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The U.S. Department of the Interior this week announced new fracking regulations that will serve as the only federal rules enforcing any kind of safety measures on the controversial drilling technique when they go into effect in a few months.
The rules only apply to oil and gas wells on public lands, however, and most fracking is done on private or state-...
Smoke and C02: how to spin global warming [video]
Smoke and C02: how to spin global warming [video]
This new American News Project video nails the history of spin on global warming and tobacco:
Previous Comments
Energy companies battle AGW. Tobacco companies battled product demonization (they lost and yet somehow cigs are still in every cornier store)
compare smoking to CO2 emission.
Smoking is bad for you - everybody knows that and yet… worldwide more people smoke than ever. Tobacco companies are just moving more product to the poorer countries now, while plenty of people continue to smoke in rich countries.
Eliminating or even slowing tobacco is in practice impossible - even though it would have a big upside and the only downside is the temporary discomfort of the addicts.
If eliminating tobacco is fantasy, then killing fossil fuel is insanity. The world runs on fossil fuel and you just can't change gears easily or quickly.
To drastically reduce fossil fuel would mean death and poverty for millions - huge down side - and whats the payoff? - uncertain climate mitigation.
fossil fuel is not just another pack of cigs. Fossil fuel is life.
Yet Big Tobacco companies are still reporting record profits - because they are moving into other countries where there are many more people and a lack of regulations, awareness or infrastructure to deal with them.
I have news for you Rick; Tobacco companies don't care about death or poverty for millions and neither does Exxon - the only thing on their minds is profit.
try again sport - you have no news for me
- corporations are about profit - so what.
fossil fuels are still the line between a semblance of civilization and massive death and destruction.
choose life! hows that for corn?
peak oil is upon us; according to Professor David Rutledge peak coal will follow in about 2025 CE.
Then what, hmmm?
How about putting sustainable alternatives in place before then.
sure - you have to try - I like the idea of throwing some weight behind solar and wave energy. It just bugs me when we compare tobacco to the energy that has made us rich as humans. Tobacco is really the opposite of fossil fuel.
…and hey - what happened to our 300 years worth of coal?
is on TheOilDrum. Easy to find.
He writes that claims of coal reserves are vastly overstated.
Rick writes - corporations are about profit - so what.
Hare Krishna! Hare Krishna! Greed is Good! Greed is Good! The free market will rescue all of us from all of our ills. The free market is our salvation. Greed is good! Praise be to Gordon Gecko! Hare Krishna!
Free market cult worshipers ascribe much importance to the speech in Oliver Stone's movie "Wall Street" in which Gordon Gecko claims that "Greed is good, greed purifies…". I find this quite amusing, since they usually ignore the ending of the movie, in which that greed brings ruin and destruction.
With banks falling faster than trees in the Amazon, we seem to be witnessing the effects of two decades of economic policies that valued greed over the common good. We borrowed against a future utopia that we were sure was just around the corner, a utopia brought on by low taxes and a free market unleashed. Now we are realizing that the word "utopia" in fact means "no place". The loans are coming due, and it is becoming clear that the so-called economic boom of recent years was a mirage brought on by borrowed money swishing around the economy.
Rick writes - fossil fuels are still the line between a semblance of civilization and massive death and destruction.
Perhaps you can explain to me how Japan manages to be a modern economy while producing a tiny fraction of the carbon dioxide that we do in North America. Or how Europe has already implemented many of the carbon dioxide reduction strategies that are proposed for North America, without your promised economic armagedon.
I'm surprised Japan has a low per capita CO2 output.
I mean they import energy and material and build stuff with it. They do a great job for a place without much for natural resources. Aren't they something like 3rd for oil imports? I'm thinking they must put out a decent amount of CO2.
Hey Japan puts out twice as much as evil Canada in total CO2. They have the larger population but my goodness, we have the tar sands. We have the huge expanse of territory. We have evil Steve…. and we still can't keep up. http://en.wikipedia.org/wiki/List_of_countries_by_carbon_dioxide_emissions
Catch22 you name is quite correct. You dislike corporations making a profit in a free enertprice market system, but losing that would mean losing all our social programs including unversal healthcare, education, welfare, etc. Profits generate wealth, wealth pays taxes. We need corporations to make more profit so they can hire more good paying jobs, and pay their taxes. Oh, and your RRSP/Pension fund requres corporations to make a profit.
But I guess you would prefer to live like we did in the Dark Ages.
Oh, and Europe is falling apart big time. Officially in a recession.
Joshua Chaffin, Financial Times, 6 October 2008
The slowing economy and financial crisis are testing Europe's goal of becoming a world leader in greenhouse gas reduction.
Industry has seized on the slowdown to lobby for delayed or watered down regulations, arguing that directives set out by the European Commission earlier this year would force them to cut jobs or relocate factories outside the European Union.
Some politicians also acknowledge that the financial crisis could hinder efforts to forge international agreements on reducing emissions.
Roger Boyes, The Times, 6 October 2008 http://www.timesonline.co.uk/tol/news/world/europe/article4888286.ece
So you're saying that, similarly to how we can't get rid of tobacco, we're never going to be able to get rid of fossil fuels. But the aspect of the comparison you're missing is that, while only nicotine can relieve your nicotine cravings, fossil fuels are completely replaceable with other sources of energy.
And it's not even going to hurt the economy to do it! Europe has already managed to reduce greenhouse gas emissions to below 1990 levels and their economy is doing just as well, if not better, than ours.
"fossil fuels are completely replaceable with other sources of energy."
That is absolutely false. It is clear you do not know how deep and dependant we are on oil to sustain our modern society. It's all about Energy Return On Energy Invested (EROEI). No other source of energy has the same energy density as oil. In the good old days we consumed 1 unit of energy to get 100 units of energy in oil. Today it's about 25. Alternatives are LUCKY to get 2:1, some, like ethanol, are negative. Others, like hydrogen, are gross net losses of energy (70-85% loss).
Here is an interesting tidbit. One barrel of oil is the same as 7 YEARS of human labour. Thus at 100:1, one day of human labour would give us 100 days of oil energy. But with alternatives, 1 day of human labour only returns just over a day of energy.
It's not how much energy we get out of a fuel, it's how much energy it takes to get that energy out of the fuel. That's everything. Simple example. Hunter-gatherers have no free time, they spend all their time getting food. Thus their EROEI is 1:1. But the invension of farming showed that we can get more energy returned on energy invested. Enough that only a few people were needed to farm so the rest of humanity was freed up to advance civilization. Thus, EROEI is EVERYTHING. And alternatives are closer to the hunter-gatherer EROEI than farmers.
Plus, there is far more in oil than liquid transport fuels. There is no replacement for many oil products at the volume we need as a modern society. Plastics is a clear example. It's a requirement to protect our food, yet cannot be made from any other source in the volume we need.
You can't fly planes on electricity.
You really need to see this series to understand how important oil is, and how important EROEI is.
Secondly, our population is entrely supported by oil. Without oil we simply cannot feed 6.5 Billion people. Again, it's all EROEI.
Must be a slow news day if the tired old shibboleth equating inaction on AGW with tobacco.
Here's the point. AGW activists have, in spite of huge sums of money spent, failed to persuade the Canadian public that drastic action is required on C02.
Having failed, AGW alarmists are incapable of introspection so must invent a bogeyman: tobacco and yes, the trail of pennies from Exxon.
It's same "Science for hire" approach used by the tobacco companies, and the oil companies are hiring the same organizations that the tobacco companies did to produce it. Yup, definitely no connection here. This point is, of course, outlined in the video, should you care to watch it.
