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November 22nd, 2013
Rupert and Wendi Murdoch Finalize Their Historic Divorce Settlement
By John Clark
In a surprisingly friendly court appearance this week, media mogul Rupert Murdoch and his longtime wife, Wendi, finalized their mutual divorce settlement, according to a report from the Los Angeles Times.
In a joint statement released shortly after their court hearing, Rupert Murdoch and Wendi Deng Murdoch, who was the billionaire's third wife, said they were "pleased to announce that we have reached an amicable settlement of all matters relating to our divorce.â€
"We move forward with mutual respect and a shared interest in the health and happiness of our two daughters. We will not comment on this any further,†concluded the former couple's statement.
The couple finalized their divorce during a hearing this week in Manhattan in a New York state court. During the hearing, the couple told the judge a trial would not be necessary and that they wanted the judge to simply confirm a settlement they reached together.
Celebrities often prefer to settle a divorce case out of court, because private settlements do not become publicly available, whereas the details of a divorce trial would have likely created a publicity frenzy.
The divorce settlement, however, is not expected to damage Rupert Murdoch's remarkable media empire. Sources say the 82-year-old mogul will continue to hold his biggest media holdings, News Corp. and 21st Century Fox.
Wendi Murdoch, though, will reportedly receive the couple's pricey Manhattan apartment, as well as an undisclosed amount of cash.
The couple's relatively amicable divorce hearing took place while the couple was reportedly sitting together at a small table in the Manhattan courtroom. And the hearing only took about 15 minutes, according to reports.
During the hearing, which progressed like most other cases, the judge read off a series of simple questions, asked the parties if they had reached a settlement, and then gave the deal her stamp of approval.
The judge also praised the couple for behaving so "amicably†during the process, and the hearing reportedly ended with the 44-year-old wife kissing her former husband on the cheek.
The hearing ends a fourteen-year marriage for the power couple. The Murdochs were reportedly married in New York Harbor on Rupert Murdoch's yacht, which is reportedly up for sale.
Sources say Ruport Murdoch married his third wife just a few weeks after finalizing his divorce with his second wife, Anna Tory, who is the mother of his three adult children. Rupert and Wendi also had two young daughters together.
Copyright © 2010 TotalDivorce, LLC. (as licensee). All rights reserved.


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Allen highlights the launch of TechnoDyne University to provide thought leadership in security and IT governance. She plans to enhance the IT services offered to the U.S. government and grow revenue 20 percent.
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March 5, 2014
There is an evening Mass tonight at 7:30pm with distribution of ashes.
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As a parish community, the members of Saint Alphonsus Worship, Educate, Reach Out, Share, Promote, and Recognize, for we are all One Body in Christ. We are a welcoming parish in Maple Glen, Pennsylvania blessed with some 6,000 parishioners, 1,700 families, and a regional elementary school. It's our hope that just as you've joined us in the digital space, you'll consider joining us in our physical place for Mass and come to be a part of our parish family.
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There is an evening Mass tonight at 7:30pm with distribution of ashes.
Knights of Columbus
between 5:30 – 6:30 PM in narthex.
The Knights will again be sponsoring
the Capt'n Chucky's Lenten Fundraiser.
Click here for the form to order crab cakes, crab fritters and Maryland Crab soup for your Friday Lenten Dinners. Orders are due March 9th.
Our next scheduled Pre Cana program will be held on March 7 and 8.
Attached is a flyer will all the necessary details.


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Until They All Have a Home™ Purple Paw Charm Bracelet
You know it -- rescue animals are amazing companions who become cherished family members in no time. And they help us live longer, too! Bringing a four-footed pal home is a win for everyone, and our charm bracelet says it with purple paw passion: we won't rest until they all have a home!
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DSmobile 610 Portable Document Scanner
The Brother DSmobile 610 is an easy-to-use, robust portable document scanner that efficiently scans and manages documents and business cards.
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This high-precision unit scans business cards, photos, and documents (including legal-sized) at up to 600 dpi. Scan invoices, insurance forms, contracts or receipts to your computer for saving or e-mailing. Use the included software to combine multi-page documents into one PDF – or to save documents as searchable files.
The Brother DSmobile 610 includes Presto! BizCard software that supports convenient scanning of business cards and exporting of contact information directly to Microsoft Outlook and other contact management programs. Compatible with both Windows and Mac operating systems.
DSmobile 610 is an easy-to-use, robust portable document scanner that efficiently scans and manages documents and business cards.
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Unisex Fitted Tee (More Styles...)
American Apparel 100% cotton t-shirt with a fitted / vintage fit. The medium-lightweight jersey fabric is made of ultra-soft combed cotton. Sizes: SM-3XL
Mens & Unisex Jump to: Tees Long Sleeve Tanks Sweatshirts Juniors / Women's Fitted Kids & Babies Accessories Description: Illustration around the concepts of music, inpiration and creativity featuring a girl making a graffiti Search: graffiti, musci, inspiration, crativity, street
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Sky Shark (Amiga)
Published by Developed by Released Also For |
100 point score based on reviews from various critics. 3.0
5 point score based on user ratings. |
Surprisingly enough, this game supports VGA mode, although the EGA/VGA screenshot bears a far greater resemblance to EGA graphics than VGA.
Also, even though the game supports two players, this feature is essentially wasted because two players cannot play simultaneously, seriously reducing the fun that can be had in the two-player mode.
Contributed by tritium4ever (32) on Apr 12, 2000. -- edit trivia


