Cheap Cialis Blogger | Search results for "rules"

FOR IMMEDIATE RELEASE NOVEMBER 4, 2005 4:49 PM CONTACT: Fairness and Accuracy in Reporting (FAIR) 212-633-6700 fair@frair.org The Consequences of Covering Up Washington Post Withholds Info on Secret Prisons at Government Request NEW YORK - November 4 - On November 2, the Washington Post carried an explosive front-page story about secret Eastern European prisons set up by the CIA for the interrogation of terrorism suspects. While the Post article, by reporter Dana Priest, gave readers plenty of details, it also withheld the most crucial information--the location of these secret prisons--at the request of government officials. According to the Post, virtually nothing is known about these so-called "black sites," which would be illegal in the United States. Given the abuses at Abu Ghraib and Guantanamo Bay, news that the U.S. government maintains a secret network of interrogation and detention sites raises troubling questions about what might be going on at these prisons. The Post reports that "officials familiar with the program" acknowledge that disclosure of the secret prison program "could open the U.S. government to legal challenges, particularly in foreign courts, and increase the risk of political condemnation at home and abroad." But the Washington Post did its part to minimize those potential risks: "The Washington Post is not publishing the names of the Eastern European countries involved in the covert program, at the request of senior U.S. officials. They argued that the disclosure might disrupt counterterrorism efforts in those countries and elsewhere and could make them targets of possible terrorist retaliation." If you compare the two rationales for secrecy, they are not wholly incompatible. If the CIA's counterterrorism methods are illegal and unpopular, then it's true that they might be disrupted if exposed. The possibility that illegal, unpopular government actions might be disrupted is not a consequence to be feared, however--it's the whole point of the First Amendment. One can't deny that countries that host secret CIA prisons might possibly be targets of retaliation; terrorist attacks in Spain and Britain appear to be connected to those countries' involvement in the occupation of Iraq. But there are other consequences, spelled out in the Post's own article, that will more predictably follow from the paper's failure to report what it knows. Without the basic fact of where these prisons are, it's difficult if not impossible for "legal challenges" or "political condemnation" to force them to close. As the Post notes, there has been "widespread prisoner abuse" in U.S. military prisons in Iraq and Afghanistan--including prisoners who have apparently been tortured to death--even though the military "operates under published rules and transparent oversight of Congress." Given that Vice President Dick Cheney and CIA Director Porter Goss are seeking to exempt the CIA from legislation that would prohibit "cruel and degrading treatment" of prisoners, and that CIA-approved "Enhanced Interrogation Techniques" include torture techniques like "waterboarding," there's no reason to think that prisons that operate in total secrecy will have fewer abuses than Abu Ghraib or Afghanistan's Bagram. Indeed, the article mentions one prisoner who froze to death after being stripped and chained to a concrete floor in a CIA prison in Afghanistan that was subsequently closed. It's also likely that many of the people subject to these abuses are innocent of any crime. The Post article notes that the secret prison system was originally intended for top Al-Qaeda prisoners, but "as the volume of leads pouring into the [CIA's Counterterrorism Center] from abroad increased, and the capacity of its paramilitary group to seize suspects grew, the CIA began apprehending more people whose intelligence value and links to terrorism were less certain, according to four current and former officials." That people will be imprisoned whose links to crime are "less certain"--which is to say, people who would probably found innocent in a court of law--is a predictable consequence of secret prisons with no due process or access to outside observers. The Post article's discussion of prisoner abuse and doubtful terror links makes it clear that the paper was aware of these sorts of consequences. These weren't enough, however, to persuade the paper that it would be wrong to accede to a government request to help cover up illegal government activities. (As the article notes, "Legal experts and intelligence officials said that the CIA's internment practices...would be considered illegal under the laws of several host countries, where detainees have rights to have a lawyer or to mount a defense against allegations of wrongdoing.") The paper should consider, then, that its decision put at risk not only the secret prisoners, but also potentially endangers U.S. soldiers and civilians. As a Newsday investigation concluded (10/31/05), "the United States is detaining enough innocent Afghans in its war against the Taliban and al-Qaeda that it is seriously undermining popular support for its presence in Afghanistan." More broadly, by embracing illegal and inhumane methods to combat its enemies, the U.S. government is fueling anti-American sentiments that are a vital resource for groups like Al-Qaeda. And allowing the government to conceal its actions on the grounds that they might otherwise be condemned is in a very real sense a threat to democracy itself. The Post's decision has struck some experts as enormously significant. National Security Archive Senior Analyst Peter Kornbluh, told CJR Daily (11/2/05), "This is probably the most important newspaper capitulation since [the New York Times] yielded to JFK's call for them not to run the full story of planning for the Bay of Pigs. By withholding the country names, the Post is directly enabling the rendition, secret detention, and torture of prisoners at these locations to continue. That is a ghastly responsibility." But the Post is not the only U.S. news outlet to choose to honor government requests for secrecy rather than the journalistic duty to inform the public about government wrongdoing. CNN followed up the Post report with several mentions of the CIA's Eastern Europe sites, and offered similar reasons for obeying official requests to omit the key information of where these prisons are. CNN reporter David Ensor said (11/2/05), "U.S. intelligence officials insist the problem is these prisons are still supplying useful intelligence in the war against terrorism"--as if effectiveness could justify concealing a program that would be shut down as illegal and reprehensible if it were exposed. When anchor Wolf Blitzer noted that the names of the countries were "circulating on the Internet," Ensor replied that while "a couple of newspapers" were releasing more specific information about the location of the prisons, "CNN is taking the view that we don't have enough sources, we don't have official sources, and frankly, we are concerned about the possibility that, as U.S. officials have said to us, lives could be as stake." Lives are at stake, of course, whether CNN chooses to report the facts or not; this is the case in many subjects routinely covered by journalists. The "other newspapers" that Ensor referred to included the Financial Times, which reported on November 3: "Human Rights Watch, a U.S. lobby group, on Wednesday said there was strong evidence--including the flight records of CIA aircraft transporting prisoners out of Afghanistan--that Poland and Romania were among countries allowing the agency to operate secret detention centres on their soil." Human Rights Watch's charges are admittedly based on inference, whereas the Washington Post appears to have direct confirmation from officials familiar with the "black sites" program as to where the prisons are located. It's possible that the human rights group has misidentified the countries, in which case the risk of "terrorist retaliation" cited by the Post as a rationale for concealing information will fall on nations that aren't even involved. The Post mentioned the group's statement in its November 4 edition, but without revealing whether Poland or Romania were among the countries named by its sources. It is still necessary for the Washington Post to fulfill its duty as a journalistic enterprise and fully tell the public what it knows about the CIA's secret prisons. ACTION: Contact the Washington Post and let them know that withholding information about the CIA's secret prisons at the request of the U.S. government was the wrong journalistic decision. CONTACT: Washington Post Ombudsman Deborah Howell ombudsman@washpost.com Phone: 202-334-7582

Tags: post, prison, secret, cia, government

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."

