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Definitions for cafenet
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alt. of Cafeneh
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WASHINGTON -- Just as the Democrats were getting ready to pass the $800 billion stimulus plan, President Obama gave the green light to water down the bill's "buy American" trade provisions.
Labor leaders were up in arms over what they saw as a betrayal of Obama's campaign promise to support tough trade restrictions. The softer language quietly added to the bill was sought by the Chamber of Commerce and other business groups as the price for their support. In the end, they got some of what they wanted.
The behind-the-scenes battle over the "buy American" language received little media attention in the fiery political warfare over the big spending bill. But the White House's late shift on the issue shook labor's trust in the new president's promises and showed that, when push came to shove, Obama can quickly turn pragmatic.
The protectionist language that Democratic leaders inserted in the original bill immediately raised red flags over at U.S. Chamber headquarters, just one block from the White House.
Section 1605 (a) of the infrastructure-spending package on the "use of American iron, steel and manufactured goods" said this: "None of the funds appropriated or otherwise made available by this act may be used for a project for the construction, alteration, maintenance or repair of a public building or public work unless all of the iron, steel and manufactured goods used in the project are produced in the United States."
This language not only threatened to invite severe protectionist reprisals from our trading partners, triggering a trade war in the midst of a global recession -- it would have violated provisions in U.S. trade agreements.
Obama began sending signals publicly and through back channels that the provisions went too far. He told Fox News that the United States "can't send a protectionism message," then told ABC News that the bill's wording could be a "potential source of trade wars that we can't afford at a time when trade is sinking all across the globe."
The president's language was right out of the U.S. Chamber's playbook, shocking labor officials that Obama could turn so quickly on the issue, but thrilling big-business lobbyists.
That language remains in the bill, but waivers are also in there, saying it "shall not apply in any case or any category of cases in which the head of the Federal department or agency involved finds that applying subsection (a) would be inconsistent with the public interest."
Donald Lambro is chief political correspondent for The Washington Times.
Bush mocks Rubio and his fans: Stop whining that it's "unfair" that you're being attacked by another candidate's Super PAC | Allahpundit

subset: commoncrawl


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Falkensteiner Hotel & Spa Iadera(5 stars)Resort Punta Skala 23231 Petrcane Dalmatien View on map
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- Hotel
- Things to do and see
Hotel review overview
Autumn break at Punta Skala
- Recommended hotel
- Families
- Countryside & spa
- October 2015
Autumn break at Punta Skala. The hotel is just at the beach. The view from the hotel is spectacular. This is a big well-run hotel. Staff is very attentive and friendly. You feel like being in a small luxory hotel. Spacious rooms and large private terraces. Excellent food and very good selection. Spa is huge and of great quality. Same can be said for fitness. WiFi works well throughout. read hotel review
High Quality hotel chain
- Recommended hotel
- Couples
- Beach holiday
- September 2015
This hotel is good for couples and families alike,although it has to be said that families with energetic children may be happier next door at Falkenstiener other hotel which is more child oriented, this hotel seems to be more for peace and relaxation. The standard of service is efficient and friendly combined with excellent spa facilities. In fact the only thing missing is a hot tub in the spa and it would be perfect. In early September the weather was warn but with a fresh breeze that was very refreshing. My wife swam in the sea every day, but ... if you have swimming shoes this would be good for getting on and off the rocky beach. Glorious views with great sunsets made for a relaxing holiday. read hotel review
Excellent 5 stars
- Recommended hotel
- Families
- Beach holiday
- August 2015
Excellent. 5 Stars ***** Everything was more than we expected. From check in to check out, there was no issues. read hotel review
A luxurious holiday in Zadar
- Recommended hotel
- Families
- Beach holiday
- July 2015
The hotel is very beautiful, the food was good. It has the best location in Zadar - I liked the big and almost private beach. The big park was great – it was easy to find a silent place for sunbathing. The stuff was very kind and helpful. read hotel review
Ian William
Relax & Enjoy
- Recommended hotel
- Couples
- Beach holiday
- June 2015
Excellent Hotel, Marvelous Staff, Great Quality and good value for money. Spa available if required but just to relax with the view and the pools with the sea just a few yards away - Heaven! The beach is not sandy but as long as you wear some footwear the crystal clear waters beckon! A lovely path alongside the shore which is lit at night lends itself to a really peaceful walks. Strangely this place gives you the feeling that sometimes you are the only ones there!!! Love it and will return! read hotel review
Good to relax
- Recommended hotel
- Couples
- Beach holiday
- June 2015
Nice place and calm, beautiful decoration of rooms and spa its also very good and cick Good food and variety in restaurant More info needed in the room like treatments, tours and roomserivce menu read hotel review
Great hotel near Zadar
- Recommended hotel
- Singles
- Business trip
- June 2015
One of the best hotels in the region, located on attractive location, 20 minutes away (by car), from old town of Zadar. This specific hotel is part of larger resort. SPA area is excellent, especially "earth" sauna with the view to the sea. read hotel review
Theo and Carol
Lovely hotel and wonderful staff
- Recommended hotel
- Couples
- Beach holiday
- May 2015
We had a lovely and relaxing stay and were spoiled and pampered by the wonerful staff at this hotel. The setting on Punta Skala, a natural promontory is picturesque and calming especially when the sea is calm. read hotel review
To relax
- Recommended hotel
- Couples
- Beach holiday
- May 2015
Superb breakfasts, gourmet dinner courses, polite reception, staff, huge, spaceous wellness, modern rooms, pure relaxation read hotel review
One step back
- Recommended hotel
- Families
- Countryside & spa
- April 2015
We stayed in this hotel for 8 nights for 1.May holidays As I am a repeater I certainly notice all the 'happenings' in this hotel. I have seen a keen progress last year, but things have faltered since the management problems-hotel managing director was changed. But there are things on the right track- in restaurant Jadran-finally order, that was missing in past years-kind, polite, quickly waiters, prompt table cleaning etc. I hope that you ll keep restaurant chefs at least until my next visit;).Dinner courses are gourmet at last. There are 2 issues I have to mention-room ... cleaning is sluggish, sloppy-Dalmatian like. The second is toddler's noise at the inside pools when it is cold or rainy weather. At the arrival, you should inform families with children about the hotel BONTON-policy and PURPOSE-quietness and relaxation.I resent you lack of NOISE attenion As I revised the hotel three times before, I can just say:' Just Continue going on this path', now with one step back.for 2 steps forward, I HOPE.Currently, you are between 4/5. With correcting these 2 gaffes mentioned, you have chances to become the best Luxury hotel in Croatia. All the best from Slovenia! read hotel review
Information about Falkensteiner Hotel & Spa Iadera
Hotel Information
Information from HolidayCheck
Information from HolidayCheck *
Hotel Beach
- What the hotel offersUnique Selling Proposition The Falkensteiner Family Hotel Diadora is a 4 star resort right on the Dalmatian coast and is great for sport enthusiasts. This hotel is recommended especially by families for a beach holiday. Hotel in General The Falkensteiner Family Hotel is a modern hotel with 250 rooms and suites, a restaurant, 3 bars and a lounge. Breakfast is served in the buffet restaurant Hedonia, which also does themed evenings. There is an Internet corner in the lobby, and the rooms have high speed Internet access points. Disabled-friendly rooms are available as well as lifts. Check-in is possible from 15:00, and check-out until 10:00. The reception is staffed 24/7. The hotel is very eco-friendly and has its own sea water pump, uses the sea water for cooling to reduce the need for fossil fuels, converts sea water into drinking water, and has its own waste water treatment plant!
- LocationThe Falkensteiner Family Hotel is located in Petrcane, Croatia, right on the beach to the Adriatic Sea. It is only a few minutes away from the capital of North Dalmatia, Zadar, and about 30 minutes from the airport. One of the best attractions is in Zadar, the water organ. Depending on the strength of the waves, tones can be heard because of concrete steps underwater. Another tip is the Old Town of Zadar to explore the local culture and sit down in one of the many comfortable cafes there. A regular bus line takes you from Petrcane to Zadar. Rooms This hotel is very suitable for families, as it offers family rooms and suites with extra beds available. The Falkensteiner Family Hotel has all the standard room amenities like a safe, minibar, air conditioning, etc. Rooms, whether single or double, can be booked with a view onto the sea. Gastronomy With full-board, guests are treated to breakfast, lunch, and dinner buffets as well as themed buffets. The restaurant Hedonia is a show-cooking restaurant enhancing the dining experience for all. Children dine in the exciting jungle restaurant and can be supervised in "Falkyland" with drinks inclusive. Regional cuisine as well as international dishes are available, and in various bars like the beach bar, pool bar, and wellness lounge guests can enjoy drinks and snacks.
- LeisureThe pool landscape of the Falkensteiner Family Hotel is surrounded by well-kept gardens and guests can relax on sun beds and a sunbathing lawn. At the hotel's beach there are sun beds reserved for hotel guests. Sports like volleyball, basketball or soccer can be played on the small sports ground. In the Acquapura spa Flora, there is everything guests need to completely relax, like a steam bath, a Finnish sauna, massages, a gym, 3 pools and even an onsite cosmetics specialist. There is also a bike rental, diving station, and a jet ski rental available for a charge. Trips can be organized with the hotel. These include trips to the nature reserves like Kornati, the Kraka waterfalls, or a Jeep Safari! For the sports enthusiasts, a canoeing adventure trip is a great day activity. Services There are 685 parking spaces below the hotel, a shop and a travel agent. Laundry, dry cleaning, shoeshine machine, and a car hire desk are all available as well! Currency can be exchanged in the hotel, too, and there is an ATM on site. Payment methods accepted by the hotel include; American Express, Visa, Euro/MasterCard, Diners Club and Maestro. The hotel reserves the right to per-authorize credit cards prior to arrival.
* HolidayCheck does not assume liability for the accuracy and completeness of the content displayed above. Please bear in mind that the services included in an offer may differ at the time of booking from the description presented here. Solely those services available at the time of booking as shown on the booking form will be offered.