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Results 1 to 3 of 3
More bullshit headlines.
L.A. Police Shoot, Kill Mentally Ill Man
The Associated Press
Updated: 7:32 a.m. ET Feb 12, 2007
LOS ANGELES - Police shot and killed a mentally ill man after he lunged at an officer with a sharp object during a disturbance at a group home for the disabled, authorities said.
The man, who was not immediately identified by police, died Sunday at Los Angeles County-USC Medical Center, Los Angeles Police Officer Mike Lopez said.
Officers were called to Fair Oaks Manor around 2 a.m. Sunday when the man became violent, according to police. Shortly after officers arrived, the man lunged at one of them with a sharp object, tearing his shirt sleeve. The officer's partner then fired, Lopez said.
Police said the officer's bulletproof vest prevented the object from going through.
It was the department's ninth officer-involved shooting this year. The LAPD's Force Investigation Division, which examines officer-involved shootings, is investigating.
We are the thin blue line
between you
and all the money in the world.
And no you can't have any.
Mentally ill or not, he was dangerous enough that the police were called. Then he tried to kill an officer. He was a threat, the threat has been eliminated, and the officers go home at the end of shift.
\\` ` ` ` < ` )___/\
`` ` ` ` (3--(____)
"...but to forget your duck, of course, means you're really screwed." - Gary Larson
The headlines should read
Police Shoot Would-Be Cop Killer...
...Oh, and by the way he was nuts.
(='.'=) This is Bunny. Copy and paste Bunny into your
(")_(") signature to help him gain world domination.
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Maclaren Triumph/Quest Single Raincover
Click on the image to zoomProduct information
This transparent raincover is designed to perfectly fit the Maclaren Triumph or Quest buggies. It will keep baby completely dry, and they can still look out and watch the world go by.
Please note: Raincovers should not be used indoors or in hot weather.
- Brand
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UK mainland delivery within 7 working days; may be longer for N Ireland, island and rural postcodes
- £3.00
International delivery not available
We want you to be happy with your purchase. If you're not, just return the products to us or to one of our shops. Unless faulty, we'd like this to be within 90 days of purchase. Exceptions apply to certain products - find out more about our refund policy.
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No one takes care of Greater Schenectady's HVAC repair needs like Roland J. Down Service Experts. We offer NATE-certified furnace and air conditioning technicians that professionally service ALL makes and models of HVAC equipment, such as Lennox, Rheem, Trane, Carrier and York, to name just a few.
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Debi, Clifton Park New York Read all Reviews on time, described in my knowledge what they were providing, completed earlier that originally informed and cleaned up
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this color is amazing, goes on creamy and smooth even though it's a matte lipstick, and stays on forever. i love the entire line of nyx matte lipsticks and have a lot of colors, but this one stands out--it's not for everyone as the color is bright and unique, but i think it's fun and looks amazing with the right outfit.
NYX Matte Lipstick in Indie Flick is a near spot-on dupe for MAC Lady Danger. Both are matte, both are intensely pigmented, both are long-lasting on the lips (but drying).
This shade of red is heavy in the coral and orange undertones, like a classic 1950's blonde/redhead pin-up lipstick shade. No blue undertones at all. It goes on your lips the exact same shade as it appears in the tube. The color is dense and solid.
Although I prefer MAC Lady Danger overall, I think NYX Indie Flick has the upper hand when applied lightly. Indie Flick is not as dry as Lady Danger when first applied so it can be used to create a slightly more sheer coral red look.
Overall, I really like this lipstick. It's a bold color, so you have to wear it with confidence. It's dry because it's matte, so if you can't stand the sensation of a dry lip product then you probably should avoid pure matte finishes in lipsticks all together. You can always counter the drying effect of matte lipsticks by applying a light balm first, but this also undermines the staying power.
I don't feel like there are any compromises being made despite the cheap price, this lipstick comparable to any matte red shade of MAC.
In some days I like this orangey red color on me and in other days I do not. I do not like it worn sharply with liner but more blotted for doll like round mouth. I am fair skinned and I like to think I have yellow undertones. My hair is blond and my eyes are a mixture of green and blue. I dont use this often simply because I prefer to play up my eyes and then dark lipstick is just too aging. This can look young if worn blotted like I do but it can also look professional and sophisticated when worn with a liner. It is matte so YES it will show every crack on your lips. It will also last long and possibly be drying. But it is very pigmented and you cant beat the price. I did not fins the fragrance of these lipsticks detectable at all, at least it is way more subtle than in Estee Lauder and Loreal lipsticks. Generally speakin, I think these are great lipsticks, but form the drugstore lipsticks, Revlon Super Lustrous range is still a winner for me. When its gone, I wont repurchase becuase I just dont love it enough. I would buy Loreal, Revlon or Mac lipstick instead.
I bought this honestly thinking that I would love it. However I have only actually worn it outside the house once in 6 months, as the color is far too garish on my skin - it is so opaque that the color shows up on your lips exactly how it appears in the tube. Often with colors like this, they can appear a bit more harmonious on a person by being a bit sheer and "mixing" with their natural lip color. However this lipstick completely cancels out my (naturally highly pigmented) lips and replaces it with an extremely bright orange-red.
It's definitely a statement for those who like it. I ususally like a statement lip myself, but there is something, as I said, garish about this lipstick on me.
The finish is very matte, as the name suggests. I found it slightly drying but not too bad, and it had good staying power. The texture seemed a bit grainy on my lips - if I look up close, it is not a smooth wash of color, but a bit... mottled? I would say flakey but that's not it, as I moisturized my lips well before application.
I had high hopes for this lipstick but I don't like the color or the finish. I wouldn't buy this again nor another color in this line.
This is a bright, bright brick red/coral matte color. It has a sweet smell, lasts all day, doesn't dry out my lips, and doesn't bleed. I apply it straight from the tube when I want to look like a J. Crew catalog model and I layer it over a more subtle mauve when I want to dial down the brightness.
Have some fun in life and get yourself a tube of this!
2 out of 2 people found this review helpful. Did you? Yes No
Don't buy it it dries up my lips completely, my lips have never been so dry in my life before and i wore lip balm and vaseline every night. such a shame tho it is a nice colour
A nice matte orangey red lipstick. I usually love NYX lipsticks so I thought I was going to love this line as well but they are way too dry for my liking. The pigmentation is amazing (maybe even too good because it's hard to apply it evenly) but I really dislike wearing it because although it still looks good it dries out my lips completely. I am wearing it right now and, to be honest, I can't wait to take it off. YSL's Rouge voluptes and WNW's Mega last lipsticks are also matte but a lot more comfortable to wear.
The packaging could be nicer as well, it looks good but once you open it it feels kinda cheap.
This is a bright coral lipstick, with matte finish. It has AMAZING pigmentation. It's creamy when you apply but it dries up to a matte finish. These are a tad drying so I apply lipbalm underneath. If you love Toxic Tale you'll love this also.
This is a fabulous classic red, matte finish lipstick. Its exact shade is somewhere between a yellow and a true red. And the price is right, that's for sure!


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Jason Tucker
Position: WR
Height: 6-1 Weight: 182 lbs.
Born: June 24, 1976 in Waco, TX
College: TCU (school history) (Tucker college stats)
Drafted by the Cincinnati Bengals in the 6th round (167th overall) of the 1998 NFL Draft.
Weighted Career AV (100-95-...): 6 (8426th overall since 1950)
Other SR Links: College Football at Sports-Reference.com
Sponsor this page for $5 and help Pro-Football-Reference.com provide this service. Your message will replace this ad.


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Posts Tagged 'speakers'
Hanging with Mr. Cooper
by LIBN Staff Published: May 20, 2012
Tags: Barack Obama, Bill Clinton, campaign, election, gala dinner, Government, Jon Bon Jovi, Jon Cooper, Manhattan, performance, politics, speakers, Waldorf Astoria
Meet 42 and 44 at the Waldorf Astoria on June 4.
Audiovox acquires Klipsch Group
by John Callegari Published: February 4, 2011
Tags: acquisitions, audio, Audiovox, Long Island, Ronkonkoma, speakers
Hauppauge-based Audiovox reached an agreement Thursday to acquire Indianapolis-based Klipsch Group, along with all of its worldwide subsidiaries. The Long Island consumer electronics giant will spend $166 million to acquire Klipsch, makers of high quality speakers and audio solutions. The acquisition will grant Audiovox control over the Klipsch brand, as well as its Jamo, Energy [...]


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Cape Tribulation
Trip Start
Nov 01, 2004
Trip End
Nov 01, 2005
Today we headed for the beautiful area of Cape Tribulation - a region full of rainforest, hills and beaches which is a National Heritage area and therefore protected. They call it the place where the rainforest meets the sea. Cape Tribulation was named by Cook after he suffered there - he also named mountains Misery & Desperation! He hit a reef here and after choosing wrongly he managed to get stranded a little up the coast for a while (he dumped all heavy stuff & supplies overboard trying to float himself - then the tide came in!!). Our first stop on the way up was for breakfast at a wildlife sanctuary - where we saw a baby kangaroo, two cassowary, parrots and the cutest little baby flying possums called sugar gliders - awwwwwh
(http://www.gliderconnection.com/picturepage4.html). Australia is just full of weird and wonderful creatures. We stopped off for a walk along a rainforest boardwalk which was lovely - the boardwalk protects the area from damage but still lets you have a feel of rainforest habitat (and mangrove swamp too in this case). We arrived at our accommodation at lunchtime - we had chosen the farmstay option on a fruit farm - all the young backpackers opted for a resort style accommodation with pub, pool & disco. It was lovely and quiet at our farm and the owners are very friendly. After unpacking we headed out into the village of Cape Tribulation. We had lunch at the very scenic Dragonfly Cafe before heading to Masons waterhole for a swim - it's still a stinger area round here so swimming in the sea is not done - the waterhole was lovely and refreshingly cold considering the sun and heat that we are suffering! We then walked along the wonderful tropical beach (almost deserted) before heading inland to do another rainforest boardwalk. The noise in the rainforest is unbelievable with thousands of chattering insects. That evening we had a fruit tasting on the farm - getting to taste fruits in the farm and then also fresh from the tree on a guided night walk we took. We tried rambutan, jackfruit, durian (not as bad as people think but the texture is horrible - it tastes like onion & garlic cream cheese), pomelle, passionfruit, mangosteen and the most interesting of the night was the miracle fruit. The miracle fruit was a rather sour little red berry that we chewed and swirled round our mouth before spitting out - we were then given a lime to eat which tasted really sweet and nice - that's what the miracle fruit does! The walk was really meant to be a wildlife walk and we wandered first through the orchard, then through the rainforest. We saw loads of cane toads in the orchard, some beautiful golden orb spiders, lovely fire flies and we saw a crocodile swimming -his red eyes stand out.


