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Coordinated Community Response to Domestic Minor Sex Trafficking (DMST) Kim Stark, LMSW Stacy Lambright, LPC Leslie Timmons Executive Director Sexual Assault Therapeutic Counselor Community Educator Lubbock Rape Crisis Center dba Voice of Hope
Brief History Established in 1975 by Lubbock Police Chief J.T. Alley and Lubbock City Councils Human Relations Committee Second oldest Rape Crisis Center in Texas In 2012, assisted on 317 cases Rebranded in 2013 as Voice of Hope
Services LRCC/Voice of Hope operates 24/7 providing: 24 hour sexual assault crisis hotline 24 hour medical accompaniment Law Enforcement accompaniment Judicial accompaniment Case management, follow-up and referral Counseling for both primary/secondary victims SA primary prevention/community education ALL SERVICES PROVIDED TO VICTIMS ARE FREE!
Community Assessment Committee In September 2011, LRCC and the Sexual Assault Nurse Examiner became alarmed when we began seeing an increase in the number of child sexual assault cases presenting at the E.R. having red flag indicators of Domestic Minor Sex Trafficking (DMST).
Details given to Advocate at the E.R. Victim indicated her father had brought her to E.R. but no one was there with her Victim seemed to want to hide her face-hoodie over her face and sunglasses hid her eyes Victim admitted she unwillingly worked for a pornography company and felt There was no way out Victim said mom sold her when she was six Victim indicated she experienced high levels of sexual abuse and torture Victim gave details of location and information on child pornography ring
Initial Steps NEEDED TO ANSWER TWO QUESTIONS First, was there in fact a problem with DMST in Lubbock and the surrounding communities? Second, if there was a problem with DMST were there gaps in services for victims?
Coordinated Community Response
First Community Assessment Committee met in November 2011 Meet monthly – did training on DMST then began working together to design the survey instrument It took a year to create the finished survey Published Survey online Nov 7, 2012 Ran the survey for 26 days
Coordinated Community Response History of /or current signs of physical, emotional or sexual abuse Tattoos& branding marks or gang involvement/use of slang associated with industry Truancy/ tardiness at school or withdrawal & lack on interest in previous activities History of running away or current status as runaway and/or youth living in group homes or youth shelters Explicitly sexual online profile via social media Inexplicable appearance of expensive gifts Presence of older boy/girlfriend or evidence of a controlling/domineering relationship
Recruitment Tactics Trafficker will target childs weaknesses; tell them what they want to hear and give them what they need o If they want love, they will give them love and become their boyfriend o If they need a place to live, they will offer them shelter o If they are lonely, they become their friend o If they dont have a loving father, they become their protector o If they are poor or have low self esteem, they sell them a dream and offer a life of status
Coordinated Community Response 124 Respondents Medical School Employees Human Services Law Enforcement Legal Other
Coordinated Community Response Medical 30% reporting youngest age of patient pregnancy being less than 10 years 20% reporting 12, 13, &14 year old pregnant patients 40 % reporting having patients they believe to currently be involved in commercial sex 60 % reporting patients presenting with no adult
Coordinated Community Response Law Enforcement 77% reporting coming across 1-5 minors in a week they know to be involved in sexual activities 33 % reporting they are aware of minor in the presence of known prostitutes and/or pimps 22% reporting 1-5 minors were being picked up on prostitution or other related charges in a months time
Coordinated Community Response Community 45% reporting minors in their communities who were homeless and going from house to house 48% reporting having to make a report of a minor believed to be in danger of physical harm
Coordinated Community Response Survey Summary 73% reporting they believe there is an issue of commercial sex in communities where they live
Coordinated Community Response In an effort to provide a continuum of care/comprehensive services it is KEY to coordinate efforts to combat DMST. Including but not limited to the following: Federal/State/Local Law Enforcement Judicial/Prosecution Medical Component Victim Advocacy/Case Management/Mental Health Components Spiritual Component