Hotel amenities
- Meeting/Banquet Facilities
- Non-smoking room
- Shops in the hotel
- Business centre
- Cash machine on site
- Hotel safe
- Internet
- Lift
- Central heating
- Air conditioning
- Car park
Room amenities
- Satellite TV
- Minibar
- Safe
- Balcony
- Bathroom
- Electronic room keys
- Wake up call/Alarm clock
- Complementary bottle of water
- Shower
- Restaurant
- Diabetic menu
- Vegetarian
- Vegetarian dishes
- Hotel bar
- Cafe
- Breakfast buffet
- Catering service
A choice of sports
- Fitness centre
- Outdoor pool
Spa offers
- Spa centre
- Massages
- Special massages
- Sauna
- Steam room/ turkish bath
- Tanning booth
Other hotel information
- 24 hour reception
- Early check in
- Late check out
- Car hire
- Information desk
- Currency exchange
- All public and private areas are no smoking zones
- Wifi
- Free Wifi access included
- Laundry service
Nearby - Hotels and Things to do
- Hotels
- Things to do & See


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Metal legends Judas Priest have returned to the Billboard Top 200 Albums Chart, at #170, with their remastered, Special 30th Anniversary Deluxe Edition of Defenders Of The Faith. Originally released back in January of 1984, Defenders Of The Faith has been highly regarded as a Metal jewel, these past 30 years, among Judas Priest and Metal fans alike.
The original release has been certified Platinum in the U.S.A. by the RIAA. The original Defenders Of The Faith release has previously spent 37 weeks on the Billboard Top 200 Albums Chart and peaked at #18. This is a Metal album that has helped recruit generations of Judas Priest fans, without any question.
Defenders Of The Faith was the ninth studio album released by Judas Priest and the revival of this Metal classic is a proud statement within the world of Metal. With such beloved Metal songs as Freewheel Burning, Some Heads Are Gonna Roll, Love Bites, The Sentinel, Eat Me Alive, Rock Hard Ride Free, Heavy Duty and the Anthemic title track, this Judas Priest album has earned its status as timeless. Metal be thy name. – Stone
* This 3CD edition comes with 2 live CD's (see info below).
* Defenders Of The Faith was remastered by producer Tom Allom.
CD 1 – Defenders of the Faith – Remastered
21 song live concert CD breakdown:
CD 2 – Live at Long Beach Arena, California 5th May 1984
CD 3 – Live at Long Beach Arena, California 5th May 1984
Purchase here:
Amazon: http://smarturl.it/Defenders30_Amz?IQid=fb.jp
iTunes: http://smarturl.it/Defenders30_iT?IQid=fb.jp
* For more info on JUDAS PRIEST:
Website: http://www.JudasPriest.co


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Here are the stories and food galleries you loved the most in March:
- 47-year-old Chinese restaurant to close
- Opening news: Panera Bread among 8 new eateries
- Route 66 pancake house to replace Spires
- El Torito Grill unit in O.C. closing temporarily
- Desperate Housewives creator filming at Italian eatery in Orange
- Founders of Duke's replacing Carl's Jr.
- Fast-food salad chain opens first O.C. unit
- Farrell's to open 2nd O.C. ice scream shop
- Popular Brea bartender with cancer needs your help
- TK Burgers to open 6th O.C. unit
[caption id="attachment_75830" align="alignleft" width="150" caption="The secret behind SoCal's top burgers"][/caption]
[caption id="attachment_14535" align="alignleft" width="150" caption="Best, worst fast-food mascots"][/caption]
[caption id="attachment_88517" align="alignleft" width="150" caption="A closer look at hippie Chipotle burrito rival"][/caption]


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26-10-2012 01:37
I have received 2 calls from someone claiming to be Skype System help. I have never received these calls before. These are Robo calls. Are they real and why are they calling me?
If Skype wants to call me than have a real person call, not some Robo call.
26-10-2012 02:04
It's not Skype...it's a phishing/spam call.
You can prevent those from getting through by signing in to your account on a Mac or PC and changing your privacy settings to allow calls from people on my Contact list only.
26-10-2012 02:29
Thank you


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The producer of Ikea meatballs withdrawn from shelves in 24 countries amid fears they contained horse said Tuesday it had found none of this meat in its product.
It was however still awaiting results from tests on meat in which Czech authorities said they found equine DNA, Dafgaard said.
"Out of 320 tests performed in the last three weeks, none contain horsemeat," said chief executive Ulf Dafgaard.
The contents of products that were ready to be sold had been analysed by the company and by an external laboratory, he said.
Dafgaard said it had unsuccessfully tried to contact the Czech laboratory that found horsemeat in meatballs sold by Ikea for more information about the amount involved.
The Swedish furniture giant said Tuesday it had pulled one-kilogramme (2.2-pound) bags of frozen meatballs off the shelves of its stores in 24 countries.
They were Poland, Austria, Hungary, the Dominican Republic, Britain, Portugal, Finland, Germany, Italy, Denmark, the Netherlands, Belgium, Romania, Slovakia, the Czech Republic, Sweden, Thailand, Spain, Bulgaria, Greece, Hong Kong, France, Cyprus and Ireland.
The Czech agency said it also found traces of horse in burgers made in Poland that were imported by Denmark-based food chain Nowaco.
Ikea was the latest group to become caught up in a Europe-wide scandal over horsemeat in food products that erupted in January when horse DNA was detected in beefburgers in Britain and Ireland.
Nestle, which last week was forced to yank products off the shelves in Spanish and Italian supermarkets after detecting horsemeat in deliveries from a German supplier, said Monday it would stop buying all products from Spanish group Servocar after traces of horse were discovered.
In Greece, Athens chief prosecutor Panagiota Fakou ordered Tuesday new checks for horsemeat amid reports that at least one Greek company may have brought tainted meat into the country.
The Greek agriculture ministry has also ordered a month-long round of checks into beef products.
"The relevant services have stepped up checks," junior agriculture minister Maximos Harakopoulos said in a statement.


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Led by three champs, King three-peats as WCWA Women's College National champions
Marina Doi (101), Samantha Klingel (116) and Forrest Molinari (155) won golds for King.
FLASH: Stieber, Hall win silvers, Humphrey a bronze at Outstanding Ukrainian Memorial
Logan Stieber (65 kg) and Adam Hall (74 kg) were second and Reece Humphrey (65 kg) was third.
No. 1 Penn State takes seven of 10 to beat Lehigh in front of record crowd at Stabler Arena
Jason Nolf, Zain Retherford and Morgan McIntosh got bonus points for the Nittany Lions
No. 8 Virginia Tech topples undefeated No. 3 NC State 19-14 to claim ACC dual meet crown
Virginia Tech wins second consecutive ACC dual meet title
Breakthrough star Tamyra Mensah primed for run on World stage
Mensah won the 2016 U.S. Open at Las Vegas back in December.
Video Gallery
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|USA Wrestler Magazine
King, OCU and Simon Fraser place four in gold-medal finals at WCWA Nationals
King led OCU by 20.5 points heading into the medal match rounds with Simon Fraser in third.
King takes 23.5 point lead over OCU after quarterfinals of WCWA Women's College Nationals
King placed nine athletes in the semifinals, while OCU has six in the semifinals.
NCAA releases newest wrestling coaches' panel rankings and RPI
The second of four coaches' panel rankings and a preliminary RPI has been released
Bonus Points Ep. 30 featuring Olympic champion and U.S. wrestling legend Kenny Monday
Listen to Ep. 30 of the USA Wrestling Bonus Points podcast with host Richard Immel


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Adam Audio A5X Powered Studio Monitor
Out of stock
The Adam Audio A5X Powered Studio Monitor is ideal for the small studio and powerful enough for any professional environment. This 5.5" woofer is able to reproduce sound below 2.5kHz giving you a very clean, flat response so you can hear your music as it truly sounds for better playback and mixing. Buy yours today from UniqueSquared.com


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Day two blogging from Disney, did you honestly expect a profund, heartfelt, witty entry from me today…as if that regularly happens here anyway!
Yes, the fun, fun, fun continues today.
I will share with you a little secret. Before this Disney adventure and our Santa Cruz Beach Boardwalk weekend last month, the last time our family circus went on a real vacation that didn't involve visiting family for the holidays or family reunions was in 1992! Yup, back when Zoë was just a baby! Sad, I know. But birthin' babies, paying bills, adoption, chronic preemie health issues and surgeries, buying our first home and other things always seemed to get in our way. But here we are and that is what is most important. The goal is to not let fourteen more years pass before the next great Big Top vacation.
It was indeed another very full day with lots of memories made for us all.
Oh yeah, it was Bill's 44th birthday too. Yes, he did wear that pin all day and yes every cast member who saw him went out of their way to wish him a "Happy Birthday". He acts like it wasn't that big of a deal but I know he enjoyed the attention.
After a desperately overpriced buffet dinner at Goofy's Kitchen (eat up kids!) we enjoyed a little bit of birthday cakey goodness.
Look! Daniel saved y'all a cupcake!
But now it is time for firewalks.
Until tomorrow…


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Robert F Benson
Centers for Disease Control and Prevention, Atlanta, MI, United States
Are you Robert F Benson?
Claim your profile
Total impact
Available from: Genyan Patrick Yang
Legionella nagasakiensis sp nov., isolated from water samples and from a patient with pneumonia
Genyan Yang
· Robert F Benson ·
Rodney M Ratcliff
Ellen W Brown
Arnold G Steigerwalt
W Lanier Thacker
Maryam I Daneshvar
Roger E Morey
Atsushi Saito
Barry S Fields
[Show abstract]
[Hide abstract]
A novel Legionella species was identified based on analysis of 16S rRNA and mip (macrophage infectivity potentiator) gene sequences, cellular fatty acids, isoprenoid quinones, biochemical reactions, antigens and quantitative DNA-DNA hybridization. Strain CDC-1796-JAP-E(T) was isolated from well water at the Nagasaki Municipal Medical Center, Japan. Two strains, CDC-3041-AUS-E and CDC-3558-AUS-E, were isolated from water samples during an outbreak of legionellosis in South Australia. Strain CDC-5427-OH-H was isolated from a 66-year-old female patient diagnosed with Legionnaires' disease in the US. Cells from these four strains were gram-negative, non-fluorescent, rod-shaped, and positive for alkaline phosphatase, esterase, leucine arylamidase, catalase, gelatinase, β-lactamase and tyrosine browning assay. Phylogenetic analysis of 16S rRNA and mip genes revealed that the four strains formed a distinct cluster within the genus Legionella. The bacteria contained branched-chain fatty acids and quinones that are typical of members of the genus Legionella. Slide agglutination tests demonstrated no cross-reaction with 52 previously described members of the Legionellaceae. DNA-DNA hybridization studies indicated that DNAs from the four strains were highly related (78-84 %) but they showed 29 % relatedness to Legionella oakridgensis ATCC 33761(T) and less than 10 % to strains of other Legionella species tested. These characterizations suggest that the isolates represent a novel species, for which the name Legionella nagasakiensis sp. nov. is proposed; the type strain is CDC-1796-JAP-E(T) ( = ATCC BAA-1557(T) = JCM 15315(T)).
