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Chief's Counsel
Disclosing Officer Untruthfulness to the Defense: Is a Liars Squad Coming to Your Town?
By Lisa A. Judge, Police Legal Advisor, Tucson, Arizona, Police Department
ince 1963, a series of U.S. Supreme Court decisions has clarified that, in a criminal case, prosecutors must disclose to the defense evidence favorable to the defendant. This includes information that may be used to impeach the credibility of government witnesses, including law enforcement officers. These decisions mean that officers who have documented histories of lying in official matters, falsifying reports, or expressing bias may become even greater liabilities to their agencies because their records may render them unable to testify credibly and consequently unable to work effectively as law enforcement officers.
Supreme Court CasesIn Brady v. Maryland the U.S. Supreme Court held that "the suppression by the prosecution of evidence favorable to an accused upon request violates due process where the evidence is material either to guilt or to punishment, irrespective of the good faith or bad faith of the prosecution."1 In Brady two men were tried for a murder that occurred during a robbery. One of the defendants, Brady, admitted that he had taken part in the robbery but claimed that the other defendant committed the killing. The Court found that the prosecution should have disclosed to Brady's attorney the co-defendant's statements confessing to the killing.
In Giglio v. United States the Supreme Court extended the obligation to share exculpatory information with the defendant to include information concerning the credibility of government witnesses.2 Giglio was convicted of forgery primarily on the testimony of an unindicted co-conspirator. At trial, the co-conspirator testified that he had not received any promises of leniency in exchange for his testimony against Giglio, when in fact the prosecutor who presented the case to the grand jury had promised not to prosecute him in exchange for testifying. The Court was unimpressed with the trial prosecutor's claims that he knew nothing of the deal. "When the reliability of a given witness may be determinative of guilt or innocence," the Court wrote, "nondisclosure of evidence affecting credibility falls within this general rule."
In United States v. Agurs the Supreme Court expanded the rule further by recognizing a duty to disclose exculpatory information even in the absence of a specific request for it.3 The female defendant was convicted of second-degree murder in the stabbing death of a male acquaintance. The defendant had claimed self-defense. After the trial, the defendant learned that the prosecutor had failed to disclose the victim's previous guilty pleas to assault and weapon possession charges. The Court held that the prosecutor's failure to disclose material exculpatory evidence violated due process.
United States v. Bagley further defined "material" evidence as information that, if disclosed to the defense attorney, would have a "reasonable probability of providing a different result in the trial or sentencing."4 This case also clarified that impeachment evidence must be disclosed to the defense. Here, the government failed to disclose contracts with confidential informants who testified against the defendant in his trial on weapons and narcotics charges, which his attorney could have used to impeach their testimony. The Court found that this type of information was material since it would cast doubt on the motives of the witnesses.
Finally, the Court's decision in Kyles v. Whitley imposed upon the prosecutor an affirmative "duty to learn of any favorable evidence known to the others acting on the government's behalf, including the police," and a resulting duty to disclose that evidence to the defense.5 In this case, the defendant was convicted of first-degree murder but was given a new trial after it was discovered that the prosecutor had not divulged exculpatory evidence, even though the prosecutor was unaware of the evidence, which was in police files. The Court stated that even if a prosecutor isn't aware of the exculpatory evidence, "procedures and regulations can be established to carry [the prosecutor's] burden and to insure communication of all relevant information on each case to every lawyer who deals with it."
Federal Law Enforcement's Response to the Disclosure RulesThe bottom line: these Supreme Court decisions create a rule that requires prosecutors to learn of and disclose to the defense information that could be used to discredit law enforcement witnesses in a case. Prosecutors are essentially held responsible for knowing what the police know. The reality is that prosecutors must rely on law enforcement agencies to inform them of a hidden witness credibility problem including, for example, evidence of an officer's prior untruthfulness in official matters.
Responding to this requirement, Attorney General Janet Reno in 1996 established the so-called Giglio policy, which required federal law enforcement agencies to inform federal prosecutors about potential impeachment information. Specifically, federal investigative agencies are required to report prior misconduct involving the officers in a case if that misconduct is "material to the defense" and would damage the credibility of an officer-witness.
This policy places a burden both on the enforcement agency and individual officers to ensure that federal prosecutors are informed about impeachment information. Mere allegations of this type of evidence need not be reported to the prosecutor unless the allegation is determined to be "very credible." However, under this policy, even allegations against the officer that were not sustained, are not credible, or resulted in exoneration may be subject to disclosure if: (1) required by a court; (2) the allegation was made by a federal prosecutor or judge, or received publicity; (3) the agency and the prosecutor agree that disclosure is appropriate under the circumstances; or (4) the agency deems such disclosure is appropriate.
Implications for State and Local Police DepartmentsMany state and local agencies have similarly begun to disclose to prosecutors any conclusive information regarding untruthfulness, bias, and crimes committed by an officer who is to be a material witness in a criminal prosecution. Once the prosecutor is aware of such information, he or she can decide if the information should be disclosed to the defense attorney.
If the misconduct involves untruthfulness, it is likely to undermine the officer's ability to testify effectively. Agencies have responded to this problem in different ways. Some have adopted strict truthfulness policies and terminate officers who violate them. Other agencies have simply placed officers with impeachment problems in administrative assignments where there is no likelihood of becoming a witness in a criminal case, essentially creating so-called liars squads.
Defense attorneys are using information about untruthful officers to create databases to be used by other defense attorneys. For example, in San Diego, a defense attorney faced with a police witness in a case need only consult a database established by San Diego County Public Defender's Office containing information about local police misconduct and bias.6 If there is information about that officer being untruthful or in some way biased as a witness, the attorney will attempt to use that information to impeach that officer.
As this trend grows, agencies will be required to deal more forcefully with officers who lie. Departments may choose to adopt strict policies regarding truthfulness and rigorously adhere to those policies. Without taking such steps, agencies set themselves up to employ a portion of their commissioned workforce as administrative employees, unable to investigate crimes and testify regarding their investigations. ■
1 Brady v. Maryland, 373 U.S. 83 (1963).2 Giglio v. United States, 405 U.S. 150 (1972).3 United States v. Agurs, 427 U.S. 97 (1976).4 United States v. Bagley, 473 U.S. 667 (1985).5 Kyles v. Whitley, 514 U.S. 419 (1995).6 "Database to Let Attorneys See Conduct of Officers," San Diego Union-Tribune, Dec. 24, 2000.
From The Police Chief, vol. 72, no. 11, November 2005. Copyright held by the International Association of Chiefs of Police, 515 North Washington Street, Alexandria, VA 22314 USA.


text:
Top Definition
the hair on your ass, ladies all guys got it so get used to it
viết bởi JDB 12 Tháng hai, 2003
Trending Now
Can you define these popular missing words?
when your pubic hair trails off to finish around your asshole... gentlemen? all ladies have it.. get used to it. Dingleberries tend to take up residence here of you don't clean yourself regularily.
I shave my girlfriends asshole to rid her of all her ass hair once a week.
viết bởi db 10 Tháng mười, 2004
Someone worse than an asshole, namely because an asshole serves an actual purpose, but an asshair smells just as bad and serves no useful purpose whatsoever.
John: Hey, that mark is an asshole
Frank:, No man, he's useless, he's an asshair.
Frank:, No man, he's useless, he's an asshair.
viết bởi Daniel Beaton 08 Tháng mười hai, 2005
hairs or pubes that appear on an asshole
your asshair yanked out and u sliped
viết bởi slapapig 23 Tháng chín, 2003
The hair on one's ass.
Goddamn - i was naked when I sat on that fuzzy chair, and when I got up I ripped out all of my asshairs
viết bởi minguab 31 Tháng một, 2007
1. An annoying person that is as worthless as a hair on your ass.
2. A person below your level, just a hair on your ass.
2. A person below your level, just a hair on your ass.
Tommy McKnight is an Asshair.
viết bởi Rein 22 Tháng tư, 2003
When someone's hair is parted down the middle, resembling an ass.
viết bởi MJA1234 29 Tháng một, 2011

subset: commoncrawl


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text:
Worldwide, gastric cancer ranks second only to lung cancer in mortality and accounts for 500 000 deaths annually. Since 1930, the incidence of gastric carcinoma in the United States has been declining steadily and plateaued during the 1980-1990 decade. Mortality rates for white males in the United States were approximately 40 per l00 000 in l930, compared with 5.4 per 100 000 in l994. For nonwhite males the rates were 23.7 per 100 000 in 1955 and 12 per 100 000 in 1985. In the United States in 2002, an estimated 21 600 new cases and 12 400 deaths were attributable to gastric carcinoma.1
Lymph node stations according to the Japanese Research Society for Gastric Cancer. A, Stations 1 through 6 (N1), 7, 9, 12, and 14 are seen. CHA indicates common hepatic artery; LGA, left gastric artery; SGA, short gastric arteries; LGEA, left gastroepiploic artery; SPA, splenic artery; RGEA, right gastroepiploic artery; RGEV, right gastroepiploic vein; SMA, superior mesenteric artery; SMV, superior mesenteric vein; MCA, middle colic artery; and MCV, middle colic vein. B, Second echelon (N2) lymph node stations 7 through 11 and third echelon (N3) lymph node stations 12 through 14 are seen. PV indicates portal vein; CA, celiac axis; SV, splenic vein. See Figure 2for the location of the stations.
Grouping of lymph node (LN) stations according to the location of the gastric cancer. CA indicates celiac axis; CHA, common hepatic artery; LGA, left gastric artery; MCA, middle colic artery; SPA, splenic artery.
With the stomach retracted upward, an omentobursectomy is performed by resecting the anterior leaf of the transverse mesocolon which is facilitated by hydrodissection (injection of a sterile saline solution).
With ligation and division of the right gastroepiploic artery, the subpyloric package of lymphoareolar tissue (station 6) is swept upwards to be included with the specimen.
A wide Kocher maneuver to expose retropancreatic (station 13) and para-aortic (station 16) lymph nodes.
A, Pancreas-preserving lymphadenectomy includes proximal ligation and division of the splenic artery after dissecting it from the superior border of the pancreas. B, Small tributaries from the splenic artery to the pancreas remain to be divided and ligated.
The hepatic artery, celiac axis, and the proximal splenic artery have been skeletonized. A spleen-sparing lymphadenectomy at the splenic hilum (station 10) is shown.
The lesser omentum and the peritoneal lining overlying the hepatoduodenal ligament is incised from the left edge, across two thirds of its width, and then downward toward the superior border of the duodenum (Inset). The anterior peritoneal lining of the ligament is open and the hepatoduodenal lymph node dissection (station 12) begun by skeletonizing the hepatic artery proper.
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Top Definition
A person in a first person shooter who jumps in order to gain an advantage over an enemy. This maneuver may be executed while turning a corner to surprise their foe around said corner, or in open conflict. When killed by a jumper nazi, one feels the need to rant about their death, insulting the enemy, and try to convince themselves that they would have killed that bastard had they not jumped.
SMSchoirboy: Damn it, that jump nazi just got me... damn n00b.
TSwift_is_a_babe: I'm such a n00b.
TSwift_is_a_babe: I'm such a n00b.
by SMSchoirboy December 30, 2011
Trending Now
Can you define these popular missing words?


