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Ezetimibe, known as Zetia and as the key component of Vytorin, was invented by friends and colleagues of mine. It was the first drug I ever saw discovered after I joined the drug industry. The initial discovery of the whole compound class happened around the corner from my lab, and the compound that became ezetimibe itself was synthesized down the hall. So, no, I'm not taking the current news about it very well. The situation is still quite confused, but there looks to have been enough stupidity, greed, and plain bad luck involved to make anyone despair. Read on – but I should warn you, I'm probably just going to get madder and madder as the post continues.
As anyone unfortunate enough to be holding Merck or Schering-Plough stock already knows, both companies took a pounding yesterday after the American College of Cardiology issued its recommendation on the use of Vytorin (ezetimibe / simvastatin). This call was based on the now-infamous ENHANCE trial, which was just published in the New England Journal of Medicine. The main points of the study had already come out in January, of course, but a closer look at the data has done nothing to help explain its results: no improvement over existing therapy. Addition of the cholesterol absorption inhibitor to the statin appears to have done nothing to help clear arteries (based on measurement of intima-media thickness) over what could be done with the statin alone. Ezetimibe seems to have had no bad effects, fortunately, but no good ones, either.
The ACC's verdict is that Vytorin should only be used as a last resort, and that patients currently taking it should strongly consider going back to plain statin therapy. Based on these study results, that seems like a reasonable recommendation. There's a large outcome trial (IMPROVE-IT) underway comparing the two treatments, but we're not going to see results from that one for another three years at the earliest. Until then, there doesn't seem to be any reason to recommend Vytorin. (There may not be any reason to recommend it afterwards, either, but we'll have to wait to see about that). Fortunately for everyone involved, no one seems to have been harmed, outside of the insurance companies who have paid out for Vytorin for the last few years – they not doubt have their own views on the subject.
It's important to remember that this result is indeed a surprise, since the combination definitely does do a better job at lowering LDL. (As an editorial in the NEJM puts it, this "dramatically contradicts our expectations"). You'd think that extra LDL reduction would be associated with a better outcome, but one of the panelists at the ACC, Dr. Harlan Krumholz, points out (PDF) that hormone therapy lowers LDL as a side effect, but isn't associated in that case with better atherosclerosis outcomes, either. Does that mean that there's more to the effect of statins than just lowering LDL, too? That possibility has to be taken seriously. The non-lipid effects of inhibiting HMGCoA reductase, the statin target, may be part of the answer, although the authors of the NEJM paper are reluctant to make that their whole explanation.
What they suggest instead is disturbing. The study may have been doomed from the start. The ENHANCE subjects were not taken from the general population, but rather were patients with a genetic abnormality in LDL handling, familial hypercholesterolemia. The idea was that these patients would be even more likely to show a benefit from Vytorin. But as the NEJM authors make clear, this may at one time have been a good patient population to show benefits in, but now the great majority of people with this condition are treated with statins starting at an early age. This, naturally, has an effect on their arterial walls. So the subjects of this trial may have already had a head start on reducing their arterial thickness, which means there may well have been a limit on what any particular therapy could have accomplished. Instead of being a better group to demonstrate your LDL-lowering powers in, they could well be worse.
If that's true, there is, in fact, a chance that the IMPROVE-IT trial could show a clear benefit for Vytorin, since it's being run in a broader population. (Just watch the confusion if that happens). But what will that mean? The results will be far too late to help Merck and Schering-Plough, and will be a clear disservice to the patients that could have benefited from the drug before then. ENHANCE would then turn out to have been a huge mistake.
But not content with that, the companies have managed to make it into a complete disaster. The controversy has been whether Merck and Schering-Plough sat on the results of the trial or spent extra time trying to find a way to make them look more appealing. This has drawn the attention of Sen. Charles Grassley and an investigative committee, which is the sort of thing that no company can wish for. Yesterday Grassley released some of the text of his letters to the management of both companies, and these include quotes from e-mails sent by John Kastelein, the lead investigator on ENHANCE. They do not look good, not by any stretch of the imagination:
" Is it correct that SP has decided not to present at AHA, but to await the two other, completely unvalidated, endpoints, which analysis is going to take us straight into 2008??!!??
If this is true, SP must have taken this decision without even the semblance of decency to consult me as PI of the study. I can tell you that if this is the case, our collaboration is over…This starts smelling like extending the publication for no other [than] political reasons and I cannot live with that."
In another e-mail, Kastelein expresses more frustration that the results would not be presented at that AHA meeting (as indeed they weren't, in the end), and says that ". . . you will be seen as a company that tries to hide something and I will be perceived as being in bed with you!"
Schering-Plough, for its part, says that these statements are taken out of context, but good grief, what other context could that possibly be? Kastelein has also backed off, saying that he wasn't accusing the company of "deliberately withholding data for political reasons", but again, it's hard to read those excerpts in any other way. These days, no one should make statements in e-mail that they're not comfortable seeing printed in the Wall Street Journal, which is where I got these.
And does it need to be said that this is exactly, I mean exactly the kind of thing that the drug industry does not need? Vytorin as a drug is easy to forgive – the combination makes perfect sense, and the fact that it didn't show a good result in ENHANCE took everyone by surprise. (And, as mentioned above, it may in the end turn out to be a good therapy in the end). But the marketing of Vytorin is perhaps another thing – the companies really made a huge aggressive push to get as much of the cholesterol-lowering market as they could. That's no sin by itself, unless business is a sin, but if you're going to push that hard, you'd better make sure that you're standing on something firm.
This trial definitely wasn't that sort of foundation, and the fallout from it has been made much, much worse by its handling. It's distressing to me that the management at Merck and Schering-Plough would even take the chance, in this climate, of being seen as data-massaging study-burying slime. What words do I find if that's what they turn out to be?
Ezetimibe was (and is) a wonderful scientific story in the drug discovery labs, and its development is a testament to some very dedicated and persistent people. What a pity that it's all come to this.
Derek Lowe's commentary on drug discovery and the pharma industry. An editorially independent blog from the publishers of Science Translational Medicine. All content is Derek's own, and he does not in any way speak for his employer.
Cardiovascular Disease
Vytorin: It's A Pity
Ezetimibe, known as Zetia and as the key component of Vytorin, was invented by friends and colleagues of mine. It was the first drug I ever saw discovered after I joined the drug industry. The initial discovery of the whole compound class happened around the corner from my lab, and the compound that became ezetimibe itself was synthesized down the hall. So, no, I'm not taking the current news about it very well. The situation is still quite confused, but there looks to have been enough stupidity, greed, and plain bad luck involved to make anyone despair. Read on – but I should warn you, I'm probably just going to get madder and madder as the post continues.
19 comments on "Vytorin: It's A Pity"
I just read an article on the ACC's Vytorin verdict in todays Wall Street Journal Europe.
Concerning the prior use of statins it said: "But other doctors said that the 19% of patients who hadn't had prior statin treatment also saw no benefits." Any thoughts?
Could this be the mechanism for failure?
The data from recent large clinical trials (last 5 -6 years) that study the correlation between statins and LDL reduction versus it's effects on CRP has tended to show that CRP reduction to below 1 mg/l is a much better predictor of reduction in risk of MI.
Unfortunately many mainstream physicians/ researchers still try to dispute/obfuscate this for reasons that have nothing to do with science. Imagine your reaction if someone came out with more evidence for a heliocentric model of the solar system when your livelihood/ prestige depended on a geocentric model.
The metabolic syndrome seems to cause both dyslipidaemia and increase in chronic inflammation through alterations in liver physiology that are not well understood. It certainly helps that statins reduce both CRP and LDL. So does continuous consumption of moderate amounts of alcohol and it is also associated with a decreased risk of MI. Coincidence?
Fibrates, niacin, CETP inhibitors and inhibitors of intestinal cholesterol transport do not reduce CRP to any worthwhile extent. Large clinical trials on the therapeutic effects of these drugs also tend to show that they are rather ineffective for reducing the risk of MI, as might have been especially evident in the last 3 years.
And yes, I have said this before. It is just that when I first said this a few years ago, it was dismissed by everyone who heard it. It seemed that people then believed that the well payed doctors + researchers working on new wonderful new cholesterol lowering drugs knew more than me. Turns out that objective assessments do win in the end.
Now, apparently, the best drug for allowing people to live longer with less disease is also the least expensive, and therefore, the least advertised.
Thus far, based on empirical study, the only cholesterol-lowering drug to actually prolong life is niacin. The interesting report is at http://www.cholesterolscore.com
And please always remember that when the press releases and MDs extoll the virtues of statins by claiming a "20%" reduction in cardiac events, they are referring to the RELATIVE risk reduction (5% with cardiac events untreated vs. 4% with statins), never the ABSOLUTE risk. Repeating the "20% Reduction!!!!" statistic sells drugs better, doesn't it? I bet telling patients that the number of patients to treat to save a single life would be met with skepticism to be sure. Especially when Statins have a significant, but always downplayed, rate of advese effects. Everyone I know on statins have muscle pain, a very well known side effect. But it's always discounted as "old age" or being "out of shape".
Drug companies are not in the business to save people's lives. They are in the business to make maximum profit any way possible, even if it results in patient deaths and unecessary drugs. And accomplished with the help of a massive sales force to sell drugs to MDs and the public.
The LDL-C mantra will eventually go by the wayside, just like the previous state of the art treatments like X-rays for acne, bleeding/purging and ill-humours.
A further concern from the ENHANCE trial is that many in the public have drawn the wrong conclusion that it also means that statins don't work. My own father falls into this category, and I have been hard-pressed to fix the PR damage that this has done to statin therapy in his mind.
The companies' behaviour has certainly done the industry and its reputation no favours. However, Having been around a while I can recollect how long it took to demonstrate any significant benefit with statins, and the reluactance to prescribe them until such data were available.
In related news
JUPITER halted: Rosuvastatin significantly reduces cardiovascular morbidity and mortality
March 31, 2008
Chicago, IL – Rosuvastatin gained clinical traction today with the announcement that a large event-driven study was stopped early because the lipid-lowering agent was shown to be more beneficial than placebo in reducing cardiovascular morbidity and mortality [1].
The study is known as the Justification for the Use of Statins in Primary Prevention: an Intervention Trial Evaluating Rosuvastatin (JUPITER), a large, multinational, long-term, double-blind, placebo-controlled, randomized clinical trial designed to assess directly whether statin therapy (rosuvastatin 20 mg/day) should be given to apparently healthy individuals with low LDL-cholesterol levels but elevated C-reactive-protein (CRP) levels.
The halting of JUPITER was announced in the wake of the presentation of the disappointing results of the Effect of Combination Ezetimibe and High-Dose Simvastatin vs Simvastatin Alone on the Atherosclerotic Process in Patients with Heterozygous Familial Hypercholesterolemia (ENHANCE) study and an American College of Cardiology consensus panel that urged physicians to prescribe statin medications with proven clinical effectiveness. AstraZeneca issued a press release saying the independent data monitoring board observed "unequivocal evidence of a reduction in cardiovascular morbidity and mortality" among those treated with rosuvastatin compared with placebo.
By the way, I should note that according to the NEJM article, Vytorin lowered C-reactive protein significantly over simvastatin alone. Depending on what's going on here, that could be good news in the long run. If Jack F.'s interesting link above is the story, though, then all bets are off. . .
Hi Derek,
The important number for CRP is 1mg/ L. If you can reduce it to around this level the risk of excess MI events is almost gone (at least in people without familial hypercholesterolemia). Reducing the median from 1.2 to 0.9 will not translate into any further therapeutic effect. This is based on the epidemiological studies.
The next important level for CRP is below 0.5 mg/ L. At this level the risk of MI is considerably below normal. If the person does not have any other MI risk factors like type II DM or untreated hypertension the chances of ever dying from a MI are slim.
Cancers, alzheimer's, stroke, hip fractures and other problems of old age will still prevent immortality.
Analytical Scientist,
Stains do work well for lowering LDL-C, if that's all one is after. Otherwise, the HOPE, PROVE-IT and public-relations-named, Pharma-funded and vetted, clinical trials really never have shown significant mortality prevention of primary cardiac events. How can there be such fanacticism regarding the notion that Statins provide total protection and saves lives?
Even in secondary event prevention, the NNT is 75. Compare that to antibiotics for Heliobacter-induced stomach ulcers, with an NNT of 1.1. I remember how the Med community, under the guidance of pharma sales reps, fought to the bitter end regarding Heliobacter. It finally turned out not to be such a great idea to treat patients forever with proton pump and H2 inhibitors, never achieving a cure, if a single course of cheap antibiotics was the best course.
It is always sad when medicinal chemists and biologists achieve exactly what they were asked to do, putting hundreds of men-year worth of work into it and it all goes to naught. At least in this case it looks like it happened for a scientific reason and it falsified the dogma that high LDL=bad therefore low LDL=good
Oh boy — what kills me here is that we're trading one surrogate endpoint off against another. Are we really about to throw the LDL baby out with the ENHANCE bathwater? I can't believe that for a minute. The caveats around the population and trial are too many. If SP and MRK have the stomach, they should continue with IMPROVE IT which is a study done in the non-familial hypercholesterolemic population. Two years seems a long ways a way, but what are the odd on that looking possibly different….?
I hate to bust everyone's bubbles…LDL-C and CRP have NOTHING to do with Cardiovascular disease.
Everyone knows it's caused by ill humors and can be cured with a little bloodletting…..
There is only one chemical whose consistent consumption has been associated with a 50% or more reduction of MI mortality/ morbidity (ethanol at 30-50 g/ day).
Less than 30g= effects not consistent
above 50g = blood pressure/ stroke risk starts increasing
Ethanol simultaneously reduces formation of unstable plaques, decreases CRP and other measures of chronic inflammation and increases insulin sensitivity. If these effects were due to inhibition/ modulation of one single paththway and could be mimicked by an otherwise reasonably safe drug it would become a mega blockbuster. Such a drug could reduce the risk of MI + type II DM (and its vascular complications) to a level that is not currently possible with any drug for either condition.
I feel for thousands of rank-and-file employees at these two companies; as a long-time BMS employee I know exactly what it's like to watch one's employers get lambasted in the media for questionable decisions by top management.
If the Feds really want to improve transparency of decision making in Big Pharma — and quite possibly even benefit Big Pharma as well as the public in the long run — they should have some of their brightest minds ponder ways to strengthen the hand of the scientific side within companies. I have never, thank God, been involved in any situation where I felt pressured to downplay important scientific data, but I'm familiar enough with the dynamics of decision making in Big Pharma to see how such things can happen. I've certainly seen enough cases where I felt some business decision was harming the long-term future of the company due to short-term financial pressures. Just about any reasonable policy intervention that would stiffen the spines of the scientific side in such internal debates would benefit everybody in the long term.
Derek wrote:
It's distressing to me that the management at Merck and Schering-Plough would even take the chance, in this climate, of being seen as data-massaging study-burying slime. What words do I find if that's what they turn out to be?
Ah! Climate! The social climate of disillusionment with the industry. Such social issues are critical to the industry. Incompetence in them is just as deadly as scientific incompetence.
In this climate, perhaps it should have been asked "what is the SOCIAL risk of an unexpected Enhance outcome, such as it showing no plaque thickness difference difference, considering past drug flaps and what we are charging for the drug?"
Perhaps pharma should go back to studying drugs primarily in their major intended audience, with truly meaningful endpoints – i.e., actual patient outcomes – and use surrogate endpoints more cautiously.
You have made several comments on several threads that alcohol reduces mortality.
I don't know of any clinical trials showing this effect. Do you have any references/links you can provide?
I hope this link helps you, BEW, for it has plenty references:
Comments are closed.


