text:
Pulmonary rehabilitation (PR) is a multidisciplinary approach to reducing symptoms and improving quality of life in patients with compromised lung function. The approach can be used in patients with chronic pulmonary disease and as preoperative conditioning before lung surgery.
The American Thoracic Society (ATS) and the European Respiratory Society (ERS) define pulmonary rehabilitation (PR) as "an evidence-based, multidisciplinary, and comprehensive intervention for patients with chronic respiratory diseases who are symptomatic and often have decreased daily life activities. Integrated into the individualized treatment of the patient, pulmonary rehabilitation is designed to reduce symptoms, optimize functional status, increase participation, and reduce health care costs through stabilizing or reversing systemic manifestations of the disease. Comprehensive pulmonary rehabilitation programs include patient assessment, exercise training, and psychosocial support." (1)
Pulmonary rehabilitation programs are intended to improve the patient's functioning and quality of life. The vast majority of study has focused on patients with chronic obstructive pulmonary disease (COPD), although there has been some interest in PR in patients with asthma, cystic fibrosis, or bronchiectasis. According to a joint ATS/ERS (American Thoracic Society/European Respiratory Society) statement issued in 2006, pulmonary rehabilitation may be of value for conditions other than COPD in cases in which respiratory symptoms are associated with diminished functional capacity or reduced health-related quality of life.
Pulmonary rehabilitation is also routinely offered to patients awaiting lung transplantation and lung volume reduction surgery (LVRS). PR before lung surgery may stabilize or improve patients' exercise tolerance, teach patients techniques that will help them recover after the procedure, and allow healthcare providers to identify individuals who might be suboptimal surgical candidates due to non-compliance, poor health, or other reasons.
A pulmonary rehabilitation outpatient program is a comprehensive program that generally includes team assessment, patient training, psychosocial intervention, exercise training, and follow-up. The overall length of the program and the total number of visits for each component may vary from program to program.
Candidates for pulmonary rehabilitation should be medically stable and not limited by another serious or unstable medical condition. Contraindications to pulmonary rehabilitation include severe psychiatric disturbance (e.g., dementia, organic brain syndrome), and significant or unstable medical conditions (e.g., heart failure, acute cor pulmonale, substance abuse, significant liver dysfunction, metastatic cancer, disabling stroke).
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 exclusion 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.
A single course of pulmonary rehabilitation in the outpatient ambulatory care setting may be considered medically necessary for outpatient treatment of chronic pulmonary disease for patients with moderate to severe disease who are experiencing disabling symptoms and significantly diminished quality of life in spite of optimal medical management.
A single course of pulmonary rehabilitation may be considered medically necessary in an outpatient ambulatory care setting as a preoperative conditioning component for those considered appropriate candidates for lung volume reduction surgery or for lung transplantation.
Multiple courses of pulmonary rehabilitation are considered experimental, investigational and unproven:
Home-based pulmonary rehabilitation programs are considered experimental, investigational and unproven.
Policy Guidelines
While there are global HCPCS codes for pulmonary rehabilitation services such as G0237-G2039, G0302-G0305, G0424 and S9473, the component services may be reported separately using CPT codes such as 97110 and 97530, or an unlisted code such as 94799 or 97799 may be reported.
The original policy was based on a Blue Cross Blue Shield Association (BCBSA) Technology Evaluation Center (TEC) Assessment. (2) The policy was updated regularly with searches of the MEDLINE database. Following is a summary of the literature to date.
Initial course of pulmonary rehabilitation programs for patients with chronic pulmonary disease
Patients with Chronic Obstructive Pulmonary Disease (COPD)
There are 2 Cochrane Collaboration systematic reviews of randomized controlled trials (RCTs) on pulmonary rehabilitation (PR) for COPD. Both reviews included inpatient, outpatient, and in-home patients and did not stratify their findings by location of program. Lacasse and colleagues reviewed the literature through July 2005 and identified RCTs comparing rehabilitation programs of at least 4 weeks' duration to usual care for patients with a clinical diagnosis of COPD. (3) The primary outcomes were health-related quality of life (HRQOL) and/or maximal or functional exercise capacity in 4 important domains of quality of life (QOL: dyspnea, fatigue, emotional function, and mastery). The effect of PR was greater than the minimal clinically important difference of 0.5 units. Moreover, there was statistically significant greater improvement in the PR group for 2 of the 3 domains in the St. George's Respiratory Questionnaire (SGRQ). The other Cochrane review, by Puhan and colleagues, searched the literature through March 2010 and included studies on the effect of outpatient or inpatient PR following an acute exacerbation of COPD. (4) To be included, the rehabilitation program needed to begin within 3 weeks of initiating exacerbation treatment and had to include physical exercise. Nine trials with a total of 432 participants met inclusion criteria. Rehabilitation was outpatient in 4 trials, inpatient in 4 trials, and the fifth trial included both in- and out-patient rehabilitation. In a pooled analysis of 5 trials, there was a statistically significant reduction in the primary outcome, rate of hospital admissions, with PR compared to usual care (odds ratio [OR]: 0.22, 95% confidence interval [CI]: 0.08 to 0.58). Secondary outcomes also favored the PR group. For example, there was also a significant reduction in mortality with PR when findings from 3 studies were pooled (OR: 0.28, 95% CI: 0.10 to 0.84). In addition, in a pooled analysis of 6 studies, there was a greater change from baseline in the 6 minute walk distance (6MWD) with PR (mean difference=77.7 meters, 95% CI: 12.1 to 143.2 meters).
A 2010 systematic review by Vieira and colleagues focused on RCTs of home-based PR for patients with COPD. (5) Eligible trials included patients at least 40-years-old; programs could compare home-based PR to rehabilitation in another setting or to standard care but needed to have a minimum duration of 4 weeks or 12 sessions. Studies evaluating home-based PR for maintaining the effects of inpatient or outpatient rehabilitation were excluded. Twelve studies met the inclusion criteria; the comparison intervention in 3 studies was a hospital-based program, in 8 studies was standard care, and 1 study had both types of comparisons. The methodologic quality of the studies was considered to be average to poor, and most had small sample sizes and relatively short follow-up duration. (The largest trial was by Maltais and colleagues and had 252 participants; it is described in a later section of the Rationale). Only 3 of the 8 studies that compared home-based PR to standard care reported data on between-group differences in QOL; in all 3 studies, differences were reported as statistically significant. The 2 studies that reported differences in exercise capacity found home-based PR to result in significantly greater improvement in the 6-minute walk distance (6MWD) or constant work rate test than standard care. On the other hand, in the 3 studies comparing home-based PR and hospital-based programs, there were no statistically significant differences between groups in quality-of-life changes. Moreover, in the 2 studies that assessed maximal work level and the 2 studies that assessed the 6-minute walk test (6MWT), outcomes did not differ significantly after home-based or hospital-based PR programs. The authors commented that the review was limited by the generally low quality of the randomized trials and that most studies had only short-term follow-up.
In 2011, Beauchamp and colleagues conducted a systematic review of trials on pulmonary rehabilitation for COPD, with the aim of determining the optimal duration of rehabilitation programs. (6) Five studies met inclusion criteria which were that studies needed to be randomized and compare different lengths of rehabilitation and that more than 90% of patients in the study needed to be diagnosed with COPD. A pooled analysis of findings was not possible due to heterogeneity of PR program duration and outcome measures. Three of the trials reported a significant difference in quality of life in favor of the longer programs. The length of programs was 18 month versus 3 months in 2 studies and 7 weeks versus 4 weeks in the third study. In the other 2 trials, there was not a statistically significant difference between groups.
A review of a representative sample of randomized trials is provided below. Of interest, PR programs differed, both in the individual components of the program and its duration. For example, the programs ranged in length from 6 weeks to 6 months. In addition, all the randomized studies were conducted outside the United States, and thus conclusions regarding the structure of a PR program may not be applicable to the U.S. healthcare system.
Guell and colleagues reported on the results of a study that randomly assigned 60 patients with COPD to undergo PR or standard care. (7) The specific focus of the study was to examine the long-term effects (24 months) of the PR program. The patients received breathing retraining in the first 3 months followed by exercise training in the next 3 months. The improvement in both symptoms and QOL noted at 3 months after completion of the program continued with somewhat diminished magnitude in the second year of follow-up.
Griffiths and colleagues focused on the use of health services over 1 year in a group of 200 patients with COPD who were randomly assigned to a PR program or standard medical management. (8) The days spent in the hospital were substantially lower in the PR group compared to the control group. The PR group also showed greater improvement in walking ability and disease-specific health status, which declined with time, similar to the Guell et al. study.
Wedzicha and colleagues examined the effects of a PR program in patients with moderately severe and severe COPD who were randomly assigned to receive an 8-week program of PR or standard care. (9) Patients with severe COPD were treated at home. While significant improvement was noted in exercise performance and QOL among those with moderately severe COPD assigned to the PR program, no improvement was found in those with severe COPD.
Maltais and colleagues conducted a non-inferiority trial in Canada with 252 patients with COPD. (10) Eligibility criteria included stable COPD for at least 4 weeks before study participation and no previous participation in PR programs. All patients initially completed a 4-week self-management educational program. They were then randomized to receive 8 weeks of either self-monitored home-based exercise training or outpatient hospital-based exercise training. The exercise program included aerobic and strength exercises conducted 3 times per week. Patients were followed up for 40 weeks after completion of the exercise program. Both interventions produced similar improvements in the Chronic Respiratory Questionnaire dyspnea subscale at 1 year: improvement in dyspnea of 0.62 (95% CI: 0.43 to 0.80) units in the home intervention (n=107) and 0.46 (CI: 0.28 to 0.64) units in the outpatient intervention (n=109). The difference between treatments at 1 year was considered clinically unimportant. The study did not evaluate a comprehensive pulmonary rehabilitation program.
The trial reported by van Wetering and colleagues focused on patients with less advanced COPD. (11) They randomly assigned 199 patients with average moderate airflow obstruction but impaired exercise capacity (peak work load <70% predicted normal) to a 4-month PR program or usual care. At the end of the intervention, the PR group had significantly greater improvement in the SGRQ total score, a mean reduction of 3.9 points in the PR group, and an increase of 0.3 point in the usual care group. At 12 months, the SGRQ score had almost returned to baseline in the PR group; it remained stable in the usual care group. A total of 156 of 199 (79%) participants completed the 24-month follow-up. After 24 months, the total SGRQ score was slightly higher than baseline in the usual care group and lower than baseline in the PR group, a statistically significant 2.6 unit mean difference (p=0.045).
Patients with other chronic respiratory diseases