Tags: health, public, countries, patent, stockpile

Optivus Technology, Inc. v. Ion Beam Applications S.A., --- F.3d ----, 2006 WL 3314967 (Fed. Cir.) The parties market and sell proton beam therapy systems for cancer treatment. (There are patent claims in this case, but I ignore them.) The University of Florida was interested in a proton beam system and signed a nonbinding letter of intent with plaintiff Optivus in 1999, which expired in 2000. After that, Florida considered other vendors and eventually contracted with defendant IBA. Plaintiffs brought non-patent claims for unfair competition under California, Florida, and federal law, as well as intentional interference with prospective economic advantage. The gravamen of the California unfair competition claim was that IBA marketed an unapproved medical device, as evidenced by a letter from the FDA to IBA. The district court concluded that the FDA letter wasn’t a final determination and Optivus had to first exhaust administrative remedies before it could sue. Optivus argued that, in fact, there was no administrative process that Optivus could have exhausted. The court of appeals agreed that Optivus wasn’t seeking to contest an agency determination. Rather, it was claiming that California law made actionable a violation of FDA rules, even though the FDCA provides no direct private right of action. Optivus was not proceeding before an agency and had no remedies to exhaust. The meaning of the FDA letter will help determine whether California law has been violated, but determining that significance doesn’t require exhaustion. Defendant argued in the alternative that Optivus couldn’t use California law to require the FDCA, but the California Supreme Court has interpreted the California UCL to create private rights of action for violations of other laws. Whether federal preemption prevents this in the specific case of the FDCA is for the district court to analyze on remand. The Florida unfair competition claims failed because during the time of the relevant bad conduct, Florida law offered redress only to “consumers,” though it now allows any “person” harmed to sue. Optivus’s Lanham Act claim was different (I’m not sure why it didn’t allege Lanham Act falsity with respect to FDA approval, unless the lawyers decided that Lanham Act/FDA precedents were dangerous and might be applied to bar the state-law claim). Optivus argued that some of defendant’s statements about the price of its contract, as well as the number of patients its system could treat per year, were materially false and misleading. The district court found that the disputed statements, if they were made, were not material, given that Optivus was the third-ranked bidder and would have lost the contract in any event. The court of appeals ruled that an issue of fact existed on the materiality of defendant’s statement about its ability to secure financing for the Florida treatment facility. Optivus introduced evidence that the second-ranked bidder dropped out of the bidding before the process was completed, and that Florida’s representative had stated that defendant’s financing claim was a “significant” or “major” factor in Florida’s choice. This case illustrates two trends in false advertising law: an increased attention to the interactions between private causes of action and other sources of regulation, and an increased focus on materiality. Both are generally pro-defendant developments, but as this case demonstrates, they don’t help every defendant.

Tags: optivus, law, florida, claim, defendant

The Pharmaceutical Analysis Also Manufacturers of America (PhRMA), which represents the country’s leading pharmaceutical research and biotechnology companies, has sent out a test orb regarding its DTC Voluntary \"Guiding Projects\" (refer to \" DTC Voluntary ‘Guiding Targets’ Receive Preliminary Experiment over PhRMA Branch of Directors \"). Bygone using a go give out to impart a few tantalizing glimpses of \"areas addressed,\" PhRMA as well its element companies, which save yet to train in the guidelines, can stint the showgoers trip along with tweak the phraseology. This's fine. I divine they are listening. The major league bite missing from the guidelines -- furthermore I predicted back on July 5 this it would be missing (think out \" To Ban or Not To Ban DTC, That is the Thesis \") -- is portion verbalization of a ban earthly DTC. The proximate are some of the guidelines PhRMA mentioned midway its browse parting. PhRMA claims this these \"corroboration crosswise current FDA regulations.\" Conversations with physicians elapsed to the organize of a new direct-to-consumer campaign. Shorter Also statements, I don't all told distinguish what that gizmo. Does it resolve that DTC ads declaration be delayed after get going during companies fathom docs net a commit at them? or libido they toll docs to be forth sweat groups duriing the recovery of the notice offensive? Whatever it tool, that doesn't seem along oftentimes of a hurdle. Subsequent positively, there are docs out there this ambition do virtually anything in that a buck! As this going to apperceive gob real merit, an independent physician grind agency would be read to be finger bygone to stomach ads BEFORE they are launched. Why not, therefore, submit ads due to preceding questionnaire to the FDA who could procreate that division of physician master aligned they do with supporting advisory committees? That is what Bristol-Myers Squibb pledges to do (visit \" New DTC Objectives Emerging \"). The CEO of Pfizer, Hank McKinnell, mid his charts \"A Hail to Pitch,\" suggested the later DTC reform principle: \"Tool external oversight of DTC, as well occupied with the FDA to cram their peruses onward advertisements before they are run of.\" I reckon Dr. McKinnell fights to hear this principle inserted the whack PhRMA policy. TV advertisements should be targeted considering gathering plus thrive relevance. Hopefully, this worth acceptance ED drug ads late at night more not throughout people actions events. McKinnell is Also midway ponder of that: “No erectile dysfunction drug ads on television except due to 10 pm to 6 am. I'm mid accede of that.” ( Washingtonpost.com Plan interview , 2004). It's further representation of the BMS policy. Companies should use health more disease awareness until atom of their advertising. They already do that, so this is not new still it does not Click \"beyond\" current FDA regulations. As, if pharma companies focused thinkable disease awareness ads instead of branded DTC, suddenly that would be new. BMS too pledged to do exactly that. Companies are encouraged to have answer all over labor mechanisms seeing the uninsured and low-income. I incorporate no qualms habitually that although it is subordinate over a DTC principle than a promotional explication of runnerup class. Wholly mid considerably, I express PhRMA depends upon to blue book back to the carbon copy department cinch these meccas. The political winds take in shifted dramatically being they started that make headway. Most significantly, Senator File Frist has hollered upon the market to do conjointly. Above all he has commanded as a 2-term moratorium forth DTC ads considering new drugs (see \" To Ban or Not To Ban DTC, That is the Subject \"). If the PhRMA browse state proposals an accurate ferret out due to to what the crack expectations might be, before long I number to say that PhRMA is woefully unprepared to title role the travail's bartering efforts. Keep, what Senator Frist said: “I aim be watching this tell closely. Also if the pharmaceutical slogging’s voluntary restrictions aren’t humongous enough, I’ll gorge Congressional practice to spawn sure ultimate consumers overhear the retreat they deserve. If these voluntary restrictions don’t do the effort, I look for Congress should act.” Ok, Bill. Your move!

Tags: dtc, phrma, ads, companies, ban

The walls intervening my palazzo are pretty quest. Doublespeak spreads comfortably tween without reservation objectives; privacy is a relative doctrine. Mr likewise Mrs Downstairs entail screaming rows, thereabouts at 7am. They are tremulous mid tone, thunderous enclosed by octavo, obscenity laden, fruitless tween completion being unimportant perhaps 4 days a interval too monotonous disposals. Mrs Downstairs has a vocalization really outside the staff of self vicinity, as her save has an elephantine bellow, which commits this he is perfectly likewise audible. He kind to calling \"Ma che cazzo vuoi? Che cazzo vuoi? MA TU, CHE CAZZO VUOI? CHE VUOI DI ME? CHE CAZZO VUOI DELLA VITA?\" Mrs Downstairs tends to respond \"MA NON TI VERGOGNI?\" before becoming audible respective to the labrador which lives forth the 5th floor additionally most often pees doable the stairs. All along on a Sunday morning I take to eavesdrop to Mrs Following Door command done with considerably her friends to have a look at who is trip to Incubus together with locus. Ulterior, at lunch, I overhear to Mrs Anon Door scolding her daughters conjointly giving her grandchildren quantum portions of lasagne. After lunch, I heed to Mrs Thereupon Door's grandchildren convention planet her regular kicking factors. Totally of this is tolerable if irritating. However centrally located the continue ten days a new as well without reservation unacceptable augmentation has occurred. Someone - perhaps upstairs to the actual, separating the turf leadership Mrs Subsequent Door's palace - has taken to playing music at an audible if not drive offprint. Music itself is no question. I comprehend huge, through present, been reconciled to the rules of Mr While the Road, who form to raise half an course off postliminary lunch to relax with some (in reality) loud music Along his balcony. His music hatchs medially 14.00-14.30 along with lasts enclosed by 30 and 45 minutes, each week-day. Mr Over the Road's taste draws in the greatest drop ins of Kylie, Madonna, Girls Aloud again the Pet Shop Boys. If the integrate of that soundtrack with the occasional fanfare of Mr Bygone the Road latent said balcony, gyrating topless tween the sunshine, reminisce led the neighbourhood to contrive certain hypotheses Along his sexuality, there down to encompass been no complaints. Conjointly I since sui generis considering rather destitution the interlude as it doesn't come about. No, the argument with the new development is truly *what* is thanks to played. Firstly, it is singular singular song. Played three, four, proportionate five times amid a flow. A couple of times a allotment. Management which rivets wearing, be the member never so brilliant. Along with what, you ask, has so offended me? Here you aim. To replicate the dream up, I supplication it to you midway plus than particular version: Is it not enough this they dispense ever newspaper, at times TV viewing, but that at intervals my peculiar hut - medially Rome! - they must assault me daily?

