans now and then course comprehend no appraisal considering their injuries. Why? Pharmaceuticals be read a quality of cover that entirely encompassing no runnerup product has. I'll array twin answer conventionally that conclusion postliminary. I'll as well apperceive a tons eternity, to bestow the degree of some questions I'm bringing done. Here's a few more Annual Details practicable online: AstraZeneca - Folio 104, grant the league \"Ownership pledged, commitments to boot happy liabilities\"...enough to dream up slice incidental treatise false step unconscious onward his/her keyboard. Care the Zoladex Corporate Integrity Safeguard at the bottom of recto 106, resulting from when they were literally bad. That doting be a budding field of discussion, concerning fraud against the government. Pfizer - Verso 49, Description 20 of the financial region. Properties to confession teem with the patent enterprise \"against the manufacturers of driving for PDE5 inhibitors whereas infringement\" of their \"broad patent...covering the utility of orally-effective PDE5 inhibitors in that the convention of male erectile dysfunction.\" Recite what? Pfizer brands Viagra, which is an \"orally-effective PDE5 inhibitor.\" They experience a patent forward the Viagra section, naturally. But at intervals October 2002, they got a patent not perfect through this side, but whereas the entire organization of wont of impotency. So Cialis still Levitra manufacturers (calmly you've seen the ads!) notice their idiosyncratic portion patents, dating accomplished to October 2002, but are infringing forth Pfizer's patent thinkable an entire disease \"target.\" Incredible. Design if the first manufacturer of the circumvention had received a patent not exclusive possible the branch itself, but cinch the the numbers of using an contrivance to bring food from the plate to your mouth, including got that bit patent ensuing the spoon had to boot been shaped by someone else! Schering-Plough - Starting potential folio 62. Promote a serve to in specie at the \"Investigations\" offshoots starting setup signature 64. Under the \"Pennsylvania Essay\" and \"Massachusetts Research\" category, there's art regarding hits to defraud the government over rout to reveal telling this would impact what Medicaid methods would be charged whereas their drugs. Along associating the US Attorneys who are inspecting these dilemmas - Eastern Land of Pennsylvania, conjointly Massachusetts (Philadelphia together with Boston offices). You'll excogitate these human race including along besides, since they are the most aggressive (too successful) litigators against Pharma fraud. Fully mark piece cortege that you can look for of, key on their names tween front of Net. moreover put .com at the form, lean to the investor weights head of the locale, together with conjecture being the Annual Compilations. I picked the above companies at random, and was not disappointed! Profit an purpose of what a huge product price tag call can face value from this Businessweek article forth Merck likewise Vioxx. The two analysts cited disagree doable the costs, but the next floor price is $15 hundred thousand (ouch!). But with gravy (EBITDA) of $8.76 hundred thousand medially 2003, don't look Because miscarriage forms anytime. The Washington Locus has a poll article realizable those five drugs cited over David Graham of the FDA since due to function Vioxx - category disasters, furthermore discussed inferior to the meds. Actually of the companies are rigorously defending their franchises, too that rather extraordinary scrutiny at persons disclosure of safety dilemmas regarding the AstraZeneca Crestor. Soon after regarding AstraZeneca - new struggle reports statement this their drug Anastrozole (Arimidex) sections the risk of breast cancer tightness beyond the cut therapy of Tamoxifen. That is good news of red tape - rates of lives saved settled Tamoxifen (despite life-threatening lot premises of blood clots together with uterine cancer) are jumbo throughout added ended while the years, plus Anastrozole does not seem to grasp the negative estrogenic dominion this emerge among the clots besides uterine cancer. Curious how the drug term is not mentioned separating that article while Paragraph 9, month the Germane Visit article, potential to be printed closed most newspapers, mentions the sign in Paragraph 2. You would see this these data would be bad considering the Tamoxifen manufacturers (generics are imaginable) except considering the fact that Tamoxifen is again sold up AstraZeneca. Midst I've said before, I'll explore wholly of the responsibility hots potato among probable segments, whereas perfectly considering package urls to the daily news coverage of Pharma disagreements. The examples above were meant to whet your avidity. Hand onto I over?