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Partner, New York
Phone +1-212-558-4000 Fax +1-212-558-3588
Phone +44-20-7959-8900 Fax +44-20-7959-8950
Add to Address Book
Mark Welshimer is the deputy managing partner of the Firm's Financial Institutions Group, a member of its Corporate Finance Group and the coordinator of its Structured Finance Group. Mr. Welshimer's practice focuses on capital markets activities and structured financings, with a particular focus on new products, and bank regulatory advice. He has represented most of the nation's largest financial institutions, or their underwriters, in capital-raising transactions and, during the recent period, along with other members of the Firm's Financial Institutions Group, has been deeply involved in advising clients with respect to bank regulatory reform.
Mr. Welshimer was one of the founding members of S&C's securitization practice and represented issuers or underwriters in a number of "first-time" transactions, including the first public automobile loan securitization, the first public commercial real estate loan securitization, the first funded C&I loan securitization and the first public good bank/bad bank transaction. He has extensive experience representing financial institutions more generally in commercial transactions and regulatory matters.
Mr. Welshimer was recognized as a 2007 "Dealmaker of the Year" by The American Lawyer for his representation of major financial institutions in their capital-raising efforts. He has also been recognized as a leading lawyer in numerous other publications.
Rankings and Recognitions


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Clinicians, payers, and policymakers turn to technology assessment to help provide better information—to assist decision making in clinical care, to guide coverage decisions, and to set national health policy. Technology assessment can play a valuable role in the entire process of improvement of health and health care. For example, an assessment may show that the data needed for a complete evaluation of a technology are not available. This finding may serve as an impetus to initiate research to supply the missing information. Similarly, an assessment may lead to changes in practice norms when it yields a conclusion that differs from common clinical behavior.
Deciding which of the myriad medical technologies require assessment—and at what point—is a necessity. Even with unlimited funds, it would not be feasible to evaluate all health care technologies; rather, it would be necessary to identify which assessments should have priority. With limited resources, the need to allocate technology assessment funds is essential, but the choices must be defensible. The purpose of this report is to describe such a process—specifically, a priority-setting process for a federal agency— the Office of Health Technology Assessment (OHTA) of the Agency for Health Care Policy and Research (AHCPR). Its broader objective, however, is to propose a process that has wider applications and general utility to other organizations that must set priorities for health technology assessment. This chapter describes how the establishment of AHCPR supports clinical evaluation and how the expanded role of OHTA prompted this Institute of Medicine (IOM) study. It also discusses the committee that was constituted to respond to this request and the methods and terms used by the committee to develop the process proposed in the report.
Below are the first 10 and last 10 pages of uncorrected machine-read text (when available) of this chapter, followed by the top 30 algorithmically extracted key phrases from the chapter as a whole.
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OCR for page 17
Setting Priorities for Health Technology Assessment: A Model Process
Technology Assessment and the Need for Priority Setting
Clinicians, payers, and policymakers turn to technology assessment to help provide better information—to assist decision making in clinical care, to guide coverage decisions, and to set national health policy. Technology assessment can play a valuable role in the entire process of improvement of health and health care. For example, an assessment may show that the data needed for a complete evaluation of a technology are not available. This finding may serve as an impetus to initiate research to supply the missing information. Similarly, an assessment may lead to changes in practice norms when it yields a conclusion that differs from common clinical behavior.
Deciding which of the myriad medical technologies require assessment—and at what point—is a necessity. Even with unlimited funds, it would not be feasible to evaluate all health care technologies; rather, it would be necessary to identify which assessments should have priority. With limited resources, the need to allocate technology assessment funds is essential, but the choices must be defensible. The purpose of this report is to describe such a process—specifically, a priority-setting process for a federal agency— the Office of Health Technology Assessment (OHTA) of the Agency for Health Care Policy and Research (AHCPR). Its broader objective, however, is to propose a process that has wider applications and general utility to other organizations that must set priorities for health technology assessment. This chapter describes how the establishment of AHCPR supports clinical evaluation and how the expanded role of OHTA prompted this Institute of Medicine (IOM) study. It also discusses the committee that was constituted to respond to this request and the methods and terms used by the committee to develop the process proposed in the report.
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Health care technology encompasses a wide range of items and services that support clinical practice; it comprises an extensive number of well-established technologies and newly emerging ones. The technologies may include materials from a variety of industries, adaptations of technologies for use in new health settings, replacement of damaged organs and tissue using new or modified procedures and materials, and systems that integrate and monitor information. In what has been called an American "technocopia," such technologies include numerous new and anticipated applications drawn from space and materials technology, the human genome project, and biological research. These may result in genetic engineering applications and new generations of genetic "super drugs." Other technologies may extend preventive and diagnostic techniques to self-care, home, and ambulatory care settings. For example, biosensors and implantable materials for delivering therapies and monitoring the body, as well as the miniaturization of devices, permit treatment to be moved from the hospital to a patient's home or the doctor's office. This flexibility greatly increases the possible range of settings for care and in some cases may decrease the invasiveness of procedures (e.g., new surgical techniques that use small incisions). Other technologies have emerged from work on artificial intelligence systems and from software that assists in monitoring, diagnosis, and therapy—an example is three-dimensional diagnostic imaging. At a multipatient level in the informatics area, health care technologies include microcomputer-integrated clinical management and information systems (Coile, 1990; Misener, 1990).
Ingenious applications such as these seem to hold great promise, and health care technology is often praised for improving medical care. At the same time, it is blamed for fueling the rise in per-capita health care expenditures (Altman and Blendon, 1979; Schwartz, 1987; Ginsberg, 1990). As the costs of health care continue to increase well beyond the rate of inflation in other sectors of the U.S. economy, society has devised methods to control these costs. Yet across-the-board efforts to control the use of procedures and other health care technologies—for example, through administratively imposed caps or cuts in services and programs—have been accompanied by warnings from some health care sectors about the danger these efforts pose to quality and access to care.
Two separate, but related, areas of research—variations research conducted by John Wennberg and others and appropriateness research conducted by Robert Brook and his colleagues—have led policymakers and health services researchers to argue that efforts to control costs should fo-
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cus on encouraging selective use of technologies; that is, (1) identifying and then encouraging appropriate uses of technologies and (2) discouraging inappropriate uses. Physicians often disagree about the optimal use of diagnostic tests and treatment even for common conditions and well-established therapies (Mushlin, 1991). Wide variations in uses of technologies (see, e.g., Wennberg and Gittelsohn, 1973, 1975, 1982; McPherson et al., 1982; Paul-Shaheen et al., 1987) are thought to be due, at least in part, to such disagreement and uncertainty about their appropriate use (Eddy, 1984; Eddy and Billings, 1988; Ellwood, 1988; Moskowitz et al., 1988; Holohan et al., 1990). A separate body of published evidence on appropriateness has indicated that a significant amount of money is spent in the United States on technologies that are ill suited to the needs of patients and even at times harmful (Moloney and Rogers, 1979; McPhee et al., 1982; Brook and Lohr, 1986; Chassin et al., 1986, 1987; Merrick et al., 1986; Park et al., 1986; Winslow, 1988a,b; Brown et al., 1989).
Medical leaders are convinced that appropriate medical and reimbursement decision making require a better understanding of the value of new or well-established clinical practices, which might be gained from an evaluation of the outcomes of clinical practices in the settings in which they are used (Fuchs and Garber, 1990). Such efforts toward more rigorous evaluation of medical practice are variously called outcomes and effectiveness research, evaluative clinical science, and clinical evaluation (Lohr, 1988; Relman, 1988; Gelijns, 1990; Wennberg, 1990). Effectiveness research has become an important concept in the rapidly evolving field of technology assessment, which in the past has focused on studies of clinical efficacy.1 The efficacy approach describes results obtained under controlled conditions with carefully chosen patient populations, indications, and settings. Effectiveness research, on the other hand, measures the usefulness of technologies in day-to-day clinical practice. In addition to the more traditional outcomes measured in clinical trials, such as physiological and anatomical change, effectiveness research focuses on other outcomes that are also relevant to patients and clinicians—for example, health status, functioning, and quality of life. Many people believe that effectiveness research will provide physicians with tools for selecting the patients for whom a technology is most likely to provide benefits that are important in day-to-day living.
According to Banta and colleagues (1981), efficacy is a measure of the probability of benefit to individuals in a defined population from a medical technology applied for a given medical problem under ideal conditions of use.
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The Effectiveness Initiative and Establishment of the Agency for Health Care Policy and Research
Three recent events indicate the attention and interest being directed by the federal government toward effectiveness research as a way to address the nation's growing concerns about quality, effectiveness, and the escalating costs of health care.
First, in 1988, William Roper, then administrator of the Health Care Financing Administration (HCFA), introduced the Effectiveness Initiative within that agency (Roper et al., 1988; Relman, 1988). This initiative sought to identify ''what works in the practice of medicine'' and to use this information to improve patient care. Roper and his colleagues described an overall approach with three elements: (1) facilitating the use of the large administrative Medicare data sets to monitor trends in the use of services and to analyze geographic variations in the use and outcomes of services, (2) supporting research, and (3) providing this information to clinicians. In support of this initiative, the IOM held a series of workshops to determine which medical conditions should receive highest priority (IOM, 1989a, 1990a,b,d,e).
Second, in 1988, John Wennberg and others prompted the National Center for Health Services Research and Health Care Technology Assessment (NCHSR) to establish the Patient Outcomes Assessment Research Program. Through this program, NCHSR funded a set of multidisciplinary research studies, focused on particular clinical conditions, to assess the outcomes and effectiveness of alternative health care interventions.
