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Finding the Essence of InnovationBy Samuel Greengard
Finding the Essence of Innovation
Amid a dizzying array of management philosophies\ and business strategies, one thing stands out in the daily scramble to create viable products and services: Above all, success centers on a company's ability to innovate.
Equifax CIO Robert Webb understands the concept well. "The ability to transform ideas into viable policies, practices and programs is what ultimately leads to a competitive advantage and generates profitable growth," he says.
At Equifax, innovation falls between science and religion. In recent years, the $1.9 billion credit reporting behemoth has established itself as an industry leader with an array of products and services. The company has built a formal system for developing and incubating ideas, introduced a process that encourages experimentation, and constructed a pipeline for transforming promising ideas into actual business and IT initiatives. "We view innovation as the engine that drives our existence," Webb explains.
Lofty words. Nevertheless, Webb and many other CIOs understand that innovation is a tricky and elusive concept. Great ideas inexplicably flounder, mundane ideas flourish, and there's no simple and consistent way to understand what works. Further adding to the challenge: IT continues to evolve and change at a mind-bending pace--and IT departments must serve a dual role of helping solve business challenges but also facilitating incremental process improvements through hardware, software and systems.
At the eye of the storm, perhaps only one thing is clear: IT innovation isn't a destination, it's an ongoing journey. A 2007 Boston Consulting Group study found that 46 percent of senior executives from 2,468 firms were dissatisfied with the results and return on investment from innovation initiatives.
The upshot? "Ultimately, it's great to be creative and inventive," says Scott Anthony, author of The Silver Lining: An Innovation Playbook for Uncertain Times and president of Innosight, a consulting firm that focuses on innovation. "But unless an organization can transform ideas and concepts into something that has a material impact, the ideas really don't matter."
How do successful organizations and CIOs grapple with innovation? How do ideas evolve into business and IT improvements that lead to bottom-line gains? And how can an enterprise move past the hype and put innovation to work?
There are no easy answers. As Andrew McAfee, associate professor at Harvard Business School and author of the forthcoming book Enterprise 2.0, observes: "You have to fully understand the business drivers in order to plug in the right IT systems and build a foundation for innovation."
Rethinking Thinking
Rethinking Thinking
One thing that makes innovation so difficult is that there's no simple template for achieving it. Different industries, business models and cultures create an infinite number of potential approaches. What works at Google isn't necessarily going to succeed at Wal-Mart. Worse, says Anthony, "Vendors are always ready and willing to sell you the next great version of software. But innovation isn't a result of technology. It's the result of people using technology to facilitate change."
Further complicating matters is that many organizations and CIOs lack a basic understanding of how innovation unfolds. Creativity is not innovation. Brilliant ideas and cool technologies aren't necessarily the ticket to competitive gain.
"It doesn't always come down to the usual suspects," McAfee says. "It's not always the case that a company needs to do something faster or cut costs by x percent. It's sometimes as simple as providing convenience, simplicity or accessibility. In many cases, it's about giving people something they seek."
In fact, a common misunderstanding is that structure stifles innovation. Although initiatives such as Total Quality Management (TQM) and Six Sigma reduce variability, increase predictability and sometimes leave little space for innovation, says Kartik Hosanagar, assistant professor of information and operations management at the University of Pennsylvania's Wharton School, structure and innovation aren't mutually exclusive concepts. The actual innovation process should encompass metrics and formal data, but it can't be limited to these alone. What's more, the process should tap into project management techniques and take on a formal structure.
Few are more aware of this than Webb of Equifax, where focus groups, interviews and other feedback tools gauge the pulse of the customer base and detect changes in the marketplace. He also makes sure that employees carve out time for introducing, discussing and vetting ideas. More than 100 individuals from various functions--spread across a wide swath of geographies--participate in highly focused sessions on idea development. These "entrepreneurial teams" take "green-shoot ideas and build businesses out of them," Webb says.
The result: new lines of business--along with IT systems that enhance defined processes. For example, a couple of years ago, Equifax introduced a service that combines credit verification with appraisals and title insurance processing.
Adapting IT systems was one of the simplest parts of the project because the innovation process pointed to specific systems and software. "This was an idea that came directly out of brainstorming sessions," Webb says. "Employees communicated a need, and we pursued it."
Beyond Chaos
Beyond Chaos
The first step to IT playing an integral role in the innovation process is to understand its role within the overall organization. Most importantly, it's necessary to connect to overarching strategic goals and have both a vision and a view of how IT supports business processes. Harvard's McAfee says that an organization must balance an outside-in perspective that's focused on technology and how it can affect an enterprise with an inside-out view that taps into the organization's business model and strategic focus.
The right balance is essential. A problem with outsourcing, McAfee says, is that over time it's easy to lose sight of the core strategic vision. On the other hand, organizations that are too internally focused can lose sight of today's fast-changing technology landscape.
"You may not understand the nuances and opportunities," he notes. "A Digg-type application that allows bookmarking and voting or a Twitter-like application that provides a mechanism for sharing and building on ideas quickly can fall between the cracks."
Success requires a culture that accepts risk, manages failure and puts an organization's cognitive surplus to work. "Even the busiest of us on our busiest week have some downtime and spare time to think," McAfee points out.
Moreover, says the Wharton School's Hosanagar, employees can't feel as if they're on the chopping block if they make a mistake. Equifax's Webb agrees. "The idea is to celebrate the learning that results from failure," he says. "The goal is to do lots of prototyping, lots of piloting and experimenting. If something doesn't work, we move on." These "fast kills," as McAfee puts it, help maximize resources while minimizing costs.
Anthony's takeaway: Innovation is a lot more predictable than executives generally believe. But it requires a distinct discipline. Yes, it's about nurturing creativity, but it's also about connecting dots and creating processes that transform ideas into improvements.
When an enterprise gets it right, everything from incremental improvements to a radical revamping of technology and the business is possible. Only then, says Anthony, "are people able to solve problems and confront challenges in a highly effective way while building a competitive advantage for the organization."


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This article contains lore taken from Warcraft II: Tides of Darkness, Warcraft II: Beyond the Dark Portal, the manuals, and official bonus maps.
Having established some order in the region with a display of naval power, Admiral Proudmoore advises that the time has come to search out the secret lair of the Orcs.
Scouts report that this base is located somewhere within the Zul'dare region of the Channel Islands, just south-east of Hillsbrad.
Lordaeron artificers have completed designs for a Foundry. With this new innovation, you will be able to construct Transport ships that can ferry your troops across large bodies of water.
These vessels should provide great assistance in the completion of your task.
Destroy the Orc base
Given the threat of enemy ships nearby, the Alliance first priority was to get a shipyard into operation as soon as possible. First, they sent their worker into the mines for the purpose of training more. At the same time, the two destroyers that had brought them there were sent from the northern shore around to the south where an enemy destroyer guarded an oil patch. When it was safely below the waves, they remained near the shore to guard the shipyard site. After training several more peasants, they placed half of them in the mines and set the other half to collecting lumber. Soon they raised a lumber mill, and soon after, began construction of the shipyard on the southern shore near camp. Taking no chances, they constructed a barracks to train a force of archers for the coming amphibious assault. Though they were still training peasants and building farms, there was more than enough material and sufficient laborers to start the refinery and foundry. Meanwhile, new tankers began exploiting the nearby patch of oil.
With all the necessary structures in place and operational, they next began preparations for war. They raised guard towers on the north shore to fend off landing raiders and spent time upgrading their arrows, ship cannons, and armor. More destroyers were necessary to clear the way for their transports, which were constructed only after they already had five destroyers in the water. During this time, they continually trained new archers until there were ten units, which easily defended the camp until transports that would carry them were completed. Their fleet of destroyers began the operation by sailing south and southeast, directly into enemy territory, soon there was little opposition to them reducing the platforms and coatal structures to piles of smoking ash. With that completed, they anchored the destroyers close to shore near the enemy camp and let them fire at orcs for sport while the transports were being loaded with ten archers and two peasants. Once they had landed safely just west of the Alliance destroyers, the archers made sure the workers could construct two guard towers directly north of the destroyers. They were very careful not to let the archers wander into the camp, keeping them close to the towers and destroyers for defense. Once the guard towers were in place and upgraded, next came a barracks, whose completion spelled doom for the orcs.
While they were cleaning up the enemy camp, the remaining enemy ships in the area decided to try for their home base. They were soundly defeated by the guard towers, that the Alliance force had constructed along the shore. They then sought out and killed the few remaining orcs, and celebrated their victory among the ruins, which still burned and smoked angrily. It had been a great triumph for the Alliance, their skill in battle earned them a trip to the heart of the war on the mainland to the north.[1] (W2ToDOSG 106-109)
Although the Horde's base on Zul'dare had been destroyed, and the Horde driven from the shores of Lordaeron, it was a bittersweet victory; the townships of Hillsbrad and Southshore had been left in ruins. It was clear to the Alliance that the war would cost the them dearly... With the cities decimated rumors spread throughout the Human kingdoms like wildfire of their impending doom. War Chief Doomhammer was pleased with his commander's and Urok Scratcher's success and ordered them into in Khaz Modan to help defend their outpost in Dun Modr. Meanwhile, Milan's commander was ordered to Khaz Modan to assist Stromgarde and Kul Tiras attacking the outpost. Both forces were ordered to fight over control of Stromgarde's island at Tol Barad.


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Intellectual Disability
OverviewIntellectual disability (ID) describes a heterogeneous group of conditions characterized by low or very low intelligence and deficits in adaptive behaviors without reference to etiology. [Sattler: 1988] While there is no treatment for ID, some of the conditions causing it (e.g., metabolic errors or hypothyroidism) can be treated and much can be done to limit secondary disabilities, to optimize functional abilities, and to assist the affected child and his/her family in adapting to the condition.
Other Names & Coding
Static encephalopathy
F70, intellectual disability, mild
F71, intellectual disability, moderate
F72, intellectual disability, severe
F73, intellectual disability, profound
Coding for Intellectual Disability (!CD10Data.com) provides further coding details.