Domestic Minor Sex Trafficking (DMST) DMST is the commercial sexual exploitation of American children within U.S. borders. The Game/The Life The subculture of prostitution, complete with rules, a hierarchy of authority, and language. Facilitator Any business or person allowing or assisting a trafficker to carry out his/her business. These facilitators (taxi drivers, hotel or property owners, etc.) benefit from the proceeds earned through the commercial sexual exploitation of children. Survival Sex A term referring to a situation that involves a minor providing sexual favors to an adult in exchange for basic needs such as shelter, food, or security. Daddy The term a pimp will often require his victim to call him. Coordinated Community Response
Family/Folks The term used to describe the other individuals under the control of the same pimp. He plays the role of father (or Daddy) while the group fulfills the need for a family. Bottom Bitch One girl, among several controlled by a single pimp, appointed by him to supervise the others and report rule violations. Sister Wife/Wifeys/Wife-in-Law What women and girls under the control of the same pimp call each other. Stable A group of victims under the control of a single pimp. Date The exchange when prostitution takes place, or the activity of prostitution. A victim is said to be with a date or dating. Coordinated Community Response
Circuit A series of cities among which prostituted people are moved. One example would be the West Texas circuit of Lubbock, Midland/Odessa, Amarillo, and the cities between. Quota A set amount of money that a trafficking victim must make each night before she can come home. Quotas are often set between $300 and $2000. Seasoning A combination of psychological manipulation, intimidation, gang rape, sodomy, beatings, deprivation of food or sleep, isolation from friends or family and other sources of support, and threatening or holding hostage of a victims children. Seasoning is designed to break down a victims resistance and ensure compliance. Reckless Eyeballing A term which refers to the act of looking around instead of keeping your eyes on the ground.
Coordinated Community Response Choosing Up The process by which a different pimp takes ownership of a victim. When a victim makes eye contact with another pimp she is choosing him to be her pimp. Trade Up/Trade Down To move a victim like merchandise between pimps. Finesse Pimp/Romeo Pimp One who prides himself on controlling others primarily through psychological manipulation. Gorilla Pimp A pimp who controls his victims almost entirely through physical violence and force. Renegade A person involved in prostitution without a pimp. Lot Lizard A derogatory term for a person who is prostituted at a truck stop.
Coordinated Community Response Future Direction for LRCC/Voice of Hope Stage 1: Immediate Goal Research, Training & Development of DMST Program; Implement comprehensive community awareness and DMST Primary Prevention Programs to include extensive staff training Provide education for Law Enforcement, Medical, 1 st Responders, Educators, Truck Drivers, Oilfield workers, Social Services & community
Coordinated Community Response Stage 2: Hire & extensively train additional staff Prepare to open Regional Resource Center Open Regional Resource Center Regional Resource Center will be designed to provide a variety of resources (training videos, print materials, etc) to professionals and services to DMST victims needing case management and referral information
Coordinated Community Response Stage 3: Establish facility for Therapeutic Residential Safe House Hire and extensively train staff Open Therapeutic Residential Safe House Stage 4: Maintain and expand program
Coordinated Community Response For a copy of the Community View Final Report: www.voiceofhopelubbock.org Contact information: Presentations/Training-Leslie Timmons, Community Educator firstname.lastname@example.com Lubbock Rape Crisis Center dba Voice of Hope (806)763-3232
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2015 Chevrolet Cruze China - Press Release
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The 2015 Chevrolet Cruze made its global sales debut in the Chinese market. The sedan was unveiled at the Beijing Auto Show earlier this year. Images at IndianAutosBlog.com
