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Akzeptanz des Tötens von Tieren: Umfrage bei Tierärzten und anderen Berufsgruppen
Dürr, S
Fahrion, A
Doherr, M G
Grimm, H
Hartnack, S
Bibliographic Citation
Schweizer Archiv für Tierheilkunde 2011 May; 153(5): 215-22
Professional veterinarians are one of the most affected professions when it comes to killing animals. However, in some situations the opinion about the acceptance of killing of animals differs between people, which can cause a dilemma for the executing person. In a pilot study based on questionnaires, veterinarians from different working fields and students of different branches stated their acceptance of killing of animals in diverse concrete situations. The result clearly demonstrates a higher acceptance of killing of animals among veterinarians with longtime experience in contrast to other groups and the almost same acceptance among agricultural students. The acceptance increased with age, however, we could not find a gender specific difference except of within a narrow age interval. The variability of acceptance within the same profession group differs between the situations. Veterinarians should be aware of their different thinking about killing of animals in some situations compared to other people and should know the reason of such differences. This is important not least to protect themselves and their opinion and to contribute to their societal responsibility by their veterinarian activity.
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Schutz Intellektueller Leistungen im Bereich der Biotechnologie: Ethische Überlegungen zur "Patentierung" von Tieren und Pflanzen: Ein Diskussionsbeitrag Eidgenössische Ethikkommission für die Gentechnik im ausserhumanen Bereich = Commission fédérale d éthique pour le génie génétique dans le domaine non humain = Commissione federale d etica per l ingegneria genetica nei settore non umano = Swiss Ethics Committee on Non-human Gene Technology [ECNH] (2001-03-12)


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Kukla's Korner Hockey
Ted Leonsis Says
by Paul on 09/30/06 at 09:53 AM ET
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The team has been quick to embrace new media formats, such as podcasts and blogs. What advantages do you see in them? Three things: One, if you are writing a blog, and you are religious about it, and you are updating every day or every week, you are obviously a great fan, and we need to reward great fans. Two, the blogosphere is important because bloggers communicate with one another, and they show up very high in search engines. Third, the traditional media are having to cut expenses. Some of the big-city newspapers, thankfully not ours, aren't even allowing reporters to travel with the teams. Are there any blogs you recommend? Bleating From a Caps Nut, DCSportsChick, Off Wing Opinion, Japers' Rink. Those are good ones locally.more (reg. req.) from Ted on the Caps...
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text: This is a list of things that I love about men. Pure and simple. No talk of feminism or slut shaming or gender depictions in the media or rape culture here—just an unadulterated tribute to men, a panegyric, a compilation of reasons to be thankful for the male species, in ways both big and small,… READ MORE »