text:
Top Definition
Something that's way cool maybe tooo cool!
you check out my new twenty-foz they wicked pissa!
by oscar from the block April 18, 2003
Trending Now
Can you define these popular missing words?
Boston/Rhode Island speak for AMAZING.
cappyXwise is mad wicked pissa.
by Lynn February 28, 2005
Something that is bad or not.
It's a pissa your girl friend gave you the clap.
by gdnoggin June 12, 2003
a name given to Marissa who happens to be from boston
Wicked pissa Missa is wicked cool.
by Marissa February 09, 2005


text:
Tim Tebow is about to talk (a lot) for a living as an SEC Network college football analyst for ESPN. But that still hasn't quite quelled the talk of his potential NFL comeback. Because, well, he mentioned it.
Tebow, speaking in his new television personality capacity at an event in Nashville, told The Tennesseean that in the unlikely event a team knocks on the quarterback door, he's trying to stay ready enough to walk through it.
MORE: Top 10 free agents still available | All-breakout team
"I'm training every day and feel like I'm the best that I've ever been," Tebow said. "I still love it, love playing, talking about it, and I'm just excited about whatever the future holds. Who knows what could happen? But I'm excited about it, though."
When Tebow uses "excited" that much, you know he's moderately interested.
Even though a team such as the local Tennessee Titans have a bit of a QB question going into 2014, don't expect Tebow's recent work throwing to receivers from the Nashville Venom -- the city's professional indoor football league — to get him attention from the "big club" or any other NFL outfit.
Speaking of outfits, it's a good bet that we've seen the last of him in a popular, best-selling jersey and we'll see a lot more of him in flashy, TV-friendly suits this fall.


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essie shades featured at the Jill Stuart show
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Star Tracks: Monday, May 16, 2016 42 years, 2,191 covers and 55,436 stories from PEOPLE magazine's history for you to enjoy
Latest News!
- Iconic Golfer Arnold Palmer Dies at 87
- Read the Cover Story: Brad & Angelina Split After 12 Years: It's Over
- Jacqueline Laurita Plans Early Departure from Vermont Trip After Threats from Teresa Giudice's Friend
- WATCH: Dancing With The Stars Listen up! Usain Bolt Wants in
- American Horror Story's Denis O'Hare: Even the Actors Are Surprised by the Show
People Top 5
LAST UPDATE: Tuesday February 10, 2015 01:10PM EST
PEOPLE Top 5 are the most-viewed stories on the site over the past three days, updated every 60 minutes
- August 05, 1985
- Vol. 24
- No. 6
In Her New Job as a Video Jock, Singer Rita Coolidge Helps Vh-1 Make It Through the Night
Not for long, she hopes. This summer Coolidge has appeared as the sole female veejay on VH-1, MTV's laconic, easy-listening spin-off. As the first bona fide female entertainer to become a video jock, Coolidge is treading where no solo recording star has gone before. Although cynics would say her middle-of-the-night slot is the last stop before oblivion, Rita doesn't see it that way. She likes the idea of being a pioneer of sorts—and, not incidentally, on a frontier that "improves my visibility." Coolidge shared the job after some assiduous campaigning by her manager, Ron Rainey. Last January she flew from L.A. (where she lives with her only child, daughter Casey Kristofferson, 11, and musician Thorn Mooney, 38) to audition in New York City. Judy Collins was also considered, but, says VH-1 executive Kevin Metheny: "We saw a warmth in Rita you seldom see in TV."
At 40, the lithe and graceful singer has the look of a moneyed California matron who wears clothes a trifle too young for her: The gauzy white shirt, suspendered jeans, silver-studded leather belt and dangly rhinestone earring would not look out of place on her daughter. On a five-day jaunt from L.A. to tape three weeks' worth of shows in New York, Coolidge seems on the brink of sensory overload. "New York is not my pace," Rita admits. "I feel like I'm back at Florida State cramming for exams."
When she debuted in May, the excitement meter registered low. Rita's Southern speech sounded somnolent, and her face looked haggard under inexpert lighting. "I could see room for improvement in the first shows," says Coolidge. Agrees Holly St. Lifer, Coolidge's director: "It took her a while to get the jargon down, but once she did, her energy level went up."
VH-1 happened along at a crucial time in Coolidge's life. Last year her singing career was endangered when a small nodule appeared on her vocal cords. "My voice went away completely for a while," she says. "I got dizzy onstage from forcing air and had to have shots of cortisone so I could do road shows."
The cortisone triggered depression, but no improvements. An Australian tour was canceled partway through because of her problems, and Coolidge went speechless for two weeks at a stretch. Last October she had surgery to remove the nodule. "I wish I'd known about the operation earlier," she says. "I had a sore throat for two days and then it was over."
Thom Mooney, her lover of four years, saw her through it all. The drummer in Rita's band since 1982, "he takes care of the music and the band business, and he protects me," she says. "I appreciate that." Their life together is markedly different from the high-profile frenzy of her marriage to Kristofferson. "Kris and I were public people—we never had much privacy," says Rita. "I like the fact that Thorn and I have a private life. Thorn is very secure—he doesn't need or want fame. And we're in tune to the same kind of music."
Coolidge and Kristofferson have long since made their peace. It is Kris and third wife Lisa who look after Casey during Rita's long weeks on tour. "When they first got married, I was a little jealous," Rita admits. "But Lisa and I are close now—Kris has a way of doing that with his wives. Lisa is very bright, and she and Casey really love each other."
Casey has experienced more trouble adjusting to Thorn. "It's been hard," Coolidge admits. "She wouldn't call him by his name for the whole first year—she'd just say, 'him.' " And frequent separations are difficult for both mother and daughter. "About once a day I have to pick up her picture and call her. Sometimes she says, 'I'm so lonely,' and it breaks my heart. When I get home, Casey wants all of me. She has trouble sharing me with Thom."
But Casey can at least watch her mother in absentia on VH-1. The woman with what cable execs call "preexisting marquee value" will be introducing videos by such artists as Kris Kristofferson ("My favorite ex-husband," she confides to the cable audience) and even, blush, by Rita Coolidge.
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Piper today increased their 12 month price target from $16 to $26.
regards endo
What is your source for this? This is rather dubious; Nothing has been reported by PJ on NVDQ. Its best to think to the facts as it helps everyone.
My source was Schwab.
"** NOVADAQ TECHNOLOGIES INC , $16.98, up 7 pct (10:26 a.m. ET)
Piper Jaffray raised its price target on the medical device maker's stock to $26 from $16, citing positive feedback from hospitals and clinics for Novadaq's imaging technology and the management's confidence in meeting the company's 2013 goals." - Reuters
Sentiment: Strong Buy
Triple to normal daily volume. Increasing sales and market expansion. Saw a technical stock chart analyzer which puts NVDQ at between 18 and 21 in the near future. We are just getting started.


text:
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text:
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text:
When John Molner tried to pop the question to Katie Couric on the beach in East Hampton, the seasoned newswoman wasn't exactly overcome with joy. Confusion is a better word.
"He said that there was a reason he'd brought me there to the beach, and that he loved me and was committed to me, and I said, 'Yeah, I know that, you didn't have to bring me here to tell me that,' " the Katie host tells PEOPLE in this week's cover story.
"Finally he said, 'Couric, I'm trying to propose to you,' and I was stunned."
So much so that as Molner, 50, got down on one knee and offered up a gorgeous diamond ring, "It took me a while to say yes, because I was so confused!" Couric, 56, says. "It took a long time for my brain to process what was going on."
It's also taken a long time for Couric to get her happily-ever-after. Since losing her husband, Jay Monahan, to colon cancer in 1998, Couric has had a string of romances that didn't go the distance. But she never lost hope that she'd finally find someone built for the long haul.
"I knew that I wanted this," she says of finding a husband. "I made it a priority, and I pursued it with some purpose."
For much more on Couric's engagement, including how her two daughters reacted and how she reached out to her late husband's family, pick up the new issue of PEOPLE, on newsstands Friday.
Katie Couric 'Stunned' by Wedding Proposal


text:
Libsane bug number 419197 is interesting here as scanimage does in fact
work even with 2.6.20-1-686. Perhaps the problem is in libsane but
upgrading libsane to 1.0.19~cvs20070421-1 has not corrected the problem.
% scanimage -L
device `plustek:libusb:004:003' is a Canon CanoScan N670U/N676U/LiDE20
flatbed scanner
To UNSUBSCRIBE, email to firstname.lastname@example.com
with a subject of "unsubscribe". Trouble? Contact firstname.lastname@example.com