- 1. Shanghai GM Launches New Chevrolet Cruze Midsize performance sedan sets benchmarks for styling, efficiency and user- friendliness SHENZHEN – The new Chevrolet Cruze, Shanghai GM's new-generation midsize performance sedan, was officially launched today in Shenzhen. Priced between RMB 109,900 and RMB 169,900, the new Cruze is offered in seven variants with a choice of segment-first 1.4L mid-mounted direct injection turbocharged or 1.5L mid- mounted naturally aspirated gasoline engines. "The new Cruze is the first model based on GM's new global platform for midsize compact cars," said Shanghai GM President Wang Yongqing. "With GM's global intelligent technology, it sets new benchmarks for styling, efficiency and user-friendliness in its segment. We expect the new Cruze to appeal to younger car buyers looking for an exhilarating driving experience." "Designed to Raise your Heartbeat" The new Cruze was developed by GM's global design team based on Chevrolet's new "Designed to Raise your Heartbeat" concept. Its design was inspired by the Chevrolet Tru 140S concept vehicle, which made its global debut in 2012. Its short front and rear overhangs make the new Cruze dynamically compact. A fastback design enhances aerodynamics and fuel economy. It has a drag coefficient of 0.28. The new Cruze is available with a choice of six exterior colors: Pearl White, Jazz Black, Street Grey, Metallic Silver, Magic Red and Crystal Blue. The wheels were pushed out to the corners of the car and the roofline stretched, while the center point of the lower edge of the windshield was moved forward. In combination with its more compact powertrain, this gives the new Cruze a spacious interior with 22 mm of additional knee room for back seat occupants. The saddle brown interior and Chevrolet's characteristic dual-cockpit styling enhance the feeling of sportiness and luxury. Ergonomically designed, multifunctional front seats wrapped in soft premium leather with a three-option heating function add to the refinement. Energy-efficient automatic climate control filters out 90 percent of PM 2.5 in the interior. New Global Compact Midsize Car Platform The new Cruze is the first model to adopt GM's new global compact midsize car platform. It was developed by a team of European engineers. Most of its tuning and road testing were carried out at Germany's legendary Nürburgring. Although 72 percent of the new Cruze's body consists of high-strength steel, the extensive use of aluminum and lightweight materials in key areas such as the engine, chassis and


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SoCal City Employees Allegedly Caught Drinking, Driving, Going To A Strip Club During Work Hours (Updated)
It's the promo that has Los Angeles news hounds buzzing: CBS2's David Goldstein will report on Thursday's 11 p.m. show that "city workers" have been captured on video allegedly drinking on the job, drinking while driving city vehicles and making at least one stop to a strip club during work hours. It's not yet clear what city they're from (one shot appears to show men near the Alameda Strip club in Vernon). But if they're employees of Los Angeles, we have to wonder if these are the jobs that Mayor Antonio Villaraigosa and the City Council are bending over backwards to save as L.A. faces a nearly $700 million deficit come July 1? Just curious ...
(Update): KNX 1070 Newsradio reports the employees in question work for L.A. city's embattled Department of Water and Power. H. David Nahai, the former head of the department, called them "a few bad apples."
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The slip/skid indicator is the small portion of the lower segmented triangle displayed on the attitude indicator. This instrument depicts whether the aircraft's longitudinal axis is aligned with the relative wind. [Figure 7-54]
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Jen Sincero, in her book "You Are a Badass", which was a NY Times #1 bestseller, leads her readers astray in two crucial points. Why this is important for you today is because these two serious errors are committed by most people and are at the root of our suffering and of missed spiritual opportunities. Read more
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Statute of frauds essay
English contract law is a body of law regulating contracts in England and Wales. With its roots in the lex mercatoria and the activism of the judiciary during the. Source: Lucius Annasus Seneca. Moral Essays. Translated by John W. Basore. The Loeb Classical Library. London: W. Heinemann, 1928-1935. Reproduced with permission of the author; see also 7 Vindobona Journal of International Commercial Law and Arbitration (2003) 255-276 Understanding the Remedy of.
THE AMERICAN HALLUCINATION. AN INDICTMENT OF THE AMERICAN MIND . Subject: THE AMERICAN HALLUCINATION Date: Tue, 26 Jun 2001 14:06:18 -0400 … If you wish to include essay type questions in your exams,. claiming that any agreement violated the statute of frauds (it could not be performed within one year.