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Hypertension and peripheral vascular disease
Cigarette smoking is a leading cause of mortality and morbidity and is associated with cardiovascular disease via contributory processes such as endothelial dysfunction, inflammation and thrombosis. Cigarette smoke both contains and stimulates the production of cellular oxidants and it may also promote vascular inflammation. Osteopontin is a non-collagenous matrix protein first identified in bone and there is increasing evidence for its role in inflammation and cardiovascular disease via its action as a soluble cytokine.
In this study we have examined the mechanisms underlying the expression of osteopontin in human vascular endothelial cells
Non-cytotoxic concentrations of PM increased osteopontin levels in cultured human endothelial cells and this effect was reduced in the presence of ascorbate, suggesting a role for oxidants in the response to PM. However, oxidant production played no role in the PM-evoked induction MMP-3, an enzyme which cleaves osteopontin. In smokers who quit smoking for 5 days, serum osteopontin levels were significantly lowered compared to those measured prior to smoking cessation.
Atherosclerotic cardiovascular disease is a leading cause of mortality and morbidity worldwide
Osteopontin is a non-collagenous matricellular protein
Given the link between inflammation, atherosclerosis and smoking, and also given the emerging evidence of a role for osteopontin in cardiovascular disease, we have examined the expression of osteopontin in endothelial cells exposed to cigarette smoke
Cigarette smoke total particulate matter generation
Particulate matter from cigarette smoke was generated using 3R4F reference cigarettes (University of Kentucky). Cigarettes were conditioned for a minimum of 48 h at 22°C and 60% humidity (ISO 3402:1999) before smoking on a RM20S smoking machine (Borgwaldt KC, Hamburg, Germany) under ISO standard conditions (35 ml puff taken over 2 sec. every minute; ISO 3308:2000). Smoke particulate matter (PM) was collected on a Cambridge filter pad at a minimum of 250 mg tar per pad. These are non-ISO standard conditions designed to provide a higher yield of particulate matter than conventionally achieved. PM was eluted with dimethylsulphoxide (DMSO) at 24 mg/ml and stored protected from light in single use aliquots at -20°C for no longer than 1 month.
Cell culture and treatment
Human umbilical vein endothelial cells (HUVECs; Lifeline Cell Technology, California, U.S.A.) were maintained at 37°C in a 5% CO2 humidified atmosphere. Cells were cultured in VascuLife® VEGF media (Lifeline Cell Technology) supplemented with VEGF (5 ng/ml), EGF (5 ng/ml); basic FGF (5 ng/ml), IGF-1 (15 ng/ml), ascorbic acid (50 μg/ml), L-glutamine (10 mM), hydrocortisone hemisuccinate (1.0 μg/ml), heparin sulphate (0.75 units/ml) and foetal bovine serum (2%). Cells were seeded at 1×104 cells/ml for all assays with the exception of PCR experiments where cells were seeded at 2x104 cells/ml. Cells were treated for 24 h either with PM or with 1% DMSO as a diluent control. To examine the contribution of oxidative stress in regulating osteopontin levels, cells were incubated with the anti-oxidant ascorbate (200 μM) for 5 h prior to PM exposure.
Assessment of cell viability
Cell viability was measured by neutral red uptake assays. In brief, HUVECs were incubated in 150 μl neutral red solution diluted 1:65 in VascuLife® VEGF media. Cells were incubated for 3 h at 37°C to allow active uptake of the dye into viable cells. Plates were washed twice in PBS before the addition of 150 μl de-stain solution (50% ethanol, 49% distilled water and 1% glacial acetic acid). After 20 min. of agitation, the optical density was determined at 540 nm with a reference filter of 630 nm using a microplate spectrophotometer (Thermo Labsystems, Waltham, MA, U.S.A.). Background readings taken from blank wells were subtracted from wells containing both untreated and treated cells. Neutral red uptake was expressed as a percentage of the level in untreated cells.
Quantification of osteopontin and MMP-3 gene expression
Gene expression was assessed with the RT2 profiler™ PCR array system (SABiosciences) using an atherosclerosis-specific panel. Cells were lysed using TRIzol® reagent and centrifuged with chloroform. The supernatant was added to an equal volume of isopropanol and incubated at -20°C to precipitate RNA. Samples were centrifuged to pellet mRNA followed by an ethanol wash. Genomic DNA was eliminated using the supplied First Strand Kit and mRNA was diluted to 1 μg total mRNA. The components of the RT cocktail were combined in a microfuge tube and added in equal volume to RNA. The resultant mixture was incubated at 42°C for 15 min., after which the reaction was inactivated at 95°C for 5 min. cDNA was diluted in dH20 and combined with the PCR mastermix and 25 μl of solution was added to each well of the array plate. The following thermal cycler protocol was used: 10 min. at 95°C, 40 cycles of 15 sec. at 95°C and 1 min. at 60°C.
Quantification of osteopontin, IL-6 and MMP-3 protein levels
Osteopontin and MMP-3 levels were evaluated by electrochemiluminescence using the MSD® platform (Meso Scale Discovery, MD, U.S.A.), in supernatants collected from HUVEC cultures or sera from smokers and abstainers. 25 μl of conditioned media or serum and calibrators (0-100 ng/ml osteopontin, 0-2,500 pg/ml IL-6 and 0-100 ng/ml MMP-3) were incubated with agitation on the assay plate (osteopontin singleplex, ultrasensitive pro-inflammatory-4 II (IL-6) MULTI-SPOT® and MMP-3-plex MULTI-SPOT® 96-well small spot plates) for 1.5 h. After this, SULFO-TAG anti-human osteopontin, anti-human IL-6 or anti-human MMP-3 antibodies were added to each well at 1 μg/ml. After a further 1.5-hour incubation period, plates were washed in 0.05% (v/v) PBS-Tween-20 solution followed by the addition of 150 μl Read Buffer. Plates were read using a MSD® SECTOR 2400 imager and protein concentration assessed against a standard curve, using MSD Workbench® software.
Detection of osteopontin by immunocytochemistry
After PM treatment, HUVECs were washed in PBS and fixed in ice-cold methanol for 15 min. Cells were then blocked in PBS containing 2% BSA for 45 min at room temperature. After two PBS washes, the cells were incubated with 4 μg/ml rabbit anti-osteopontin polyclonal antibody (Abcam, Cambridge, U.K.) for 1 h. The cells were washed twice in PBS and incubated with 5 μg/ml Alexa Fluor® 568-labelled goat anti-rabbit antibody (Invitrogen, Paisley, U.K.) for 1 h. Cells were further washed with PBS and counterstained with DAPI (10 μg/ml in PBS). Coverslips were mounted onto slides using fluorescence mounting media (Dako, Denmark), viewed with a TE2000 inverted fluorescence microscope (Nikon, Surrey, U.K.) and images captured with an Orca 12-bit camera (Hamamatsu, Japan). Images were taken of the DAPI (blue) and osteopontin (red) channels using IPLabTM software. Image data were quantified using MetaMorph® software. Regions of interest were created using a 70 × 70 pixel circle around the DAPI-stained nucleus by examining only the blue channel. The red fluorescence of interest was then examined within this region and the average pixel intensity of fluorescence in each region of interest assessed. 10 nuclei per treatment were evaluated.
Detection of osteopontin by western blotting
Whole-cell lysates were prepared by scraping cells off in 1 ml ice cold PBS and pelleting by centrifugation at 1500 g for 5 min. The resultant cell pellet was resuspended in 200 μl lysis buffer. Cell extracts were incubated for 20 min at 65°C with reducing agent and sample buffer. Equal amounts of proteins (25 μg per lane) were resolved on 12% SDS-polyacrylamide gels and transferred to PVDF membranes. Membranes were blocked using 5% non-fat dried milk solution in PBS containing 0.1% (v/v) Tween-20 (PBST). Membranes were probed for 1 h with either 1 μg/ml rabbit polyclonal osteopontin (Abcam, Cambridge, U.K.) or 0.5 μg/ml mouse monoclonal β-actin (Sigma, Poole, U.K.) antibodies. Membranes were washed in PBST and then incubated with secondary 4 μg/ml goat anti-rabbit (Abcam, Cambridge, U.K.) or 1:1000 goat anti-mouse (R&D systems, Minneapolis, U.S.A.) HRP-conjugated antibodies with 1:3000 dilution
Obtaining sera from human smokers
A single-centre, randomized, controlled, open-label, parallel group clinical study (approved by an Institutional Review Board) was conducted targeting enrolment of at least 120 smokers smoking their usual brand of cigarettes. U.S. adult smokers between 21 and 65 years old were enrolled in the study. Subject inclusion/exclusion criteria and baseline demographics can be found in Additional file
Additional file 1
Table S1. Subject demographics.
Click here for file
Pre-study assessment (e.g. medical history, physical exam, hematology, serology, virology, urinalysis) showed that all subjects were generally healthy. Subjects were confirmed to smoke between 19 and 25 cigarettes per day and had been smoking for at least 3 years. Subjects resided in the clinic for approximately 8 days. Smoking status was verified during screening and daily in-clinic by measuring exhaled carbon monoxide.
On Days −2 and −1 in clinic, all subjects acclimated to smoking 20 cigarettes per day (20 CPD). The intervention started on Day 1 and consisted of maintaining or reducing to zero the number of CPD. On Day 1, subjects were randomized to 1 of 4 groups (20 CPD, 10 CPD, 5 CPD, and 0 CPD). From Day 1 until the end of the study on Day 5, subjects smoked up to the maximum allocated number of CPD/group.
Blood was collected from subjects in the 20 CPD and 0 CPD groups on Day −1 and Day +5 and serum was separated using BD diagnostics vacutainer serum separator tubes. After blood samples were drawn, tubes were inverted 5–6 times and placed upright for ≤2 h. Tubes were then centrifuged at 1300-2000 x g. Using disposable pipettes, serum was transferred into 2 ml cryovials and stored frozen at ≤ -80°C until analysis. Levels of osteopontin in sera were determined using the MSD® platform as described.
Data analysis and statistics
Data are expressed as means ± standard deviation (S.D.). For both the
Concentration-dependent cytotoxicity of PM in endothelial cells
To determine a non-cytotoxic range of cigarette smoke PM concentrations, neutral red viability assays were used to determine the cytotoxicity of PM exposure (0 to 200 μg/ml for 24 h) in human umbilical vein endothelial cells (HUVECs). Data from a representative donor show that between 0 and 88 μg/ml there was a modest and insignificant reduction in cell viability (p > 0.05 at each concentration; Figure
Figure 1
Cytotoxicity of cigarette smoke total particulate matter (PM) in HUVECs.
Cytotoxicity of cigarette smoke total particulate matter (PM) in HUVECs. Following a 24-hour exposure to the indicated concentration of PM, cell viability was assessed using neutral red uptake assays. Experiments were performed in triplicate in a single HUVEC donor, and data are representative of those obtained in 3 other donors. Data are presented as mean ± S.D. cell viability. Levels are normalised to the viability of cells not exposed to PM. *p < 0.05 compared to controls.
Figure 2
Effects of PM treatment on osteopontin gene and protein expression.
Effects of PM treatment on osteopontin gene and protein expression. A, HUVECs from four different donors were exposed in triplicate experiments to 88 μg/ml PM for 24 h. Gene expression was examined using a PCR array. Data are mean fold changes in gene expression normalised to DMSO controls. B, 24-hour exposure to PM induced the secretion of osteopontin in a concentration dependent manner. Data are mean ± S.D. osteopontin concentrations (n = 6 in each case), as detected by electrochemiluminescence. *p < 0.05 compared to controls.
PM exposure induced osteopontin gene expression
To assess the effects of PM on osteopontin expression we exposed HUVECs from four different donors to 88 μg/ml PM for 24 h, after which gene expression was examined using a multi-gene PCR array. PM exposure caused osteopontin gene up-regulation of 2-fold or greater when compared to dimethylsulphoxide (DMSO) controls (Figure
Effects of PM on osteopontin protein expression
To assess further the osteopontin response to PM exposure, secretion of osteopontin protein into the supernatants of PM-treated HUVECs was measured by electrochemiluminescence. As shown in Figure
To further elucidate the effect of PM exposure on osteopontin protein expression, experiments were conducted using immunostaining and Western blotting. The localisation and expression of cellular osteopontin protein was visualised by immunocytochemistry, using an antibody raised against amino acids 170-183 (CKSKKFRRPDIQPD) of the osteopontin peptide. When compared to controls, PM treatment caused an increase in osteopontin expression (Figure
Figure 3
Localisation and expression of osteopontin following PM exposure.
Localisation and expression of osteopontin following PM exposure.A, exemplar images from immunostaining studies showing the induction of osteopontin expression upon PM treatment. B, results of pixel intensity analysis of images such as those shown in A. Data are mean ± S.D. pixel intensities from 10 cells at each concentration. *p < 0.05 compared to controls. C, Western blot analysis showed the presence of osteopontin at 66 kDa, which was greater in cells treated with 48 μg/ml PM for 24 h. D, quantification of band densities showed a 25% increase in osteopontin levels following PM exposure.
A role for oxidative stress in the induction of osteopontin production by PM
Since cigarette smoke is a rich source and also a strong inducer of the cellular production of oxidants we examined the effects of pre-treatment with the antioxidant ascorbate (200 μM for 5 h) on the response to a 24-hour PM exposure. The supernatants of treated cultures were collected and osteopontin levels assessed by electrochemiluminescence. As shown in Figure
Figure 4
Induction of osteopontin expression by PM is oxidative stress-dependent.
Induction of osteopontin expression by PM is oxidative stress-dependent.A, ascorbate pre-treatment (200 μM for 5 h) prior to a 24-hour exposure to 12, 24, or 48 μg/ml PM reduced osteopontin secretion compared to cells exposed to PM alone. Data are presented as mean ± S.D. osteopontin concentrations, as detected by electrochemiluminescence. N = 6 in each case. B, similar to the secretion studies, immunocytochemistry showed that ascorbate pre-treatment blunted the increase in osteopontin immunostaining caused by PM exposure. Graphical data are mean pixel intensities from 10 cells at each concentration. In A and B, *p < 0.05 compared to controls and #p < 0.05 compared to PM alone. C, Western blotting studies detected the presence of bands at 66 kDa and 33 kDa representing full-length and MMP-3 cleaved osteopontin, respectively. Ascorbate pre-treatment caused a reduction in the PM-induced elevation of osteopontin protein levels, which was most prominent in the MMP-3 cleaved form. Lane one, DMSO; lane two, ascorbate alone; lane three, PM; and lane four, PM with ascorbate pre-treatment. Graphical data are band densities obtained by densitometric analysis of Western blots.
Are MMPs involved in the PM-induced production of osteopontin?
Full-length osteopontin can be cleaved by MMP-3 to alter integrin binding and therefore cellular responses
PM-induced expression of MMP-3 is independent of oxidative stress
Since PM caused an increase in osteopontin expression via an oxidative stress-sensitive mechanism which may involve MMP-3 cleavage of osteopontin, we examined MMP-3 expression in HUVECs exposed to PM. Using electrochemiluminescence we constructed a concentration-response curve for the effects of PM on MMP-3 protein levels (Figure
Figure 5
PM-induced MMP-3 elevation occurs independently of oxidative stress.
PM-induced MMP-3 elevation occurs independently of oxidative stress. A, PM induced a concentration-dependent increase in MMP-3 levels. Data are mean ± S.D. MMP-3 levels were assessed by electrochemiluminescence in supernatants taken from treated cells. n = 6 in each case. *p < 0.05 compared to controls. B, PM-induced MMP-3 expression was not affected by ascorbate pre-treatment. n = 6 in each case. *p < 0.05 compared to controls. #, p > 0.05 compared to TPM alone.
Osteopontin levels in sera from smokers and abstainers
Previous studies have shown that cigarette smoke promotes oxidative stress by delivering free radicals and by promoting the endogenous generation of free radicals by activated vascular cells. The oxidative stress induced by smoking is rapidly reversed on cessation
The interaction between cigarette smoke, oxidative stress, inflammation and cardiovascular disease has been widely reported
The analysis of gene expression was important to verify that cigarette smoke-induced changes in protein expression were due to transcriptional regulation and not transient changes in local protein concentration. This finding of altered osteopontin gene expression is in accordance with the increased osteopontin mRNA expression seen in atherosclerotic plaques
Subsequent to the gene expression analysis we demonstrated that osteopontin protein levels were elevated following cigarette smoke extract exposure and that this effect was reduced by antioxidant pre-treatment. Cigarette smoke is both a source and a cause of the production of cellular reactive oxygen species. The pro-inflammatory effects of cigarette smoke have been well described
The functional effects of osteopontin are determined not only by its expression levels but also by its cleavage by various enzymes into functionally diverse fragments
Oxidative stress has been proposed to play a prominent role in numerous smoking-related diseases including atherosclerotic cardiovascular disease
In the
In this study, we examined the levels of osteopontin protein in human sera obtained from smokers who abstained from smoking for 5 days. In this period, the levels of osteopontin in these sera were reduced compared to their levels prior to smoking abstinence. However, further studies would be required in order to understand the long-term effects of smoking cessation on osteopontin levels in serum and to assess its involvement in inflammation and its association with smoking-related cardiovascular disease.
Cigarette smoke extracts induced osteopontin expression in cultured vascular endothelial cells and we propose that this may play a role in the pro-inflammatory effects of cigarette smoke.
Competing interests
IMF and EB hold stock in British American Tobacco. EHT holds stock in R.J. Reynolds Tobacco Company.
Authors' contributions
EB performed all
Authors' information
IMF and EB are currently employees of British American Tobacco Group Research and Development. EHT is currently an employee of R. J. Reynolds Tobacco Company.
We acknowledge Mr. Mark Taylor for support with the PCR studies. We also acknowledge Dr. Karsta Luettich and Mr. Frazer Lowe for their discussions and suggestions on this work. This work was supported by British American Tobacco Group Research and Development and by R.J. Reynolds Tobacco Company.
Smoking and smoking cessation- The relationship between cardiovascular disease and lipoprotein metabolism: a review
Smoking cessation and inflammatory markers in older chinese men: The Guangzhou Biobank Cohort study
Smoking and atherosclerotic cardiovascular disease: Part 1: atherosclerotic disease process
The Complexity of Tobacco and Tobacco Smoke
Mechanisms of cigarette smoking induced pathogenesis: an overview
Osteopontin and cardiovascular system
Macromolecules in bone matrix
Osteopontin: a multifunctional molecule regulating chronic inflammation and vascular disease
Osteopontin: a novel inflammatory mediator of cardiovascular disease
Osteopontin: a multifunctional protein at the crossroads of inflammation, atherosclerosis, and vascular calcification
Osteopontin, a novel substrate for matrix metalloproteinase-3 (stromelysin-1) and matrix metalloproteinase-7 (matrilysin)
Plasma osteopontin levels are associated with the presence and extent of coronary artery disease
Osteopontin in cardiovascular disease: a potential therapeutic target
Oxidative stress and cardiovascular disease: novel tools give (free) radical insight
Effect of giving up cigarette smoking and restarting in patients with clinically manifested atherosclerosis
Quitting cigarette smoking results in a fast improvement of in vivo oxidation injury (determined via plasma, serum and urinary isoprostane)
Distinct regulatory profiles of interleukins and chemokines in response to cigarette smoke condensate in normal human bronchial epithelial (NHBE) cells
The role of oxidative stress in the biological responses of lung epithelial cells to cigarette smoke
Agents associated with lung inflammation induce similar responses in NCI-H292 lung epithelial cells
Effects of smoking cessation on markers of inflammation and endothelial cell activation amoung individuals with high risk for cardiovascular disease
Smoking, smoking cessation and inflammatory markers in older Chinese men: The Guangzhou biobank cohort study
Matrix metalloproteinase-3 and coronary remodelling: implications for unstable coronary disease
Cigarette smoke alters tissue inhibitor of metalloproteinase 1 and matrix metalloproteinase 9 levels in the basolateral secretion of human asthmatic bronchial epithelium in vitro
Cigarette smoke exposure inhibits extracellular MMP-2 (gelatinase A) activity in human lung fibroblasts
Pre-publication history
The pre-publication history for this paper can be accessed here:


