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The seasons change, and we believe, so should your headwear. Whether you are looking for winter hats, spring caps, summer ball cap, or fall fedora or beanies you will find something to love. For skiers and snowboarders during the winter we have snow hats, neoprene ski face mask, beanies, ear muffs, so many ski glove styles and more. Take the outdoor by storm no matter the season. When the weather begins to heat up, stay protected from the sub with hundreds of visors, floppy women's sun hats, baseball caps, protective flap cap, bucket hat and more. With thousands of sun cap styles to choose even hard to find styles like UV50+ material, novelty cowboy hats, and even jackets and t-shirts are for sale. You can quickly and easily shop from thousands of men's, women's and children's hat styles all year round.
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Welcome to TalkBass, the Premier Bass Player Community and Information Source. Register a FREE Account to post and unlock tons of features!
Did you mod your Fender jazz bass?
Discussion in 'Pickups & Electronics [BG]' started by Green Lantern, Dec 25, 2012.
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Originally written on NFL Trade Rumors | Last updated 11/20/14
According to an agent who spoke with Rich Cimini of ESPN New York, the odds of the Jets trading CB Darrelle Revis before the NFL Draft aren't very good. "Not a chance," said the agent. He added that the lack of cap space around the NFL is really the main impediment for a Revis trade. Revis, 27, is believed to be targeting as much as $16 million annually in his contract. That would put him up there with Bills DE Mario Williams as the highest paid defensive player in the league. Revis can void his contract after the 2013 season. Due to a clause in his contract, the Jets will not be able to franchise him next offseason, so idea regarding a trade is related to them securing better than the third-round compensatory pick they would receive if he were to depart via free agency. NFL teams are reluctant to trade high draft picks in situations where they would have to sign a guy to massive contract, so it makes that the Jets would have a hard time trading him given these factors. The post Jets Unlikely To Trade Darrelle Revis Before The Draft appeared first on NFL Trade Rumors -.
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Tottenham boss Andre Villas-Boas has questioned the importance of Chelsea's Champions League triumph.
Tottenham boss AVB faces his former club tomorrow for the first time since they sacked him last season.
Chelsea went on to lift the Champions League trophy under Roberto Di Matteo.
But AVB — who took over at Spurs in the summer — lit the touchpaper for the London derby by insisting that achievement was easier than his 2011 Primera Liga triumph in Portugal, when his Porto side emulated Arsenal's Invincibles.
AVB said: "Winning any league is extremely difficult but going through it unbeaten is also extremely difficult.
"Which is more difficult — winning the Champions League or remaining unbeaten in the league?
"Remaining unbeaten in the league."


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A grand lobby gets even grander
More News from Philippine Daily Inquirer
Fresh from one of its largest makeovers ever, the Waterfront Cebu City Hotel and Casino officially launched its recently renovated grand lobby on July 27.
Guests were treated to cocktails, a delicious spread of pastries by chef Daniel Lejoux, and a fashion show by Cebu's best designers—Philip Rodriguez, Cary Santiago, Protacio Empaces Jr., Edwin Ao, Jun Escario.
But the highlight of the evening was the lobby itself—its sleek, contemporary look and state-of-the-art sound and lights system. A special audio-visual presentation projected on the lobby's wide white walls detailed the re-design.
Even the ribbon-cutting ceremony went digital. After a short toast, Tourism Undersecretary Ma. Theresa Martinez, Cebu Gov. Gwendolyn Garcia, Rep. Rachel "Cutie" del Mar and Mariquita Yeung virtually "cut" the red ribbon, also projected on the walls.
The recent renovation, worth P100 million, is the Waterfront lobby's first in 15 years, says Weslie Gatchalian, Waterfront Philippines Inc. assistant to the president. The tall, potted palm trees are now gone, making the lobby appear even bigger. The installation of LED lights has also brightened up the area.
The front desk/reception area is more spacious, too. WCCHC tapped Rajo Laurel to redesign its staff's uniform.
The whole lobby is a dining area, as well. Wine enthusiasts can find here the Enomatic Elite Wine Dispenser, which serves wine in a full glass, half glass (60 ml), or just for tasting (25 ml). The dispenser holds eight bottles. To gain access, one must acquire a Wine Card from the hotel.
Aside from the lobby, WCCHC will also renovate its convention center, and a lower-level lobby will be built to accommodate large-group check-ins.
"Our mission here is to be the largest integrated casino resort in the Visayas-Mindanao region," says Gatchalian.
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Interspinous spacers are small devices implanted between the vertebral spinous processes. After implantation, the device is opened or expanded to distract (open) the neural foramen and decompress the nerves. Interlaminar spacers are implanted midline between adjacent lamina and spinous processes to provide dynamic stabilization following decompressive surgery.
Interspinous spacers are devices implanted between vertebral spinous processes. Interlaminar spacers are implanted between adjacent lamina and have 2 sets of wings that are placed around the inferior and superior spinous processes. These implants aim to restrict painful motion while otherwise enabling normal motion. The devices (spacers) distract the laminar space and/or spinous processes and restrict extension. This procedure theoretically, enlarges the neural foramen and decompresses the cauda equina in patients with spinal stenosis and neurogenic claudication. Other types of dynamic posterior stabilization devices are pedicle screw/rod-based devices and total facet replacement systems; these are not covered in this policy.
One type of interspinous implant is inserted between the spinous processes through a small (4–8 cm) incision and acts as a spacer between the spinous processes, maintaining the flexion of that spinal interspace. The supraspinous ligament is maintained and assists in holding the implant in place. The surgery does not include any laminotomy, laminectomy, or foraminotomy at the time of insertion, thus reducing the risk of epidural scarring and cerebrospinal fluid leakage. Other interspinous spacers require removal of the interspinous ligament and are secured around the upper and lower spinous processes. Interlaminar implants are inserted between the adjacent lamina and spinous processes following decompressive surgery.
Regulatory Status
In November 2005, the X-STOP® Interspinous Process Decompression (IPD®) System (Kyphon-now part of Medtronic Spine LLC) was approved by the U.S. Food and Drug Administration (FDA) for "treatment of patients aged 50 or older suffering from neurogenic intermittent claudication secondary to a confirmed diagnosis of lumbar spinal stenosis." It is approved for patients with moderately impaired physical function who have had a regimen of at least 6 months of non-operative treatment and who have relief of their pain when in flexion. The device is approved for implantation at 1 or 2 lumbar levels in patients whose condition warrants surgery at no more than 2 levels. The X-STOP PEEK (polyetheretherketone) received approval in 2006 and is a modified version of the X-STOP that includes a PEEK spacer and additional 16-mm spacer size. The indications are the same as for the X-STOP titanium model.
The FDA lists the following contraindications to use of the X-STOP:
The coflex® Interlaminar Technology implant (Paradigm Spine) was approved by the FDA in 2012 (P110008). It is a single-piece U-shaped titanium alloy dynamic stabilization device with pairs of wings that surround the superior and inferior spinous processes. This device was previously called the Interspinous U.
The coflex® is indicated for use in 1- or 2-level lumbar stenosis from L1-L5 in skeletally mature patients with at least moderate impairment in function, who experience relief in flexion from their symptoms of leg/buttocks/groin pain, with or without back pain, and who have undergone at least 6 months of non-operative treatment. The coflex® is intended to be implanted midline between adjacent lamina of 1 or 2 contiguous lumbar motion segments. Interlaminar stabilization is performed after decompression of stenosis at the affected level(s).
The FDA lists the following contraindications to use of the coflex®:
The FDA labeling also contains multiple precautions and the following warnings:
Coflex® Interlaminar Technology should only be used by surgeons who are experienced and have undergone hands-on training in the use of this device. Only surgeons who are familiar with the implant components, instruments, procedure, clinical applications, biomechanics, adverse events, and risks associated with the coflex® Interlaminar Technology should use this device. A lack of adequate experience and/or training may lead to a higher incidence of adverse events. Data has demonstrated that spinous process fractures can occur with coflex® implantation. Potential predictors for spinous process fractures include:
If a spinous process fracture occurs during the surgical procedure, the surgeon should assess if sufficient bone stock exists for coflex® implantation.