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) [American: 2013] generally designates the same codes as ICD-10 does, but its publisher, the American Psychiatric Association, prohibits our including their codes or descriptions.
PrevalenceThe prevalence of ID in the general population is approximately 1:100; prevalence for severe ID is approximately 6:1,000. [American: 2013]
GeneticsMany etiologies for ID are genetic. When possible, all children with ID without a known etiology should have a genetic evaluation.
PrognosisMeasures of intellect and adaptive behavior are somewhat predictive of eventual ability to live independently. For instance, individuals with mild to moderate ID should become relatively self-sufficient with appropriate family and community support. Individuals with severe and profound ID will need a great deal of support and do not usually live independently. Individuals with severe and profound ID tend to have shortened life expectancies as well, often due to the conditions causing ID.
Practice Guidelines
Moeschler JB, Shevell M.
Comprehensive evaluation of the child with intellectual disability or global developmental delays.
Pediatrics. 2014;134(3):e903-18 (reaffirmed 2020). PubMed abstract / Full Text
Szymanski L, King BH.
Practice parameters for the assessment and treatment of children, adolescents, and adults with mental retardation and comorbid mental disorders. American Academy of Child and Adolescent Psychiatry Working Group on Quality Issues.
J Am Acad Child Adolesc Psychiatry. 1999;38(12 Suppl):5S-31S. PubMed abstract
Roles of the Medical HomeA diagnosis of ID is important to allow the family to begin making realistic plans for the education and future of the child. The diagnosis also allows the child to qualify for early intervention, special educational services, and, depending on the financial status of the family, entitlement programs such as disability services.
The medical home can:
- Schedule health maintenance visits frequently enough to be proactive about new issues.
- Ensure that the family has access to reliable information, community services, and resources.
- Coordinate care and interpret information or advice from specialists.
- Facilitate access to private providers or other systems of care if the child does not quality for government or school sponsored services, such as OT, PT, or speech therapy.
- Assess parental stress, sibling problems, and social supports during follow-up visits; referral to support organizations and agencies may be particularly useful if the family is headed toward a crisis.
- Connect families with others in similar situations in order to provide support and alleviate the sense of isolation.
- Ensure that children with ID are provided opportunities for socializing and recreation. (Programs for recreational and leisure opportunities are listed toward the bottom of the Intellectual Disability, Services & Other Resources section of the module.)
Clinical Assessment
OverviewImportant steps in the clinical assessment of a child with ID include:
- Suspicion of ID, which is often prompted by parent interview and/or direct observation of the child, should be confirmed with norm-referenced testing for IQ and adaptive functioning. The Portal's issue page on Psychometric Testing (general) provides lists of possible tests for IQ/development, adaptive behavior, achievement, and behavior.
- Treatable diagnoses that might mimic ID, such as severe auditory or visual impairment or neurologic disorders, must be ruled out.
- Identification of the etiology, if possible, through medical history (including 3 generations) and/or physical exam (e.g., a large head circumference may indicate fragile X syndrome or distinctive facial features might suggest Cornelia de Lange syndrome). An etiology can be found in about 2/3 of individuals with severe ID, but in only about 1/3 of those with mild ID. A small number of etiologies for ID may be treatable. [Engbers: 2008] [Mueller: 2008] Knowing the cause can be helpful in determining prognosis and risk of recurrence in the family and for predicting the child's ability to live independently in the future.
- Determining the severity of ID, with psychometric and adaptive function testing can be helpful in prognosis for independent living.
- Determining the needs for educational interventions and support for the child and family, through testing and comprehensive evaluation by the school and/or community agencies and professionals.
Pearls & Alerts for AssessmentChildren with autism may have normal intelligence
IQ tests on children with autism may underestimate IQ because the testing is often language based.Misdiagnosis of seizures possible
Although the clinician should be alert for seizures, physiological events, behaviors, and even syndrome features may be mistaken for seizures. [Chapman: 2011]DD vs. ID
The term "developmental delay" (DD) is usually reserved for younger children (typically younger than 5 years), and the term "intellectual disability" (ID) is usually applied to older children when IQ testing is valid and reliable. Delays in development, especially those that are mild, may be transient and lack predictive reliability for ID or other developmental disabilities.
For the ConditionDevelopmental screening, an important component of routine well-child care, should identify many children with developmental delay (DD) early in life.
PresentationsPresentation typically includes cognitive skills delay, language delay, and adaptive skills delay. Developmental delays vary depending on the etiology and degree of ID.
Clinical ClassificationThe severity of ID is classified by the following degrees of intellectual functioning:
- Borderline
- Mild
- Moderate
- Severe
- Profound
Differential DiagnosisAutism spectrum disorders, specific language problems, and hearing problems may be confused with ID in young children, or may coexist with ID. ID can also be confused with developmental delay or static encephalopathy.
ID should only be diagnosed when there is clear evidence that cognitive abilities and adaptive behavior are significantly below average and that, although the individual might make progress in learning, they will always be significantly below average. This excludes individuals with conditions that might be temporary (e.g., the convalescent period after a brain insult such as meningitis or trauma, the response to early neglect, or children soon after foreign adoption). It also excludes the very young where cognitive ability and adaptive behaviors are not easily measurable. This is especially true in mild cases, because children with mild developmental delay are more likely to "catch up" to their peers.
Medical Conditions Causing ConditionOut of the hundreds of known causes of ID, half are thought to be exogenous (e.g., prenatal exposure to infection or toxins); the other half are likely due to genetic causes. [Battaglia: 2003] When seeking the cause for a particular child, it is often useful to consider broad categories of etiologies, including:
- Inherited/chromosomal: PKU, hypothyroidism, fragile X syndrome, Trisomy 21, tuberous sclerosis, autism. Approximately 15% of males with non-specific ID may have an X-linked syndrome. [Stevenson: 2009]
- Factors associated with pregnancy: intrauterine infections, toxins (including drug and alcohol abuse, prescription drug effects), abnormal brain development (e.g., cortical dysplasia), and hypoxia/ischemia (placental insufficiency)
- Birth-related hypoxic-ischemic encephalopathy, extreme prematurity
- Post-natal infection, head injury, abuse/neglect, malnutrition, lead/mercury exposure
Comorbid & Secondary ConditionsCo-morbid conditions include Childhood Absence Epilepsy, Cerebral Palsy, anxiety disorders, oppositional behavior disorders, Attention Deficit Hyperactivity Disorder (ADHD), and Autism Spectrum Disorder. [Oeseburg: 2011]
History & Examination
Current & Past Medical HistoryAsk about decreased growth or overgrowth, infection, head injury, abuse/neglect, malnutrition, unusual eye movements, concern for seizures, motor abnormalities (asymmetric tone/strength/muscle use), social skills, lead/mercury exposure, hearing and vision problems, and previous testing.
Parents may not realize that sleep issues are potentially treatable and the medical home should asked about their child's sleep habits, history of snoring, and any daytime sleepiness at well-child visits. The Sleep History Questionnaire ( 20 KB) has a printable sleep log and one page of mostly yes/no questions about sleep routines and behavior.
Family HistoryA family medical history (3 generations, if possible) may provide clues to etiology and prognosis. Family history should include ethnic background, metabolic diseases, parental consanguinity, relatives with autistic features, multiple miscarriages, or unexplained infant/childhood deaths. Attention should be paid to the sex of affected relatives because there are several X-linked ID syndromes.
Pregnancy/Perinatal HistoryAsk about:
- Difficulty conceiving, intrauterine infections or maternal illness, toxins (including drug and alcohol abuse, prescription drug effects), abnormal brain development (e.g., cortical dysplasia), and hypoxia/ischemia (placental insufficiency)
- Birth-related factors such as hypoxic-ischemic encephalopathy during labor (and Apgar scores) and extreme prematurity
- Birth weight/height for evidence of placental insufficiency or a genetic syndrome
- Prenatal screening or testing, type of delivery and why, weight gain and difficulty feeding during the first few weeks, and bonding/attachment
Developmental & Educational ProgressAsk about time of achievement of developmental milestones. Children with more severe ID are likely to have all developmental milestones delayed from an early age, whereas children with mild ID are more likely to display normal early milestones. In addition to asking the child and family directly, reports from early intervention or school including evaluations and report cards, are helpful to monitor progress in this area.
Ask about behavior problems and self-injurious behaviors; mental health problems are frequent in children and adolescents with ID.
Maturational ProgressAsk about signs of puberty when appropriate and the ability of the child and family to handle the changes appropriately.
Social & Family FunctioningAsk about family functioning, parental jobs, financial resources for caring for a child with ID, and family support systems. (The end of the Intellectual Disability, Services & Other Resources section has links to financial help, adaptive recreation, and other helpful services.)
Physical Exam
GeneralObserve behavior and interaction, including quality of eye contact, attention/focus, interaction, repetitive movements, hand flapping, or aggression.
Growth ParametersHt | Wt | OFC for deviations from typical growth charts, head shape, presence of fontanels (FTT, compare to parents), asymmetry?
SkinLook for the presence of abnormal textures, hyper- or hypopigmentation, eczema, Wood's lamp findings, hemangiomata.
HEENT/OralNote head size and shape. Look at facies - similar to family members? Look for epicanthal folds, ear position/shape/size, prominence of chin or forehead, size and shape of eyes, ears, mouth, philtrum. Check hair for abnormal texture or color. Check for caries and enamel defects. Children with ID may have difficulty with oral hygiene and may not have access to dentists comfortable with their care.
Extremities/MusculoskeletalLook for single palmar creases, clinodactyly, size of hands/feet, nail abnormalities, presence of contractures, and hyperextensibility.
Sensory TestingHearing and vision testing is important for identifying any impairments, which are a common cause or contributor to ID. Periodic retesting is indicated, particularly if deterioration in function is noted.