Patients with chronic lung diseases other than COPD have not been studied as extensively as those with COPD, in large part because the lower prevalence of these disorders. No RCTs evaluating comprehensive PR programs in this population were identified. There are several published case series and comparative observational studies. Case series included a 2006 retrospective study of 422 patients (309 with COPD and 113 with other forms of chronic lung disease) enrolled in a multidisciplinary PR program at a single medical center. (12) Of the non-COPD patients, 27 had asthma and 25 had restrictive disease. This study found similar improvements in the 6-minute walk and the Chronic Respiratory Questionnaire (CRQ) in both groups. In 2010, Kozu and colleagues compared outcomes in 2 cohorts of patients that participated in an identical 8-week outpatient PR program in Japan. (13) This prospective study included 45 patients with idiopathic pulmonary fibrosis (IPF), and these were matched by age and disease severity to 45 COPD patients. A total of 36 of 45 (80%) IPF patients and 40 of 45 (89%) completed the program. At the end of the program, each group experienced statistically significant increases in exercise capacity (distance walked in 6 minutes), improvement in dyspnea (lower dyspnea grade), and an increase in the activities of daily living (ADL) score compared to baseline. The COPD group, but not the IPF group, also had statistically significant increases in health status as measured by the short form-36 (SF-36). Six-month follow-up data were available for 30 of 45 (67%) of IPF patients and 37 of 45 (82%) of COPD patients. Comparing the 2 groups at 6 months, patients in the COPD group had significantly greater exercise capacity, greater improvement in dyspnea, and higher ADL scores compared to the IPF group.
In 2011, Ong and colleagues in Australia retrospectively compared findings in patients with bronchiectasis (n=69) and an age- and gender-matched group of patients with COPD who attended an outpatient PR program. (14) During the 12-month follow-up period, the 2 diagnosis groups did not differ significantly on the primary outcome measures, 6MWD (p=0.20) and score on the Chronic Respiratory Disease Questionnaire (p=0.7). At the 12-month follow-up, the mean between-group difference in the 6MWD was 16.1m (95% CI: -15.0 to 47.1), and the mean between-group difference in the CRQ was -1.3 points (95% CI: -10.1 to 8.3). This study was not designed to evaluate whether or not patients with bronchiectasis benefit from PR programs (e.g., it did not compare PR to usual care).
Conclusions: Multiple RCTs and meta-analyses of RCTs have found improved outcomes (i.e., functional ability and quality of life) in patients with moderate to severe COPD who undergo a comprehensive PR program in the outpatient setting. No published RCTs were identified in patients with chronic respiratory diseases other than COPD.
Repeat and maintenance pulmonary rehabilitation programs for patients with chronic pulmonary disease
Both repeat and maintenance PR programs provide additional rehabilitation services after initial participation in a PR program. Program categories are not strictly defined but repeat programs are generally considered to be those that include patients who failed to respond to an initial program or whose response to an initial rehabilitation program has diminished over time. In contrast, maintenance programs tend to be those designed to maintain the effects of the initial PR program, and they are open to all patients who successfully completed an initial program.
One RCT was identified that evaluated a repeat PR program. Carr and colleagues in Canada prospectively identified patients with moderate to severe COPD who experienced an acute exacerbation within 12 months of participating in a PR program. (15) Initially, patients completed either a 6-week inpatient program or a 12-week outpatient program. The repeat PR program lasted 3 weeks and consisted of exercise and education; patients could choose inpatient or outpatient versions. Over 6 months, a total of 41 patients developed an exacerbation and 12 did not have an exacerbation. Seven patients withdrew from the study, and the remaining 34 were randomly assigned to receive a repeat PR program within 1 month of the exacerbation (n=17) or no repeat PR program (n=17). One patient in the intervention group dropped out; of the remaining 33 patients, 25 (76%) experienced an exacerbation of moderate severity; the remaining 8 had severe exacerbations. Nine of 16 patients (56%) remaining in the intervention group chose an inpatient program and 7 chose an outpatient program. Patients were assessed before the repeat PR program, immediately after the program (3 weeks later), and again 12 weeks after the beginning of the exacerbation (approximately 5 weeks after completing the repeat rehabilitation program). The primary outcome was change in HRQOL as measured by the Chronic Respiratory Questionnaire (CRQ), a validated measure with 4 domains (dyspnea, fatigue, emotional function, and mastery). There was no statistically significant difference between groups in change in CRQ scores. Among patients in the intervention group, the magnitude of improvement in the domains of dyspnea (0.7 +/- 1.5 points) and fatigue (0.5 +/- 1.3 points) met or exceeded the minimum clinically important difference (MCID). In the control group, the magnitude of change in all dimensions did not meet the MCID. Change in the 6MWD, a secondary outcome, was not significantly different between groups at either follow-up time. Outcomes were not reported separately for patients who chose inpatient versus outpatient programs (the policy addresses outpatient programs). The authors recommended that future evaluations of repeat PR programs include patients with more serious exacerbations, last longer than 3 weeks, and start as close in time as possible to the exacerbation. Conclusions about repeat PR programs cannot be drawn from one study with a small sample size.
In 2012, an Ontario Health Technology Assessment was published on pulmonary rehabilitation for patients with COPD. (16) The review identified 3 RCTs (total of 284 participants) evaluating maintenance PR programs for individuals with COPD who successfully completed an initial PR program. The studies excluded patients who had experienced a recent acute exacerbation of COPD. The maintenance programs all consisted of supervised exercise sessions; program duration was 3 months in 1 program and 12 months in the other 2 programs. One program also included an unsupervised exercise component, and 1 included educational sessions. The reviewers judged the quality of the studies as generally poor due to methodologic limitations such as inadequate information on randomization, allocation concealment and blinding and lack of clarity around the use of an intention-to-treat (ITT) analysis. In a pooled analysis of data from 2 of the studies (total n=168), there was a significantly greater 6 minute walk distance in patients who participated in the maintenance program compared to those in a control group (mean difference: 22.9 meters [95% CI: 5.2 to 40.7]). The confidence interval was wide, indicating lack of precision in the pooled estimate. In addition, the review authors considered the minimal clinically important difference in meters walked to be 25-35 meters, and the meta-analysis of study findings did not meet this threshold of difference between groups.
Conclusions: A few small RCTs have been performed that evaluate repeat or maintenance rehabilitation programs. Due to the small number of RCTs, methodologic limitations of available studies, and lack of clinically significant findings, the evidence to determine the effect of repeat and maintenance PR programs on health outcomes in patients with COPD is insufficient.
Preoperative candidates for lung volume reduction or lung transplantation
Pulmonary rehabilitation prior to lung volume reduction surgery (LVRS) represents a distinct subset of patients with COPD, and the National Emphysema Treatment Trial (NETT) requires all candidates to undergo a vigorous course of PR. The final results of the NETT Trial support treatment effectiveness in a subset of patients with COPD. (17)
Several small RCTs have been published evaluating preoperative pulmonary rehabilitation for patients undergoing lung cancer resection. In 2012, Morano and colleagues published a single-blind study that was conducted in Brazil. (18) Patients were randomly assigned to receive 4 weeks of pulmonary rehabilitation (exercise-only, 5 sessions per week) or chest physical therapy; there were 12 patients in each group. All patients in the PR group and 9 of 12 in the chest physical therapy group subsequently underwent surgery (the other 3 patients were found to have inoperable disease). Several postoperative outcomes were assessed. Patients in the PR group spent significantly fewer days in the hospital than patients in the chest physical therapy group (mean of 7.8 vs. 12.2 days, p=0.04). In addition, patients in the PR group spent fewer days with chest tubes than the physical therapy group (mean of 4.5 vs. 7.4 days, p=0.03). There was not a significant difference between groups in the length of hospital stay. The study did not assess longer-term functional outcomes after surgery.
In 2011, Benzo and colleagues published findings of 2 small exploratory RCTs evaluating pulmonary rehabilitation prior to lung cancer resection. (19) Eligibility criteria included having moderate to severe COPD and being scheduled for lung cancer resection either by open thoracotomy or video-assisted thoracoscopy. The first study had poor recruitment and was only able to enroll 9 patients. The second study enrolled 19 patients in either a 10-session pre-operative PR program (n=10) or usual care (n=9). The mean number of days in the hospital was 6.3 (standard deviation [SD]=3.0) in the PR group and 11.0 (SD=6.3) in the control group; p=0.058. A total of 3 patients (33%) in the PR group and 5 patients (63%) in the control group experienced post-operative pulmonary complications; p=0.23. The study likely had too small a sample size to detect statistically and clinically significant differences between groups. The authors recommended that a larger multicenter randomized trial be conducted in this population of patients.
Conclusions: There is a lack of large RCTs comparing PR to no PR for preoperative candidates undergoing LVRS, lung transplantation, or lung cancer resection. However, the National Emphysema Trial (NETT) required PR prior to lung volume reduction surgery: PR is standard of care prior to LVRS and lung transplantation. The few small RCTs published to date on PR prior to lung cancer resection did not find consistent evidence of benefit.
Ongoing Clinical Trials
Pulmonary Rehabilitation in Interstitial Lung Diseases (NCT00882817): (20) This trial is randomizing patients with interstitial lung disease to receive 6 months of pulmonary rehabilitation or usual care. The primary study outcome is change in the six minute walk distance after 6 months. The study is sponsored by Katholieke Universiteit Leuven in Belgium, and the expected sample size is 60 patients.
Effects of Home-based Pulmonary Rehabilitation in Patients With Severe or Very Severe Chronic Obstructive Pulmonary Disease (COPD) (NCT01198288) (21): The study, conducted in Italy, is randomizing patients with COPD to receive standard care only (medication, information about exercise, and monthly check-in calls) or standard care plus 10 in-home supervised pulmonary rehabilitation sessions. The primary outcome is the distance walked test, and secondary outcomes include quality of life, dyspnea, and COPD relapse rate. Estimated enrollment is 182 patients. The study is sponsored by the Associazione Riabilitatori Insufficienza Respiratoria.
The literature supports the conclusion that a comprehensive pulmonary rehabilitation (PR) program in the outpatient ambulatory care setting in patients with moderate to severe chronic respiratory disease is associated with improved symptoms and quality of life. Although there have been many randomized trials, the structure of PR programs is variable, so no further guidance is available regarding the components of an optimal PR program or its duration. There are insufficient data that a comprehensive home-based PR program improves the net health outcome compared to no PR or PR provided in the ambulatory care setting. Thus, a single course of PR may be considered medically necessary in the ambulatory care setting for patients with moderate to severe chronic pulmonary disease who meet criteria and investigational in the home setting. There are insufficient data focusing on programs designed to maintain the benefits of a PR program or evaluate repeat PR programs. Thus, repeat and maintenance PR programs are considered experimental, investigational and unproven.
For patients undergoing lung surgery, findings from the National Emphysema Treatment Trial suggest a subset of COPD patients who are appropriate candidates for PR prior to lung surgery. Therefore a single course of PR in an outpatient setting is considered medically necessary for patients prior to lung resection surgery. For patients undergoing lung transplantation, PR is considered standard of care to maximize preoperative pulmonary status, and PR may be considered medically necessary for these patients.
Practice Guidelines and Position Statements
A 2011 joint guideline on management of COPD was issued from the American College of Physicians (ACP), the American College of Chest Physicians (ACCP), the American Thoracic Society (ATS), and the European Respiratory Society (ERS) (22): The guideline recommends that "clinicians should prescribe pulmonary rehabilitation for symptomatic patients with an [forced expiratory volume] FEV <50% predicted (Grade: strong recommendation, moderate-quality evidence). Clinicians may consider pulmonary rehabilitation for symptomatic or exercise-limited patients with an FEV >50% predicted (Grade: weak recommendation, moderate-quality evidence)."
In 2007, a joint guideline on pulmonary rehabilitation was issued by the American College of Chest Physicians (ACCP) and the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) (3): The panel issued a number of recommendations. Following are the strong recommendations based on strong (1A) or moderate (1B) evidence:
Grade of Recommendation 1A
Grade of Recommendation 1B
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.
93.18, 93.19, 135, 235.7, 277.00-277.01, 277.6, 277.8, 402.10, 415.1, 416.0, 491.20, 491.8, 491.9, 492.0, 492.8, 494.0, 496, 515, 516.3, 710.1, 745.4, 748.61, 770.7