Full-text · Article · Mar 2011 · International Journal of Systematic and Evolutionary Microbiology
Available from: Leonard F Peruski
Incidence of respiratory pathogens in persons hospitalized with pneumonia in two provinces in Thailand
S J Olsen
S Thamthitiwat
S Chantra
M Chittaganpitch
A M Fry
J M Simmerman
H C Baggett
T C T Peret
D Erdman
· R Benson · [...] ·
L Thacker
M L Tondella
J Winchell
B Fields
W L Nicholson
S Maloney
L F Peruski
K Ungchusak
P Sawanpanyalert
S F Dowell
[Show abstract]
[Hide abstract]
Although pneumonia is a leading cause of death from infectious disease worldwide, comprehensive information about its causes and incidence in low- and middle-income countries is lacking. Active surveillance of hospitalized patients with pneumonia is ongoing in Thailand. Consenting patients are tested for seven bacterial and 14 viral respiratory pathogens by PCR and viral culture on nasopharyngeal swab specimens, serology on acute/convalescent sera, sputum smears and antigen detection tests on urine. Between September 2003 and December 2005, there were 1730 episodes of radiographically confirmed pneumonia (34·6% in children aged <5 years); 66 patients (3·8%) died. A recognized pathogen was identified in 42·5% of episodes. Respiratory syncytial virus (RSV) infection was associated with 16·7% of all pneumonias, 41·2% in children. The viral pathogen with the highest incidence in children aged <5 years was RSV (417·1/100,000 per year) and in persons aged ≥50 years, influenza virus A (38·8/100,000 per year). These data can help guide health policy towards effective prevention strategies.
Full-text · Article · Mar 2010 · Epidemiology and Infection
Available from: ncbi.nlm.nih.gov
Virulence Factors Encoded by Legionella longbeachae Identified on the Basis of the Genome Sequence Analysis of Clinical Isolate D-4968
Natalia A Kozak
Meghan Buss
Claressa E Lucas
Michael Frace
Dhwani Govil
Tatiana Travis
Melissa Olsen-Rasmussen
· Robert F Benson ·
Barry S Fields
[Show abstract]
[Hide abstract]
Legionella longbeachae causes most cases of legionellosis in Australia and may be underreported worldwide due to the lack of L. longbeachae-specific diagnostic tests. L. longbeachae displays distinctive differences in intracellular trafficking, caspase 1 activation, and infection in mouse models compared to Legionella pneumophila, yet these two species have indistinguishable clinical presentations in humans. Unlike other legionellae, which inhabit freshwater systems, L. longbeachae is found predominantly in moist soil. In this study, we sequenced and annotated the genome of an L. longbeachae clinical isolate from Oregon, isolate D-4968, and compared it to the previously published genomes of L. pneumophila. The results revealed that the D-4968 genome is larger than the L. pneumophila genome and has a gene order that is different from that of the L. pneumophila genome. Genes encoding structural components of type II, type IV Lvh, and type IV Icm/Dot secretion systems are conserved. In contrast, only 42/140 homologs of genes encoding L. pneumophila Icm/Dot substrates have been found in the D-4968 genome. L. longbeachae encodes numerous proteins with eukaryotic motifs and eukaryote-like proteins unique to this species, including 16 ankyrin repeat-containing proteins and a novel U-box protein. We predict that these proteins are secreted by the L. longbeachae Icm/Dot secretion system. In contrast to the L. pneumophila genome, the L. longbeachae D-4968 genome does not contain flagellar biosynthesis genes, yet it contains a chemotaxis operon. The lack of a flagellum explains the failure of L. longbeachae to activate caspase 1 and trigger pyroptosis in murine macrophages. These unique features of L. longbeachae may reflect adaptation of this species to life in soil.
Preview · Article · Dec 2009 · Journal of bacteriology
Request full-text
Available from: Thomas H Taylor Jr
Distribution of lag-1 Alleles and Sequence-Based Types among Legionella pneumophila Serogroup 1 Clinical and Environmental Isolates in the United States
Natalia A Kozak
· Robert F Benson ·
Ellen Brown
Nicole T Alexander
Thomas H Taylor
Brian G Shelton
Barry S Fields
[Show abstract]
[Hide abstract]
Approximately 84% of legionellosis cases are due to Legionella pneumophila serogroup 1. Moreover, a majority of L. pneumophila serogroup 1 clinical isolates react positively with monoclonal antibody 2 (MAb2) of the international standard panel. Over 94% of the legionellosis outbreaks investigated by the Centers for Disease Control and Prevention are due to this subset of L. pneumophila serogroup 1. To date, there is no complete explanation for the enhanced ability of these strains to cause disease. To better characterize these organisms, we subtyped 100 clinical L. pneumophila serogroup 1 isolates and 50 environmental L. pneumophila serogroup 1 isolates from the United States by (i) reactivity with MAb2, (ii) presence of a lag-1 gene required for the MAb2 epitope, and (iii) sequence-based typing analysis. Our results showed that the MAb2 epitope and lag-1 gene are overrepresented in clinical L. pneumophila serogroup 1 isolates. MAb2 recognized 75% of clinical isolates but only 6% of environmental isolates. Similarly, 75% of clinical isolates but only 8% of environmental isolates harbored lag-1. We identified three distinct lag-1 alleles, referred to as Philadelphia, Arizona, and Lens alleles, among 79 isolates carrying this gene. The Arizona allele is described for the first time in this study. We identified 59 different sequence types (STs), and 34 STs (58%) were unique to the United States. Our results support the hypothesis that a select group of STs may have an enhanced ability to cause legionellosis. Combining sequence typing and lag-1 analysis shows that STs tend to associate with a single lag-1 allele type, suggesting a hierarchy of virulence genotypes. Further analysis of ST and lag-1 profiles may identify genotypes of L. pneumophila serogroup 1 that warrant immediate intervention.
Full-text · Article · Jul 2009 · Journal of clinical microbiology
Available from: Genyan Patrick Yang
Dual detection of Legionella pneumophila and Legionella species by real-time PCR targeting the 23S-5S rRNA gene spacer region
G Yang
· R Benson ·
T Pelish
E Brown
J M Winchell
B Fields
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[Hide abstract]
Clin Microbiol Infect 2010; 16: 255–261 Although the majority of cases of Legionnaires' disease (LD) are caused by Legionella pneumophila, an increasing number of other Legionella species have been reported to cause human disease. There are no clinical presentations unique to LD and hence accurate laboratory tests are required for early diagnosis. Therefore, we designed a real-time PCR assay that targets the 23S-5S rRNA intergenic spacer region (23S-5S PCR) and allows for detection of all Legionella species and discrimination of L. pneumophila from other Legionella species. In total, 271 isolates representing 50 Legionella species were tested and the assay was validated using 39 culture-positive and 110 culture-negative patient specimens collected between 1989 and 2006. PCR-positive results were obtained with all 39 culture-positive samples (100% sensitivity). Specimens that tested positive according to 23S-5S PCR, but were culture-negative, were further analysed by DNA sequencing of the amplicon or the macrophage infectivity potentiator (mip) gene. In addition to L. pneumophila, Legionella longbeachae, Legionella cincinnatiensis and Legionella micdadei were identified in the specimens. The assay showed a 7-log dynamic range displaying a sensitivity of 7.5 CFU/mL or three genome equivalents per reaction. Sixty-one specimens containing viruses or bacteria other than Legionellae were negative according to 23S-5S PCR, demonstrating its specificity. Use of this assay should contribute to the earlier detection of respiratory disease caused by Legionella species, as well as to increased rates of detection.
Full-text · Article · May 2009 · Clinical Microbiology and Infection
Available from: Maria L Tondella
Development and Evaluation of a Novel Multiplex PCR Technology for Molecular Differential Detection of Bacterial Respiratory Disease Pathogens
Robert Benson ·
Maria L Tondella
Julu Bhatnagar
Maria da Glória S Carvalho
Jacquelyn S Sampson
Deborah F Talkington
Anne M Whitney
Elizabeth Mothershed
Lesley McGee
George Carlone
Vondguraus McClee
Jeannette Guarner
Sherif Zaki
Surang Dejsiri
K Cronin
Jian Han
Barry S Fields
[Show abstract]
[Hide abstract]
The ResPlex I assay (Qiagen) was designed to amplify and detect DNA of six bacterial respiratory pathogens. This assay was compared with real-time PCR assays based upon the same target sequences for the ability detect the target bacteria by use of both stock strains and specimens from respiratory disease patients. The ResPlex I assay is somewhat less sensitive than real-time PCR assays but offers the advantage of multiple assays in a single reaction.