Laboratory TestingThe percentage of people with identifiable metabolic disorders as of cause of ID ranges from 1%-5%. Although newborn screening identifies many of these disorders, further metabolic testing maybe necessary. [Engbers: 2008] Other signs/symptoms that might prompt targeted testing include: stigmata of hypothyroidism, seizures, lethargy, vomiting, abnormal urinary odors, and failure to thrive. Deterioration of a child's developmental status should prompt further testing as it may be suggestive of a degenerative disease. [Moeschler: 2014]
ImagingA brain MRI will identify an abnormality in about 40% of patients with specific findings, such as microcephaly or a focal neurologic abnormality; in the absence of clinical clues, the yield is only about 14%. When an etiology cannot be identified, an MRI may still be cost-effective as a once-in-a-lifetime test, particularly when results might be important in family planning and genetic counseling. The American Academy of Neurology and Child Neurology Society recommends neuro-imaging as part of an evaluation of the child with ID [Shevell: 2003], whereas the American College of Medical Genetics does not feel that neuroimaging should be considered "standard of care" in the absence of specific neurologic findings. [Curry: 1997] Others suggest MRI and magnetic resonance spectroscopy be performed in children with otherwise unexplained ID. [Battaglia: 2003]
MRI is preferred over CT in almost all cases (unless the examiner is looking for calcifications, as in congenital CMV). The risk of sedation for an MRI and the parents' desires should be considered, along with the potential helpfulness of the information gained.
EEG should be performed when clinical seizures or a seizure syndrome are suspected.
Skeletal survey, other imaging may be recommended as part of a genetics consultation.
Genetic TestingChromosomal microarray (CMA) is now considered a first-tier diagnostic test in all children with global developmental delay and/or ID, replacing karyotyping and FISH. This type of high-resolution analysis for small chromosomal deletions and duplications results in a diagnostic rate of about 12%, at least twice the rate of a standard karyotype. [Moeschler: 2008] High-resolution karyotyping should be used as a first test only when there is an obvious chromosomal syndrome (e.g., trisomy 21) or a family history of chromosomal rearrangements.
If no etiology is found on CMA, testing for fragile X syndrome, via an X-linked intellectual disability panel or MECP2, may be warranted even when the child does not fit the clinical syndrome, particularly if history or exam findings are suggestive of a genetic cause. [Curry: 1997] Genetic testing is best guided by a geneticist, but information about available tests for conditions associated with ID can be found at Genetic Disorders and ID (Genetic Testing Registry).
Medical home providers should work closely and communicate clearly with the consulting geneticist when interpreting CMA test results, particularly when variants of unknown significance are identified. [Moeschler: 2014] Findings may be pathogenic, benign, or of unknown significance.
Other TestingA positive screen should lead to a confirmatory evaluation and, if significant developmental delay is found, full Psychometric Testing is performed. Testing strategies will depend on age and degree of developmental delay.
Norm-referenced testing for IQ and adaptive functioning (a.k.a. neuropsychological, neurocognitive or psychoeducational testing) is critical to confirm the diagnosis, provide some idea of the child's prognosis, guide therapeutic interventions, and a diagnostic workup in some cases. See the Intellectual Disability, Services & Other Resources section for details on neuropsychological testing resources.
A sleep study should be performed if clinically indicated.
Specialty Collaborations & Other Services
Once the diagnosis of developmental delay/ID is suspected, the medical home clinician should have the child tested by psychology (via the educational or medical systems), and then decide whether to refer to neurology, genetics, etc. based on the history and physical exam.
Pediatric Genetics (see NV providers [3])
When a diagnosis of ID is confirmed, a genetic evaluation is recommended. Since knowledge of new genetic syndromes and new genetic testing is evolving rapidly, consider periodic reassessment of the child with unknown etiology. Genetic counseling may also be appropriate for the family.
Pediatric Metabolics (see NV providers [0])
If a metabolic etiology is suspected, the child with ID should be evaluated by a metabolic geneticist. Additional metabolic laboratory studies/screening may be indicated.
Pediatric Neurology (see NV providers [6])
Children with specific neurologic problems, such as seizures, abnormal tone, motor asymmetry, or developmental regression, should be seen by neurology and followed as needed for ongoing management.
Pediatric Physical Medicine & Rehabilitation (see NV providers [1])
Physiatrists may be helpful in directing services such as physical therapy, occupational therapy, and feeding management. They can also evaluate for needed adaptive equipment and recommend helpful programs available through the school system.
Pediatric Ophthalmology (see NV providers [6])
In addition to finding and treating visual impairment, a pediatric ophthalmologist may find etiologic clues (e.g., cherry red spot, papilledema or optic nerve pallor) from ophthalmologic exams.
Developmental - Behavioral Pediatrics (see NV providers [4])
Developmental pediatricians can offer a complete developmental evaluation and assist in coordinating services. They may also be helpful in periodically evaluating a child's developmental progress, guiding parental expectations, and establishing an ongoing plan for ever-changing educational needs.
General Counseling Services (see NV providers [172])
Periodic visits may be helpful for following progress and monitoring associated problems such as ADHD or mood disorders, which, if not treated, may hinder educational progress and lead to additional psychosocial barriers. Comprehensive assessment of the domains of intellectual, social, cognitive, behavioral, academic, and emotional functioning is helpful in identifying strengths and weaknesses, formulating a diagnosis, and implementing recommendations for interventions.
Psychiatry/Medication Management (see NV providers [39])
Consider referral if mental health problems, such as depression or anxiety, are suspected; if there is a strong family history of psychiatric illness; or, for difficult behavior problems.
Neuropsychiatry/Neuropsychology (see NV providers [7])
Assessment of functioning is particularly important when the child has neurological symptoms, such as brain injury or seizures. This process helps identify learning challenges, describe communication styles, and summarize a child's strengths and weaknesses for the purpose of formulating a diagnosis and implementing modifications/interventions.
Sleep Studies/Polysomnography (see NV providers [0])
A sleep study may be indicated in the setting of snoring, apnea spells, frequent nighttime awakenings, parasomnias, or excessive daytime sleepiness. While adults manifest fatigue by appearing tired, children can appear hyperactive or distracted.
Treatment & Management
Pearls & Alerts for Treatment & ManagementUnderlying condition can cause challenging behaviors
Check carefully for underlying medical conditions that may be causing challenging behaviors in individuals who may not be able to express their needs.Perceived regression as child ages
The degree of ID is generally stable throughout life, although it may seem to be worsening as the child gets older and gaps in ability widen when compared with peers. Even children with profound ID may differ very little from their peers at 1 year of age, but are very different at age 10. Concern for regression, as opposed to stable disability, would be a reason to consider referral to a neurologist or developmental pediatrician to evaluate for a potential CNS or metabolic cause for dysfunction.
Development (general)
Specialty Collaborations & Other Services
Developmental - Behavioral Pediatrics (see NV providers [4])
Developmental pediatricians can periodically evaluate a child's developmental progress and determine an ongoing plan for educational needs.
Developmental Assessments (see NV providers [3])
Developmental evaluations assess a child for typical versus atypical development in multiple domains.
Early Intervention for Children with Disabilities/Delays (see NV providers [29])
Early Intervention programs are services to help identify and improve developmental outcomes in early childhood for babies and toddlers with ID or other disabilities.
Specialty Collaborations & Other Services
School Districts (see NV providers [21])
School districts are the contact point for evaluation and determination of services for children who qualify for an IEP. Typically, school districts provide services for eligible children ages 3-21.
Mental Health/Behavior
Behavior problems, especially aggression directed toward self or others, can cause tremendous difficulties for families. Problems with behavior often increase exponentially with adolescence. Self-injurious behaviors can include individuals hitting and biting themselves or causing themselves to gag, head banging, and chewing on extremities. In children without good communication skills, rule out potential medical causes of new self-injurious behaviors (such as dental caries, gastroesophageal reflux, ear infections, etc.) and environmental causes (e.g., a new aide at school, a new sibling, etc.) Social isolation caused by ID may add to the incidence of affective disorders. If these factors are ruled out, behavioral management should be tried.
Although use of antipsychotics to manage aggression is controversial [Tsiouris: 2010], management will generally involve medication and behavioral management techniques. The medical home should not be hesitant to use medications, even if temporary, to help manage difficult behavior or situations that need immediate help. Medications may include antipsychotics, atypical antipsychotics, serotonin specific reuptake inhibitors, mood stabilizers, benzodiazepines, stimulants, and clonidine. Risperidone may be especially helpful in these children and adolescents, and has been approved by the FDA for this use. [Shea: 2004] Medications should be started at low doses and raised very gradually. A referral to a child psychiatrist familiar with children with ID can help with this process. If access to psychiatry is not possible, consider a phone consultation if not familiar with medications for problem behavior.
Evaluating sustained and focused attention and impulse control is important, since treating attention problems behaviorally and/or pharmacologically might maximize the child's potential by helping him/her to be more cognitively "available" for instruction and intervention. Such evaluation should be performed by specialists and may include assessment of speech, language, gross and fine motor development, social and emotional responsiveness, play imitation, non-verbal communication, attention and impulse control, intelligence, learning abilities, and more. An interdisciplinary approach is recommended for management, including professionals from social work, child psychology, and child psychiatry, in addition to primary care physicians and educators when possible. See the Portal's Behavioral Medication Information and Aggression and Self-Injurious Behavior (ddhealthinfo) for more information.
Specialty Collaborations & Other Services
Psychiatry/Medication Management (see NV providers [39])
Consider a referral to child psychiatry, particularly if medication is being considered.
Pediatric Physical Medicine & Rehabilitation (see NV providers [1])
PM&R physicians may have expertise in behavior management.
General Counseling Services (see NV providers [172])
Therapists may help the child and family with behavior management, counseling, and support.
Social Workers (see NV providers [7])
Social workers may help the child and family with counseling and assist with access to mental health resources.