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Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death. Analyses of seventeen placebo-controlled trials (modal duration of 10 weeks) largely in patients taking atypical antipsychotic drugs, revealed a risk of death in drug-treated patients of between 1.6 to 1.7 times the risk of death in placebo-treated patients. Over the course of a typical 10-week controlled trial, the rate of death in drug-treated patients was about 4.5%, compared to a rate of about 2.6% in the placebo group. Although the causes of death were varied, most of the deaths appeared to be either cardiovascular (e.g., heart failure, sudden death) or infectious (e.g., pneumonia) in nature. Observational studies suggest that, similar to atypical antipsychotic drugs, treatment with conventional antipsychotic drugs may increase mortality. The extent to which the findings of increased mortality in observational studies may be attributed to the antipsychotic drug as opposed to some characteristic(s) of the patients is not clear. SEROQUEL XR is not approved for the treatment of patients with dementia-related psychosis [see WARNINGS AND PRECAUTIONS]. Selection of an ADHD medication selection depends on patient specific factors as well as drug side effects, interactions and existing conditions. However, stimulant medications have more evidence of use and are more effective than non-stimulants.Glipizide (Glucotrol)
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Federal Deposit Insurance Corporation (FDIC) is part of the socialist plot to Communistasize America's free market.
History Of The FDICEdit
How the FDIC WorksEdit
Bank customers deposit money into banks. The banks pay their shareholders and CEOs. Lobbyists distract Congress with hookers and blow while the banks fail to pay into the system for 10 years.
When America elects a muslin, the dollar tanks and banks no longer have money. The government is forced to bail them out.
Later, mortgage-owners are foreclosed on when the banks call in the loans and people are unable to pay off the loans because they failed to keep their jobs leaving them with no money because banks aren't providing credit to other industries, which are laying people off by the millions. The only people this doesn't work on are sheriffs and U.S. Marshalls; they will always have work.


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Judy Lowe in Boston, Massachusetts looks for container-friendly plants that will grow well in her urban garden. One of her favorites is sunny daffodils. She cites Dutch Master and February Gold as her preferred varities.
The Grumpy Gardener invited 8 other bloggers around the U.S. to share their must-plant list.


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Colin Mallard played in bomb craters and bombed out buildings as a child in England during the Second World War. Perhaps this was the origin of his interest in peace. He attended University in Boston and was deeply involved in the Civil Rights and Anti War Movements of the 60s. In fact, the story of the sanctuary at Boston University's Marsh Chapel, described in Stillpoint, was written from personal experience.
He worked for a number of years at an inner city church in Providence with the local black population and was harassed, threatened and beaten by the police. Later the church was firebombed and destroyed. (Click on the link below and see some interesting photos from that time. He's the one with the large mustache.)
Some of his many jobs have included such esoteric skills as taxi driver, magician's assistant, tree planter, mountain guide and a street counselor on Vancouver's skid-road. Colin laughs, "Jack of all trades and master of none."
He spent eleven years as a Unitarian minister. His interest in exploring spiritual matters took him into the ministry and out of it again.
For the next 20 years he worked as a psychologist. For some of that time he lived in Hawaii and worked with families in which children had been abused. The State of Hawaii believed the family was the best place to raise children and were prepared to provide the needed help. He taught parents effective communication and parenting kills, and helped them understand the sources of anger and conflict. It was during this time he wrote a first novel, a teaching story for his clients.
Behind it all was a consuming interest in the nature of peace and who or what we are as human beings. This led him to a lengthy study of Taoism, and Zen and, latterly, the Advaita Masters, Ramesh Balsekar and Dr. Jean Klein.
He has written a number of books on the subject of peace. Something to Ponder, reflections from Lao Tzu's Tao Te Ching, and Understanding, draw the reader into a deep exploration of life and how it works. A number of his books have won awards in such categories as Eastern Religion, General Fiction and Interior Design and Layout.
His latest novel Stillpoint uses fictional characters to bring to life the events that took place before, during and after the creation of the State of Israel. "If there is no awareness of what took place and what continues to this day, how can there be any real understanding?" Colin asks. "With deep understanding," he continues, "shifts in behavior spontaneously take place and peace becomes a possibility."
"Beliefs are not facts" he points out, "We may believe we can fly but gravity doesn't care what we believe."
Colin lives on Vancouver Island, where he writes and teaches about the wisdom and insights of Eastern Philosophy. He is also an avid soccer player and photographer.
Review by:
Paddy O'Callaghan
on May 11, 2013 :
This is a profoundly important book with the power to expose the truth behind the Arab-Isareli conflict.
If you enjoyed Michelle Cohen Corasanti's The Almond Tree, you'll love this, and vice Versa.
It's set over seventy years, two continents and three generations:
"Threescore and ten I can remember well:
Within the volume of which time I have seen
Hours dreadful and things strange; but this sore night
Hath trifled former knowings." - Macbeth by Billy The Bard
but there's even more to it than that. READ IT!!!!!!!!!!
(reviewed the day of purchase)