Oh, and it's CO2, not C-zero-2.
"Oh, and it's CO2, not C-zero-2." - DOGOMATIC
Who gives a rat's arse? This is the internet, not an English course.
Warmers have failed to democratically persuade the electorate that their dire warnings should be heeded.
Warmers far, far outspend any anti-AGW groups. You can't seriously pretend it is because of the tiny sums of money spent by anti-AGW proponents, can you?
Warmers have spent $50B+ in the past 20 years, and many more BILLIONS are coming.
they don't call him dogomatic for nothin
Science is always for hire. Everybody gets paid and everybody has some kind of bias. Don't be a denier over it.
Paul S. writes: Here's the point. AGW activists have, in spite of huge sums of money spent, failed to persuade the Canadian public that drastic action is required on C02. Having failed, AGW alarmists are incapable of introspection so must invent a bogeyman: tobacco and yes, the trail of pennies from Exxon.
Now I know what Orwell's 1984 looks like. The above post typifies the "War Against Facts" that certain right wing organizations wage. Their goal is to balance every inconvenient factual assertion with a counterwieght "fact" that is more conducive to their agenda. In the absence of clear facts, the public retreats to an implicit assumption that there is no such thing as fact, only opinion.
How's this for an opinion: I believe that these intellectual saboteurs are helping to destroy the values that we have inherited from the rennaisance. Before the rennaisance, the church was the ultimate source of truth. The church did not need to provide evidence for its assertions. It was enough that the church had political and military power. During the rennaisance, it became a more widespread view that assertions needed to be backed up by EVIDENCE. The church lost power because its assertions could not be backed up by logical argument and facts.
As the public slowly loses sight of actual facts, they will increasingly look to authority figures to form their views. They will look for facts from sources they trust and identify with. But trust is largely an emotional phenomenon, and is thus easily manipulated, especially when the public is afraid.
I'm sure that the right wing GW deniers will accuse me of the same thing that I am accusing them of. But there is a key difference between those who actually understand the science and those whose main purpose is the obfuscate the science: Those who know the science have EVIDENCE to back up their assertions, while those who obfuscate have only half-facts and flawed arguments.
I seriously doubt the parent poster has any real understanding of the arguments he is trying to refute. I challenge him to prove me wrong, by describing why the typical characterization of greenhouse gasses as a plate of glass is incorrect. I'm waiting…
glass puts the brakes on convection flow of heat energy, whereas so called "green house" gas molecules absorb and radiate heat rather than contain it.
am I close on that one?
I have no education beyond reading junk on the internet - but I think I get it.
Thank you for responding to my request. Strictly speaking your response is correct. However I wasn't really referring to a literal glass roof, but rather a mechanism by which greenhouse gasses are absorbed. This will be a bit long, but I'd like to describe some of my understanding of the science.
The common understanding of the greenhouse effect is that the greenhouse molecules act as some sort of shield. They allow energy from the sun (short wave radiation) to pass through, while absorbing infrared (long wave radiation) emitted from the ground, making the air warmer in the process. This was the understanding of the greenhouse effect in the early 1900's. Experiments were done in which infrared light was shone through different tubes of CO2. Those experiments showed that CO2 didn't seem to absorb much infrared radiation, and that doubling the length of the tubes had only a small effect. Thus, many scientists of that time were not convinced that CO2 was an important greenhouse gas. The problem was that their model of the greenhouse effect was simplistic and incorrect.
The actual mechanism of the greenhouse effect is subtle and a bit complicated.
Heat Balance
The Sun provides the Earth with short wave radiative energy. The Earth absorbs that short wave radiation and emits long wave infrared radiation, which is emitted into space. If more energy is coming in than is going out, then the Earth warms, increasing the outgoing long wave radiation until the energy output balances the input.
The Infrared Relay
The warm surface of the Earth emits infrared radiation. That radiation travels upwards towards space. But on the way, there is a good chance that the parcel of infrared radiation will run into a greenhouse gas particle, such as CO2 or H2O. The infrared may be absorbed, making the gas molecule warmer. The gas molecule may then re-emit another parcel of infrared radiation out towards space. The new infrared parcel may go through the same process. The infrared parcel may be absorbed and re-emitted several times before leaving the Earth for space.
The Upper Emitting Layer
There is an upper layer from which almost all infrared radiation is emitted to space. The amount of energy emitted by this layer basically controls the heat balance of the Earth. If the amount of infrared energy emitted by this upper layer is reduced, then the Earth warms.
The Effect of Carbon Dioxide
Adding more carbon dioxide to the atmosphere makes it more difficult for infrared radiation to escape into space. The effect is most important in the upper emitting layer. Adding more CO2 ensures that infrared radiation parcels will be absorbed and re-emitted more frequently. This results in the infrared parcels being emitted to space at HIGHER ALTITUDES. Because temperature decreases with altitude, the CO2 causes the infrared parcel to be emitted from a colder layer of air. This makes the radiation process less efficient, resulting in less energy flow into space. Thus the Earth warms.
It should also be noted that there is little water vapor at in these emitting layers, since the air is so dry. Thus water vapor is not a significant factor in this process.
Complicated, eh.
"How's this for an opinion: I believe that these intellectual saboteurs are helping to destroy the values that we have inherited from the rennaisance." - CATCH22
Let's not exxaggerate. Questioning AGW orthodoxy is not detroying any "inheritance". Your example is simply another overwrought exxaggeration warmers like to use to suppress and silence any questioning of the "facts".
"The church did not need to provide evidence for its assertions. It was enough that the church had political and military power. During the rennaisance, it became a more widespread view that assertions needed to be backed up by EVIDENCE."
And that's what skeptics are doing. Demanding more evidence. Climate scientists are claiming an ability to predict climate hundreds of years in advance and at present, much of the populace remains doubtful of this claim. Being a democracy, scientists do not rule, but must instead persuade the public that the drastic measurest they advocate must be taken. So far, climate change activists have been unable to do this.
I see a future where rabid enviros vandalize solar installations to save the Earth.
good for a laugh
I hope those of you that want in my pocket to solve global warming will be ready to repay me when you become the emperor with no clothes. Otherwise we should have the option of putting all of you on the shores of Hudson's Bay where you can tend to your imaginary palm trees and your memorials to the Polar Bear. I was in the early phases of my graduate science education when the coming of the new Ice Age phonies were after grants to spread the sky is falling alarm in my University. Now the same climate whores are serving the needs of the neo-socialists that after the fall of the Soviet Union have found a home in the environmental movement. I know both sides of this coin well and am sad to see us hustled by this crowd again.
There is only one complete and exact computer of global climate and that is the planet itself. By definition it complies with all laws of nature. Einstein said "no number of tests can prove I'm right but only one is needed to prove I'm wrong". There have been many tests that prove to be wrong the theory that added atmospheric carbon dioxide causes significant global warming. They were run on the planet computer and the results are archived in the Vostok and EPICA ice cores and other proxies. They show that, repeatedly, a temperature increasing trend changed to a decreasing trend and vice versa. For those who understand how feedback works, this temperature trend direction change proves that there is no significant net positive feedback. All that is needed to determine if there is net positive feedback is a temperature trace for a long enough time to average out cyclic variation from random noise and other factors, ENSO, etc. The temperature trace does not even need to be correct in absolute terms just reasonably accurate in relative terms time-wise.