If a child with ID has difficulty sleeping, look for signs and symptoms of underlying medical problems (e.g., gastroesophageal reflux, dental caries) and obstructive sleep apnea (obesity, large tonsils, loud snoring). A sleep study may lead to diagnosis of a causative factor, such as seizures, apnea,, or restless leg syndrome, which have potential treatments. Nonspecific treatments, such as melatonin or sleep medications, may also be useful. See the Portal's Sleep Medications and Sleep Issues for further information.
Specialty Collaborations & Other Services
Pediatric Sleep Medicine (see NV providers [0])
Sleep evaluations and treatment with sleep hygiene methods, breathing devices, and medications may be helpful.
Pediatric Otolaryngology (see NV providers [5])
Surgery may be necessary if adenoids and tonsils are causing obstructive sleep apnea.
Two subgroups at especially high risk for oral health problems are people with Down syndrome and people unable to cooperate for routine dental care. [Anders: 2010] Children with genetic syndromes or other diagnoses that are known to be associated with ID have a relatively high incidence of enamel hypoplasia and delayed eruption. Children with ID may have problems with tongue-thrust and bruxism and may demonstrate oral self-injurious behavior. The medical home should inquire about dental problems and refer to dentists comfortable with this population. Oral Care for People with Disabilities (National Institute of Dental and Craniofacial Research) provides information for people of all ages with disabilities and dental care.
Specialty Collaborations & Other Services
General Dentistry (see NV providers [27])
These dental providers have expressed an interest in caring for children with special health care needs and may help patients except routine care, treat issues related to underlying congenital or developmental anomalies, and treat periodontal disease.
Pediatric Dentistry (see NV providers [29])
Children with ID should be followed by a pediatric dentist from early in life. These dentists have formal training in pediatric dentistry, including those children with special health care needs.
Specialty Collaborations & Other Services
Nutrition Assessment Services (see NV providers [14])
The individual and his/her family may be helped by a referral to a nutritionist in the childhood years, before this becomes an ongoing problem
- Negative attitudes about the sexuality of these individuals [McCabe: 1993]
- The assumption that teens with disabilities do not need this information
- The lack of available sex education specific to people with disabilities
- The presence of intellectual impairment that might complicate understanding of sex education material
- Concerns about sexual exploitation in this population, as individuals with ID are more likely to be abused than those without ID [Mansell: 1998]
- Body image/self-esteem concerns on the part of the adolescents
Specialty Collaborations & Other Services
Gynecology: Pediatric/Adolescent; Special Needs (see NV providers [0])
Providers on this list have expressed interest in caring for girls and adolescents with special health care needs.
Issues Related to Intellectual Disability
Clinical AssessmentPsychometric Testing
Learning/Education/SchoolsInclusion Models
Mental Health/BehaviorBehavioral Medication Information
Ask the Specialist
Will insurance pay for genetic testing?
Not all health plans in the US will cover genetic testing, regardless of who orders it or the nature of the encounter during which it is ordered (i.e. inpatient vs. outpatient).
Should I order the genetic testing or wait until patient is seen by genetics?
In a nondysmorphic patient with GDD/ID of unknown etiology, chromosomal microarray should be performed. Patients/families may want to check with their insurance company to see if coverage is at all dependent on who orders the testing. Any abnormalities should be reviewed with the help of a medical geneticist.
Should I perform imaging prior to consulting neurology or a developmental pediatrician?
Yes, particularly in the setting of abnormal head size, focal findings on neurologic exam, extrapyramidal signs, intractable epilepsy, or focal seizures. [Moeschler: 2014] In a patient <8 years of age who would need sedation in order to have imaging performed, it is reasonable to consult neurology first.
Resources for Clinicians
On the Web
PubMed search for intellectual disability in children, last 2 years.
Developmental Disabilities Information (ddhealthinfo.org)
Information and resources about developmental disabilities for clinicians that includes clinical practice considerations for related conditions and information about related issues (communication, dental, mental health, CAM); University of California San Diego, School of Medicine.
Developmental and Behavioral Pediatrics (AAP)
Information for professionals interested in child development and behavior. Contains practice management resources, upcoming educational events, relevant policy statements, and high-quality links; American Academy of Pediatrics.
Genetic Disorders and ID (Genetic Testing Registry)
List of disorders that often result in ID and direct links to phenotype-gene relationship and clinical synopsis on Online Mendelian Inheritance in Man (OMIM) List of disorders that often result in ID and direct links to phenotype-gene relationship and clinical synopsis on Online Mendelian Inheritance in Man (OMIM) and GeneReview.
Genetics in Primary Care Institute (AAP)
Contains health supervision guidelines and other useful resources for the care of children with genetic disorders; American Academy of Pediatrics.
Helpful Articles
PubMed search for intellectual disability in children, last 2 years.
Battaglia A, Carey JC.
Diagnostic evaluation of developmental delay/mental retardation: An overview.
Am J Med Genet C Semin Med Genet. 2003;117(1):3-14. PubMed abstract
Nevels RM, Dehon EE, Alexander K, Gontkovsky ST.
Psychopharmacology of aggression in children and adolescents with primary neuropsychiatric disorders: a review of current and potentially promising treatment options.
Exp Clin Psychopharmacol. 2010;18(2):184-201. PubMed abstract
van Karnebeek CD, Stockler S.
Treatable inborn errors of metabolism causing intellectual disability: a systematic literature review.
Mol Genet Metab. 2012;105(3):368-81. PubMed abstract
Clinical Tools
Assessment Tools/Scales
Ages and Stages Questionnaire: Developmental (ASQ-3)
Parent-completed, age-specific questionnaires that screen for developmental delays in children between 1 month and 5½ years old; available for purchase.
Parent's Evaluation of Developmental Status (PEDS) site
PEDS and PEDS:DM provide 5-minute screenings, longitudinal surveillance, and triage for developmental as well as behavioral/social-emotional/mental health problems. Can be completed by parent self-report, interview, or administered directly to children; available for a fee.
Questionnaires/Diaries/Data Tools
Sleep History Questionnaire ( 20 KB)
A 14-day sleep tracker and 1-page questionnaire about sleep routines and behavior.
Patient Education & Instructions
Intellectual Disability Fact Sheet (English & Spanish) (CDC)
One-page fact sheet for families who may be concerned that their child has intellectual disability; Centers for Disease Control and Prevention.
Resources for Patients & Families
Information on the Web
Financing Your Child's Healthcare (Medical Home Portal)
Information, services, and resources that may help offset some of the medical costs of caring for your child with special health care needs.
Care Notebook (MHP)
The care notebook helps keep track of appointments, resources, labs, medications, tests, care providers, and more. Download the complete notebook, compile in your own binder, or download separate forms; Medical Home Portal.
Forms for Education
Descriptions and links to forms that can be adapted for states and Local Education Authorities (LEAs), usually school districts, or charter schools. Topics include evaluation and service recommendations, special dietary needs, medication administration, and authorization to release information; Medical Home Portal.
A Family Handbook on Future Planning (ARC)
Helps families develop a plan that provides personal, financial, and legal protections for their children with cognitive, intellectual, or developmental disabilities after the parents either die or can no longer provide care; a publication of The Arc of the United States and the Rehabilitation Research and Training Center (RRTC) on Aging with Developmental Disabilities.
Intellectual Disability (MedlinePlus)
Overview of the causes, symptoms, and treatment of ID; from the National Library of Medicine and National Institutes of Health.
Learn the Signs. Act Early (CDC)
Offers many tools, videos, lists, learning materials, and an app to track a child's developmental milestones (ages 2 months to 5 years) and act if concerned about progress; Centers for Disease Control and Prevention.
National & Local Support
The Arc
A national, community-based organization advocating for people with intellectual and developmental disabilities and their families.
Center for Parent Information and Resources
A large resource library related to children with disabilities. Locate organizations and agencies within each state that address disability-related issues.
Clinical Trials in Intellectual Disabilities (clinicaltrials.gov)
Compilation of clinical trials related to Intellectual Disabilities in children; from the National Institutes of Health
Services for Patients & Families in Nevada (NV)
|Service Categories
|# of providers* in:
|Other states (5) (show)
|Developmental - Behavioral Pediatrics
|Developmental Assessments
|Early Intervention for Children with Disabilities/Delays
|General Counseling Services
|General Dentistry
|Gynecology: Pediatric/Adolescent; Special Needs
|Nutrition Assessment Services
|Pediatric Dentistry
|Pediatric Genetics
|Pediatric Metabolics
|Pediatric Neurology
|Pediatric Ophthalmology
|Pediatric Otolaryngology
|Pediatric Physical Medicine & Rehabilitation
|Pediatric Sleep Medicine
|Psychiatry/Medication Management
|School Districts
|Sleep Studies/Polysomnography
|Social Workers
|Special Education/Schools
For services not listed above, browse our Services categories or search our database.
* number of provider listings may vary by how states categorize services, whether providers are listed by organization or individual, how services are organized in the state, and other factors; Nationwide (NW) providers are generally limited to web-based services, provider locator services, and organizations that serve children from across the nation.
American Psychiatric Association.
Diagnostic and Statistical Manual of Mental Disorders, DSM-5.
Fifth ed. Arlington, VA: American Psychiatric Association; 2013. 978-0-89042-554-1
American Psychiatric Association: DSM-5 Task Force.
Diagnostic and Statistical Manual of Mental Disorders.
Fifth ed. The American Psychiatric Publishing; 2013. http://dsm.psychiatryonline.org/doi/book/10.1176/appi.books.9780890425...
Anders PL, Davis EL.
Oral health of patients with intellectual disabilities: a systematic review.
Spec Care Dentist. 2010;30(3):110-7. PubMed abstract
Battaglia A, Carey JC.
Diagnostic evaluation of developmental delay/mental retardation: An overview.
Am J Med Genet C Semin Med Genet. 2003;117(1):3-14. PubMed abstract
Chapman M, Iddon P, Atkinson K, Brodie C, Mitchell D, Parvin G, Willis S.
The misdiagnosis of epilepsy in people with intellectual disabilities: a systematic review.