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Our 2014 conference on Saturday, February 1 at Milford High School, was a resounding success! Thank you to all who presented, attended, exhibited, and sponsored the event. Special thanks also goes out to our keynote speaker, Dr. Doug Tallamy, author of Bringing Nature Home. We've been working to bring Dr. Tallamy to DAEE for several years, and it finally worked out!
Below are a few items captured from the conference that we think you might enjoy.
First, here is a collection of apps, compiled by Jennie Marang and Angel Burns, from their conference session, Environmantel Education: There's an app for that!
Next, we'd like to share some reflections on the conference. The first is a recap from Kat Logullo, from Avon Grove Charter School, who also served as the conference chair. The second reflection is from Becky Burgess, a naturalist at White Clay Creek State Park, and first-time DAEE attendee:
"The DAEE conference on February 1st was a great success. We had a total of 63 attendees and 24 presenters. Of those numbers 31 were new members and 29 renewed from 2013 which is wonderful for our growing organization as we celebrate our 5th year. One of the nice things we are seeing is a growth in our [classroom] teacher attendees. We had 16 attendees that are formal educators, so we are starting to connect that aspect of education and forming a bridge between the formal and non-formal environmental education community.
Doug Tallamy was riveting as our keynote and really brought home our theme of "It's only Natural" with his discussion of native plantings and what we could do to make a difference and help nature. Our other presenters offered engaging classes for everyone in attendance and great take aways that we could all apply to our own niche in the environmental education world." -Kat Logullo
"I loved the DAEE conference! It was full of such interesting ideas and engaging people. I got a chance to meet many of my colleagues in the state park system, and also made connections with professionals in other fields. The workshops gave me a lot of exciting ideas for my own programs and introduced me to new educational resources. AND I won "The Sense of Wonder" by Rachel Carson in the silent auction – a book that I quickly fell in love with. This was my first educational conference, and I am really looking forward to more in the future!" -Becky Burgess
This photo gallery is complements of DAEE Past-Chair, Rick Mickowski.


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|Message view
|« Date » · « Thread »
|« Date » · « Thread »
|"Evan J " <maps.this.addr...@gmail.com>
|Re: Autodeployment of web.xml Does Not Work
|Sat, 15 Apr 2006 23:12:46 GMT
On 4/15/06, Wendy Smoak <firstname.lastname@example.com> wrote: > On 4/15/06, Evan J <firstname.lastname@example.com> wrote: > > > But again, "ANY" classes that does not have "url mapping" in > > WEB-INF/web.xml, would not be autodeployed even if Tomcat server is > > restarted. So once again, any class that has an existing url-mapping > > in WEB-INF/web.xml, can be recompiled and autodeployed upon placement > > in WEB-INF/classes but no newly compiled class that does not have > > url-mapping in web.xml can be autodeployed or deployed at all (or at > > least I get status 404 when I point my browser to the servlet). > > If there is no mapping in web.xml, Tomcat doesn't know what to do with > the request, so the 404 is expected. You can't just "point your > browser to the servlet". At least, not unless you enable the invoker > servlet... > > > http://vh.domain.com/SomeNewClass (or /servlet/SomeNewClass). > > ... and this URL containing /servlet/ makes me think you're working > from some old documentation that expects the invoker servlet to be > enabled. > > * http://tomcat.apache.org/faq/misc.html#evil > > You should put your servlet classes in packages and explicitly map > them in web.xml. URLs matching those mappings are the only ones you > can expect to work. > > Whether changes to web.xml are picked up without reloading the context > is a different question. I always re-deploy for web.xml changes, so > I'm not sure. > > You might want to try your experiments again, (using only URLs that > match mappings in web.xml,) and post another (shorter!) question if > you're still not seeing the behavior you want. > > -- > Wendy > > --------------------------------------------------------------------- > To unsubscribe, e-mail: email@example.com > For additional commands, e-mail: email@example.com > > Hi, The reason I posted my question in such a long thread was because I did not want any ambiguity as far as what has been done to tackle the issue. And from your response, I take it you did not read the post throughly. I wasn't following any document and the reason I mentioned servlet/MyClass was because, as for one of my settings in the Apache webserver, I had /servlet/* mounted for servlets but I had long gone moved away from that. As far as packaging, I mentioned that I had been trying to only examin this issue with web.xml redeployment and used packaging where it's applied. My problem lies in the realm of not being able to re-deploy web.xml for any modification. If I could get that to work, I would be more than happy to use the url-mapping to map my new classes. Again, I can access servlets accordingly with url-mapping already presented in web.xml but since I cannot redeploy it, I have no other choice but to restart the server. I wonder if I have understood the purpose of WatchedResource in Context correctly... --------------------------------------------------------------------- To unsubscribe, e-mail: email@example.com For additional commands, e-mail: firstname.lastname@example.com
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Photoshine Mini 4.0
What Is the FileHippo Safety Guarantee?
We know how important it is to stay safe online so FileHippo is using virus scanning technology provided by Avira to help ensure that all downloads on FileHippo are safe. The program you are about to download is safe to be installed on your device.
Photoshine is a photo editing and manipulation tool to easily create collages, frames and magazine style layouts with fancy effects such as sticking your favorite photograph on a cup or flower, or decorating it with a pink picture frame. Photoshine has 9 theme categories: Baby, Dream, Festival, Frame, Girl, Love, Magazine, Simulation and Other. The free version includes 230 templates while the full version comes with a whooping 680 templates. Creating a framed picture or funny effect is easy. After opening the picture in Photoshine you simply select a template to use with it. You can then fine tune it in through moving and rotating the picture within the template, for example to precisely position it within a mirror frame. You can add additional photos to the same template to create a collage. Photoshine also lets you change the color to black and white, sepia or a line drawing effect.


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Get an overview of this hotelMontpellier hotel in Historic Centre, walk to Comedy Square
Popular property highlights
Located in Historic Centre, this hotel is within a 5-minute walk of Opera House and Comedy Square. Fabre Museum and Peyrou Gardens are also within 15 minutes.
Hotel Features
This smoke-free hotel features a 24-hour front desk, multilingual staff, and a front-desk safe. WiFi in public areas is free.
Room Amenities
All 28 rooms offer free WiFi, flat-screen TVs with satellite channels, and hair dryers. Guests will also find showers and free toiletries.Information missing or incorrect? Tell us!Opens in a new window
Hotel Europa
Hotel Amenities
Hotel Amenities
Hotel Europa features multilingual staff and a safe deposit box at the front desk. Public areas are equipped with complimentary wireless Internet access.
Hotel Europa is a smoke-free property.
- 24-hour front desk
- Total number of rooms - 28
- Number of floors - 2
- Free WiFi
- Multilingual staff
- Luggage storage
- Safe-deposit box at front desk
- Offsite parking discounted rates available
- Smoke-free property
Available in all rooms: Free WiFi
Available in some public areas: Free WiFi
Offsite parking discounted rates available
Room Amenities
- Air conditioning
- Daily housekeeping
- Private bathroom
- Free toiletries
- Hair dryer
- Shower only
- Satellite TV service
- Flat-panel TV
- Free WiFi
- Rollaway/extra beds (surcharge)
If you have requests for specific accessibility needs, please note them at check-out when you book your room.
- Accessible bathroom
- Roll-in shower
Hotel Policies
Check-in time starts at 1 PM
Minimum check-in age is 18
Check-out time is 11 AM
Payment types
Children and extra beds
- Children are welcome.
- Rollaway/extra beds are available for EUR 15.00 per night.
- Cribs (infant beds) are not available.
- Pets not allowed
You need to know
Extra-person charges may apply and vary depending on property policy.
Government-issued photo identification and a credit card or cash deposit are required at check-in for incidental charges.
Special requests are subject to availability upon check-in and may incur additional charges. Special requests cannot be guaranteed.
- No onsite parking is available.
No cribs (infant beds) available
- Resort fee
Optional extras
- Rollaway bed fee: EUR 15.00 per night
Hotel Name
- Abasun Center
- Abasun Montpellier Center
- Hôtel Abasun Center
- Hôtel Abasun Montpellier Center
- Hotel Europa Montpellier
- Europa Montpellier
We should mention
A resort fee is included in the total price displayed.