While determination of the magnitude and even the sign of feedback in climate is difficult using climatology, it is trivial, as described above, for someone who understands feedback to deduce from the temperature record alone that significant net positive feedback does not exist. Many climatologists apparently don't know how feedback works so they don't realize this. Unaware of their ignorance, they impose significant net positive feedback in their GCMs which causes them to predict substantial warming from carbon dioxide increase. Without significant net positive feedback, the GCMs do not predict significant Global Warming.
what you write. I recommend reading "The Discovery of Global Warming" by Spencer Weart:
Review of above:
the tone of those two posts are so similar. If I was on the Frank and Fern team I would speculate they came from the same person.
no wait they aren't similar - they're exactly the same.
I'm calling you on it Dan and Bob. You are the same guy.
Seems to me that Desmog is getting more and more enlightened people commenting who realize that AGW is a fraud. Interesting trend.
Oh, and about the Cigs in other countries. I saw a program about that on the Discovery Channel a while back. Seems it's their culturial and religeous beliefs that will prevent any attempts to curb smoking. They have a firm belief that God will take them when God wants them regardless if they smoke or not.
I like how you've just managed to paint with one brush the attitudes about cigarettes for the *entire* rest of the world. That must have been one long documentary.
I think I can paint even a broader stroke. People of all cultures are fools. They prove it by paying good money to suck tar into their lungs. Common sense should overcome cultural pressures to smoke. I conclude that 30% of humanity has no common sense.
Since 85% of the peoples of the world accept religion over reason, then "I conclude that 85% of humanity has no common sense."
I'm just standing by and letting you guys play amongst yourselves for awhile until the new comments policy comes into effect. I imagine that many of the other regular participants are doing the same. I look forward to conversations that are on-topic and civil, with fewer actionable diatribes and outright lies. So enjoy your 15 minutes, guys.
Fern Mackenzie
what - you're going to chase us away to the scary parts of the internet? But Fern - We need you to fix our spelling!
oh - so the good guys are laying low for now eh? - I was wondering what happened to Gary
Was away on business.
but now
I'mmm BaaaaACK!
Fern Eludes to upcoming censorship on the Blog.
Could this be?
Is Desmog going to admit defeat on the issue and resort to the propaganda methods of reality denier sites like RealClimate?
Time will tell. But I suspect she may be on to something.
Since the left has never needed truth and honesty to promote their agendas, I see no reason they should care about it now.
As the world cools the propaganda will increase.
When is that coming? I look forward to modding them out of existence a la reddit.
Gotta deal with this Rick spam somehow.
great - now I'm gonna be modded out of existence by pupomatic - how will I ever go on?
As I understand it, if you refrain from obscene language, stay on topic, cite valid sources and avoid actionable claims, you can post here all you want.
Maybe, though, I should suggest to Richard L. that he allow no more than 5 spelling errors in any single post;)
Fern Mackenzie
More on the cooling planet. http://icecap.us/index.php/go/joes-blog/is_this_the_beginning_of_global_cooling/
And This is interesting.
Who would have thought that natural cycles could possibly have any effect over the ALL POWERFUL CO2 effect?
Can we say "PDO" boy and girls?
Talking about smoke and Spin.
Remember all the hysterical doom and disaster talk over melting in the arctic?
Winds are Dominant Cause of Greenland and West Antarctic Ice Sheet Losses
Two new studies summarised in a news article in Science magazine point to wind-induced circulation changes in the ocean as the dominant cause of the recent ice losses through the glaciers draining both the Greenland and West Antarctic ice sheets, not 'global warming.'
You guys have no shame. The fact is that the wind patterns that increased the melting have occurred in the past. They are in fact not that unusual. What IS unusual is the well documented THINNING OF THE ARCTIC SEA ICE. The thinness of the ice made it extremely vulnerable to wind and current variations. The thin ice was easily blown out of the Arctic waters and into warmer waters. This year's melting accelerated in late August due to some storms which shattered the already thin ice. Once it was broken, the melting accelerated.
hey - this place is totally dead except for a few skeptics.
listened to Chris Martenson's crash course the last couple days….wow - If he's even half right, GW is the least of our problems - not even worth thinking about. We've got big population problems, big resource problems, huge energy problems. GW is nothing but a petty distraction.
all those problems much, much worse.
Already starting to do so.
This might be worst situation but we should teach people and companies something about these issues. Everybody is making money regardless considering this issue. There should be distance learning high school diploma for all those people who need these kind of education. Government must force them to education themselves from these issues and try to solve them
So true that CO2 is affecting the air to be polluted filled by much destructive substances in the atmosphere. Also the cigarette has much substances turning to the air that was converted to different kinds of harmful elements filling the air. A lot of us would give a no fax cash advance to get Glenn Beck and the growing Chicken Little cabal to pipe down.


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<< Return to IRB Policies and Forms
IRB Standards for Privacy and Security of Protected Health Information
To establish guidelines for procedures in order to use and disclose the protected health information (PHI) of research participants, as defined by the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule. Use and disclosure of PHI for research purposes requires prior IRB approval.
The Cottage Health System Institutional Review Board (CHS IRB) has established and shall follow written guidelines for complying with HIPAA regulations and for protecting PHI of individuals enrolled in research studies. Requests for use and disclosure of PHI for research purposes shall first be submitted to the IRB, or a designated subcommittee, such as the Data Use Committee (DUC). HIPAA references and guides, including the complete Rule, are available from the CHS IRB Department in the Office of Research.
This policy reflects:
Covered Entity (CE) – Health plans (HMOs, group health plans, etc.), health care clearinghouses (billing and repricing companies, etc.), or health care providers (doctors, dentists, hospitals, etc.) who transmit any electronic PHI (45 CFR 160.103). Covered Entities must maintain reasonable and appropriate administrative, physical, and technical safeguards to protect the confidentiality, integrity, and availability of their electronic PHI against any reasonably anticipated risks. All Covered Entities must comply with the Security Rule.
"HIPAA": Health Insurance Portability and Accountability Act of 1996, which includes regulations that specifically address the use of "protected health information" in research.
HIPAA Privacy Rule:
The Privacy Rule permits a covered entity to use or disclose PHI for research under the following circumstances and conditions:
HIPAA Security Rule:
The final Security Rule became effective as of April 21, 2003:
PHI – Protect Health Information: As it relates to research, includes all personally identifiable records and documents containing information and/or data pertinent to the research study in which the individual is enrolled. PHI includes the patient's medical record (both physical and electronic charts), and/or other records containing physician notes and progress reports (if related to the patient's study participation), research records (including case report forms), and any other documentation required and necessary to extrapolate essential research data.
1. The CHS IRB, or any subcommittee(s) designated on its behalf, will perform the following HIPAA review and approval responsibilities, within the larger context of its responsibilities for the protection of human research participants, that include review of privacy and confidentiality issues broader than those covered by HIPAA:
2. Patient Authorizations to use and disclose PHI may be included in the informed consent document or be a separate document. Authorization language must comply with HIPAA regulations by containing sufficient and appropriate information as outlined in this policy.
3. The CHS IRB has developed an Authorization form template for investigators wishing to use separate Authorization forms or when the informed consent document has been waived and the Authorization is the only document required. All language in the template that must be included is indicated.
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HIPAA privacy requirements are in addition to ethical and regulatory protections for human research subjects and do not supersede them. The HIPAA Privacy Regulations are focused on privacy and security protections for individuals' health care information that is termed protected health information (PHI). If a research study either uses or creates PHI, HIPAA documentation requirements apply to those research uses of PHI in addition to relevant privacy and confidentiality protections that are required by federal regulations for human research subject protection and the ethical standards used to oversee research.