text:
Meet Our Founder
Dr. Wong Kee Cheong (Tommy) is a Registered Dental Surgeon who is passionate to make a dent in the World of Dentistry. Dr. Wong attained his Bachelor Of Dental Surgery (BDS) at AIMST University and he is currently doing his Master Of Business Administration (MBA) at SEGi University. Being a Dental Personnel, he has always wanted to leave a positive impact in the field of Dentistry.
Throughout the journey of Dentistry, he has realised that there is still a lack of Oral Health Education to the public globally. This leads to high prevalence of Oral Diseases such as Dental Caries, Periodontal Diseases, Oro-dental Trauma, Tooth Loss and etc among the human population globally. Most of these Oral Diseases are preventable.
Prevention is better than Cure. And this can be achieved by providing professional Oral Health Education to the public globally. With this mission, he and his team have established "GlobalDentalPro - Your Oral Health Educator" in 2016 with the mission to provide valuable information about oral health in such a way that the public is motivated to use that information for the protection or advancement of own, family's or community's oral health.
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subset: commoncrawl


text:
The next edition includes Michael Mayer's series debut and the first track from Terrapin, a collaboration by Matias Aguayo and Jörg Burger.
At this point Pop Ambient is part of the electronic music calendar—there's been one every year since 2001—but they still manage to do something new every time. The 2013 edition is no exception. This year's collection features Kompakt co-founder Michael Mayer's first ever appearance in the series with the Wolfgang Voigt remix of "Sully" (the opening track from his recent album, Mantasy). Another first comes from label staples Matias Aguayo and Jörg Burger, who debut their new collaborative project, Terrapin, with "Cirrus Minor" (a Pink Floyd cover, which also happened to be the closing track on Mayer's recent RA Podcast). Other highlights include Jens-Uwe Beyer (AKA Popnoname), Danish dub techno artist Mikkel Metal and Argentina's Leandro Fresco, who returns to the series for the first time since 2002.
01. Leandro Fresco - Cuando El Sol Grita La Manaña
02. Michael Mayer - Sully (Wolfgang Voigt Mix)
03. Jens-Uwe Beyer - Deutz Air 2
04. Triola - Jean Vigo
05. Marsen Jules - Point of No Return
06. Mikkel Metal - Recombination
07. Anton Kubikov - Ambianopolis
08. Wolfgang Voigt - Rückverzauberung 7
09. Leandro Fresco - El Cruce Imposible
10. Terrapin - Cirrus Minor
Kompakt will release Pop Ambient 2013 on January 21st, 2012.