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These leading emerging economies represent a combined pharmaceutical market of US$132.2 billion. How have they emerged from the economic downturn? Where do commercial opportunities exist for pharmaceutical companies over the 2011-16 forecast period?
Putting things in perspective...
With strong economic growth, a combined population of 2.9 billion people and significant unmet healthcare needs, challenges and opportunities remain in BRIC pharmaceutical markets. Their combined market, including pharmacy and hospital sales, is valued at US$132.2 billion at retail prices. This market is collectively lower than the USA and just higher than Japan, but impressive growth rates mean that pharmaceutical companies ought to have long-term interests in these markets. China, in fact, is expected to become the second leading worldwide pharmaceutical market by 2016.
Sizeable opportunities exist …
There are wide regional health expenditure differences within the BRIC markets, far more than in developed countries where health systems provide a more uniform coverage level. These four countries, however, have a relatively wealthy urban population with a far greater spending power than their respective national average. In the case of China and India, these urban populations have grown rapidly, and number hundreds of millions. The challenge for these countries is to extend this level of wealth to the rest of the population, so that better levels of healthcare become affordable. China, for instance, plans to create a solid platform for universal healthcare access for all by 2020.
A long haul...
Pharmaceutical market growth has been impressive in recent years. Market change, however, is expected to be incremental. Short-term opportunities exist to meet the health demands of the burgeoning middle classes, whilst future prospects are bright, fuelled by strong economic performance. A high pharmaceutical market growth projected in BRIC markets is expected to erode some of the commercial differences with the established, but more sluggish, pharmaceutical markets in North America, Japan and Europe. Only Brazil is expected to have a low market CAGR in US dollar terms over the 2011-2016 period, as the Economist Intelligence Unit projects a strong exchange rate of the US dollar against the local currency.
Current and accurate decision support intelligence is vital
Effective planning is vital and that is why Espicom, the leading provider of pharmaceutical market intelligence, has issued this report collection The Outlook for Pharmaceuticals in Brazil, Russia, India & China. For each country there is a comprehensive examination of the pharmaceutical market that covers all aspects of the operating environment, from the regulatory situation through health provision/expenditure to domestic production. Importantly, each market evaluation includes five-year growth forecasts and SWOT analysis. An additional benefit – and at no additional cost – is that these reports are updated and issued quarterly and include an annually updated statistical report packed with hard-to-source health market facts and figures.
The government aims to encourage the development of biosimilar drugs. In 2012, ANVISA is expected to publish specific guidelines for the development of biosimilars of monoclonal antibodies. In October 2011, ANVISA published four guidelines for biosimilars. Along with these guidelines, ANVISA created a technical chamber for biologics and posted the main regulations, including those for the registration and post-registration, on its website in 2011. The Ministry of Health is very keen to encourage the local production of biosimilars. As part of these efforts, for instance, the Ministry of Health and the government of Sao Paulo signed an agreement with Instituto Butantan in December 2011. Local companies also consider the biosimilar sector very attractive, therefore a number of initiatives are in the pipeline. Foreign companies have also shown interest. Amgen, for example, acquired the local producer Bergamo in April 2011, and reacquired a number of products previously licensed to Mantercorp, which was acquired by Hypermarcas in January 2011. Novartis has confirmed its plans to build a plant for the production of vaccines against meningococcal B within three years.
The Russian pharmaceutical market is the largest in Central & Eastern Europe (CEE) and accounts for two-fifths of the total CEE pharmaceutical market, due to its large economy and population. However, Russia has one of the smallest per capita pharmaceutical spending, comparable to Romania. The Russian pharmaceutical market is projected to expand at a double-digit CAGR in US dollar terms between 2011 and 2016. It will continue to be driven by import growth; imports registered a double-digit CAGR between 2006 and 2010. In fact, a heavy reliance on imports has resulted from the lack of locally-manufactured innovative pharmaceuticals. A strategy for encouraging growth in the Russian pharmaceutical industry for the period up to 2020 envisages the government helping local producers to cover the costs of the R&D that is required to boost production of innovative pharmaceuticals.
The need to maintain low prices for essential medicines has been addressed in the government's draft National Pharmaceutical Pricing Policy (NPPP), released in 2011. The proposed NPPP focuses on the National List of Essential Medicines (NLEM), which is periodically revised. The headline major change is a move from the principle of cost-based pricing to a market-based pricing model. The Department of Pharmaceuticals argues that market-based pricing would result in more transparent and fair pricing, as well as increasing competition in the marketplace. Price regulation will encompass all drugs listed in the NLEM, as well as formulations containing combinations of drugs listed in the NLEM; this will include combinations comprising listed drugs and unlisted drugs. If the NPPP is implemented, around 60% of the drugs currently available in India will come under price control.
The Ministry of Health (MoH) has made lowering drug prices a top priority for health authorities in 2011. The National Development and Reform Commission (NDRC) implemented two rounds of drug price reductions in 2011, one in March and the other in September. Most of the drugs reduced were manufactured by multinationals, which had previously not been subject to pricing controls. In terms of regulatory developments, the SFDA started to inspect overseas manufacturing facilities in November 2011, as the agency seeks to align its practices with international standards. In July 2011, the MoH revealed that it may introduce mandatory licensing policy to secure cheaper drugs for HIV/AIDS patients, as part of the country's universal health coverage programme. In January 2011, the MoH announced that the Essential Drugs List would be further expanded to cover nearly all government-sponsored grass-roots health institutions.
Use these original and insightful reports to...
Table Of Contents
EXECUTIVE SUMMARY 1Snapshot: Strategic Espicom Analysis2Snapshot: Key Data Projections 3
MACROENVIRONMENT 4POLITICAL4ECONOMIC5Projections5LEGAL6Patent Rejection of Tenofovir6Compulsory Licence for Efavirenz 7DEMOGRAPHIC8Projections8Demographic Indicators9Birth Rate 9Death Rate 9Infant Mortality 9Life Expectancy at Birth 9
EPIDEMIOLOGY 10DISEASE BURDEN10DISEASE PREVALENCE11Communicable Diseases11HIV/AIDS 11Malaria 12Non-Communicable Diseases12Anaemia 12Cancer 12Vaccination13
HEALTHCARE - ACCOMPANYING HEALTH STATISTICS 14ORGANISATION14Main World Bank Health-Related Projects14National AIDS/SUS Programme 14QUALISUS-REDE Brazil Health Network Formation and Quality Improvement Project 14Second Family Health Extension Adaptable Lending Project 14INSURANCE15EXPENDITURE16Projections16Public Health Expenditure17Federal Health Expenditure 17INFRASTRUCTURE18Healthcare Establishments18SERVICES19Inpatient Care Analysis19Ambulatory Care Analysis20WORKFORCE21Physician Projections21Other Workforce21
REGULATORY AFFAIRS 22INTERNATIONAL DEVELOPMENTS 22MERCOSUR Regulation22Agreement with the FDA22NATIONAL REGULATION 22MARKETING REGISTRATION 23Registration of APIs23Exemptions24IMPORTS24CLINICAL TRIALS24LABELLING & PACKAGING 25QUALITY CONTROL26ADVERTISING26TRACEABILITY26PHARMACY REGULATION27Regulation of Technical Responsibilities27Regulation of Antibiotic Drug Data27Regulation of Dispensing Practices27
PRICING & REIMBURSEMENT 28Drug Price Authority28Drug Price Readjustments28Drug Price Control29The Tax Substitution System30REIMBURSEMENT 30PFPB31
DISTRIBUTION CHANNELS 32DRUG WHOLESALING32Distribution Trade Associations32ABAFARMA 32ABRADILAN33Distributors35Athos Farma35Panpharma35Profarma36Santa Cruz 37DRUG RETAILING 38Pharmacy & Drug Store Chains38Pharmacy Chain Associations41ABRAFARMA 41ASSIFARMA 42FEBRAFAR43Pharmacy Chains44Brazil Pharma44Droga Raia45Drogaria Araújo45Drogaria Sao Paulo45Drogarias Pacheco45Drogasil46Drogasmil46Farmácias Pague Menos 47Panvel Farmácias48Hypermarkets48
MARKET ANALYSIS 49SIZE 49Projections49Historical Figures51Structure53Pharmacy Sales 53Public Sales54PRODUCT DEVELOPMENT55Private Product Development55Public Product Development55MANUFACTURING 56Manufacturing Using CNAE 2056Manufacturing Using CNAE 1061TRADE 65Exports65Imports67Balance of Trade72
COMPETITION 73TRADE ASSOCIATIONS 73ALANAC 73ALFOB 74INTERFARMA 75SINDUSFARMA 76TRADE FAIRS76ABRADILAN FARMA & HPC 76ECONOFARMA 76EXPO FARMÁCIA 76EXPO PHARMA 76FCE PHARMA 76Pharmanager 76COMPANY INTELLIGENCE 77Foreign Producers77Abbott77AstraZeneca77Bayer78Boehringer Ingelheim78Daiichi-Sankyo79GlaxoSmithKline80Johnson & Johnson80Merck 81Merck Sharp & Dohme82Novartis83Novo Nordisk84Nycomed84Pfizer85Roche86Sanofi87Servier88Zambon88Local Producers89Aché89Apsen90Biolab 91Cimed 91Cristália 92EMS 93Eurofarma95Hypermarcas98Libbs Farmacêutica100União Química101Competitive Strategies102
OTC PHARMACEUTICALS 105MARKET SIZE 105COMPETITION 105Trade Association105ABIMIP105Competitive Strategies106
GENERIC PHARMACEUTICALS 107REGULATION 107Registration of Generic Medicines108MARKET SIZE 108Private Pharmacy Sector108Patent Expiries109COMPETITION110Trade Association110Pró-Genéricos 110Competitive Strategies110
BIOLOGICS & BIOSIMILARS 113MACROENVIRONMENT113REGULATION113RDC No 53/2011 114RDC No 55/2010 114MARKET114Public Vaccine Sector 114COMPETITION115Trade Association 115BrBiotec 115Foreign Company Intelligence116Amgen 116GlaxoSmithKline 116Novartis 116Local Company Intelligence116CPPI 116Biomm 116Blau 117Cristália 117Eurofarma 117Hebron 117Hemobrás 117Instituto Butantan 118PharmaPraxis 118Competitive Strategies 118
CONCLUSIONS: OPPORTUNITIES & CHALLENGES 120Strategic Espicom Analysis120MACROENVIRONMENT120EPIDEMIOLOGY120HEALTHCARE120REGULATORY AFFAIRS121PRICING & REIMBURSEMENT122DISTRIBUTION CHANNELS122MARKET122COMPETITION 123OTC PHARMACEUTICALS123GENERIC PHARMACEUTICALS123BIOLOGICS & BIOSIMILARS124Radar Analysis126SWOT Analysis126
DIRECTORY 127COMPETITION127Foreign Biologic Companies127Foreign Pharmaceutical Companies127Local Biologic Companies127Local Pharmaceutical Companies127GOVERNMENT ORGANISATIONS 128TRADE ASSOCIATIONS 128
List of Tables
Espicom Analysis of the Pharmaceutical Market, 2011 2Key Data Projections, 2011-2016 3Political Landscape, 2011 4Regional Ranking of Projected Economies, 2016 5Projected Economy, 2011-2016 5Regional Ranking of Projected Demographics, 2016 8Projected Demographics, 2011-2016 8Projected Demographic Indicators, 2010-2016 9Deaths by Selected Cause, 2000-2008 10Infectious Diseases, 2001-200911Health Insurers, 2000-June 201015Beneficiaries with Medical Services (With/Without Odontology) by Contract Type,2000-June 2010 15Regional Ranking of Projected Health Expenditure, 2016 16Projected Health Expenditure, 2011-2016 16Healthcare Establishments by Type, 2005-September 2010 18SUS Hospital Admissions by Specialty, 2000-2009 19SUS Ambulatory Procedures by Type, 2009 20Approved SUS Ambulatory Procedures by Provider, 2000-2009 20Regional Ranking of Projected Physicians, 2016 21Projected Physicians, 2011-2016 21Members of ABAFARMA, 2011 32Members of ABRADILAN, 2010 33Profarma's Gross Sales by Type, QIII 2010 vs QIII 2011 (R$ Million) 36Profarma's Net & Gross Sales, 2005-2010 (R$ Million) 36Profarma's Distribution Centres by Location, 2011 37ABRAFARMA's Ranking of Pharmacy Chains by Sales, 2008-2010 39ABRAFARMA's Ranking of Pharmacy Chains by Number of Outlets, 2008-201040ABRAFARMA's Financial Indicators, 2008-2010 41Members of ABRAFARMA, 2011 42Members of ASSIFARMA, 2011 42Members of FEBRAFAR by Region, 2011 43Drogasil's Financial Indicators, 2004-2010 (R$ Million)46Pague Menos' Sales, 2000-2011 47Regional Ranking of Projected Pharmaceutical Markets at Retail Prices, 2016 49Projected Pharmaceutical Market at Retail Prices, 2011-2016 50Historical Pharmaceutical Market at Retail Prices, 1995-2010 51Historical Pharmaceutical Market at Manufacturers' Prices, 1997-2009 52Pharmacy Sales Value & Volume at Manufacturers' Prices, 2006-2010 53Pharmacy Sales by Leading Company, 2010 53Pharmaceutical Production Indicators by Company Size, 2007-2009 57Pharmaceutical Production Indicators by Manufacturing Unit Size, 2007-2009 58State Pharmaceutical Production Indicators by Manufacturing Units with 5+ Employees, 2009 59State Pharmaceutical Production Indicators by Manufacturing Units with 5+ Employees, 2009 (%) 60Pharmaceutical Manufacturing Units by Leading State, 2002-2007 61Pharmaceutical Workforce by Leading State, 2002-2007 62Pharmaceutical Gross Production by Leading State, 2002-2007 (R$ Million) 63Pharmaceutical Gross Production by Companies with 30+ Employees, 2007 (R$ 000s) 63Pharmaceutical Gross Production by Manufacturing Units with 30+ Employees, 2007 (R$ 000s) 64Pharmaceutical Exports by Category, 1995-2010 (US$000s) 65Pharmaceutical Exports by Country/Region, 2010 (US$000s)66Pharmaceutical Imports by Category, 1995-2010 (US$000s) 67Imports of Raw Materials by Country/Region, 2010 (US$000s) 69Imports of Antisera & Vaccines by Country/Region, 2010 (US$000s) 70Imports of Medicaments by Country/Region, 2010 (US$000s) 71Balance of Pharmaceutical Trade, 1995-2010 (US$000s) 72Members of ALANAC, 2011 73Members of ALFOB, 201174Members of INTERFARMA, 2011 75Hypermarcas' Major Acquisitions, 2005-201199Hypermarcas' Net Sales by Division, 2009-2010 (R$ Million)99Members of ABIMIP, 2011 105Cumulative Active Ingredients, Registrations & Presentations of Generics, 2000-April 2011 108Pharmacy Generic Sales by Value & Volume, 2006-2010109Top-12 Leading Brands Losing Patent, 2012 109Members of Pró-Genéricos, 2011110Espicom Analysis of the Pharmaceutical Market, 2011125SWOT Analysis of the Pharmaceutical Market, 2011126
List of Charts
Regional Comparison of Top 4 Projected Pharmaceutical Markets at Retail Prices, 2016 49Regional Comparison of Projected Pharmaceutical Market Share at Retail Prices, 2016 50Historical Pharmaceutical Market at Retail Prices, 1995-2010 51Historical Pharmaceutical Market at Manufacturers' Prices, 1997-2009 52Pharmaceutical Monthly Production Index, January 2008-August 2011 56Number of Pharmaceutical Producers, 1997-2007 61Pharmaceutical Workforce, 1997-2007 62Pharmaceutical Gross Production, 1997-2007 63Pharmaceutical Gross Production by Manufacturing Type, 2007 (%)64Pharmaceutical Exports, 1995-2010 (US$ Millions) 65Pharmaceutical Imports, 1995-2010 (US$ Millions) 67Pharmaceutical Imports by Country/Region, 2010 (%)68Balance of Pharmaceutical Trade, 1995-2010 (US$ Millions) 72Radar Graph of the Pharmaceutical Market, 2011126
MACROENVIRONMENT 4POLITICAL4ECONOMIC6Projections6LEGAL7DEMOGRAPHIC8Projections8Demographic Indicators9Births 9Deaths 9Infant Deaths 9Life Expectancy at Birth 9
EPIDEMIOLOGY 10DISEASE BURDEN10Leading Causes of Mortality10DISEASE PREVALENCE11Communicable Diseases11HIV/AIDS 11Non-Communicable Diseases12
HEALTHCARE - ACCOMPANYING HEALTH STATISTICS 13ORGANISATION13Fundamentals of Protection of Public Health in the Russian Federation Bill 13Regional Healthcare Modernisation Programme14Concept for the Development of the Healthcare Sector until 2020 14National Health Project 14EXPENDITURE15Projections15Social Security16New Legislation 'Concerning the Obligatory Medical Insurance' 16INFRASTRUCTURE17Hospital Infrastructure17Outpatient Infrastructure18SERVICES19Hospital Inpatient Services19Outpatient Services20WORKFORCE21Projections21Physicians22
REGULATORY AFFAIRS 23NATIONAL AUTHORITY 23REGULATORY DEVELOPMENTS 23MARKETING REGISTRATION24IMPORT REGULATIONS 25PROMOTION 25Advertising 25
PRICING & REIMBURSEMENT 26PRICING 26New Methods for Setting Retail Prices of Medicines Explored 27Registration of Maximum Prices27Price Freezes27REIMBURSEMENT 28Procurement of Pharmaceuticals for the DLO29Future of the DLO29Subsidising of Prescription Medicines29List of Vitally Important Drugs for 201129
DISTRIBUTION CHANNELS 30DRUG WHOLESALING 30Leading Wholesalers30Protek30Shreya Corporation30SIA International30DRUG RETAILING31Leading Pharmacy Chains31Pharmacy Chain 366 31Rigla 31
MARKET ANALYSIS 32SIZE32Projections32Historical Figures34Current Structure35Pharmacy Market35Hospital Market 37PRODUCT DEVELOPMENT39Clinical Trials39MANUFACTURING 40Government Programme for the Development of the Pharmaceutical Industry 40TRADE43Exports43Imports46Balance of Trade50
COMPETITION 51TRADE ASSOCIATION51AIPM 51TRADE FAIRS52Hospital 52Pharmtech 201252COMPANY INTELLIGENCE53Foreign Producers53KRKA 53Sanofi 53STADA CIS 54Local Producers54Akrikhin54JSC Farmacon54Pharmstandard55Pharm-Sintez58Valenta58Veropharm58Yugrafarm58Competitive Strategies59AstraZeneca59Aurospharma Company59Chemical Diversity Research Institute (CDRI)60Dr Reddy's60Incuron60JB Chemicals & Pharmaceuticals60Maxwell Biotech Group 61Neuralstem 61Novartis 61Nycomed 61Panacela Labs62Pfizer62Pro Bono Bio62Ranbaxy63Teva63
BIOLOGICS & BIOSIMILARS 66COMPETITION 66Binnopharm66Biocad66Generium 67Pushchino Scientific Centre 67
CONCLUSIONS: OPPORTUNITIES & CHALLENGES 68Strategic Espicom Analysis 68MACROENVIRONMENT68EPIDEMIOLOGY68HEALTHCARE68REGULATORY AFFAIRS69PRICING & REIMBURSEMENT69DISTRIBUTION CHANNELS70MARKET70COMPETITION71OTC PHARMACEUTICALS71GENERIC PHARMACEUTICALS71BIOLOGICS & BIOSIMILARS71Radar Analysis 73SWOT Analysis 73
DIRECTORY 74GOVERNMENT ORGANISATIONS74PHARMACEUTICAL PRODUCERS74Foreign Pharmaceutical Producers74Local Pharmaceutical Producers74Biologic & Biosimilar Producers74TRADE ASSOCIATIONS74
Espicom Analysis of the Pharmaceutical Market, 20112Key Data Projections, 2011-20163Political Landscape, 20115Regional Ranking of Projected Economies, 20166Projected Economy, 2011-20166Regional Ranking of Projected Demographics, 20168Projected Demographics, 2011-20168Demographic Indicators, 2001-20099Leading Causes of Death, 2007-200910HIV & AIDS Trends, 1986-200611Incidence of Morbidity by Diagnosis, 2007-2009 (000s)12Regional Ranking of Projected Health Expenditure, 201615Projected Health Expenditure, 2011-201615Total Hospitals & Beds, 1990-200917Outpatient Care Facilities, 1995-200818Public Inpatient Activity, 2002-200819Public Hospital Discharges by Group of Diseases, 2005-200819Day Surgery Discharges by Group of Diseases, 2005-200820Regional Ranking of Projected Physicians, 201621Projected Physicians, 2011-201621Pharmacy Chain 366 Financial Results, 2002-2010 (US$ Millions)31Regional Ranking of Projected Pharmaceutical Markets at Retail Prices, 201632Projected Pharmaceutical Market at Retail Prices, 2011-201634Historical Pharmaceutical Market at Retail Prices, 1995-201034Pharmacy Sales at Retail Prices, 2003-201135Pharmacy Sales at Wholesale Prices, 2003-201135Pharmacy Sales Volume, 2003-201135Moscow City Pharmacy Sales at Retail Prices, 2004-201136Moscow City Pharmacy Sales at Wholesale Prices, 2004-201136Moscow City Pharmacy Sales Volume, 2004-201136St Petersburg City Pharmacy Sales at Retail Prices, 2004-201136St Petersburg City Pharmacy Sales at Wholesale Prices, 2004-201137St Petersburg City Pharmacy Sales Volume, 2004-201137Hospital Purchases at Wholesale Prices, 2003-201137Hospital Purchases Volume, 2003-201137Moscow City Hospital Purchases at Wholesale Prices, 2004-201137Moscow City Hospital Purchases Volume, 2004-201138St Petersburg City Hospital Purchases at Wholesale Prices, 2004-201138St Petersburg City Hospital Purchases Volume, 2004-201138APS Sales at Wholesale Prices, 2006-201138APS Sales Volume, 2006-201138Production Value at Manufacturers' Prices, 2004-201140Pharmaceutical Exports by Category, 1995-2010 (US$000s)43Pharmaceutical Exports by Country/Region, 2010 (US$000s)45Pharmaceutical Imports by Category, 1995-2010 (US$000s)46Imports of Raw Materials by Country/Region, 2010 (US$000s)48Imports of Antisera & Vaccines by Country/Region, 2010 (US$000s)48Imports of Medicaments by Country/Region, 2010 (US$000s) 49Balance of Pharmaceutical Trade, 1995-2010 (US$000s) 50AIPM Members, 2011 51Top Pharmaceutical Companies by Sales, 2009-2010 (%) 53Pharmstandard Financial Results, 2004-2010 (R Millions) 55Pharmstandard Pharmaceutical Sales, 2007-2010 (R Millions) 55Pharmstandard Top 10 OTCs, 2009 56Pharmstandard Production by Facility, 2009-2010 57Top Ten Manufacturers, Trade Names and ATG Groups in the OTC Market, 2009 64Espicom Analysis of the Pharmaceutical Market, 2011 72SWOT Analysis of the Pharmaceutical Market, 2011 73