Seizure. 2011;20(2):101-6. PubMed abstract
Curry CJ, Stevenson RE, Aughton D, Byrne J, Carey JC, Cassidy S, Cunniff C, Graham JM Jr, Jones MC, Kaback MM, Moeschler J,
Schaefer GB, Schwartz S, Tarleton J, Opitz J.
Evaluation of mental retardation: recommendations of a Consensus Conference: American College of Medical Genetics.
Am J Med Genet. 1997;72(4):468-77. PubMed abstract / Full Text
A consensus statement regarding a rational clinical approach to a child with mental retardation including history, physical exam and recommended testing.
Engbers HM, Berger R, van Hasselt P, de Koning T, de Sain-van der Velden MG, Kroes HY, Visser G.
Yield of additional metabolic studies in neurodevelopmental disorders.
Ann Neurol. 2008;64(2):212-7. PubMed abstract
Kaunitz AM, Arias R, McClung M.
Bone density recovery after depot medroxyprogesterone acetate injectable contraception use.
Contraception. 2008;77(2):67-76. PubMed abstract
Mansell S, Sobsey D, Moskal R.
Clinical findings among sexually abused children with and without developmental disabilities.
Ment Retard. 1998;36(1):12-22. PubMed abstract
McCabe MP.
Sex education programs for people with mental retardation.
Ment Retard. 1993;31(6):377-87. PubMed abstract
Moeschler JB.
Genetic evaluation of intellectual disabilities.
Semin Pediatr Neurol. 2008;15(1):2-9. PubMed abstract
Moeschler JB, Shevell M.
Comprehensive evaluation of the child with intellectual disability or global developmental delays.
Pediatrics. 2014;134(3):e903-18 (reaffirmed 2020). PubMed abstract / Full Text
An AAP Clinical Report that provides guidance for primary care clinicians assisting families in preparing for a genetic evaluation; reaffirmed 2020.
Mueller S, Sherr EH.
The importance of metabolic testing in the evaluation of intellectual disability.
Ann Neurol. 2008;64(2):113-4. PubMed abstract
Nevels RM, Dehon EE, Alexander K, Gontkovsky ST.
Psychopharmacology of aggression in children and adolescents with primary neuropsychiatric disorders: a review of current and potentially promising treatment options.
Exp Clin Psychopharmacol. 2010;18(2):184-201. PubMed abstract
Oeseburg B, Dijkstra GJ, Groothoff JW, Reijneveld SA, Jansen DE.
Prevalence of chronic health conditions in children with intellectual disability: a systematic literature review.
Intellect Dev Disabil. 2011;49(2):59-85. PubMed abstract
Sattler, J.
Assessment of Children.
Third Edition ed. San Diego: Jerome M. Sattler Publisher; 1988. 9780961820978
Shea S, Turgay A, Carroll A, Schulz M, Orlik H, Smith I, Dunbar F.
Risperidone in the treatment of disruptive behavioral symptoms in children with autistic and other pervasive developmental disorders.
Pediatrics. 2004;114(5):e634-41. PubMed abstract
Shevell M, Ashwal S, Donley D, Flint J, Gingold M, Hirtz D, Majnemer A, Noetzel M, Sheth RD.
Practice parameter: evaluation of the child with global developmental delay: report of the Quality Standards Subcommittee of the American Academy of Neurology and The Practice Committee of the Child Neurology Society.
Neurology. 2003;60(3):367-80. PubMed abstract / Full Text
Stevenson RE, Schwartz CE.
X-linked intellectual disability: unique vulnerability of the male genome.
Dev Disabil Res Rev. 2009;15(4):361-8. PubMed abstract
Szymanski L, King BH.
Practice parameters for the assessment and treatment of children, adolescents, and adults with mental retardation and comorbid mental disorders. American Academy of Child and Adolescent Psychiatry Working Group on Quality Issues.
J Am Acad Child Adolesc Psychiatry. 1999;38(12 Suppl):5S-31S. PubMed abstract
A review of mental health disorders in the DD/MR population. Although possibly more frequent in this population, psychiatric disorders are essentially the same as in normally developing children; however, behavioral observations are very important due to decreased verbal skills in this population.
Tolaymat LL, Kaunitz AM.
Long-acting contraceptives in adolescents.
Curr Opin Obstet Gynecol. 2007;19(5):453-60. PubMed abstract
Tsiouris JA.
Pharmacotherapy for aggressive behaviours in persons with intellectual disabilities: treatment or mistreatment?.
J Intellect Disabil Res. 2010;54(1):1-16. PubMed abstract
Walsh JS, Eastell R, Peel NF.
Effects of Depot medroxyprogesterone acetate on bone density and bone metabolism before and after peak bone mass: a case-control study.
J Clin Endocrinol Metab. 2008;93(4):1317-23. PubMed abstract
van Karnebeek CD, Stockler S.
Treatable inborn errors of metabolism causing intellectual disability: a systematic literature review.
Mol Genet Metab. 2012;105(3):368-81. PubMed abstract


text:
Colorful Boats by Jetties beach
A group of rental boats lined up just near Jetties beach in the early morning.
Taken with my Pentax 6 x 7 camera, using Fuji Provia film.
Cathedral Under the Canvas, Before the Crowds, Rising Expectations, A Narrow View, Ghost Birds, Sailor's Reprieve, Middle Wave, Foggy Evening on Long Pond, Hanging Out in the Secret Garden, Centre Street Designs, Madaket Afternoon, Points of View, Dune's End, Hint of Sunshine, Gateway, Stars on the Edge, Boat in Grass, Solitude at Sunrise, November Dinghy, Waiting by the Harbor, Colorful Boats by Jetties beach, Stormy Beach, Brant Point Sunrise, Window Shopping, Two Flags, Early Morning Swim, Wooden Boats, Can Do Attitude, Trail to the beach, Twilight at Sankaty Lighthouse, Bicycle at Rest, Small Boats at Madaket, Brant Point in Blue, Sea Wall Shells , Lines in the Sand, Madaket Sailor's Delight, Brant Point Lighthouse with flag, Leaving with First Light, Leaving the Path, Sankaty Lighthouse Early Morning, Madaket Beach After the Storm, Sunfish by Sesachacha Pond, Scattered on the Wood, Boats and shack by Jetties Beach, Ferns, img - 5 Red Boat in Madaket Marsh, AM Boat, Conch Shell in the Surf, House at Madaket, Sunset at Dionis,


text:
Is it time for telecom to bring its email services back in-house rather than outsourcing it?
There have been ongoing issues with yahoo mail for a number of years - not just for telecom customers.
I am not an expert on hacking (dyslexics dont make good programmers) but as I understand, the vunerability in the yahoo webmail service has been around for a number of months, and it appears yahoo hadnt fixed the issue on webmail.xtra.co.nz
Among other things - random / arbitrary disabled pop3 access, mailbox / account migration restrictions, etc
Personally I think it might be time to go back in-house, or at least give a flirtatious wink to the gmail wholesale sales people, or perhaps go as far as showing them some leg too.
What do you guys think?


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STOCKTON - Only now, they say, are they ready.
STOCKTON - Only now, they say, are they ready.
It took 24 years, countless tears and the school shootings on that tragic morning in Connecticut three months ago.
"We're just now there, able to do it," retired Cleveland Elementary teacher Judy Weldon, 64, said this week.
Memories of the Jan. 17, 1989, shootings at Cleveland that killed five young children and wounded 31 other people still redden the eyes of those who were there.
But after 20 children and six adults were killed by a gunman at Sandy Hook Elementary in Newtown, Conn., on Dec. 14, Weldon and some of the other Cleveland survivors knew they had to act.
In recent weeks, they have been organizing. They have named their group Cleveland School Shooting Survivors. A website is in the works.
They say they will fight for national gun regulations and for improved school safety preparedness. They intend to reach out to the people of Newtown. They would like to form a national network for those affected by school shootings. They have met four times in the past few weeks. They welcome any who want to join them.
Late one afternoon this week, the eight members of the group met in the north Stockton living room of retired Cleveland teacher Sue Rothman, 68. Seven of the eight were former Cleveland employees who were there that day in 1989. The eighth, 57-year-old Sovanna Koeurt, was the parent of two Cleveland students who escaped unharmed.
"After 24 years, we have to do something," said Marianne Castillo, 57, a Cleveland instructional assistant in 1989.
They speak fondly of Rob Young, their former student. But they vehemently disagree with his recently voiced support of legislation that would permit the arming of teachers and principals. Young, now 30, was 6 years old when he was wounded at Cleveland in 1989.
"Are we still in the Wild West?" asked retired teacher Barbara Sarkany, 76.
Rothman added, "When you are teaching, all your energy should be focused on engaging the children."
Armed teachers and principals?
"It's not what a civil society does," said retired teacher Julie Schardt, 65.
They say politicians need to start listening. Sarkany said elected officials should be "just as afraid of offending us as the National Rifle Association."
"They're powerful," Koeurt said of gun-lobbying organizations. "They have a lot of money. We don't have money. We have a commitment."
The trauma stays close to the surface. The pop of a boy's potato-chip bag at Safeway can evoke disturbing memories. Hearing Fourth of July fireworks is stressful. Castillo, who works these days at Walton Special Center, had to go home early when she learned of the Newtown tragedy.
Rothman says the answer is a ban on assault weapons like the one used by Patrick Purdy at Cleveland back in 1989.
"My kindergarten room had 29 bullets that went through the wall," she recalled. "Eight bullets went through one classroom into the next room. We kept finding bullets for the next two years, the next three years."
Sandy Hook hit the group members even harder than other school shootings that have occurred since the one at Cleveland Elementary. Like Cleveland, the attack at Sandy Hook was committed by an outsider who walked onto campus, not by troubled students attending the school. Like Cleveland, Sandy Hook's victims were only a few years removed from diapers.
They say they have begun their effort because they need to honor the children of Newtown, the children of Cleveland Elementary and all the young shooting victims in Stockton and elsewhere in the United States through the months and years.