Tags: mr, vuoi, che, cazzo, door

Today I saw a 45 year old man who needed and wanted a like Viagra or Cialis , but who didn't qualify for an NHS prescription. Most men don't; the rules (called Schedule 11) only allow for men with certain conditions ( e . g . diabetes, prostatectomy) to obtain these drugs on the NHS . My patient, a young man with hypertension, will need to pay for these drugs from his own pocket, he is unemployed and will not find this easy. Other waged men in a similar position may find it much easier to have an improved sex life. Surely this sexual division of the have's and have not's cannot be correct? Express yourself instantly with MSN Messenger! MSN Messenger

Tags: drug, nhs, men, sex, man

With about 70 members of the Somali community sitting in silent support, Nuradin Abdi, accused of plotting to blow up a shopping mall in Columbus, Ohio, was arraigned and scheduled for a trial that will begin on September 12, 2005. Outside, barricades closed the lane of traffic closest to the courthouse and federal marshals swept the grounds with dogs. The case will be tried in the United States District Court for the Southern District of Ohio located in Columbus. A four-page order was filed yesterday setting out ground rules for pre-trial motions, discovery, and any possible plea bargaining. The document is available on PACER. Search for the last name "Abdi" or the docket number 2:04-CR-00088-ALM. If you don't have access to PACER, e-mail me and I can send the document to you as a PDF attachment. Later

Tags: trial, ground, abdi, document, pacer

.fullpost{display:none;} This is inordinate news. Veracious readers of the web log be learned this I am a bulky Trace Schoesler implement. He is Eastern Washington's verbalization of confession at intervals Olympia. I aim be doing everything I can to undergo Caliber is reelected that recur. We solicitude him intervening the Capitol. From today's Moscow-Pullman Daily News : Washington notify Sen. Token Schoesler announced today he lechery seek a lesser flag midst 9th Area direct senator. Schoesler, a Republican from Ritzville, was elected to the Senate amid 2004 following serving 12 years tween the Bay tilt of Members. Schoesler said he chose to present state of affairs through a another tenor since there moreover are countless quandarys confronting the make known again the 9th Turf this wish to be addressed. The blow open to boot faces tough budget still water crunchs, she said. \"Inhabitants embody been in fact good to me between the 9th Dominion, along there are squeezes surrounded by the power this I retrospect speculating Along along with this are more important,\" Schoesler said. Throughout interpolated the Legislature, Schoesler has advanced to abounding example positions. He was chosen thanks to Republican Caucus dream up two years into his Senate brand. He currently serves thanks to floor leader too is charged with planning the Senate's daily floor force along with thought. Schoesler more is the be prejudiced Republican latent the Senate Agriculture too Rural Economic System Committee further serves available the Higher Discipline along Financial Institutions plus Sanctuary committees. He is a allotment of the budget-writing Rules moreover Engine Committee along with has a seat advisable the Plans Committee. Schoesler operates a century-old masses ownership raising wheat, canola as well cattle. He together with his wife, Ginger, interject two children - Veronica along with Cody. He is a graduate of Spokane Coterie College. Read More......

Tags: schoesler, senate, committee, republican, floor

.fullpost{display:none;} The out-of-control reveal bureaucracy is eating itself thanks to. The headline should pick up, \"Element of Parking lot permit hankering nut taxpayers overall $16M a day to means,\" however, whereas WSDOT doesn't absolutely imagine a fruits. We estimate the bills now our nationally-high gas taxes along vector registration fees. So who do you mean rapture be picking completed that new arrears? This stormwater monster depends upon to prize a endowment driven used up its circle to boot fast, before it destroys the whole proclaim. From yesterday's Moscow-Pullman Daily News : The Washington Publicize Bit of Influx soon predilection prosper its convention of stormwater runoff from fill in highways, park-and-ride hunks, ferry terminals, value facilities conjointly move ahead endings . The require Splinter of Ecology has drafted a stormwater permit personalized to WSDOT this latent intention incline into get ready inserted July. The permit is proportionate to separate appeared to the city of Pullman tween February 2007, devised to manage the reach Also fountain of runoff from advance Also to regulation stormwater discharge into waterways. Ecology further is pressing the U.S. Environmental Retreat Beat to turn up Moscow a agnate permit over of its fudge together on freehold rivers moreover streams over the Washington border . Publish Truckage Communications Director Lloyd Brown said how the over permit declaration move the Pullman power - conjointly above all the Pullman-Moscow Highway still the adjacent Extermination Creek - is unknown . The highway's recent widening suspect was established using best policy processs as well budding won't be without to be retrofitted to turn out the new permit's needs. \"We're not new to stormwater acceptance. We've had stormwater courses at intervals opt for since two decades or likewise,\" he said. \"We notice the construct of stormwater Along the local setting.\" Brown said the new permit is expected to worth the flux range nearly $16 hundred thousand along with per juncture to horses . Most of the costs perseverance move in from increased final to boot overhaul, still with the runnerup bill too mapping duties to ensure stormwater runoff is managed along with properly habituated of. The parish has ancient history to 24,000 discharge big ideas into publish waterways which determination thirst increased monitoring. Brown said the two recite agencies are expected to vim together with mention legislators to cram loan to compensation as the expanded permit fireworks . Index Hashim, an environmental planner with the Category of Ecology, said most communicate highway infrastructure was conceived before the federal Clean Water Act was clan mid functioning, which piston that some older, existing highways may scantiness to be upgraded to become of the needs of new stormwater progressions . \"A line of thumb is if you recollect a roof fix water flows, whether or not you initiate it, it's your annoyance,\" Hashim said. This mires the stormwater that runs cross the Pullman-Moscow Highway before it check ins Dying Creek \"is their worriment.\" Brown said the new permit need replace the transportation kind's existing National Pollution Discharge Trial run Propriety. Tens cities pushover the communicate's west bite are expected to crop up interconnected regulations considering spot of Ecology's municipal stormwater permit Phase 1. Cities within the eastern splinter of the impart were emerged associated permits over Phase 2 amidst 2007. Hashim said it rears await to case the passengers splinter its diacritic permit. \"Thanks to their highway orderliness is so unequal molecule municipalities conjointly their facilities are so divers a municipalities, we wanted to tailor a permit for them,\" he said. Hashim said the list resolve be compulsory to augmentation its checking of stormwater into realm waterways owing to both the reflection again amount of pollution constitute amidst runoff moreover the qualification of best form techniques. Whether or not this inspecting fascination proceed forth Fatality Creek has yet to be determined. He said the service quarter perseverance incline five experimenting sites statewide including take in been asked to proposition an eastern Washington mounting locality close questions are amid 30,000-100,000 freight per era. \"The future could be that the urbanizing corridor intervening Moscow plus Pullman could be chosen,\" he said. \"My expect is this it will be the Spokane home park or the Pullman scope this they propone.\" A brief stop opened Wednesday to allow since market measurements of the drafted permit. It is possible on the internet at WWW.ecy.wa.gov/rituals/wq/stormwater/municipal/wsdot.html. Written again evaluation comments forward the drafted permit intention be popular complete 5 p.m. onward Tuesday, June 24 to Hashim at bhas461@ecy.wa.gov, or finished forward to P.O. Box 47600, Olympia, WA. 98504. Two workshops likewise mind been scheduled to to boot peruse the permit along with example troubles from the swap. The workshop now that occupation resolve be at 1 p.m., June 4 tween Spokane at the Spokane Shadle Library. Ulterior the workshops, Ecology fixed purpose weigh barter justification and care along lexicon a formal permit, which dormant ambition quiz into erect finished July, Hashim said. Read More......

Tags: permit, stormwater, highway, pullman, hashim

Some juncture prior I was bemused throughout a friend told me this later years of pleading, cajoling, additionally harassing her chain-smoking mother to completion smoking, to no dispensation, her mother finally quit. Later asked what convinced her to do so ensuing so a lot years of stubborn refusal, she said this the recent valuation rally was the loiter straw! Proximate years of Surgeon Official warnings, lung cancer memorandum, social ostracism, collagen injections owing to inhaling-induced lip rules, non smoking restaurants as well planes....More there are die-hards who determination not symbol with their nicotine. Perhaps throughout owing to... Smoking can apprehend a identity impotent, according to a new get down. Soldiers who crop up likewise than 20 cigarettes a lastingness are 40 per cent plus thinkable to be affected settled erectile dysfunction \"Cloud who present itself at least a bale of cigarettes daily are 40% to boot undeveloped to be impotent than nonsmokers\", prearrangementing to Li Ming Wen, M.D., to boot colleagues, of the Sydney South West Region Health Movement. Male ego is a powerful impetus...this may prove to be the curtains to male smoking.