text:
Mon-Fri: 7am-1am EST / Sat-Sun: 7am-11pm EST
ApplianceMaytag Dryer
Level of DifficultyEasy
Time to do repairLess than 15 mins
Age of ApplianceMore than 10 years
0 out of 1 people found this instruction helpful
removed the dial skirt, the little round plastic piece cracked. Popped the top knob off with pliers and popped in the new timer dial skirt.
Help other customers find the most helpful instructions.
Were these instructions helpful?
Part Number: PS2035480
All brand logos are trademarks of their respective owners.
The PartSelect logo is a Registered Trademark of Atlantic Laundry Centres, Ltd.
Copyright © 1999-2015 , Eldis Group Partnership. All rights reserved.

subset: commoncrawl


text:
Today is Friday, May 29, 2015
Please enter your email to personalize your news.
Not a member?
to RISMedia's daily business building updates!
Friday, May 29, 2015
Read Current Issue
Past Issues
Our Team
Easy Email
What is Pop-a-Note?
Pop-a-Note Member Login
Signup Now
Licensed Content
REsource Member Login
About REsource
Signup Now
About Top 5
Becoming a Member
Preferred Partners
Contact Us
RISMedia's Power Broker Forum at the NAR REALTORS® Legislative Meetings & Trade Expo
RISMedia's Power Broker Forum, Reception & Dinner – Annual
RISMedia's CEO Exchange
About Us
Our Team
Contact Us
Expand Your Education with These Courses from
Business Creation - Prospecting: Skills for Sales Success: Part Three.
Customer Relationship Building: Skills for Sales Success: Part Seven.
Accredited Buyer's Representative.
ACE: Purchase Reverse Mortgage Course.
Bundle 1: CIPS Core Courses (Non-US Version).
Finance, Economy & Government Issues Archive
Home Prices Continue Rising, Sales Steady
RE/MAX Releases National Housing Report on 52 Metro Areas ...
Spotlight on Housing Q3: Home Values Strengthening, Affordability Sliding
Strengthening house prices and increased interest rates in metros across the country contributed to lower housing affordability in the third quarter, according to the National Association of Home Builders Housing Opportunity Index (HOI), released recently. ...
Rising Home Prices Push Down Housing Affordability during Third Quarter
Housing affordability fell for the sixth consecutive quarter, after reaching an all-time high in the spring of 2012, as significantly higher home prices shut out more California home buyers during the third quarter of 2013, the CALIFORNIA ASSOCIATION OF REALTORS® (C.A.R.) reported. ...
The Beginning of the Middle Inning: Housing on Strongly Paved Road to Recovery, New Research Shows
Housing is on the way up, according to new research from The Urban Land Institute (ULI) and PwC. The recently released report, Emerging Trends in Real Estate®, focused on the key trending industry outlooks for the year ahead, which the report predicts will be a bright one. ...
Majority of Non-Revolving Credit Held By Federal Government
Recently released data from the Federal Reserve Board indicates that consumer credit outstanding is continuing to expand. According to the release, total consumer credit outstanding increased at a seasonally adjusted rate of 5.4 percent in September. For the quarter overall, consumer credit ...
Investors Are Buying Less, but Might Be Ready to Sell Now
Current market conditions are ripe for home sellers: Prices are up, inventory is tight (but improving) and mortgage rates are still at record lows. But homeowners who are looking to make their next move aren't the only past clients you should talk ...
Builder Confidence in the 55+ Housing Market Continues to Improve in Third Quarter
Builder confidence in the 55+ housing market showed continued improvement in the third quarter of 2013 compared to the same period a year ago, according to the National Association of Home Builders' (NAHB) latest 55+ Housing Market Index (HMI) released recently. All ...
Bay Area Home Sales Slower, Median Prices Lower As Buyers Take A Break
Would-be San Francisco Bay Area homebuyers spooked by fast-rising home prices, a brief uptick in mortgage interest rates and potential fallout from the federal government shutdown took a break from their home search in the third quarter of 2013, spurring a slowdown in home sales that, for the first time ...
Detroit, Santa Barbara and Reno Lead Turnaround
Detroit, Santa Barbara, Calif. and Reno, Nev. markets are currently leading the nation in recovery according to realtor.com®'s third quarter ranking of America's top turnaround markets. ...
September Bay State Foreclosure Activity Remains Slow
Regional Spotlight—Foreclosure activity statewide in Massachusetts declined in September, marking the 16th consecutive month of year-over-year completed foreclosure declines, according to The Warren Group, publisher of Banker & Tradesman. ...
Rates on New Home Loans Still Rising
In September, interest rates on conventional mortgages used to purchase newly built homes increased for the fourth month in a row, according to data released today by the Federal Housing Finance Agency (FHFA). ...
REALTORS® Advocate Housing Finance System Overhaul That Protects Taxpayers and Access to Credit
As lawmakers debate how best to reform the secondary mortgage finance market, they must ensure that any new system retains access to safe, secure and affordable sources of mortgage capital for creditworthy consumers in all market conditions or risk a major disruption ...
Pricier Properties Lead the Recovery
More than 11 percent of homes sold over the past 12 months had a sales price over $500,000, sales growth was highest among homes in above-median-priced categories not entry level starter homes according to a new analysis by an economist at the ...
Pending Home Sales Continue Slide in September
Pending home sales declined for the fourth consecutive month in September, as higher mortgage interest rates and higher home prices curbed buying power, according to the National Association of REALTORS®. ...
Existing-Home Sales Down in September but Prices Rise
After hitting the highest level in nearly four years, existing-home sales declined in September, but limited inventory conditions continued to pressure home prices in much of the country, according to the National Association of REALTORS®. ...
Our Latest News
Tweets by @RISMediaUpdates
Real Estate Hot Topics - Industry
Business Development & Best Practices
Business Outlook
Coaching & Training
Finance, Economy & Government Issues
Luxury Real Estate
Real Estate News
Real Estate Technology
Real Estate Trends
Sales & Marketing Tips
Today's Marketplace
Today's Featured Listing
Today's Homespun Wisdom
Real Estate Hot Topics - Consumer
Consumer News and Advice
Home Buying 101
Homeowner News
Today's Homespun Wisdom
Members and Clients
Preferred Partners
Power Broker Profiles
RREIN Broker Referrals
RREIN Press Releases
RREIN Member Login
RREIN Directory
RISMedia Solutions
Sign Up For Our Newsletter
Media Kit
Products & Services
About Us
Our Team
Online Store
Contact Us
Privacy Policy
RISMedia On the Go
RISMedia Mobile
RSS Feeds
© 2015 RISMedia.
All Rights Reserved