Continued FDA approval of the coflex® is contingent on annual reports of 2 post-approval studies to provide longer-term device performance and device performance under general conditions of use. One study will provide 5-year follow-up of the cohort in the pivotal investigational device exemption (IDE) trial. The second will be a multi-center trial with 230 patients with follow-up at 5 years that compares decompression alone versus decompression plus coflex®.
The Wallis System (originally from Abbott Spine; currently from Zimmer Spine) was introduced in Europe in 1986. The first generation Wallis implant was a titanium block; the second generation device is composed of a plastic-like polymer that is inserted between adjacent processes and held in place with a flat cord that is wrapped around the upper and lower spinous processes. The Wallis System is currently being tested in an FDA-regulated clinical trial. Also in a FDA-regulated clinical trial is the DIAM Spinal Stabilization System (Medtronic Sofamor Danek), which is a soft interspinous spacer with a silicone core. The DIAM system requires removal of the interspinous ligament and is secured with laces around the upper and lower spinous processes. Other clinical trials underway at U.S. centers are studying the In-Space (Synthes), Superion® (Vertiflex), and FLEXUS™ (Globus Medical) devices; the comparator in these trials is the X-STOP device.
ExtendSure and CoRoent (both from NuVasive) were launched in Europe in 2005 and 2006. The NL-Prow (Non-Linear Technologies), Aperius (Medtronic Spine), and Falena (Mikai) devices are in trials in Europe.
Each benefit plan, summary plan description or contract defines which services are covered, which services are excluded, and which services are subject to dollar caps or other limitations, conditions or exclusions. Members and their providers have the responsibility for consulting the member's benefit plan, summary plan description or contract to determine if there are any exclusions or other benefit limitations applicable to this service or supply. If there is a discrepancy between a Medical Policy and a member's benefit plan, summary plan description or contract, the benefit plan, summary plan description or contract will govern.
Blue Cross Blue Shield of Montana (BCBSMT) considers interspinous distraction devices (spacers) experimental, investigational and unproven for all indications.
Use of an interlaminar stabilization device following decompressive surgery is considered experimental, investigational and unproven.
This policy was originally created in 2007; this section of the current policy has been substantially revised, and was updated regularly with searches of the MEDLINE database. The most recent literature search was performed through April 4, 2013. The literature on this technology is dominated by reports from non-U.S. centers on devices that have not received FDA approval, though a number of them are in trials at U.S. centers. As of April 2013, only the X-STOP and coflex devices have FDA approval for use in the U.S. Following is a summary of the key literature to date.
Interspinous Distraction Devices
Systematic Reviews
In 2009, Chou and colleagues presented a review of evidence related to surgical treatments for low back pain for the American Pain Society. (1) They concluded, on the basis of the randomized trial data described below, (2) that the evidence was fair quality and that an interspinous spacer device is superior to nonsurgical therapy for 1- or 2-level spinal stenosis with symptoms relieved with forward flexion but that insufficient evidence exists to judge long-term benefits or harms. Of note, the reviewers considered the Zucherman et al. (2) and Anderson et al. (3) reports as 2 separate studies, while this analysis considers the Anderson et al. to be a subset of the Zucherman et al. study. No trial had compared an interspinous spacer device to standard decompressive surgery.
Kabir et al., in a 2010 systematic review, observed that apart from the randomized controlled trial (RCT) performed for FDA approval, other studies with X-STOP were not of high methodologic quality. (4) The authors observed that results at 2 years were analyzed using only the Zurich Claudication Questionnaire (ZCQ), while analysis of 1-year results also included the Short-Form 36 (SF-36). They also noted concerns about the trial raised by the FDA: First, the block randomization employed could potentially be used to select patients more likely to respond to the intervention. Second, outcomes in both groups were worse than expected, suggesting that power calculations were invalid. Third, results from one center were clearly superior to those of other centers. Four-year follow-up included only 18 of the original 100 patients, and Oswestry Disability Index (ODI) scores were reported instead of ZCQ scores. Studies of the other devices (DIAM, coflex, Wallis,) included in the review showed satisfactory outcomes to varying degrees; however, it was stated that "due to small numbers and poor design of studies, it is difficult to clearly define indications for their use in lumbar degenerative disease". The authors concluded that X-STOP may improve outcomes compared to nonoperative treatment in a select group of patients 50 years of age or older with radiologically confirmed lumbar canal stenosis and neurogenic claudication who have improvement of symptoms on flexion; however, they suggest that further good quality trials are required to clearly identify indications for the use of the devices.
Randomized Controlled Trials
Multiple reports have been published from a single prospective randomized trial, conducted for FDA approval that compared the X-STOP device to medical therapy.
This study randomized 191 patients from 9 clinical centers in the U.S. to implantation of the X-STOP device or medical therapy. Inclusion criteria were neurogenic intermittent claudication caused by lumbar spinal stenosis, age at least 50 years or older, and able to walk at least 50 feet. The primary outcome measure was the ZCQ, which consists of a physical function domain, a symptom severity domain, and a patient satisfaction domain. Outcomes were assessed at 6 weeks, 6 months, 1 year and 2 years.
Using the entire study population of 191 patients in this multicenter trial, Zucherman et al. reported an improvement of 45% over the mean baseline Symptom Severity Score in the treated patients at 2 years compared with 7% improvement in the control group, which had medical (nonoperative) therapy including epidural injection. (2) In a separate paper, Anderson and colleagues, reporting on a subset of 75 randomized patients who had spondylolisthesis (out of the total 191 patients with 1- or 2-level lumbar spinal stenosis), found a success rate of 63% in treated patients compared with 13% in controls. (3) Four-year follow-up was reported for 18 of the treated patients in the study. (5) Hsu et al. reported quality-of-life data (SF-36) from the same trial. (6) The patients, who had to meet a number of inclusion/exclusion criteria, were assessed at baseline and at 6 weeks, 6 months, 1 year, and 2 years following the initial treatment. The X-STOP group showed improvements (by single-factor ANOVA or t-test) in both physical and mental component scores compared to both baseline and control subjects. There was a large loss to follow-up (42%) in the medical-treatment group; 6% of the experimental and 26% of the control subjects underwent laminectomy.
A randomized non-inferiority trial of the X-STOP compared to decompressive surgery was published by Bjorn et al. in 2013. (7) One hundred patients with symptomatic one- or two-level lumbar spinal stenosis and neurogenic claudication relieved on flexion were included in the study. Blinding of patients and evaluators was not described. There was a decrease in surgical time (62 vs. 98 minutes) and blood loss (54 vs. 262) with insertion of the X-STOP, although statistical analysis was not reported. Both intention-to-treat analysis and as-treated analysis at 6, 12, and 24 months found no significant differences between the groups on the patient-reported ZCQ, visual analog score (VAS) for leg and back pain, or Short Form (SF)-36. Thirteen patients (26%) in the X-STOP group had additional surgery (typically decompression) compared to 3 patients (6%) in the decompression group, and there was 1 spinous process fracture. The X-STOP patients who later underwent decompression were not considered to be treatment failures.
Preliminary results have been published from a FDA-regulated multicenter randomized IDE non-inferiority trial comparing the Superion interspinous spacer to the X-STOP. (8) Non-blinded results at 6-month follow-up showed similar efficacy for the 2 devices. Twenty percent of patients in the Superion group and 23% of patients in the X-STOP had complications. The FDA-mandated primary endpoint of this trial is noninferiority to X-STOP at 2 years, with additional postmarketing surveillance for 10 years. Over 300 patients are expected to be enrolled. Interpretation of this study is limited by the lack of blinding and lack of control groups treated by surgical decompression or medical management.
Uncontrolled Series
Several large case series of patients implanted with X-STOP devices have been reported.