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With an impressive list of traditionalists, revivalists, and torchbearers, including Lee Rocker of the Stray Cats and Sonny Burgess and his Legendary Pacers, the first installment of Memphis' International Rockabilly Festival promises to deliver something no other music festival in the world can: two solid days of live music and nostalgia, all taking place a few hundred feet away from Sun Studio.
On March 3, 1951, Willie Kizart's, water-damaged guitar amp malfunctioned, giving a recording of Ike Turner's "Rocket 88" a distinct and fortuitous buzz. Two years later, a starry-eyed kid named Elvis Presley walked in the front door looking for an audition, and the corner of Union and Marshall officially became ground zero for the big bang of rock-and-roll. Howlin' Wolf, Rufus Thomas, Johnny Cash, Jerry Lee Lewis, Carl Perkins, and Roy Orbison all launched recording careers at Sun. Now, 64 years after Kizart's amp went all fuzzy, festival organizers Darrin Hillis and Mark Lovell are bringing rock-and-roll back to the place where it all started.
Hillis says he has no idea why it's taken so long for someone to finally organize a major vintage music event in Memphis during Elvis Week, when tourists flock to Whitehaven to visit Graceland and celebrate the King's life and legacy.
"We're selling tickets all over the world, from Australia to Japan," Hillis says. "A whole movie crew is coming from the United Kingdom."
Hillis, who first partnered with Lovell to launch the Delta Fair in 2007, isn't from Memphis, but he says he's always been drawn to the city and its music. It started when he was only a kid living in a trailer park in Gainesville, Florida, playing Jerry Lee Lewis singles on his sister's record player. "I wore it out," says Hillis, who was encouraged to finally act on a longstanding desire to organize a rockabilly festival by Memphis' rocket-powered piano man Jason D. Williams and his wife/manager Jennifer James.
"We really want this to be an experience," Hillis says. "We want people to feel like they are walking back in time." To achieve a sense of temporal displacement, Hillis has organized a hot rod car show and offered discounts to all festival vendors who dress in a vintage style reminiscent of the 1950s. To help complete the vibe, tattoo artists will be available to give music fans the ultimate souvenir. Those looking for a less permanent remembrance can visit pinup photography specialists, the Memphis Bombshells. They'll be giving hair and makeup tips and performing retro makeovers in the Premiere Palace.
In addition to the shows, fans hoping to get up close and personal with their favorite rockabilly artists will be able to visit the Dizzy Bird, a 70-seat venue housed in the former Hattiloo Theatre. Selected performers will be available before or after their main-stage shows to tell stories, sign books, and play songs in a more intimate environment.
Sun Studio sax man Ace Cannon is scheduled to perform, as is Johnny Cash's longtime drummer W.S. Holland. The first-wave rockers are playing alongside notable innovators like Memphis guitar prodigy Travis Wammack, whose quirky instrumental recordings "Scratchy" and "Fire Fly" inspired a generation of hot-lick guitar pickers including Led Zeppelin's Jimmy Page. The schedule is rounded out by contemporary Memphis players like Nancy Apple, Jason Freeman, and the Motel Mirrors, featuring John Paul Keith and Amy LaVere, who played rockabilly star Wanda Jackson in the 2005 Johnny Cash biopic Walk the Line.
Memphis music has few champions as outspoken as Texas troubadour Dale Watson, who is scheduled to perform Sunday evening at 6 p.m. Watson's based out of Austin, but since 2001, he's recorded five albums' worth of material at Sun Studio.
"I've been recording at Sun for almost 20 years now," says Watson, who launched the Ameripolitan Music Awards in 2014 as a means of recognizing artists performing original music inspired by the sounds of traditional honky-tonk, rockabilly, and western swing. "Something about that room is so magical. A lot of it's because of Elvis, Johnny Cash, and Jerry Lee's having been there. But even more, it's just the sound that you get recording in that room. It's like nowhere else. And the talent that came to perform there made the perfect storm."
The Rockabilly Festival also showcases the talents of newly-minted octogenarian and human jukebox Sleepy LaBeef, who takes the stage Sunday afternoon at 4:30 p.m. LaBeef wasn't a Memphis artist, but he was definitely around for the "perfect storm" Watson describes.
"At the beginning, it was all country, hillbilly, rhythm and blues, bluegrass, and the old foot-stomping, hand-clapping gospel rhythms all put together," says LaBeef, recalling his early days on the road with all of the original rockabilly artists.
"I never made a record in that building there in Memphis," says LaBeef, who became a Sun recording artist in the 1970s, after the label moved to Nashville. "Now, in 1954 and 1955, I was opening some shows for Elvis, Scotty [Moore], and Bill [Black]. We also did some shows with Fats Domino, Chuck Berry, Buddy Holly, Gene Vincent, and all these different people.
"We were mixing a lot of stuff together back then to see if it worked," LaBeef says. "And if it worked, we done it."
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text: OK, so last night I played in the back up orchestra for Il Divo, for an outdoor concert here in Phoenix. The 4 singers were ok, their voices were quite good. But the main event for me was meeting and chatting with Gary Wallis. This guy is the Pink Floyd drummer/percussionist in the post-Waters era. He was also the Music Director for last night's show. Quite a nice and unassuming gentleman! And wouldn't you know it... I didn't have a camera with me. Except for the crappy one on my cell phone. So I snapped a pic next to the guy. I will post it once I figure how to d'load it. (any advice?)


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4 Big Myths About Dental Care for Baby Teeth
We're about to debunk four of the most harmful myths in the world of dental care for infants. If you are a new parent, be sure not to fall victim to believing one of these dental care fallacies.
Myth #1 – Babies Don't Need Two Brushings Per Day
We're not sure where this one came from, but tartar doesn't magically form slower in a child's mouth. The twice per day brushing rule is designed to ensure you clear away plaque before it can harden into tartar that has to be removed by a dental professional.
Myth #2 – Kids Don't Have to See a Dentist Until They Begin School
The American Academy of Pediatric Dentistry recommends your first dental visit be scheduled as soon as the baby's first tooth emerges and by the child's first birthday at the latest. Waiting until school means that those early teeth can be subject to years of tooth decay and plaque with no professional cleanings, recommendations from a pediatric dentist, or preventative dental care.
Myth #3 – You Don't Have to Clean a Baby's Teeth After Breastfeeding
After you eat, you should brush your teeth. That's even true for a baby that is nursing. In fact, you can protect your baby's gums even before teeth emerge by wiping the gums clean after feeding with a soft, damp, clean cloth.
Myth #4 – It's Okay to Put a Baby to Bed with a Bottle
We often brush our teeth right before bed. Why? Because that clears away any food on the teeth, protecting them from decay while we sleep overnight. The same should be true for a baby. Putting a baby to bed with a bottle negates the ability to clean the teeth before bed and exposes teeth to the possibility of decay all night long.
Preventative Care for Your Baby's Teeth
If you have a new baby in the San Diego area, BRSH+FLSS Pediatric Dentistry wants to be your child's dental home. Parents love our focus on prevention, friendly atmosphere, and board-certified pediatric dentists. To schedule your infant's first dental appointment, call 619-741-1500 today.