"It's for all children who died of gun violence," Rothman said.
And not just for the children, added retired teacher Adrienne Egeland, 65.
"I always think of the parents," she said.
Contact reporter Roger Phillips at (209) 546-8299 or firstname.lastname@example.com. Visit his blog at recordnet.com/phillipsblog.


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Did you know that attic insulation is the key to many problems regarding mold, rodent havoc, water damage and crazy AC bills?
Some homeowners might think the attic is the least important part of their house. In reality, however, the condition and temperature of any attic will affect everything that is stored in it and everyone living below it. An attic that is not properly sealed against the weather and temperature fluctuation will soon begin to suffer from damage inflicted by damp, mold, rodents, odors, ice, and heat.
Temperature fluctuation puts unnecessary wear and tear on the timbers and materials that support the roof. Additionally, it forces the air conditioning in the living areas below to work harder than necessary and accomplish very little. It's because of this that the heating and cooling bills are so high. This is not only a problem in the summertime when an attic can reach a damaging temperature of 150 degrees but also in the winter when icicles can collect on beams and timbers.
Lowering the cost of heating and cooling bills have become one of the primary concerns of the modern homeowner. No matter how efficient your central heating system may be, hot air rises into the attic, whereupon it is instantly cooled. It then sinks back down into the ground floor, pushing more hot air to rise and cool. This means that you lose your heat almost as fast as you can generate it.
However, there is a solution! That solution is properly insulating your attic. Based on your particular needs, there are several different types of attic insulation from which to choose...
As its name would suggest, fiberglass insulation is made of long glass fibers spun together and coated with an agent to bind it together. It is available in batts, as loose fill, and as rigid boards, depending on the size of the spaces you need to cover. It's very popular for household use because it is both fire resistant (very practical) and mold resistant, as well as being able to withstand a small amount of moisture without decreasing its R-value.
This insulation is constructed primarily of newsprint that has been chemically treated to stand against corrosion, rodents, fungal growth, and fire. In comparison to fiberglass, cellulose is only available in a loose fill form, making it the more obvious choice for filling attics, around air ducts, wires, nails, roof trusses etc. For those who live in areas that are subject to cooler temperatures and damp environments, cellulose would be a more efficient option.
Spray Foam
This insulation type is made up of a two-part liquid consisting of a polymer and a foaming agent. Spray foam insulation is applied by shooting the liquid through a nozzle into the area you are insulating. Because it expands as it dries, this foam is a very efficient means of ensuring the best quality of insulation in small or oddly shaped areas by completely sealing off unwanted airflow and moisture. Having an area that is properly air sealed can enhance the benefits of your insulation by up to 50%.
Insulation Is Not Forever
These are only three common options among many to choose from when it comes to insulation. After several years it may be necessary to check and be sure you are still receiving the best quality possible from your insulation. This is known as the R-value. It refers to the "Resistance" levels and efficiency of insulation. It is advised that you speak to an insulation expert such as Clean Crawls and arrange for an attic insulation check-up.
Again, having an attic carefully and professionally sealed is very beneficial to you as the homeowner. Not only does it preserve the quality of your materials, but it also raises the value of your house. Over half of the energy bill is spent on adjusting the temperature of your house; by regulating the temperature of your attic, you can ensure that the heating and cooling levels of your home are proving effective.
In the end, proper attic insulation will save you and your family money in both repairs and energy bills.


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(Rolling Stone) -- Mere months after Rolling Stone named Gnarls Barkley's "Crazy" one of Best Songs of the 2000s, the singing half of to duo, Atlanta rapper-gone-crooner Cee Lo Green, now finds himself in contention for the best track of 2010 with the viral, retro-soul sensation "F--- You."
It's been a long musical odyssey for Cee Lo, from his days as a member of the rap collective Goodie Mob to Gnarls, but for the first time he's climbing the charts as a solo artist. Brian Hiatt recently caught up with Cee Lo to talk about "F--- You" (and his his distaste for the radio edit "Forget You"), his new album The Lady Killer, the future of Gnarls Barkley, and his dream of a residency in Las Vegas.
Before "F--- You," you had "Crazy" hanging over you.
I was just talking about that the other day. "Yay! I'm not a one hit wonder."
It seems like "Crazy" didn't even blow up this fast.
I don't think so. I'm proud of that accomplishment, too. The idea that Rolling Stone put us in the top 100 out of the top 500 songs of all time -- that's awesome. I can't believe I got the chance to do that in my lifetime.
The idea of the gold-digging woman and all that -- how much of that is fiction, and how much did that draw from some point in your life?
There had to be some back story of how the lady killer was caused, or created. And most things are created due to trial and error, you know? The truth, as far as it being exact, or a current event in my life ... I'm rich. Nah, I'm just kidding. Well, I was rich before taxes -- now I'm just fortunate.
What do think about 50 Cent recording that stuff over it?
I was cool with it. It was very flattering for him to take the melody, record his own version, and then not stop there, but actually go a giant step further with the video. It was just a testament to what this song was so quickly becoming. I don't think I would have stopped anyone from joining in and having some fun with it.
The lyrics are negative in the chorus and negative, but the song still comes out feeling happy, because it's cathartic. It's joyful somehow.
Well, that's the core resistance of both of those energies, man. It's the yin and yang, it's the exact math of a perfect circle, you know? What car do you know cranks up without a positive and negative charge?
The rest of the album will have to be really good to live up to this song.
[Laughs] I was like, yo can we follow this up? But at the very least, I have a great record prepared for you. It is a brand new chapter in Cee-Lo Green. It's my lighthearted and bubbly and liberal side. I think so many people have become convinced that I was Gnarls Barkley 24 hours a day, and that's not true.
Do you think that's a darker side of you, in Gnarls?
In comparison to Lady Killer, yes. But even Lady Killer has its edge -- you know, I definitely do like edge. I believe that my audience is not anticipating what I'll do the same, but what I'll do different, you know?
What is the current state of your relationship with Brian Burton -- Danger Mouse?
Oh, we talk every day. He called me and we had a good laugh about the record. He kinda called me to let me know that he was listening, and he knows where we've been, he knows that song stems from something very, very true to life -- it's definitely an extension of our sense of humor. I'm the talkative one and he's the quiet one in Gnarls Barkley, so people know me a bit better, but the mystique [we each have] is equally attractive. He's actually a very funny guy. He's outspoken and opinionated, and his opinion for the most part is that he doesn't like hardly anything. We kind of have that love-hate relationship with each other, too. For the most part we don't like what either one of us does around the other. He feels like I'm at my best when I'm with him. He does have a point.
Do you think you'll do another Gnarls record someday?
We'll definitely do one more. And that's so crazy, because we were only supposed to do one. I feel so young. I feel like I can do anything right now. I feel like people are hearing me for the first time and I've been around for seventeen years, for god's sake!
Technically this is your first solo smash after all these years.
That only goes to show, if you stay diligent and you dedicate yourself ... I was accustomed to moderate success and critical acclaim and being ahead of my time and for once in my life, I'm right on time. It's very reinvigorating and rejuvenating. I feel there is a whole 'nother 20 years worth of music in me.
And "Forget You" is the clean version.
Yeah. But I must say, I don't like it as much. And neither will you -- but you have both versions.
I've heard little rumblings that parents groups are mad about this song. In the scheme of everything in today's world, this seems pretty minor, but are you prepared to be confronted by a few angry moms and grandmas?
I will make sure I have my iPad with me and go right to YouTube and say, "Yo, let me play you something so far worse. Let me play you 100 songs you don't want your kids to hear." They'll beg me to play them my song before they hear those. [It's like] John Lithgow in Footloose. Know what I'm saying?
Yeah. He would not like this song.
That only goes to show how big of a hit record it is at this point. I didn't mean to offend anyone. It was done in good taste and it wasn't meant to be an insulting thing. I'm sorry, kiddies.
Are you going to go on a solo tour? What are you doing for live shows?
It really depends. I hope that the album is well-received, and I'll see what venues are more fitting for it. I kind of had a vision -- it's a long shot, but I really wanted to do a residency in Vegas. I wanted to be one of the first from our generation to be able to do it. You know: "Live in Las Vegas!" That would be cool, if I could do something stationary, but still a spectacle of sight and sound and sophistication.
Copyright © 2011 Rolling Stone.


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French police officers arrested red carpet prankster Vitalii Sediuk at the Cannes Film Festival on Friday (16May14) after he tried to scramble under actress America Ferrera's dress.
The Ugly Betty star was taken aback when the madcap Ukrainian journalist got too close while she was posing for the cameras with How to Train Your Dragon 2 castmates Djimon Hounsou, Cate Blanchett and Kit Harington.
Sediuk, who was once slapped by Will Smith for trying to plant a kiss on him and stormed the stage at the 2013 Grammys to 'collect' Adele's Best Pop Solo award, dashed onto the red carpet at the Palais des Festivals premiere, lay on the ground and attempted to put his head under Ferrera's white dress.
It is not clear how the big event prankster gained access to the red carpet.
tagged in Adele America Ferrera Cate Blanchett Djimon Hounsou Will Smith Kiss Officers Kit Harington


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Police: Teen shot in the head
A 13-year-old boy has improved to serious condition Friday after a shooting last weekend.
Police said Michael Wells, of Berwick, was visiting another 13-year-old friend at a home in Ankeny when the shooting happened at about 3 p.m. last Sunday.
Police said Wells was found in the parent's bedroom with a single gunshot to the head and was taken to Mercy Medical Center.
According to police, there were two other teens at the home at the time of the shooting: a 14-year-old girl and her 13-year-old brother.
Police are treating them as witnesses, and their names are not being released.
Police said the parents of the teens were not home at the time of the shooting.
Wells family told KCCI Monday that he's in a medically induced coma.
Dr. Brad Buck is the superintendent of Saydel Community School District where Wells is a seventh grader at Woodside Middle School.