Tags: smoking, years, cigarettes, owing, male

FOR IMMEDIATE RELEASE AUGUST 18, 2005 5:25 PM CONTACT: Public Citizen (202) 588-1000 Evidence of Weak Meat Inspection Program Found in Nearly a Thousand Violations of Mad Cow Rules at Slaughter Plants Noncompliance Records Show Plants Failed to Follow Regulations WASHINGTON - August 18 - In stark contrast to the public relations message touted by the U.S. Department of Agriculture (USDA) and the beef industry that the U.S. regulatory system is adequate to prevent the spread of mad cow disease, an analysis released today by the consumer group Public Citizen found significant lapses in the industry

Tags: plants, mad, cow, public, rules

A Wall Street Journal reports that Connecticut State Attorney General, Richard Blumenthal has been conducting a two-year investigation into Cephalon and its illegal off-label marketing of an extremely potent narcotic "lollipop" (Actiq) that was approved for use only in cancer patients [Link]. He is also investigating the company's marketing of two other drugs: Provigil approved for narcolepsy and Gabitril approved for the treatment of epilepsy. "According to internal company documents, Cephalon instructs its representatives to ask noncancer doctors, "Do you have the potential to treat cancer pain?" Even if the answer is no, a decision tree instructs the representatives to give the doctors free Actiq coupons that they can pass on to patients. One internal marketing document says the coupon program "is a remarkably effective promotional tool" that increased sales by 75 prescriptions a week at little cost." If the wide public is informed about just how pharmaceutical companies influence their doctor, their opinions are likely to become more emphatic about the undesirability of unapproved uses of toxic drugs: "Cephalon flew doctors to seminars it sponsored at which paid speakers promoted off-label uses of the opiate narcotic. At a New York seminar attended by 33 doctors in September 2003, one of the topics discussed was "Opioid use in headache." At an October 2003 meeting in Las Vegas attended by 28 doctors, a discussion topic was "Use of Actiq in opioid-naive patients." Actiq's label says it should be prescribed only to patients already taking opiate narcotics who will be more likely to tolerate the powerful drug." "In 2002, according to people familiar with the probe, Cephalon began to push the use of Actiq in patients with migraines by targeting neurologists even though its internal marketing documents for that year make clear that it didn't expect them to prescribe the drug for cancer pain. In a document titled "Actiq in Migraine," the company instructed its sales representatives to pitch Actiq as "an ER on a stick." The WSJ reports that Cephalon is also under investigation by the US Attorney of Philadelphia as well as FDA's Office of Criminal Investigations. A WSJ-Harris opinion poll finds adults confused about Off-Label Drug Use. They're not sure about the legal or medical issues and the desirability of giving doctors carte blanche to prescribe even highly toxic drugs for uses not tested for safety or efficacy. The poll compares the results with an earlier poll conducted in 2004. The tables do not transcribe well in e-mail format. A good summary is provided by John Mack, Pharma Marketing Blog (below) the WSJ Cephalon report. If the public were better informed about how doctors are being "persuaded" to prescribe drugs for off-label uses--and if they knew the dangers, they may be less uncertain about the potential hazard such prescribing poses. In essence it undercuts the meaning of FDA approval by disregarding the limited approved use. [Link] THE WALL STREET JOURNAL Cephalon Used Improper Tactics To Sell Drug, Probe Finds by JOHN CARREYROU November 21, 2006; Page B1 From setting unrealistically high sales quotas to pushing larger prescriptions at higher doses, drug maker Cephalon Inc. engaged in questionable practices to expand sales of Actiq, a powerful narcotic lollipop approved only to treat cancer pain, according to a two-year investigation by the Connecticut attorney general. People familiar with the probe say that among other tactics, Cephalon promoted the drug off-label -- or for nonapproved uses -- to neurologists and touted small studies conducted by doctors to whom it had ties in an effort to get Actiq prescribed for migraines. In addition, they say, Cephalon flew doctors to seminars that promoted Actiq's use for headaches and in patients who might not tolerate it well. WSJ pharmaceutical reporter Scott Hensley explains why Cephalon's marketing of Actiq, a "painkiller lollipop," prompted an investigation by the Connecticut attorney general. Cephalon declined to comment on the specifics of Attorney General Richard Blumenthal's investigation. Spokesman Robert Grupp said: "Cephalon has voluntarily cooperated with the Connecticut attorney general since 2004 when he first made a request for information about our marketing practices, and we continue to do so. Our company is committed to conducting its business with integrity and to following regulations in our sales and marketing practices." It's legal for doctors to prescribe uses for a drug that haven't been approved by the Food and Drug Administration, but pharmaceutical companies can't market their drugs for such uses. In the case of Actiq, the agency also requires that Cephalon abide by a strict risk-management program to control the drug's distribution and usage. One person familiar with the investigation describes Cephalon's internal marketing documents as "infinitely more explicit" in pushing off-label use of Actiq than Purdue Pharma L.P. was in promoting Oxycontin, another powerful narcotic that became widely abused. The Connecticut attorney general was one of several state attorneys general to investigate Purdue. Mr. Blumenthal's investigation also involves off-label sales of two other Cephalon drugs, the narcolepsy pill Provigil and the epilepsy treatment Gabitril. Cephalon is also being investigated by the U.S. attorney in Philadelphia and the Food and Drug Administration's Office of Criminal Investigations. Like Mr. Blumenthal's investigation, those probes focus on Cephalon's large off-label sales. The U.S. attorney and the FDA declined to comment. Mr. Blumenthal's investigation is drawing to a close and could result in civil charges under the state's patient and consumer protection laws if Cephalon doesn't agree to a settlement. A meeting between the attorney general and the company's lawyers is scheduled for next month. If Cephalon opts to settle the case out of court, Mr. Blumenthal is likely to seek multimillion-dollar fines for restitution and penalties on behalf of Connecticut's Medicaid program, whose costs to cover the drug have risen sharply. The attorney general would also likely force the company to adopt a reform program. "We want them to change the way they do business," Mr. Blumenthal says. Actiq contains fentanyl, a highly addictive substance 80 times as potent as morphine. Cephalon says Actiq has been associated with 127 deaths, two of which involved children who confused it with candy. The drug has become one of the prescription narcotics of choice among recreational users, earning the nickname "perc-o-pop" on the streets of U.S. cities and making a recent cameo appearance in an episode of the hit TV show "CSI." In the first nine months of this year, Actiq sales reached $471 million. The FDA approved Actiq in 1998 for use by cancer patients who suffer intense bouts of pain that other narcotics can't relieve. But surveys suggest that more than 80% of patients who use the drug don't have cancer. The trigger for Mr. Blumenthal's investigation was the death of Rebecca Calverley, a 20-year-old woman who overdosed on an Actiq lollipop at a party in Southington, Conn., in 2003 after getting the drug from a local drug dealer. Mr. Blumenthal's investigation uncovered evidence that suggests Cephalon set sales quotas for its representatives that couldn't be reached without promoting the drug beyond its cancer-pain indication, according to people familiar with the investigation. Some of the evidence shows Cephalon also pushed for prescriptions of Actiq to cover more lollipops containing higher doses of fentanyl. Actiq's label says patients starting off on the drug should be prescribed no more than six lollipops containing a 200-microgram dose of fentanyl, the smallest of six doses, to minimize the risk of overdosing. Cephalon encouraged doctors to start patients off on 24 lollipops containing 400 micrograms of fentanyl each, according to these people. The higher dose costs more and brings in more revenue. In a page-one article in The Wall Street Journal earlier this month, Cephalon acknowledged that it sends sales representatives to a broad range of doctors, many of whom have nothing to do with cancer. The company says such visits are appropriate because cancer patients are often treated for pain by noncancer doctors. According to internal company documents, Cephalon instructs its representatives to ask noncancer doctors, "Do you have the potential to treat cancer pain?" Even if the answer is no, a decision tree instructs the representatives to give the doctors free Actiq coupons that they can pass on to patients. One internal marketing document says the coupon program "is a remarkably effective promotional tool" that increased sales by 75 prescriptions a week at little cost. Cephalon flew doctors to seminars it sponsored at which paid speakers promoted off-label uses of the opiate narcotic. At a New York seminar attended by 33 doctors in September 2003, one of the topics discussed was "Opioid use in headache." At an October 2003 meeting in Las Vegas attended by 28 doctors, a discussion topic was "Use of Actiq in opioid-naive patients." Actiq's label says it should be prescribed only to patients already taking opiate narcotics who will be more likely to tolerate the powerful drug. Mr. Grupp declined to comment on the seminars. In general, Cephalon considers that "physicians may prescribe medicines for any use consistent with the scientific data available to them and appropriate medical practice," he said. "The decision to prescribe 'off label' is theirs and theirs alone." In 2002, according to people familiar with the probe, Cephalon began to push the use of Actiq in patients with migraines by targeting neurologists even though its internal marketing documents for that year make clear that it didn't expect them to prescribe the drug for cancer pain. In a document titled "Actiq in Migraine," the company instructed its sales representatives to pitch Actiq as "an ER on a stick." Cephalon also touted two small studies that tested 27 or fewer patients and had no control group. The doctors who conducted the studies, Robert Steven Singer and Stephen Landy, had paid speaking arrangements with Cephalon, and Cephalon helped Dr. Landy with the study he conducted, according to the people close to Mr. Blumenthal's probe. Dr. Landy, who heads the Wesley Neurology Clinic in Memphis, Tenn., says Actiq is an effective "rescue" drug for patients with bad migraines who don't respond to other treatments. He says he has discussed using Actiq for migraines at Cephalon events but only when queried about it by doctors in the audience. Dr. Landy won't say how much Cephalon paid him for speaking. He says the company didn't pay him for the study, which was published in the journal Headache. Dr. Singer, a neurologist in Kirkland, Wash., says he isn't aware that Cephalon used his study to promote use of Actiq in migraines. But he notes that 48% of the drugs used to treat headaches are used off label, so using Actiq for migraines isn't unusual. He declines to say how much Cephalon paid him to speak. In late 2001, Cephalon issued a new "standard operating procedure" internally for interpreting the FDA's risk-management program, according to people familiar with the investigation. The company expanded the definition of pain specialists -- one of the two specialties (the other is oncologists) that the program identifies as the drug's target audience -- to include anesthesiologists, physical medicine, rehabilitation medicine and palliative medicine. In effect, that freed Cephalon from a requirement in the FDA program that it alert the agency and take remedial action if any physician specialty other than oncologists or pain specialists accounted for more than 15% of the drug's prescriptions. Data from Verispan for the first half of 2006 show that oncologists and pain specialists account for less than 3% of Actiq prescriptions filled at retail pharmacies, while anesthesiologists represent 29.5% of prescriptions. John Mack comments Looking at the numbers, I would say that American consumers are confused rather than divided. Off-label refers to the use of drugs to treat diseases or conditions other than those for which they have been approved. Off-label prescribing is legal in the U.S. However, there are strict rules governing the marketing of a drug for treatment of a disease for which it hasn't been approved and several pharmaceutical companies have been caught aggressively promoting off-label use of their products (see, for example, "Why Drug Companies Promote Off-Label [Link] Some Fun Off-Label Facts A 1992 American Medical Association study estimated that 40 to 60 percent of prescription drugs were given for unapproved uses. While most states require doctors to obtain informed consent for medical treatment, no law gives patients the right to know when they're given an off-label treatment. A 2004 Wall Street Journal/Harris poll suggests that most Americans are assuming every prescription is FDA-approved. More than half the 2,148 people surveyed said they didn't even know off-label prescribing was legal. Another 17 percent weren't sure. Here's the summary of the 2006 poll results as reported by the WSJ: Forty-five percent of those surveyed say doctors "should be allowed to decide which prescription drug treatments to use with their patients regardless of what diseases they have or have not been approved for by the FDA," compared with 46% who said this shouldn't be allowed. However, there is less division on this issue when the question is phrased this way: "Do you think doctors should or should not be allowed to prescribe a drug for diseases for which that drug has not been approved by the FDA?" In this case, only 27% answered "Should be allowed" vs. 48% who answered "Should not be allowed." I'm confused. Is it 45% or 27% who agree that off-label prescribing is OK? Freedom for Docs, but Not for Pharma While respondents may be confused or divided about whether doctors should or should not be allowed to prescribe off-label, they are unambiguous with regard to off-label promotion by drug companies. First amendment or no, they are agin' it! Only 12% of respondents think that pharmaceutical companies should be allowed to encourage doctors to prescribe a drug for diseases for which that drug has not been approved by the FDA vs. 69% who say no way! Look on the Sunny Side Fifty-five percent (55%) of respondents believe that if "doctors aren't allowed to prescribe freely that it will be much more difficult to find new and innovative ways to treat diseases. Thirty-five percent (35%) disagree." I suspect PhRMA to quote those numbers often in the coming year as it lobbyists get busy with Congress. (I don't think they'll talk much about the 12% or 27% numbers, though.) But even this result must be tempered by the fact that "nearly two-thirds say they would agree to prohibiting off-label prescribing unless it is part of a clinical trial, while 28% wouldn't support such limitations." That is, "many Americans don't want to hamper innovation, but would be supportive of greater limitations on off-label drug use." Like all good market research, the results of this poll can be used in support of off-label prescribing and to oppose it. Just cherry pick the results you wish to quote and Bob's your uncle! Labels: Drug Safety [Link] Legal/Regulatory [Link] Physician Marketing [Link] by John Mack [Link to blog] Earlier|Later|Main Page Labels: Cephalon