Regional Comparison of Top 6 Projected Pharmaceutical Markets at Retail Prices, 2016 33Regional Comparison of Projected Pharmaceutical Market Share at Retail Prices, 2016 33Historical Pharmaceutical Market at Retail Prices, 1995-2010 35Pharmaceutical Exports, 1995-2010 (US$ Millions)44Pharmaceutical Imports, 1995-2010 (US$ Millions)46Pharmaceutical Imports by Country/Region, 2010 (%) 47Balance of Pharmaceutical Trade, 1995-2010 (US$ Millions) 50Radar Graph of the Pharmaceutical Market, 2011 73
EXECUTIVE SUMMARY 1Snapshot: Strategic Espicom Analysis2Snapshot: Key Data Projections3
MACROENVIRONMENT 4POLITICAL4ECONOMIC5Projections5LEGAL6Background to Pharmaceutical Patents6Mashelkar Committee Report, December 20066The Patents (Amendments) Bill, 20057Compulsory Licensing 7Pre- & Post-Grant Opposition 8Mailbox Applications 8Other Issues 9The Patents (Amendment) Rules, 20069Previous Patents Act Amendments and Exclusive Marketing Rights 10Challenges and Patent Decisions in the Indian High Courts 10Novartis Once Again Challenges the Indian Patents Act 10Bayer's Nexavar Patent Challenged by Compulsory Licence Application 11US Special 301 Report - India Remains on Priority Watch List 12DEMOGRAPHIC13Population13Demographic Indicators15Births 15Deaths 15Infant Mortality 15Life Expectancy at Birth 16
EPIDEMIOLOGY 17DISEASE BURDEN17Leading Causes of Mortality17DISEASE PREVALENCE18Communicable Diseases18HIV/AIDS20Leprosy 21Tuberculosis 21Vector Borne Diseases22Non-Communicable Diseases22Blindness22Cancer23Diabetes, Cardiovascular Disease and Stroke24National Rural Health Mission24
HEALTHCARE - ACCOMPANYING HEALTH STATISTICS 26ORGANISATION26Public Sector26Department of Health and Family Welfare26Department of AYUSH27Private Sector27Health Insurance28EXPENDITURE 29Projections29Latest Figures30INFRASTRUCTURE31Hospital Infrastructure31Private Hospitals and Clinics32Apollo Hospitals Group 32Fortis Healthcare33Max Healthcare33Wockhardt Hospitals34Other Commercial Providers34Ambulatory Infrastructure35Primary Care35First Aid and Disaster Relief35Healthcare for the Underprivileged, Scheduled Castes and Scheduled Tribes 36WORKFORCE37Projections37Latest Figures38
REGULATORY AFFAIRS40NATIONAL AUTHORITY 40REGULATORY DEVELOPMENTS41New Drug Advisory Committees41MARKETING REGISTRATION42DGCI Set to Co-ordinate Drug Approvals43PROMOTION43
PRICING 44Drugs (Prices Control) Amendment Order and Second Amendment Order, 2006 44Draft National Pharmaceuticals Pricing Policy, 201145
DISTRIBUTION CHANNELS 47Medical Stores Organisation47Pharmacy Chains47Apollo Pharmacy 47Guardian Pharmacy 47Religare Wellness 47984 47
MARKET ANALYSIS48SIZE 48Projections48Historical Figures51Current Structure52PRODUCT DEVELOPMENT53Traditional Indian Medicines54MANUFACTURING 56TRADE57Exports57Imports59Balance of Trade63
COMPETITION64Foreign Direct Investment in the Pharmaceutical Industry under Review 64TRADE ASSOCIATIONS 65TRADE FAIRS 65Bangalore Bio 201265India Chem 201265Pharma World EXPO65COMPANY INTELLIGENCE 66Foreign Private Producers66Abbott66Actavis66Bayer Healthcare66Daiichi Sankyo 67GlaxoSmithKline 67Mylan 67Pfizer India68Reckitt Benkiser68Sanofi68Local Private Producers69Alembic Ltd69Aurobindo Pharma71Cipla Ltd73Claris Lifesciences 76Dr Reddy's Laboratories Ltd77Glenmark Pharmaceuticals80Jubilant Life Sciences83Lupin Limited84Natco Pharma87Orchid Chemicals & Pharmaceuticals Ltd89Piramal Healthcare 92Ranbaxy Laboratories94Strides Arcolab97Sun Pharma99Torrent Pharmaceuticals102Wockhardt Ltd104Zydus Cadila107COMPETITIVE STRATEGIES111Recent Acquisitions & Divestitures111Agreements 111
BIOLOGICS & BIOSIMILARS113COMPETITION113Company Intelligence 113Avesthagen 113BCG Vaccine Laboratory, Chennai 114Biocon 114Cipla 116Claris Lifesciences 116Dr Reddy's 116Glenmark Pharmaceuticals 117Lupin 117Panacea Biotec 118Ranbaxy/Daiichi Sankyo 118Wockhardt 119Zydus Cadila 119COMPETITIVE STRATEGIES120
CONCLUSIONS: OPPORTUNITIES & CHALLENGES 121Strategic Espicom Analysis121MACROENVIRONMENT121EPIDEMIOLOGY121HEALTHCARE122REGULATORY AFFAIRS122PRICING & REIMBURSEMENT122DISTRIBUTION CHANNELS123MARKET123COMPETITION123OTC PHARMACEUTICALS123GENERICS123BIOLOGICS & BIOSIMILARS124Radar & SWOT Analysis126
Espicom Analysis of the Pharmaceutical Market, 2012 2Key Data Projections, 2011-2016 3Political Landscape, 2012 4Regional Ranking of Projected Economies, 2016 5Projected Economy, 2011-2016 5Regional Ranking of Projected Demographics, 2016 14Projected Demographics, 2011-2016 14Summary of Demographic Data 16Demographic Indicators, 2000-2009 16Reported Incidence of Communicable Diseases, 2005-2009 18Reported Incidence of Vaccine Preventable Diseases, 2008-2010 19Regional Ranking of Projected Health Expenditure, 2016 29Projected Health Expenditure, 2011-2016 29Health Expenditure, 201030Regional Ranking of Projected Physicians, 2016 37Projected Physicians, 2011-2016 37Physicians Registered with State Medical Councils, 2007-2009 38Regional Ranking of Projected Pharmaceutical Markets, 201648Projected Pharmaceutical Market at Retail Prices, 2011-2016 50Historical Pharmaceutical Market at Retail Prices, 1995-2010 (US$ Milllion) 51Pharmaceutical Exports by Category, 1995-2010 (US$000s) 57Pharmaceutical Exports by Country/Region, 2010 (US$000s) 58Pharmaceutical Imports by Category, 1995-2010 (US$000s) 59Imports of Raw Materials by Country/Region, 2010 (US$000s)60Imports of Antisera & Vaccines by Country/Region, 2010 (US$000s) 61Imports of Medicaments by Country/Region, 2010 (US$000s) 62Balance of Pharmaceutical Trade, 1995-2010 (US$000s) 63Foreign Acquisitions of Indian Pharmaceutical Companies, 2007-201164Alembic: Financial Results, 2007-2011 69Alembic: Manufacturing Facilities 70Aurobindo Pharma: Financial Results, 2007-2011 71Aurobindo Pharma: Manufacturing Facilities 72Cipla: Financial Results, 2007-2011 73Cipla: Manufacturing Facilities 75Dr Reddy's: Financial Summary, 2007-2011 78Dr Reddy's: Manufacturing Facilities 79Glenmark: Financial Results, 2007-201180Glenmark: Manufacturing Facilities 82Jubilant Life Sciences: Financial Results, 2010-2011 83Lupin: Financial Results, 2007-2011 85Lupin: Manufacturing Facilities86Natco Pharma Financial Results, 2007-2011 87Orchid: Financial Results, 2007-201190Orchid's Top-10 Brands90Orchid: Manufacturing Facilities 91Piramal Healthcare: Financial Results, 2007-2011 92Piramal Healthcare: Manufacturing Facilities 93Ranbaxy: Financial Results, 2006-201094Ranbaxy: Manufacturing Facilities96Strides: Financial Results, 2006-2010 97Sun Pharma: Financial Results, 2007-201199Sun Pharma: Manufacturing Facilities 101Torrent Pharma: Financial Results, 2007-2017 102Wockhardt: Financial Results, 2006-2011104Wockhardt Manufacturing Facilities106Zydus Cadila: Financial Results, 2007-2011108Zydus Cadila: Manufacturing Facilities110Biocon: Financial Results, 2007-2011115Panacea Biotec: Financial Results, 2007-2011118Espicom Analysis of the Pharmaceutical Market, 2012125SWOT Analysis of the Pharmaceutical Market, 2012126
Population by Age Group (%)13Regional Comparison of Top 5 Projected Pharmaceutical Markets at Retail Prices, 2016 49Regional Comparison of Projected Pharmaceutical Market Share, 2016 49Historical Pharmaceutical Market at Retail Prices, 1995-2010 52Pharmaceutical Exports, 1995-2010 (US$ Millions) 57Pharmaceutical Imports, 1995-2010 (US$ Millions) 59Pharmaceutical Imports by Country/Region, 2010 (%)60Balance of Pharmaceutical Trade, 1995-2010 (US$ Millions) 63Radar Graph of the Pharmaceutical Market, 2012126
MACROENVIRONMENT 4POLITICAL4ECONOMIC5Projections5Government's Revaluation of CNY6LEGAL6Administrative Protection7USTR Status7DEMOGRAPHIC8Projections8Current Figures9Demographic Indicators9Births 9Deaths 9Infant Deaths 9Life Expectancy at Birth 9
EPIDEMIOLOGY 10DISEASE BURDEN10Leading Causes of Mortality10DISEASE PREVALENCE11Communicable Diseases11HIV/AIDS 12Non-communicable Diseases12Diabetes 12
HEALTHCARE - ACCOMPANYING HEALTH STATISTICS 13ORGANISATION13Healthcare Reform Plan 13Ministry of Health13Hospitals 13Rural Healthcare 14Red Cross Society of China14EXPENDITURE15Projections15Latest Figures16Health Insurance16Public Health Insurance 16Private Health Insurance 18INFRASTRUCTURE18Hospital Infrastructure18Outpatient Infrastructure19SERVICES 20Inpatient Analysis20Outpatient Analysis21WORKFORCE 22Projections22Current State23
REGULATORY AFFAIRS 24NATIONAL AUTHORITY24Department of Drug Registration24REGULATORY DEVELOPMENTS 25SFDA Starts Overseas Factory Inspections25Revised GMP Regulations25Revised Antibiotic Regulations25MARKETING REGISTRATION26Department of Drug Safety & Inspection27Department of Drug Market Compliance27Drug Classification27Regulatory Legislation282001 DAL Amendments28Drug Import Regulation28GMP Regulations29Drug Approval Process29Clinical Trials29Quality Tests29Certification30PACKAGING 30POST-MARKETING SURVEILLANCE31Revoked Licences31Bribery Cases31PROMOTION31Advertising 31
PRICING & REIMBURSEMENT 32PRICING 32National Pricing32REIMBURSEMENT 33
DISTRIBUTION CHANNELS 35DRUG WHOLESALING35Selected Wholesalers36Alliance Boots36China Medical System36Chindex36First China Pharmaceutical Group 37Global Pharm Holdings Group 37Hainan Kangtong Pharmaceutical 37Huazhong Pharmaceutical 37Hunan Provincial Medicines & Health Products Import & Export Corp 37Hutchison China MediTech38Jiangbo Pharmaceuticals38Jointown Pharmaceutical Group38Nanjing Medical Company38Shandong Medicines & Health Products Import & Export Corp 38Shanghai Pharmaceutical Group39Sincer Pharmchem39Sinochem Jiangsu Suzhou Import Export Corp39Sinopharm39Tianjin Medicines & Health Products Import & Export Corp 40Yong Yu40DRUG RETAILING41Selected Pharmacy Chains41China BCT Pharmacy Group 41ShenZhen Nepstar 41
MARKET ANALYSIS 42SIZE42Projections42Historical Figures44Current Structure45PRODUCT DEVELOPMENT4712th Five-Year Plan 2011-201547Mega New Drug Development Programme47SFDA R&D Initiatives47Beijing Economic-Technological Development Area48Zhangjiang Hi-Tech Park48MANUFACTURING 49China to Turn Five Companies into International Producers 51TRADE51Exports51Imports54Balance of Trade58
COMPETITION 59TRADE ASSOCIATIONS59CAPC59CCCMHPIE59CPIA59RDPAC60TRADE FAIRS61Interphex China 61PharmChina 61COMPANY INTELLIGENCE 62Foreign Manufacturers62Abbott62Astellas Pharma62AstraZeneca62Bayer62Boehringer Ingelheim63Bristol-Myers Squibb63Daiichi Sankyo63Dainippon Sumitomo Pharma64Dragon Pharmaceuticals64Eisai64Eli Lilly65GlaxoSmithKline65Hovione65Johnson & Johnson66Merck Sharp & Dohme66Mitsubishi Tanabe Pharma 67Novartis 67Novo Nordisk 67Pfizer68Roche69Sanofi69SciClone70Servier70Shionogi70Takeda71Competitive Strategies71Local Manufacturers72Aida Pharmaceuticals 72Beijing Four Ring Biopharmaceutical72Beijing Union Pharmaceutical Factory72Changzhou Siyao Pharmaceuticals72China Meheco Corporation73China Pharmaceutical Group 73CSPC Weisheng Pharmaceutical Company73Fuzhou Antibiotic Group Corp73Haizhou Pharmaceutical73Heshuo Ephedrine Factory73Huazhong Pharmaceutical 74Jiangbo Pharmaceuticals 74Jiangsu Jiangan Pharmaceutical 74Lansen Pharmaceutical 74Ningbo Jierfu Pharmaceutical 74North China Pharmaceutical Huasheng 74Shanghai Pharmaceutical Group 75Shenzhen Salubris Pharmaceuticals 75Shenzhen Taitai Pharmaceutical Company 75Shenzhen Zhijun Pharmaceutical Company 75Sihuan Pharmaceutical Group 75Sinobiopharma 76 76Sinochem Group 76Sinopharm 76Simcere77Wenzhou Pharmaceutical Factory77Xiamen No2 Pharmaceutical Factory77Xinhua Pharma77YiYuan Pharmaceutical78Zhejiang Jingxin78Zhejiang Jinhua Lixin Fine Chemicals78Zhejiang Medicine Company78
OTC PHARMACEUTICALS 80REGULATION 80MARKET SIZE 80COMPETITION81Trade Association81CNMA 81Company Intelligence81China Sky One Medical 81Harbin Pharmaceutical Group 81Sanofi82
GENERIC PHARMACEUTICALS 83REGULATION 83Prescribing Regulation83MARKET SIZE 83COMPETITION 84Foreign Company Intelligence84Desano84Mylan84Ranbaxy84Sandoz84Watson84Local Company Intelligence85China Pharma Holdings85Qilu Pharmaceutical85Shanghai Fosun Pharmaceutical Company85Zhejiang Hisun86Competitive Strategies86
BIOLOGICS & BIOSIMILARS 87REGULATION87MARKET SIZE87PRODUCT DEVELOPMENT87COMPETITION 88Foreign Company Intelligence88Agenix88AutekBio88Avid Bioservices88Genzyme89GlaxoSmithKline89Merck Millipore89Merck Serono89Microbix90NeoStem90Novartis90OriGene90Sanofi90Local Company Intelligence913SBIO 91Anhui Anke Biotech 91China Biologic Products 91China National Biotech Group 91GeneScience 92Guangdong Techpool Bio-Pharma 92Harbin Gloria Pharmaceuticals 92Kun Run Biotechnology 92Lanzhou Institute of Biological Products 92Livzon Pharmaceutical93Nuokang Bio-Pharmaceutical93Shenzhen Hepalink93Shenzhen Kexing Biotech93Simcere94Sinopharm94Sinovac Biotech94Walvax Biotechnology94WuXi AppTec95Wuyi JiuYuan95Zhejiang Tianyuan Bio-Pharmaceutical Company95Zhuhai United Laboratories96Competitive Strategies96
CONCLUSIONS: OPPORTUNITIES & CHALLENGES 97Strategic Espicom Analysis97MACROENVIRONMENT97EPIDEMIOLOGY97HEALTHCARE98REGULATORY AFFAIRS98PRICING & REIMBURSEMENT99DISTRIBUTION CHANNELS99MARKET99COMPETITION 100OTC PHARMACEUTICALS100GENERIC PHARMACEUTICALS101BIOLOGICS & BIOSIMILARS101Radar Analysis 103SWOT Analysis 103
DIRECTORY 104GOVERNMENT ORGANISATIONS 104PHARMACEUTICAL COMPANIES 104Foreign Pharmaceutical Companies104Local Pharmaceutical Companies105TRADE ORGANISATIONS 106
Espicom Analysis of the Pharmaceutical Market, 20112Key Data Projections, 2011-20163Political Landscape, 20114Regional Ranking of Projected Economies, 20165Projected Economy, 2011-20165Regional Ranking of Projected Demographics, 20168Projected Demographics, 2011-20168Demographic Indicators, 2002-20089Leading Causes of Death, 200810Reported Infectious Diseases, 2001-2008 (Rate/100,000 Population)11Regional Ranking of Projected Health Expenditure, 201615Projected Health Expenditure, 2011-201615Healthcare Expenditure by Type, 1999-2008 (CNY Billions)16Hospitals, 2000-200818Hospitals by Region & Municipality, 200818Outpatient Institutions by Type, 2001-200819Health Centres & Clinics by Region & Municipality, 200819Inpatient Admissions, 2002-2008 (Millions)20Inpatient Admissions by Type & Institution, 2008 (10,000s)20Outpatient Visits, 1999-2008 (Millions)21Outpatient Visits by Type & Institution, 2008 (Millions)21Regional Ranking of Projected Physicians, 201622Projected Physicians, 2011-201622Medical Personnel by Type, 2008 (000s)23Physicians by Region & Municipality, 2008 (000s) 23ShenZhen Nepstar Drug Stores by City, 2008-2010 41Regional Ranking of Projected Pharmaceutical Markets, 2016 42Projected Pharmaceutical Market at Retail Prices, 2011-201644Historical Pharmaceutical Market at Retail Prices, 1995-201044Pharmaceutical Sales at Retail Prices, 2000-2011 (CNY Billions) 45Pharmaceutical Sales by Sector, 2009-2010 (CNY Billions)46Pharmaceutical & Medical Device Output, 1998-2011 (CNY Billions) 49Pharmaceutical & Medical Device Output by Type, 2010 (CNY Billions) 50Pharmaceutical Exports by Category, 1995-2010 (US$000s) 51Pharmaceutical Exports by Country/Region, 2010 (US$000s) 53Pharmaceutical Imports by Category, 1995-2010 (US$000s) 54Imports of Raw Materials by Country/Region, 2010 (US$000s) 56Imports of Antisera & Vaccines by Country/Region, 2010 (US$000s) 56Imports of Medicaments by Country/Region, 2010 (US$000s) 57RDPAC Members, 201160OTC Pharmaceutical Sales, 2005-2009 (CNY Billions)80Espicom Analysis of the Pharmaceutical Market, 2011 102SWOT Analysis of the Pharmaceutical Market, 2011 103
Regional Comparison of Top 5 Projected Pharmaceutical Markets at Retail Prices, 2016 43Regional Comparison of Projected Pharmaceutical Market Share, 2016 43Historical Pharmaceutical Market at Retail Prices, 1995-2010 45Pharmaceutical Sales at Retail Prices, 2000-2011 (CNY Billions)46Pharmaceutical & Medical Device Output, 1998-2011 (CNY Billions) 49Pharmaceutical Exports, 1995-2010 (US$ Billions) 52Pharmaceutical Imports, 1995-2010 (US$ Billions) 54Pharmaceutical Imports by Country/Region, 2010 (%) 55Pharmaceutical Balance of Trade, 1995-2010 (US$ Billions) 58OTC Pharmaceutical Sales, 2005-2009 (CNY Billions)80Radar Graph of the Pharmaceutical Market, 2011 103
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Fifty children, ranging in age from pre-schoolers to teens, shopped for back-to-school clothes Tuesday at Target on West Main, thanks to the Breakfast Optimist Club of Kalamazoo (BOCK).
What began in 1989 as a project to support the well-being of children has become an annual tradition by BOCK to help local families who otherwise would not be able to provide these necessities for their children.
The 76-member club has worked with Family & Children Services for 20 years to ensure the success of this event which has helped hundreds of children since it started.
Rosemary Gardiner, chief executive officer of Family & Children Services, said BOCK has developed a longtime relationship with the agency and one of its therapeutic programs that emphasizes healthy families.
"Our children are the lucky recipients of BOCK's generosity," said Family & Children Services' Behavioral Health Director Diane Marquess. "We work with families who have multiple needs and we aren't always able to meet them all.
"We are so fortunate that BOCK is filling a need in our community. Otherwise, these families would go without."
At the Annual Right Start Auction Party in July, BOCK raised $8,000 – enough money to take 50 children shopping for back-to-school clothes.
After receiving the list of families from Family & Children Services, BOCK members Lyn Lenox, Julie Howes and Carmen Jonaitis did research to find out what each child would need for their grade level and school to make sure they would have the correct supplies for their classes. From that research, trademark red Target bags were filled with supplies hand-picked for each child. BOCK members shopped for the school supplies in advance and packed the bags ahead of time.
Families arrived at the store between 9 and 11 a.m. on Tuesday and picked out school clothing, then checked out and received the red bags filled with school supplies.
Gardiner said, "BOCK reminds us of the importance of relationships with our donors and the agency's privilege to connect service clubs with young families in need. It's an amazing three-way relationship and Family & Children Services is honored to connect that community generosity with need."
"This is one of the many ways that BOCK is lending a helping hand in the community," says a BOCK Facebook post.
BOCK meets weekly at 7:30 a.m. Thursday at Michelle's Café on Romence Road in Portage. For more information about the club, contact Nicole Ingersoll at firstname.lastname@example.com.
Story provided by - Rebecca Pierce