Statute of frauds essay
Quia Emptores is a statute passed in the reign of Edward I of England in 1290 that prevented tenants from alienating their lands to others by subinfeudation, instead. The "Battered Woman's Defense" Its History and Future. Find out more about this topic, read articles and blogs or research legal issues, cases, and codes on FindLaw.com. CONTRACT MODIFICATION UNDER THE RESTATEMENT (SECOND) OF CONTRACTS Robert A. Hillman t The challenge of effective rulemaking is to formulate … PREVIOUS SAC; 1855:1881; Russian Great Reforms, cultural flourish & resistance; 1857:1870; London| Alexander Herzen as political refugee; 1859:Several great …
William and Mary Law Review; The Second Amendment and States' Rights: A Thought Experiment, by Glenn Harlan Reynolds & Don B. Kates Question (Business Law CRN 51884) Assignment: Week 8. 1. award: 2.22 out of 2.22 points. Which of the following statements is true of the scope of the Uniform. Why, in a country with a written Constitution and a founding document (the Declaration of Independence) that is grounded on natural right, should we pay attention to.
What it was like to take the 1917 CPA Exam Here is a sampling of the questions, which were all essay, from that test. By Alex Granados So many issues with what Rowling wrote, like the demolishing of the diversity of Native American cultures, and the depiction of real-life Medicine Men as frauds in. 2Write includes extensive database of Report Writing Samples explaining about Solomon v Solomon & Co. Ltd (1895-99) Introduction Human beings are generally legal.


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Meat Free presents XDB on Friday 22nd July 2016
We welcome Metrolux label head XDB to our favourite intimate venue in Manchester. Germany's XDB has been DJing since the early 90s, and his creative growth enhances this decisions of what lables and musicians he chooses to coolaborate with.
After years of working in a record shop, he launched his Metrolux label in 2006. He sees his music heading in a direction that ranges from deep and soulful house to raw, analogue sounding dub techno.
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Cape Town - Nine people have been killed and four seriously injured in an accident involving a truck and a minibus taxi on the N1 highway outside Worcester, Cape Town emergency medical services said on Tuesday.
"A truck was parked on the shoulder of the road when it was hit from behind by the taxi," spokesman Robert Daniels said.
He said it was not clear if the truck had just parked or if it had broken down.
The accident forced emergency services to close the road for at least three hours as they worked to clear the scene. - Sapa


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Why I Love Being Autistic | Autism Awareness Month 2017
I've often thought about why I love being autistic. When so many people focus on the bad sides of this condition, why am I so happy about it? I guess the simple answer is that this is me. I can love myself or hate myself, but either way, I'm not going to change who I am. Autism doesn't have a cure—this is me forever.
I wanted to take this opportunity to talk about some of the reasons why in more detail.
I love being autistic because…
I can re-watch/read the same things over and over again without getting bored.
I'm currently re-watching a TV series I watched last year, and I'm loving it. I do the same with films and books on a regular basis, too. There's one film on Netflix (X+Y) that I've watched six times over, and could happily watch again. I notice neurotypical people watch something once, and then disregard it forever. I get way too attached to do that.
It does mean that I'm never stuck for something to watch, though. If I can't find anything new, I can always go back and watch something I've watched before.
It's the same with books. Some people wonder why I keep the books I read, and it's because I never know when I'll want to read it again. Does anyone remember reading 'Double Act' by Jacqueline Wilson when they were younger? I read that so many times that the cover came off, and the pages didn't look great by the end.
I can offer logical solutions to problems.
I'm one of many autistic people who looks at small details rather than the bigger picture. I take a more logical approach to life, which enables me to provide a unique outlook on many situations. It can make me guilty of overthinking things and making anxiety worse, but it isn't all bad.
It means I can offer logical advice to friends who might be struggling with something that they may not have considered before. It means I can offer solutions within group situations, too, which make me feel part of a group I might otherwise feel excluded from.
I can become very knowledgeable about certain things.
I wrote a blog post about my special interests a while ago. They are one of my favourite things about being autistic. I love the fact that I can focus on one thing for a long time, and know a lot about it.
Some of these things I indulge in will prove helpful in my future career. Things like psychology, which has been a main special interest for several years now. It's even helped me to understand my brain when I couldn't explain how I was feeling to mental health professionals.