text:
Dark Nights
Lacey had a nice, normal life. She had a few great, supportive friends. Sucked at math and did normal te...
Hmmm....I don't know what to put so I'll start off with my nickname is Moe. I'm an out and proud lesbian.I'm a huge supporter of LGBT everything basically. If you have a story of any variety you want to have read just ask and I'll read and comment honestly if that is what you want. Read, comment, vote, and fan. I like constructive critism because I want to be a better writer in the long run. Oh and I like to play softball. A catcher all the way!
50 reads [x]
100 reads [x]
250 reads [x]
500 reads [x]
1000 reads [x]
1500 reads[x]
2000 reads [x]
2500 reads[x]
3000 reads{x}
3500 reads{x}
4000 reads{x}
4500 reads{x}
5000 reads{x}
10,000 reads {x}
12,000 reads {}
10 votes [x]
25 votes [x]
50 votes [x]
75 votes [x]
100 votes [x]
125 votes [x]
150 votes[x]
200 votes[x]
250 votes{x}
300 votes{x}
25 fans[x]
50 fans[]
FAvorite Songs right now:
Runaway by P!nk
Rihannon-Fleetwood Mac
Go your own way- Fleetwood Mac
Landslide- Fleetwood Mac
My oh my by Tristian Pettyman
Just the Way You Are Boyce Avenue cover
hard Left(it explains my relationship perfectly)
I have another account on here with more LGBT stories. Just PM me if you want to know what my other account is!
Description: Alma has grown up her whole life trapped inside a castle in an ever growing country called, Catera. Her life is to serve her Master but he is no ordinary master and she is no ordinary servant. Alma is a witch that does whatever her master wants. He...
Lacey had a nice, normal life. She had a few great, supportive friends. Sucked at math and did normal te...
Spencer Cade appears to have an average teenage life, He is a great athlete, has an amazing girlfriend...
This user has no recent activity.
Both you and this user will be prevented from:
You will still be able to view each other's stories.
Select Reason:


text:
Antwan Harris / Eyewitness News
Email: firstname.lastname@example.com | Twitter: @antwanharris
NEW ORLEANS -- Every day, thousands of cars pass through the high rise, which peaks at 115 feet.
Now some are calling for more safety on the interstate after a November 2013 crash pushed 29-year-old Danielle Rhone and her 2-year-old nephew over the side to their deaths.
State Rep. Austin Badon, D-New Orleans, said much of the interstate in his district is set to get an upgrade of safety barriers, as the old aluminum barriers aren't enough.
'Years ago when the Louisiana Department of Transportation put these barriers out there, they were never designed to be safety barriers but there for an aesthetic look. Over time they became damaged and you had some people who started stealing them.'
Theft has been one issue that has kept the state from replacing some areas that need upgrades because of the elevated costs.
It's also changed how the scrap industry does business. Lawmakers passed strict rules on the requirements to sell and increased the punishment for those caught selling stolen materials.
'So when thieves are stealing from us, they are stealing the profit right out of our pocket,' said Simone Bruni of Demo Diva.
Bruni said the same thieves stealing guard rails are hitting her demo sites for steel, aluminum and copper, costing her thousands of dollars of profit.
'My profit is tied to completely to scrap metal,' Bruni said. 'In commercial jobs scrap metal is what funds our business.'
The state of Louisiana is set to install more than 20 miles of cable barriers between interstate 510 and the Twin Span as an upgrade to the highway system.
Badon said they have been proven to save lives by stopping cars from going over railings and crossing lanes of oncoming traffic.
His push is for the state to install the barriers across the nearly 900 miles of Louisiana interstates.
'When you drive around and see one damaged, that means a vehicle has been repelled from going to the other side,' Badon said.
The upgrade is being paid for by federal dollars.
The same project was completed along interstate roadways between New Orleans and Baton Rouge in 2012. That project cost $2.7 million, all paid for the Federal Highway Administration.


text:
Search Results for: label/easylunchboxes
My Favorite Back to School Lunch Supplies
By 187 Comments
There might be an amazing giveaway at the end of this post…. so please keep reading!
{post contains affiliate links}
Easy St. Patrick's Day Lunchbox Ideas
Lucky lunches….coming right up!
School and Work Lunchbox Ideas -week 17
By 7 Comments
I've got some work AND school lunches for you this week!
(contains affiliate links)
Fun Halloween Lunch Box Ideas – week 19
By 2 Comments
Last minute spookified lunches!
(Post contains affiliate links)
Easy Lunchbox Ideas for the Family: Week 3
By 2 Comments
Here are some new ideas for you to try next week!
School Lunchbox Ideas
By 1 Comment
Here are some new ideas to fill your lunchboxes!
Easy Lunchbox Ideas for the Family: Week 2
By 3 Comments
Here are some new ideas for you to try this week!
Family Lunch Box Ideas – Week 12
By 4 Comments
A peek into our lunchbox week!
Valentine's Lunchbox Ideas for the Family
By 19 Comments
A little TLC goes a long way.