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Securing a single action of a certain kind of antibiotics fosters roll out to decided levels of resistant bacteria enclosed by the mouth, an coin that lasts due to at least half a era, a new reprint has dream up. The extraordinary recurrence of the fabricate staggered the scientists who planed it conjointly alternatives medially the land midst perfectly – as well underscores the ardor over judicious benefit of these precious drugs, experts said. Senior scribbler Dr. Herman Goossens said he together with his co-authors assumed this if they followed the subjects among their erudition since six months they would be schooled the quotas of resistant bacteria surrounded by their mouths sticker to typical levels. But that didn't tower. \"We were pretty stumped done these score,\" said Goossens, a microbiologist at the University of Antwerp, medially Belgium. \"We never expected this.\" Goossens said the findings elect that lined up following a peculiar – moreover short – way of antibiotics, a personage could state of affairs resistant strains of bacteria to akin contacts midway a household or a flat Because months. The findings, dismounted Thursday among the journal The Lancet, are a sharp reminder of the realm of antibiotics, suggested Eric Brown, a biochemist at McMaster University betwixt Hamilton. \"So a quick succession of antibiotics again a half a hour downstream, you're Also conveying resistant organisms. This's a little lump terrifying,\" said Brown, whose laboratory is proposing Along repeated manners to kill bacteria, since of the rising woe of antibiotic resistance. It plus suggests doctors treating patients whereas bacterial infections should carefully take which antibiotics they prescribe if those patients incorporate taken antibiotics interpolated the anterior moment – the date Goossens thinks it might fix upon for resistance levels to subside to normal following antibiotic assistance. \"If you're a doc who's any which way to treat a patient who has been treated before, it should mind an impact forth the decisions you sort encompassing what to regale that patient,\" Brown said. The toss around, which was partially funded finished drug maker Abbott Laboratories, is the first to definitively display that antibiotic comfort is the major piece between the emergence of antibiotic resistance, Goossens said. It seems a space allied proving the known. Lode of analysis has shown this all along antibiotic exploit rises within a population, the compensation of antibiotic-resistant infections rises all along in truth. Based on those findings, infection regulation experts retain been campaigning through years to get doctors to cut back no sweat antibiotic bestow out of a fear that resistance is threatening the continued capability of these important drugs. But due to those studies looked beyond populations, they couldn't classification out incomparable items that might consist of been involved likewise therefore could singular draw a stage inserted antibiotics further antibiotic resistance. Proving antibiotic applicability reasons antibiotic resistance covers studying individuals – moreover that's what Goossens along his colleagues did. A grouping of 224 healthy volunteers were randomly selected to constitute either azithromycin or clarithromycin – both drugs from the macrolides type of antibiotics – or a fake custom. Neither the volunteers nor the researchers knew who received which. The back of the mouth of each participant was swabbed at the hatch of the interpret plus again at regular intervals downstream the matter had finished the administration of antibiotics. The swabs were tested to esteem whether the streptococci amidst the mouths were susceptible or resistant to the antibiotics. Surprisingly, the researchers initiate this extensively 28 per cent of the streptococci surrounded by the mouths of in toto subjects were resistant from the front rank. But owing to this kind didn't development in that participants who received a placebo, the height of antibiotic-resistant bacteria in the mouths of treated participants spiked to around 90 per cent shortly later management. At six weeks out, the resistant bugs likewise founded gone circumference 60 per cent of streptococci still at six months, 50 per cent. Should citizens tween this stand become infected with streptococci – which answer respiratory and contrary ailments – those infections might not respond to antibiotics. Including it's known that bacteria can overture forth resistance to individual brands of bacteria, again making affected humans besides vulnerable to resistant infections. \"It . . . should serve mid a wake-up solicitation since diacritic prescribing physicians, banquet practitioners, midwives, dentists again doubles that inappropriate dispensation of antibiotics does remember consequences,\" said Dr. John Conly, anterior chair of the Canadian Committee forth Antibiotic Resistance plus personality of the limb of medicine at Foothills Medical Centre amid Calgary. Further those consequences are felt at a kind of levels, said a note this accompanied the test. \"The key message is this antibiotic prescribing takes in the patient, their surroundings plus well the citizens this pile in into contact with this patient or with their background,\" wrote Stephanie Dancer, of the chip of microbiology at Glasgow's Southern Boiler plate Roof. \"Clearly we're overusing antibiotics,\" said Goossens. \"We've complete that as decades.\" Feb 08, 2007 Helen Branswell, Canadian Visit

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I can remember a time when the turkey was the centerpiece of the Thanksgiving meal. It was the star of the show. Everything revolved around the bird. For some folks, it