Full-text · Article · Jul 2008 · Journal of clinical microbiology
Available from: Piyada Wangroongsarb
Epidemiology of Severe Pneumonia Caused by Legionella longbeachae, Mycoplasma pneumoniae, and Chlamydia pneumoniae: 1-Year, Population-Based Surveillance for Severe Pneumonia in Thailand
Christina R Phares
Piyada Wangroongsarb
Somrak Chantra
Wantana Paveenkitiporn
Maria-Lucia Tondella
· Robert F Benson ·
W Lanier Thacker
Barry S Fields
Matthew R Moore
Julie Fischer
Scott F Dowell
Sonja J Olsen
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Legionella species, Mycoplasma pneumoniae, and Chlamydia pneumoniae are recognized as important causes of pneumonia in high-income countries, but their significance in middle-income countries, such as Thailand, is unknown. Population-based surveillance identified inpatient 3489 cases of clinically-defined pneumonia in a rural Thai province for 1 year. Patients who had a chest radiograph performed (for 2059 cases of pneumonia) were enrolled in an etiology study (which included 755 cases of pneumonia among 738 patients). Paired serum, nasopharyngeal swab, and urine specimens were obtained for diagnostic immunologic and molecular tests. Patients aged <18 years were not systematically tested for Legionella species. We report a lower limit of incidence (observed incidence) and an upper limit extrapolated to persons not tested or not enrolled in the study. The incidence of pneumonia due to Legionella longbeachae requiring hospitalization was 5-29 cases per 100,000 population. No case of Legionella pneumophila pneumonia was observed. The definite C. pneumoniae pneumonia incidence was 3-23 cases per 100,000 population; rates were highest among patients aged <1 year (18-166 cases per 100,000 population) and those aged >or=70 years (23-201 cases per 100,000 population). M. pneumoniae pneumonia had a similar age distribution, with an overall incidence of 6-44 cases per 100,000 population. These pathogens were associated with 15% of all cases of pneumonia. A nonsignificantly higher proportion of patients with pneumonia associated with L. longbeachae, compared with patients with pneumonia associated with M. pneumoniae or C. pneumoniae, required supplemental oxygen or mechanical ventilation (45% vs. 18%; P<.1). Among patients with atypical pneumonia, only 15% received antibiotics with activity against the associated pathogen. M. pneumoniae, C. pneumoniae, and L. longbeachae, but not L. pneumophila, are frequently associated with severe pneumonia in rural Thailand. Few patients receive antibiotics that cover atypical pathogens.
Full-text · Article · Dec 2007 · Clinical Infectious Diseases
Available from: Matthew Robert Moore
Legionnaires' disease among residents of a long-term care facility: The sentinel event in a community outbreak
Christina R Phares
Elaine Russell
Michael C Thigpen
William Service
Matthew B Crist
Martha Salyers
Jeffrey Engel
· Robert F Benson ·
Barry Fields
Matthew R Moore
[Show abstract]
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A long-term care facility (LTCF) reported an outbreak of Legionnaires' disease (LD) in September 2004. We conducted case finding through enhanced surveillance, medical record review (n = 131), and community surveys (n = 258). We cultured water samples from the LTCF and assayed their outdoor air-intake filters for Legionella DNA. We also investigated a cooling tower, the only nearby outdoor aerosol source. Among 7 confirmed cases, 2 LTCF residents never exited, and 2 community residents never entered the LTCF during the incubation period. Among 63 water and biofilm samples collected from throughout the LTCF, we found no evidence of Legionella colonization, either in the potable water or air-handling systems. Conversely, we isolated a common outbreak-causing strain of Legionella pneumophila serogroup 1 from an industrial cooling tower located 0.4 km from the LTCF and recovered L pneumophila DNA from the LTCF's outdoor air-intake filters, suggesting that aerosolized Legionella from the cooling tower most likely entered the LTCF through the air-intake system or, possibly, through open windows. Residents of LTCFs can acquire LD from community sources. A cluster of LD cases among LTCF residents does not necessarily indicate transmission from within the LTCF.
Full-text · Article · Jul 2007 · American Journal of Infection Control
Available from: cid.oxfordjournals.org
A Large, Travel-Associated Outbreak of Legionellosis among Hotel Guests: Utility of the Urine Antigen Assay in Confirming Pontiac Fever
Laurence J Burnsed
Lauri A Hicks
Laura M K Smithee
Barry S Fields
Kristy K Bradley
Neil Pascoe
Shawn M Richards
Sue Mallonee
Lisa Littrell
· Robert F Benson ·
Matthew R Moore
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During March 2004, a large outbreak of legionnaires disease and Pontiac fever occurred among hotel guests in Oklahoma. An investigation was conducted to identify the source and evaluate the utility of the Legionella urine antigen assay and serologic testing for the identification of Pontiac fever. A retrospective cohort investigation of hotel guests and employees and an environmental evaluation were performed. Participants were interviewed, and clinical specimens were collected from consenting individuals. Six cases of legionnaires disease and 101 cases of Pontiac fever were identified. Exposure to the indoor pool and hot tub area was associated with legionellosis (relative risk, 4.4; 95% confidence interval, 2.8-6.9). Specimens from the pool and hot tub tested positive for Legionella pneumophila serogroup 1 by polymerase chain reaction. For Pontiac fever, the sensitivity and positive predictive value were 35.7% and 100%, respectively, for the urine antigen assay, and 46.4% and 90%, respectively, for serologic testing. The specificity and negative predictive value were 100% and 47.8%, respectively, for the urine antigen assay, and 89.3% and 45.5%, respectively, for serologic testing. Urine antigen testing, with or without serologic testing, can be used to confirm outbreak-associated cases of Pontiac fever caused by L. pneumophila serogroup 1.
Preview · Article · Feb 2007 · Clinical Infectious Diseases
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Restaurant outbreak of Legionnaires' disease associated with a decorative fountain: an environmental and case-control study. BMC Infect Dis 7:93-101
Rosalyn E O'Loughlin
Lon Kightlinger
Matthew C Werpy
Ellen Brown
Valerie Stevens
Clark Hepper
Tim Keane
· Robert F Benson ·
Barry S Fields
Matthew R Moore
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From June to November 2005, 18 cases of community-acquired Legionnaires' disease (LD) were reported in Rapid City South Dakota. We conducted epidemiologic and environmental investigations to identify the source of the outbreak. We conducted a case-control study that included the first 13 cases and 52 controls randomly selected from emergency department records and matched on underlying illness. We collected information about activities of case-patients and controls during the 14 days before symptom onset. Environmental samples (n = 291) were cultured for Legionella. Clinical and environmental isolates were compared using monoclonal antibody subtyping and sequence based typing (SBT). Case-patients were significantly more likely than controls to have passed through several city areas that contained or were adjacent to areas with cooling towers positive for Legionella. Six of 11 case-patients (matched odds ratio (mOR) 32.7, 95% CI 4.7-infinity) reported eating in Restaurant A versus 0 controls. Legionella pneumophila serogroup 1 was isolated from four clinical specimens: 3 were Benidorm type strains and 1 was a Denver type strain. Legionella were identified from several environmental sites including 24 (56%) of 43 cooling towers tested, but only one site, a small decorative fountain in Restaurant A, contained Benidorm, the outbreak strain. Clinical and environmental Benidorm isolates had identical SBT patterns. This is the first time that small fountain without obvious aerosol-generating capability has been implicated as the source of a LD outbreak. Removal of the fountain halted transmission.
Full-text · Article · Feb 2007 · BMC Infectious Diseases
Conference Paper:
Epidemiology of Mycoplasma pneumoniae, Chlamydia pneumoniae, and Legionella longbeachae in Thailand
Barry Fields
Christina Phares
Julie Fischer
Lanier Thacker
Lucia Tondella
Matthew Moore
Piyada Wangroongsarb
· Robert Benson ·
Scott Dowell
Somrak Chantra
Sonja Olsen
W. Paveenkitiporn
[Show abstract]
[Hide abstract]
Background: Etiologic data are critical for developing evidence-based standards for diagnosing and treating pneumonia. M. pneumoniae (MP), C. pneumoniae (CP), and Legionella are increasingly recognized as important causes of pneumonia in upper-income countries, but their significance in middle-income countries, such as Thailand, is unknown. Methods: Active, population-based surveillance identified all inpatients with pneumonia in Sa Kaeo Province during a 1-year period (n=3489). Patients with a chest x-ray (n=2059) were approached for enrollment in an etiology study (n=762). Infection was defined as seroconversion for MP; a ≥4-fold antibody rise for CP or L. longbeachae (LL); a single IgM ≥1:16 for CP; or positive PCR for CP or MP from nasopharyngeal swabs. Patients <18 years were not tested for LL. Results: CP incidence was 19/100,000. Rates were highest in patients <1 year (53/100,000) and ≥75 years (241/100,000). MP had a similar age distribution, with an overall incidence of 6/100,000. LL incidence was 5/100,000. CP, MP, and LL infections accounted for 15% of all pneumonias. Clinical presentation and x-ray findings did not differ by etiology; however, a higher proportion of LL cases then MP/CP cases required intubation or oxygen (45% vs.18%, p<0.1). Among those with atypical infection, 93% received antibiotics but only 15% received optimal therapy. Conclusions: CP, MP, and LL are frequently associated with pneumonia in rural Thailand. LL has not been described in SE Asia and the risk of infection is underappreciated. Atypical infections cannot be distinguished clinically and few patients receive antibiotics that cover these pathogens.
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Two Outbreaks of Severe Respiratory Disease in Nursing Homes Associated with Rhinovirus
Lauri A Hicks
Colin W Shepard
Phyllis H Britz
Dean D Erdman
Marc Fischer
Brendan L Flannery
Angela J Peck
Xiaoyan Lu
W Lanier Thacker
· Robert F Benson ·
Maria L Tondella
Mària E Moll
Cynthia G Whitney
Larry J Anderson
Daniel R Feikin
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To characterize illness and identify the etiology for two nursing home outbreaks of respiratory illness. Multisite outbreak investigations; cohort. Setting: Two nursing homes in Pennsylvania. Facility A residents (n = 170), Facility B residents (n = 124), and employees (n = 91). Medical records for Facility A and B residents were reviewed, and employees from Facility B self-administered a questionnaire to identify risk factors for illness. Serological, oropharyngeal, and nasopharyngeal specimens were collected for both outbreaks, and testing for respiratory pathogens was performed. In Facility A, 40 (24%) of 170 residents were identified with respiratory illness; 13 (33%) case-patients had radiographically confirmed pneumonia, 15 (38%) were taken to a hospital, and two (5%) died. Of 10 specimens collected from symptomatic Facility A case-patients, four (40%) tested positive using reverse transcription polymerase chain reaction for rhinovirus. In Facility B, 77 (62%) of 124 residents had respiratory illness, and 40 (52%) had radiographically confirmed pneumonia; 12 (16%) case-patients were hospitalized, and five (6%) died. Of 19 respiratory specimens collected from symptomatic Facility B case-patients, six (32%) were positive for rhinovirus; one was from an employee. Five (50%) of 10 rhinovirus-positive cases in both outbreaks had clinical and radiographic evidence of pneumonia. These investigations suggest that rhinoviruses may be an underrecognized cause of respiratory outbreaks in nursing homes, capable of causing pneumonia and perhaps death.