text:
- Introduction
- Land
- People
- Economy
- Government and society
- Cultural life
- History
- India from the Paleolithic Period to the decline of the Indus civilization
- The development of Indian civilization from c. 1500 bce to c. 1200 ce
- The early Muslim period
- The Mughal Empire, 1526–1761
- Regional states, c. 1700–1850
- India and European expansion, c. 1500–1858
- British imperial power, 1858–1947
- The Republic of India
- Pre-Mughal Indian dynasties
- Prime ministers of India
Demographic trends
A population explosion in India commenced following the great influenza epidemic of 1918–19. In subsequent decades there was a steadily accelerating rate of growth up to the census of 1961, after which the rate leveled off (though it remained high). The total population in 1921 within the present borders of India (i.e., excluding what is now Pakistan and Bangladesh) was 251 million, and in 1947, at the time of independence, it was about 340 million. India's population doubled between 1947 and the 1981 census, and by the 2001 census it had surpassed one billion. The increase between 1991 and 2001 alone—more than 182 million—was greater than the total present-day population of all but the world's most-populous countries, and that value was matched by the increase between 2001 and 2011. Although there has been a considerable drop in the birth rate, a much more rapid decline in the death rate has accounted for the rise in the country's rate of population growth. Moreover, the increasing proportion of females attaining and living through their childbearing years continues to inhibit a marked reduction in the birth rate.
The effect of emigration from or immigration to India on the overall growth of population has been negligible throughout modern history. Within India, however, migration from relatively impoverished regions to areas, especially cities, offering some promise of economic betterment has been largely responsible for the differential growth rates from one state or region to another. In general, the larger a city, the greater its proportion of migrants to the total population and the more cosmopolitan its population mix. In Mumbai, for example, more than half of the population speaks languages other than Marathi, the principal language of the state of Maharashtra. The rates of migration to Indian cities severely tax their capacity to cope with the newcomers' needs for housing, safe drinking water, and sanitary facilities, not to mention amenities. The result is that many migrants live in conditions of appalling squalor in bastis or, even worse, with no permanent shelter at all.
Refugees constitute another class of migrants. Some date from the 1947 partition of India and many others, especially in Assam and West Bengal, from the violent separation in 1971 of Bangladesh from Pakistan. Still others are internal refugees from the communal violence and other forms of ethnic strife that periodically beset many parts of India.
India has one of the largest, most highly diversified economies in the world, but, because of its enormous population, it is—in terms of income and gross national product (GNP) per capita—one of the poorest countries on Earth. Since independence, India has promoted a mixed economic system in which the government, constitutionally defined as "socialist," plays a major role as central planner, regulator, investor, manager, and producer. Starting in 1951, the government based its economic planning on a series of five-year plans influenced by the Soviet model. Initially, the attempt was to boost the domestic savings rate, which more than doubled in the half century following the First Five-Year Plan (1951–55). With the Second Five-Year Plan (1956–61), the focus began to shift to import-substituting industrialization, with an emphasis on capital goods. A broad and diversified industrial base developed. However, with the collapse of the Soviet system in the early 1990s, India adopted a series of free-market reforms that fueled the growth of its middle class, and its highly educated and well-trained workforce made India one of the global centres of the high-technology boom that began in the late 20th century and produced significant annual growth rates. The agricultural sector remains the country's main employer (about half of the workforce), though, with about one-fifth of the gross domestic product (GDP), it is no longer the largest contributor to GDP. Manufacturing remains another solid component of GDP. However, the major growth has been in trade, finance, and other services, which, collectively, are by far the largest component of GDP.
Many of the government's decisions are highly political, especially its attempts to invest equitably among the various states of the union. Despite the government's pervasive economic role, large corporate undertakings dominate many spheres of modern economic activity, while tens of millions of generally small agricultural holdings and petty commercial, service, and craft enterprises account for the great bulk of employment. The range of technology runs the gamut from the most traditional to the most sophisticated.
There are few things that India cannot produce, though much of what it does manufacture would not be economically competitive without the protection offered by tariffs on imported goods, which have remained high despite liberalization. In absolute terms and in relation to GDP, foreign trade traditionally has been low. Despite continued government regulation (which has remained strong in many sectors), trade expanded greatly beginning in the 1990s.
Probably no more than one-fifth of India's vast labour force is employed in the so-called "organized" sector of the economy (e.g., mining, plantation agriculture, factory industry, utilities, and modern transportation, commercial, and service enterprises), but that small fraction generates a disproportionate share of GDP, supports most of the middle- and upper-class population, and generates most of the economic growth. It is the organized sector to which most government regulatory activity applies and in which trade unions, chambers of commerce, professional associations, and other institutions of modern capitalist economies play a significant role. Apart from rank-and-file labourers, the organized sector engages most of India's professionals and virtually all of its vast pool of scientists and technicians.
Agriculture, forestry, and fishing
Roughly half of all Indians still derive their livelihood directly from agriculture. That proportion only relatively recently has been declining from levels that were fairly consistent throughout the 20th century. The area cultivated, however, has risen steadily and has come to encompass considerably more than half of the country's total area, a proportion matched by few other countries in the world. In the more fertile regions, such as the Indo-Gangetic Plain or the deltas of the eastern coast, the proportion of cultivated to total land often exceeds nine-tenths.
Water availability varies greatly with climate. In all but a small part of the country, the supply of water for agriculture is highly seasonal and depends on the often fickle southwest monsoon. As a result, farmers are able to raise only one crop per year in areas that lack irrigation, and the risk of crop failure is fairly high in many locales. The prospects and actual development of irrigation also vary greatly from one part of the country to another. They are particularly favourable on the Indo-Gangetic Plain, in part because of the relatively even flow of the rivers issuing from the Himalayas and in part because of the vast reserves of groundwater in the thousands of feet of alluvial deposits underlying the region. In peninsular India, however, surface-water availability relies on the region's highly seasonal rainfall regime, and, in many areas, hard rock formations make it difficult to sink wells and severely curtail access to the groundwater that is present.
For such a predominantly agricultural country as India, resources of cultivable soil and water are of crucial importance. Although India does possess extensive areas of fertile alluvial soils, especially on the Indo-Gangetic Plain, and other substantial areas of relatively productive soils, such as the black (regur) soils of the Deccan lava plateau, the red-to-yellow lateritic soils that predominate over most of the remainder of the country are low in fertility. Overall, the per capita availability of cultivable area is low, and less than half of the cultivable land is of high quality. Moreover, many areas have lost much of their fertility because of erosion, alkalinization (caused by excessive irrigation without proper drainage), the subsurface formation of impenetrable hardpans, and protracted cultivation without restoring depleted plant nutrients.
Although the average farm size is only about 5 acres (2 hectares) and is declining, that figure masks the markedly skewed distribution of landholdings. More than half of all farms are less than 3 acres (1.2 hectares) in size, while much of the remainder is controlled by a small number of relatively affluent peasants and landlords. Most cultivators own farms that provide little more than a bare subsistence for their families; given fluctuations in the agricultural market and the fickle nature of the annual monsoon, the farm failure rate often has been quite high, particularly among smallholders. Further, nearly one-third of all agricultural households own no land at all and, along with many submarginal landowners, must work for the larger landholders or must supplement their earnings from some subsidiary occupation, often the one traditionally associated with their caste.
Agricultural technology has undergone rapid change in India. Government-sponsored large-scale irrigation canal projects, begun by the British in the mid-19th century, were greatly extended after independence. Emphasis then shifted toward deep wells (called tube wells in India), often privately owned, from which water was raised either by electric or diesel pumps; however, in many places these wells have depleted local groundwater reserves, and efforts have been directed at replenishing aquifers and utilizing rainwater. Tank irrigation, a method by which water is drawn from small reservoirs created along the courses of minor streams, is important in several parts of India, especially the southeast.
The demand for chemical fertilizers also has been steadily increasing, although since the late 1960s the introduction of new, high-yielding hybrid varieties of seeds (HYVs), mainly for wheat and secondarily for rice, has brought about the most dramatic increases in production, especially in Punjab (where their adoption is virtually universal), Haryana, western Uttar Pradesh, and Gujarat. So great has been the success of the so-called Green Revolution that India was able to build up buffer stocks of grain sufficient for the country to weather several years of disastrously bad monsoons with virtually no imports or starvation and even to become, in some years, a modest net food exporter. During the same period, the production of coarse grains and pulses, which were less in demand than rice and wheat, either did not increase significantly or decreased. Hence, the total per capita grain production has been notably less than that suggested by many protagonists of the Green Revolution, and the threat of major food scarcity has not been eliminated.
1Includes 12 members appointed by the president.
2Includes 2 Anglo-Indians appointed by the president.
3The first symbol for the rupee was officially approved in July 2010, and coins and banknotes with the new symbol began being issued in late 2011.
|Official name
|Bharat (Hindi); Republic of India (English)
|Form of government
|multiparty federal republic with two legislative houses (Council of States [2451]; House of the People [5452])
|Head of state
|President: Pranab Mukherjee
|Head of government
|Prime Minister: Narendra Modi
|New Delhi
|Official languages
|Hindi; English
|Official religion
|Monetary unit
|Indian rupee ₹3
|(2014 est.) 1,278,689,000
|Total area (sq mi)
|Total area (sq km)
|Urban-rural population
|Urban: (2012) 30.2%
Rural: (2012) 69.8%
|Life expectancy at birth
|Male: (2011) 63.9 years
Female: (2011) 67.1 years
|Literacy: percentage of population age 15 and over literate
|Male: (2007) 76.9%
Female: (2007) 54.5%
|GNI per capita (U.S.$)
|(2013) 1,570


text:
By Christian Viveros-Fauné
Bridget Everett Whacks Rock Bottom at Joe's Pub
By Miriam Felton-Dansky
The Valley of Astonishment Will Leave You...Astonished
By Tom Sellar
By Tom Sellar
By Jessica Dawson
In September, Site-Specific Theater Rules the Day
By Tom Sellar
How Chuck Jones Defined America Through Cartoons
By R. C. Baker
Between Riverside and Crazy Bares Its Wounds
By Tom Sellar
The story of that flight forms the core of Thomas Laird's Into Tibet, a scrupulously documented account of Cold War intrigue. Mackiernan and his party embarked on a grueling 10-month, 2000-mile hike, from desolate northwestern China, through the Taklamakan Desert, over the inhospitable Kunlun Mountains, and all the way to Lhasavast, forbidding territory where temperatures were extreme, food and water scarce, and death a constant presence. For some, the trek proved fatalbut for reasons political rather than natural.
Laird's reportage is so lavishly devoted to facts, half the book reads like a compendium of news bulletins. However, when he lets go of his "just the facts, ma'am" approach, we get a grippingly good narrative, especially in the account of the torturous passage across the frozen Changthang Plateau, so high up that Mackiernan would stick his hand in boiling water "and it didn't even burn." The book does provide a detailed view into the CIA's shadowy world and the havoc it wreaks on individual lives, as it did on Mackiernan's family. Just as importantly, Into Tibet lays bare the pressures of domestic policies. McCarthyism and the paranoia it inspiredfed partly by the defeated Chiang and his allies in Congressbeclouded what could have been a lucid view of Communist China, Tibet, and, later, Vietnam. Into Tibet demonstrates clearly that while Washington may have the means to gather intelligence, it does not always have the intelligence to use those means well.
Sponsor Content


text:
Countersteering confusion : (
View Single Post
Studly Adventurer
Joined: Aug 2010
Location: Waterford, CT
Oddometer: 539
Originally Posted by
How can you say a coach that understands the principle , but doesn't ride well is a good coach. How can they not ride well knowing the principle. No , most people don't know the principle , they don't need to to turn a bike. If they steer and not countersteer , they're not going ten feet. You want to understand coutersteering? Ride down a moderately curvy road with your left hand on the gas cap the whole time. You'll understand all there is to know about how countersteering works. I'll make it even simpler for the egghead , real life impaired. Lets forget about the word countersteering and just call it steering , because that's what it is on a bike , it's just done differently. You want to save your life? Get something small that you can get sideways and control it sideways . That's what's going to save your life , through avoidance. I have taught people to ride and I've taught people to ride hard and I've taught a couple to be faster than myself. You can't learn control if you don't know what out of control is.
Where did I say "doesn't ride well?" You quoted me, nowhere in my post will you see the words "doesn't ride well." YOU TYPED THEM. It is poor form to discuss ideas with someone, and in the process of attempting to counter a statement they made, counter a statement you make instead.
Journeyman is the word I used. It has two main meanings, the first having only to do with learning a craft, and that can be discounted here. Its second main meaning, which I will quote in a moment from Mirriam-Webster online, is a common cliché in discussing athletic activities. E.g., "Journeyman career as a player helped form Arizona's Whisenhunt as a coach" from an AP article about the NFL Coach.
From Mirriam-Webster online: Journeyman, 1
a worker who has learned a trade and works for another person usually by the day;
an experienced reliable worker, athlete, or performer especially as distinguished from one who is brilliant or colorful
Clearly, in the context of this discussion, I was referring to the second item. How exactly is that the same thing as saying "doesn't ride well?" One can ride quite well enough to have a deep understanding of the process, and still lack the brilliance of a Valentino Rossi or an Eddie Lawson.
Ken Griffey Jr. had a batting coach. Ken Griffey Jr. could hit better than his coach. Picabo Street had a coach. She could ski better than her coach. I could go on and on, but I think you probably get the point. What people look for in coaches is someone who can understand the concepts and help them (the athlete) better understand themselves what they are doing and how to improve it. I would be willing to bet that if you look at some of the great coaches in any field, many of them had journeyman careers themselves. I think you will find that true whether team sports or individual sports.
I am beginning to think that, in spite of what you said earlier, you are only interested in "scoring points" with clever responses to an argument from a different point of view. But you really should at least respond to the argument, and not respond to your own (incorrect) interpretation of what was said.
David B.
View Public Profile
Find More Posts by davidbeinct