Third, by means of an amendment to the Public Health Service Act in the Omnibus Budget Reconciliation Act of 1989 (Public Law 101-239), Congress established within the Public Health Service the Agency for Health Care Policy and Research (AHCPR), which superseded NCHSR. (For further details on the functions of AHCPR, see the appendix to this chapter.) The legislation relocated the Office of Health Technology Assessment, which had previously been part of NCHSR, within the new agency.
The Office of Health Technology Assessment
The Office of Health Technology Assessment, or OHTA, was and remains responsible for performing health technology assessments in response to requests from HCFA. (OHTA also conducts assessments for the Medicaid and CHAMPUS programs, but these are a small fraction of its portfolio.) HCFA uses the assessments for Medicare coverage determinations. OHTA is located in the Public Health Service rather than in HCFA, the agency responsible for Medicare payments, to reduce any appearance of conflict of interest in technology assessment.
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In 1989, the authorizing legislation for AHCPR focused and expanded the agency's role in effectiveness research and defined an expanded role for technology assessment as well. In particular, the legislation directed the agency "to promote the development and application of appropriate health care technology assessments—(1) by identifying needs in, and establishing priorities for, the assessment of specific health care technologies..." (Section 904). This charge, and related technology assessment responsibilities, go well beyond the Medicare program and call for the agency to address issues that will benefit the general public.
This legislation was designed to alter significantly the mission of OHTA. Thus, broadening of its role has required OHTA to devise a method to set priorities for the use of its funds. OHTA does not now have such a process for deciding whether to conduct assessments or reassessments other than those initiated by HCFA and, if so, which ones it should undertake.
In addition to its directives regarding AHCPR, the legislation directed the Secretary of Health and Human Services to call on the IOM to recommend priorities for the assessment of specific health care technologies. In asking the IOM to conduct this study, and in keeping with the legislation, the agency proposed that the IOM effort focus specifically on developing a process for setting priorities for technology assessment and reassessment within OHTA.
The agency requested a priority-setting process that would be viewed as objective, broadly based, and defensible against charges of institutional bias. It asked that the process include criteria to permit it to decide whether a technology had reached a threshold for assessment or reassessment and a method to rank-order conditions or technologies requiring assessment. In developing such a process, however, the committee tried to ensure that the process could be useful to other organizations engaged in priority setting. Given the broad scope and purpose of OHTA's new legislative authority, the committee concluded that if the process was properly designed to achieve OHTA's mission, it could be readily adapted by others for their own particular needs.
Previous Pilot Study of Preliminary Model
The current study has its roots in a 1990 IOM monograph, National Priorities for the Assessment of Clinical Conditions and Medical Technologies: Report of a Pilot Study (IOM, 1990f), which presented a preliminary model of priority setting for technology assessment. The monograph was the report of work conducted by the Council on Health Care Technology
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(CHCT).2 Congress authorized the establishment of the CHCT in 1984-1985 within the Institute of Medicine to promote development of technology assessment and coordination of the many technology assessment programs in the public and private sectors (IOM, 1988). To carry out its mandate, the council established panels on methods of technology assessment, on information dissemination, and on evaluation.
In response to a request from the director of the National Center for Health Services Research, the council charged its evaluation panel with setting priorities for technology assessment. In its 1990 monograph, the panel described such a process and its outcome, which it titled a pilot study. It focused on both clinical conditions and technologies rather than exclusively on individual technologies, the historical targets of technology assessment. It also used explicit criteria and a Delphi-like process to compile a list of national assessment priorities. (Chapter 2 describes the pilot study in greater detail.) It is referred to in this report as the IOM/CHCT pilot study to distinguish it from the pilot study work that was performed as part of the current project. When Congress created AHCPR, it asked the IOM to extend the council's pilot effort as a way of assisting the new agency in responding to its expanded mandate.
The IOM began its current effort by installing a 13-member committee in January 1991. The committee members collectively had experience that represented the perspectives of practicing clinicians and those in academic medicine and other health professions; national legislative and health care executive policymaking; pharmaceutical and device manufacturing; technology assessment in academic, medical association, research, and third-party organizations; and the areas of health economics, ethics, insurance, managed care, hospitals, and public advocacy.
Between January and September 1991, the committee met three times. Using the previously published IOM/CHCT pilot study as a starting point for discussion, it reviewed the priority-setting methods of a number of organizations and the quantitative models developed by Eddy (1989) and Phelps and Parente (1990). After outlining a process for priority setting, the committee held a 2-day subcommittee meeting in July 1991 to test this process. It heard presentations, made a brief videotape describing aspects of the process it was considering, and sought reactions from individuals who were familiar with technology assessment methods and the needs of
The council was disestablished in the same authorizing legislation that created AHCPR.
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organizations that undertake technology assessment. Finally, nine individuals, representing expertise comparable to that on the IOM study committee, reviewed the report in accordance with the policies of the National Research Council.
Terms such as technology and technology assessment are often used without a common understanding of their meaning. To avoid possible misunderstanding, the committee agreed on the following definitions for its discussions.
Medical Technology
Medical technology encompasses a wide range of items and services that support clinical practice, including "drugs, devices, medical and surgical procedures, and the organizational and supportive systems within which such care is provided" (Office of Technology Assessment [OTA], 1978). The term is often defined by example—electronic fetal monitoring, drug therapy, coronary artery bypass surgery, magnetic resonance imaging (MRI), coronary intensive care management. Whether diagnostic or therapeutic, whether intended for the benefit of one patient or many, the term medical technology is used to denote all such activity. Diverse organizations, including the IOM in previous reports (IOM, 1985), have accepted this definition, as did this committee.3
Technology Assessment
The goal of technology assessment is to provide information on patient care alternatives to patients and clinicians and information on policy alternatives to policy decision makers. It is based on an explicit analytic framework that is specified before the study begins and is comprehensive in scope; that is, it considers higher order impacts such as direct and indirect, short- and long-term, and intended and unintended effects on populations and society.
There are two main categories of technology assessment. Primary technology assessment involves collecting data from or about patients and
HCFA defines a health care technology as a "discrete and identifiable regimen or modality used to diagnose or treat illness, prevent disease, maintain patient well-being, or facilitate the provision of health care services" (Federal Register 54:4305, 1989). This definition is compatible with the OTA definition.
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sometimes the collection and analysis of cost dam; it results in the generation of new information through such means as randomized clinical trials and epidemiologic observational studies. Secondary technology assessment uses existing data. Its methods include literature synthesis and meta-analysis, cost-effectiveness and cost-benefit analyses, computer modeling, and ethical, legal, and social assessments.
The term technology assessment entered medical and health policy parlance in the 1970s, and from the beginning its intent was to consider the social impact of medical technologies (Banta et al., 1981; Perry and Pillar, 1990); OTA (1982) standardized the definition of medical technology assessment as "the field of research that examines the short- and long-term consequences of individual medical technologies." It viewed technology assessment as "a source of information needed by policymakers in formulating regulations and legislation, by industry in developing products, by health professionals in treating and serving patients, and by consumers in making personal health decisions." This formulation grew out of the ongoing efforts of OTA and the National Center for Health Care Technology to promote this field of study as a form of research that would describe and evaluate the effects of a technology on individuals and society. Key areas of attention—safety, efficacy, and cost-effectiveness—and key areas of impact—clinical, social, economic, and ethical—are retained in the term as it is used today. Programs of technology assessment define their goals and objectives in various ways, but in practice they adhere to the OTA definition. In 1985, the Institute of Medicine defined technology assessment, consistent with the OTA definition and very broadly, as "any process of examining and reporting on medical technology used in health care, such as safety, efficacy, feasibility, and indications for use, cost and cost-effectiveness, as well as social, economic and ethical consequences, whether intended or unintended'' (IOM, 1985:2).
Consonant with the emergence of the field of effectiveness research, the most recent addition to the terminology of technology assessment comes from Fuchs and Garber (1990), who assert that the field has evolved from an "old" to a "new" form. The old form emphasized biomedical perspectives, that is, the safety and efficacy of an intervention. The new form has a much broader perspective that draws on multiple investigators, multiple data sets, and diverse methodologies to yield an assessment that is based on a range of values and interpretations of the data. As a result, Fuchs and Garber assert that the "new technology assessment is more challenging, more complex, more controversial, and potentially more useful than the old one." Current approaches to technology assessment embrace considerations of health-related quality of life, return to work, functional social and mental status, and patient preferences (McNeil et al., 1978; Fowler et al., 1988; IOM, 1989b), as well as increasingly refined evaluations of costs and
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benefits (OTA, 1980) and of cost-effectiveness (Leaf, 1989). Indeed, some authors now assert that the aims of and the term technology assessment itself have been subsumed in the more encompassing activity of effectiveness research, which goes well beyond measures of safety and efficacy to encompass the assessment of clinical practice (Fuchs and Garber, 1990; Rettig, 1991).
The IOM committee defined the term reassessment literally as a subsequent assessment of a health technology conducted by the same institution or organization that conducted the first assessment. Thus, evaluation of a technology by a second organization would not be considered reassessment, although the information from the first assessment would certainly be weighed as part of any new assessment effort.
In their report on health care technology reassessment, Banta and Thacker (1990) note that technology assessment since the 1970s has been focused too narrowly on new technologies. They urge that assessment be an iterative process over the life cycle of a technology as it is developed, disseminated, becomes obsolete, and is dropped from use.