Buck said both teachers and students are upset to hear the news.
"It's especially upsetting for those closest to him," said Buck. "We have a group of Michael's close friends that are pretty upset. They have been in to talk to counselors today."
Buck has been in touch with Wells family and said they seem to be cautiously optimistic.
"In talking to Michael's mom, they believe things are progressing better than they thought they could and there is a chance that he could be off the medication for the coma as soon as tomorrow," said Buck.
No charges have been filed in the case, police said. The investigation into the shooting is ongoing.


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The apes still rule the multiplex.
The summer hit about genetic engineering gone wrong starring James Franco and Andy Serkis stayed strong in its second weekend at the box office, keeping its hold on the top spot with $27.5 million in ticket sales. "Rise of the Planet of the Apes" has grossed $105 million domestically and $180 million overall.
U.S. & World
"It's remarkable to only drop 50 percent and do $27.5 million worth of business, despite $60 million worth of new movies coming into the marketplace," 20th Century Fox senior VP Chris Aronson said, according to The Hollywood Reporter.
"Rise of the Planet of the Apes" maintained its edge with male audiences, hurting "Final Destination 5," which opened in third with $18.4 million, and "30 Minutes or Less," which bowed in fifth with $13 million.
But the industry surprise of the weekend was the film that drew in women, "The Help," which debuted at No. 2 with $25.5 million in box office receipts. The adaptation of the 2009 Kathryn Stockett bestseller about white women and their maids in 1962 Mississippi is probably benefiting from "exceptional word of mouth," EW.com said, as CinemaScore audiences have rated the flick an A+.
Its distributor, Disney, said 74 percent of the movie's audience was female, and 60 percent was over age 35.
Disney released the film (which was made by DreamWorks and Participant Media) early, on Wednesday, and it made $9.9 million on that day and Thursday—so its five-day total is $35.4 million.
"The Smurfs" placed fourth in the U.S. this weekend with $13.5 million, but it was all green internationally, winning the overseas box office with $60 million in sales.
"Glee: The 3D Concert Movie" failed to even crack the top 10 in its debut, coming in 11th with $5.7 million.
Selected Reading: The Hollywood Reporter, EW


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"Makers, Takers, Fakers": A Major Rhetorial Shift For The Party Of Sneering Plutocrats
Republicans have a problem. For years they could shout down any attempt to point out the extent to which their policies favored the elite over the poor and the middle class; all they had to do was yell "Class warfare!" and Democrats scurried away. In the 2012 election, however, that didn't work: the picture of the G.O.P. as the party of sneering plutocrats stuck, even as Democrats became more openly populist than they have been in decades.
As a result, prominent Republicans have begun acknowledging that their party needs to improve its image. But here's the thing: Their proposals for a makeover all involve changing the sales pitch rather than the product. When it comes to substance, the G.O.P. is more committed than ever to policies that take from most Americans and give to a wealthy handful.
Consider, as a case in point, how a widely reported recent speech by Bobby Jindal the governor of Louisiana, compares with his actual policies.
Mr. Jindal posed the problem in a way that would, I believe, have been unthinkable for a leading Republican even a year ago. "We must not," he declared, "be the party that simply protects the well off so they can keep their toys. We have to be the party that shows all Americans how they can thrive." After a campaign in which Mitt Romney denounced any attempt to talk about class divisions as an "attack on success," this represents a major rhetorical shift.
But Mr. Jindal didn't offer any suggestions about how Republicans might demonstrate that they aren't just about letting the rich keep their toys, other than claiming even more loudly that their policies are good for everyone.
Meanwhile, back in Louisiana Mr. Jindal is pushing a plan to eliminate the state's income tax, which falls most heavily on the affluent, and make up for the lost revenue by raising sales taxes, which fall much more heavily on the poor and the middle class. The result would be big gains for the top 1 percent, substantial losses for the bottom 60 percent. Similar plans are being pushed by a number of other Republican governors as well.
Like the new acknowledgment that the perception of being the party of the rich is a problem, this represents a departure for the G.O.P. — but in the opposite direction. In the past, Republicans would justify tax cuts for the rich either by claiming that they would pay for themselves or by claiming that they could make up for lost revenue by cutting wasteful spending. But what we're seeing now is open, explicit reverse Robin Hoodism: taking from ordinary families and giving to the rich. That is, even as Republicans look for a way to sound more sympathetic and less extreme, their actual policies are taking another sharp right turn.
Why is this happening? In particular, why is it happening now, just after an election in which the G.O.P. paid a price for its anti-populist stand?
Well, I don't have a full answer, but I think it's important to understand the extent to which leading Republicans live in an intellectual bubble. They get their news from Fox and other captive media, they get their policy analysis from billionaire-financed right-wing think tanks, and they're often blissfully unaware both of contrary evidence and of how their positions sound to outsiders.
So when Mr. Romney made his infamous "47 percent" remarks, he wasn't, in his own mind, saying anything outrageous or even controversial. He was just repeating a view that has become increasingly dominant inside the right-wing bubble, namely that a large and ever-growing proportion of Americans won't take responsibility for their own lives and are mooching off the hard-working wealthy. Rising unemployment claims demonstrate laziness, not lack of jobs; rising disability claims represent malingering, not the real health problems of an aging work force.
And given that worldview, Republicans see it as entirely appropriate to cut taxes on the rich while making everyone else pay more.
Now, national politicians learned last year that this kind of talk plays badly with the public, so they're trying to obscure their positions. Paul Ryan, for example, has lately made a transparently dishonest attempt to claim that when he spoke about "takers" living off the efforts of the "makers" — at one point he assigned 60 percent of Americans to the taker category — he wasn't talking about people receiving Social Security and Medicare. (He was.)
But in deep red states like Louisiana or Kansas, Republicans are much freer to act on their beliefs — which means moving strongly to comfort the comfortable while afflicting the afflicted.
Which brings me back to Mr. Jindal, who declared in his speech that "we are a populist party." No, you aren't. You're a party that holds a large proportion of Americans in contempt. And the public may have figured that out.
By: Paul Krugman, Op-Ed Columnist, The New York Times, January 27, 2013


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This article, written on November 13th 2011 offers fantastic insights into the evolution of social youth movements and leads to a very interesting conclusion of where we are today. Check out the article here or continue reading below. Enjoy!
Generation Sell
By WILLIAM DERESIEWICZ
Published: November 12, 2011 108 Comments
EVER since I moved three years ago to Portland, Ore., that hotbed of all things hipster, I've been trying to get a handle on today's youth culture. The style is easy enough to describe — the skinny pants, the retro hats, the wall-to-wall tattoos. But style is superficial. The question is, what's underneath? What idea of life? What stance with respect to the world?
The beatniks aimed at ecstasy, embodied as a social form in individual transcendence. Theirs was a culture of jazz, with its spontaneity; of marijuana, arresting time and flooding the soul with pleasure (this was before the substance became the background drug of every youth culture); of flight, on the road, to the West; of the quest for the perfect moment.
The punks were all about rage, their social program nihilistic anarchy. "Get pissed," Johnny Rotten sang. "Destroy." Hip-hop, punk's younger brother, was all about rage and nihilism, too, at least until it turned to a vision of individual aggrandizement.
As for the slackers of the late '80s and early '90s (Generation X, grunge music, the fiction of David Foster Wallace), their affect ran to apathy and angst, a sense of aimlessness and pointlessness. Whatever. That they had no social vision was precisely what their social vision was: a defensive withdrawal from all commitment as inherently phony.
So what's the affect of today's youth culture? Not just the hipsters, but the Millennial Generation as a whole, people born between the late '70s and the mid-'90s, more or less — of whom the hipsters are a lot more representative than most of them care to admit. The thing that strikes me most about them is how nice they are: polite, pleasant, moderate, earnest, friendly. Rock 'n' rollers once were snarling rebels or chest-beating egomaniacs. Now the presentation is low-key, self-deprecating, post-ironic, eco-friendly. When Vampire Weekend appeared on "The Colbert Report" last year to plug their album "Contra," the host asked them, in view of the title, what they were against. "Closed-mindedness," they said.
According to one of my students at Yale, where I taught English in the last decade, a colleague of mine would tell his students that they belonged to a "post-emotional" generation. No anger, no edge, no ego.
What is this about? A rejection of culture-war strife? A principled desire to live more lightly on the planet? A matter of how they were raised — everybody's special and everybody's point of view is valid and everybody's feelings should be taken care of?
Perhaps a bit of each, but mainly, I think, something else. The millennial affect is the affect of the salesman. Consider the other side of the equation, the Millennials' characteristic social form. Here's what I see around me, in the city and the culture: food carts, 20-somethings selling wallets made from recycled plastic bags, boutique pickle companies, techie start-ups, Kickstarter, urban-farming supply stores and bottled water that wants to save the planet.
Today's ideal social form is not the commune or the movement or even the individual creator as such; it's the small business. Every artistic or moral aspiration — music, food, good works, what have you — is expressed in those terms.
Call it Generation Sell.
Bands are still bands, but now they're little businesses, as well: self-produced, self-published, self-managed. When I hear from young people who want to get off the careerist treadmill and do something meaningful, they talk, most often, about opening a restaurant. Nonprofits are still hip, but students don't dream about joining one, they dream about starting one. In any case, what's really hip is social entrepreneurship — companies that try to make money responsibly, then give it all away.
It's striking. Forty years ago, even 20 years ago, a young person's first thought, or even second or third thought, was certainly not to start a business. That was selling out — an idea that has rather tellingly disappeared from our vocabulary. Where did it come from, this change? Less Reaganism, as a former student suggested to me, than Clintonism — the heroic age of dot-com entrepreneurship that emerged during the Millennials' childhood and youth. Add a distrust of large organizations, including government, as well as the sense, a legacy of the last decade, that it's every man for himself.