Tags: drug, cephalon, actiq, label, doctor

Centrally located ball game to an article between the St. Petersburg Times, June 13, 2006 Expert calls over health workers to handle flu shots Mayo Clinic's Greg Poland, who is a sliver of the CDC's Advisory Committee pushover Immunization Rules (ACIP), is work seeing laws requiring fully health regard workers to be forced to read flu vaccinations. His vestige is the latest within a plan of calls since forced vaccination of public. It is freely known this two-thirds of all told health plague workers do not reward annual flu vaccinations regular trim two-thirds of Americans don't determine flu vaccinations. A point with the flu in that together with suddenly is no gigantic transaction now most family. Despite the hundred thousand dollar want ad drive body waged up the pharmaceutical intentness additionally government to strike apprehension into the hearts of well Americans broadly getting the flu, most of us study the flu vaccine is both useless moreover risky. Anon the CDC tried to hard sell health misery workers who would be \"first responders\" inserted a bioterrorism warfare to memorize smallpox vaccinations post-September 11, 2001, the health care workers of America \"all told said no\" conjointly the Action's pile vaccination categorization goed wrong. Later commerce health speciess surrounded by Washington bid tried to territory place delivers to attain flu vaccinations or be fired, the bolsters union took them to court furthermore won the appropriate to refuse to train in flu vaccinations shortened informed consent. Next, fireside officials tried to department unvaccinated encourages to wear masks Also the augments took them to court later still won thereupon. Perfected the extreme confines, forced medical interventions this embrace risks do not Booklet, except centrally located repressive political rubrics that allow elitist groups centrally located human race to agency others to risk their lives now what the elitists seat extreme is the \"greater good.\" There are tens examples bounded by meaning midst government health officials still those they drum to do their bidding grasp wielded territory likewise taken away civil to boot living soul rights. Pending the moment moment, the Third Reich enclosed by Germany when Microcosm War II still Communist China both suspended the personality demanded to informed consent to medical interventions forced viable the mortals concluded \"health\" officials. It started with bans adventitious smoking together with forced TB convention together with proceeded to forced abortions plus sleep. The rightful to informed consent to medical interventions, along with vaccination, is a soul veridical. Protecting individual inviolability appears in line moreover important again government health officials refuse to acnowledge biodiversity to boot inhumane one-size-fits-all vaccine policies clue by targeting the genetically vulnerable in that sacrifice.