The issue of reassessment of established technologies or of new uses of older technologies has been growing in prominence. Many urge that new technologies not be adopted unless they are known to provide at least some benefit, and that obsolete uses of technologies be eliminated. Yet knowledge of the best uses of a given technology may be scanty, and the diffusion and pattern of its actual use seldom conform to an idealized conception of a linear flow in distinct stages (e.g., developing, newly emergent, diffusing, well established, and obsolete and fallen from use [Banta et al., 1981; see Gelijns, 1990, for extensive discussion]).
Indeed, the diffusion of new technologies while they are still evolving is both a characteristic of medical progress and the bane of efforts to rationalize selective use. Technologies in wide use often require ongoing modification based on clinical experience and studies to determine and refine their most appropriate application. Further, many established technologies tend to be used for wider and wider indications after their initial introduction, even though those new applications have never been formally evaluated. For example, beta-blockers (beta-adrenergic antagonists) were originally marketed for two indications. They are now approved by the Food and Drug Administration for eight conditions but are used in clinical practice for more than 20 (Gelijns and Thier, 1990). Thus, although the committee did not adopt Banta and Thacker's use of the term reassessment to include initial assessments of "technologies already in place," it certainly agrees with the need to assess established and possibly obsolete uses of technologies.
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The remainder of the report is organized as follows. Chapter 2 briefly reviews several methods of priority setting and draws from these elements the core features of the committee's proposed priority-setting process. Chapter 3 explains the principles that guided the committee's work.
Chapter 4 presents the committee's recommendations for a priority-setting process. It describes the elements of the proposed process and how the committee proposes that these elements be implemented to determine priorities for assessment and reassessment. Because the process entails activities that are beyond the present scope of OHTA, Chapter 5 examines the implications of the committee's process for priority setting within that agency.
Finally, Chapter 6 summarizes the committee's rationale and recommendations, addresses possible problems, and considers how the priority-setting process developed by the committee might be modified by nonpublic entities. In an appendix (Appendix A) the committee describes the pilot study it conducted to assess the priority-setting process it recommended.
Clinicians, payers, and policymakers are turning to technology assessment to help provide better information for clinical decision making, to guide coverage decisions, and to set national health policy. Yet the efficient use of resources for technology assessment requires a systematic priority-setting process. In the legislation that established AHCPR, the Institute of Medicine was asked to develop a process and criteria for setting priorities for health care technology assessment and reassessment to assist OHTA in its expanded role within that agency. The establishment of AHCPR itself can be seen as recognition of the need to consider systematically the value of health care services in improving health. This kind of consideration uses measures of effectiveness as a means of better understanding the appropriate use of new and established technologies; the expansion of the role of OHTA to develop a comprehensive process to guide this work is consistent with that goal. The process should also be of value to other organizations that, notwithstanding their differing goals, must develop priorities for the use of limited assessment resources.
The establishment of AHCPR is a reflection of concerns about the rising costs of health care, the effect on health care quality and costs of knowing little about the value of many health care technologies, and the consequences
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of using those technologies inappropriately. As stated in the authorizing legislation for the agency (Public Law 101-239, Omnibus Budget Reconciliation Act of 1989, Title IX, Part A, Section 901[b]), its purpose is to "enhance the quality, appropriateness, and effectiveness of health care services."
Center for Medical Effectiveness Research
AHCPR retains many of the functions and personnel of the National Center for Health Services Research (NCHSR) but has a greatly expanded role and much greater visibility than that agency had. For example, the Center for Medical Effectiveness Research within AHCPR has incorporated the medical effectiveness studies of the Patient Outcome Assessment Research Program of NCHSR and is now funding a set of condition-focused grants and contracts called Patient Outcomes Research Teams, or PORTs. These multidisciplinary teams use methods for making inferences from experimental and nonexperimental data to assess all reasonable alternative practices for a specified clinical condition. Thus, one PORT is investigating the care of patients after acute myocardial infarction; other PORTs are studying outpatient care of the diabetic patient and alternatives in the treatment of biliary disease; another team is examining pre-, inter-, and postoperative alternatives in the care of patients with cataracts. In addition to the multiyear, multi-institutional PORT research, AHCPR also funds other, smaller extramural projects as part of its continuing mission of funding health services research.
Office of the Forum for Quality and Effectiveness in Health Care
AHCPR's Office of the Forum for Quality and Effectiveness in Health Care is assigned responsibility for arranging for the development of clinical practice guidelines. Forum guidelines use clinical conditions as a starting point and often incorporate the products of technology assessment. Currently, topics for guideline development are chosen based on a number of criteria such as prevalence, potential benefits and risks, large variations in practice, costliness, and availability of data. Guidelines presently being developed include care of patients with cataracts in otherwise healthy eyes, care of depressed patients, treatment of benign prostatic hypertrophy, and pain management for patients with cancer.
Office of Science and Data Development
The Office of Science and Data Development is responsible for increasing the quality and quantity of data available for health services research
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(Department of Health and Human Services [DHHS], 1990). It supports extramural research, demonstrations, and conferences, and is currently investigating the possibility of linking research-related data from different sources. It also formulates science policy for AHCPR and conducts intramural research.
Center for General Health Services Extramural Research and the Division of Technology and Quality Assessment
Two other components of AHCPR deserve mention. The Center for General Health Services Extramural Research promotes research in three areas: cost and financing, primary care, and technology and quality assessment. The Division of Technology and Quality Assessment supports research that includes development and evaluation of methods for conducting health care technology assessments and identification of factors that influence the development, diffusion, and adoption of health care technologies (DHHS, 1990).
Office of Health Technology Assessment
OHTA assesses the effectiveness of medical technologies that are being considered for coverage under Medicare. When a coverage decision cannot be resolved at the regional level or within HCFA, HCFA may refer the question of effectiveness to OHTA. OHTA's plans for conducting an assessment are published in the Federal Register.
Historically, the responsibilities of OHTA have entailed what Blumenthal (1983) has called "knowledge processing" rather than "knowledge development"; that is, OHTA does not perform or contract for primary research. Rather, it collects, synthesizes, validates, and disseminates existing knowledge concerning health care technologies. Originally, it was part of the National Center for Health Care Technology (NCHCT). The center itself, however, lacked constituency support and encountered such strong professional (e.g., from the American Medical Association) and manufacturer group (e.g., from the Health Industry Manufacturers Association) opposition to procedure- and device-oriented technology assessment that budget authorization was withheld and all functions of the center, except OHTA, ceased operations after fiscal year 1981 (only 3 years after the center was created). Subsequently, OHTA became a program within the National Center for Health Services Research. In Blumenthal's view, OHTA survived despite the demise of the NCHCT because of its demonstrated ability to save money for Medicare ($100-$200 million per year; Perry and Pillar, 1990). Thus, strong, although recent, historical reasons locate OHTA in AHCPR with its customary responsibilities of responding to requests for assessment from HCFA.
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OHTA Technology Assessments
The procedure used by OHTA in its assessments is explained briefly below. Because the agency uses secondary synthesis of published literature for its technology assessments, a given circumstance for beginning work on any topic is that it must be able to retrieve sufficient data to perform an assessment.
Collection of Information. Once OHTA has accepted a request for an assessment and has formulated the assessment question so that it is scientifically and medically answerable, it publishes a notice in the Federal Register soliciting comments within 90 days. The agency reviews these comments (which often total a hundred or more) and also solicits opinions from professional organizations and societies, manufacturers, manufacturers' trade associations, consumer organizations, and practitioners and institutions who perform the procedure or use the device. It sends formal letters of inquiry to other PHS agencies, particularly the Food and Drug Administration (FDA), the National Institutes of Health (NIH), and the Alcohol, Drug Abuse, and Mental Health Administration.
OHTA expects the proponents of a new technology to submit data that demonstrate safety and effectiveness. For technologies such as surgical procedures, the proponents must come forward with convincing scientific studies and not simply expert opinion or anecdote.4
Analysis of Data. OHTA uses a graded, hierarchical system for examining evidence that is based on study design. The system is comparable to the five grades used by the Canadian Task Force on the Periodic Health Examination (Woolf et al., 1990). Because data from prospective randomized controlled trials are usually not available, OHTA synthesizes the results of other studies, including "quasi-epidemiologic" data or case studies. Recently, OHTA has put greater emphasis on evaluating the quality of studies and on determining whether the technology results in improved health outcomes for patients. For instance, in assessing carotid endarterectomy, the question examined was not whether lesions could be removed from the carotid artery but how the outcomes for patients with removal of lesions compared with outcomes for patients who did not have the procedure.
Assessment and Recommendations. Assessments are subject to peer review within OHTA and are then forwarded to the FDA, NIH, and other
For a technology that is currently covered, however, the burden of proof of ineffectiveness would lie with HCFA and OHTA, which makes removal of coverage much more difficult.
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appropriate federal agencies. Assessments generally take from 12 to 14 months. OHTA sends HCFA a memorandum that states whether coverage is or is not recommended. Although these memoranda are not subject to the Freedom of Information Act and thus are not available to the public, the literature synthesis and analysis are published and widely disseminated in the series AHCPR Health Technology Assessment Reports. At the time of this writing, OHTA had published 10 reports (9 assessments and 1 reassessment) in its 1990 report series. Report topics comprised four procedures (e.g., no. 1, on liver transplantation), two diagnostic technologies (e.g., no. 3, on electroencephalographic [EEG] video monitoring), three treatments (e.g., no. 8, on salivary electrostimulation in Sjögren's syndrome), a revision based on new clinical trial findings (no. 5R, on carotid endarterectomy), and a reassessment (no. 9, on reassessment of external insulin infusion pumps).5
One report addressed both diagnosis and treatment, hence the apparent discrepancy in the totals.