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Winchester Daily Briefing 1 April 202020200401-Winchester-Daily-Briefin01
Winchester Daily Briefing 1 April 202020200401-Winchester-Daily-Briefin01
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3D Supply Chain Process System
Ubims is the world's first patented, cloud-based meta-platform as a 3D supply chain process system for connecting multiple providers of goods with consumers worldwide and for a complete reinvention of the global supply chain process.
It is a shared supply chain infrastructure for entrepreneurs and SMEs modeled as a three-dimensional [3D] globally interconnected e‐marketplace and e-supply chain process system for both communication and distribution of real goods. The most obvious example of a [3D] network is the Internet in the sense that it is simply a meta-platform for information, connecting multiple information sources to multiple information recipients.
Moreover, Ubims will be developed on blockchain technology. Ubims is the first decentralized open supply chain infrastructure system, and blockchain is a new decentralized public ledger technology. Therefore, Ubims [3D] process platform with blockchain technology will disrupt the whole global supply chain industry.
The current U.S. supply chain market size is $4.25 trillion. About 10% ($425 billion) would be the market size for Ubims in the U.S. market alone
Traction and Validation
The Council of Supply Chain Management Professionals (CSCMP), one of the most recognized and well-established organizations in the supply chain industry, has endorsed the concept of a [3D] supply chain process system by publishing UbiMS founder Luke Ho-Hyung Lee's article "How a "3-D" supply chain process system could revolutionize business" in its Supply Chain Quarterly Journal.
A [3D] supply network ranked #1 out of the Top 10 Supply Network Trends by ES3 Research, one of the most recognized research centers in the logistics industry.
Ubims was mentioned by Adrian Gonzalez: Ubims, which is using blockchain technology "to change the way businesses manage data, adapt to shifting consumer demands, and coordinate the flow of goods around the globe 24.7.365." UbiMS sees blockchain's potential to become a new operating system for Supply Chain Operating Networks, and also help to federate those networks.
Why Ubims ?
Product Liquidity Trap
Because customers are widely dispersed, it is very difficult, expensive and time consuming for individual suppliers (especially, for individual SME suppliers) to construct their own marketing and supply chain networks to supply all potential customers in the market.
Moreover, many new brands, kinds (flavors or designs), and sizes of products have been created in almost all industries of our economy over the last 50 years. As a result, the number of different products has increased exponentially or in a three-dimensional way during that period. In addition, due to the rapid advancement of communication technology and transportation capability, many more differentiated products have been imported from abroad. However, the current supply chain processes, mostly with limited store or distribution center space, and high individual product delivery or fulfillment costs, have caused the higher liquidity costs in physical products and seriously impeded the smooth flow of all products to the market. More seriously, in this situation, many small- and medium-size company businesses still using the conventional distribution processes have kept on being destroyed, mainly due to multiple costly transaction stages, over the last several decades. This must be a hidden and critical flaw in our economy, and we believe our markets have already fallen into a liquidity trap for physical products.
The Ubims Solution
With Ubims, businesses will no longer need to spend unnecessary time and money constructing individual private marketing, logistics and supply chain networks; instead, they will seamlessly connect and transact on Ubims' network for almost all kinds (brands), sizes, and prices of products, resulting in lower costs, shorter delivery times and higher profits.
In this way, the liquidity costs for physical products could be significantly reduced - and the current physical-product liquidity trap could also be easily broken down.
Who will benefit from this platform ?
- Constructed as a partnership of collective power of all participating members; therefore, everyone can benefit from the size of the supply chain infrastructure
- Significantly lowers barriers to entry for businesses by reducing supply chain infrastructure costs
- Small- and medium-size businesses and even individuals will durably compete with companies the size of Walmart, Amazon, and Alibaba
- Less than 6-hour delivery for all orders will be possible
- Last-mile delivery services between local retail centers and end-customers will improve significantly
- Numerous new businesses and jobs will emerge from improved local margins
Our Team
Luke Ho-Hyung Lee
Founder & CEO
Michael Lin
Darren Sweet
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Adviser & Partner for legal & fundraising
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Dual Layer Microfiber Terry Lined Robe-
Dual Layer Microfiber Terry Lined Robe
AllegroMedical.com presents The Dual Layer Microfiber Terry Lined Robe. Comfy 52' microfiber robe has the comfort of microfiber on the outside with the softness of terry on the inside. It has a shawl collar, roll-up cuffs, two patch pockets and double belt loops to fit clients of different heights. Our finest robe. Choose from a variety of colors. One size fits most.
- 100% brushed microfiber shell
- 80% cotton and 20% polyester knit terry lining
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- 22' sleeves
- Inside hanger loops for easy storage
- Belt loops alongside and center back
- 2 front pockets
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SAN DIEGO (AP) — Federal energy regulators on Tuesday blamed inadequate planning and lack of grid coordination for a massive blackout last year that started with the loss of a single transmission line at an Arizona substation and quickly affected millions of people in Southern California and Mexico's Baja California.
The Sept. 8 outage that lasted through the night shows the need for close communication between major utilities and smaller operators and for everyone to update their emergency settings, officials said.
The blackout was caused by many of the same problems that triggered a 2003 outage that cut power to 50 million people in the Midwest and the Northeast, regulators said in a teleconference from Washington.
It was another reminder that U.S. transmission lines remain vulnerable to cascading power failures despite recent safety measures.
The system is built to quickly compensate for glitches — like the loss of a single line — but a lack of understanding of what was happening between neighboring operators caused the problem in Arizona to balloon into something much bigger than it should have been, according to the joint report by the Federal Energy Regulatory Commission and North American Electric Reliability Corp.
When a maintenance worker caused the loss of the line operated by Arizona Public Service, it immediately overloaded adjacent systems stretching to California and northern Baja California.
The outage knocked out traffic lights, causing gridlock on roads in the San Diego area. Two reactors at a nuclear power plant along the California coast went offline after losing electricity, and nearly 3.5 million gallons of sewage spilled into the ocean, closing beaches in San Diego.
People on both sides of the U.S-Mexico border spent the night struggling to fall asleep in high temperatures that reached 115 degrees in desert areas. There were no reported deaths or injuries related to the outage.
"This report highlights the growing need for more coordination of grid operations in the West," FERC Chairman Jon Wellinghoff said in a statement.
Federal officials conducted an eight-month inquiry to determine the cause.
During an 11-minute time span after the Arizona transmission line tripped, some outside operators "observed changes in flows into their systems but were unable to understand the cause or significance of these changes and lacked sufficient time to take corrective actions," according to the report.
Regulators said a separate process looks at whether any utility might have been in violation of rules, which could result in a hefty fine. That process is confidential and regulators declined to say whether any utilities were being investigated in the 2011 blackout.
Gerry Cauley, president and CEO of the North American Electric Reliability Corp., said the outage underscored the complexity and interdependence of the North American electric system and the importance of information sharing and system studies.
In 2005, a major outage struck the Los Angeles metropolitan area. That same year, Congress required utilities to comply with federal reliability standards for the electric grid instead of doing self-regulation. Layers of safeguards and backups were intended to isolate problems and make sure power keeps flowing.
But some of those safeguards — such as measures that automatically kick facilities offline when there is an overload of power — also may have been set too strictly in this case and need to be revised, the regulators said.
As lines were knocked out, power flows jumped to levels that matched or exceeded the standards and led to the San Onofre Nuclear Generation Station being taken offline, which caused San Diego and much of the surrounding county to go dark.
Mexico also took power plants offline to contain the blackout.
Federal regulators found if the emergency settings had allowed for a higher level of power flows, it could have given operators time to mitigate the problem and the outage could have affected a much smaller area.
Similar relay problems contributed to the 2003 blackout, said NERC Senior Vice President Dave Nevius.
He said outages continually help officials better understand how to prevent cascading failures in the future.


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A Shropshire vehicle valeting firm had a sparkling surprise when it arrived at a new customer's home.
Mango Valeting of Shrewsbury discovered that it had been booked to clean the car of one of Britain's favourite actresses, Fay Ripley.
Fay, who shot to fame in hit 1990s Manchester series Cold Feet, booked Mango as the mobile valeting business was recommended by a friend.
Mango Valeting boss Jason Heath said it was a shock when Fay met him and his colleague at the door of her north London home.
"We could not believe it – she was so lovely and extremely pleased with the work we did, in fact she said it was 'incredible'!" he said.
"Her 4x4 was a little grubby inside and out because she has two young children and a dog but we managed to leave it sparkling.
"We have just re-branded our company and taken on more staff and launched a new website so it is an exciting time for us and fabulous to have a star as one of our first new customers."
Mango Valeting has recently made a major investment in an additional mobile valeting vehicle with its own electricity and water supply, as well as awning, so it can carry out cleaning work at any location and in any weather.
Fay, who most recently starred in the BBC remake of Reggie Perrin and is seen in the National Lottery advertisements, was so grateful that she recorded a video testimonial for the Mango Valeting website.
In it she says she called Mango Valeting because her car was filthy but she was shocked at the transformation after it was cleaned inside and out.
"I am genuinely gobsmacked. My car literally looks like new, even all the little scratches have disappeared from the paintwork. Mango have done an incredible job," she commented.
For further information on Mango Valeting, please contact Jason Heath on 01939 252111.
Member since: 10th July 2012
That's our team, L-R Emma, Louise and Andy. We run thebestof and our sister marketing company, Key 3 Media. With over 40 years' combined marketing experience, we help promote local businesses through our...