A series of 175 patients were treated at a German center between February 2003 and June 2007. (9) Mean VAS score was reduced from 61.2 to 39 on a 100-point scale at 6 weeks postoperatively and maintained to the 2-year evaluation. Mean ODI scores were 32.6 (range 8-80, SD: 16.0) preoperatively, 22.7 (range 0-85, SD: 15.6) at 6 weeks postoperatively, and 20.3 (range 0-42, SD: 17.5) at 2 years. No complications were associated with use of the device. Eight patients required removal of the device and microsurgical decompression because of unsatisfactory outcome.
Case series from other institutions have found good outcomes in only about a third of patients treated with the X-STOP. (10-12) For example, one study found that by 12 months, clinically significant improvement in symptoms and physical function was reported by 54% and 33% of the 24 patients, respectively, and 29% of patients required caudal epidural after 12 months for recurrence of symptoms of neurogenic claudication. (11) In another series with 46 patients the overall clinical success rate, defined as an improvement of the ODI by at least 15 points or a satisfaction rating of "very satisfied", was 36%,. (12) A third series of 65 patients found that a good outcome was achieved in 31% of patients. (10)
In a 2010 paper, Rolfe and colleagues evaluated outcomes of a series of 179 patients with and without scoliosis in order to test a contraindication which limits X-STOP use to patients with a maximum scoliosis of 25 degrees. (13) Patients, who received the device between January 2006 and May 2007, were divided into 3 groups: Group 1 without scoliosis (controls, n=116), Group 2 patients with low scoliosis (11-25 degrees, n=41), and group 3 (high scoliosis, n=22). At 1 year, 56% of Group 1 and Group 2 patients, but only 18% of Group 3 patients, achieved improvement of 15 or more points on ODI. Satisfaction rates were 76% for Group 1, 78% for Group 2, and 59% for Group 3. On average, all 3 groups improved for each outcome: Group 1 (ODI: 17.3, VAS: 2.0, standing time 39 minutes, and walking time 43 minutes), Group 2 (ODI: 20.0, VAS: 1.9, standing time 65 minutes, and walking time 64 minutes), Group 3 (ODI: 7.2, VAS: 0.9, standing time 18 minutes, and walking time 16 minutes). The authors conclude that surgeons and patients must be aware that overall lumbar scoliosis greater than 25 degrees may portend less favorable outcomes
Adverse Events
A number of papers focus on complications with the X-STOP device.
Barbagallo et al. analyzed complications in a series of 69 patients and proposed an anatomic scoring system for patient selection. (14) At a mean follow-up of 23 months, 8 complications (11.5%) were recorded: 4 device dislocations and 4 spinous process fractures.
Bowers et al. reviewed records of 13 patients implanted with the X-STOP device at one U.S. center. (15) Nine patients had severe and 4 had moderate stenosis. Average follow-up was 42.9 months (range, 3-48 months). Initially, pain improved an average of 72%; however, preoperative pain returned in 77% of the patients. The overall complication rate was 38%, including 3 spinous process fractures and 2 instances of new onset radiculopathy. Eleven of the 13 patients required additional spinal surgery.
A prospective observational study found a high rate of spinous process fractures in 38 patients (50 implants, 97.4% follow-up) after implantation of the X-STOP titanium (n=34), X-STOP PEEK (n = 8), or Aspen (n=8) devices. (16) Although no fracture was identifiable on plain radiographs, postoperative computed tomography (CT) identified nondisplaced spinous process factures in 11 patients (28.9% of patients, 22% of levels). Direct interview of patients and review of medical records indicated that 5 fractures were associated with mild to moderate lumbar back pain, and 6 fractures were asymptomatic. Three of the 11 patients underwent device removal and laminectomy for persistent pain. Fractures in 3 other patients had healed by 1 year.
Verhoof et al. reported that, in a cohort of 12 consecutive patients with symptomatic lumbar spinal stenosis caused by degenerative spondylolisthesis who were treated with X-STOP and followed up for a mean of 30.3 months, 8 patients had complete relief of symptoms postoperatively while 4 had no relief. (17) Recurrence of pain, neurogenic claudication, and worsening of neurologic symptoms were observed in 3 patients within 24 months. Postoperative radiographs and magnetic resonance imaging (MRI) did not show changes in percentage of slip or spinal dimensions. Seven patients had posterior fusion within 24 months. The authors did not recommend the device for treatment of spinal stenosis complicating degenerative spondylolisthesis.
Interlaminar Stabilization Devices
The pivotal investigational device exemption (IDE) trial for coflex® Interlaminar Technology was a non-blinded randomized multi-center non-inferiority trial of coflex® compared to posterolateral fusion with pedicle screw fixation. (18) A total of 344 patients were randomized in a 2:1 ratio (215 coflex® and 107 fusion controls, with 22 protocol violators). This study was conducted in a restricted population with numerous exclusion criteria. Compared to fusion, implantation of the coflex® device required less operative time (98.0 vs. 153.2 minutes) and resulted in less blood loss (109.7 vs. 348.6 cc) and a shorter hospital stay (1.9 vs. 3.2 days). Composite clinical success (a combination of a minimum 15-point improvement in Oswestry Disability Index (ODI), no reoperations, no device-related complications, and no epidural steroid injections in the lumbar spine) at 24 months achieved non-inferiority compared to posterolateral fusion (66.2% coflex® and 57.7% fusion). Secondary effectiveness criteria, which included the ZCQ, visual analog score (VAS) for leg and back pain, Short Form-12 (SF-12), time to recovery, patient satisfaction, and several radiographic endpoints, tended to favor the coflex® group by Bayesian analysis. (In this analysis, non-overlapping confidence intervals imply statistically reliable group differences.) For example, ZCQ composite success was achieved in 78.3% of coflex® patients (95% confidence interval [CI]: 71.9%, 84.7%) compared to 67.4% of controls (95% CI: 57.5%, 77.3%). The percentage of device-related adverse events was the same for the 2 groups (5.6% coflex® and 5.6% control), and a similar percentage of asymptomatic spinous process fractures were observed. The FDA considered the data in this non-blinded study to support reasonable assurance of safety and effectiveness for device approval, but approval is conditional on 2 additional studies that will provide longer-term follow-up (in the IDE cohort) and evaluate device performance under actual conditions of use (decompression alone vs. decompression with coflex®).
Controlled Cohort Studies
In 2010, Richter et al. reported a prospective case control study of the coflex® device in 60 patients who underwent decompressive surgery. (19) Two-year follow-up from this study was published in 2012/2013. (20) Decompression involved a partial laminotomy, removal of ligamentum flavum, and undercutting facetectomy. The surgeon determined whether the midline structures were preserved or resected and whether the coflex® device was implanted (1 or 2 levels). The indications for the two groups were identical, and use of the device was considered incidental to the surgery. No significant differences were observed between the groups on the ODI, the Roland-Morris disability questionnaire (RMS), VAS for pain, and pain-free walking distance. At 2-year follow-up, there were no significant differences between the 2 groups for any of the outcome measures in this non-randomized controlled cohort study, suggesting that additional placement of the coflex® device does not improve the clinical outcome of decompressive surgery. Randomized controlled trials are needed to determine the efficacy of the coflex® interlaminar implant with greater certainty.
Interspinous and interlaminar implants (spacers) stabilize or distract the adjacent lamina and/or spinous processes and restrict extension in order to reduce pain in patients with lumbar spinal stenosis and neurogenic claudication. Although the randomized device trials report short-term improvements in symptoms and functional status when compared to non-operative therapy, a number of questions remain. Overall, high-quality comparative data are limited. There is a need for longer-term (more than 2 years) outcome data on symptom relief, the need for repeat procedures, and implant survival. Future studies need to better control for potential biases and avoid other methodologic issues, including follow-up of patients in the control group and consistent use of outcome measurements. There are also questions about patient selection criteria; for instance, whether patients with any degree of spondylolisthesis should be excluded from this treatment. In addition, comparisons with decompressive surgery without an interlaminar implant are lacking, and recent case series indicate that outcomes may be less favorable than those reported in the multi-center randomized trial. Because the impact of this technology on net health outcome is not known, these devices are considered experimental, investigational and unproven.