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The IRB has an Authorization template that complies with HIPAA requirements. The researcher must customize the Authorization for the specific study he or she intends to perform and submit it with the IRB application for review and approval.
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A Covered Entity that creates PHI, in whole or in part, for the purpose of research, must obtain an Authorization for the use or disclosure of such information. Such an Authorization must meet all of the requirements of 45 CFR Section 164.508, which provides that:
1. An Authorization for the use or disclosure of PHI for a specific research study may be combined with any other type of written permission for the same or another research study. This exception includes combining an Authorization for the use or disclosure of PHI for a research study with another Authorization for the creation or maintenance of a research database or repository, or with a consent to participate in research. Where a covered health care provider has conditioned the provision of research-related treatment on the provision of an Authorization for use/disclosure of PHI for such research, any compound Authorization created must clearly differentiate between the conditioned and unconditioned components and provide the individual with an opportunity to opt in to the research activities described in the unconditioned Authorization (45 CFR Section 164.508(b)(3)(iii)).
2. A covered healthcare provider may condition the provision of research-related treatment on the provision of an Authorization for the use or disclosure of PHI (45 CFR Section 164.508(b)(4)).
3. The statement "end of research study" or similar language is sufficient to describe the expiration event for the Authorization to use PHI for research (45 CFR Section 164.508(c)(1)(v)). Since California law does not require an Authorization for use of patient information in this instance, this is an exception to the general rule in California that an Authorization must have a specific expiration date.
4. The statement "none" or similar language is sufficient to describe the expiration event if the Authorization is for the Covered Entity to use or disclose PHI for the creation or maintenance of a research database or research repository (45 CFR Section 164.508(c)(1)(v).
As mentioned above, California's Confidentiality of Medical Information Act (CMIA) does not require patient Authorization to use or disclose PHI for research purposes. Therefore, an Authorization form to use or disclose PHI for research purposes must contain only the federal HIPAA-required elements, and need not contain the CMIA-required elements.
DHHS has reversed its position that a HIPAA Authorization that allows the disclosure of PHI to create a research database or repository may not also cover use or disclosure of the PHI for future research. DHHS has harmonized its interpretation of HIPAA with practice under the Common Rule regarding informed consent for future research, and allows Covered Entities, researchers, and IRBs to have flexibility in determining what adequately describes a future research purpose depending on the circumstances. DHHS notes that it is aligning its interpretation with existing practice under the Common Rule in regard to informed consent and still requires that all required elements of Authorization be included in an Authorization for future research, even if they are described in a more general manner than is done for specific studies.
Covered Entities that wish to obtain Authorization for the use or disclosure of PHI for future research may do so at any time after March 26, 2013 [78 Fed. Reg. 5566, 5612-13 (Jan. 25, 213)].
V. Required Components of a HIPAA Authorization
HIPAA requires that the Authorization be written in plain language and contain the following core elements:
Invalid Authorizations An Authorization is not valid if it lacks any of the required elements listed above. It is also invalid if it has expired, was not filled out completely, has been revoked, was improperly combined with another document or contains information known to be false.
Documenting Authorizations Providers must document and retain all Authorizations for six years. A Provider must give the individual a copy of his or her signed Authorization if the Authorization was requested by the provider.
Compound Authorizations The Final Rule amended 45 C.F.R. § 164.508(b)(3)(i) and (iii) to allow a Covered Entity to combine conditioned and unconditioned Authorizations for research, provided that the compound Authorization (1) clearly differentiates between the conditioned and unconditioned research components, and (2) clearly allows the individual the option to opt-in to the unconditioned research activities. The Final Rule permits the use of compound Authorizations for any type of research activities, including optional sub- studies, and secondary future use of data (to the extent secondary future use is permitted by the Final Rule as discussed below), except where the research involves the use and/or disclosure of psychotherapy notes.
The Final Rule does not allow an Authorization to include an option to opt-out of the unconditioned research activities. So, for example, the Authorization cannot say "check here if you do not want your data provided to the biospecimens bank." In the commentary to the Final Rule, the Department of Health and Human Services (HHS) approves of three methods proposed by the Secretary's Advisory Committee on Human Research Protections (SACHRP) to obtain the necessary opt-in for unconditioned research activities:
(1) a combined consent / Authorization form for a clinical trial and optional banking component, with a check-box for the individual to have the choice to opt-in to the optional banking component, and one signature;
(2) a combined consent / Authorization form for a clinical trial and optional banking component, with one signature for the clinical trial and another signature to indicate the individual agrees to the optional banking component; and
(3) a combined consent / Authorization form for a clinical trial and optional banking component, with a check box to opt-in to the banking component, one signature, but with the detailed information about the banking presented in a separate brochure or information sheet referenced directly in the consent / Authorization form.
HHS clarifies that, for the third approach, the brochure or information sheet must be incorporated by reference into the Authorization / consent form such that it is considered part of the form. In addition, if the brochure or information sheet includes any of the required elements of the Authorization, and the Authorization has not been altered by an IRB approved waiver, then the brochure / information sheet must be made available to potential research participants before they are asked to sign the Authorization. Finally, in such cases, a Covered Entity must keep not only the signed Authorization, but also a copy of the brochure or information sheet, in order to comply with documentation requirements under the Privacy Rule.
HHS explains in the preamble that Covered Entities are permitted but are not required to create compound Authorizations for conditioned and unconditioned research activities. So, researchers may choose to use separate Authorization forms. HHS makes clear that Covered Entities and researchers have flexibility in the methods used to distinguish the conditioned and unconditioned research activities and to provide the individual with a clear opportunity to opt-in to the unconditioned portions.
In response to a comment asking whether a portion of the compound Authorization can be revoked without revoking the entire Authorization, HHS clarifies that, where it is clear that an individual is revoking only part of a compound Authorization, then the researchers can proceed accordingly. If it is not clear that only a specific part of the compound Authorization is being revoked, then the researchers must either obtain written clarification from the participant or the entire Authorization must be treated as revoked.
Conditioning Treatment upon an Authorization Conditioning treatment upon Authorization is permitted for research related purposes. However, in general, providers may not condition treatment upon an Authorization.
VI. California-Specific Authorization Requirements
Although some of the requirements for Authorization for PHI uses and disclosures are stricter under California state law, Authorization for PHI for research purposes is exempt. According to the California Civil Code Chapter 2.0 § 56, Disclosure of Medical Information by Providers (the Confidentiality of Medical Information Act), at Section 56.10(a)(c)(7):
"No provider of health care, health care service plan, or contractor shall disclose medical information regarding a patient of the provider of health care or an enrollee or subscriber of a health care service plan without first obtaining an authorization, except as provided in subdivision (b) or (c).
(c) A provider of health care, or a health care service plan may disclose medical information as follows: (7) The information may be disclosed to public agencies, clinical investigators, including investigators conducting epidemiologic studies, health care research organizations, and accredited public or private nonprofit educational or health care institutions for bona fide research purposes. However, no information so disclosed shall be further disclosed by the recipient in any way that would disclose the identity of any patient or be violative of this part."
Because institutions must comply with regulations by applying the stricter standards (regardless of whether they are state or federal), research conducted in California shall comply with the federal HIPAA requirements.
VII. Procedure for Signing an Authorization
Adults: A competent individual, 18 years of age or older, should always sign the Authorization to use or disclose his/her PHI. A person is competent if he/she has the general ability to understand the concept of release of his/her medical information. If the patient is not conscious, coherent, or not competent for whatever reason, a legally recognized proxy, such as a legal guardian, must sign the Authorization.