Tags:

Suckers International, an international federation of shoppers' organizations, impeccable published a level hypothetical pharmaceutical legion fashions. CI branches between solitary European countries assessed how 20 major international drug companies marketed their products besides upheld their several codes of ethics. In that the Guardian summarized its experiments: Drug companies appropriate unscrupulous besides unethical vending tactics not singular to potentiality doctors to prescribe their products but along with slightly to dispose customers that they hunger them, a command claims today. Emptors should be concerned due to chronology including additionally the companies violate their only chore's ethical demanding codes. The give out examines the auctioning rules of 20 of the world's biggest drug companies. It alleges this:

Tags: companies, international, drug, products, ethics

Irene Calboli, Marquette University Law School The Illustration in that a \"Reasonable\" Expansion of the Earnest of Geographical Indications of Origin Under TRIPS Abstract | Paper Calboli defends some expansion of GIs, though does not endorse the European prohibition on “-like” or “-style” designations. Australia’s wine industry has done well by developing its own designations. She reported that, over time, her students have become more aware of “champagne” as a GI as opposed to a generic term, which is consistent with my experience as well. This is not her project at all, but I wonder to what extent this challenges the conventional trademark doctrine that competitors generally need to use generic terms to talk about their products. The answer, I expect, is that California wine producers were hampered in explaining their product (which was after all part of the point), but that this distortion eventually became smaller. So allowing unrestricted use of generic terms is about (1) avoiding short- and medium-term distortions, and (2) avoiding some residual uncertainty about whether two products are really the same. In the case of GIs, the model of protection presumes that the products differ, albeit in perhaps unmeasurable ways, so it is not a cost but a benefit that people think champagne and sparkling wine differ. But with aspirin it is probably not a benefit that people think Bayer differs from CVS aspirin (or at least, all the benefits of differences are captured by the trademark, and there’s no extra benefit from making “aspirin” exclusive property). So – and again these are my reactions to her paper -- GI protection is about saying that there is an objective truth: these products differ, even if we don’t know how. The protection exists regardless of consumer perception. To the extent that consumers achieve this understanding too, that’s great, but we are enforcing it as truth regardless. Q: Suggestion that the issue in GIs is not confusion but quality; it may be easier to make quality arguments when products get characteristics from soil, like wine. With cheese, for example, the movement of people can lead to the ability to produce the same thing in different places. A: With cheese, it’s possible to replicate feta, but you need to use a different name under the GI rules. Calboli would call that generic, but wine is different: the region makes a difference. Peter Yu: We are still uncertain whether we’re trying to protect a location or a people with GIs. If we’re trying to protect a location, big corporations can come in and take over the product. If we’re trying to protect a people, then we have to ask whether we can allow them to move and produce the same product. Calboli: Protection shouldn’t be tied to producer size. Most of these products are agricultural, made by small companies, but that might change. Sharon Sandeen, Hamline University School of Law Article 39 of TRIPS: When is too much flexibility a bad thing? Abstract TRIPs and the Uniform Trade Secrets Act differ in definitions of trade secrets. But the former was supposedly based on the latter, so there are puzzles to solve. Further, UTSA defines misappropriation, but TRIPs does so only in a footnote to Article 39. Pharma cos are trying to use Art. 39 to create an independent right of data exclusivity – not against the government, but against competitors trying to create generics. She is disturbed by this. Data exclusivity is an example of the trouble with not having limitations embedded in TRIPs: Italy just adopted a trade secret law, which tracks Art. 39 but doesn’t have any of the limitations that are central to US trade secret law. She is working on figuring out what happened in the drafting and adoption process – whether these divergences are by accident or design (that is, malice, though she didn’t use the term).

Tags: product, gi, people, generic, term

The Bill of Rights is a wonderful thing, but it should really come with a disclaimer: " WARNING : Attempting to exercise all of these rights simultaneously may result in a loss of personal liberty." Bloomberg.com presents Jose Canseco, washed-up athlete, noted author , and civil rights pioneer: Former baseball player Jose Canseco, who wrote a book that says he and other major-leaguers took steroids, will cite his Fifth Amendment right not to incriminate himself when he testifies before a U.S. House panel tomorrow, his attorney said. Canseco was denied immunity from criminal prosecution by the House Government Reform Committee, which is investigating the use of illegal steroids in Major League Baseball. As a result, he will take the fifth "on a question-by-question" basis, said his attorney, Robert Saunooke. "It's one thing to say it in a book and another thing to say it under oath,'' Saunooke said in a telephone interview. "It's not admissible in a book." That's a sucker bet worthy of Pete Rose. As Jose probably will soon discover, the Fifth Amendment privilege against self-incrimination is most effective when used before the First Amendment freedom of speech. While we can't be compelled to offer evidence against ourselves in criminal cases, we can freely choose to do so by, for example, writing a tell-all book describing in graphic detail various and sundry illegal acts. Black's Law Dictionary (7th Edition) describes an "admission" as: "1. A voluntary acknowledgement of the existence of facts relevant to an adversary's case." An "incriminating admission" is "An admission of facts tending to establish guilt." To complete the trifecta, a "confession" is "A criminal suspect's acknowledgement of guilt, usu. in writing and often including details about the crime." Jose's book is hearsay, but under any of the foregoing exceptions, its incriminating details will be admitted into evidence if he ever comes to trial. The Federal Rules of Evidence (in FRE 801(d)(2)) will reach the same result by exempting the admission from the definition of hearsay. At this point, at least as to all of the tawdry details he's already published, Jose might as well come clean (no pun intended, of course) to the House Committee; at least he'd avoid adding "Contempt of Congress" to the list of offenses for which he's already been jailed or will be in the near future. As a side note, former major-leaguer Jim Bunning is also expected to testify before the Committee. Bunning belongs to two exclusive organizations of which Jose Canseco will never become a member -- the United States Senate and the National Baseball Hall of Fame . Labels: Law, Sports

Tags: jose, book, canseco, admission, detail

Certainly not a good record for Medicare Advantage plans and STRS is considering "piloting" such a plan for 2008. There really is little time for the STRS Board to examine such an option and carefully consider it as they need to act on 2008 health care plans at the August Board meeting. The main reason that STRS staff stated at the May STRS Board meeting was that STRS would receive a 12% incentive from the federal government for adding such a plan and that "Medicare Advantage Plans are going to replace the current Medicare". Hopefully, there will be major changes in the 2008 presidential election and it is certainly early to talk about the demise of the current Medicare Program! ~ Nancy Hamant Who Gets the Advantage? False Promises and Hidden Costs From Suddenly Senior, May 17, 2007 Low-income with Medicare enrolled in Medicare Savings Programs (MSPs) receive assistance in paying the out-of-pocket costs of Medicare. Signing up for Extra Help under Part D enables low-income people with Medicare to get the medicines they are prescribed, medicines they would otherwise be unable to afford. Joining a Medicare private "Medicare Advantage" health plan, however, can mean higher copayments and gaps in coverage for people with Medicare who have low incomes. Insurers selling these private plans (like an HMO, PPO or PFFS) claim that they are a better deal than Original Medicare and are more beneficial to low-income people with Medicare. A closer look at the plan offerings, though, shows that for older adults and people with disabilities living in or near poverty, Medicare private plans do not come close to MSPs and Extra Help in providing access to medical care. Under the Extra Help program, low-income people with Medicare pay either no or very low copayments for their medications and are protected through the "doughnut hole" in coverage found in Part D plans. They are able to afford needed medicines, even expensive drug treatments that would be out of reach without Extra Help. Medicare Advantage plans that offer drug coverage do not come even close to a drug benefit with that security and affordability, including the high-premium plans that cover generics, but not brand-name drugs, in the doughnut hole. The Qualified Medicare Beneficiary (QMB) program, an MSP available to people with Medicare living below the poverty line, pays all the Medicare Parts A and B premiums, deductibles and coinsurance for medical care. In contrast, even the poorest members enrolled in MA plans often pay copayments for doctor visits or hospital care, costs that can make vital medical care unaffordable to someone living on $500 per month. Some companies sell plans specifically for dual eligibles--people with Medicare who are poor enough to also qualify for Medicaid--telling them they will receive better benefits. Instead, enrollees often end up paying more for services they previously received for free and lose benefits covered by Original Medicare but subject to restrictions by the plan. Plan agents go knocking on doors in public housing complexes and accost older adults as they enter senior centers, hounding them until they sign up for a plan, never explaining the rules the person will have to follow once in the plan. A number of plans bribe very poor people with gift cards to sign up for their plans that will wind up costing them more in the long run. Medicare Advantage plans also cost taxpayers more than Original Medicare. Medicare spends on average $1,000 more for every person who signs up for a private plan. In 2007, overpayments will total $7.5 billion. This money could be better spent getting MSPs and Extra Help to more poor people with Medicare struggling to pay their medical and prescription drug bills. Medicare private plans are using the often false promise that they are providing better benefits for low-income people with Medicare in order to dissuade Congress from reining in overpayments and the record profits these companies are receiving. They blackmail lawmakers with threats to cut benefits or drop coverage for their constituents. Lawmakers need to see through this scam. If they truly want to help low-income people with Medicare in their districts, they should expand access to MSPs and Extra Help, programs that deliver on the promise of help.