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Pakistan National Anthem [ROCK REMIX!] **NEW AUGUST 2009** MP3
WATCH IN HIGH QUALITY** DOWNLOAD: http://www.mediafire.com/?pya124qoaav8ts9 Just took some time to do something patriotic, it's a quick beat but it's ...
JUNOON - PAKISTAN national anthem in UN Assembly MP3
on 12SEP 2009 at NEW YORK (UN Assembly Hall) What a peformance by Salman Ahmed Junoon... We Proud of You.
Pakistan's National Anthem(Instrumental) MP3
find us on facebook... facebook.com/pagal.khana.45.
Pakistan National Anthem-Junoon MP3
Instrumental National Anthem of Pakistan, from Junoon's Album...
Paul Van Dyk Exclusive Remix Pakistan's National Anthem 2010 MP3
for all those haters this is real n genuine exclusive remix.
Estonia National Anthem (Instrumental) MP3
Eesti - Mu isamaa, mu õnn ja rõõm Estonia - My Fatherland, My Happiness and Joy Subscribe for more ...
United States of America National Anthem (Instrumental) MP3
United States of America - The Star-Spangled Banner Subscribe for more - http://www.youtube.com/user/NationalAnthemsChan?sub_confirmation=1 All national ...
National Anthem of Pakistan (قومی ترانہ) MP3
The national anthem is unique in that its music preceded its lyrics. The music composed by Chagla reflects his background in both eastern and western music.
Shaleem David-National Anthem MP3
An instrumental of the National Anthem of Pakistan by myself.........its my tribute to My Pakistan.............Pakistan Zindabad! Shaleem!
Indian National Anthem (Instrumental) Dedicated to the Natural World of India MP3
Launched at United Nations COP21 (Paris) on the 30th of Nov 2015 by Hon'ble Prime Minister of India Narendra Modi and President of France François ...
National Anthem of Pakistan - Instrumental MP3
Junoon - National Anthem Of Pakistan (HQ) MP3
INQUILAAB The most EXPLOSIVE & REVOLUTIONARY & TREND SETTING album of Junoon! ... Comprises of all the greatest ROCK ANTHEMS which changed ...
National Anthem (India) Janaganamana Instrumental & Animation MP3
REPUBLIC DAY & Independence day song-kidsone [The Republic of India is a country in South Asia. It is the seventh-largest country by geographical area, the ...
Pakistan national anthem (E-Guitar) junoon MP3
Pakistan national anthem in E Guitar By Junoon.
National Anthem of Saudi Arabia - "النشيد الوطني" MP3
ஜ۩ESPAÑOL۩ஜ▭▭▭▭▭▭▭▭▭○ Aash al-Maleek (Larga Vida al Rey) es el himno nacional de Arabia Saudita. ○▭▭▭▭▭▭▭▭▭ஜ۩ENGLISH...
Pakistan National Anthem Song With Lyrics And English Translation MP3
Pakistan National Anthem Song Pakistan National Anthem With Lyrics And English Translation Pak sarzamin shad bad Kishware haseen shad bad Tunishane ...
National Anthem of Pakistan - Qaumī Tarāna (Instrumental) MP3
Pakistan National Anthem Piano Tutorial MP3
I tried on my PC Keyboard using www.virtualpiano.net Check this link for keyboard keys http://www.youtube.com/watch?v=Ow6oj_GlOu4.
"Qaumi Tarana" - Pakistan National anthem Vocal MP3
The Qaumī Tarāna (Urdu: قومی ترانہ) is the National Anthem of Pakistan. The words "Qaumi Tarana" in Urdu literally translate to "National Anthem".
National Anthem of Pakistan (قومی ترانہ) MP3
Qaumī Tarāna (Urdu: قومی ترانہ) is the national anthem of Pakistan. Lyrics by Hafeez Jullundhri. Music by Akbar Mohammed. Adopted in 1954. Lyrics: Pak ...


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AsianHopes Studios Photographer
jun hongModel Male Singapore, Singapore, Singapore
My Website: http://www.modelmayhem.com/junhongMy MM URL: http://www.modelmayhem.com/junhong
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Contact me at firstname.lastname@example.com if u're keen on working with me.
Looking forward to try out and experience new stuff.
I wouldn't say no to travel notice if the price is right
Picture speaks a thousand words
Have you worked with jun hong? Add Credits for jun hong! >>
Credit Notes-
AsianHopes Studios Photographer
Elfa Y Model
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Jessica Turale Photographer
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text:
ON THE very first day of my very first visit to Los Angeles, I looked up from a restaurant table and saw the unmistakable face of the veteran character comedian Fritz Feld. He had lunched and was leaving, but when he saw the expression on my face, he must have recognised the recognition he received every day. Although he was then 81 he looked almost exactly like the Fritz Feld whose film performances first made me laugh 43 years before. He smiled and stopped at my table, answered a few questions - then paused expectantly. It was an obvious cue, so I asked: 'Would you mind doing the . . . ?' Before I'd even finished the request, he smiled assent, slapped his mouth to simulate the sound of a popping cork, waved jauntily, and made an exit.
Feld first demonstrated this cork-popping trick as an improvisation in an otherwise forgettable Eddie Cantor film called If You Knew Susie (1948). As Feld said in a 1982 interview in Screen Actor: 'I played a waiter called Fritz, and Eddie Cantor says, 'Fritz, champagne.' And I said, 'Champagne - (popping mouth with palm of hand) - coming up]' People laughed and I kept it as a trademark.'
Born in Berlin to prosperous Jewish parents, Feld became stagestruck at the age of 12 when his father gave him a puppet theatre. Determined to be an actor, he auditioned for Max Reinhardt's Deutsche Theater, but was rejected because of the lisp that was later to become his stock in trade. Eventually accepted by the Deutsche Theater, he appeared in many of their productions, and acted as Reinhardt's assistant. He made his film debut in the expressionistic Der Golem (1917), playing, appropriately, a court jester. More film offers followed, but he decided to emigrate to the United States because of the anti-Semitism that was poisoning his homeland.
Soon after arriving in Hollywood, he was hired by Ernst Lubitsch, an old friend from his Berlin days, as a script-reader. Acting roles began coming his way and they kept coming for over 70 years. Feld's films include Tovarich, Hollywood Hotel (both 1937), Idiot's Delight (1939), The Phantom of the Opera, Holy Matrimony (both 1943), The Secret Life of Walter Mitty (1947), Call Me Madam (1953), Barefoot in the Park (1967), Hello, Dolly (1969), The Sunshine Boys (1975), A Fine Mess (1986) and Barfly (1987). He was cast as milliners, movie directors, psychiatrists, spies, composers, hotel clerks, impecunious noblemen, but mostly as waiters and maitres d'. He even played a maitre d' in the Roman Empire sequence of Mel Brooks's History of the World, Part I (1981).
Brooks, a great fan, also used him in Silent Movie (1976). Jerry Lewis, another fan, employed him in eight films. At the age of 89, Feld acted in two television movies.
Married for 53 years, he was a proud father and a diligent worker for the Academy of Motion Picture Arts and Sciences, the Screen Actors Guild and local theatre groups. He and his longtime friend Joseph Schildkraut were the co-founders of the prestigious Hollywood Playhouse.
Feld's favourite film was Howard Hawks's Bringing Up Baby (1938), in which he played a monocled, Teutonic psychiatrist with the unlikely name of Dr Digby. 'The most beautiful scene ever written' was his description of a scene he shared with Katharine Hepburn. 'She's sitting in the chair, and I analyse her. The scene ends up that I am sitting in the chair and she analyses me.'
My own favourite among Feld's more than 500 films is the Marx Brothers' romp At the Circus (1939). He played Jardinet, the imperious, bearded symphony conductor brought from Paris by the socially prominent Mrs Dewksbury (Margaret Dumont, of course) to entertain at her lavish Newport party. While Feld is conducting his orchestra on a floating bandstand by the ocean, Chico and Harpo cut him loose. The film ends with the oblivious Jardinet ecstatically waving his baton as the bandstand sails back to France.
(Photograph omitted)
- More about:
- Film Directors
- Hollywood
- Psychology
- State of Virginia


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Cinema Studies student and grad win first Peabody Award given for a viral video
Congratulations Cinema Studies Student Samantha Stendal and Cinema Studies Graduate Aaron Blanton on Peabody Award
Cinema Studies would like to congratulate Samantha Stendal and Aaron Blanton for winning the first ever Peabody Award given to a viral video for a piece they created last year that put a spotlight on rape culture. The video was one of 43 recipients of this year's Peabody Awards out of more than 1,100 submissions.
The Peabody Awards, founded in 1943, celebrates the best of television, radio and web storytelling. In their comments about "A Needed Response," the judges said: "Short, simple and spot-on in its critique of rape culture, the ingenious PSA by two University of Oregon students takes just 25 seconds to makes its point that real men treat women with respect."
Shot and edited in two days, "A Needed Response" has been watched more than three million times since it was uploaded to YouTube in March 2013.
To watch the video and read more about their award, please visit the Oregonlive website and University of Oregon's Celebrating Champions website.