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Animation, Baymax, Chris Williams, Disney, Don Hall, Hiro, Hiro Hamada, Kabuki mask, Marvel, Microbots, Professor Callaghan, Robot, Ryan Potter, San Fransokyo, Scott Adsit, Superheroes
D: Don Hall, Chris Williams / 102m
Cast: Scott Adsit, Ryan Potter, Daniel Henney, T.J. Miller, Jamie Chung, Damon Wayans Jr, Genesis Rodriguez, James Cromwell, Alan Tudyk, Maya Rudolph
Hiro Hamada (Potter) is a fourteen year old orphan living with his brother Tadashi (Henney) and aunt Cass (Rudolph) in San Fransokyo. He's a precocious teenager, a genius with robotics who takes part in underground robot fights (and gets himself into trouble). Tadashi believes Hiro is wasting his time and talents, and takes him to the robotics lab at the university he attends. Hiro meets his brother's friends, Go Go (Chung), Wasabi (Wayans Jr), Honey Lemon (Rodriguez) and Fred (Miller). Tadashi also introduces him to his own special project, a robot called Baymax who provides personal healthcare. Seeing the inventive projects they are all working on, Hiro becomes committed to enrolling at the university.
Hiro works on a project that he can use to apply, and comes up with microbots, tiny robots that can be connected in any way possible via the use of a neural sensor (basically a headband that reads a person's thoughts and communicates them to the microbots). The head of the robotics department, Professor Callaghan (Cromwell) is sufficiently impressed to offer Hiro a place at the university. Also interested in the microbots is businessman Alistair Krei (Tudyk), but at the urging of Professor Callaghan – who dislikes Krei intensely – Hiro declines his offer to buy the microbots and make a fortune. Later, a fire breaks out at the university; Callaghan is trapped inside and Tadashi rushes in to rescue him. Hiro can only stand by and watch as the building explodes, killing both his brother and Callaghan.
Hiro retreats from daily life. One day he accidentally injures himself. This causes Baymax to activate and try to help Hiro. At the same time, one of Hiro's microbots comes to life; they soon realise it's trying to unite with the other microbots, but they should all have been destroyed in the university fire. They follow the microbot to an abandoned warehouse where they discover that someone is mass producing the microbots. Confronted by a man in a kabuki mask who uses the microbots to attack them, Hiro and Baymax manage to escape but not before Hiro realises his project is going to be used for evil purposes.
Hiro upgrades Baymax to be able to fight and equips him with body armour. They track the microbots to the docks where they encounter the masked man. Before Hiro can instruct Baymax to attack him, Tadashi's friends all turn up; a chase ensues in which the masked man attempts to kill all of them. They manage to avoid being killed and head for Fred's palatial home where Fred tells them he believes Krei is the man behind the mask and the theft of the microbots (and the deaths of Tadashi and Professor Callaghan). They use Baymax's sensors to locate Krei and, kitted out in costumes that allow them to act as superheroes, head for an island off the coast where they discover an abandoned facility that contains the remains of a machine that they further learn was used as a teleportation device. And then the masked man appears, and attacks them all…
Watching Big Hero 6 – especially if you're a Disney executive – is a reassuring experience. In the same year that Marvel took a chance on one of their lesser known titles (something called Guardians of the Galaxy), the House of Mouse also took a chance on releasing another Marvel adaptation, a comic book property that had an even lower profile than Star Lord and his pals. The result is a funny, exciting, refreshing, beautifully rendered, heartwarming tale that introduces audiences to one of the most lovable animated characters in recent memory: a rotund primary care robot called Baymax.
It's a recognisably Disney movie. There's the standard emphasis on family bonds and the importance of friendships, as well as doing the right thing, but it's a Disney movie that's been meshed with the standard tropes of a Marvel origin story, its action heroics and in-house maxim "with great power comes great responsibility" adding an extra layer to the emotional content that makes it more affecting than expected. Given free rein by Marvel to adapt Big Hero 6 in whatever way they saw fit, directors Hall and Williams and screenwriters Jordan Roberts, Dan Gerson and Robert L. Baird have created a movie that is a model of consistent, gratifying entertainment.
Of course, Big Hero 6 would be nothing without Baymax, an irresistibly charming, sweet-natured character who melts the heart and warms it at the same time. He's a brilliant creation, a soft, cuddly vinyl-formed teddy bear whose personality chip is completely in the right place (where his heart would be – coincidence?). Voiced to perfection by Adsit, Baymax is the kind of friend we'd all love to have: solicitous, kindly, generous, selfless, supportive, and always there for us (it would be a hard heart indeed that didn't fall in love with him at first sight).
With Baymax proving to be such a wonderful character it wouldn't have been a surprise to find Hiro lacking in appeal by comparison, but thanks to the very cleverly assembled script, Hiro is as immediately likeable as Baymax is, his scamming at the opening robot fight proving to be a great introduction to a character the viewer can both identify and sympathise with throughout, even when his thirst for revenge for the death of Tadashi threatens to overwhelm his sense of right and wrong. And he's not as self-centred as most fourteen year olds, having a refreshingly sincere relationship with both his brother and his aunt. And even more refreshingly, the script avoids any notion that Baymax is a replacement for Tadashi; the lovable lug, ultimately, is more than that, fulfilling the roles of brother, friend, and father.
What's also refreshing is the fact that the villain actually has a good reason for stealing Hiro's microbots and replicating them. When this reason is revealed it adds yet another emotional layer to the storyline, as well as an unexpected sadness that is amplified by highlighting how much the villain and Hiro have in common. It's a neat twist on the usual hero-villain relationship, and allows Big Hero 6 to be comprised of more than just the customary bad-guy-out-to-take-over-the-world-and-stopped-by-errant-genius scenario we're so used to seeing.
The supporting characters are all endearing in their own ways, with Miller's Fred proving especially likeable (stay til after the end credits for a great "reveal" relating to his dad), and Wayans Jr's Wasabi often very funny as the constantly risk assessing member of the group. The voice cast are all excellent, with special mention going to Potter and Henney who make their scenes together genuinely touching, and Adsit once more for making Baymax so appealing and irresistible.
As for the animation, the use of new technology means that Big Hero 6 is possibly one of the most beautifully animated movies so far. There's also a level of detail that is absolutely breathtaking, notably in the scenes that take place on the streets of San Fransokyo. The mix of Eastern and Western cultures is a joy to behold, and very cleverly assimilated, providing a rich visual palette that can be enjoyed time and time again. The character designs are also impressive, with a welcome reduction on the size of the eyes that has hampered the design of so many previous animated characters. And the use of a kabuki mask makes the villain truly intimidating and menacing, augmenting the threat he presents and making him look creepy as well.
With Hall and Williams showing an obvious command of the material, and choosing not to set this in another corner of the Marvel Cinematic Universe, the viewer is free to enjoy the movie for what it is and not where it might fit in to any future Marvel outings. With this potential aspect removed, Big Hero 6 is free to be delightful and entertaining on every level it aims for.
Rating: 9/10 – a winner, pure and simple, continually inventive and captivating in equal measure; Big Hero 6 is yet another triumph from Disney, and is – probably – one of the most visually ravishing, heartwarming animated movies you're likely to see in this or any year.


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As a business owner or director, you don't have time for sick leave or illness, right? Coughs and colds won't […]
Date: 8 April 2019
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Brown on Girardin, trans. Wilkinson (2017)
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Girardin, Delphine de. Balzac's Cane. Translated by Marta L. Wilkinson, Peter Lang, 2017, pp. xvi + 136, ISBN 978-1-4331-4068-6
Noëlle V. Brown, Principia College
Delphine de Girardin's novella playfully brings a literary myth to life by granting Honoré de Balzac's ornate cane the supernatural power of invisibility. The cane takes on a new role when the handsome Tancred Doriment, suffering from an excess of beauty, yearns for invisibility. Allowing him access to political secrets and literary salons, the cane eventually permits him to penetrate the private room of a young female poet whom he admires. In this way, Girardin anchors her tale of science fiction and romantic intrigue in the concrete literary and historical context of 1830s France. Marta Wilkinson skillfully translates the poems incorporated within the novella as well the voice of Girardin's sassy narrator who comments on the romantic and social escapades of Tancred and the cane. While Wilkinson translates Girardin's text superbly, her paratextual materials, notably the introduction and the timeline, could have better situated the novella within its 1836 context.
In an "Introduction," Wilkinson identifies intriguing themes from the novel, such as the importance of physical beauty and the growing lack of separation between public and private spheres. Wilkinson touches on issues of gender by pointing out that the three characters who use the cane to access private spaces and hear private conversations—knowingly or unknowingly—are male. She also notes that only the young female poet gives up her literary aspiration, whereas Balzac and Tancred succeed in their ambitions. In addition to linking the novella to questions of gender inequality, Wilkinson specifically directs her "Introduction" toward professors considering the inclusion of the text in their courses, citing additional concerns for privacy and self-representation.
However, Wilkinson's effort to establish the novella's connection with modern American readers in the introduction limits its effectiveness. Questions regarding Tancred's ability to be on American Idol, or The Voice may appeal to modern young readers, yet the link may not be clear to all. Nor are they entirely relevant since Tancred did not wish for celebrity, but rather, to fade into the crowd, as proven by his negotiation with the Balzac character over the use of his cane. Wilkinson's intertextual allusion to the characters from the twentieth-first-century Twilight series—in which a male protagonist similarly watches a young woman sleep—perhaps seeks to imitate Girardin's more or less subtle references to the literature of her time. However, not all readers will understand the reference and some may consider it a banalization of Girardin's novella since the romantic angle only appears in chapter nineteen out of twenty-four. The story is pertinent to today's world, but Wilkinson tries too hard to make the story appear relevant to modern student readers who use Twitter and Facebook while neglecting to provide other key contextual information.
For instance, missing from the "Introduction" is sustained discussion of the novella's historical relevance and context. From the novella's title, the reader anticipates the importance of Balzac himself, largely absent from the introduction. Modern readers might also be interested in nineteenth-century gossip and myths circulating about Balzac's sartorial choices, including his cane, especially when Girardin purposefully ends the novella with the sly suggestion that Balzac uses it to make profound psychological and social observations. Including famed writers, such as Lamartine and Chateaubriand, as well as disguising other characters' names with asterisks, Girardin has carefully prescribed a specific literary and social context for her readers, yet much of this remains unclear for readers unfamiliar with literary salons, Balzac's writing, and biography. Had Wilkinson included the dates of some of Balzac's novels and texts by Lamartine and Chateaubriand in the "Timeline" preceding the translation, it might have better situated the novella in its literary context.
Despite these quibbles, the modernizing elements do animate the novella. Wilkinson admires the "charm" and the "wit" (ix) of Girardin's text and renders them accessible to Anglophone readers. Direct and unwavering, the pithy narrator speaks her mind and the characters and scenes come to life in French as in English. In her "Translator's Note," Wilkinson explains the difficulty in translating words like "beau" and "belle." A similar justification of the choice of "timid" to translate Girardin's use of both "timide" and "docile" to describe the female author might also have been helpful: one carries a sense of yielding to societal norms and the other could be a psychological condition. Overall, Wilkinson succeeds in the difficult act of idiomatic rather than purely literal translation, especially in the case of the poems included near the end of the novella which she presents as a particularly exacting challenge in her work. By comparing the original French poems provided in the "Notes" section, the reader feels the power of the rhythms and rhymes in both.
Wilkinson has successfully accomplished her goal of making Girardin's La Canne de M. de Balzac "accessible to anyone who enjoys such creative works" (xiv). Bringing renewed attention to Girardin's little-known French novella in a text available to non-French speaking publics makes an admirable contribution to nineteenth-century studies.


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Future Smartphones Could Have A Self Healing Display
As technology moves forward, all future smartphones are expected to have wireless charging as a common feature. One thing that we have learnt from current smartphones that support wireless charging is that they are almost entirely made of glass. This means that as much hard as companies claim their glass is, there are chances of it breaking.
That may not be the case in the near future as a team of researchers in South Korea have developed a self-healing material that can repair cracks in under thirty minutes. The material is called Elastomer and could be the answer to the fragile build of smartphones in order to support certain features.
Elastomer is able to heal itself at room temperature and at the same time, doubles the amount of the highest level of existing tensile strength. In simple words, tensile strength is the resistance of a material to breaking under tension. Something that happens to a lot of smartphones made of glass. Elastomer not only heals itself but, it also maintains the original ruggedness of the material.
According to the research team, this new material can be used as a protective layer on smartphones. While it is hard to predict the timeline for the material to become commercially available for smartphone makers, it seems like a step in the right direction. As gadgets become thinner, their frailties against drops will invariably become more prominent and companies don't seem to be lowering the repair costs of out of warranty devices.
Right after the launch of the iPhone X, it was discovered that people who don't opt for Apple Care might have to shell out up to US $279 to get the screen repaired. A self-healing material will definitely help the consumers save money and also use their devices a bit more freely without always worrying about the damage.
This is not the first time we are hearing about a solution for fragile smartphones. A few months ago, it was reported that Motorola would start featuring a self-healing display on its future smartphones. Recently, students of the University of Tokyo claimed that they had discovered a self-healing glass that could be used in smartphones as well.