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December 3, 2013
By Talbot Martin
The Aviation Safety Reporting System is a voluntary safety reporting program that allows airmen to make anonymous reports to the government about issues encountered in aviation, with anonymity allowing the airman to be candid—even when their actions may have been a violation of the regulations. This is commonly referred to as filing a "NASA report." The reason for this short-handed title is simply because the report is filed with NASA. While most airmen have heard of NASA reports by now and know to file such a report when something out of the ordinary happens in the course of a flight, there continues to be some confusion over parts of the program. One of the common areas of confusion is when to file a NASA report. Our straightforward advice: If something happens, file a NASA report. Next question: When do you file it?
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In honor of National Breast Cancer Awareness Month, BET.com has gathered info on breast cancer walks around the country. —Naeesa Aziz
Making Strides Against Breast Cancer has walks planned for Saturday, Oct. 6, 2012, at Atlanta's Centennial Olympic Park and Marietta's Glover Park on The Square on Saturday, Oct. 27, 2012. Also, Susan G. Komen's Atlanta 3-Day walk will take place from Oct. 19-21 and It's the Journey's 2-Day walk starts on Oct. 6.
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The mere utterance of the word can send shivers up the spine of even the most savvied dandy. It's one of those rare fabrics that has both low- and highbrow connotations—and you wouldn't want to be pegged to either—but if there's any time of year you could get away with donning the dandified older cousin to corduroy, it's now. So we've put together this handy guide:
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Hulu has closed another fruitful year, expanding 60% from 2010 to approximately $420 million in revenue, according to CEO Jason Kilar. Despite a "soft advertising market" in the second half of 2011, the site's ad business grew aggressively. The company has served over 1,000 brand advertisers since 2008. Its premium offering has also been successful, tallying 1.5 million paying members, supposedly making it the fastest growing video subscription service (online or offline) in US history.
Hulu says it's attracting more than twice the rate of subscribers every day compared to the same time last year (shortly after Hulu Plus launched) and the company's paid service is expected to account for more than half of its overall business later in 2012. The outfit counted less than 300,000 customers in the fourth quarter of 2010 and roughly 500,000 in the first quarter of 2011. Membership increased steadily throughout the year and shows no sign of slowing down in the immediate future.
The streaming platform marked a healthy expansion of its video offerings for both free and paid viewers during 2011. Its free catalog grew by 40% compared to the prior year and its paid selection grew more than 105%. Hulu boasts current season TV episodes from five of the six largest US broadcast networks, adding more than a dozen shows to its roster over the past year. Kilar said the company plans to keep that momentum rolling, allocating approximately half a billion dollars to content in 2012.
Along with providing more videos, the service is focusing on making it easier for viewers to access Hulu. The company "invested heavily" in the development of Hulu Plus apps for various devices, including the Xbox 360, Kindle Fire, Nook Tablet, select Android phones, as well as numerous smart TVs and Blu-ray players. In his closing comments, Kilar couldn't resist jabbing Netflix, saying Hulu Plus' dual revenue stream lets it compensate content owners ~50% more per subscriber than its rivals.
User Comments: 3
Got something to say? Post a comment-
They should invest that money on less commercials. I absolutely hate the commercial right before the end of an episode.
That commercial is paying the bill for you to watch the show. So... we gotta deal with it.
And yes, they have 5 of 6 major broadcasters... everyone but CBS. That's like saying we have 5 of 6 pro sports contracts. Golf, baseball, basketball, Hockey, NASCAR, and Bowling.
I'll sign up as soon as CBS does.
I just started a free trial - THER IS NO WAY - I will pay for it with that many commercials - for free I watch commercials - NOT when I'm pay for a subscription.
Zulu sem to have MORE commercials then normal TV.
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San Lorenzo won the first half of the Argentine first-division season Sunday after a 0-0 draw with Velez Sarsfield, thanks to previous champion Newell's Old Boys earning only one point in a 2-2 draw against Lanus.
Google's mystery barge is heading on a short cruise to comply with an order requiring it to move from its current home.
Non-availability of top players in the 4th Hockey India men's national championship (Division A) will rob the tournament of its sheen.
MP Sameer Bhujbal on Thursday inaugurated the Nature's Boat Club at Gangapur dam despite the environment department not yet giving its permission to open the boat club and the water sports centre to the public.
Crammed into a 10ft x 10ft room, 30 children squat on the floor with a leaky cement roof above their heads.Their mission is to learn, but there are no benches and no blackboard.
The Matri Shishu Raksha Kendra located at Beniabagh under the health department of Varanasi Municipal Corporation, has failed in providing maternity facilities offered by the state government.
Gandhi, a Special Protection Group (SPG) protected VIP, along with other VIPs, was in the city to address a public rally.
Signage installed along the bridge to inform motorists about restriction of speed to 40 km per hour more than a decade ago has faded or disappeared.
Acclaimed filmmaker Sanjay Leela Bhansali, who turned 51 Monday, says he enjoys being "on my own" on his birthday and that he is now more creatively fulfilled than he was at 40.
Finally, Trichy has got a super-specialty and trauma care centre to meet the growing medical needs of poor living in and around the district.