No preview · Article · Mar 2006 · Journal of the American Geriatrics Society
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Recurrence of Legionnaires Disease at a Hotel in the United States Virgin Islands over a 20‐Year Period
Karen D Cowgill
Claressa E Lucas
· Robert F Benson ·
Shadi Chamany
Ellen W Brown
Barry S Fields
Daniel R Feikin
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We investigated 3 cases of legionnaires disease (LD) that developed in travelers who stayed at a hotel in the United States Virgin Islands where cases of LD occurred in 1981–1982 and in 1998. The temperature of the potable water at the hotel was in a range that could optimally support the growth of Legionella species, and the potable water was colonized with Legionella pneumophila in 1981–1982 and in 2002–2003.
Full-text · Article · May 2005 · Clinical Infectious Diseases
Available from: Victor Coronado
SARS Surveillance during Emergency Public Health Response, United States, March–July 2003
Stephanie J Schrag
John T Brooks
Chris Van Beneden
Umesh D Parashar
Patricia M Griffin
Larry J Anderson
William J Bellini
· Robert F Benson ·
Dean D Erdman
Alexander Klimov
· [...] ·
Daniel Feikin
Joy L Herndon
William A Bower
Barbara W Klibourn
Deborah A Levy
Victor G Coronado
Joanna Buffington
Clare A Dykewicz
Rima F Khabbaz
Mary E Chamberland
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In response to the emergence of severe acute respiratory syndrome (SARS), the United States established national surveillance using a sensitive case definition incorporating clinical, epidemiologic, and laboratory criteria. Of 1,460 unexplained respiratory illnesses reported by state and local health departments to the Centers for Disease Control and Prevention from March 17 to July 30, 2003, a total of 398 (27%) met clinical and epidemiologic SARS case criteria. Of these, 72 (18%) were probable cases with radiographic evidence of pneumonia. Eight (2%) were laboratory-confirmed SARS-coronavirus (SARS-CoV) infections, 206 (52%) were SARS-CoV negative, and 184 (46%) had undetermined SARS-CoV status because of missing convalescent-phase serum specimens. Thirty-one percent (124/398) of case-patients were hospitalized; none died. Travel was the most common epidemiologic link (329/398, 83%), and mainland China was the affected area most commonly visited. One case of possible household transmission was reported, and no laboratory-confirmed infections occurred among healthcare workers. Successes and limitations of this emergency surveillance can guide preparations for future outbreaks of SARS or respiratory diseases of unknown etiology.
Full-text · Article · Mar 2004 · Emerging infectious diseases
Available from: Fred A Rainey
Gamma-Proteobacteria Aquicella lusitana gen. nov., sp. nov., and Aquicella siphonis sp. nov. Infect Protozoa and Require Activated Charcoal for Growth in Laboratory Media
Paula Santos
Isabel Pinhal
Fred A Rainey
Nuno Empadinhas
Joana Costa
Barry Fields
· Robert Benson ·
António Veríssimo
Milton S Da Costa
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Several isolates, belonging to two new species of the same novel genus of gamma-proteobacteria, were recovered from drilled well (borehole) and spa water at São Gemil in central Portugal. These organisms are phylogenetically most closely related to the strictly intracellular uncultured species of the genus Rickettsiella, which cause disease in arthropods, and to the facultatively intracellular species of the genus Legionella, some of which cause Legionnaires' disease and Pontiac fever. The São Gemil strains grew only on media containing charcoal, as is also true of the species of the genus Legionella. Unlike the vast majority of Legionella isolates, the new isolates did not require l-cysteine or ferric pyrophosphate for growth but like the legionellae had an absolute requirement for α-ketoglutarate. Strains SGT-39T and SGT-56 grew consistently between 30 and 43°C, while strains SGT-108T and SGT-109 grew between 30 and 40°C. The pH ranges for growth of these organisms were surprisingly narrow: strains SGT-39T and SGT-56 grew between pH 6.3 and 7.3, while strains SGT-108T and SGT-109 grew between pH 6.3 and 7.0. Both organisms proliferated in the amoeba Hartmannella vermiformis but did not grow in U937 human cells. Based on 16S rRNA gene sequence analysis and physiological, biochemical, and chemical analysis we describe two new species of one novel genus; one species is represented by strain SGT-39T, for which we propose the name Aquicella lusitana, while strain SGT-108T represents a second species of the same genus, for which we propose the name Aquicella siphonis.
Full-text · Article · Dec 2003 · Applied and Environmental Microbiology
Available from: cid.oxfordjournals.org
Epidemiologic Investigation of a Restaurant-Associated Outbreak of Pontiac Fever
Timothy F Jones
· Robert F Benson ·
Ellen W Brown
Jerry R Rowland
Steven C Crosier
William Schaffner
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This case-control study investigated a cluster of respiratory illness among patrons of a restaurant. Of 173 patrons interviewed, 117 (68%) were ill. Symptoms included myalgias (93%), headache (87%), and fatigue (79%). The mean incubation period was 49 h and the mean duration of illness was 71 h. Patrons aged >15 years were more likely to have been ill than younger patrons (odds ratio [OR], 2.96; P = .002); 58% of persons who were ill sat near a large fountain, compared with 18% of respondents who were not ill (OR, 7.5; P = .005). Legionella anisa was cultured from water samples obtained from the fountain pool. Of 22 individuals who were ill, 11 (50%) had a ⩾4-fold increase in the titer of antibody to that strain of L. anisa from acute-phase to convalescent-phase serum samples; 3 others (14%) had persistently elevated titers of ⩾512; of a group of 20 individuals who had not been exposed to the restaurant, none had titers of >128. Pontiac fever should be considered as a diagnosis during acute outbreaks of influenza-like illness with a high attack rate and no other identified etiology.
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Legionellosis among Residents of a Newly Constructed Nursing Home
Michael Baysinger
Claressa Lucas
· Robert Benson ·
Barry Fields
Ellen Brown
Kevin Smith
Richard Besser
Rachel Gorwitz
Joseph DiMino
Colin Shepard
Rebecca Garabed
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Legionnaires disease (LD) is a severe pneumonia usually transmitted by aerosolized Legionella-contaminated water. Although numerous hospital-associated outbreaks have been reported, LD outbreaks in nursing homes are rarely described. Legionella colonization of plumbing systems is most common in older buildings. In June 2002, a LD outbreak occurred among residents of a newly constructed nursing home. We conducted a cohort study and environmental investigation to identify sources of and opportunities to prevent transmission. Residents exposures to potential transmission sources were assessed by chart review and staff interviews. Multivariable regression was used to calculate risk ratios (RR) for associations between exposures to potential transmission sources and laboratory-confirmed (positive culture or urine antigen) LD, controlling for smoking and underlying disease. Water samples for Legionella culture were collected throughout the facility. Environmental Legionella isolates were sub-typed and compared to a clinical isolate. Eleven LD cases, two of them fatal, occurred among 259 facility residents (attack rate 4.2%) over a 17-day period. LD risk was significantly greater (RR=7.1, 95%CI=2.2-30.8) among residents who bathed or showered during a two-day period nine days (one incubation period) before the outbreak peak. Going outside near the cooling tower and history of dysphagia were not associated with disease. Legionella isolates from a case-patient and the facilitys potable water were identical by monoclonal antibody subtyping and amplified fragment length polymorphism. Potable water temperatures and biocide concentrations were conducive to Legionella growth. LD transmission likely occurred via aerosolized potable water. Increased LD risk associated with bathing during a particular two-day period suggests a concentrated release of Legionella from the potable water system occurred at that time. LD transmission can occur even in newly constructed nursing homes. LD testing should be performed for nursing home residents with pneumonia to allow early detection of an outbreak. Water systems should be maintained to limit potential for Legionella growth.
No preview · Conference Paper · Oct 2003
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Legionnaires' Disease Outbreak in an Automobile Engine Manufacturing Plant
Alicia M Fry
Miai Rutman
Terry Allan
Heidi Scaife
Ellen Salehi
· Robert Benson ·
Barry Fields
Scott Nowicki
Mary Kay Parrish
Joseph Carpenter
Ellen Brown
Claressa Lucas
Timothy Horgan
Elizabeth Koch
Richard E Besser
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We investigated 4 cases of legionnaires' disease (LD) reported among workers at an Ohio automotive plant in March 2001. A "confirmed" case of LD was defined as x-ray–confirmed pneumonia and a confirmatory laboratory test. A "possible" case of LD was defined as elevated titers of antibody and respiratory symptoms. Legionella pneumophila serogroup 1 (LP1) was isolated from 1 case patient. Legionella was isolated from 18 (9%) of 197 environmental samples; 3 isolates were LP1 but did not match the case isolate. We conducted a case-control study; 17 case patients with confirmed or possible LD and 86 control subjects (workers with low antibody titers and without symptoms) were enrolled. Visiting a specific cleaning line (odds ratio, [OR], 7.29; 95% confidence interval [CI], 2.31–23.00) and working in the cleaning region of the plant (OR, 3.22; 95% CI, 1.11–9.38) were associated with LD. LD can be transmitted in industrial settings in which aerosols are produced. Clinicians should consider LD when treating persons from these settings for pneumonia
Preview · Article · Apr 2003 · The Journal of Infectious Diseases
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Specific, Sensitive, and Quantitative Enzyme-Linked Immunosorbent Assay for Human Immunoglobulin G Antibodies to Anthrax Toxin Protective Antigen
Conrad P Quinn
Vera A Semenova
Cheryl M Elie
Sandra Romero-Steiner
Carolyn Greene
Han Li
Karen Stamey
Evelene Steward-Clark
Daniel S Schmidt
Elizabeth Mothershed
· [...] ·
Anne Schuchat
Jairam R Lingappa
Sandra K Martin
John Walls
Melinda Bronsdon
George M Carlone
Mary Bajani-Ari
David A Ashford
David S Stephens
Bradley A Perkins
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The bioterrorism-associated human anthrax epidemic in the fall of 2001 highlighted the need for a sensitive, reproducible, and specific laboratory test for the confirmatory diagnosis of human anthrax. The Centers for Disease Control and Prevention developed, optimized, and rapidly qualified an enzyme-linked immunosorbent assay (ELISA) for immunoglobulin G (IgG) antibodies to Bacillus anthracis protective antigen (PA) in human serum. The qualified ELISA had a minimum detection limit of 0.06 micro g/mL, a reliable lower limit of detection of 0.09 micro g/mL, and a lower limit of quantification in undiluted serum specimens of 3.0 micro g/mL anti-PA IgG. The diagnostic sensitivity of the assay was 97.8%, and the diagnostic specificity was 97.6%. A competitive inhibition anti-PA IgG ELISA was also developed to enhance diagnostic specificity to 100%. The anti-PA ELISAs proved valuable for the confirmation of cases of cutaneous and inhalational anthrax and evaluation of patients in whom the diagnosis of anthrax was being considered.