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UPDATE: The Blues have released their schedule. They will play in six preseason games, two against Dallas, two against Tampa Bay and two against Minnesota. The full schedule can be found here.
The St. Louis Blues haven't officially released their preseason schedule for the 2013-14 season. However, several teams have released their schedule, offering a preview of what's to come for the Blues prior to the regular season.
Here's what we know: St. Louis will play in two preseason games against the Minnesota Wild and two preseason games against the Tampa Bay Lightning.
September 18th: Blues will take on the Lightning at the Amway Center in Orlando.
September 20th: Lightning will travel to St. Louis.
September 25th: Blues will travel to Minnesota to take on the Wild in an exhibition game.
September 27th: The Wild travel to St. Louis.
These four games have been confirmed by both the Wild and the Lightning. The Blues should have two other preseason games on their schedule, but it's unclear who those will be against at this time. Based on the traditional format, one will be played at the Scottrade Center and one will be played at the opponent's house.


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A video that has become an internet viewing boom is of a young boy playing with a Tiger Cub at the Point Defiance Zoo in Tacoma, Washington.
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Hi! My name is Fashion
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Someone dropped out an adorable calico cat at my boyfriend's doorstep. But it was not Fashion. It was her mother Rena (Mom cat)! I did not expect for her to come home to my house and have baby kittens, but one day I found three little bundles of fur under a chest of drawers, and since then, my cat family has been four =^w^=
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56,006 words (≈ about 4 hours)
Vernon Lee was the pseudonym of the British writer Violet Paget (1856 – 1935). She is remembered today primarily for her supernatural fiction and her work on aesthetics. An early follower of Walter Pater, she also wrote over a dozen volumes of essays on art, music, and travel.
Language: English
Written in: 1890
Published: 2010-08-29
Word count: 56,006 words (≈ about 4 hours)
License: Public Domain