Practice Guidelines and Position Statements
The United Kingdom's National Institute for Health and Clinical Excellence (NICE) published guidance in November 2010 stating that "Current evidence on interspinous distraction procedures for lumbar spinal stenosis causing neurogenic claudication shows that these procedures are efficacious for carefully selected patients in the short and medium term, although failure may occur and further surgery may be needed. The evidence reviewed consisted mainly of reports on X-STOP. (21)
2009 guidelines from the American Pain Society indicate that interspinous spacer devices, based on fair evidence, have a B recommendation (panel recommends that clinicians consider offering the intervention). (1, 22) The net benefit was considered moderate through 2 years, with insufficient evidence to estimate the net benefit for long-term outcomes.
In 2007, the North American Spine Society published new guidelines on the diagnosis and treatment of degenerative lumbar spinal stenosis. (23) They concluded that with a single Level 1 study on the X-STOP, "there remains insufficient evidence to make a recommendation." These guidelines remain current in October 2012.
Disclaimer for coding information on Medical Policies
Procedure and diagnosis codes on Medical Policy documents are included only as a general reference tool for each policy. They may not be all-inclusive.
The presence or absence of procedure, service, supply, device or diagnosis codes in a Medical Policy document has no relevance for determination of benefit coverage for members or reimbursement for providers. Only the written coverage position in a medical policy should be used for such determinations.
Benefit coverage determinations based on written Medical Policy coverage positions must include review of the member's benefit contract or Summary Plan Description (SPD) for defined coverage vs. non-coverage, benefit exclusions, and benefit limitations such as dollar or duration caps.
Experimental, investigational and unproven for all codes.


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France, 16th September 2003 Xbox®
today unveiled its strongest line-up of games yet as it gears up for its second
Christmas in Europe. With more than
100 titles on show at X03, gamers can look forward to games that benefit from
the power that only Xbox can offer.
A strong portfolio of Xbox® Live-enabled titles also proved that
online gaming is getting even more
New games announced at X03 and
coming to Xbox included:
Challenge 2 (Microsoft Game Studios)
RalliSport Challenge 2 is the highly anticipated second instalment in the
critically acclaimed RalliSport Challenge franchise and the first racing title
in the XSN Sports brand. Heading exclusively to Xbox in Spring 2004, RalliSport
Challenge 2 offers gamers many new features, including a new graphics engine,
online play via Xbox Live, the
ability to set up leagues and tournaments using XSNsports.com, new race modes,
and more cars and tracks.
In addition, Microsoft announced a
partnership with Epic Games, developers of the legendary Unreal series of
games. Under the terms of the
partnership, Epic Games will develop a number of exclusive titles for Xbox and
Windows, to be published by Microsoft Game Studios.
titles shown at X03, many for the first time in Europe,
(Namco) --
Breakdown, shown for the first time in Europe before its public unveiling at the
Tokyo Game Show later this month, offers an unique first-person action/adventure
gaming experience by combining unprecedented hand-to-hand combat and traditional
weapons-based action, with an intense story line and incredible graphics in a
thrilling and suspenseful search for the truth. Trapped inside a
mysterious laboratory and unable to remember his past, Derrick Cole discovers
his extraordinary powers as he fights for survival against a determined military
faction and a legion of seemingly invincible super-human
or Alive Online (Tecmo) Tecmo's "Team Ninja" and Xbox will be
teaming up to bring the beloved classics, Dead or Alive 1 and Dead or Alive 2 to
the Xbox video game system in Dead or Alive Online. The new anthology will bring
3D fighting to the masses with full Xbox Live capabilities. It is time to kick
some major $#%^* with gamers from around the world!
Ex: Invisible War (Eidos)
It is fifteen years since the end
of the global conspiracy depicted in Deus Ex - widely regarded as one of the
greatest action games of all time. In the aftermath, a catastrophic depression
has crippled the world and conflicting militant groups seek to enforce their own
violently destructive agendas. As corporate anti-terrorist mercenary Alex D you
must track these factions down and destroy them. Enhancing your skills with
molecular bio-modifications and hi-tech weaponry you seek to restore the world
order. But in the huge, free-roaming world of Deus Ex it seems that the
challenge is to know your real enemies. And for this you must uncover the veil
of secrecy surrounding your own existence. Deus Ex: Invisible War is
console-exclusive to Xbox.
Spectrum Warrior (THQ)
A squad-level, dismounted, Light
Infantry training simulator created for use by the US Army, Full Spectrum
Warrior focuses on critical tactical decision making by the Squad Leader. Coming exclusively to Xbox, Full
Spectrum Warrior emphasises action and fun while the underlying structure of
highly detailed accuracy and authenticity serve to highlight the action and
tactical challenges likely to be faced by the Army in the year
Gaiden (Tecmo)
One of gaming's most treasured franchises is given new life as Tecmo's Team
Ninja and the powers of Xbox join forces to present one of the most anticipated
games of the new millennium. Ninja Gaiden boasts cutting-edge action with
gorgeous pre-rendered environments and visuals as the player takes on the role
of powerful ninja, Ryu Hayabusa. New features include a revolutionary Xbox Live element, swift new moves and
intense action sequences, and amazing visual
Starcraft®: Ghost
(Blizzard Entertainment) - StarCraft: Ghost, Blizzard Entertainments
upcoming tactical-action console game, refines the epic experience of StarCraft
to the level of the individual soldier. Engage the StarCraft universe
face-to-face as a deadly Ghost operative in the employ of the Dominion. With the
help of determined allies, follow story-driven missions that take you from
massive planetary battles through dangerous solo operations to an unexpected
turn of events that leaves the fate of the universe in your
Steel Battalion
Line of Contact (Capcom) The
next evolution in the battle-mech genre, exclusively for Xbox and playable via
Xbox Live, Steel Battalion Line of
Contact is based on the award-winning Steel Battalion phenomenon and gives
players the opportunity to once again use the most elaborate controller
interface ever created to partake in futuristic military warfare. Ultra realistic visual effects and mech
battles in the first or third person perspective create the ultimate mechanized
military combat experience.
Clancys Rainbow Six 3 (Ubi Soft)
Command an elite, multinational squad of special operatives against a hidden
terrorist foe. In Tom Clancys Rainbow Six 3, the third instalment in the wildly
popular Rainbow Six series, Team RAINBOW races against time to stop terror and
unravel a mystery. In locations around the world, from
to the Cayman
to Rio
de Janeiro,
lead Team Rainbow in a desperate effort to battle a madman and foil his doomsday
plot. Only on Xbox, Rainbow Six 3
features streamlined multiplayer via Xbox Live.
Clancys Splinter Cell: Pandora Tomorrow (Ubi Soft)
A follow-up to the phenomenally successful Xbox smash hit of last Christmas, Tom
Clancys Splinter Cell: Pandoras Tomorrow brings back more of the single-player
intrigue that made the original game a best-seller, along with multiplayer
online missions allowing several players to simultaneously share Sam Fisher's
shadowy world of espionage. With exciting new action scenes and a strong
cinematic feel, the player will experience new and even more realistic
A variety of family-friendly titles
aimed at the broadening Xbox audience were on
Stage Unleashed (Konami)
The hit franchise Dance Dance Revolution debuts on the Xbox in an all-new game
with new songs, licensed music and new game modes. Designed especially for the
Xbox, the revolution goes online with Xbox Live support, offering a host of new
downloadable features. With robust options, modes and great music, Dancing Stage
Unleashed for Xbox will be a must-have for any fan of the
by the Ghoulies (Rare/Microsoft Game Studios)
From the team that brought the world the hugely popular Banjo-Kazooie and its
sequel comes a spirited new gameplay experience, crammed to the rafters with new
faces and a bony handful of twists on genre expectation. Grabbed by the Ghoulies is a frenetic
chase through long-standing haunted house tradition, complete with sinister
aristocrats, cobweb-choked rooms and a gentlemanly butler, but also with a few
Rare twists and surprises thrown into the mix. Vast amounts of fun with a
healthily modest dose of seriousness is what Rare's very first Xbox release is
all about.