Other interests are just for fun, a way of de-stressing from long days of real life commitments. If you know me in real life, you're likely to know I love The Walking Dead, to the point of an obsession. I'll never have to use anything I learn in this programme or the comics in real life (at least I hope not), but it's fun to watch nonetheless.
I am comfortable with being different.
I struggled a lot with feeling like I was different before my diagnosis. Everyone wants to fit in as a teenager, but I often took it to extreme lengths, hiding my real personality. I'd pretend, instead, to be interested in the same thing as my friends, even when I didn't understand the appeal.
Now, I am comfortable with being different. I love that my brain works differently to other people's, and I embrace it regularly. People seem to like me more now that I've stopped pretending, which is definitely a good thing.
I am a perfectionist.
Most people would argue that this is a negative thing in my life, but I love it. Being a perfectionist allows me to walk away from something knowing I can be proud of myself, and have done all that I can to do something right. I like that it enables others to put their trust in me, too, knowing that I won't put much effort into something.
In reality, I love being autistic on the whole. I am proud of my disability, and nothing anyone says will change that. It's so tempting to focus on the bad things when that's what everyone else talks about, but there are good things there, too.
If you're autistic, why do you love being autistic? If you know an autistic person, what is your favourite thing about them? Let me know in the comments below!
Thanks for reading, and until next time,
15 Comments
GirlMasked22/04/2017 at 3:06 PM
Such a great and positive post, I like it!! So good to look on the bright side of things.😊 I also read Double Act by Jacqueline Wilson years ago and loved it, so good!!
Aarti Kamath22/04/2017 at 4:28 PM
I loved this post! A very good friend of mine is autistic and she is so positive!.. Thanks a lot for this wonderful read :)…
Muffin top mummy22/04/2017 at 8:59 PM
I really love this! You are absolutely right that Autism always seems to be painted in a negative light so it's refreshing to read your post and understand another side 😊
Mx. Vera Didenko22/04/2017 at 9:02 PM
Excellent post. It makes me think about what I enjoy doing and becoming super interested in and take pride in that.
KaitM22/04/2017 at 10:42 PM
So inspiring!!! I love your outlook and I am now going to use this inspiration to finish off my day with a bright outlook. Keep it up xx you rock!
Jo ~ Beyond the Lamp Post25/04/2017 at 3:09 AM
This is such a fantastic post! I really think we need to see more people celebrating their differences like this, because who would want a world where we were all the same?!
jodiedcmitchell05/05/2017 at 9:21 PM
This is such a positive post with an angle that you don't always see! A super interesting read! xx
April Overview: Movie Nights & Social Media Frenzy! - Rebekah Gillian06/05/2017 at 4:35 PM
[…] they affect me, as well as some opinion posts. I also celebrated being autistic with a post about why I love being autistic. You can see all the posts from this month by […]


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|Publication number
|Publication type
|Application number
|Publication date
|Jul 24, 2001
|Filing date
|Aug 18, 1994
|Priority date
|Oct 9, 1992
|Fee status
|Also published as
|Publication number
|Richard P. Palestro, Dale R. Morgan, Michael Dee Iseman, Donald Preston Rosier
|Original Assignee
|National Jewish Center For Immunology And Respiratory Medicine
|Export Citation
|BiBTeX, EndNote, RefMan
|Patent Citations (3), Referenced by (52), Classifications (4), Legal Events (6)
|External Links: USPTO, USPTO Assignment, Espacenet
This is a continuation of application Ser. No. 08/087,178 filed Jul. 2, 1993, now abandoned which is a continuation-in-part of application Ser. No. 07/960,085 filed Oct. 9, 1992 now abandoned.
The present invention relates to the field of germicidal systems employing bacteria-destroying ultraviolet lights. In particular, the present invention relates to a system for producing an air flow through a baffled ultraviolet sterilization chamber mounted behind a wall or ceiling, wherein the ultraviolet light intensity, the air residency time, and the air exchange rate for the air volume in a given space, are such that a percentage of tuberculosis bacteria are destroyed that effectively prevents transmission of such disease by airborne sputum.