Minors: Any parent or legal guardian may sign an Authorization for a minor child in his/her legal custody. (Note that HIPAA does not require that a research-specific assent document include any version of a HIPAA Authorization).
The individual must be provided with a copy of the signed Authorization.
VIII. Waiver or Alteration of the Authorization Requirement by an IRB or Privacy Board
For some types of research, it may be impracticable for researchers to obtain written Authorization from research participants, for example, for some research conducted on existing databases or repositories where no contact information is available. To address these situations, the Privacy Rule contains criteria for the waiver or alteration of the Authorization requirement by an IRB or another review body called a Privacy Board. The Privacy Rule permits a Covered Entity to use or disclose PHI for research purposes without Authorization (or with an altered Authorization), if the Covered Entity received proper documentation that an IRB or Privacy Board has granted a waiver (or an alteration) of the Authorization requirement for the research use or disclosure of PHI. The Privacy Rule establishes criteria to be evaluated by an IRB or Privacy Board in approving an Authorization Waiver or Alteration. For a Covered Entity to use or disclose PHI under a waiver or alteration of the Authorization requirement, it must receive documentation of, among other things, the IRB or Privacy Board's determination that the use or disclosure of PHI involves no more than a minimal risk to the privacy of individuals, based on the presence of at least the following elements:
Authorizations for research use of PHI may be waived by the IRB, provided these criteria are satisfied and documented (generally in addition to satisfaction of waiver of informed consent requirements pursuant to 45 CFR 46.116 since many of the elements overlap). A request for Waiver of Authorization must be completed by the researcher and submitted to the IRB for prior review and approval. The IRB shall maintain documentation of the request and its approval. This request may be combined with a waiver of informed consent for research.
IX. Limited Waiver of Authorization Solely for the Purpose of Prescreening, Contacting and/or Recruiting Potential Research Participants
In addition to the scenarios that would support a Waiver of Authorization for all study activity, there is the potential need to grant a Limited Waiver of Authorization solely for the purpose of prescreening, contacting and/or recruiting potential research participants. Since a researcher cannot practicably obtain a potential research participant's Authorization for review of PHI in advance of contacting the potential participant, the IRB may issue a Limited Waiver of Authorization permitting specified access and use of PHI solely for prescreening and recruitment contact pursuant to an approved protocol. An example of a scenario in which a limited waiver may be appropriate is if a researcher needs to review health care records to make recruitment contacts.
IRB approval of a Limited Waiver of Authorization will be in accord with the criteria for a Waiver of Authorization as applied to the prescreening, contact, and recruitment procedures described in the protocol and IRB application.
Physicians and other health care professionals who have a direct treatment relationship with an individual may review that individual's PHI for eligibility with respect to a research protocol and may initiate a discussion with the individual about potential participation as a research subject in a protocol relevant to the treatment relationship. This scenario does not require an Authorization or a Waiver of Authorization
X. Recruitment of Subjects identified through Private Medical Information
Recruitment efforts frequently target individuals known to have a specific medical condition. Medical records, patient registries, clinical databases, and referrals from treating physicians can be useful resources to identify potential subjects; however it is essential to take special precautions to ensure that patient privacy is protected and that the individual patient is appropriate to participate in the research. It is not appropriate for investigators to make the first contact with potential subjects identified through their private health information. Rather, active participation by the patient's primary/specialist health care provider in the recruitment process ensures that consideration is given to the appropriateness of an individual patient's participation in the research prior to recruitment and that the patient's privacy is respected.
XI. De-identified Data Sets
The Privacy Rule permits Covered Entities to release data that have been de-identified without obtaining an Authorization and without further restrictions upon use or disclosure because de-identified data is not PHI and, therefore, not subject to the Privacy Rule. A Covered Entity may de-identify PHI in one of two ways. The first way, the "safe-harbor" method, is to remove all 18 identifiers enumerated at section 164.514(b)(2) of the regulations. Data that are stripped of these 18 identifiers are regarded as de-identified, unless the Covered Entity has actual knowledge that it would be possible to use the remaining information alone or in combination with other information to identify the subject.
The second way is to have a qualified statistician determine, using generally accepted statistical and scientific principles and methods, that the risk is very small that the information could be used, alone or in combination with other reasonably available information, by the anticipated recipient to identify the subject of the information. The qualified statistician must document the methods and results of the analysis that justify such a determination.
The Privacy Rule allows a Covered Entity to assign to, and retain with, the de-identified health information, a code or other means of record re-identification if that code is not derived from or related to the information about the individual and is not otherwise capable of being translated to identify the individual. For example, an encrypted individual identifier (e.g., a social security number) would not meet the conditions for use as a re-identification code for de-identified health information because it is derived from individually identified information. (See 67 Federal Register 53233, August 14, 2002.) In addition, the Covered Entity may not (1) use or disclose the code or other means of record identification for any purposes other than as a re-identification code for the de-identified data, and (2) disclose its method of re-identifying the information.
XII. Limited Data Sets
Where only certain identifiers are needed, it may be permissible for a covered entity to provide a researcher with a Limited Data Set (see Attachment A, Frequently Asked Questions and Answers, p. 6). Limited Data Sets are data sets stripped of certain direct identifiers that are specified in the Privacy Rule. Limited Data Sets may be used or disclosed only for public health, research, or health care operations purposes. They are not de-identified information under the Privacy Rule. Importantly, unlike de-identified data, protected health information in Limited Data Sets may include the following: Addresses other than street name or street address or post office boxes, all elements of dates (such as admission and discharge dates) and unique codes or identifiers not listed as direct identifiers.
Before disclosing a Limited Data Set to a researcher, a Covered Entity must enter into a Data Use Agreement with the researcher, identifying the researcher as the recipient of the Limited Data Set, establishing how the data may be used and disclosed by the recipient, and providing assurances that the data will be protected, among other requirements. If the Covered Entity learns that the researcher has violated this agreement, the Entity must take reasonable steps to end or repair the violation and, if such steps are unsuccessful, stop disclosing PHI to the researcher and report the problem to the HHS Office for Civil Rights.
XIII. Databases and Registries
The collection of data for the purposes of establishing a database or registry, as well as for general research purposes, must comply with HIPAA regulations regarding use and disclosure of protected health information. These activities therefore come under the oversight of the IRB. It is possible that these activities may be reviewed by expedited review or be deemed exempt from further review, however, such determinations must be made by the IRB following the submission of an IRB application. Local Institutional Review Board approval is required of all clinical studies and deserves to be a major consideration when designing data collection. Regardless of whether it is a retrospective analysis of collected data or a prospective clinical trial, no data collection should be initiated until all ethical, procedural, and legal requirements are satisfied.
XIV. Activities Preparatory to Research
Covered Entities may permit researchers to review PHI in medical records or elsewhere to prepare a research protocol, or for similar purposes preparatory to research. This review allows the researcher to determine, for example, whether a sufficient number or type of records exists to conduct the research. Importantly, the Covered Entity may not permit the researcher to remove any PHI from the Covered Entity. To permit the researcher to conduct a review preparatory to research, the Covered Entity must receive from the researcher representations that:
Under the "preparatory to research" provision of the HIPAA Privacy Rule, an investigator may maintain identifying information until the subject meets with study staff to discuss the study further and sign the consent form. During the meeting with the potential subject, the subject must be asked to sign the written Authorization, and / or research consent form containing Authorization language, to use and disclose his / her identifiable healthcare information and be given a copy of the hospital's Notice of Privacy Practices.