text:
Credit Suisse Summer Associate Investment Banking Webinar
Learn about building an exciting future in the financial services industry.
Join Credit Suisse's interactive webinar to learn about the company, Associate roles in Investment Banking and Private Banking, and the application and interview process. Hear from Credit Suisse employees in the departments who also have law school degrees. There will be an opportunity to ask questions.
What: Investment Banking and Private Banking Relationship Manager Information Session
Where: Online Webinar – Register before June 2nd to receive login information
When: June 3, 2015, 5:00 PM Eastern Time
Posted by Morgan Hoey at 11:33 AM - Categories: 1L/1E/2E | Off-campus programs


text:
Hi, I have an extra Vinylmation set of figures from the Shag Haunted Mansion event August 8 which I will pick up the day of the event and mail to the lucky buyer 8-11-09 via priority mail.
Please contact me at [email protected]
if you are interested.
I can send you a picture and more information.
I will be selling them on Ebay if I don't sell to one of you by Sunday, August 3.


text:
Ultrasound Center - Apple Valley, CA
WebMD Physician Directory
Apple Valley, California
While the patient's history and physical examination are the building blocks of making a medical diagnosis, the ability to peer inside the body can be a powerful tool. Ultrasound is an imaging technique that provides that ab...
Other Related Ultrasound Articles
Emergency Contact for Apple Valley
Nearby Apple Valley Hospitals *
St Mary Medical Center
Victor Valley Community Hosp
Desert Valley Hospital
Mountains Community Hospital
Bear Valley Community Hospital
St Bernardine Medical Center
Ballard Rehabilitation Hospital
Patton State Hospital
Barstow Community Hospital
Community Hospital San Brnrdn
Arrowhead Regional Medical Ctr
Jerry L Pettis VA Medical Ctr
Loma Linda University Behaviora
Loma Linda University Med Ctr
Loma Linda University Med East
Fontana Medical Center
Redlands Community Hospital
*Provider Directory Terms of Use:
The WebMD 'Provider Directory' is provided by WebMD for use by the general public as a quick reference of information about Providers. The Provider Directory is not intended as a tool for verifying the credentials, qualifications, or abilities of any Provider contained therein. Inclusion in the Provider Directory does not imply recommendation or endorsement nor does omission in the Provider Directory imply WebMD disapproval.


text:
Hey Grace!!
I saw that you are a Spanish major, so I read a few of your blogs and got really excited when I saw that you are involved in Young Life!!!! If you have time, I would love to ask you some questions about the Spanish department and YL group! :) My name is Rachel, I am a rising senior from Ohio!
Rachel Walters
To receive information, simply create a MyCUBoulder account.
Office of Admissions
University of Colorado Boulder
Regent Administrative Center 125
Boulder, CO 80309-0552
The Clery Act and Campus Security Report
The university's Annual Security Report and Annual Fire Report are available online. These reports contain the university's security policy statements, crime, and fire statistics, as required by the Jeanne Clery Disclosure of Campus Security Policy and Campus Crime Statistics Act (the Clery Act), a federal law requiring institutions of higher education to collect and release this information. The university will provide prospective students a paper copy of these reports upon request. To request a paper copy, please send your request to email@example.com.
Student Consumer Information: Your Right To Know
Visit the Right To Know website for information pertaining to financial aid programs, graduation rates, athletics, and other general information associated with attending CU-Boulder.
University of Colorado Boulder
© Regents of the University of Colorado
Legal & Trademarks • Privacy


text:
News from WTOP
News from the AP
Mike Causey
Shows & Panels
Shows & Panels
- Agency of the Month
- Business of Government Hour
- The CFO Agenda: Delivering value from financial transparency and audit efforts in the public and private sector
- Cloud-Driven Data Insights in Government
- CXO Surveys
- Disaster Resilience for America
- Federal News Countdown
- Government Perspectives on Mobility and the Cloud
- Reducing Risk in the Cloud
- Reimagining the Next Generation of Government
Shows & Panels
- AFCEA Answers
- American Readiness: Renewable Power and Efficiency Technologies
- Ask the CIO
- The Business Case for Cloud Computing in Government
- Cloud-Driven Data Insights in Government
- Connecting the Dots: Digital Authentication in Government
- Cybersecurity Game Changer: Real-Time Event Processing in Government
- Data-Centric Approaches to Government in the Cloud
- Delivering the Digital Government Mission
- Federal Executive Forum
- Federal News Radio's National Cyber Security Awareness Month Special Panel Discussion
- Federal Tech Talk
- The Future of Government Data Centers
- Government Perspectives on Mobility and the Cloud
- Industrialized, Interoperable and Insight-driven Federal Health Panel
- Innovation and Tech Superiority through Acquisition Reform
- Mitigating Insider Threats in Virtual & Cloud Environments
- Moving Agency Applications to the Cloud with PaaS
- Reducing Risk in the Cloud
- Security in the Age of Targeted Attacks
- Air Traffic Management Transformation Report
- The Business of Cloud
- Cloud First Report
- Data Driven Cloud Series
- Disaster Resilience for America
- General Dynamics IT Enterprise Center
- Gov Cloud Minute
- Government in Technology Series
- Homeland Security Cybersecurity Market Report
- The Intersection: Where Technology Meets Transformation
- Modern Mission Critical Series
- National Cybersecurity Awareness Month
- The New IP for Federal IT
- The Social Platform Solution for the Department of Veterans Affairs
- Technology Insights
- The Cyber Security Report
- The Next Generation Cyber Security Experts
Shows & Panels
- Cloud-Driven Data Insights in Government
- Disaster Resilience for America
- F-35 Lightning II Program
- Government Perspectives on Mobility and the Cloud
- On DoD
- Pentagon Solutions
- Reducing Risk in the Cloud
- Reimagining the Next Generation of Government
- Transforming Business Operations at the Defense Department
Sandusky scandal headed for another trial
Wednesday - 7/31/2013, 2:58pm EDT
Associated Press
HARRISBURG, Pa. (AP) -- The Jerry Sandusky scandal appears headed for another court fight that is sure to prolong the media spotlight and relive the testimony of how the former Penn State assistant football coach molested boys, sometimes in the university's athletic facilities.
Penn State's ex-president and two former top school administrators were ordered Tuesday to stand trial on charges accusing them of covering up their failure to tell police about a 2001 allegation that Sandusky molested a boy in a university locker room shower, even after they knew police investigated complaints about Sandusky showering with boys in 1998.
It was, said lead state prosecutor Bruce Beemer, a "conspiracy of silence."
District Judge William Wenner called it "a tragic day for Penn State University" after ruling that prosecutors showed enough evidence during a two-day preliminary hearing to warrant a trial for ex-President Graham Spanier, former vice president Gary Schultz and ex-athletic director Tim Curley.
The key testimony centered on a series of emails among the three defendants that discussed the 1998 and 2001 cases and the testimony of Mike McQueary, a former team assistant and quarterback who said he had immediately told Schultz, Curley and the late longtime football coach Joe Paterno that he had seen Sandusky molesting a boy in the shower in 2001.
Spanier's lawyer, Elizabeth Ainslie, told Wenner that the case against him "amounts to innuendo and far-fetched inference." Meanwhile, Curley's lawyer, Caroline Roberto, took aim at McQueary, saying his testimony included "embellishment" and that every time he testifies he says "something more or different."
Sandusky, a defensive coordinator under Paterno until his retirement in 1999, was convicted last year of 45 counts of child sexual abuse. He maintains his innocence and is appealing a 30- to 60-year prison term.
Anthony Lubrano, a Penn State trustee who watched the two days of testimony, said he had not expected Wenner to throw out the case, given the low level of evidence necessary to send the case to trial. However, he said, "if you get an unbiased jury (at a trial), it'll be hard to get those charges to stick."
Spanier testified to a grand jury that he was unaware of the 1998 investigation while Curley and Schultz testified that McQueary reported only that Sandusky and the boy were engaged in naked, inappropriate horseplay that made him uncomfortable. Once the defendants became aware of an investigation into Sandusky in 2010 or 2011, they did nothing to stop it, obstruct it or hide evidence, their lawyers said.
The three were charged with perjury, obstruction, endangering the welfare of children, failure to properly report suspected abuse and conspiracy. Those charges include allegations of hiding evidence from investigators and lying to the grand jury.
Penn State and the Paterno family declined to comment.
Curley and Schultz were initially charged in November 2011, when Sandusky was arrested, and accused of perjury and failure to properly report the incident.
Spanier was forced out as president at that time. A year later, he was charged with covering up a complaint about Sandusky while additional charges were filed against Curley and Schultz. Spanier remains a faculty member on administrative leave.
Paterno was fired and died in January 2012.
Associated Press writer Genaro C. Armas in State College, Pa., contributed to this report.
Copyright 2013 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.