Because this isn't only them. The small business is the idealized social form of our time. Our culture hero is not the artist or reformer, not the saint or scientist, but the entrepreneur. (Think of Steve Jobs, our new deity.) Autonomy, adventure, imagination: entrepreneurship comprehends all this and more for us. The characteristic art form of our age may be the business plan.
AND that, I think, is the real meaning of the Millennial affect — which is, like the entrepreneurial ideal, essentially everyone's now. Today's polite, pleasant personality is, above all, a commercial personality. It is the salesman's smile and hearty handshake, because the customer is always right and you should always keep the customer happy. If you want to get ahead, said Benjamin Franklin, the original business guru, make yourself pleasing to others.
I was contacted recently by a young man who plans to start a Web site to promote the need for reading and reflection to people of his generation. Not just promote it, though, of course, but market it. When he asked me for advice, I suggested he begin by pointing out the superficiality of so much social media. Well, he said, I agree with that idea, that's a big premise of what I'm trying to do, but I wouldn't want to come across as negative, because that turns people off. If they think you're criticizing them, they won't want to buy what you're selling.
That kind of thinking is precisely what I'm talking about, what lies behind the bland, inoffensive, smile-and-a-shoeshine personality — the stay-positive, other-directed, I'll-be-whoever-you-want-me-to-be personality — that everybody has today. Yes, we're vicious, anonymously, on the comment threads of public Web sites, but when we speak in our own names, on Facebook and so forth, we're strenuously cheerful, conciliatory, well-groomed. (In fact, one of the reasons we're so vicious, I'm convinced, is to relieve the psychic pressure of all that affability.) They say that people in Hollywood are always nice to everyone they meet, in that famously fake Hollywood way, because they're never certain whom they might be dealing with — it could be somebody who's more important than they realize, or at least, somebody who might become important down the road.
Well, we're all in showbiz now, walking on eggshells, relentlessly tending our customer base. We're all selling something today, because even if we aren't literally selling something (though thanks to the Internet as well as the entrepreneurial ideal, more and more of us are), we're always selling ourselves. We use social media to create a product — to create a brand — and the product is us. We treat ourselves like little businesses, something to be managed and promoted.
The self today is an entrepreneurial self, a self that's packaged to be sold.
In "Bobos in Paradise," David Brooks articulated the phenomenon of the bourgeois bohemians, a class that merges respectable incomes with countercultural attitudes. Where, I wondered recently, do the real bohemians — the hipsters, in other words — fit into the scheme? Some are just bobos in training; others are destined to remain bohemians for life. But whatever their individual trajectories, hipsters possess a relationship to mainstream society that is radically different from that of their youth-culture forebears, and they have the bobos to thank. Indeed, they have them to thank for their very existence.
The rise of the bobos in the 1990s (when creativity became lucrative and money became cool) put a new kind of pressure on the true bohemians. Now they no longer stood in opposition to mainstream culture, as the beatniks did to the company men or the slackers did to the business boys. Now they looked exactly like it. Mainstream culture had come to them, and it drew them to itself. Et voilà, the hipster. Instead of having to get a haircut and a new wardrobe, not to mention a new set of friends, if you wanted to go over to the man, you just kept doing what you were doing, at gradually higher price points. Hence the hipster as Bobo-in-training, bohemia merging imperceptibly with the bourgeoisie.
Hipsters and bobos are symbiotic. I should know; I'm a bobo in a hipster-bobo neighborhood — which is pretty much what I was looking for when I moved to Portland in the first place. We're all into organic food and progressive politics; we just have different relationships to the commodities through which those attitudes are expressed. Hipsters create bobo culture. They make or sell or serve, or simply pioneer, what bobos buy. Try to picture Allen Ginsberg having a chat with Don Draper, across the counter at the local coffeehouse, about the latest Lady Gaga video, and you'll realize how far we've come.
All this is why, unlike those of previous youth cultures, the hipster ethos contains no element of rebellion, rejection or dissent — remarkably so, given that countercultural opposition would seem to be essential to the very idea of youth culture. That may in turn be why the hipster has proved to be so durable. The heyday of the hippies lasted for all of about two years. The punks and slackers held the stage for little more than half a decade each. That's the nature of rebellion: it needs to keep on happening. The punks rejected the mainstream, but they also rejected the previous rejection, hippiedom itself — which, by the late '70s, was something that old people (i.e. 28-year-olds) were into. But hipsters, who've been around for 15 years or so, appear to have become a durable part of our cultural configuration.
Or maybe not. These movements always have an economic substrate. The beatniks and hippies — love, ecstasy, transcendence, utopia — were products of the postwar boom. The punks and slackers and devotees of hip-hop — rage, angst, nihilism, withdrawal — arose within the long stagnation that lasted from the early '70s to the early '90s. The hipsters were born in the dot-com boom and flourished in the real estate bubble.
Affability is a commercial virtue, but it is also the affect of people who feel themselves to be living in a fundamentally agreeable society. Already, the makings of a new youth culture may be locking into place.
A version of this op-ed appeared in print on November 13, 2011, on page SR1 of the New York edition with the headline: Generation Sell.


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Anyone who knows me, knows I don't like fast-food. I make exceptions for In-N-Out and White Castle (when I'm back home). Life is too short to eat bad food, I do not like Burger King, Wendy's or McDonald's much to my nephew's dismay.
The other day we had this exchange...
Nicky: Do you like McDonald's?
Me: No.
Nicky: You don't like their hamburgers?
Me: No
Nicky: Not even chicken nuggets? (his favorite)
Me: Nope.
Nicky: (completely dumbfounded) Why?
Me: I just don't like the taste.
Nicky: Silence. Soon, Amy was on the line. He was done with me.
It's been 8 or 9 years since I had McDonald's. Well, I take that back. Four years ago, the day my nephew was born, I had McDonald's breakfast. It was his mommy's choice. You do not second guess a mommy-to-be on her delivery day. I guess the boy was even a fan back then.
Anyway, Frank's been grabbing lunch at Raising Cane's every now and then. He urged me to try it. After quite a bit of convincing, I finally did. It was nothing like KFC which is what I expected. We went to the location on Flamingo near Maryland Pkwy.
Another odd quirk I have is I do not like chicken on the bone. Wings, thighs, drumsticks -- none of it. Chicken is also my least favorite protein. So, it's not something I often enjoy. At Raising Cane's all they do is Chicken Fingers. It's kind of like it was made for me. All white meat chicken, never frozen and lightly breaded and fried to order. I had the three finger box, sounds dirty, doesn't it? Once I got my head out of the gutter I was able to enjoy it.
It was crisp without being greasy, and juicy on the inside. Their sauce is pretty good, I like the peppery-ness of it. Although, I felt like it could use some smoke flavor. BBQ sauce and chicken fingers just go hand in hand. I suppose, honey mustard does, too. The fingers came with crinkle fries, crisp and light in the center just the way I like 'em. You can tell they fry in fresh oil, too. I always appreciate that. I also had a side of Texas Toast. It's light and airy, brushed with butter and garlic. It's so good. Yum.
I've since learned Raising Cane's got its start in Baton Rouge, LA. The founder was told by banks and his teacher that a chicken finger business would never work. He raised much of his own funds and showed them. I love stories about people who were told the can't, but prove they can.
Now, In-N-Out isn't alone. I like Raising Cane's, too.
October 27, 2010
4 comments:
- KathyinNY said...
I love your commentaries on food. Being in upstate NY we do not have a Raising Cane's but we sure do have McDonald's, Wendy's, BK, Taco Bell. What I love is SONICS which we do not have either. I have to go down south for that. LOL
- Kellee said...
We have Sonic here, too. I tried a burger from there once I wasn't a fan. Frank loves their slushy Powerade drinks.
If you're ever hungry and near a Raising Cane's it's worth a stop. If you enjoy chicken fingers, anyway.
- Tara said...
We've had our Cane's for about 6 months now and I LOVE it. A little pricey for fast food, but worth every penny.....
- Kellee said...
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Faculty contact: Ryan Halter, Alexander Hartov


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Whether government should ratify a new law to put a ban on tobacco and alcohol is a controversial subject, thus requiring a lot of rigour. Concerning the two proposals put forward above, I consider them superficial and of little substance for the following reasons.
To begin with, the decision to attach illegality to the tobacco and alcohol businesses risks producing a wave of anger and protest within many groups of people. Businessmen* will sustain heavy losses of capital and profit for by the closure of their factories. Employees in the relevant industries have to face the probability of unemployment. Tobacco addicts and alcoholics, for want of these products,would/will run riot. All of these factors can pave the way for demonstrations and rebellion. Thereby, the promulgation of this new law is synonymous with seeking more problems.
On the other side, the further legalization of addictive products should be regarded as a retrograde step. Currently, though restricted in quantity and popularity by the government, drugs still seduce a large number of customers. In case the grip over them were loosened or even abrogated, this would serve as a catalyst for their boom. With the effective assistance of advertising, they would intrude into all the corners of public media, tempting people into buying more and more. What is worse is that children – highly subject to influence – would be intrigued to have a try and then get addicted. A dramatic increase in the number of cases of diseases related to smoking and drinking, a decline in the quality of work performed by an addicted labour force, and downgrade in moral standards wouldprobably be unavoidable concomitants.
The Essay on Hould You Use Tobacco
... are much more likely to become herion, cocaine, and crack addicts. Tobacco can even cause death! It kills more than eight thousand ... stick the snuff straight up their noses. Tobacco is very addicting. The nicotine in the tobacco is what causes the addiction. There are ... many illness that one can acquire from using tobacco ...
To summarize, the two suggested policies are equally unfavourable. I am convinced that, due to the complexity of the issue, many remedies, instead of only one, should be synchronized to take effect. Firstly, it is advisable to put a limit on production and variety of addictive products. Secondly, government officials should tighten their control and management so that advertising for these kinds of products have no probability to see the light. Thirdly, depending on each groups of customers, an acceptable amount is prescribed. Last but not least, the task of education for the public about the danger of drugs like tobacco and alcohol should be better boostered.