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I got the tall variety in grey, and LOVE LOVE LOVE them.ugg mens "No," he replied after waiting a moment or so. It would make his machine affordable, but it would carry a long-term cost. He had a real moral sense to him. They areworking in the earth now--pushing up pale green pointsbecause the spring is coming. [Ugg Coquette Sale] In the meantime I will go to Ithaca, to put heart into Ulysses' son Telemachus; I will embolden him to call the Achaeans in assembly, and speak out to the suitors of his mother Penelope, who persist in eating up any number of his sheep and oxen; I will also conduct him to Sparta and to Pylos, to see if he can hear anything about the return of his dear father — for this will make people speak well of him.
. Longchamp Boxford Luggage " When Jobs told the folks at Atari that he was quitting to go search for a guru in India, the jovial Alcorn was amused. Her father felt the resentment of one whose hospitality is casually received, and, more consciously, of one whose daughter is too lightly esteemed.. [Longchamp Boxford Luggage] "He who is abandoned is an abandoner," she said.


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Group Accountant/Internal Auditor
- Recruiter
- Charterhouse Recruitment Limited
- Location
- Hessle, East Riding of Yorkshire
- Salary
- £35,000 - £45,000
- Posted
- 14 Mar 2017
- Closes
- 13 Apr 2017
- Sector
- Manufacturing
Group Accountant/Internal Auditor
Our client, a global manufacturing fully listed business are currently recruiting for an experienced commercial accountant to join them. Reporting to the Group Financial Controller this role is split into two main areas of Group Accounting and Internal Audit.
Group Accountant
Consolidation of the Group's monthly management accounts, forecasts and annual budgets
Assist the Group Chief Accountant with the preparation of the Group's published Half Year and Annual Report
Prepare statutory accounts for UK subsidiaries
Other Head Office projects as required
Internal Audit
Conduct internal audit visits to operating subsidiaries worldwide
Work closely with the Senior Group Internal Auditor to maintain and improve and the Group's internal control systems
Ensure timely and accurate feedback to Management of existing internal controls
This role would suit someone with a natural drive and ambition to progress their career. You will ideally be CIMA qualified with Manufacturing experience but my client is open to other backgrounds including those looking at making their first move from practice. As this company has a global reach then you must be prepared to undertake international travel as part of the role. Excellent analytical skills with an attention to detail is essential. You will be a good communicator, energetic with a can do attitude.
Salary guide £35000 - £45000 ( dependent on experience) plus pension & bonus
Due to the volume of applications we receive, if you have not heard from the managing consultant within 1 week, please assume you have not been short listed.
Charterhouse Recruitment (Yorkshire) Ltd is committed to a policy of equal opportunities in relation to job applications. A copy of our Diversity Policy is available upon request.
Charterhouse Recruitment (Yorkshire) Ltd is acting in the capacity of an Employment Agency for permanent appointments and an Employment Business for temporary assignments.


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Forty-nine educators in the Philippines recently graduated from a MOOC Camp based on "Leaders of Learning," a HarvardX course taught by Richard Elmore, Gregory R. Anrig Professor of Educational Leadership at the Harvard Graduate School of Education (HGSE).
The Leaders of Learning MOOC Camp brought together educators from various school and universities to identify and understand their own theories of learning and leadership. Participants explored the course content online and collaborated face-to-face during three meet-up sessions. They also had opportunities to interact with Professor Elmore, who engaged with students during their learning presentations and shared a video message at the graduation ceremony.
Samuel Macagba III, Assistant Principal for Formation at Xavier University Junior High School, speaks about his experience in the Leaders of Learning MOOC Camp. (video credit)
The Leaders of Learning MOOC Camp was sponsored by the American Spaces Philippines of the U.S. Embassy, Manila Philippines, as part of an effort to assist local educators in adjusting to the K-12 transition. Over 300 educators and students at eight Mindanao locations, including the American Corners in Cagayan de Oro, Davao, Zamboanga, and Marawi, and Department of Education and Commission on Higher Education partner venues completed the Leaders of Learning course. Read more about the MOOC Camp in this article.


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Randa is a small mountain village in the Canton of Wallis, Switzerland. Randa is only two trains stops away from Zermatt and it's world famous Matterhorn.
The House
The Randa Meetings take place in the Ferien- und Kurshaus Randa. The beautiful building used to be a hotel and is today used as holiday camp and course house. With over 100 beds and more than 4 group rooms there is plenty of space to sleep and work. The beautiful surroundings (mountains up to 4'500m high) and quiet atmosphere make it the perfect place for focused and productive developer sprints.