text:
Opposition accuses BJD of winning ULB polls by use of money power
Little business could be transacted on the second day of the winter session of the State Assembly on Friday as the House witnessed pandemonium resulting in frequent adjournments as both opposition and ruling party legislators resorted to slogan shouting and display of banners and placards against each other.
Trouble began soon after the House condoled the death of former legislator and Member of Parliament Ainthu Sahu (86) who passed away on Thursday.
Legislators of both opposition Congress and ruling Biju Janata Dal rushed to the well of the House with placards in their hands as soon as the question hour began after a few leaders spoke to condole the death of Sahu.
In their placards, the opposition legislators alleged that the ruling Biju Janata Dal had won the recently held urban body polls in western Odisha by use of money power.
They also blamed the State government for the deteriorating law and order situation in the State, and inaction against the authorities of Bhushan Steel Ltd located at Meramundali in Dhenkanal district where three labourers were killed recently and many were injured in a major fire on November 13.
In a well-planned action, the ruling party legislators stood up and displayed banners condemning the Congress led United Progressive Alliance Government at the Centre for not releasing any financial assistance for the relief and restoration of cyclone and flood victims so far.
As a result, the proceedings had to be adjourned thrice and finally till 5 p.m. after repeated disruptions caused by both the opposition and ruling party legislators.
After the House was adjourned first time till 12 noon, the BJD legislators staged a dharna near the statue of Mahatma Gandhi inside the Assembly premises with placards denouncing the alleged Central neglect.
Normalcy could not restored even when the House reassembled at 5 p.m.
The proceedings were adjourned for the day minutes after Finance Minister Prasanna Acharya laid the supplementary budget of Rs. 9,421.25 crore for approval amid uproar by opposition members on various issues.


text:
- Home
- News
- Sports
- Classifieds
- Obituaries
- Special Sections
- Local Guide
- Games
Fridays are pay days for high school football teams. That is what Head Coach Tony Stanford told his squad after the first two-a-day practice Thursday morning at Oak Hill Academy.
It is the beginning of football season. Overcast skies welcomed the opening practices for the Mississippi Association of Independent Schools (MAIS) football teams around the state as preparation got under way for the season.
With its first practices, Stanford and Oak Hill honed in on learning new defensive schemes and the offensive play book. The Raiders also focused on adjusting to Stanford's new rules.
"Every year when you start a new season, you have things you have to take care of. It's kind of like cleaning up the house," Stanford said. "We set regulations for the players to follow for our expectations of them. We want our guys to get those things right, and I know they will."
The Raiders are putting in the hours to earn the victories on Friday nights. Senior returning quarterback Riley Pierce said the team will be in shape for the season, but it needs time to adjust.
"We need to learn the offense. It's a whole new system, and the play calling is different," Riley said. "We are running the spread this year, when we are used to running the wing-t. I think we will get it all together before the first game. Coach Stanford knows what he is doing."
The Raiders return a bulk of last year's starting lineup from a 5-6 season in which Oak Hill made its second consecutive playoff berth – the first time since 1989-90 seasons. Stanford wants the most out of his team on both sides of the ball.
"Trying to learn new things, we had a decent effort today," Stanford said. "I think we can get more effort in coming practices."
To subscribe to the E-edition, please click here.View more articles in:


text:
Cheap RKS to Fort Yukon flights
Popular Flights from Rock Springs, Wyoming
Top Rock Springs Flights to US Destinations
Top Rock Springs International Destinations
Popular Flights from Fort Yukon, Alaska
Top Fort Yukon Flights to US Destinations
Top Fort Yukon International Destinations
RKS to FYU Route Map
Rock Springs to Fort Yukon Flights, Stats and Airplanes
Route information for flights from Sweetwater County to Fort Yukon AK.
2,202.86 miles
RKS - Sweetwater County Airlines
Browse the most popular airlines servicing the Rock Springs (RKS) airport. Visit their flights pages to learn more about the most popular routes these carriers fly.


text:
In a recent post on Linked In, David Vose argues that the advantages of Latin Hypercube sampling (LHS) over Monte Carlo are so minimal that "LHS does not deserve a place in modern simulation software." [1] He makes some interesting points, yet products like Analytica and Crystal Ball still provide LHS and even offer it as their default method. Why? Are we, the makers of these simulation products naïve? As the lead architect of Analytica for two decades, I've explored this question in detail. I've compared the performance of LHS vs. Monte Carlo on hundreds of real-world models. And I've concluded that yes —it does make sense to keep Latin Hypercube as the default method. Let me explain why I disagree with David Vose on some issues and agree with him on others. Several of his complaints are specific to Crystal Ball or @Risk and don't apply to Analytica. Then I'll add some key insights garnered from my own experience. What is Latin Hypercube Sampling? First some background. (Feel … [Read more...]
Latin Hypercube vs. Monte Carlo Sampling
Estimation of Mutual Information
Abstract: This article explores the difficult problem of estimating the mutual information between two variables from a sample of data. I use examples to demonstrate the challenges, and introduce a new algorithm for estimating mutual information along with an explicit representation of its uncertainty. A measure of association is a function that rates the strength of statistical dependence between two variables. In casual talk, people often express this idea by asserting that two things are "correlated"; however, in statistics the term correlated has a more precise meaning, where correlation (or more precisely, Pearson correlation) is a measure of how linear a statistical dependence is. Also in common usage is rank correlation, which measures how monotonic a statistical dependency is. But many dependencies can elude these measures, motivating the use of other measures of association. Another possible measure is mutual information, I(x,y). In Figure 1, the variables have a … [Read more...]


text:
You and your two best pals are like a carton of Neapolitan ice cream. You're perfectly fine on your own, but everything's better when you're together. The frustrating thing is that they both have an annoying knack for giving the perfect gifts. This is the year you surpass even their skills and send them over the moon—plus, you'll end up treating yourself to something in the bargain. This trio of PB&J BFF Necklaces will rock their world and give you all something to wear as a reminder of your special bond.
Set of 3 necklaces (peanut butter, grape jelly, and strawberry jelly toast). Each clay charm comes on a 16" silver-plated chain with barrel clasp.
This product has no reviews yet. Be the first to review this product. Write a review
Enjoy 10% off your first order*


text:
Download English Speaking ebooks, Engl;ish grammar, accent, audio Books, Dictionaries and more
Click To see
wonderful site not for the students but for seniors also.
Please add some hindi and english audio books.
Best of luck.
Enlightening. Good to see all good books at the same place.
All these books are available at MyDeals247.com at low prices. I already got some of them there. you can also try :)
not working any links. admin plsch kReplyDelete


text:
Hilary Clinton Mask
Hillary Clinton Mask
…Democrats and Republicans can agree on is that our Hillary Clinton mask is one of the most popular political masks of the season. With the 2016 election on the horizon, this funny mask is perfect for a Hillary Clinton costume. Pair this mask with the Bill Clinton mask for a great couples costume!
Catitude Mask
Bring your attitude with you when you wear the Catitude Mask. This hilarious and slightly creepy mask features unhappy kitty cat details, including a perma-frown.
Chimp Mask
Why monkey around? When you want to have more fun than a barrel of monkeys on Halloween, this realistic looking Chimp mask is one way to ensure zany hijinks and hilarious antics!
Scarecrow Mask
Keep away the crows and humans alike when you wear this Scarecrow Mask. Terrify the neighborhood in this brown mask with prun-like skin and stitching detail.
Godzilla Mask
Terrorize the city as a giant monster when you wear the officially licensed Godzilla Mask. This 100% vinyl reptilian mask features creepy details of this classic character.
Deadpool Mask
Top off your mercenary costume with the officially licensed Marvel Deadpool Mask. This red and black character mask features see-through white eye holes and it's also breathable.
Camel Mask
Get ready to guide your followers through the desert when you wear the Camel Mask. This awesome animal mask features realistic details.
Fox Mask
You can tell everyone what the fox says when you wear the Fox Mask. This awesome latex mask features a detailed animal design that look so realistic.
Elephant Mask
You surely will never forget Halloween when you wear the Elephant Mask. This awesome, grey mask features elephant hair, trunk and tusks and large ear details.
Pumpkin Mask
Bring your pumpkin costume to life when you top it off with the Pumpkin Mask. This creepy pumpkin mask features stem detail on top with beady yellow eyes and a jagged mouth.
Spider Mask
Go the extra mile with your spider costume on Halloween when you use this Spider Mask to complete the look! Creepy mask features several red eyes and a viscous mouth.
Vampiro Mask
Friends and strangers alike will turn and run when you snarl at them in this Vampiro Mask. Pointed ears and sharp teeth make this mask a character to be afraid of, especially on a dark Halloween night!
Strain Mask
If you're tired of the boring 2 fanged vampire the officially licensed Strain Mask will make you the ultimate vamp this Halloween. Infect everyone around you when you wear this gory and gruesome mask, that looks right out of The Strain. Features creepy wrinkled design, pointed ears, blood splatters…
Gourdee Mask
You'll be one rotten gourd wearing this Gourdee Mask. Your face will consist of mostly fangs so they won't be the ones eating you on Halloween.
Executioner Mask
Prisoners are lined up on death row and it's time for you to perform your duty in this gruesome Executioner Mask. Suit up for the job and man the guillotine dressed in all black.
Weed Mask
You don't need drugs to have a great time on Halloween, but you do need this Weed Mask to create a fun costume. Take the term "pot head" to the next level when you wear this rubber latex disguise.
Hamster Mask
There's something very sinister about a animal that runs on a wheel all day, possibly plotting world domination. Dominate Halloween when you use this Hamster Mask to create or complete your costume.
Tiger Mask
Be an animal on Halloween when you wear this Tiger Mask! Convenient eye and nose holes make this an easy and comfortable part of your Tiger Costume.
Visitor Mask
Take me to your leader. Lead the way to an out of this world Halloween when you don the Visitor mask - it moves when you do so you can be animated and act up all you want.
Meateater Mask
Feast on those little trick-or-treaters this Halloween as a morbidly obese cannibal in this Meateater Mask. This realistic latex mask covered in fake blood comes equipped with grotesquely misaligned, razor sharp teeth. Who wants salads, when you can dig your fangs into some fresh meat?
Pappy Mask
Add a couple decades to your appearance when you wear the Pappy Mask. This latex mask features attached white hair and creepy face details.
Unicorn Mask
You'll surely have a magical time when you finish off your costume with this Unicorn Mask. Bring a mythical creature to life on Halloween!
Skull Mask
Create a spooky character costume with this black and white and scary Skull mask.
Kennedy Mask
Ask not what your country can do for you -ask what you can do for your country. John F. Kennedy immortalized these words. Repeat them and salute the legend with this realistic Kennedy mask. Great couples costume idea - pair with Jacqueline or Marilyn!