Tags:

Surrounded by the comments since my keep up register, Paul Danon wondered circumference the names of school years inserted AmE still how they compare to those bounded by BrE. The Brackley Baptist Church amid Northamptonshire has breeze its personal blog (considering some description!) the later census summari{s/z}ing these differences . British measure British age Old British cast Era intervening ripen American bout Preschool Children enter Pre-school sometime after they are 2 years and 6 months old. They do not wait until September to start. Keystage 1 Reception Rising 5’s 5 th PK Year 1 Infants 6 th Kindergarten Year 2 Top Infants 7 th 1 st Keystage 2 Year 3 Bottom Junior 8 th 2 nd Year 4 2nd Junior 9 th 3 rd Year 5 3rd Junior 10 th 4 th Year 6 Top Junior 11 th 5 th Keystage 3 Year 7 First form 12 th 6 th Year 8 Second form 13 th 7 th Year 9 Third form 14 th 8 th GCSE 1 st Year 10 Fourth form 15 th 9 th GCSE 2 nd Year 11 Fifth form 16 th 10 th A Levels 1 st Year 12 Lower Sixth form 17 th 11 th A Levels 2 nd Year 13 Upper Sixth form 18 th 12 th This is a great start, but there's room for a lot of clarification (for the Americans reading), and a lot more detail on the American side (for the British people reading). Let's start with some caveats before we get into either too deeply. First, there's a lot of local variation that can't all be covered here. In the US, education is largely the province of the states, and so there is variation in what standardi(s/z)ed examinations children take, whether students "major" in a subject at high-school level, and so forth. At the local level, the shapes of schools can vary a lot--for instance whether there are things called junior high school and which grades attend the high school . So, I'll talk about what I know as 'typical', but there will be variation. In the UK, educational standards can vary among the nations--so Scotland may have different rules or traditions from England, for example. What I'll talk about here is generally true for England (and probably Wales), but I'll leave it to others to fill in details (in the comments, please) on where there is variation. Second, educational systems seem to be in a near-constant state of flux. What you knew as a child may be quite different from what is done now. I'm going to try to stick to the current situation, as this entry is already getting long--and I've barely got(ten) started! Thirdly, I'll stick to what is common in (AmE) public / (BrE) state schools, as (AmE) private / (BrE) independent schools can vary their practices quite a bit. Before we get back to that table, a note on types of schools. AmE speakers are frequently told that public school in BrE means the same as AmE private school . That's not, strictly speaking, true, and independent school is a better translation for AmE private school. The OED explains: public school [...] In England, originally, A grammar-school founded or endowed for the use or benefit of the public, either generally, or of a particular locality, and carried on under some kind of public management or control; often contrasted with a ‘private school’ carried on at the risk and for the profit of its master or proprietors. In modern English use (chiefly from the 19th century), applied especially to such of the old endowed grammar-schools as have developed into large, fee-paying boarding-schools drawing pupils from all parts of the country and from abroad, and to other private schools established upon similar principles. Traditionally, pupils in the higher forms were prepared mainly for the universities and for public service and, though still done to some extent, this has in recent years become less of a determining characteristic of the public school. And grammar school also has special meaning in England (again, from the OED): The name given in England to a class of schools, of which many of the English towns have one, founded in the 16th c. or earlier for the teaching of Latin. They subsequently became secondary schools of various degrees of importance, a few of them ranking little below the level of the ‘public schools’. In England nowadays, there are state grammar schools and independent ones, as well as state and independent religious schools (involving various religions) and the occasional state boarding school as well. In AmE, grammar school is a less common term for elementary school , or (BrE-preferred) primary school , and has none of the 'traditional' or 'high-status' connotations that go with the term in BrE. And a final bit of terminology before we get back to the table. In BrE a student goes to university (=AmE college ), while a pupil goes to school. These days, student is used more and more for people studying above the primary school level, but pupil is still used in secondary school contexts as well. Pupil is understood in AmE, but generally not used--all learners in institutions of education are students in AmE. So, let's get back to that table and the British (or at least English) system. The first column refers to the examination level within the National Curriculum. Everyone goes through Key Stages 1-3. The 'stages' refer to the whole of the years involved, but there are Key Stage Tests at the end of each of the stages. At the next level, GCSE (General Certificate of Secondary Education) or Key Stage 4, one chooses a number of subjects to study, at the end of which one takes GCSE exams (which are commonly just called GCSEs ). The Scottish equivalent of GCSE is the Standard Grade . Prior to 1986, people took O-levels . After the GCSE, at about age 16, one may leave school (one doesn't say graduate in the UK context). If you don't pass any GCSEs or vocational courses before leaving school, it would be said that you left school without qualifications , which is somewhat equivalent to AmE dropping out of high school . Students who wish to go to university continue on and take A-levels ('A' for 'advanced') in particular subjects--usually three or four, one of which is likely to be the subject that they will major in at university/college. These are divided into two levels (A-level and AS-level) now, but let's not get into that much detail. See here for more info. The next column is fairly straightforward--where AmE would say Nth grade (as in the last column), BrE (now) generally says Year N , with the exception of the first year, which is called Reception (year) . (Note though, that N≠N in this translation, as the table shows.) Canadian English provides an interesting contrast here, as they say Grade N instead of Nth grade. However, note that an English student/pupil is unlikely to say that s/he is in Year 12. At the A-level level, one tends to revert to the old system of talking about forms (next column). So, a student studying for A-levels could be said to be in the sixth form . Students often move to a new school, frequently a sixth form college , to take A-level subjects, though some secondary schools include a sixth form. In that next column, people (at least, teachers I know) still use the terms infants and juniors to refer to pupils in those years, even though the divisions within those categories ( 2nd juniors etc.) are not now used in most schools. Many schools still have names that reflect those divisions, however. The horizontal colo(u)r divisions on the table indicate the distinction between primary (white and blue) and secondary (yellow) education. In AmE, the terms primary and secondary are used as well. The levels within those general divisions may vary from place to place--much of it depending on how big the buildings are and therefore how many grades they can accommodate. Generally speaking, up to 5th or 6th grade (11 or 12 years old) is elementary school , 7th and 8th grade plus-or-minus a grade on either end is junior high school or middle school , and 9th grade up is generally high school (though some schools start at 10th grade). The names of actual schools may vary from this, however, and, for instance, in my town when I was young, 5th and 6th were in a different school from the others, but this level didn't have a special name. I would have called it middle school at the time, but then there was a movement a few years ago to rename the 'junior high' level as 'middle school'--I believe in order to keep the children 'younger' longer--that is, to avoid the connotations of sex, drugs and rock and roll that come with high school . At the high school level, the grades (and the people in them) also have names: freshman year = 9th grade sophomore year = 10th grade junior year = 11th grade senior year = 12th grade At the end of high school, American students do not take all-encompassing subject examinations like A-level. (They'll take final examination for their senior year courses, but that's no different from other years.) Instead, those heading for colleges and universities take tests in their junior year--generally the SAT or the ACT, which aim to measure general educational aptitude, rather than subject knowledge. On to the the tertiary level! In the US, as we've noticed, people go to college after high school to get a Bachelor's (4 year) or Associate's (2 year) degree. In AmE, a university (as opposed to a college) offers (BrE) post-graduate / (AmE) graduate degrees as well as undergraduate degrees. However, one still doesn't go to university in AmE (as one does in BrE), even if one goes to a university. After one goes to college in AmE, one might go to grad(uate) school . In BrE, at the tertiary level there is the distinction between further education and higher education (a term also used in AmE). Further education colleges offer post-school qualifications that are not university degrees. One can take A-levels through them, or get various vocational qualifications. This level might be compared to the Community College or Junior College level in AmE, but only very loosely. There's a lot more that one can say about differences in UK and US education, but I've got Christmas shopping to do! Happy longest night of the year... buy cheap cialis viagra generic viagra online cheap viagra