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MN Commercial Remodeling Services
With more than 35 years of combined MN commercial remodeling services and experience, Titus Contracting has been a trusted name in MN commercial and retail remodeling – and with good reason!
Our clients know they can trust us from start to finish. From the initial consultation and design phases to putting the finishing touches on your newly renovated commercial space, Titus Contracting is here to make your life easier during the commercial remodeling process.
As business owners ourselves, we understand firsthand the challenges that a commercial remodeling project can present. If you are remodeling a business that is already open, you want to be sure that the construction work does not interfere with your business and your employees' ability to do their jobs. And if your business is not open yet, you want to be sure that the construction work does not delay or impede your business' grand opening or impede it in any way.
Our awareness of the importance of your business running smoothly is why you should call us to find out more about our commercial remodeling services. We realize you already have a lot to worry about, and we can take some of that stress off of your plate by handling all aspects of your commercial remodeling project.
Give us a call to find out more. We can even give you a free estimate so you know how much to budget for your project.
Commercial Remodeling from Titus Contracting
A commercial remodeling project is usually a pretty big undertaking. Not only do you have to worry about what you want your final results to look like, but you also have to take in account the technical and legal aspects too. For example, securing the proper work and construction permits, hiring reliable licensed subcontractors to do the work and making sure all your T's are crossed and I's are dotted.
Thankfully, this is where Titus Contracting can help! We will take care of every single facet of your commercial remodeling project. From helping with the design plans to getting work and construction permits to hiring subcontractors, we can take care of it all. You can trust Titus Contracting to handle your commercial remodeling project on schedule and on budget.
When you call us to learn more, we can answer your questions and get you on our schedule as soon as possible.
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Inefficient stores or factories can result to clients assuming you provide flawed services, or worse, they experience or purchase your defective products due to an issue in your building or in the dynamics of your office complex. Prevent this issue from happening by treating your commercial property to remodeling or renovation.
If your store, workplace, office complex, factory or building has chipped paint, stained carpets or any issue that requires a major commercial facelift, let us help you out. We offer commercial construction and renovation services for clients looking to improve or remodel their space.
How We Can Help
The projects we take on are varied and can involve multiple stories, extensive exploration of land use, permitting and special inspections. From sealants and caulking to roofing and flooring, and even your windows and doors, sidings and gutters, we can restore, remodel and renovate them all.
Our team is also capable of providing clients with commercial interior design, space planning, and structural repairs. We make sure all our services are time-efficient, to lessen your company downtime and to prevent the construction from affecting your productivity.
More importantly, our commercial remodelers in Minneapolis and Minnesota offer redesigning services that are safe and stress-free. We understand how some projects can be challenging and complicated, but our 35 years in the industry has lent us the necessary experience and expertise to get you the outcome you need seamlessly and quickly.
Improve your workplace productivity or your office safety with one of our top commercial construction and renovation services today. We offer professional, affordable and time-efficient services you can trust.
Are you looking for Twin Cities residential remodeling services as well? We are ready to help!


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African News
Campaigning Starts For Tense Ivory Coast Presidential Vote
Election campaigns have begun in Ivory Coast on Thursday ahead of the presidential election on October 31.
There are four candidates in all, the incumbent president and key opposition figures, including a former president and a former prime minister, have been disqualified.
Opposition parties have called for civil disobedience to protest against an attempt by the incumbent, Alassane Ouattara to seek a third term. They say the bid is illegal.
Thousands of people rallied against the move in the commercial capital, Abidjan, on Saturday. Ouattara was elected president 10 years ago in a disputed election that was reported marred by violence.
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African News
Police Arrest 100 Over Angola Anti-Government Demos
At least 100 protesters have been arrested in Angola following what is described as violent anti-government demonstrations in the nation`s capital Luanda over the weekend.
Interior ministry secretary, Salvador Rodrigues, said on state television, one hundred three persons, including political party leaders, were arrested and detained.
Protesters took to the streets to demand jobs and better living conditions. They are also demanding a new date for local government elections that were due this year, but put on hold because of the coronavirus pandemic.
Angolan authorities accused protesters of being violent – throwing stones, burning tires and damaging a fire engine. The protesters have been charged for arson and rioting, among other.
In a statement on Sunday, main opposition party, Unita, alleged police use of excessive force and demanded "unconditional release" of all persons arrested.
African News
Russia Sends More Military Equipment To Central African Republic – RIA
Russia has opened a representative office in the Central African Republic, C.A.R., and has donated ten armoured vehicles to the country.
Moscow has been solidifying its presence in the C.A.R. in recent years, sending weapons, contractors and political advisors, and has been growing its role on the continent overall as part of a renewed push for global prestige.
The RIA news agency cited the Russian ambassador as saying on Saturday that five members of the Russian military had arrived in Bangui, C.A.R.'s capital, on Saturday, led by senior military officer – Oleg Polguev who will head up the Russian defence ministry's representative office in the country.
The African nation has asked for Russia`s help in lifting an arms embargo imposed by the United Nations.
African News
Guinea President Alpha Condé Wins Controversial Third Term
Guinea`s incumbent president, Alpha Conde, has won re-election. A full preliminary tally from the election commission released on Saturday shows Conde won the October eighteenth poll with nearly sixty percent of the vote.
The 82-year-old Conde`s victory, once confirmed by the constitutional court, will give him a third term in office. The opposition had said the president had no right to participate in the election, but Conde says a constitutional referendum in march reset his two-term limit. Opponents say he is breaking the law by holding on to power.
Results showing conde`s lead has sparked street protests in opposition strongholds leading to at least 17 deaths. Gunfire rang out across Guinea's capital, Conakry, on Friday as security forces dispersed protesters and soldiers patrolled the streets in trucks.
Former prime minister, Cellou Dalein Diallo, Conde's nearest rival with thirty-three and a half percent of the vote, said he has evidence of fraud and plans to file a complaint with the constitutional court.
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by Jennifer
Witch Doctor Costume
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Witch Doctor Costume
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This homemade costume for boys entered our 2014 Halloween Costume Contest.
A word from Sandra, the 'Witch Doctor' costume creator:
A witch doctor on my 11 year old son. Normally very fair skinned, we sprayed him with black temporary hair color spray. We purchased all accessories for the costume separately, like the grass skirt, shrunken heads, beads, wig, etc. Painting his face and putting it all together worked out nicely.
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Author – Nick Korzhenevsky, senior analyst with AMarkets Company.
The anchorman of a TV program "Economics. Day rates".
- Chinese economy and the Sino-American relations are set to become the primary theme for the markets in 2019.
- U.S. overheating – and more Fed tightening – is the risk that comes in second.
- We still do not expect either a U.S. or a global recession in 2019, but the yield curves will likely invert.
- Trading environment will remain difficult as China is determined to allow further yuan weakness, while the twin deficits problem is once again a headwind for the dollar.
- General asset volatility is forecast to stay below the end-2018 levels, with the two usual jumps expected in the spring and in the fall.
As anticipated, the year of 2018 proved to be one of the worst in financial history. For the third time in half a century, every asset class has yielded negative total returns. Towards the end of the year, the market looked like it was in a full-blown panic mode. The sell-off affected all asset classes, prompting holders to liquidate and move their money into safe havens like the U.S. treasuries. Of note, oil prices were falling sharply for three months straight, from early October until the very end of December.
Now, before we delve into the forces driving investor fear, let us remind the readers of the main reason for this turbulence: the Fed's rate hike and balance sheet roll-off. Tighter dollar liquidity means higher volatility and less more risk-off episodes, which is, of course, bad for the markets, specifically those that used to benefit from liquidity injections. That is, in fact, the reason for the sell-off being this massive. While QE clearly inflated the bond market, stocks were also enjoying inflows and the low-rate environment. With both gone, positioning inevitably underwent major adjustments.
So how far can the market plunge go? Is the recent market turmoil justified at all? The answer here, as always, depends on what central banks, primarily the Fed, do next. The recent spike in volatility suggests that the FOMC will be more cautious about marching rates higher in 2019. This is also reflected in the fact that the Fed is now prepping the market for the end of the tightening cycle.
Under our baseline scenario, we now anticipate just two rate hikes in 2019, and one or two more in 2020. We're still projecting a fairly hawkish terminal rate (70 b.p. higher than priced in by the futures market), although we now expect the Fed to shift its strategy and rhetoric. The next opportunity for that would be at the January 29-30 policy meeting. We may even be in for some headline-grabbing statements from the Fed's key officials, including chair Jerome Powell. Traders shouldn't expect much of an adjustment to the central bank's rate-hike plans though. Instead, they'll probably put out something about slowing down the QE unwind, which would spark a massive surge in risk appetite. The environment is perfect for these as there is simply no factors for a 2008-like crash: liquidity surplus in the U.S. banking system remains very high at $1.7 trillion (versus the deficit 11 years ago).
A fundamental change for the new year is that investors will start reacting to economic data again, and the reaction will be very literal. Positive data coming from the U.S. will reduce risk appetite and vice versa. The major exception is the dollar. The greenback has also demonstrated an extremely asymmetrical response to the newsflow. In 2018, the USD failed to post any significant gains, yet was quick to respond to every negative headline. The weakness is likely to drag into 2019 as there is virtually no reason to expect tighter financial conditions from the Fed, while the twin deficits are again an acute problem. But that's a story for our next review.
Among other factors affecting every single market is the PBoC. China's central bank wants—and needs—to ease its monetary policy, which is virtually impossible amid a trade war. Lower rates or even larger amounts of local liquidity would immediately put the yuan under pressure. In other words, the PBoC simply can't ease when the Fed tightens (short-term nominal returns in the U.S. and China are now nearly equal).
The trade war difficulties force money out of China, yet Beijing can't let the yuan weaken now as it would be seen as competitive devaluation by the Trump administration, and risk yet another round of tariffs. That, in turn, would have a negative impact on China's current account, and exert more pressure on the yuan (of course, we're simplifying the process for the purposes of clarity). That's precisely why the PBoC is de-facto tightening its policy. China's credit is expanding at around about 10%, while M2 money supply growth is at just 7.5-8%. Both values are the lowest since the beginning of the '00s.
It is critical to understand that the Chinese economy has accumulated sizable imbalances and it's only a matter of time before the yuan devaluation begins. We estimate that the USDCNY will reach 7.25 in H2 2019 in one of the most important market events. That will likely hit all EM-currencies, and, unless the Fed acts, could trigger another risk-off episode. That said, Beijing can still buy some time in the dispute with the U.S. by loosening the fiscal policy. In fact, the government has already announced new individual income tax cuts. The program amounts to 0.6-1.2% of GDP, a better estimate will be available as more details become public.
And the last, but not least, of global market-moving stories is, of course, Brexit. The United Kingdom is to leave the EU on March 29, 2019, yet the deal is still not finalized. The biggest roadblock is the British parliament itself which is reluctant to approve Theresa May's Brexit plan. We did read the deal and actually find the contents reasonable, given the circumstances: most of economic freedoms are still there, while the thorniest of the issues are put off till later. Most MPs will surely read the plan by the end of January, taking the number of "yes" votes higher.
Of course, it is still too early to bet on a positive outcome. Brexit remains the key risk for the British pound and could grow into a systemic problem should the worst-case scenario suddenly plan out. We, however, note that there are bigger risks to be worried about. The market is aggressively discounting a serious global growth slowdown, yet the Fed and the PBoC—the regulators of the world's two largest economies—are not providing the market with fresh liquidity anymore. We expect the Fed to shift its rhetoric and tactics in early 2019. But if Mr. Powell decides to be conservative in his policy-making, the positive effect won't last and the PBoC will ruin the fun as soon as H2 2019.
Main trading ideas for 2019:
- Going short USDRUB at 68.8 targeting 62.1, stop-loss at 72.5.
- Going short AUDNZD at 1.05, targeting 1.012, stop-loss at 1.062.
- Going long USDCNY at 6.9 targeting 7.25, stop-loss at 6.85.
- Alternatively, go short gold (XAUUSD) at 1280, targeting 1044, stop-loss at 1302.
- Going short EURUSD at 1.18 targeting 1.072, stop-loss at 1.195.
- Going short CADNOK (a USDCAD long against a USDNOK short) at 6.44 targeting 6.08, stop-loss at 6.56.
Analytical materials and comments reflect only personal views of their authors and can't be considered as trading advices. AMarkets is not responsible for losses as the result of analytical materials usage.