If identifiable health information is collected on persons who are not enrolled, there are several options: (1) destroy the information; (2) obtain IRB approval of a Waiver of Authorization for Prescreening; or (3) obtain Authorization from each individual.
If a failure log must be maintained for a trial sponsor, the PI must do one or more of the following, depending upon the study and data disclosed: (1) completely de-identify the log prior to disclosure; (2) obtain IRB approval of a Waiver of Authorization for Prescreening, which specifically identifies the data to be shared and to whom it will be disclosed; (3) limit the data to a Limited Data Set and include a Data Use Agreement Addendum to the Clinical Trial Agreement; and/or (4) obtain Authorization from each individual.
XV. Retaining Information from Individuals who are Pre-Screened but not Enrolled
Pre-screening documents with identifying information gathered to obtain written Authorization and prior to enrollment (signing of informed consent form) may also be retained in research files, but must have segments containing identifiable information blacked out or cut off as soon as it is clear that the individual will not be enrolled. If identifiable health information is to be retained, the investigator must obtain an Authorization from each of the persons screened.
XIV. Research Involving Decedents' PHI
A Covered Entity may provide access to decedents' records for research purposes if the Covered Entity receives from the researcher:
Decedents are not included in the Common Rule definition of "human subjects," however, the disclosure of their protected health information by a Covered Entity is subject to specific HIPAA requirements. Moreover, the HIPAA-HITECH Final Rule of 2013 established that PHI becomes public record 50 years following a person's death.
XVII. Other Privacy Rule Requirements
Minimum Necessary Standard
When using or disclosing PHI for research without an Authorization, a Covered Entity must make reasonable efforts to limit the PHI used or disclosed to the minimum necessary amount to accomplish the research purpose. If an IRB or Privacy Board has granted the researcher a Waiver or an Alteration of Authorization, a Covered Entity may reasonably rely upon the researcher's request consistent with the description of PHI in documentation from the IRB or Privacy Board as the minimum necessary amount of PHI for the research.
Right to an Accounting of Disclosures The Privacy Rule grants individuals new rights, including the right to receive an accounting of disclosures made for research by a covered entity without the individual's Authorization (e.g., under a Waiver of Authorization), except for disclosures of a Limited Data Set. The individual has a right to such an accounting of disclosures made by a Covered Entity in the 6 years prior to the date on which the accounting is requested, not including the period prior to the compliance date. For such disclosures, in general, individuals who request an accounting must be told what PHI was disclosed, to whom it was disclosed, and the date and purpose of the disclosure. Covered Entities must provide the address of the recipient, if known.
For certain research disclosures made by a Covered Entity, two other options exist for providing an accounting. When multiple disclosures of PHI are made to the same person or entity for a single purpose, the accounting for such disclosures may consist of the information described above for the first disclosure, plus the number or frequency of disclosures, and the date of the last disclosure during the time period covered by the request.
If, during the period covered by the accounting, the Covered Entity has disclosed the records of 50 or more individuals for a particular research purpose, the Covered Entity may provide a more general accounting to the requestor. The Covered Entity would provide the following information in the general accounting:
Section 164.528(b)(4)(ii) of the Privacy Rule requires that, upon request, the Covered Entity must help the individual contact the sponsor and researcher when it is reasonably likely that the individual's PHI was disclosed for a particular protocol.
XVIII. Fines for Unauthorized Access to Patient Information
California Bills SB 541 and AB 211 (effective January 1, 2009) impose significant financial liability oon both the individual committing the unauthorized access and/or release of health information, as well as on the institution involved in the unauthorized access. Because research often involves the use of a patient's Protected Health Information (PHI), including the use of electronic access to patient medical records, it is imperative that investigators be familiar with these State Bills. It is the obligation of Cottage Health System to report any willful unauthorized activities to the appropriate authorities.
SB 541: An act to amend sections 1280.1 and 1280.3 of, and to add section 1280.15 to, the Health and Safety Code, relating to health facilities.
AB 211: An act to amend sections 56.36 of the Civil Code, and to add Division 109 (commencing with Section 130200) to, the Health and Safety Code, relating to health.
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Unfortunately B-Square InterLock One-Piece Bases (Without Rings) - Marlin Model 39, Blue 45539 is no longer carried by OpticsPlanet. You can also explore other items in the Riflescope Mounts, Rings & Bases category yourself to try and find the perfect replacement for you!
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Menshov won Russian Cup so perhaps now Kovtun competes at JW? In which case, winner is up in the air. If neither Yan or Kovtun complete, the podium is up for grabs, maybe skaters like Hino, Jin, Kolyada, Uno, or Omori can wind up with medals!
Menshov won Russian Cup so perhaps now Kovtun competes at JW? In which case, winner is up in the air. If neither Yan or Kovtun complete, the podium is up for grabs, maybe skaters like Hino, Jin, Kolyada, Uno, or Omori can wind up with medals!
I just saw Han Yan's name disappeared from the entry. Wonder if it suggests he is going to Senior Worlds or he is injured.
Yes and the others I mentioned could likely contend for the empty podium spot.
And in some ways, idk what to expect. Maybe we are in for a surprise. I love Josh's skating and would be thrilled to see him win, but he just had a stunning Nationals so I wonder if he may have peaked there and whether or not he'll be able to pull out another great pair of skates here. Jason is due for a really good competition, but the 3a is still so new so not sure what to expect. Maybe Hino could pull an upset and win the whole thing? His skating has really grown on me this season, I especially like his SP.
Contenders for a medal. After all, Hino can't win all three
Sorry to hear Keiji Tanaka's injury and withdrawal.. He had such a great moment at this year's Nationals with his passionate Free skate.
Hope Hino gets onto the podium, and he and Uno can make secure three spots for the next season. Best of luck to Ryuju and Shoma!
Seems like Han Yan will be going to the Senior Worlds, after such a great showing at 4CC. Sooo scaring to other senior skaters in London!
I agree actually. If Yan and Kovtun are out, Farris is the favorite to win, but he skated really well at Nationals and may have peaked there, so if he has an off-competition here, my money is on Hino to win. Brown should also be a factor, but Hino already beat Brown once and I do think he could beat a Farris with mistakes.
Hino beat Brown by just 0.6 points at the GPF, and only because Jason popped the axel in the FS. Previously, Brown had beaten Hino at Courchevel. Jason has a 4-point PCS edge over Hino in the SP, and an 8-point PCS edge in the FS.
Just because Josh Farris skated well at Nationals doesn't mean he peaked there. Nationals is a much tougher competition than JW, and Josh had succumbed to nerves at both of his previous Senior Nationals. That he held together this year shows he has learned to compete under pressure. I don't see that as a negative.
All I meant was that if Farris struggles like he did at JGPF and Jason doesn't hit all his 3a attempts, then Hino COULD win with a pair of good skates. He's not a favorite, of course, or well maybe for a medal but not to win, but I could see it happening.
Where'd the bloodbath go? :(
Oh well, Joshua vs Jason Round 35643698374694387, and a chance to add a new 1-2 to their already illustrious collection.
I must say, if Jason hits all of his 3As and Joshua goes clean, I will be verrrrrrrrrry interested to see how their scores compare. Jason's PCS is so good, it might counterbalance the difference in TES with the 4T.
Joshua should easily win this
will be contended by Hino, Brown, Jin
outside shots are Shoma and Alexander
I predict :
1 Farris
2 Hino
3 Boyang
4 Brown
5 Samarin
6 Uno
15-17 Kolyada
Why Kolyada so low?