Full-text · Article · Nov 2002 · Emerging infectious diseases
Available from: cid.oxfordjournals.org
Benin AL, Benson RF, Besser RE. Trends in Legionnaires' disease, 1980-1998: declining mortality and new patterns of diagnosis
Andrea L Benin
· Robert F Benson ·
Richard E Besser
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New diagnostic tests and empirical therapy for pneumonia may have important ramifications for the identification, treatment, and control of legionnaires disease (LD). To determine trends in the epidemiology of LD, we analyzed data for 1980–1998 from the passive surveillance system of the Centers for Disease Control and Prevention. During this time period, there were 6757 confirmed cases of LD (median annual number, 360 cases/year). Diagnosis by culture and by direct fluorescent antibody and serologic testing decreased significantly; diagnosis by urine antigen testing increased from 0% to 69%. The frequency of isolates other than Legionella pneumophila serogroup 1 (LP1) decreased from 38% to 4% (P = .003). The case-fatality rate decreased significantly, from 34% to 12% (P < .001) for all cases, from 46% to 14% (P < .0001) for nosocomial cases, and from 26% to 10% (P = .05) for community-acquired cases. LD-related mortality has decreased dramatically. The decrease in culture-based diagnosis limits the recognition of non-LP1 disease and impairs outbreak investigation, because fewer Legionella isolates are provided for further examination.
Preview · Article · Nov 2002 · Clinical Infectious Diseases
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text:
"Strange Justice": A Victory For Right-Wing Ideology, But A Profound And Deep Loss For Racial Justice
Yesterday marked the twentieth anniversary of one of the great wrong turns in American civil-rights history, a grotesque decision that helped those who falsely and nonsensically believe that eliminating federal efforts to establish racial equality will somehow, in and of itself, establish racial equality. The horror of that day still reverberates, the pain of that moment still sears.
On June 12, 1995, the United States Supreme Court, in a ghastly 5-4 decision known as Adarand Constructors v. Pena, gutted the legal infrastructure upholding the country's affirmative action programs:
In refusing for the first time to uphold a federal affirmative action policy, the court said that such race-based policies enacted by Congress must now survive the same judicial standard that state and local programs have faced since 1989. Known as 'strict scrutiny,' it is the toughest judicial standard to meet. To survive, a program must serve a compelling governmental interest and must be narrowly tailored to address identifiable past discrimination.
"Government may treat people differently because of their race only for the most compelling reasons," Justice Sandra Day O'Connor wrote for the court. She said the Constitution's guarantee of equal protection of the laws protects "persons, not groups" of people.
"It follows from that principle that all governmental action based on race – a group classification long recognized as . . . irrelevant and therefore prohibited – should be subjected to detailed judicial inquiry to ensure that the personal right to equal protection of the laws has not been infringed."
O'Connor and her conservative court colleagues effectively struck Rep. John Lewis in the head one more time with this disgusting and destructive ruling, which was, of course, seized upon by right-wing ideologues to block pathways to black progress. The Adarand decision represented the Supreme Court's shout-out to those who believed that the federal government had done too much to combat past and present-day discrimination.
Perhaps the most repugnant aspect of this decision was the concurring opinion written by Justice Clarence Thomas–an opinion that rhetorically lynched his own black brothers and sisters. Then-TIME Magazine columnist Jack E. White was correct beyond refutation when he observed:
These days Washington seems to be filled with white men who make black people uneasy, like Newt [Gingrich] the slasher, Bill [Clinton] the waffler and Jesse the crank—Helms, that is, not Jackson. But the scariest of all the hobgoblins may well be a fellow African American, Supreme Court Justice Clarence Thomas. In the four years since George Bush chose him to fill the "black seat" vacated by Thurgood Marshall, Thomas has emerged as the high court's most aggressive advocate of rolling back the gains Marshall fought so hard for. The maddening irony is that Thomas owes his seat to precisely the kind of racial preference he goes to such lengths to excoriate. And as long as he is on the court, no other black need apply: Thomas fills a quota of one.
The most disturbing thing about Thomas is not his conclusions, but his twisted reasoning and bilious rage. In his written opinions, he begins with premises that no self-respecting black would disagree with, then veers off into a neverland of color-blind philosophizing in which all race-based policies, from Jim Crow laws designed to oppress minorities to affirmative-action measures seeking to assist them, are conflated into one morally and legally pernicious whole. He delights in gratuitously tongue-lashing the majority of blacks who disagree with him on almost every civil rights issue. He heaps scorn on federal judges who have used the bench to enforce and expand civil rights, accusing them of a paternalistic belief in black inferiority…
[Thomas] does not hesitate to incorporate dubious theories into his opinions when they suit his purposes. In his brief concurring opinion in the court's Adarand Constructors v. Pena, in which the court suggested that federal set-aside programs for minority contractors may be unconstitutional, Thomas wrote, "Inevitably, such programs engender attitudes of superiority or, alternatively, provoke resentment among those who believe that they have been wronged by the government's use of race. These programs stamp minorities with a badge of inferiority and may cause them to develop dependencies or to adopt an attitude that they are entitled to preferences." That claim reflects the wisdom of Gingrich country, where, as the House Speaker opined last week, most problems poor black people face are caused by their own "bad habits."
What Thomas, O'Connor and their right-wing friends will never admit is that bigotry will always be with us; it is hard-wired into our very nature, and thus the federal government will always need to take measures to ensure that bigotry does not strangle the aspirations of Americans of color. To that end, there will never be a day that we can get rid of affirmative action. We will always need goals, timetables, set-asides, preferences and yes, even the dreaded quotas, as they are nothing more than tangible measures by which we seek to reduce racial inequality.
The Adarand decision did great violence to the dream of racial equality. It empowered aggrieved right-wing whites to attack affirmative action programs with vicious vehemence, and put white progressives on the defensive against dubious claims of so-called reverse discrimination. The case was a victory for right-wing ideology, but a profound and deep loss for racial justice.
By: D. R. Tucker, Political Animal Blog, The Washington Monthly, June 13, 2015
"Patterns Or Practice Of Unnecessary Force": Justice Department Reaches Settlement With Cleveland Over Police Conduct
The Justice Department has reached a settlement with the city of Cleveland over the conduct of its police officers, the latest case in which the Obama administration has investigated excessive use of force and the violation of constitutional rights by a local department, according to an agency official.
The settlement, amid the growing national debate about American policing, is expected to be announced early this week, the official said. It comes just days after a judge acquitted a Cleveland police officer for his role in the fatal shooting of two unarmed people in a car in 2012 when officers thought the sound of the car backfiring was gunshots.
The Justice Department in December issued a scathing report that accused the Cleveland Police Department of illegally using sometimes deadly force against citizens. The Justice Department civil rights division found that the Cleveland police engaged in a "pattern or practice" of unnecessary force — including shooting residents, striking them in the head and spraying them with chemicals.
In one incident, an officer used a stun gun on "a suicidal, deaf man who committed no crime, posed minimal risk to officers and may not have understood officers' commands." The police were also accused of repeatedly punching in the face a handcuffed 13-year-old boy who had been arrested for shoplifting.
The Cleveland report was released the month after a 12-year-old African American boy, Tamir Rice, was fatally shot by a white Cleveland police officer. Cleveland officers had responded to a 911 call that reported a person pointing a gun. It turned out to be a toy pistol.
A Justice Department spokeswoman would not comment on the settlement, which was first reported on the Web site of the New York Times.
When last year's report about Cleveland was released, then-Attorney General Eric H. Holder Jr. traveled to the city to announce the findings and said the Justice Department and the city had agreed to establish an independent monitor who would oversee police reforms. The changes will include better training and better supervision of officers, Holder said.
In the past five years, the Justice Department's civil rights division has opened more than 20 investigations of police departments across the country, more than twice as many as were opened in the previous five. The department has entered into 15 agreements with law enforcement agencies, including consent decrees with nine of them. They include the New Orleans and Albuquerque police departments.
The Cleveland settlement will be the first under the new attorney general, Loretta E. Lynch.
Justice Department officials would not provide any details of the Cleveland settlement. But other cases have required an independent monitor and significant changes in training and policies.
Since April 27, when Lynch was sworn in as the first African American woman to serve as the nation's top law enforcement official, she has been immersed in the debate on policing tactics. Her first meeting with President Obama was to discuss the violence in Baltimore after the funeral of 25-year-old Freddie Gray, who suffered a fatal spinal injury while in police custody. Six Baltimore police officers have been indicted in connection with Gray's death.
Lynch's first official trip was to Baltimore to meet with the mayor, law enforcement officials and community leaders. She also met with Gray's family and spoke with an officer who was injured in the violence.
At her first news conference, on May 8, Lynch announced that the Justice Department had opened a broad "pattern or practice" investigation into the Baltimore Police Department to determine whether officers have committed systemic constitutional violations.
The investigation is separate from the Justice Department's criminal civil rights probe into the death of Gray.
Similarly, the settlement with the city of Cleveland is separate from the Justice Department's investigation into the conduct of Cleveland police officer Michael Brelo.
On Saturday, a judge found Brelo, a 31-year-old white officer, not guilty of two counts of felony manslaughter in the deaths of African Americans Timothy Russell, 43, and Malissa Williams, 30.
Hours of protests ensued in downtown Cleveland, and the Justice Department released a statement saying that the Cleveland U.S. attorney's office, the FBI and the Justice Department's civil rights division were all still investigating the case.
Russell and Williams were killed in November after they led 62 police vehicles on a chase across Cleveland. When Russell's car finally stopped, 13 officers opened fire and shot at least 137 rounds into the vehicle. Brelo was accused of being the only one who continued to shoot after any possible threat was contained. Prosecutors said he climbed onto the hood of the car and shot 15 rounds into the windshield, striking both Russell and Williams.