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Courtney Smith-Pope
2009 USASF Coach of the Year
Owner & Head Coach of CEA
Former Wake Forest Varsity Cheerleader
USASF Level 5 Certified
Kasey Cloutier
Gym Director & Head Coach
(781)864 3288
I'm originally from Boston, Massachusetts where I cheered and coached at East Elite/ East Celebrity Elite from 1998-2012. Graduating high school in 2009 as certified preschool teacher, I attended Dental School that fall in Boston earning my degree in Dental Assisting, graduating in 2012. I have been with Cheer Extreme for 4 years now and absolutely love it. I am USASF certified levels 1-5 and CPR/First aid certified.
Tyler Lewis
Head Coach
(781)635 0350
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To determine the population effectiveness of a city-wide perinatal HIV prevention program.
An anonymous surveillance of newborn cord blood for HIV serology and nevirapine (NVP).
All 10 public-sector delivery centers in Lusaka, Zambia participated. All mother–infant pairs delivering during the 12-week surveillance period at the participating centers and who received antenatal care at a public-sector facility in Lusaka were included in the study. The main outcome measure was population NVP coverage, defined as the proportion of HIV-infected women and HIV-exposed infants in the population that ingested NVP.
Of 8787 women in the surveillance population, 7204 (82%) had been offered antenatal HIV testing, of which 5149 (71%) had accepted, and of which 5129 (99%) had received a result. Overall, 2257 of 8787 (26%) were cord seropositive. Of the 1246 (55%) cord blood seropositive women who received an antenatal HIV test result, 1112 (89%) received a positive result; the other 134 comprise seroconverters and clerical errors. Only 751 of 1112 (68%) women who received a positive antenatal test result and a NVP tablet for ingestion at labor onset had NVP detected in the cord blood (i.e., maternal non-adherence rate was 32%). A total of 675 infants born to 751 adherent mothers (90%) received NVP before discharge. Thus, only 675 of 2257 (30%) seropositive mother–infant pairs in the surveillance population received both a maternal and infant dose of NVP.
Successful perinatal HIV prevention requires each mother–infant pair to negotiate a cascade of events that begins with offering HIV testing and continues through adherence to the prescribed regimen. This novel surveillance demonstrates that failures occur at each step, resulting in reduced coverage and diminished program effectiveness.
Each year in Zambia's capital city of Lusaka, more than 10 000 babies are born to HIV-infected mothers. Without intervention, around 40% would become infected during gestation, delivery, or breastfeeding, but this risk can be reduced substantially with antiretroviral prophylaxis [1]. Since November 2001, we have been operating a large program for the prevention of mother-to-child HIV transmission (PMTCT) in Lusaka [2]. We use intrapartum and neonatal single-dose nevirapine (NVP) as the primary prophylactic intervention, because of its ease of administration, persistent efficacy in the face of breastfeeding [3], and no-cost availability from the manufacturer [4].
Monitoring the population effectiveness of the Lusaka PMTCT program is difficult. Virologic testing of infants is too costly and complex for widespread use in our setting. Serologic testing is offered after breastfeeding cessation, but uptake is low, and it is unlikely that surviving infants presenting for testing are representative of the population as a whole. Thus, we rely upon estimates of population coverage, the proportion of infected-exposed mother–infant pairs in the population that ingest a peripartum dose of NVP, as the primary metric for PMTCT program monitoring in Lusaka. Until this study, we, like others [5,6], have relied upon available process indicators to estimate population coverage; the number of prophylactic doses prescribed was divided by an estimate of the number of HIV-exposed infants in the population. However, this approach is potentially flawed [7]. HIV prevalence, typically derived from the population who accepts testing, may in fact differ in those who refuse. In addition, we have observed that as many as 26% of HIV-infected women who receive NVP for self-administration at labor onset may not actually ingest their NVP tablet [8].
The delivery center provides a unique opportunity to collect population coverage data. First, because of the inescapable need for delivery care (coupled with a strong tradition of institutional delivery in Lusaka), the great majority of women in the population will present for delivery. Second, following delivery, umbilical cord blood is discarded with the placenta and becomes available for sampling. Since anti-HIV IgG antibodies cross the placenta freely throughout pregnancy [9,10], and since NVP crosses the placenta within minutes of its rapid oral absorption [11,12], infant cord blood surveillance at delivery is an excellent source of information on both population HIV seroprevalence [13,14] and NVP coverage [8] for PMTCT program monitoring.
The Lusaka PMTCT program has been described in detail elsewhere [2]. However, there are a few aspects of its procedures that are particularly germane to this surveillance exercise, which we will briefly reiterate here. Women seeking public sector obstetrical services in Lusaka receive their primary antenatal care in the 24 clinics of the Lusaka District. HIV testing and NVP services are available at no cost in each facility. There is a city-wide policy to offer HIV testing to all antenatal women, and, in those who refuse, to offer testing again at a subsequent antenatal visit. Women who accept testing receive individual post-test counseling. Prophylactic NVP is given to seropositive women at the time of diagnosis, along with instructions to ingest the tablet at the time of labor onset. Whether HIV testing has been offered or accepted, the test result, and receipt of NVP are documented in the obstetrical record through the use of a code. Delivery services are offered at 10 of the Lusaka District clinics and at the University Teaching Hospital. Upon presentation in labor, HIV-infected women are identified by the code in their antenatal record, and asked whether they need a replacement NVP dose prior to delivery. The same code serves to remind clinicians to dose infants with NVP prior to discharge from the facility.
Between 7 June and 31 August 2003, we collected anonymous cord blood specimens from the discarded placentas of live-born public sector deliveries in the city of Lusaka. Participating facilities included all 10 clinics that provide delivery services in the Lusaka District, and the labor ward of the University Hospital. Facilities were staffed continually and an attempt made to obtain specimens from every delivery. In the event of a failed attempt, the reason was noted. At delivery, approximately 5 cm3 of cord blood were obtained in an anticoagulated collection tube affixed with a unique number. From each woman's antenatal record, we extracted the following non-identifying information onto an anonymous surveillance form: her age and gravidity, whether she had been offered HIV testing in antenatal care, whether she had accepted it, whether she had received the result, and, if seropositive, taken possession of a NVP tablet. We also recorded the dates of these events when available. A carbon copy of the form, marked with the unique specimen number, was placed in the patient record. At the time of discharge, clinical personnel recorded whether the infant was given NVP prophylaxis on the surveillance form and then removed it from the patient record. (All infant NVP in the Lusaka PMTCT program is administered by nursing staff prior to discharge from the delivery facility.) We obtained a single cord blood specimen in the instance of twin or triplet birth. Babies who were born before arrival at the delivery center and those who were stillborn were excluded from the surveillance exercise; these are relatively rare events and if coupled with other patient-level information (e.g., clinic of delivery) the anonymity of an individual could have been jeopardized.
Cord blood specimens were analyzed for HIV antibodies via a serial rapid antibody algorithm, consisting of a highly sensitive screening test (Determine HIV-1/2, Abbott Laboratories, Abbott Park, Illinois, USA) with positive results confirmed by a second rapid test (Capillus HIV-1/HIV-2, Trinity Biotech, Wicklow Co, Ireland). Discrepant results were resolved with a third 'tie breaker' rapid assay (Genie II HIV I/II BioRad Laboratories, Redmond, Washington, USA). This algorithm is expected to be > 99.9% sensitive and > 99.8% specific in field settings [15]. In a few cases, the results of the antenatal test (abstracted from the medical record) did not agree with the result of the cord blood test. Although we report the results of both, we believe that the cord blood test results are definitive and were used to categorize women as to their HIV serostatus in this study. Those specimens found to be seropositive were analyzed for NVP with a validated quantitative high-performance liquid chromatography (HPLC) assay developed at the University of Alabama at Birmingham Antiviral Pharmacology Laboratory. We have previously reported that of 179 women in whom NVP ingestion was directly observed by study personnel, in 178 (99.4%) the drug was detectable in the cord blood; this validates cord blood HPLC as an objective and sensitive measure of adherence [16].
Population NVP coverage was defined as the proportion of HIV-exposed infants in the population in whom both the maternal and infant NVP doses were received. (Infant HIV-exposure was ascertained by cord blood antibody testing, [13] maternal NVP dosing was determined by cord blood chromatography, and infant NVP dosing was determined by direct observation.) Only receipt of both the maternal and infant doses of NVP has been proven to be effective in preventing perinatal transmission [17]. Maternal dosing alone will often fail to achieve a prolonged infant prophylactic level, especially if the ingestion to delivery interval is short [18]. Infant dosing alone has been shown to have modest, if any, prophylactic efficacy [19]. Thus, we selected population NVP coverage as the primary indicator of PMTCT program performance in this surveillance.
Maternal adherence was defined as the proportion of women who were given a NVP tablet in antenatal care that actually ingested it (as measured in the cord blood). It differs from coverage in that the denominator is restricted to those women who knew their HIV status and took possession of a NVP tablet for ingestion at labor onset. To assess the comparability of age, gravidity, and other continuous variables between groups we used unpaired, two-tailed Student t-tests. Categorical variables were analyzed by chi-squared or Fisher's exact tests. All analyses were performed using SAS System release 9.0 for Windows (SAS Institute, Cary, North Carolina, USA) The study was approved by the University of Zambia Research Ethics Committee and the University of Alabama at Birmingham Institutional Review Board.
Over the 12 week surveillance period, 10 384 women gave birth to live infants at public sector institutions in Lusaka. From these, we obtained 10 194 specimens (98%, Fig. 1). Mothers from whom we were unable to obtain cord blood specimens did not differ from those from whom we did obtain specimens with respect to age, gravidity, or whether they had been offered and/or accepted HIV testing in antenatal care (data not shown). Of the 10 194 women from whom we obtained specimens, 8787 (86%) had received their antenatal care at a public sector facility within Lusaka (and thus at a facility that was providing PMTCT services at the time of the surveillance.) We refer to these women and their infants as the surveillance population below.
The 8787 maternal members of the surveillance population were a median of 23 years old (range, 12–50). Their median number of pregnancies (including the present one) was 2 (range, 1–13). On cord blood testing, 2257 mothers (26%) were HIV seropositive (Fig. 2, step A); 7204 women (82%) had been offered HIV testing in antenatal care, of whom 5149 (71%) had accepted testing (Fig. 2, Steps B–C). HIV prevalence was similar among those who had been offered antenatal HIV testing (1854 of 7204, 26%) as compared with those who had not (403 of 1583, 25%; P = 0.9). However, HIV prevalence was significantly lower among women who accepted antenatal HIV testing (1250 of 5149, 24%) as compared with those who refused it (604 of 2055, 29%; P < 0.0001).
Of 5149 women who accepted HIV testing in antenatal care, 5129 (99%) received a test result (Fig. 2, Steps C–D). Of these, 1246 (24%) were seropositive on cord blood testing at delivery. Of the 1246 women who were cord blood seropositive and who received an HIV test result in antenatal care, 1112 (89%) received a positive test result. The remaining 134 comprise false-negative antenatal tests, false-positive cord blood tests, clerical errors at the level of the antenatal clinic or delivery site, and seroconversions between the first test and delivery, and are discussed in more detail below.
Of 1112 cord blood seropositive women given a positive HIV test result in antenatal care, 751 (68%) had NVP detected in the cord blood (i.e., maternal non-adherence was 32%; Fig. 2, Step F). Women who adhered to the maternal NVP dose had a shorter mean interval between HIV testing and delivery than women who did not adhere (96 ± 46 versus 104 ± 46 days; P = 0.006), but they did not differ by age or gravidity. Among the 751 infants born to mothers who adhered to intrapartum NVP, 675 received directly observed NVP by a health care worker (90%; Fig. 2, Step G).
Of 2257 infants born to HIV-seropositive mothers in the surveillance population, 675 (30%) had evidence of both maternal and infant NVP dosing. Reasons for failed coverage (70%) included (Fig. 3): mother was not offered HIV testing in antenatal care (n = 403; 18%), mother refused HIV testing (n = 604; 27%), mother did not receive her test result and/or NVP tablet at post-test counseling (n = 4; < 1%), mother's test result in antenatal care was recorded as negative (n = 134; 6%), mother did not ingest NVP at labor onset (n = 361; 16%), and infant was not dosed with NVP prior to discharge (n = 76; 3%).
This novel, surveillance-based evaluation demonstrates that despite a seemingly robust PMTCT program in the city of Lusaka, only a minority of HIV-exposed infants are receiving appropriate prophylaxis. In order for a given infant to receive perinatal HIV prophylaxis, a specific sequence of events must transpire, one that begins with the offering of PMTCT services and HIV testing and continues through good medical record keeping and encouragement of adherence to the prescribed regimen. Our study demonstrates that failures can and do occur at each step along this cascade, resulting in reduced coverage and diminished program effectiveness.
Among the most striking findings of this surveillance exercise is the large proportion (32%) of HIV-infected women in the population who do not actually ingest the NVP tablet given to them in antenatal care. We have previously described a rate of 26% non-adherence to NVP in the more controlled circumstances of a clinical trial [8], but these new data suggest that the problem may be worse among an unselected clinic population and perhaps potentiated by longer intervals between receipt of the tablet in antenatal care and delivery. The finding of low NVP adherence, combined with our observation that women who refuse testing are more likely to be HIV infected than those who accept testing, seems to indicate that reliance upon simple process indicators (such as numbers of women tested or numbers of NVP doses given out) may substantially overestimate PMTCT program performance.
Our results also indicate that seroconversions in late pregnancy and provision of incorrect HIV test results in antenatal care may represent previously unrecognized and important failure points in the Lusaka PMTCT program. A negative antenatal test result that is positive upon cord blood testing at delivery can have a number of explanations. Some cases can be attributed to the PMTCT program and its patients. These include: (1) seroconversion between the first test and delivery; (2) clerical errors at the level of the antenatal clinic; and (3) false-positive antenatal tests. The remaining cases can be attributed to the surveillance exercise itself. These include: (4) false negative cord blood tests; and (5) specimen mix-ups at delivery. Errors attributable to the surveillance exercise can be quantified [20]. We have recently reviewed the performance of rapid HIV tests used in combination algorithms [15]. Even under suboptimal field conditions, the negative predictive value of the Determine screening test typically exceeds 0.998 (i.e. the false-positive rate is less than two per 1000). Likewise, if specimen mix-ups were a major contributor (meaning the HIV testing history of a woman who tested negative in antenatal care was erroneously attached to the cord blood of a woman who tested positive in antenatal care), we would expect a large proportion of the specimens to be NVP positive as well. In fact only 13 of the 134 'seroconverters' (9.7%) were also NVP positive. Thus, we can reasonably conclude that around 10% of the apparent seroconversions can be attributed to errors in the surveillance exercise, and that the remaining majority fall into a category of de facto seroconversions. Whether false-negatives in ANC derive from laboratory errors, clerical errors at the level of the antenatal clinic, or from actual recent infection, the result is the same – failed coverage.
Much attention has been paid recently to developing and advocating for more efficacious PMTCT regimens [21]. Yet drug efficacy, the ability of a drug regimen to reduce the risk of transmission in a given mother–infant pair, applies only to the last step in the PMTCT attrition cascade, namely those mother–infant pairs who are 'covered'. The population coverage model we present here demonstrates the critical importance of early steps in the cascade to the overall effectiveness of the PMTCT program. For example, Figure 2 demonstrates an 18% failure rate at the first step of offering HIV testing and a 32% failure rate (nearly double) at the later step of maternal non-adherence. Yet, in absolute terms, attrition at the first step is more important: 403 HIV-infected mothers are lost due to failure to offer testing, compared to only 361 due to non-adherence. Thus, policy makers who wish to maximally reduce the incidence of pediatric HIV in the population should focus first on ensuring that services are offered widely and on increasing antenatal HIV testing rates. Increasing the efficacy of the PMTCT regimen offered will only be expected to have a large population effect in the instance where other aspects of the program are functioning well (i.e., where coverage is high). Otherwise, resources may be better spent in maximizing coverage of simple and moderately effective interventions such as NVP, graduating later to more efficacious drug regimens.
There are limitations to this study. First, the processes we have measured in this exercise, and the ultimate outcome of population coverage, are likely to be most relevant to other urban and periurban settings in sub-Saharan Africa, where PMTCT services are delivered in a similar way. Rural and sparsely populated areas that have predominately home and/or unattended deliveries face their own unique set of challenges to PMTCT program implementation. Second, although the evidence is compelling that peripartum NVP reduces MTCT [17], and that this efficacy is evident months later even in breastfeeding populations [3], population coverage is in fact a surrogate marker for what ultimately matters: HIV-free child survival. Although we did not measure this, our previous work suggests that NVP in cord blood correlates well with lower HIV infection rates in the exposed newborn [8,16].
In response to the findings of this research, we have begun to make program reforms at each step in the 'attrition cascade', including clinic-level incentives to ensure all women are offered services, community efforts to encourage HIV testing and NVP adherence, and quality assurance programs for the small clinical labs that are performing the HIV rapid testing. It is our belief that problems in our program made clear in this analysis should not be interpreted as limitations in our research effort; rather, they are its focus.
These data indicate that population coverage is an important indicator of PMTCT program performance, and that all efforts should be made to maximize it. A key unanswered question in resource limited settings is whether the introduction of more complicated and potent PMTCT regimens may adversely affect population coverage and paradoxically negate their superior efficacy with reduced coverage. Alternatively, antiretroviral regimens that are perceived as highly efficacious by patients and staff may be better received than simpler ones, resulting in both higher coverage and increased efficacy. We are currently in the process of piloting more efficacious antiretroviral combinations in Lusaka and assessing the extent to which their increased complexity affects coverage rates and viral resistance patterns. Understanding the relationship between regimen complexity and population coverage in high prevalence, resource-poor settings is a particularly urgent operations research question.
We are grateful to Dr Miriam Chipimo for her assistance with this study.
Sponsorship: This study was funded by the Lusaka Urban Health District, with complimentary resources from the Elizabeth Glaser Pediatric AIDS Foundation (EGSA 19-02), and the US National Institutes of Health (K23 AI52481, U01 AI479727). No funding organization was involved in the design, conduct, data collection, analysis, or interpretation of the study.
PubMed Central Canada is a service of the Canadian Institutes of Health Research (CIHR) working in partnership with the National Research Council's national science library in cooperation with the National Center for Biotechnology Information at the U.S. National Library of Medicine(NCBI/NLM). It includes content provided to the PubMed Central International archive by participating publishers.