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Canada a favorite employment hub for jobless Americans
Canada, 13th October: Canada seems to be attracting increased number of Americans looking for jobs.
As per immigration lawyers in Canada, more and more Americans are showing interest to move to Canada for getting jobs here.
Record number of Americans seeking Canada temporary work visas--- In fact, last year's figures revealed by Canada immigration department are a proof that Canada witnessed a record number of applications for Canada temporary work visas from Americans. And this clearly signals the widening gaps between the labor markets of these two neighboring nations.
Canada is reportedly facing shortage of skilled workforce while the neighboring US is failing to deal with soaring rates of joblessness.
The scenario in America has already worsened with the recent financial crisis engulfing the nation.
Taking a look at the jobless rates of both these nations shows the differences between both these nations. While Canada has a jobless rate comfortably stable at 6.3 percent, the US, on the other hand, is fighting to control its unemployment rate of 9.1 percent thereby rendering around 14 million Americans jobless.
Meanwhile, Canadian province Alberta has admitted shortage of skilled workers in oil sector and is chalking out ways to allow higher number of skilled workers from America to fill the skills gap.
Canadians returning from America for better prospects---A large number of Canadians who had shifted to America several years ago are considering returning back to Canada once again in search of better employment opportunities especially in finance and law, admits Sergio Karas, an immigration lawyer from Toronto.
And, more and more Americans are looking to immigrate to Canada keeping in view increased employment opportunities and better quality of living there.
Canada boasts of stable housing market, quality and affordable healthcare facilities and a strong banking system.
This is nothing but a reverse brain drain from America to Canada, adds Karas. Canada has managed to remain unscathed from the 2008 global economic recession and this has resulted in increasing its stability in the global market.
It has been ranked as among the best nations for living and doing business abroad. No wonder, Canada is planning to tap the vast skilled potential of American workforce.
According to Canadian immigration minister, Jason Kenney, Canada is looking to its solve labor shortage by alluring Americans into the nation.
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Numero di telefono(▒▒▒) ▒▒▒- ▒▒ 97
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Ciao, sono Lindsey!
Salem, Massachusetts, Stati Uniti · Membro da Gennaio 2011
My fiance and I are bopping around the islands the week of Aug 7th- 15th and are looking forward to camping, hiking, exploring and meeting locals. We will have been camping a lot leading up to our stay here so it will be a much welcomed bed! We are in our late 20s early 30s and very friendly. 1 chef and 1 teacher with ambition to explore the island. We are experienced travelers and used to roughing it. We look forward to staying in the Bracken Fern Lodge!