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More One-off Poets
So you say you never heard of "The Hound of Heaven"? Fair enough. In this go-round we get a bit more modern. Well, one of our poets is early 19th century, but the other two are early 20th century. The first poem and poet some of you might not recognize, but another I can guarantee you know, and the third—at least the poem—is also a good bet.
Jenny kissed me when we met,
Jumping from the chair she sat in.
Time, you thief! who loves to get
Sweets into your list, put that in.
Say I'm weary, say I'm sad;
Say that health and wealth have missed me;
Say I'm growing old, but add—
Jenny kissed me!
That charming bauble is by (James Henry) Leigh Hunt, 1784-1859, critic, essayist, sometime poet, and all around busy man. He knew everyone on the literary scene and was close friends with Shelley and Byron. (He was there when Shelley's body was burned on the beach near Pisa.)
There are a couple of stories connected to the Jenny poem. "Jenny" is supposed to have been Jane, the wife of Thomas Carlyle. The story goes that Hunt had been ill for some time and when he did show up at the Carlyles' house—they were neighbors—Jane impulsively jumped up and kissed him. A couple of weeks later he sent over the poem in gratitude. It's a charming little poem, no? A wonderful grace note tossed off as if it were written in a happy rush of inspiration. The fact is that Jane Carlyle was a rather dour woman and the impulsive kiss is quite out of character. But why spoil a good story?
Ok, here's the easy one:
I think that I shall never see
A poem lovely as a tree...
We don't even need finish that, eh? And I'll bet you even know the poet, Joyce Kilmer, 1886-1918. He was a man of enormous energy, a champion of the Catholic faith, much admired as a poet and much in demand as a lecturer. The sentiment behind "Trees" is hard to fault, though as for the poem itself, Kilmer was no Shakespeare. (It is not enough in the poetry game just to be earnest.) Nonetheless, "Trees," though often parodied, has become a fixture in our popular culture. Sgt. Kilmer was felled by a sniper's bullet in the Second Battle of the Marne; Kilmer memorials (schools, parks, etc.) are as thick as, well, as leaves on the ground.
In my much younger days I would often stay up until the local TV station signed off for the day. The National Anthem would get played, and then, against a background of sky and clouds, a rich baritone would rumble, "Oh! I have slipped the surly bonds of earth / And danced the skies on laughter-silvered wings..." The poem would conclude with reverential awe: "And while with silent lifting mind I've trod / The high untrespassed sanctity of space, / Put out my hand, and touched the face of God."
It's called "High Flight," and you get extra points if you know who wrote it.
John Gillespie Magee, Jr., 1922-1941, was a golden boy, excelling at everything he attempted, garnering one accolade after another. Accepted into Yale, he instead joined the Royal Canadian Air Force (the U.S. had not yet entered the war) to do his part in making the world safe for democracy. He wrote "High Flight" in the late summer of 1941 and scrawled it on the back of a letter to his folks. That December, his Spitfire breaking out of a cloudbank during a training exercise, he was killed in a mid-air collision. He was 19. We will never know what he might have gone on to do or to write.
"High Flight" is a much better poem than "Trees." Magee had a good ear, understood the rhythm of a line and how to exploit the stresses in a line, and the rhymes. Listen to that last couplet. You see—or hear—what he does with "space" and "face," and how that sets up the wonderful ending with those iambs ("and TOUCH'D the FACE of GOD")? You see how he sets up that pregnant pause before "of God"? When I hear dressage prancing like that, I think of my man Edwin Arlington Robinson, a proven poet.
In somewhat the same way, and in pop culture, we have "flashes in the pan," like Johnny Ray, Grace Metalius, Rod McKuen, and others who have gone to join the shadows even if they are still with us. You can probably add some of your own favorites to the list. Good for them, though, because even if fame is fleeting, obscurity is forever.
Meet Your Macinstructor
Jerome Shea is an emeritus professor of English at the University of New Mexico, where he still teaches his classical tropes course every fall and his prose style course every spring. He has been the Weekend Wonk since January of 2007. His email is [email protected].


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Asus stirred up some excitement when it announced the Transformer Book T100, and now the Bay Trail-based tablet running Microsoft's Windows 8.1 OS is up for pre-order on Amazon.
Affordable, but also useable, Windows tablets utilizing Intel's processors are hard to come by, and Asus is aiming to crush that preconception that $300-$400 can only afford you an ARM-based Android tablet or a practically unusable tablet running Windows RT.
The 32GB T100 is going for $350, but shoppers can step up to the 64GB model for $399. Currently, only the 64GB version is up for pre-order on Amazon, although it is likely that the online gadget vendor will make available a pre-order form for the other model soon also.
Asus claims that the T100 will offer up to 11 hours of battery life, which is definitely the focal point of any tablet shoppers—especially those that want to have a device that will have legacy support. Included with the T100 will be a detachable keyboard dock for full notebook functionalities.
As for features, the T100 sports a 1366×768 IPS touch display, a 1.2MP camera, micro USB port, micro SD slot, and micro HDMI port.