If Joshua is clean and lands 4t he should win even if Jason is also clean. At JGPF and Nationals they were virtually tied in PCS and that's usually the case with them, one gets maybe a point more than the other, so TES should determine the victory. Josh was so close to Yan last season with no quad attempt because Yan, who did land a quad, only attempted one 3a. So one 4t and one 3a isn't much of a TES bump over two 3a with one in combination. Then there was also Yan's 2-1-1 combo. Josh's current layout has two 3a (one in combo with 3t, the second in the bonus) and the 4t so that's the difference, in Lake Placid where he skated so great and landed the quad, he still didn't quite top his FS score from JW because he doubled his second planned 3a and URed a 3lo - the 2nd 3a in the bonus makes a big difference TES wise.
Anyways, apart from Josh skating perfectly, there's no clear winner here. Does Hino have a quad and will he try it here? He's such a good jumper and has had 3a for a long time, I feel like he can probably do a quad but idk if he tried it at Japanese events yet. Edge calls could play a factor in the outcome here too.
Last edited by silverlake22; 02-22-2013 at 04:55 AM.
Kolyada's only good performance was at junior nationals and that was with higher pcs than Samarin and Petrov which I am sure he will not get internatonally
Joshua has quads with very good pcs , Jin has a chance to win silver or bronze with his quads and ambitious jump layouts while Hino has more consistent triple axel than Jason


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Top Definition
Practical, couragous, outgoing and brillant. Smart and witty. A woman who knows what she wants, how she wants it, and how to get there. She is the true definition of leadership and pose. Mamie (2): Peace maker, creative thinker, and a intellect at heart.
Man, we are lost we need a Mamie to get us home!
автор: diva17
5 февраля 2010
3 more definitions
"You still distance-dating that girl from out west?"
"Nah dude, she was a total mamie. Couldn't stand it anymore."
"Nah dude, she was a total mamie. Couldn't stand it anymore."
автор: SkeezeWheezer
10 октября 2011
derogatory name for any teacher you hate
"jeez that test was hard"
"That teachers name must be mamie"
"That teachers name must be mamie"
автор: InternationalPH
11 февраля 2009


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The girls played with Silly Bandz for Saturdays on end when we went to synagogue services. Some of the older kids had them. They were a marvel, a delight, a wonder. We heard stories about them and we were asked if we could purchase them and I gave the same noncommittal answer I give as policy whenever I'm asked to purchase anything: "Maybe, loves. I'll remember that you want them." (See also: Pillow Pets (unicorn, ladybug and dolphin, conveniently pre-negotiated and specified); the entire Barbie display at Target and pretty much anything they see in the Sunday advertisements if I don't get them in the recycling bin fast enough.)
But then S got Silly Bandz and I knew the end was nigh. The campaigning began in earnest.
That next night I took G for his four-month doctor's appointment while M picked up the girls. We were supposed to meet for dinner but that half of the family was stuck in traffic so G and I perused the shops of the strip mall where dinner was to be eaten and lo and behold, the toy store had a big sign: SILLY BANDZ BACK IN STOCK!!!!!!!!!!!!!!!!!!!! I discovered that for $3.00 I could get 24 glow-in-the-dark bracelets. I decided to be a $6 hero and surprise two hungry girls during the painful interstice between ordering food and eating the first bite of food.
I was, indeed, a hero.
And then in the days that followed their collections multiplied, largely due to my mother's largesse, she who misses her granddaughters very much and also would never be accused of excelling at moderation.
Here is a way that the girls are different: E is a careful worrier, like me, and L is chaos theory personified.
When I was in late elementary or maybe middle school my Aunt Nancy gave me a small stationery set of 16 or 20 notecards. Each card had my name in the bottom corner and a line drawing of a woman. The woman was embellished differently on every card. Each card had a hat and the collar or suggestion of a dress made out of triangles of velvet. On some cards the hats were wide brimmed. On some they were petite pillboxes. Some dresses had plunging necklines and some were boatnecks and some were off-the-shoulder, all perceived so by the angle of the velvety triangles against the same line drawing. Some hats had pluming feathers. Some had jewels made of sequins. Some of the women had earrings of sequins and some had broaches of sequins. On every notecard the velvet was a different color.
I couldn't use them.
They were too beautiful to me to give up. I never wrote a single note on those cards, save the one I used as a thank-you to my aunt, and for that sacrificial task I carefully weighed the aesthetics of each card to determine which I could lose forever with the least pain (brown velvet, gold sequin earrings, and yes I still remember it). The rest I hung on my wall as decoration, just to have and behold.
E collects her Silly Bandz. She arranges them by theme or color or hierarchy of wonderfulness, and then she leaves them on the dresser in her room. She will not wear them. One broke, once (yellow, shaped like french fries) and now she prefers simply to have them.
L likes to take all of the magnets off of the fridge. She will climb by any means necessary to reach even the most implausibly attractive magnets. She plays intricate sorting games with them; sometimes she just practices Crazy-Making with them (it's a real phenomenon); often she'll denude the fridge for the joy of the strip show itself. We'll find stacks of magnets in the family room; tucked into one of her dress-up purses; hiding in the Playdoh box. I'll find them on the floor of my shower where the water will push one off of my foot that I've been walking around unknowingly attached to for hours. We'll find them tucked in our shoes like presents from elves and huddling at the bottom of the basement stairs and in the cup holder of my car.
And now she does the same with Silly Bandz. Yesterday she wore about 30 of them. I also found a small stack on the kitchen table; a pile of yellow and orange ones under the coffee table; all the farm animals in a line in her skirts-and-dresses drawer. They are everywhere, yet another instance of L disassembling the order of the natural world and our lives faster than we can re-assemble the last scattered collection.
Yesterday evening the five of us went to the grocery store after a long, full day together (their school was closed for a teacher training day) and just as I steered the cart toward the much beloved bakery blueberry muffins L yelled out and pointed and almost climbed out of the cart. SILLY BANDZ!! And Harris Teeter, I thought you loved me but I also thought the muffins themselves were the special treat, and you go and stick these bracelets right at child-in-a-cart eye-level in the muffin area?
But I calculate that though it could not possibly be argued any longer that these girls are lacking in these shaped bracelets I can buy a lot of good behavior out of them for lo these many, many more grocery store aisles for the low, low price of, let's see, $2.49 per 12 bracelets that are shaped like motorized vehicles per child. The lovely husband smirks and teases that he just read an interview with the Silly Bandz inventor who said that he wanted to come up with a product that kids would buy $100 of, $4.99 at a time. I don't remind him that the last time he took the girls to the grocery store they each came home with a $5 coloring book with built-in crayons, when we already have a dozen coloring books and a kazallion crayons at home.
Kazallion: it's the biggest number. It's higher than infinity-and-ten. E taught us that.
So this morning G rolled all the way over, grinned, thrust out his fat little fist, scooped up an orange eighteen-wheeler Silly Band from its completely random location in the middle of the carpet, and immediately shoved it into his mouth with a smile.
The last time I had to baby proof, the two-year-old of the house would have rather hide her toys from the baby than have the opportunity to play with them herself. This time, the two-year-old of the house believes that the best way to show belongings some love is to throw them up in the air like parade confetti and smile with pleasant surprise when you find them again three weeks later. In that way, every minute of every day brings a happy reunion.
We're in so much trouble.


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What Is Rabies?