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Today I think I'm not going to work (ZEdEx)
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July 5-- A Toombs County man has died of injuries received in a motorcycle accident.
Twenty-year-old Josh Sikes of Lyons was impaled on an exhaust pipe June 18th when his motorcycle slid under the rear of a vehicle. He was taken to the Medical Center of Central Georgia where he died July 4.
Josh was a 2008 graduate of Toombs County High School and Southeastern Technical College. He was employed in the lab at Meadows Regional Medical Center in Vidalia.


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Pellegrini appointed Manchester City manager
Premier League - 8 months ago
Watching: Manuel Pellegrini has ended months of speculation by signing a three-year deal to become the new manager of Manchester City.
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Organized by the International Breast Cancer and Nutrition (IBCN) group
The goal of this symposium is to bring together global public health actors, advocates, and researchers on breast cancer prevention, to discuss the impact of environmental factors such as foods, stress, exercise on the genome. The symposium will take us on a journey across disciplines to study different levels of gene –environment interactions. Concretely, we will explore the epigenetic mechanisms of gene expression control, health policy and practices, socioeconomic and cultural contexts in which these environmental factors come into play.
Breast cancer prevention is a global public health challenge that requires: Utilization of the diversity of diet: environment and epigenomic pool globally; A multidisciplinary approach: biology, epidemiology, medicine, nutrition, social sciences and communication, education, and public policy; Contributions from scientists, clinicians, and advocates; Sustained international effort in research and action.
Abstracts submission for poster and oral presentations will be open for submissions until June 30, 2014. If you have questions, please contact Kris Swank at email@example.com. Submit abstract
Symposium Sessions
Status of breast cancer prevention …from around the world
From Risk to Tumor: Transition Mechanisms
The molecular Bases of Nutritional Influence on Breast Cancer Prevention
Epigenetic Memory and Breast Cancer Risk
Behavior and Breast Cancer Risk
Gene-Environment Interactions that Impact Policies
Symposium Speakers
Shuk-mei Ho, Director, Cincinnati Cancer Center, University of Cincinnati, USAVictoria Seewaldt, Professor of Medicine, Duke University, USA
Valerie M. Weaver, Professor of Surgery, Anatomy and Bioengineering and Tissue Regeneration, University of California, USA
Anna H. Wu, Professor of Preventive Medicine, University of Southern California, USA
Sponsor for the 2014 Symposium
International Breast Cancer & Nutrition (IBCN) • Purdue Marketing & Media •
Oncological Sciences Center, Purdue Discovery Park


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Justin Chigbogu hits two home runs, Yimi continues his strike out run, Lookouts continue to put up zeros.
Corey Seager did not play today due to the Quakes having the day off, and the offensive repercussions were felt up and down the affiliates.
Great Lakes was the only Dodgers affiliate to win on Sunday, as the teams at the top three levels each lost by one run.
Dodgers minor league affiliates went 4-3 on Saturday as the Loons, Raptors, AZL and DSL Dodgers all win
Dodgers minor league affiliates went 3-3 on Friday night, Matt Palmer pitched well in a Isotope loss, the Lookouts never put it all together this season and Corey Seager was promoted to Rancho Cucamonga.
Dodgers minor league affiliates went 2-5 on Thursday, but there was enough good news in the wins from Single-A Great Lakes and rookie level Ogden to go around, such as the first professional home run from 2013 draftee Dillon Moyer.
The rookie teams continued to pound the ball, while the Lookouts continue to evade home plate like the plague.
The prospects did their best to make themselves trade worthy but will it be enough to bring help to the major league team?
Dodgers minor league shortstop Corey Seager had three hits Monday and now sports a cool .900 OPS.
While Chris Capuano was putting his stamp on the fifth spot in the rotation, Stephen Fife was busy reminding the Dodgers they have some depth.
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I really think the filtering is out of hand in a lot of cases. You have to step back and think that there just might be a legitimate reason someone in another part of the world might want to see your information or contact you. Sometimes this comes across as being a bit small-minded, but I can see where there would be legitimate reasons for turning off traffic or mail as well...that's your prerogative. </rant>
What chiyo said...I run some Chinese and Japanese websites and have to keep those channels of information open, but I agree the vast majority of spam I get is from the US...what do you say chiyo & Woz, let's filter out all of those pesky .com spammers ;) Pot? This is the Kettle...you're black


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James Mortimer 13.Jun.2013Getty Images
McCaw, feted by some as the most valuable player in the game, stepped away from rugby late last December after playing in his 116th Test match against England, which was Test number 14 for the World Champions in 2012, and represented what was close to McCaw's 1,000th minute of international rugby for the season - the most of any All Black.
The 32-year-old is expected to lead the All Blacks out as they begin their major title defence of the year, looking to keep hold of The Investec Rugby Championship trophy they won so emphatically last season.
While there is a small chance that McCaw might play for the Crusaders before donning the Black jersey, it is most likely that he will return via his club 'Christchurch', meaning that he will play in his original club colours for the first time in over five years.
Linking back up with the Crusaders would take a lot of factors, such as a potential appearance in the Investec Super Rugby Finals, the injury toll of the team, and who is playing in the back row at the time.
While listed this season by the Crusaders as part of their squad, there was no guarantee McCaw would play his 101st Super Rugby match according to Fairfax Media.
"It's still three or four weeks away yet,' McCaw said.
"That's the plan, whether it's a couple of weeks for them (his local club) or I go back and play for the Crusaders, it actually depends on how they go a little bit.'
Far from just running around his hotel room when travelling the world, McCaw was on a specific training program and was already on the way to preparing his body for rugby again.