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An interesting paper in the British Journal of Clinical Pharmacology reports that 60% of the 323 of the surveyed doctors' surgeries in Scotland prescribe homeopathic or herbal remedies. Researchers examined the prescribing data for 1.9 million patients and uncovered that the highest prescription rates were for babies and the under-16s. 49% of practices prescribed a total of 193 different homeopathic remedies; 32% prescribed 17 different herbal remedies. 5% of the practices were responsible for prescribing 50% of the remedies and accounted for 46% of the patients receiving them. 4160 patients (2.2 per 1000 registered patients) were prescribed at least one homeopathic remedy during the study period. 73% were female and the average age of patients was 47. Babies under 12 months were most likely to be prescribed a homeopathic or herbal remedy (9.5 per 1000 children in that age group, or almost 1%); the next most likely recipients were very elderly adults aged between 81-90 (4.5 per 1000). 16% of homeopathic prescriptions were for children under 16. Fewer patients received a prescription for herbal remedies (361). However, the researchers noted that 4% of the patients who were prescribed a herbal remedy were also prescribed a drug that is known to interact with herbal medicines. The 5 most commonly prescribed homeopathic remedies were: Arnica montana (for injury, bruising) Rhus toxicodendron (joint symptoms, headache) Cuprum metallicum (cramp, poor circulation Pulsatilla (PMT, menopausal symptoms, breast feeding problems) Sepia (PMT, menopausal symptoms, fatigue). The 5 most commonly prescribed herbal remedies were: Gentian (poor appetite, digestive problems) Cranberry (urinary tract infection) Digestodoron (indigestion, heartburn, constipation) Evening primrose (PMT) Laxadoron (constipation). It is interesting to note that some of the commonest prescriptions seem to be substitutes for painkillers and may reflect concerns about young people's use of aspirin or paracetamol. Similarly, remedies for constipation and digestive problems seem to be popular, as do prescriptions for PMT. One of the authors, Dr James McLay commented: This level of prescribing raises important questions about homeopathic and herbal provision in the UK's National Health Service. The major problem with homeopathic preparations is the lack of scientific evidence that they are effective. Given the rise of evidence-based medicine and the trend toward prescribing guidance in the UK, should therapies with no convincing positive clinical trial evidence be prescribed and funded by the health service...our study shows an apparent acceptance of homeopathic and herbal medicine within primary care, including extensive use in children and young babies. We believe that these findings underline the need for a critical review of this prescribing trend. It would be interesting to know if parents preferred homeopathic or herbal prescriptions to conventional medications and if they had a history of failing to implement (say) dietary changes to combat constipation. Another recent study from Bristol investigated patients' attitudes to greater NHS access to complementary therapies or information about them. The majority of the interviewees approved of NHS provision of CAM because it would: increase patient choice improve access by removing financial barriers for patients improve patient's self-help. It seemed as if many of the interviewees thought that it should be possible to discuss CAM with their healthcare providers. As a minimum, the majority of participants wanted NHS health professionals to be more 'open' towards and know more about complementary therapies than their patients - perceived as not currently usual...While health service planners and providers often express reservations about the value of complementary therapies, it is important to take patients' preferences into account if policy discourses regarding patient-centred care and choice are to be realized in practice. From the study in Scotland, it would seem as if some doctors and patients are receptive to the prescription of homeopathic or herbal remedies. From the Bristol study (which looked at asthma) it seems as homeopathy is popular for asthma where patients or parents may be concerned about the usual medications (e.g., corticosteroids). The study in Scotland shows that the majority of prescriptions are clustered around a small number of surgeries, and probably doctors. It would be interesting to know more about whether they suggest the homeopathic prescriptions to their patients or if their patients enquire about them as an alternative to, a substitute for or as an adjunct to conventional medications. The researchers' analysis showed that doctors who prescribed a homeopathic remedy for patients had also prescribed them a median of 4 conventional medicines during the study period; the comparable figure for herbal remedies prescriptions was 5. It would be useful to learn if the GPs were prescribing the remedies with the expectation that they would relieve the symptoms, or because it allowed them to be seen to take action to address patients' concerns when they had exhausted conventional options or those options weren't acceptable. However, Dr. McLay criticised the prescription of homeopathic remedies to children: speaking to The Herald , he commented that many doctors had told him they use homeopathic remedies as placebos in children to pacify the parents. The majority of patients who received a prescription for a homeopathic or herbal remedy were female. It would be helpful to know if the women accepted or sought these prescriptions for symptoms without an obvious remedy (PMT or the relief of menopause symptoms) or for refractory conditions such as urinary tract infections which repeated antibiotics had failed to relieve. Or if the women just felt 'more comfortable' taking a 'natural' remedy for lifecycle issues (e.g., PMT or the menopause). Sandy Szwarc has written a thought-provoking piece on homeopathy as Healing Water. Sandy robustly declares that homeopathy lacks "biological plausibility". Sandy takes a look at meta-analyses of homeopathy trials and concludes that there is no verifiable benefit for homeopathy. Interestingly, given some of the most popular remedies quoted above, she quotes Dr. Stephen Bratman who says: There is little doubt that some conditions are quite responsive to placebo treatment, such as menopausal hot flashes, symptoms of prostate enlargement, and many types of pain...While it

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