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For use in: A variety of professional Insect Light Traps, including the Vector Classic, Mantis 1 x 2, Luralite Pro, Gardner GT-180 Slimline, and the Garnder WS85 Wall Sconce
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I would like to know if it possible in Maple 12 to efficiently compute recursive procedures with two variables.
A simple example would be: f(a,0):=1 for all a>=0, f(0,b):=1 for all b >=0 and f(a,b) :=f(a-1,b) + f(a,b-1) for
a>0, b>0 (which defines the binomial coefficients). In trying to do this in a straightforward way i get
the error message "too many levels of recursion". Using 'trace' I see that Maple doesn't seem to be
creating a remember table for functions of two variables. Am I missing something?
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World Teachers' DayBlack Hockey Jesus
To honor World Teachers' Day (October 5th), I'd like to, 32 years later, pay tribute to my 3rd Grade teacher, Sunny Wood, and the teaching ideals her style in the classroom so deftly embodied.
To utilize the artistic (indeed, teaching is an art) terms of form and content, the content a teacher works with is an odd kind of substance: it's the stuff the students must know. You might also include the students themselves in the metaphor of content, so that teachers mold the curriculum into the minds of little people, creating art projects that are hopefully on or above grade level.
The form with which teachers create their content (students who know things and do things) consists of a handful of "strategies" that teachers use to deliver their content (the odd intangible stuff). And the development of a teacher is largely focused on the accrual of more and more strategies, which often amount to not much more than packaged tricks. Fads. The latest approach to get better and faster results. I think, if you know your content well and you're armed with a large arsenal of researched based strategies, you can be a really good teacher. But being a great teacher requires a deeper formal need, an inherent selflessness and knack for empathy that, for some people, makes teaching a genuine vocation in the sense of a calling.
Mrs. Wood had a boa constrictor named Nigel.
Now when I use the word "selflessness," I mean it quite literally insofar as the teacher is able to forget herself (including her research based strategies and even the content she's required to deliver) in order to see into, properly imagine (be?), the student for whom she is responsible – perhaps inhabit that student – toward the end of understanding what it's like for that particular student to be in the world. This is not a talent one learns in M.Ed. programs; it's sorcery. And it's the way great teachers understand, not how to lead students to the best possible scores on state tests, but rather what kids need.
A great teacher, via unquantifiable intuition and insight, taps into what a child needs. And, again, we are not here talking about different approaches to multiplying by 12s. Before it's even possible for kids to care about multiplication, something else, something vital, is necessary and I'm purposely avoiding the attempt to identify it with a noun because we all sense what's fumbling toward expression while knowing that it likes to hide from words. It's as obvious as oxygen but, because it is, it eludes articulation.
Mrs. Wood had us, a bunch of 3rd Graders, engage the process of opening a restaurant from the initial planning stages to actually serving breakfast to our parents. It was called The Outer Space Pancake Place. I'm not sure if it was me or Mark Durbin who named the joint. Probably Durbin.
The straight dope is that I was not a very happy 9-year-old boy for reasons that extend beyond the scope of this essay and Mrs. Wood knew it. Maybe she didn't and I made that part up because this is, after all, my myth but, either way, that's how it was. And something she did for me, often, was give me a picture. Nothing more. Just an image and a challenge. I was to write a story that corresponded with the image and I remember staring hard at those pictures, those static images of frozen presence, until they began to melt into their pasts and futures, imagination, words, stories.
"You're creative and being creative is the most important thing in the whole world. YOU… are going to be a writer." That's what she said to me. It's what I needed. The word "creative" resonated all through my bones. It sounded like a wonderful thing to be. So much better than nothing. A way to work with nothing. I would be creative.
When I think about teachers and remember some with fondness, the fondness never revolves around what they taught me. I never think "Now Mrs. Berg? Man, she could deliver some content!" Not at all. Mattering to kids resides in showing them how they matter, that they can matter, and that they will matter. Work that magic and you won't need better and better strategies to deliver content. You'll have kids lining up to devour it. Thank you, Mrs. Wood. Happy World Teachers' Day!
Read more from me at Black Hockey Jesus.
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Recent posts: Banned Books, Social Media, Moving Boxes, Questions, Hibachi, Losing Your Kids, Top 5 Things To Talk About With Your Son On An Airplane, Frozen Popcorn, The Biological Father, I Don't Know What's Best For Kids, On The Reality Of Stuffed Animals, How My Daughter's Wish Undermined My Faith In The Validity Of Memories, Kanye West, No Grown-Ups, Letting Lean In Be, Top 5 Educational Activities For Summer Fun, Picking Candy, The Baseball Game With My Kids, The Dead Boy