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Solutions for Chapter 2
After the Big Bang, many theories were developed to explain how atoms formed. The air is a mixture of many types of gases (for example, , , , , ).
Observe the following figure.
Blue spheres represent nitrogen atoms. Red spheres represent oxygen atoms.
We can see that there are two types of molecules present in the figure.
Therefore, it is a mixture of two types of gases. The gases are:
Hence, the correct answer is option (c).


text: WalzCraft Industries Inc22.Dec 2015 Employee Not what it seems 2.72 2.72 Suggestions for improvementEncourage communications, engage employees in the process and be open minded to constructive criticism. Company WalzCraft Industries Inc City La Crosse, WI Are you a Current or Former Employee? Former job since 2015 Position Others Department Administration


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Ernest Major
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<ebb8eea6-f8d7-47fe-88ab-ac23f2e19...@e6g2000prf.googlegroups.com>, backspace <sawireless2...@yahoo.com> writes >http://en.wikipedia.org/wiki/Genetic_drift >"...It contrasts with the evolutionary mechanism, natural selection, a >non-random selection process in which the tendency of alleles to >become more or less widespread in a population over time is due to the >alleles' effects on adaptive and reproductive success..." >What would a random selection process look like? Isn't there something in the Bible about drawing lots? For a contemporary example, a random data stream can be obtained from the number of decays in a sample of radioactive material. This could be used to select the winners of a lottery.
The data stream from the decays sample had no intent, it didn't produce anything with the intent of providing a lottery selection winner
When somebody selects for a ball in a bag of balls one can state that he did a "random selection" if the intent is clear that he a conscious being with a goal did a "selection at random".


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Mail Order Pattern 4553; ca. 1950s; Misses' and Women's Slip with optional Lace Banding and optional Ribbon Shoulder Strap.
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Note from the Clinic - Medications and Clinic Forms
Print and complete any Health Plan Forms and/or the Medication Request Form that are applicable to your child. Bring the completed form(s) to the clinic during Open House on August 8.
For the safety of all students at our school, below are several guidelines and necessary forms for medications and health plans.
Administration of prescription and over-the-counter medicine (even for a short period of time) is discouraged.
Parents should check with their physician regarding the need for medicines to be administered during school hours. Medications prescribed for three times daily often can be given before school, after school, and at bedtime.
All medications, both prescription and over-the-counter, must be accompanied by Administration of Medication Request and brought to the school clinic by an adult.
All medications must be in the ORIGINAL CHILD PROOF CONTAINER. Prescription medications must be in the labeled prescription bottle. Pharmacists can give a duplicate labeled container with only the school dose. It is the responsibility of the parent/guardian to inform school of any changes and update medication forms.
Medications stored in envelopes, baggies, etc., will not be administered.
Administration of Medication Request Form 2016
Allergy Plan Form 2016
Asthma Plan Form 2016
Seizure Management Plan Form 2016
Generic Health Management Plan Form 2016
All students must have up to date immunizations.
7th grade students have an additional immunization update.
All rising 7th grade students born on or after January 1, 2002 need updated Immunization Certificate (form# 3231) to be assigned a homeroom for 2016-17. Please check with your healthcare provider or local health department if you have not submitted this form to your respective middle school.
The required Immunization Certificate (form# 3231) for the 2016-17 school year must have:
-----1 dose of Tdap (tetanus, diptheria, pertussis) vaccine
-----1 dose of meningococcal conjugate (MCV) vaccine.
If you have any questions, please email Lori Pirkle at firstname.lastname@example.com
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Hours: 09:15 AM – 04:05 PM
Phone: 770-904-5450
Fax: 770-904-5452
"The mission of Glenn C. Jones Middle School is to educate and inspire each child to become a productive citizen who contributes to society."


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