"We will continue our assessment, review all available legal options and will collaboratively determine what, if any, additional steps are available and appropriate given the requirements and limitations of the applicable laws in the federal judicial system," said the statement from several officials, including Vanita Gupta, head of the Justice Department's civil rights division.
As with the Ferguson, Mo., civil rights investigation into the August death of Michael Brown, an unarmed black 18-year-old who was shot and killed by Officer Darren Wilson, the Justice Department faces a high bar in bringing federal civil rights charges. Prosecutors would have to prove beyond a reasonable doubt that Brelo intended to violate the constitutional rights of Russell and Williams.
When Holder released the December report about the "unreasonable and unnecessary" use of force by the Cleveland police, he said he was hopeful that "meaningful change" was possible in the police department.
"Accountability and legitimacy are essential for communities to trust their police departments and for there to be genuine collaboration between police and the citizens they serve," Holder said.
By: Sari Horwitz, The Washington Post, May 25, 2015
"Kansas Has Gone Full Tea Party": Kansas' Experiment In Concentrated Conservatism Keeps Getting Grimmer
Kansas is in the midst of a grim experiment putting crackpot supply-side economic theories into practice. While these economic anti-reforms will have devastating results for poor people in the state, in other respects Republican Gov. Sam Brownback and his legislative allies have made the government more intrusive into the private lives of the state's citizens. April has provided some particularly egregious examples of this disastrous turn.
Kansas has been a Republican state for a long time. Since 1936, the only time the state has given its electoral votes to a Democratic candidate was to Lyndon Johnson in the massive landslide of 1964. Despite this, Kansas has historically not been a far-right state. Prominent Kansas Republicans have generally been moderates, like Bob Dole and Nancy Kassebaum. Kathleen Sebelius, President Obama's former secretary of health and human services, was the state's Democratic governor as recently as 2009.
But since the election of Brownback, Kansas has gone full Tea Party. Kansas Republicans have enacted massive upper-class tax cuts, with the idea that they would produce such an explosion of economic growth that the state would actually gain revenues. This makes no sense in theory and has been a catastrophe in practice. Revenues have cratered, while economic growth lags behind neighboring states. Spending on the poor has decreased, while the tax burden on the poor has increased. Needless to say, Kansas has rejected the Medicaid expansion offered by the Affordable Care Act, denying access to health care for many poor Kansans.
Kansas Republicans certainly have no intention of taking responsibility for this disaster, which means a search for scapegoats. The targets should not be surprising: poor people, women, and gay people.
Earlier this month, Brownback signed a bill that, among other things, prevents welfare recipients from spending government-provided funds on things poor people do not spend their money on, such as cruise ships. As Emily Badger of The Washington Post observes, this reflects a trend in Republican-governed states of placing burdens and restrictions on poor people that do not apply to any other recipients of government benefits — and for no good reason.
The demeaning of the poor doesn't end there. Recipients of funds from the Temporary Assistance to Needy Families program will have their daily withdrawals, using the provided ATM cards, limited to $25 a day, not only creating needless inconvenience, but effectively transferring money from the poorest citizens in the state to banks in the forms of additional fees.
Brownback rose to prominence as more of a social conservative than a fiscal conservative. So it's not surprising that Kansas is placing irrational legal burdens on women as well. Kansas passed a bill banning dilation and evacuation abortions (under the junk science name "dismemberment abortions.") The procedure is safe — so there is no health-related justification for banning it — and is the most common one used for second-trimester abortions, which women have a constitutional right to obtain.
Even worse, the ban does not contain exceptions for rape, incest, or most threats to a woman's health. The law puts women's health at risk by interfering with the judgment of doctors in order to punish women for exercising their constitutional rights in a way Kansas legislators disapprove of.
Brownback's attacks on basic justice and equality don't end there. In 2007, Sebelius issued an order banning discrimination against LGBT state employees. Earlier this year, Brownback rescinded the order, creating a new standard under which state employees could be fired simply because of their sexual orientation. Brownback defended the order using the traditionally disingenuous "special rights" language so often employed by those who favor legal protection for bigotry: "This Executive Order ensures that state employees enjoy the same civil rights as all Kansans without creating additional 'protected classes' as the previous order did."
This argument would make sense — if you think that gay and straight people are equally likely to be discriminated against because of their sexual orientation. In the actually existing world, Brownback's measure does not guarantee civil rights to all Kansans, opening the door for discrimination against gays and lesbians based on their sexual orientation.
Under Brownback, Kansas has offered a concentrated form of what most national Republicans claim to want. Tax cuts for the wealthy, tax increases and reduced benefits for the poor, arbitrary interference with the reproductive freedom of women, and increased discrimination against gays and lesbians. Voters next November should ask themselves whether they want this ghastly agenda to be repeated on a national scale.
Editor's note: A previous version of this article mistakenly asserted that Kansas recently banned dilation and extraction abortions, but these were already illegal.
By: Scott Lemieux, The Week, April 24, 2015
"Rand Paul Consistently Defends Discrimination": And Opposes The Government's Right To Protect People From Discrimination
In the past, when Senator Rand Paul has been asked about enforcement of the Civil Rights Act of 1964 or other civil rights bills, he's fallen back on the idea that you can better assure, for example, desegregated lunch counters by denying that particular Woolworth's your business than by enacting federal legislation. When it came to housing, he said this, "Decisions concerning private property and associations should in a free society be unhindered. As a consequence, some associations will discriminate."
Using this rough logic, if you can call it that, people who seek to order lunch or buy a home are behaving a certain way. And people who deny patrons a meal or won't sell them a house are also behaving a certain way. And people should be free to behave pretty much however they want. In a free society, some people will exhibit racist behaviors: "some associations will discriminate." Other people will try to do certain things and find that they can't accomplish them because of their race, gender, religion, or sexual orientation. But no one told them that they couldn't try.
For Rand Paul, the best way to change someone's behaviors is to behave some way yourself. Like Indiana Governor Mike Pence, who said he wouldn't continue to eat at a restaurant that turned away gay couples, Rand Paul thinks that businesses can best be persuaded to serve all people by the threat of lost business from customers whose patronage they actually want.
So, pretty much across the board, Senator Rand Paul thinks about civil rights as a matter of how people behave rather than a matter well-suited for legal solutions or protections.
But, then, look at this:
"I don't think I've ever used the word gay rights, because I don't really believe in rights based on your behavior." –Senator Rand Paul
The logic of that statement appears straightforward. Being black or a woman, how old you are, are not things you can change through behavioral modifications, but who you are physically attracted to is purely a matter of choice. Someone can deny you a sandwich or a wedding cake based on their perception of your sexual orientation because the presumption is that you behave a certain way, not that you are a certain way.
So, suddenly, the gay couple seeking dinner is distinct from the black gentleman seeking lunch, even though their behaviors are nearly identical.
If you're seeking some consistency here, it's not that hard to find. Rand Paul, in all circumstances, defends the right to discriminate and opposes the government's right to protect people from discrimination.
He'll shift around how he justifies these positions, but the positions remain the same.
There's a certain appeal to the Paulista philosophy that has the potential to attract a lot of people in the younger generations, but here we see him running afoul of a core value of our youth, which is that gays should not be denied the same rights as everyone else.
It's not just that he seems to be insisting that sexual orientation is a choice, but also that he wants to defend people's right to behave any way they want, even in an openly discriminatory manner, unless their behavior involves sex.
This is not a winning position and it will hurt Paul badly with the very generations that might otherwise flock to his campaign.
By: Martin Longman, Ten Miles Square, The Washington Monthly, [Cross-posted at Progress Pond], March 31, 2015
"Let's Not Worry About Civil Rights In This Country": Tom Cotton; Opponents Of Anti-Gay Law Need 'Perspective'
I'm starting to long for the good old days, just weeks ago, when nobody had to think about Senator Tom Cotton, Republican of Arkansas.
Mr. Cotton, you will remember, was the primary author of the constitutionally outrageous and substantively mindless letter from Republican senators telling the leaders of Iran that they shouldn't negotiate on nuclear weapons with President Obama. Now, he is adding his voice to those who are telling gay Americans that they shouldn't get too pushy about their civil rights.
Mr. Cotton was asked by Wolf Blitzer on CNN yesterday about a law passed by legislators in his home state that is clearly intended to permit businesses and individuals to discriminate against people on the basis of their sexual orientation.
"In Arkansas," he began, "we believe in religious freedom." Mr. Blitzer, to his credit, pointed out that "everybody believes in religious freedom."
Mr. Cotton countered with the irrelevant fact that President Clinton signed a federal law on which the current assault on gay rights is based. (The comically named Religious Freedom Restoration Act). That's true. He also signed the Defense of Marriage Act, an outrageous infringement on the constitutional rights of gay, lesbian, bisexual, and transgender Americans. And he signed the bill that turned military policy against gays and lesbians serving openly in the armed forces into the moronic law known as "don't ask, don't tell."
So Mr. Clinton was lousy on this civil rights issue. What's Mr. Cotton's point?
"It's important that we have a sense of perspective about our priorities," he said. "In Iran they hang you for the crime of being gay."
So, let's not worry about civil rights in this country, which Mr. Cotton and other lawmakers can actually protect, but rather in Iran. Why Iran?
I'm so glad you asked — because Mr. Cotton wanted to turn the conversation to his current propaganda campaign about Iran. "We should focus on the most important priorities facing our country, right now," he said, adding that the prospect of a "nuclear-armed Iran" is one such priority.
So why is Mr. Cotton trying so hard to scuttle the talks in Switzerland that could actually lead to limits on Iran's nuclear programs?
By: Andrew Rosenthal, Taking Note, The Editorial Page, Editor's Blog, The New York Times, April 2, 2015


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ITA (Marchetti; Zambrotta, Cannavaro, Chiellini, Criscito; Gattuso, De Rossi, Montolivo; Pepe, Iaquinta, Di Natale) 2, SVK 1
According to the Gazzetta dello Sport, today's practice featured:
Defence: Zambrotta – Cannavaro – Chiellini – Criscito
Midfield: Gattuso – Montolivo – De Rossi
The front line, though, seems totally up in the air. Appartently it's between Gilardino and Pazzini for the centre-forward role, whereas on one side it's between Pepe and Di Natale, and on the other it's between Iaquinta and Quagliarella.
The Corriere dello Sport, on the other hand, says preference up front will go to Iaquinta-Gilardino-Di Natale.