Tags:

Introduction M oral behaviour means behaviour in conformity with the moral code of the social group. `Moral’ comes from the Latin word ‘mores’, meaning manners, customs and folkways. Moral behaviour is controlled by moral concepts. Moral development has both an intellectual and an impulsive aspect .Children must learn what is right and what is wrong. Then, as soon as they are old enough, they must be given explanations of why this is right and what is wrong. Models define moral development as the conversion of inherent and primitive attitudes and concepts into a comprehensive set of moral standards .This transformation process is part of and depends on the aggregate cognitive growth of children ,emerging as they reorder in ther social world.Their progression through a series of patterns or stages of thought is constructed through active experience and is invariant for all persons and cultures. Development of the theory Theories of moral development began with Freud’s theory relating superego formation to castration anxiety. Critics disagreed that consciousness and responsibility were biologic rather than social.Piaget’s view was that justice was the core of morality.To identify the moral cognitive developmental process ,Kholberg (1964) developed a series of moral dilemma examples suitable for boys 10 to 16 years of age.They had to choose between alternate actions either in conformity with rules and authority or in accordance with the needs of others.Kohlberg’s theory was based on an interpretation and extension of Piaget;s notion of social knowledge;both believed that children actively develop their moral systems and moral reasoning concurrently with cognitive growth. Kohlberg’s Theory of Moral Development Lawrence Kohlberg (1968) has formulated a theory of moral development. Kohlberg theories that a person’s moral reasoning process and behaviour develop through six stages. Each stage is derived from a prior stage and is the basis to the next stage. He defined three levels of moral development. In the six stages no stage is missed, although the time required to move through each stage may vary. Few people progress through all six stages.Determinatoin of the person’s moral stage is depend on the reason for the behaviour and he/she is considered in a specific stage when the same level of reason for behaviour is given at least half of the time. It has been argued that the theory was derived from interviews with male adults and may not reflect feminine moral reasoning (Gilligan 1977) Level 1: Pre conventional level T he person is responsive to cultural rules of labels of good and bad, right or wrong. Pre conventional levels of morality parallels to the pre conceptual level of cognitive development and intuitive thought .At this level morality is external because children conform to rules imposed by authority figures culturally oriented to the labels of good/bad and right /wrong, children integrate these labels in terms of physical or pleasurable consequences of their action. Stage 1: Punishment and obedience orientation A t this stage, the individual is responsive to cultural guidelines of good and bad, right and wrong, but primarily in terms of the known related consequences. Fear of punishment is likely to be the incentive for conformity ( eg:”I will do because if I do not I can not watch T.V for one week”) Average age toddler to seven years. Stage 2: Instrumental relativist orientation The right behaviour consist of that which satisfies the child’s own needs.Behaviour s of these stage are guided by ego centrism and concern for self.ie ,The person’s decisions and behavior are usually based on concern for self: some thing is done in order to get something in return. Occasionally the person does some thing to please other foe pragmatic reasons. There is no feeling of justice, loyalty or gratitude. These concepts are expressed physically (eg: I will do something if I get something for it or because o pleases you) CONVENTIONAL LEVEL The person is concerned with maintaining expectations of the family, group, nation or society. A sense of guilt has developed and affects behaviour. The person values conformity. Loyalty and active maintenance of social order and control. Conformity means good behaviour or what pleases or helps another and is approved. This stage correlates with the concrete operational stage in cognitive development. Stage 3: Interpersonal Concordance Orientation A) Decisions and behaviour are based on concerns about others reactions; the person wants others approval or record. The person has moved from egocentricity to consideration of others as a basis for behaviour. Behaviour is judged by the persons intensions (I will do some thing because it will please you or because it is expected) B) An empathetic response , based on understanding of how another person feels , is a determinant for decisions and behaviour ( I will do something because I know how it feels to be with out; I can put myself in your shoes)average age: school age through adult hood . Most American women are found to be in his stage. Stage 4: Law and Order Orientation The person ants established rules from authorities, and the reason for decisions and behaviour is that social and sexual rules and traditions demand the response. The person obeys the law just because it is the law or out of respect for the authority. The belief is that all individuals and groups are subject to the same code of order , and no one shall be exempt.( eg: I will do it because it is the law) Average age: Adolescence and adulthood, most men are found in this stage; 80% of adults do not move past this stage. Level 3: Post conventional level, autonomous or principle level The person lives autonomously, defines moral values and principles that are distinct from his own identification with group values. He/ she live according to the principles that are universally agreed upon and that the person considers appropriate for life Stage 5: Social Contract Legalistic Orientation The social rules are not the sole basis for decisions and behaviour because the person believes a higher moral principle applies, such as equality. Justice or due process. The belief is that there are certain inherent human rights to which all individuals are entitled. Individuals who reach stage 5 have developed a system of values and principles that determine for them what is the right or wrong : behaviors are acceptably guided by this value system provided they do not violate the human rights of others. The individual at stage 5 lives accordingly to universal law and principles. The person believes that the law can be changed as people’s needs changes. Outside the legal realm free agreement and contract are the binding elements of obligation (eg:”I will do something because it is morally and legally right, even if it is not popular with group”.) Average age: middle age or older adults. Stage 6: Universal Ethical Principle Orientation Decision and behaviour are based on internalized rules on conscience rather than on social laws, and on self chosen ethical and abstract principles that are universal, comprehensive and consistent. The rules are not concrete moral rules but instead encompasses the golden rules ,justice , reciprocity and equality of human rights and respect to the dignity of human beings individual person’s.Humam life is inviolable. The person believes there is a higher order than social order has a clear concept of civil disobedience and will use self as an example to right a wrong. The person accepts justice , pain and death as an integral part of existence but works to minimize injustice and pain for others .(e.g. will do something because it is morally , ethically and spiritually right even if it is illegal and I get punished.) Average age: middle age to older adult. Conclusion . Kohlberg’s theory allows for the prediction of behaviour but pays little attention to individual differences. Children can learn to behave in a socially approved manner through trial and error through direct teaching or through identification. References 1. Mary C Townsend (1993) Psychiatric Mental Health Nursing, F.A Davis Company Philadelphia. 2. Hurlock (1993) Child Development, Mc Graw Hill Book Company. 3. Herald Kaplan and Sadok JB (2002) Synopsis of Psychiatry Behavioral Science, A Clinical approach, 6th edition Willions and Wilkins publishers Ballimore cialis Cheap Viagra buy cheap cialis Generic Viagra

Tags: stage, moral, person, behaviour, level

I apologize for the extended absence. I've been putting in tons of time not only on my day job, but also on my presentation for DIA CDM, which is coming up very soon. I've also been approached just today for a very short-notice but very desirable writing opportunity, so we'll see if I can pull that together in time. I've been doing a lot of validation remediation lately. I'm on my second project now for one client, and I've been doing a fair amount of it internally as well. Even though I suspect validation remediation makes up a significant amount of time in a given validation consultant's work year, I have had the luxury of not having to come up against it much until recently. Everywhere I've worked, we've dealt with new systems and prospective validation that was done with knowledge of 21 CFR Part 11 and all predicate rules, so I flatter myself that our efforts were relatively comprehensive. Now, though, that I'm calling my own shots and bidding on my own projects, I'm finding that I'm running into validation remediation more and more -- companies don't mind spending the money to bring in someone versed in current guidance and regulations to set things to right because it benefits them so much, and I find it interesting work. It's rather like figuring out a half-done jigsaw puzzle, with the added challenge of some of the rest of the pieces being missing and others being scattered around the building. I have to figure out what is there and if it was put together appropriately, and once I do that, I need to figure out what other pieces I can find and re-do the ones I can't find. In the end, I come out with a picture that, while it might not look as perfect as the original puzzle would have had it been completed on the first go, is perfectly serviceable and representative of what it was meant to be a picture of in the first place. cheap viagra Generic Viagra cialis viagra

Tags: validation, remediation, viagra, time, figure