text:
Brothers plead guilty to torching three synagogues
Associated Press
SACRAMENTO -- Two white-supremacist brothers pleaded guilty Friday to federal charges of setting fire to three Sacramento-area synagogues and an abortion clinic in 1999.
Benjamin Matthew Williams, 33, faces 30 years in prison and James Tyler Williams, 31, faces 19 to 21 1/2 years under plea agreements. Sentencing is set for Nov. 30.
The brothers still face state murder charges and possible death penalties in the slayings of a gay couple in Shasta County on July 1, 1999. The Redding-area residents have pleaded innocent and face an April jury trial.
A July 7, 1999, search of the brothers' home in connection with the slayings of Gary Matson, 50, and Winfield Mowder, 40, of rural Happy Valley, turned up evidence linking them to the arsons.
"The main event, the murder trial, is yet to come," Brian Matson, Gary Matson's brother, said after Friday's hearing. "These arsons were just part of a single, hate-inspired spree of terrorism for which they must pay with their lives."
Though no one was injured in the fires, set June 18, 1999, the arsons caused more than $3 million in damage to the Congregation B'nai Israel and Kenesset Israel Torah Center, both in Sacramento, and the Congregation Beth Shalom in Carmichael. The pair also pleaded guilty to setting fire to Country Club Medical Center, which houses the Choice Medical Group abortion clinic, on July 2.
The arsons triggered a state law Gov. Gray Davis signed this week prohibiting insurers from canceling the policies of organizations that file claims for damages stemming from hate crimes.
About 15 representatives from the synagogues and abortion clinic attended Friday's appearance in Sacramento federal court. Matson's former wife and Mowder's cousin also attended.
"This is an emotional time for us and we are so excited to say the wounds which were inflicted, which ran so deep, are beginning to be healed," said Lou Anapolsky, president of B'nai Israel.
"We are grateful that these haters will spend much of their lives behind bars," added Candice Fields, president of the Jewish Community Relations Council of Sacramento.
The brothers had been charged with 13 counts of arson, conspiracy to commit arson, destruction of religious property and the use of fire to commit a felony. They faced a maximum penalty of 235 years in prison.
Assistant U.S. Attorney Steve Lapham said the potential sentences were "very appropriate to that crime." Benjamin Williams faces a longer sentence, Lapham said, because he planned and organized the arsons.
James Williams told U.S. District Judge Garland E. Burrell he pleaded guilty in part because his brother also decided to accept the sentencing offer.
Benjamin Williams pleaded guilty to four counts of arson of a building in interstate commerce, which included one charge on the abortion clinic arson. He also pleaded to four counts of using fire to commit another felony.
His brother pleaded guilty to two counts of arson for the B'nai Israel and Beth Shalom fires.
Classified as hate crimes for using fire to destroy religious property, the arsons mean Benjamin Williams will receive a mandatory 30-year sentence.


text:
Remember when Tiger Woods was known more for his amazing tee shots than for his amazing menagerie of hos? The new Golf Ball Launcher lets you drive the golf ball 300 yards from the tee without the hassle of those annoying golf clubs. Or talent.
The Golf Ball Launcher is powered by an air compressor and does precisely what you want it to – shoot a golf ball a long, long way.
While the Golf Ball Launcher will give you amazing tee shots, once you hit the green the putting is still up to you.
The device is not yet available and is probably illegal on most golf courses. When it does hit the market, expect to shell out around $800.
[via Oh Gizmo]
Related posts:


text:
In the Iliad, there is no natural death--
everything comes about by intent
as if the pulse and very breath
we take were something meant
Evening succeeds evening.
Demons discourse
on familiar topics.
Not spent those bloodshot friendships those
soul-marriages sealed and torn
those smiles of pain
I told her a mouthful
Four previously unpublished poets are honored as winners of Discovery/The Nation 07, the annual Joan Leiman Jacobson Poetry Prize of The Unterberg Poetry Center.
Communism, Catholicism and radical Modernism meet on the dissecting table of César Vallejo's poetry.
Tidewater, Oregon
The tractor has left rows in the grass,
somewhat like rows of cut cane. Louisiana,
I take you everywhere.
The field itself is a giant row
between aisles of fir and alder,
a chute running west to east,
as I will run west to east,
not like the hurrying of the sun--
beginning and end being one and all that.
Some might call this loafing.
It is such a pleasure at this point
not to care what the locals
in their trucks, the loggers,
and the UPS man might think
if they saw me from the road.
A field with no boundaries,
an expanse of tideland
is more honest really
my back sinking in the mud,
high tide covering my joy.
A poem in tribute to the passing of James Brown.
It's hard to know whether today or yesterday was the full moon;
excitement isn't rigorous. It's just river-silvering


text:
Want to learn all about digital filmmaking using a video-enabled DSLR camera? Want to create a killer app for iPhones and Android smartphones? Looking to sharpen your Photoshop and web design skills? A cool new website called creativeLIVE.com is the place where all of these classes are happening, and you're invited to join every course for free! Check out this post to find out how you can register for Vincent Laforet's upcoming Introduction to HDDSLR Cinema course...
Recently, our very own David Brommer chatted with famous photographer and cinematographer Vincent Laforet. They discussed filmmaking, creativity, technology, his photographic upbringing, and his new book, Visual Stories.
Get into the mind of the master himself. Check out the video after the jump.
US Dollar
Prices, specifications, and images are subject to change without notice. Not responsible for typographical or illustrative errors. Manufacturer rebates, terms, conditions, and expiration dates are subject to manufacturers printed forms NYC DCA Lic.: Elec. Store #0906712 Elec. & Home App. Serv. Deal. #0907905; Sec. Hd. Deal. Gen. #0907906


text:
Staff Reporter
Bangalore: Neeraja Kuliyappa (27) suffered from severe diabetes for two-and-a half years before it was decided that her father Ramachandra Kuliyappa (62) would donate a part of his pancreas and one of his kidneys so that she would be relieved of her discomfort.
This simultaneous pancreas and kidney transplant from a live donor in India was performed by kidney specialist Hasith Mehta and transplant surgeon Shantanu Bhattacharya from Narayana Hrudayalaya Institute of Cardiac Sciences.
One month after the operation, the father and daughter were brought to be part of Narayana Hrudayalaya's press meet about pancreatic transplant as a solution to diabetes.
The transplant took close to 10 hours.
"The operation was performed by six surgeons and 10 anaesthetists. We had ten theatre nurses, five theatre boys and ten other nurses who were part of the operation," said Dr. Bhattacharya who addressed the press meet along with Dr. Mehta and senior paediatrician and liver specialist Ashley D'Cruz and consultant nephrologist Ishtiaque Ahmed, all of whom were part of the team of surgeons.
The risks of pancreatic surgery entail a 5 to10 per cent chance of the donor developing diabetes.
"The patients are chosen carefully and a complete health profile is drawn out to understand their risk," Dr. Bhattacharya said and added that pancreatic transplant required that the patient take care of the graft for life.
The entire procedure cost Rs. 11 lakh. While Narayana Hrudayalaya bore the cost of the drugs, which was Rs. 7.5 lakh, the rest was arranged by the patients.
There was also emphasis on cadaver donor transplant and the fact that it needed to be promoted in India.
Now fully recovered, Ms. Neeraja Kuliyappa is off medication and both father and daughter will require some more rest and dietary restrictions to keep themselves healthy.


text:
Everything tagged
Latest from The Spokesman-Review
Here's the Dirt: Chef in the Forest returns
Dec. 10, 2010 in Business on Page A12 An electrical fire one year ago destroyed Hauser's Chef in the Forest restaurant. It's taken nearly 12 months to put the pieces back together. Owners Debbie Mustered and her mother, …
Here's the Dirt: Sky High Sports Spokane franchise under construction
Oct. 8, 2010 in Business on Page A10 Take an abandoned warehouse, cover its main floor and walls with trampolines, open it to the public and you have Sky High Sports, a new Spokane business that wants customers …