Potter: Quidditch Cup (Electronic Arts)
Take to the air in the first game that allows players to fully experience the
magical speed, power, and competition of Quidditch, the favorite sport of
witches and wizards, in the Harry Potter: Quidditch World Cup game. Featuring stunning 3D graphics and
special effects, gamers will experience the full complexity and exciting
challenge of Quidditch.
Other highly-anticipated Microsoft
Game Studios games slated to arrive for Christmas and beyond, only on Xbox and
shown at X03 included:
2 (Microsoft Game Studios)
(Big Blue Box/Microsoft Game Studios)
(Microsoft Game Studios)
(Lionhead Studios/Microsoft Game
2 (Bungie/Microsoft Game Studios)
Racing 2 (Microsoft Game Studios)
(Microsoft Game Studios)
Spin (Microsoft Game Studios)
Music Mixer (Microsoft Game Studios)
Finally, major global franchises
were well represented at X03, with Xbox versions of key multi-platform titles
wowing the crowds:
the Vampire Slayer: Chaos Bleeds
2004 (Electronic Arts)
Bond: Everything or Nothing (Electronic
of Honour Rising Sun (Electronic
Heroes (Sega)
Lord of the Rings: Return of the King (Electronic
Hawks Underground (Activision)
Crime: Streets of LA (Activision)
3D (Sega)
is our third year of X0 events and the calibre of games that we show each year
just keeps getting better, said Ed
Fries, vice president of Xbox game content. We know that Xbox is the most powerful
console on the market and the generation of games we see here at X03
demonstrates how this vision has been taken by developers and publishers and
totally embraced.


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- Green Street - http://greenstreet.weei.com -
Kevin Garnett: 'I hear y'all calling me old'
Posted By Ben Rohrbach On March 29, 2012 @ 2:11 am In General | 30 Comments
Perhaps it was the presence of Al Jefferson [1], the kid who he has enjoyed trash talking [2] ever since the Celtics [3] swapped them for each other five years ago. Whatever the reason, Kevin Garnett [4] assumed Yoda's persona.
"His Jedi mind tricks worked tonight," said Celtics guard Keyon Dooling [5] after the Celtics tuned out the Jazz [6].
Wednesday night, Big Al was just another patron at the Mos Eisley Cantina, at least to the masterful Garnett, who considered Jefferson an afterthought in a mind that's clearly had plenty weighing on it this season. Rarely do we get a glimpse into KG's consciousness, so when we do it's best to savor it completely. Here goes.
"I'm motivated, you know? I hear y'all calling me old. I hear y'all calling me older, weathered. It don't take really much to motivate me, man. I'm older in basketball years, but in life I'm 30-something. I'm looking at your gray hair, no hair, half hair, beautiful hair, wet hair. I'm just motivated. I like to use that word.
"The first half wasn't the most pleasurable for us. I thought I could be better, and I've been working towards that. I've been giving myself a true analysis in the mirror, looking at myself, telling myself, 'What can I do better?' And I've been going towards that. I know there are some things I can get better at, and I've been trying to do that.
"It doesn't take much to motivate me, man. I don't watch too many of you guys' interviews — garbage — but the ones I do catch, it's an opinion and it is what it is, but it puts a spark under me, and I like that. Playing against younger talent that's supposed to be prolific and supposed to be above average, but I'm old, though, you know? Like I said, again, for the third time, it doesn't take much to motivate me. That's what it is. That's what you see."
So, Kevin, how motivated were you playing Big Al tonight?
"I wasn't motivated. Next question."
What caused that self-analysis?
"I think whenever you're going through something, you have to be able to look at yourself and give yourself a true perspective and be honest with yourself. My level of expectations will always exceed everybody's in here. Half of y'all have never touched a basketball, therefore played in the NBA, so it's irrelevant at some point.
"I can't ask a teammate to do something and look in himself if I'm not looking in myself. I'm every bit of the word of a true leader — not by the words that come out of my mouth, but by example. That's just me. I've always been built like that. I've always tried to better myself on and off the basketball court, but when it comes to basketball you've got to put in your time, you've got to put in your work and not just talk that talk, but you've got to be able to walk it. So, you know, I'm here. I'm dealing with everything, ailments and all that. I'm here."
For more on how Garnett's soul searching could lead him to grow even older in a Celtics uniform, read this fantastic Paul Flannery piece [7] on KG's metamorphosis into a center.
Article printed from Green Street: http://greenstreet.weei.com
URL to article: http://greenstreet.weei.com/sports/boston/basketball/celtics/2012/03/29/kevin-garnett-i-hear-yall-calling-me-old/
URLs in this post:
[1] Al Jefferson: http://media.weei.com/basketball/al-jefferson.htm
[2] he has enjoyed trash talking: http://www.weei.com/sports/boston/this-just-in/21187791/big-al-thats-just-kevin-being-kevin
[3] Celtics: http://media.weei.com/basketball/boston-celtics.htm
[4] Kevin Garnett: http://media.weei.com/basketball/kevin-garnett.htm
[5] Keyon Dooling: http://media.weei.com/basketball/keyon-dooling.htm
[6] Jazz: http://media.weei.com/basketball/utah-jazz.htm
[7] this fantastic Paul Flannery piece: http://www.weei.com/sports/boston/basketball/celtics/paul-flannery/2012/03/29/kevin-garnett-center-now-and-future
[8] > Kevin Garnett: 'I hear y'all calling me old'" data-url="http://greenstreet.weei.com/sports/boston/basketball/celtics/2012/03/29/kevin-garnett-i-hear-yall-calling-me-old/">Tweet: http://twitter.com/share
[9] : #disqus_thread
Click here to print.
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Confirmatory Factor Analysis of the Work Limitations Questionnaire (WLQ-25) in Workers' Compensation Claimants with Chronic Upper-Limb Disorders
- Kenneth Tang,
- Dorcas E. Beaton,
- Benjamin C. Amick III,
- Sheilah Hogg-Johnson,
- Pierre Côté,
- Patrick Loisel
- … show all 6 hide
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Purpose: To examine the factorial validity of the Work Limitations Questionnaire (WLQ-25) among workers' compensation claimants with chronic upper-limb disorders. Methods: Attendees of the WSIB Shoulder and Elbow Specialty clinic in Toronto, Ontario, Canada, completed a survey that includes the WLQ-25 [4 subscales: time-management (TM), physical demands (PD), mental-interpersonal (MI), and output demands (OD)]. Confirmatory factor analyses (n = 2262) were conducted to evaluate and compare alternative 4- and 5-factor WLQ-25 structures [MI subscale intact vs. separated into mental demands (MD) and interpersonal demands (IP) subscales]. Model fit indices, saliency of factor loadings, and convergent/divergent validity of latent factors (r = 0.4 − 0.85 expected) were concurrently assessed. Results: The 4-factor WLQ-25 showed acceptable model fit after allowing the residuals of a pair of PD items to correlate (CFI = 0.924, TLI = 0.915, RMSEA = 0.057, SRMR = 0.054); however, significantly lower-than-expected correlations between the PD factor and all other factors (r = −0.11 – −0.03) were also observed. Model fit for the 5-factor WLQ-25 was even more optimal (CFI = 0.934, TLI = 0.925, RMSEA = 0.053, SRMR = 0.051), with MD and IP factors correlating at r = 0.83. Conclusions: Evidence of factorial validity was demonstrated by the WLQ-25; however, users should be attentive of an instrumentation issue that could be directly related to the psychometric performance of its PD subscale.