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Ethics Roundtable Home
Case Study
Annotated Bibliography
David Liao, M.D.Clincical Instructor of MedicineHarvard Medical SchoolStaff InternistSpaulding Rehabilitation HospitalBoston, Massachusetts
Mr. Duffy' s request, "I'll go for the works" contradicts the family' s statements about his previous wishes. When critical choices are made by proxy decision-makers, health care professionals must determine as clearly as possible what the patient' s original wishes are in both this specific circumstance and overall intent. This might involve detailed discussions with family, primary physicians, friends, and/or clergy.
I assume Mr. Duffy believes that "heroic" or life sustaining treatment should be instituted if the goal is the return of some or all function or quality of life. However, in a situation that is hopeless or affords no quality of life he would not want any interventions that merely prolong his physiologic life.
In my experience, most patients agree in principle with these objectives. However, health care providers are still faced with the burdens of uncertainty about prognosis and identifying all the subjective components of this philosophy: i.e. "quality of life" or "hopeless." Immediately following a stroke no one can predict prognosis or the timetable for return of function. Despite clinical instinct or experience, the answer to "is the condition hopeless?" or "will it afford no quality of life?" is "We don' t know right now."
A time-limited trial of tube feeding could afford Mr. Duffy the opportunity to recover and possibly participate in his own healthcare decisions, recover in order to eat without risk, or both. If at the end of the trial, the situation appears hopeless or affords no quality of life tube feedings should be discontinued, based on the patient' s right to self-determination.
Hare, J., Pratt, C., & Nelson, C. (1992). Agreement between patients and their self-selected surrogates on difficult medical decisions. Archives Internal Medicine . 152(5): 1049-1054.
Tippett, DC & Sugarman, J. (1996). Discussing advance directives under the patient self-determination act: A unique opportunity for speech-language pathologists to help persons with aphasia. Am. J. SLP . 5(2): 31-34.
To submit cases or to be added to the list of respondents please contact: Helen Sharp Department of Speech Pathology and Audiology, 307 WJSHC University of Iowa, Iowa City, IA 52242. Phone: 319-335-6596, fax 319-335-8851, e-mail: [email protected]
What to Know If Your School Bills Medicaid: Does your school system seek Medicaid coverage for services? Here are some pointers.
Celebrating My Career Choice: An international SLP reflects on the many ways and places in which she has used her credentials.
Parent-Child Language Barrier Linked to Bad Behavior
The American Speech-Language-Hearing Association (ASHA) is the national professional, scientific, and credentialing association for 186,000 members and affiliates who are audiologists; speech-language pathologists; speech, language, and hearing scientists; audiology and speech-language pathology support personnel; and students.
The ASHA Action Center welcomes questions and requests for information from members and non-members.
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"Regimens of Health: House Books and Everyday Medicine in the Middle Ages."
The session will focus on household remedies and medical treatments that were popularly available, or described in sources such as hausbuchs, recipe collections, or writings on the regimen of health. Papers on all aspects of medicine and daily life are welcome.
If you are interested in participating, or if you have any questions about the session, please contact Harry York (firstname.lastname@example.com). Proposals for papers should include your name, the title of your paper and an abstract.
Deadline for submissions is 15 September 2009.


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The author of this book is well known for his splendid contributions to the study of constitution and its relation to disease. Few other medical authors are better qualified by virtue of medical training and philosophic background to present to the intelligent lay public a short and comprehensive discussion of a subject so diverse in its manifestations. This is not an ordinary treatment of the subject but a scholarly and dispassionate presentation filled with useful scientific information about the disease and punctuated with enough philosophical reflection so that the reader not only learns but gains a certain amount of reassurance. The author has anticipated the numerous questions which the lay reader will want to know concerning the nature of the disease, its prevention, and what can be done after the disease is contracted. Any treatise written by this author without consideration of aspects of inherent susceptibility would be to the
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J.J. Johnson
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Considered by many to be the finest jazz trombonist of all time,
J.J. Johnson
somehow transferred the innovations of
Charlie Parker
Dizzy Gillespie
to his more awkward instrument, playing with such speed and deceptive ease that at one time some listeners assumed he was playing valve (rather than slide) trombone.
toured with the territory bands of Clarence Love and
Snookum Russell
during 1941-1942, and then spent 1942-1945 with
Benny Carter
's big band. He made his recording debut with
(taking a solo on "Love for Sale" in 1943), and played at the first
concert (1944).
also had plenty of solo space during his stay with
Count Basie's Orchestra
(1945-1946). During 1946-1950, he played with all of the top bop musicians, including
Charlie Parker
(with whom he recorded in 1947), the
Dizzy Gillespie
big band,
Illinois Jacquet
(1947-1949), and the
Miles Davis Birth of the Cool Nonet
. His own recordings from the era included such sidemen as
Bud Powell
and a young
Sonny Rollins
, who also recorded with
the Metronome All-Stars
, played with
Oscar Pettiford
(1951) and
Miles Davis
(1952), but then was outside of music, working as a blueprint inspector for two years (1952-1954). His fortunes changed when, in August 1954, he formed a two-trombone quintet with
Kai Winding
that became known as
Jay and Kai
and was quite popular during its two years.
went their separate ways (they would later have a few reunions),
led a quintet that often included
Bobby Jaspar
. He began to compose ambitious works, starting with 1956's "Poem for Brass," and including "El Camino Real" and a feature for
Dizzy Gillespie
, "Perceptions"; his "Lament" became a standard.
worked with
Miles Davis
during part of 1961-1962, led some more small groups of his own, and by the late '60s was kept busy writing television and film scores.
J.J. Johnson
was so famous in the jazz world that he kept on winning Downbeat polls in the 1970s, even though he was not playing at all. However, starting with a Japanese tour in 1977,
gradually returned to a busy performance schedule, leading a quintet in the 1980s that often featured
Ralph Moore
. In the mid-'90s, he remained at the top of his field, but by the late '90s and early into the 2000s, the legendary musician fell ill with prostate cancer, and sadly took his own life on February 4, 2001.
Scott Yanow, Rovi
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Plays Mack the Knife/Trombone & Voices
Jay Jay Johnson
Blue Haze [Remastered]
Eight Classic Albums
Complete Recordings: J.J. Johnson Quintet Featuring Bobby Jaspar
Live in Chicago 1988
Dial J.J. 5
J.J. Johnson's Jazz Quintet
J.J. Johnson Plays Mack The Knife & Other Kurt Weill Songs
Complete '60s Big Band Recordings
1958 European Tour
Complete Fifties Studio Recordings [J.J. Johnson/Kai Winding Quintet]
A Proper Introduction to J.J. Johnson: Bone-O-Logy
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Call it development, or colonialism by another name, but the big donor nations have staked out distinct spheres of influence in Nepal. Despite the closure of the Gurkha Camp at Dharan, the bustling gateway to the eastern hills, almost half the British Army's Gurkha recruits still come from the area, and the old ties are strongly felt. Britain's aid programme, based in Dhankuta, has been handed over to the Nepalese government, but agriculture, forestry, health and cottage industries are still in operation. The biggest and most obvious British undertaking is the road to Dharan, Dhankuta, Hile and beyond, which was constructed with £50 million of British taxpayers' money. While there are few grand monuments or temples, this region is a bastion of traditional Nepali hill culture. The bazaar towns of Hile and Basantapur, in particular, give a powerful taste of what lies beyond the point where the tarmac runs out.
Nepal // The Eastern Terai and hills //
The Dhankuta road
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Dhankuta and around
Dhankuta and around
From Dharan the road switchbacks dramatically over a 1420m saddle at Bhedetar, then descends to cross the Tamur Koshi at Mulghat (280m) before climbing once again to DHANKUTA, stretched out on a ridge at 1150m. Though you'd never guess, this is the administrative headquarters for eastern Nepal.
Dhankuta is a small, predominantly Newari town, with a friendly, well-to-do feel. Steps lead up from the bus park to the main bazaar, which climbs north along the ridge. The lower half of the bazaar, up to the police station, is paved and reasonably active; the upper half is quieter and more picturesque, lined with whitewashed, tiled and carved Newari townhouses. The outlying area is populated by Rais, Magars and Hindu castes, who make Dhankuta's haat bazaar, on Thursdays, a tremendously vivid affair.
Although you can't see the Himalayas, the area makes for fine walking. In Santang, about 45 minutes southeast of town, women are seen embroidering beautiful shawls and weaving dhaka. You can walk to Hile in about two hours by taking short cuts off the main road: stick to the ridge and within sight of the electric power line.
Most buses to Dhankuta continue as far as HILE, 15km beyond Dhankuta and 750m higher up along the same ridge. This spirited little settlement is one of the most important staging areas in eastern Nepal. Poised over the vast Arun Valley, Hile's bazaar strip straggles up the often fog-bound ridge, drawing in to trade Tamangs and Sherpas from the west, Newari and Indian traders from the south, and Rais from their heartland of the roadless hillsides all around. The most visible minority group, however, are Bhotiyas from the northern highlands, who run a number of simple lodges. One of the most exotic things you can do in Nepal is sit in a flickering Bhotiya kitchen sipping hot millet beer from an authentic tongba (miniature wooden steins with brass hoops and fitted tops unique to the eastern hills).
The only thing to do in town is browse the bazaar: Hile's haat bazaar, on Thursday, is lively, but smaller than Dhankuta's. Most visitors are here to trek, and magnificent views can be had just a half-hour's walk from Hile – as long as you're up early enough to beat the clouds. Walk to the north end of the bazaar and bear right at the fork up a dirt lane; after 100m a set of steps leads up to join the Hattikharka trail, which contours around the hill. The panorama spreads out before you like a map: to the northwest, the Makalu Himal floats above the awesome canyon of the Arun; the ridges of the Milke Daada zigzag to the north; and part of the Kanchenjunga massif pokes up in the northeast. Some landowners in this area also cultivate tea: take a look at the Guranse tea estate (w guransetea.com.np), whose main entrance is just down the road from the bazaar.
For a day-trip, catch a bus to Basantapur, a dank, almost Elizabethan bazaar 21km northeast. En route you get tremendous views of the Makalu massif, while in town you can sample Nepal's only wine, Hinwa, which is made from berries.


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