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Guru of Chai media release
Glorious storytelling from Indian Ink
Writers Jacob Rajan & Justin Lewis
Director Justin Lewis
Set & Costume Design Concept John Verryt
Lighting Designer Cathy Knowsley
Composer & Sound Designer David Ward
Dramaturg Murray Edmond
Musician Adam Ogle
Jacob Rajan
16 May – 4 June 2016
Downstairs Theatre
Nothing short of genius
Time Out Singapore
Our Guru (Jacob Rajan) is a buck-toothed chameleon, channeling 17 characters and leaping to multiple locations, delivering a serpentine romantic thriller while dispensing dubious spiritual wisdom. He is by turns charming, loathsome and absurdly profound. Laughter, heartbreak and enlightenment abound.
Loosely based on the Indian fairytale Punchkin, Guru of Chai tells the story of a tea-seller whose life is changed forever when an abandoned girl stops a busy train station with the beauty of her singing.
Indian Ink Theatre Company is one of New Zealand's most successful theatre companies. It is a partnership between Rajan and Justin Lewis who have been collaborating since 1997. They blend western theatrical traditions with eastern flavours and have been critically acclaimed for their use of live music, heightened theatricality, humour, pathos and great storytelling, which we can't wait to experience in the intimate surrounds of Belvoir's Downstairs theatre.
Notes for editors
Preview 16 May
Opening 17 May
Times Tues & Wed 7pm, Thursday & Friday 8.15pm, Sat 2.15pm & 8.15pm, Sun 5.15pm
Tickets* Full from $48, Seniors/Industry/Group $42, Concession $38, Previews $30,
30 Down $32, Student Saver $25
*Belvoir's ticket prices can be dynamically adjusted either up or down without notice. This can apply to a small number of tickets in response to demand for a specific performance date or time.
Downstairs Theatre
Belvoir St Theatre
25 Belvoir St, Surry Hills
Box Office
02 9699 3444
Image Gallery
Hero image by Robert Catto – download
Production images from 2010 performance by Robert Catto – download
Production images by Brett Boardman – download
Contact Details
For media information and interviews contact Elly Baxter
[email protected] | 02 8396 6242 | 0407 163 921


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Dan & Anna Julian
Calvin, Lucy
God's matchless grace in Christ Jesus has transformed us, and we want to proclaim this grace to the people of Spain.
Dan & Anna Julian live in Valencia, Spain. They are in Spain for God's glory, which is magnified by enjoying Him forever, striving to live with a whole-self love for Him, a repentant faith in Christ, a trusting life in the Holy Spirit, a persistent obedience to His Word, a selfless love for neighbor, a gospel-centered identification and fellowship with His people, and a relentless practice and pursuit of generous justice and prodigal mercy.
Our focus is on equipping new church planters and leaders through courses that provide ministry and theological training.


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Apple employee perks now include deeper discounts on Mac, iPad products
Employee discounts have long been a nice perk for being a worker bee, but new discounts just launched by Apple slash up to $500 off the company's Mac products.
Apple's new Employee Purchase Plan+ was first announced at a company-wide meeting in January, but the discounts finally kicked in on Wednesday.
Apple previously offered employees beyond their probationary period a 25 percent discount on Mac or iPad products once every three years.
With the new Employee Purchase Plan+, employees purchasing eligible Macs can shave an additional $500, or up to $250 off an iPad.
MacBook 2012 not eligible
Of course, there's always a catch: The cheaper Mac mini is not eligible, nor is the company's latest hard to come by MacBook Pro 2012.
Reports have also circulated that Apple is now paying retail workers "larger than usual" raises, and the bonuses appear to be an effort to retain employees as the company's fortune continues to skyrocket.
Where would an Apple employee want to go instead?
Microsoft reportedly offered "perks, signing bonuses and promotion opportunities" to retail store workers recently in an attempt to lure them over to the dark side.


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At Atlanta Apparel, our purpose is clear: to bring buyers and sellers together in an environment designed for success. Buyers from all over the U.S. and more than 40 nations attend our five annual Markets and rely on Atlanta Apparel for the products and services that drive their businesses forward. Reach these buyers and more — see what exhibiting with the most comprehensive fashion destination can do for you!
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12 Hollara Drive Moama
Ideally situated only two minutes drive from Rich River Golf Club, Kilkerrin Vines is a spacious four bedroom property that offers an excellent alternative for those keen golfers travelling to Echuca. Additionally, families will love all that this property one acre has to offer for their country escape.
A warm and inviting family home, the property features beautifully landscaped grounds, in ground pool (not heated) and undercover outdoor dining including fireplace and TV.
Inside there are two living areas and a modern, well equipped kitchen. The house enjoys ducted heating and refridgerated cooling as well as Netflix on most TVs.
The bedding configuration of this property is:
Master: king with ensuite and TV
Bedroom 2: queen
Bedroom 3: queen
Bedroom 4: three singles and trundle bed
There is also a central bathroom with bath and separate toilet.
The kids will love the large grassed area as well as the cubby house and sand pit. Inside, they'll find a range of toys and books to keep them entertained.
Portacot or full size wooden cot available on request.
There is plenty of off street parking, as well as a secure double car garage.
Kilkerrin Vines is only 5 minutes drive from the Five Mile Boat ramp and mountain bike trail.
Please click image below to take a 3D walk through tour of Kilkerrin Vines
Echuca Holiday Homes is on hand 24/7 to ensure we can assist with any queries or issues you might have, whether that be local shopping, special event information or even booking a haircut! We will check you in and take you through everything you need to know about the property. We'll also ensure the house is either nice and cool or toasty warm for your arrival.
Kilkerrin Vines has a two night minimum stay during most times of the year. Exclusions do apply. Upon check in, a $500 pre authorisation is taken on your credit card as security over the property. Please contact us on 03 5480 0782 for further clarification.


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Monday, January 23, 2012
How To Beat Panic Attacks – Anxiety Busters
Those were classic panic attacks that I have on occasion. When I was in 7th grade, I was in a short story reciting where we had to recite a poem that we remembered. I studied that poem inside and out, but once I got to the stage, my brain blanked out and my mouth wouldn't move. I couldn't breathe. It was embarrassing, but it was the very first panic attack I remember.
Since then they've become more common in simpler settings in daily life. So far, I identified many of my attacks dwell in conjunction with an actual fear of success. The fear of success often occurs when someone feels as if they have something to prove and has one big chance to win it or blow it. So, the thought pattern is, "don't blow it." It's overcompensation.
Common symptoms include but are not exclusive to:
Difficulty breathing
Irregular heartbeat
Numb nerves
Jumpy reflex nerves or muscle spasms
Fidgety behavior
Irregular Perspiration
Inability to focus on thoughts
Overactive communication
Lack of ability to speak
Sleepiness or sudden fatigue
These are pretty common symptoms, but for more severe panic attacks I would suppose seeking the help of a doctor would be in order. I have never had the unfortunate situation, but some who suffer from panic attacks may even lose control of their bodily functions altogether.
I haven't beaten my anxiety attacks completely, but I am getting better at dealing with it. I am sharing a few of my special tips for beating panic attacks with you so I can remember them too.
You'll want to avoid these like the plague:
Coffee, green tea or any caffeine (jitters).
Desserts, candies, and things loaded with any form of sugar.
Being around negative people.
Thinking about the future; what will happen after your moment.
Avoid self-medicating with, alcohol, pills, or drugs.
The main goal should be to CALM DOWN. Start a few days in advance of an event or situation you are anticipating.
Be sure to tell yourself over and over that everything is going to be just fine. You've come this far in life. You've got this!
Be around supportive people.
Concentrate on your present. Keep your mind on the right NOW.
Some natural supplements that have been used to help with anxiety by assisting the brain are lemon balm, St. John's Wort, omega-3 fatty acids, kava root, valerian root, SAMe, passion flower, and 5HTP. You'll want to try these a few weeks in advance to get the advantage.
Get a massage if time allows or self-massage if you can even for a short few moments.
Stretch or do your exercise warm-up routine.
Exercise, run, dance, or anything aerobic.
Make sure you eat a good meal before your event. Chew slowly. Savor the moment.
Be patient with yourself and your body. You CAN overcome this moment of panic. Trust that you can.
Get your sleep the night before. Melatonin, magnesium, and chamomile tea can help.
I can only tell you from actually experience that these work for me and I hope they can work for you too.
Posted by Veltis Angel
Labels: Personal Development, Veltis Angel's Posts
2 comments:
Nice post! Very informative to me. I am trying something like this. Anxiety is a natural human reaction that involves mind and body. It serves an important basic survival function: Anxiety is an alarm system that is activated whenever a person perceives danger or threat. Thanks for sharing!ReplyDelete
Natural health supplements
So glad you enjoyed it Harvey and offered your keen insight. I think some people also react differently to anxiety and I am not sure if there is a chemical or genetic factor in all of this. I am still researching it. But so far, these techniques have been working out for me. I hope they will help you as well. Thanks for reading and commenting. And let me know how it turns out for you.ReplyDelete
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Accountability and delegation
The topic of accountability can seem a bit scary. Whenever we discuss accountability, we tend to do so in legal-type language, speaking about things like 'duty of care', 'civil and criminal law' and 'vicarious liability.' It sometimes looks and sounds as if accountability is all about 'catching us out', and that if we make one slip, we'll be up in front of our employer on a disciplinary charge or, even worse, before the courts.
There's no doubt that both these situations can arise. As a health care assistant, you're trusted by patients/clients and your employer to perform your duties competently, safely and effectively. If you stray from the standard that's expected of you, you're letting your patients/clients and your employer down. You'll be held accountable for what you've done, and yes, that can lead to disciplinary or court action, depending on the severity of the situation.
We don't want to overplay the importance of accountability in this section, but we don't want to play it down either, or its potential impact on you as a health care assistant. Accountability is all about protecting patients/clients, employers and individual health care workers from the effects of bad, negligent and unsafe practice. As such, it's a vitally important part of health care.
We don't want to scare you, but at the same time, we don't want to suggest that accountability isn't a key issue for you. It is a key issue for you – you have accountability through the role you perform, and you'll be held accountable for your actions as part of that role.
But the fact of the matter is that if we carry out our duties as we've been trained, if we don't try to step over the mark and do something we haven't been trained to do, if we always act in what we believe is the patient's/client's best interest, and if we're prepared to challenge a senior colleague who asks us to do something we don't feel confident about, then we'll realise that accountability isn't something to be scared of – it's something to take pride in.
Accountability is also part of delegation (which refers to a registered member of staff delegating a task to you and you accepting the task). Both the registered member of staff and you have accountability for ensuring the task you've been delegated is appropriate and will cause the patient/client no harm. If that isn't the case, you are at liberty – indeed, you have a duty – to refuse to take on the task.
The RCN has provided information on accountability and delegation for all members of the nursing team. See: Accountability and delegation: What you need to know.