- Flu-like symptoms, such as headache, fever, and fatigue
- Pain, tingling, or itching at the site of the bite wound or other site of viral entry
- An increase in saliva
- Seizures
- Painful spasms and contractions of the throat when swallowing
- Erratic, excited, or bizarre behavior
- Paralysis
Who Should Get Vaccinated and When?
- Preventive vaccination
- Vaccination after exposure
Preventive Vaccination
- Veterinarians and animal handlers
- Rabies laboratory workers
- People who explore caves
- Travelers who may come in contact with rabid animals
Vaccination After Exposure
What Are the Risks Associated With the Rabies Vaccine?
- Soreness, redness, swelling, or itching around the injection site
- Headache
- Nausea
- Abdominal pain
- Muscle aches
- Lightheadedness
- Hives
- Pain in the joints
- Fever
Who Should Not Get Vaccinated?
- Had a life-threatening allergic reaction to a previous dose of rabies vaccine or one of its parts
- Have a weakened immune system from a disease, drug use, or cancer
- Are ill—Wait until you recover to get the preventive vaccine. If you have been exposed to rabies, you should get the vaccine right away.
What Other Ways Can Rabies Be Prevented Besides Vaccination?
- Vaccinate house pets.
- Avoid contact with wild animals.
- Do not touch any wild animal, even if it appears to be dead.
- Seal basement, porch, and attic openings. This will prevent an animal from getting into your home.
- Report animals that act strangely or look sick to animal control authorities.
- Strange behavior (often overly aggressive or vicious)
- Disorientation (such as nocturnal animals such as a bat or fox appearing in the daylight)
What Happens in the Event of an Outbreak?
Centers for Disease Control and Prevention http://www.cdc.gov
Global Alliance for Rabies Control http://www.rabiescontrol.net
World Health Organization http://www.who.int
Malerczyk C, Detora L, et al. Imported human rabies cases in Europe, the United States, and Japan, 1990 to 2010. J Travel Med. 2011;18(6):402-407.
McGettigan JP. Experimental rabies vaccines for humans. Expert Rev Vaccines. 2010;9(10):1177-1186.
Rabies. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated October 13, 2014. Accessed November 3, 2014.
Rabies. US Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/rabies. Updated September 24, 2013. Accessed November 3, 2014.
Rabies VIS. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccines/hcp/vis/vis-statements/rabies.html. Updated June 18, 2013. Accessed November 3, 2014.
3/26/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Use of a reduced (4-dose) vaccine schedule for postexposure prophylaxis to prevent human rabies. MMWR Morb Mortal Wkly Rep. 2010;59(2):1.
Revision Information
- Reviewer: David L. Horn, MD, FACP
- Review Date: 12/2014 -
- Update Date: 12/20/2014 -


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Main Content
Celebrate your Charlotte Bobcats fandom with this 6-pack set of 12" latex balloons! These balloons are great for adding a little Charlotte Bobcats spirit to your office party. They feature Charlotte Bobcats printed graphics and are biodegradable. Your team spirit will reach an all-time high with these balloons around.
- Biodegradable natural rubber latex balloons
- Measures approximately 12"
- Pack of 6
- Officially licensed
- Material: 100% Latex
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or event. These are advanced sale items and will ship immediately after they are
received in our warehouse.
Manufacturer direct items are shipped directly from the manufacturer. These items
are not available for international or expedited shipping.
Customized items can be personalized with options such as your name, your favorite
number, and/or designs. Some options may be limited by league rules.


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Extended applications of standard big band scoring techniques. Analysis of devices found in the compositions of major jazz writers.
In this course, students explore the musical concepts of melody, rhythm, harmony and form as applied to the principles and techniques of writing and arranging for the rhythm section (drums, bass, guitar, keyboards, basic percussion) and a lead-line in a solo instrument, two horns (trumpet, alto or tenor sax) or voice. Students learn about the conceptualization process of combining individual components to create a musically satisfying arrangement. Students also learn various contemporary musical styles and the musical concepts that comprise them, including writing from the bottom up (groove-driven) and top down (working with a melody in a lead instrument or voice). Students will complete writing assignments that incorporate combinations of acoustic, electronic, and/or MIDI instruments.
Functional tonal harmony analyzed and composed in various musical textures. Emphasis on voice leading, melodic writing, and figured bass.
Continuation of CM-211. Advanced tonal harmony and intermediate compositional procedures. Emphasis on harmonies with sevenths, other upper extensions, chromatic alterations as well as modulation.
Specific techniques of traditional tonal composition. Conclusive and nonconclusive phrases; antecedent-consequent phrase relationships; open-ended phrase relationships; sequencing; modulation; large-scale tonal relationships; thematic variation and development. Application of these techniques in writing, using models from the classical period.
During this course the students will explore and master the technique of modulation to the keys both closely related and distant. Using the concepts of three degrees of kinship between keys and the major-minor (minor-major) systems, the students will acquire the skill of gradual modulation as well as sudden modulation, as it was taught in Russia. This practical/theoretical approach will both contrast and complement current methods of handling this more advanced area of harmony, and will thus bring about for the student additional practical applications of these concepts.
The technical aspects involved in creating finished, professional scores. Score layout; instrumental/vocal ranges and performance characteristics; special playing techniques and limitations; breath and bowing considerations; choice of key, meter, beat, and subdivision values; use of slurs, articulation marks, dynamics, tempo variation, and other devices for indicating expressive nuance; proper underlaying of vocal text; calligraphy; creating a practical piano reduction; and extracting parts.
This course introduces students to diatonic harmonic analysis in various musical textures, melody writing, and harmonization of melodies in various musical textures.
This course is a continuation of CM-251. Students explore more in-depth concepts, including advanced traditional harmony and intermediate compositional procedures, as well as seventh chords, altered chords, and modulation.
Specific techniques of traditional 20th-century composition. Technical devices such as quartal harmony, serial writing, polytonality, and contrapuntal techniques. Assignments are directly related to each of these aspects of composition and are performed in class.
The continuation of CM-311 with concentration on the employment of serial approaches to composition. Various composition assignments and a final project are required.
The workshop provides opportunities for student composers to hear performances of their own work, and for student performers to gain public performing experience of original student works and works written within the last 60 years. Important works of the 20th century are explored. It is advisable, but not required, for students to have taken MHIS-261 prior to enrolling in this course. This course can be repeated for credit.


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- Summary: Since it began in 1983, 'Frontline' has been airing public-affairs documentaries that explore a wide scope of the complex human experience. Frontline's goal is to extend the impact of the documentary beyond its initial broadcast by serving as a catalyst for change.
- Genre(s): Talk & Interview, News, Documentary
- Season 11 premiere date: Oct 13, 1992
- Episode Length: 60
- Air Time: 09:00 PM
- More Details and Credits »
Score distribution:
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Negative: 0 out of


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Smoking and Heart Disease Center - Rochester Hills, MIWebMD Physician DirectoryRochester Hills, MichiganSmoking and Heart DiseaseSmoking and Heart Disease IntroductionMost people associate cigarette smoking with breathing problems and lung cancer. But did you know that smoking is also a major cause of heart disease for men and women? About 20% of al... Other Related Smoking and Heart Disease ArticlesEmergency Contact for Rochester Hills
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Top Definition
The "disease" of habitually putting all purchases on a credit card, rather than paying by cash or debit... generally without concern about whether the payments can be made when the invoice arrives.
"It's bad enough that I have a shopping addiction, but I have chronic creditcarditis too!"
Charles P. Whaleyによって