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- Beaton, DE, Wright, JG, Katz, JN (2005) Development of the QuickDASH: comparison of three item-reduction approaches. J Bone Joint Surg Am 87: pp. 1038-1046 CrossRef
- Tang, K, Beaton, DE, Gignac, MA, Bombardier, C (2011) Rasch analysis informed modifications to the work instability scale for rheumatoid arthritis for use in work-related upper limb disorders. J Clin Epidemiol 64: pp. 1242-1251 CrossRef
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- Title
- Confirmatory Factor Analysis of the Work Limitations Questionnaire (WLQ-25) in Workers' Compensation Claimants with Chronic Upper-Limb Disorders
- Journal
Journal of Occupational Rehabilitation
Volume 23, Issue 2 , pp 228-238
- Cover Date
- 2013-06-01
- 10.1007/s10926-012-9397-6
- Print ISSN
- 1053-0487
- Online ISSN
- 1573-3688
- Publisher
- Springer US
- Additional Links
- Topics
- Keywords
- Factor analysis
- Presenteeism
- Psychometric
- Work limitation
- Upper-extremity
- Validity
- Industry Sectors
- Authors
- Kenneth Tang (1) (2) (3)
- Dorcas E. Beaton (1) (2) (3)
- Benjamin C. Amick III (3) (4)
- Sheilah Hogg-Johnson (1) (3) (5)
- Pierre Côté (5) (6)
- Patrick Loisel (5) (7)
- Author Affiliations
- 1. Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- 2. Mobility Program Clinical Research Unit, Li Ka Shing Knowledge Institute of St. Michael's Hospital, 30 Bond Street, Toronto, ON, Canada
- 3. Institute for Work and Health, Toronto, ON, Canada
- 4. Behavioral Sciences, Epidemiology and Occupational Safety and Health, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA
- 5. Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- 6. Division of Health Care and Outcomes Research, Toronto Western Research Institute, University Health Network, Toronto, ON, Canada
- 7. Division of Orthopaedics, University Health Network, Toronto, ON, Canada


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"betrayed by management as they succumbed to the intimidating poisonous culture of the senior flight attendants "
- Comp & Benefits
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I worked at Alaska Airlines full-time (Less than a year)
the young enthusiastic flight crews
severe job instability, poor pay, overworked flight crews, corrupt management
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"Good, working towards great "
- Comp & Benefits
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- Culture & Values
- Career Opportunities
I have been working at Alaska Airlines full-time (More than 10 years)RecommendsPositive OutlookRecommendsPositive Outlook
The employees are great to work with, Opportunities to work in various locations, Focused on the customer, Most leaders willing to make tough decisions for the greater good, The benefits are very good (vacation time and travel especially), Leadership is focused on being a great company and not just settling for being a great airline
Lack of accounability at all levels, Compensation is low for same jobs in other companies and industries, Software and hardware are antiquated and create productivity issues, Many groups still operate in silos and actively stop efforts to work cross-divisionaly
Advice to Management
We have had a great few years, but few of them have had any effort on improving the work environment from the employee's perspective. The focus has been "what should we do" and then determining "how are we going to convince everyone this is the right plan".
Helpful (2)
"Broken systems, no accountability, lack of focus "
- Comp & Benefits
- Senior Management
- Culture & Values
- Career Opportunities
I have been working at Alaska AirlinesDoesn't RecommendNo opinion of CEODoesn't RecommendNo opinion of CEO
Personal time off, flexible schedule, occasional telecommuting
IT systems are old and in constant need of repair. Very limited investment in improving behind-the-scenes operations. As far as project management goes, the budgets are undefined because labor isn't planned or tracked well. Schedules are never met because resources are spread too thin and personnel don't feel compelled to meet a schedule. Scopes are constantly in flux.
Advice to Management
Focus! Implement and enforce use of a labor planning/time keeping tool that is easy to use. Make people accountable.


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World Diabetes Day Campaign Book
A reference guide with tips on on how to celebrate World Diabetes Day - 14 November.
Get inspired! Campaign book GetInspired! The World Diabetes Day Campaign Book 2009-2012, International Diabetes Federation 2 fourth year Following the United Nations Summit on NCDs in 2011, there is an urgent need to continue and strengthen the momentum generated by the event and widen the awareness of the factors responsible for the global diabetes and NCD epidemic and the solution that are required to counter it. It is important to appeal to the hearts of concerned individuals and the general public to achieve these goals. 66 What can you do to mark World Diabetes Day? World Diabetes Day Introduction About World Diabetes Day When does World Diabetes Day take place? World Diabetes Day takes place on 14 November every year. The date was chosen because it marks the birthday of Frederick Banting, who, along with Charles Best, is credited with the discovery of insulin in 1921. While many events take place on or around the day itself, a themed campaign runs throughout the year. How did it all begin? World Diabetes Day was introduced by the International Diabetes Federation (IDF) and the World Health Organization (WHO) in 1991, in response to concern over the escalating incidence of diabetes around the world. Since then, the event has grown in popularity every year. United Nations World Day World Diabetes Day is now an official United Nations World Health Day. On 20 December 2006, the UN General Assembly passed resolution 61/225, which designated the existing World Diabetes Day as an official world day beginning in 2007. This landmark resolution also recognized diabetes as "a chronic, debilitating and costly disease associated with major complications that pose severe risks for families, countries and the entire world." Where does it take place? World Diabetes Day is celebrated worldwide. It brings together millions of people in over 160 countries to raise awareness of diabetes, including children and adults affected by diabetes, healthcare professionals, healthcare decision-makers and the media. Numerous local and national events are organized by the member associations of the International Diabetes Federation and by other diabetes representative organizations, healthcare professionals, healthcare authorities, and individuals who want to make a difference. World Diabetes Day unites the global diabetes community to produce a powerful voice for diabetes awareness. How is it marked? IDF member associations and partners develop an extensive range of activities, tailored to a variety of groups. Activities that are organized every year include: Lighting in blue � the colour of the diabetes circle - of monuments and buildings. Walks and cycle rides Radio and television programmes Sports events Public screenings for diabetes and its complications Introduction Public information meetings Poster and leaflet campaigns Diabetes workshops and exhibitions Press conferences Newspaper and magazine articles Events for children and adolescents the WDD pages group on Flickr. Wear b Wearing a very popular activitywhich allows individuals to or bracelet. pins /or bracelets from the IDF online shop. WDD Flickr group wear in November. W on the World Diabetes Day b Facebook Twitter to the to o Calls to Action and Activities Promote the diabetes symbol Description Promote the blue circle, the global symbol for diabetes, and/or integrate the colour blue (pantone colour 279 or as near as possible) into your local diabetes and WDD promotional materials, activities, and communications. Make the blue circle and/or blue colour a key component of your WDD activities. The circle symbolizes the unity of the diabetes community in response to the diabetes pandemic. You can: Download the World Diabetes Day logo - available in over 60 languages � from www.worlddiabetesday.org. Purchase the blue circle pin from the IDF online shop. Request blue circle stickers from email@example.com. See the Logo Guidelines for information on how the blue circle can be used in promotional materials and activities. Checklist Identify elements where you could include the blue circle. Download the logo in your local language from the WDD website, or translate it if your language is not available. Order pins, stickers, and other promotional items from the IDF online shop. Prepare a short pitch about WDD and the blue circle for people that will be raising awareness of the campaign in your area. How can I promote the blue circle? There are many ways you can promote the WDD logo for World Diabetes Day. It can be incorporated into a variety of promotional elements - banners, t-shirts, balloons - and included in online and print materials such as emails, letterheads, and press releases. The blue circle can also be promoted by local personalities such as professional athletes, who can wear the symbol on their clothing or equipment. Ask a local celebrity to wear the pin or contact your local TV channel and ask them if their newsreaders could wear it. Calls to Action and Activities How can IDF support me? The WDD logo is available in over 60 languages. Visit the WDD website to see if your language is available. If not, dont worry, just send the translation of the text below to the WDD team and we will provide you will the logo in your language. Text to be translated in your local