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- : The will host Writers Live with Susan Whitall at 7 p.m. Wednesday. , Whitall is the author of Fever: Little Willie John. The event is free and open to the public.
- : The Birmingham Storytellers Guild, a sponsored group of , will be hosting a welcome back meeting at 9:30 a.m. Thursday at The Community House. During the meeting, Connie Ilmer, Baldwin's director of youth services, will discuss her favorite children's literature of 2012.
- City Commission to meet Monday: The Birmingham City Commission will meet at 7:30 p.m. Monday for their regular meeting at . On the agenda is a bistro license transfer between and their .
- School Board to meet Tuesday: The Birmingham Board of Education will meet for its first meeting of the 2012-13 school year at 7 p.m. Tuesday at the . On the agenda is a resolution approving the hiring of several new teachers across the district.
- Planning Board to meet Wednesday: The Birmingham Planning Board will meet at 7:30 p.m. Wednesday at City Hall. On the agenda is the final site plan review for renovation plans at the .
5 Things To Know This Week: Writers Live With Susan Whitall, City Meetings and More
Here's what you need to know this week about Birmingham.
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about Todd Flowerday
A Roman Catholic lay person, married (since 1996), with one adopted child (since 2001). I serve in worship and spiritual life in a midwestern university parish.about John Donaghy
John is a lay missionary since 2007 with a parish in western Honduras. Before that he served in campus ministry and social justice ministry in Iowa. His ministry blog is http://hermanojuancito.blogspot.com
He also blogs reflections on the lectionary and saints/heroes/events of the date at http://walktheway.wordpress.com
He'll be a long-term contributor here analyzing the Latin American bishops' document from their 2007 Aparecida Conference.
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Daily Archives: 5 November 2013
GMD 128-132: An Invitation
One of the shortest chapters (GMD 128-132) offers believers an invitation. Let's examine it briefly. Click on the link if you'd like more detail. But it has a nice argument to it. GMD 128 recounts Jesus calling the fishermen (Mark … Continue reading
Posted in evangelization, Go and Make Disciples
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Clavius, Jesuit on the Moon
Jesuits have lent their names to thirty-some craters on the moon. The largest of these is Clavius, named for the 16th century astronomer Christoph Klau (Latinized to Clavius). Clavius is fairly prominent in the lunar southern hemisphere, and at 135 … Continue reading
Mediator Dei 4
Pope Pius XII praised the Liturgical Movement, begun in the 19th century, rooted in good scholarship, moved forward with "initiative," and driven in part by Benedictine communities. 4. You are of course familiar with the fact, Venerable Brethren, that a … Continue reading
Posted in Mediator Dei, pre-conciliar documents
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General Orders, memoranda, militia act, regulations for schools of instructions, requisitions, and correspondence. 152 documents. Index of names. Cartographic material consists of one item entitled, "Quebec, plan showing tinted yellow the ground applied for by the Provincial Government on which to erect a drill shed for the use and purpose of the militia and volunteer forces of the city and district of Quebec as set forth in a report of a committee of the Honorable the Executive Council approved by His Excellency the Governor General on the 12 January 1864", signed by Charles Walkem, surveyor and draughtsman, and Charles E. Ford, Royal Engineers. Plan accompanies the letter from the Commander of the Royal Engineers to the Inspector General of Engineers, no. 21, of 1 April 1864.
Microfiche NMC 15195
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a new way to get away
From the moment you book your ticket to the moment youŌĆÖre warmly welcomed onboard, youŌĆÖll see that Air Canada rouge is a new way to vacation. Enjoy the upbeat Air Canada rouge spirit, our newly designed cabins, and the convenience of connecting through our Toronto hub and Montreal. YouŌĆÖve never flown leisure like this before.


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Beonex Communicator is Mozilla polished for end users. It contains Navigator, Mailnews, Composer, and ChatZilla. Navigator has support for key web standards and a convenient interface. For example, it eases searching the Internet, similar to Apple's Sherlock on Macintosh. The Bookmark Manager can deal with huge collections of bookmarks and allows you to overview and sort them while you are surfing. If you want, you can track the latest headlines or webcams using the Sidebar. The Mailnews client supports multiple IMAP, POP3 and/or news accounts for each user, so you can download and manage all your email from various accounts in one place and store them on your computer or the server. Beonex puts a strong emphasis on security, privacy, and netiquette, to protect the private or confidential information on your computer and to encourage fairness.
FAQ PLAIN is a simple FAQ preprocessor. It generates a single FAQ output page which can be used for HTML PLAIN, or as an include page. It offers a some very useful options such as a hierarchical structure of the FAQ with automatic numbering. The program is easy to use and greatly simplifies the task of creating an FAQ page.
filepp is a generic file preprocessor designed to allow the functionality provided by the C preprocessor to be used with any file type. It supports the full set of C preprocessor keywords (#include, #define, #if, etc.). filepp is also highly customisable and allows users to easily add their own keywords or modify the behaviour of existing keywords.
The Guava tools are a set of Perl scripts for HTML pre-processing. You can create multi-page documents with contents tables, or use templates to give a consistent look to a set of pages. All output is passed through the C preprocessor, so you can use directives such as #include, #define and #if. There are also built-in macros for producing dates, cross references, etc.
HTML PLAIN is a "HTML Preprocessor Lacking An Interesting Name". Symbolic names instead of filenames allows files to be moved around without breaking links. Templates allow easy customization and changes of the layout. Tags can be redefined for a better structure of the document. Beginners can use one of the given templates and do not have to use any markup language at all. Experts can write their own Perl macros in order to get access to metadata and more flexibility.


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This job is no longer available
Further information
Reed Scientific are currently looking for QC Analytical Chemist for a large Pharmaceutical company in the South West.
You will join the QC team and be involved in the analysis of a range of pharmaceutical products from raw materials, intermediates and finished products. Performing analysis according to pharmacopoeias, specifications and methods using HPLC, GC, FTIR and KF you will analysis results and report them via LIMS.
Ideal candidates will be BSc qualified ion Chemistry/ Analytical Chemistry (or equivalent) and have experience within a QC Pharmaceutical environment working to GLP & GMP. You will have experience in HPLC, GC and FTIR analytical techniques.
Reed Specialist Recruitment Limited is an employment agency and employment business.


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Jun 18, 2007, 07:24 AM | #1 |
OS X equivalent to adding PATH variables in Windows
Hi all,
I'm a mac newbie, windoze vet. I'm about to install a little program on my Mac to use through Terminal. I'd like for my Mac to recognize the program without my having to type in the entire path of where it is everytime I want to use it. In windows (XP) days, I'd do this by placing the path to the program in System Properties -> Environmental Variables -> PATH. That way, in DOS, I could just type the program name and my machine would know where it was. Is there an equivalent for Macs? Or does OSX somehow magically know where programs are? Thanks in advance... |
0 |
Jun 18, 2007, 07:54 AM | #2 |
Mac OS X does, in fact, have an equivalent. It's the PATH environment variable. Adding stuff to it isn't anywhere near as simple as in Windows, though.
Here's a tiny little shell script that might help: Code:
`export PATH=$PATH:$1`>>~/.profile
iMac Intel (Rev H, 27"), 1TB HDD, 16GB RAM, 10.8.4 |
0 |
Jun 18, 2007, 08:03 AM | #3 |
If bash is your shell you can add the path to ~/.bash_profile.
For example, to add the path /usr/local/bin In terminal create/edit ~/.bash_profile Add the following line: PATH=$PATH:/usr/local/bin; export PATH Save the file Type: source ~/.bash_profile (to get the shell to read the file without closing/restarting terminal) Note: ~/.bash_profile sets for current user (only) Last edited by localoid; Jun 18, 2007 at 08:18 AM. |
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Jun 18, 2007, 08:22 AM | #4 |
Isn't the technically better way to do this to put the executable in the /usr/local directory? I.E. something like this (say abc was the executable):
sudo mv abc /usr/local/abc sudo chown root:admin /usr/local/abc The executable will then be available to all users without needing to bother with paths.
Mohan |
1 |
Jun 18, 2007, 08:32 AM | #5 | |
iMac Intel (Rev H, 27"), 1TB HDD, 16GB RAM, 10.8.4 |
0 |
Jun 18, 2007, 08:43 AM | #6 |
Much/most of the open source stuff tends to put (via make install, etc.) the executable in /usr/local/bin and man stuff in /usr/local/man -- much/most of system wide files ends up in /usr/bin...
You can create symlinks, or move files, add $path, etc., but everyone seems to have their way of handling it, which is usually what method works best for that person, etc. |
0 |
Jun 18, 2007, 09:33 AM | #7 |
I'm a Mac newbie too and can see how all of these answers can be confusing. For what I understand, when you use the terminal, the terminal runs within a shell program. OSX's default shell is bash. You can check this by the prompt command:
echo $SHELL Bash has a profile, .bash_profile, within the root of each user account. In this profile you can add items to your PATH. It is a hidden file so therefore its name is preceded with a "dot." From the prompt, you can list all files--including the hidden files--with this command: ls -a If the .bash_profile doesn't exist then you must create one. In the file, add this line: export PATH=/path/to/location:$PATH Edit the /path/to/location then save the file. Restart the terminal and you should be set. You can check the path with this command: echo $PATH
Convert |
1 |
May 25, 2012, 03:22 PM | #8 | |
I am trying to install NCO with these instructions. How do I add this path? The above responses weren't making too much sense as I am able to run commands from the ~/usr/local/bin. I do not have a .bash_profile
0 |
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