And this just in: Umberto Bossi says he was only kidding when he said Italy would bribe their way past Slovakia.
You will know from having read my posts and tweets — including my contributions (here and here) to the Guardian / Observer — that I've been predicting a slow start for Italy. The performance of the Azzurri so far has disappointed the vast majority of Italians (especially journalists), but I was interested to see Italian newspapers look back — with some despair — to 1982 for analogies. It was a real treat to read an article written by the greatest of Italian football journalists, Gianni Brera, after Italy's second game in WC1982; here, the tone is summarized by the downbeat, yet strangely optimistic, headline: 'Conti, Cabrini and that's all: Nevertheless, we can do it'.
The Gazzetta dello Sport spoke today with that team's manager, Enzo Bearzot, about such comparisons. Bearzot believes that his team was in a much more difficult opening round than the present one, and faced a much more horrible knock-out phase in having to get past both Argentina and Brazil. He admits, though, that Maradona is right in saying everyone should fear Italy, because the Azzurri change character in the later phases of the World Cup.
In regard to Italy's game against Slovakia: it's silly to be opining without seeing the training sessions, and to be relying solely on media reports and gossip, but that has never stopped 'real' journalism before, so why change things now?
It seems Andrea Pirlo won't be ready for Slovakia, which means we'll see another Italy formation that pales in comparison to the one Marcello Lippi would like. But I must say — I like the sounds of what I'm hearing, regarding a possible 4-3-3 formation. Let's look at the possible starters …
Goal: Marchetti was absolutely fine, if underworked, versus New Zealand. There has been no talk of Buffon returning any time soon, and that's good. I really cannot see him playing later in this tournament, as the risk is too great: to his health, and to Italy's performance.
Defence: Cannavaro has been much too harshly criticised; his play has been, if not stellar, certainly more than adequate. He has been blamed for the two goals scored against Italy, but they were patently not his fault. Chiellini has been solid, and improving with the passing of the games; he also seems to be gaining confidence coming forward. Zambrotta has been very good indeed, much better than I'd expected. Criscito has been fine, too, but he's not untouchable; I think this might be a good moment to replace him with Maggio. So I hope to be seeing Zambrotta – Cannavaro – Chiellini – Maggio.
Midfield: Rumour has it that Lippi is leaning toward Gattuso – Montolivo – De Rossi, and I think this would be great. Montolivo and De Rossi have been the strongest players for the Azzurri so far. Montolivo's confident play has been a bit of a surprise, but De Rossi has not shocked anyone: he was expected to be Italy's best player, and he is also proving to be a greater leader than I'd anticipated. Gattuso is well rested, and will provide the energy that has been a little bit lacking so far, and thus free up Montolivo even more.
Forward: The attack is where things have not been clicking yet. This is partly due to the inability of the midfield, in the first two games, to free the forwards with fine passes, and partly to some reticence in breaking forward. It's not like Luca Toni in 2006, who missed many chances but whose rampant style opened space for other Azzurri; here, Iaquinta and (especially) Gilardino simply have not been receiving the ball in the box. Twice, Di Natale has been thrown in during the match, but I sense he has not yet meshed with his colleagues; when he does, the opposition will have very much to worry about, because he can pass and he can score in very unlikely situations. My sole concern in his regard is how well he interacts without his Udinese team mate Simone Pepe; perhaps the two of them need to be on the pitch at the same time during the next game or two, but I do not think that they will both be starters against Slovakia. I think now is the best possible time to be starting Pazzini and introducing Quagliarella; not only are they likely to make things happen in the box, but they also need the opportunity of playing before the knock-out phase of the tournament. So, for the 'trident', I would like to see Di Natale – Pazzini – Quagliarella (as do close to half the people polled by the Gazzetta dello Sport today, as witnessed here).
Italy will feel more comfortable playing Slovakia than either Paraguay and New Zealand. Not only will the style be more familiar to them, but they also know their players better — particularly their star, Marek Hamsik, who has been disappointing so far in the tournament. Most of all, Slovakia must attack in this game, because their only hope of progressing to the next round is to win, and this will suit Italy's mentality and style.
Che altro? The leader of Italy's Northern League, Umberto Bossi, is (quite unsurprisingly) the most despicable person in his risible movement for the independence of Padania, or the Po Valley. Yesterday evening he stated that Italy will bribe their way to victory over Slovakia, as will be witnessed by two or three more Slovaks playing with Italian teams next year. Italian football administrators have expressed their indignation, but you have to wonder why they bother. I suppose, though, it's another factor that will help with the siege mentality that Lippi has fostered as coach of the Azzurri, in 2006 as well as this year. It worked last time!
On Thursday I was asked to send to The Observer a preview of tomorrow's game; here's what I prepared for them (200 words):
By first-game standards, Italy played well against underrated Paraguay, and their physical condition was surprisingly excellent. They allowed one shot; team leader Daniele De Rossi blew that one, but he also scored Italy's goal. Newcomers Simone Pepe and Riccardo Montolivo also played commendably. The Azzurri still need time to find their feet, awaiting Andrea Pirlo's return (likely Thursday, against Slovakia) and losing, probably for the tournament, Gigi Buffon. This isn't fatal: Federico Marchetti is no Buffon, but he's excellent (Bayern has reportedly offered €15m for him already).
Italy are always confident they'll defeat a team with a modest pedigree ('New Zealand?' 'Check!') or that is notable primarily for its strength and size ('New Zealand?' 'Check!'). Sadly for the Azzurri, they often suffer against those very teams. Although Italy will switch to a more comfortable 4-4-2, they're still finding themselves, so I predict a 1-1 draw (50% likely) or a one-goal Azzurri victory (40%). The result may dismay many, but coach Marcello Lippi and his players will take it and build for Slovakia. Starting lineup: Lippi's still experimenting, but I think it's Marchetti; Zambrotta, Cannavaro, Chiellini, Criscito; Pepe, Montolivo, De Rossi, Marchisio; Di Natale, Iaquinta. Most likely substitutes: Maggio, Gattuso, Pazzini.
I didn't hear back from them to acknowledge receipt of my contribution, so I can only hope it was received and will be used in tomorrow's paper.
The impressive performances of 'new' azzurri Montolivo, Pepe and Criscito give hope. Zambrotta, who also played well, can be substituted — perhaps for the New Zealand game — by another newcomer, Maggio. It would not hurt to have Cannavaro (who played a good match) replaced by Bonucci or Bocchetti for one of the next two games, either.
But am I the only person who is concerned about Buffon being substituted because of the recurrence of a back problem??? If it is indeed back-related, he will need more than the two days of rest he claims to require. I would much rather see Marchetti or (preferably) De Sanctis start the next game.
Maybe we'll see a lineup like this one on the pitch at some point during the tournament:
Maggio – Bonucci – Chiellini – Criscito
Montolivo – Pirlo – De Rossi
Di Natale – Pazzini – Pepe
I don't think this compares badly with the v. Paraguay lineup, do you?
As expected, Paraguay played very well. Their organization was generally impressive, and the quality of several players was really notable.
More importantly (from the Boubster's point of view), Italy — by its standards — played well. Yes, the first half was rather painful; Marchisio couldn't break through the midfield at all, and Gilardino received no service. More worryingly, the goal was due to a mixup in defending, of the sort one had hoped would have been taken care of during the past few weeks of practice.
Montolivo played well, and gives promise for improved confidence in upcoming games. Maybe Gilardino as a sole striker will work with a different formation; on today's evidence, it won't be easy for Marchisio to receive and relay passes. If anything worries me regarding today's performance, it's that it took the entry of Camoranesi (apart from a change to 4-4-2) to improve the level of play.
I like the idea of Di Natale coming off the bench. He didn't do too much today, but I think his performance will improve. Pepe played very well, as did Criscito. Cannavaro, apart from the goal (which was more De Rossi's fault), played better than I expected. Chiellini was strong, as was (again, surprisingly) Zambrotta.
I had hoped for more from Iaquinta, but he (like Gilardino) was not getting much in the way of service or assistance.
Buffon's sciatica acted up again at half time, apparently, but Marchetti, on the few occasions he was tried, proved to be fine. (I wish Sirigu were present, instead of being sent home before the trip to South Africa.)
In all, by Azzurri standards, an acceptable and promising start.


text:
Standard Interpretations - Table of Contents
| Standard Number:
|1926.21(b); 1926.54(a)
September 21, 1992
Ms. Regina Keenan
Training Coordinator
Carpenter Health & Safety Fund of
North America United
Brotherhood of Carpenters
101 Constitution Avenue N.W.
Washington, D.C. 20001
Dear Ms. Keenan:
This is in response to your letter of April 8 requesting information about the Occupational Safety and Health Administration (OSHA) training requirements for the use of Level 1 lasers. I apologize for the delay in responding to your inquiry.
Although paragraph 29 CFR 1926.54(a) requires employees assigned to install, adjust, and operate laser equipment (including Level 1 type lasers) to be trained, there are no additional specific OSHA regulations that indicate what training is necessary. Consequently, the general safety training and education requirements of 29 CFR 1926.21(b) apply and those have been interpreted by OSHA to require at least the following:
1. The employer shall provide for the instruction of each laser equipment operator and instructor in accordance with the applicable manufacturer's recommendations. The instruction process shall inform the operator of various hazards associated with the use of the equipment and the necessary or recommended control measures for the elimination of hazards to personnel. In addition to information from the manufacturer, the American National Standard ANSI Z136.1-1986 could be reviewed for training information.
2. Instruction should be conducted by a qualified representative of the manufacturer, or by a knowledgeable individual designated by the employer.
It is always a good practice to maintain employee training documentation at the construction site so that the records are available for review by a compliance officer. If you have further questions, please do not hesitate to contact Mr. Roy F. Gurnham or Mr. Dale R. Cavanaugh of my staff at (202) 219-8136.
Roger A. Clark
Acting Director
Directorate of Compliance Programs
|Standard Interpretations - Table of Contents
The Department of Labor does not endorse, takes no responsibility for, and exercises no control over the linked organization or its views, or contents, nor does it vouch for the accuracy or accessibility of the information contained on the destination server. The Department of Labor also cannot authorize the use of copyrighted materials contained in linked Web sites. Users must request such authorization from the sponsor of the linked Web site. Thank you for visiting our site. Please click the button below to continue.


text:
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