language: World Diabetes Day November 14 Send your request to firstname.lastname@example.com. What IDF Materials can I use? WDD Logo - visit www.worlddiabetesday.org to download the logo in your language. WDD promotional items: pins, flags, candles, stickers, measuring tape. WDD posters and other material. Share your success with others The WDD team is eager to receive examples of how the blue circle is used around the world. All copies received will be included in our WDD archives. Please send examples of any materials featuring the blue circle to: International Diabetes Federation Communications Unit 166 Chauss�e de la Hulpe B-1170 Brussels Belgium Email: email@example.com Resources Resources WDD Logo The World Diabetes Day logo is the blue circle - the global symbol for diabetes - which was developed as part of the Unite for Diabetes awareness campaign. The logo was adopted in 2007 to mark the passage of the United Nations World Diabetes Day Resolution. It is a simple icon that can be easily adapted and widely adopted. The circle symbolizes life and health. The colour blue reflects the sky that unites all nations. Circles occur frequently in nature, and thus have been widely employed since the dawn of humankind. Most significantly for World Diabetes Day, the circle symbolizes unity. The combined strength of the global diabetes community in response to the diabetes pandemic is the key element that makes World Diabetes Day so special. The simplicity of the symbol facilitates its widespread use by anyone who wishes to support the campaign. It is so easy-to-use that a child could draw it with a crayon. By using the World Diabetes Day logo you can help establish the diabetes circle as a global icon for diabetes. The World Diabetes Day logo is available in over 60 languages. Join the campaign The International Diabetes Federation welcomes the widespread use of the World Diabetes Day logo in order to raise awareness of diabetes and establish the blue circle as the global symbol for diabetes. On request, IDF member associations, corporate partners and other individuals and organizations are permitted to use the logo in promotional documents and official publications. Written permission must be obtained from the IDF Executive Office prior to publication. This is applicable for any communications, including press releases, publications, oral presentations, websites, etc. To request permission to use the WDD logo, contact email@example.com. Resources The Blue Circle Test allows individuals to learn about their risk of type 2 diabetes and how to The Blue Circle Test consists of an online Resources /bluecircletest Resources Resources Resources Resources Resources Resources Resources Resources Facts & Figures Facts & Figures ABOUT DIABETES Diabetes is a chronic disease that arises when the pancreas does not produce enough insulin, or when the body cannot effectively use the insulin it produces. Insulin is a hormone made by the pancreas that enables cells to take in glucose from the blood and use it for energy. Failure of insulin production, insulin action or both leads to raised glucose levels in the blood (hyperglycaemia). This is associated with long-term damage to the body and the failure of various organs and tissues. There are two main types of diabetes: Type 1 diabetes is an autoimmune disease characterized by the destruction of the insulin-producing cells in the pancreas. Consequently, people with type 1 diabetes produce very little or no insulin and must take insulin to survive. Type 1 diabetes, which used to be called juvenile-onset diabetes, is most commonly diagnosed in children and young adults. Type 2 diabetes is marked by insulin resistance. People with type 2 diabetes cannot use the insulin that they produce effectively. They can often manage their condition through exercise and diet. However, in many cases oral drugs are needed and often insulin is required. Type 2 diabetes accounts for over 90% of the more than 300 million people living with diabetes worldwide. Both type 1 and type 2 diabetes are serious. A third type of diabetes is Gestational diabetes (GDM), a condition in which women without previously diagnosed diabetes have high blood glucose levels during their pregnancy. GDM affects about 4% of all pregnant women. It has few symptoms and usually disappears when the pregnancy ends. Women who had GDM have a significantly increased risk of developing type 2 diabetes. According to the latest data released by the International Diabetes Federation (IDF), diabetes now affects over 360 million people worldwide. If nothing is done to reverse the epidemic, IDF predicts that by 2030, more than 500 million people will live with the disease. For more information about diabetes, visit www.idf.org . For more information about diabetes prevalence, visit www.diabetesatlas.org. Facts & Figures Facts & Figures Facts & Figures Resources DIABETES EDUCATION AND PREVENTION Diabetes Education Diabetes is difficult. It imposes life-long demands on people with diabetes, requiring them to make multiple decisions related to managing their condition. People with diabetes need to monitor their blood glucose, take medication, exercise regularly and adjust their eating habits. Furthermore, they may have to face issues related to living with the complications of diabetes and may be required to make considerable psychological adjustments. As outcomes are largely based on the decisions they take, it is of paramount importance that people with diabetes receive ongoing, high-quality diabetes education that is tailored to their needs and delivered by skilled health professionals. Without diabetes education, people with diabetes are less prepared to take informed decisions, make behavioural changes, address the psycho-social issues presented by diabetes and, ultimately, may be ill-equipped to manage their diabetes effectively. Poor management will result in reduced health outcomes and an increased likelihood of developing complications. The role of the diabetes educator is of critical importance within the diabetes care team. The educator enables people with diabetes to manage their diabetes-related health to the best of their ability so that choices and actions are based upon informed judgement. Diabetes education is best provided by a multidisciplinary team. While multidisciplinary education is available in some countries, in many others it is not available and its value is not fully recognized by the medical profession. Primary Prevention of Diabetes At present, type 1 diabetes cannot be prevented. The environmental triggers that are thought to generate the process that results in the destruction of the bodys insulin-producing cells are still under investigation. Type 2 diabetes, however, can be prevented in many cases by maintaining a healthy weight and being physically active. The International Diabetes Federation proposes a simple three step plan for the prevention of type 2 diabetes in those at increased risk. IDF recommends that all people at high risk of developing type 2 diabetes be identified through opportunistic and self-screening. People at high risk can be easily identified through a simple questionnaire to assess risk factors such as age, waist circumference, family history, cardiovascular history and gestational history. Resources Once identified, people at high risk of diabetes should have their plasma glucose levels measured by a health professional to detect Impaired Fasting Glucose or Impaired Glucose Tolerance, both of which indicate an increased risk of type 2 diabetes. Prevention efforts should target those at risk in order to delay or avoid the onset of type 2 diabetes. There is substantial evidence that achieving a healthy body weight and moderate physical activity can help prevent the development of type 2 diabetes. In primary prevention there is an important role for the diabetes educator to help people understand the risks and set realistic goals to improve health. IDF recommends a goal of at least 30 minutes of daily exercise, such as brisk walking, swimming, cycling or dancing. Regular walking for at least 30 minutes per day, for example, has been shown to reduce the risk of type 2 diabetes by 35-40%. www.worlddiabetesday.org


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GEORGETOWN, Texas --E-cigarettes are now illegal to use in public places in Georgetown.
The citycouncil considered several factors when passing the ordinance two weeks ago, including how safe the devices really are.
The new rule goes into effect Wednesday. It's an extension of the city's current ban on indoor smoking.
Electronic cigarettes, vaping devices and liquid nicotine are now added to the ban. It is now illegal to use them in places like restaurants, buses, government buildings, art galleries, and hotels.
The debate over their safety is going on worldwide. Some say e-cigarettes can help traditional smokers quit. Others arguethat their flavored liquids, with names like cotton candy and cherry crush, and their blue lightsthey could attract children and act as a gateway to start smoking real cigarettes.
A CDC study found nearly 2 million young people had tried e-cigarettes, so city leaders hope that bans like this will turn that trend around.
The FDA hasn't fully studied e-cigarettes because they are relatively new, but testing of cartridges from two leading brands detected di-ethylene glycol, a toxic chemical used in antifreeze. However, the agency does admit e-cigarettes have far fewer toxins than traditional cigarettes.
The FDA has hinted it will begin to regulate them as soon as this year. So far, the only action the agency has taken was back in 2010, warning distributors to stop making various marketing claims they could not back up.


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Sound Off, Sept. 19
CHEERS to the NEW & IMPROVED GISD Administration! Dr. Largent, good call on Rachel's challenge. Mrs. Goode…we love seeing your smiling face and great attitude at Mambrino School.
Squirrels need to run for president. They intrude on my property; TAKE all of the produce of my pecan trees many times picking while green, gnawing on, and then WASTING loads of them to the ground; then when presented before the public they look furry, cute, and lovable…until next election, I mean pecan season.
My best friend's neighbor has three dogs that bark nonstop. Then she gets mad because they don't want to listen to her dogs. What should she do.
Cheers to Rev Paul at Acton UMC for energizing our church every week.
GMS is the school to be in this year! Thanks Mrs. Yelverton! It's going to be an amazing year!
Cheers to the GISD Curriculum and Technology Department! What an incredible example of servant leadership. Thank you for supporting the students and staff of GISD.
Let's build each other up instead of tearing each other down in Sound Off! We are very fortunate to have wonderful students, athletics, fine arts, teachers, administrators, booster clubs and parent organizations. Follow the Rachel's Challenge pledge … Let's build a community of kindness and caring!
Thanks to LGMC ER for the second time in 2 months for your professional medical attention to my husband.
All those who are blaming the BRA for low lake levels should drive around and see all the miles and miles of canals others have approved over the past few years. Each one lowers the lake level. Seems there's enough blame to go around.
The new Rec Center isn't just for kids to "have a new pool to hold their swim meets." GHS swimmers have to be bused at 4:45 AM to go to Arlington because this town does not have a year round swimming pool. Sure, the Dana Vollmer swim pool at City Park is great for the summer, but what about the rest of the year? The current YMCA is tiny and outdated.
Cheers to the Granbury High School Band! The halftime show is amazing. The show is visually enjoyable and everyone loves the "DARK ANGEL." The student who plays that part is so captivating and very beautiful and we love watching her spread her evil darkness all over the football field. Way to go Band! Keep up the good work.
$2.5 Million Yacht for lake tours? Please take note of what the BRA is doing to our lake. You need to invest in dune buggies and 4-wheelers and give river bank tours. The BRA is standing true to their name and are going to see that they only have a RIVER to be the authority over.
Jeers to the person who side-swiped me on Acton Hwy and ran like a dog in your big suv. If you have any kind of heart you would call the police.
Cheers to the kind person who found my prescription eyeglasses in the grassy aircraft parking area of the Pecan Fly-In. You took the glasses to lost and found and saved me a lot of grief! I wish I could have thanked you in person.
Category: Soundoff Archived


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About Schools in Plevna, KS
Contact a Coldwell Banker® real estate agent to learn more about the schools and school districts in Plevna, KS.FIND AN AGENT
Plevna, Kansas is located in Reno County. Nearby cities and towns include Sylvia, Abbyville, Langdon, Arlington, Partridge, Turon, Stafford, Nickerson, Sterling, Penalosa, Alden, Willowbrook, Preston, South Hutchinson, Pretty Prairie, Hudson, Raymond, Hutchinson, Cunningham, Yoder, St. John, and Kingman. Plevna is a rural community with a population of 101. The median household income is $35,499. In Plevna, 61% of residents are married, and families with children reside in 20% of the households. Half the population of Plevna commutes 27 minutes or less to work, with 60% of residents holding white collar jobs and 40% residents holding blue collar jobs. The median age of homes in Plevna, KS is 59 years, with 72% of those homes owned, 17% rented, and 11% not occupied.
Contact a Coldwell Banker® real estate agent to learn more about the schools and school districts in Plevna, KS.FIND AN AGENT
See if your personality and goals are right for real estate.SEE ALL REAL ESTATE CAREERS
Community information and market data Powered by Onboard Informatics. Copyright ©2015 Onboard Informatics. Information is deemed reliable but not guaranteed.
This information is provided for general informational purposes only and should not be relied on in making any home-buying decisions. School information does not guarantee enrollment. Contact a local real estate professional or the school district(s) for current information on schools. This information is not intended for use in determining a person's eligibility to attend a school or to use or benefit from other city, town or local services.


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STARmeterSEE RANK
Down 22,853 this week
Shay Gorman (1923–1999)
Shay Gorman was born on April 18, 1923 in Dublin, Ireland. He was an actor, known for Angela's Ashes (1999), Island of Terror (1966) and Night Plane to Amsterdam (1955). He died on April 19, 1999 in London, England. See full bio »
Born:in Dublin, Ireland
Died:(age 76) in London, England, UK


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Respond to Review of Stereo
by brit-brit
Review: I just adore stereo, the staff are fab the food's yummy and it's just a great example of Vegan food done well. My friends who aren't vegan also love it and didn't notice it was a vegan menu. It's a cleverly managed place, just like it's sister restaurant's/bar's (mono/the 78 etc.) I think they are all excellent and love visiting them!
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News from WTOP
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Search Result
Search Tags: Jon Stewart
VA-DoD health record saga becomes fodder for comedy show
The promise of a single a joint electronic health record system has long stymied the Departments of Defense and Veterans Affairs. And now it's drawn the attention of late-night comedy show "The Daily Show."
Tags: VA , DoD , EHR , The Daily Show , Health IT , VistA
Time to stop debating
Chris Core, commentator
Tags: Chris Core , Osama bin Laden ,
A D.C. weekend survival guide
Huge rallies, an annual holiday and one of the city's largest and most wide-spread events converge into a perfect storm in the D.C. area this weekend, to say nothing of the usual smattering of fetes and road closings around town.
Tags: Marine Corps Marathon , Rally To Restore Sanity , March To Keep Fear Alive , Stephen Colbert , National Mall , Paul D. Shinkman
D.C. toilet shortage is Keeping Fear Alive
Comedy Central organizers are having a hard time finding port-o-potties for their weekend rallies in a week and a half, after the Marine Corps Marathon organizers snatched up about 800 of them.
Tags: port-o-potties , port-o-potty , porta-potties , Adam Tuss , Paul D. Shinkman , Keep Fear Alive , Rally To Restore Sanity , Comedy Central , March To Keep Fear Alive , Stephen Colbert


text: The Caged Steel! wiki last edited by susurniek on 05/31/15 11:25PM View full history Welcome to Camp Angel, the government's mutant solution. What secrets about the future of the Ultimate Universe does Colossus hold? Storm and the other inmates must decide what action to take when the truth about the government's involvement in the creation of mutants goes public - and their choice could lead to deadly repercussions.


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Wash and score the cucumbers. Slice into thin rounds.
Dice the onion.
Mix the vinegar, agave, salt, pepper and non-dairy milk in a small bowl. Stir it up with the fork or whisk until smooth.
Put the cukes and onion in a big bowl. Drizzle the dressing over the top. Stir, season to taste and you're done.
Cover and place in the fridge for an hour or so to let the flavors mingle.


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2003 SAAB 9-5 • 65,000 miles
Brake lights staying on TCS off light coming on while driving highway, cruise control doesn't engage. Suggestions?
May 22, 2012.
May 22, 2012.
My brake lights went out on my 1985 ford ltd, fuses & bulbs are good. What else can it be? Also a few months back my hazard lights, and dash lights went out too. The fuses are all good...
2 answers • 1985 Ford LTD • 160,000 miles
When I'm parked I can press on my brake pedal and the brake lights come on. When I'm driving, if I don't press hard on my brake pedal, my brake lights don't seem to come on. If I press ...
1 answer • 1998 Plymouth Breeze • 140,000 miles
The brake lights on my 2001 Jeep Grand Cherokee are out completely. Tail lights and headlights work. The brake lights were staying stuck on when my headlights were on, but now the top ...
1 answer • 2001 Jeep Grand Cherokee • 120,000 miles
2002 chev cavalier no lower brake lights uppers work fine. Replaced bulbs, checked fuses OK all other lights work as suppose to.
1 answer • 2002 Chevrolet Cavalier • 178,000 miles