Tuberculosis is the most common cause of death from infectious disease in the world today. It infects millions of people each year and causes hundreds of thousands of fatalities. The disease is particularly prevalent in less-industrialized countries where high population densities, poor sanitary conditions and a high percentage of individuals in poor health contribute to the spread of infectious diseases.
After a long period of declining rates of tuberculosis infection in the United Sates, it is believed that the infection rate is now increasing. The increasing rate is apparently due to a combination of factors. One factor is undoubtedly increased immigration from parts of the world with high rates of infection. For example, in the United States the case rate of tuberculosis per 100,000 population was 9.3 in 1985, resulting in over 22,000 cases and over 1,200 deaths. In Southeast Asia, both the case rate and the death rate are believed to be many times that, and immigrants from that part of the world now constitute 3 to 5% of new cases in the United States.
Another factor related to increased rates of tuberculosis infection appears to be the use of living quarters with high population densities and less-than-ideal sanitary conditions for persons in ill health who are susceptible to the disease. Such conditions are commonly found in shelters for the homeless, prisons and some nursing homes. Another important factor in the increased rate of infection is infections among patients with Acquired Immune Deficiency Syndrome (AIDS) and intravenous drug users.
Another reason for the recent increased incidence of tuberculosis is probably the failure of many medical professionals to diagnose and treat the disease early and properly. The relative rareness of the disease in the United States since the early epidemics resulted in an entire generation of health care workers without much experience in the disease. Further, diagnosing the disease is not always easy, for the symptoms are similar to the symptoms of many other disorders. Therefore, the disease is often misdiagnosed and mistreated, and the degree of infectiousness of the disease is underappreciated.
Even after it is recognized that a set of symptoms may indicate tuberculosis, the tests for the disease are somewhat imprecise and tend to require judgment by an experienced professional. For example, one diagnostic tool is chest x-rays which typically show apical-posterior segment cavitary changes in tuberculosis infected patients. However, in elderly individuals—who comprise a relatively large proportion of tuberculosis patients—lobar or patchy lower-zone shadows may simulate bacterial or aspiration pneumonia. Also, x-rays in the elderly may mislead the physician by showing a solitary pulmonary nodule or a pleural effusion. Another important tuberculosis test is the tuberculosis skin test, but a major disadvantage to the tuberculosis skin test is that it generates a high number of both false-positive and false-negative results. The most precise test is microscopic examination of a sputum sample, but this test may require the use of at least three separate samples of sufficient volume, which may require gastric aspiration or bronchoscopy in patients with low sputum production.
The normal body reaction to infection by tuberculosis bacteria is to build a fibrous wall around each bacterium. Initially, a person may be unaware of any infection, but over a period of months or even years the infection produces inflammation and eventually destruction of tissue. The manifestations as the disease progresses generally include cough, fever, night sweats, hemoptysis, chest pain, weight loss and malaise. The usual treatment for tuberculosis is administration of drugs over a period of many months such as isoniazid, rifampin and pyrazinamide and ethambutol. Persons recently infected but with no active disease are usually given isoniazid preventive therapy, particularly if they have other risks such as malnutrition, gastrectomy, diabetes mellitus, pneumoconiosis, malignancy or if for some reason they have immunosuppression such as from corticosteroid therapy, renal impairment or HIV infection. In short, tuberculosis in a normal healthy patient is typically a disease that is curable by drugs, although the drug therapy is quite prolonged. A serious concern—and yet another reason for the recent increase in tuberculosis—is the development of drug-resistant tuberculosis. It is estimated that at least 5% of new cases are resistant to the usual drug therapy, and that the percentage in some areas of the United States is as high as 20%. While non-drug-resistant tuberculosis is typically 99% curable in patients with normal immune responses, drug-resistant tuberculosis is only about 50-60% curable. A related concern is drug therapy on non-drug-resistant tuberculosis for patients who are intolerant of the drugs. In those cases, drug therapy is complicated because the drug is effective against the infection but has serious adverse effects on the patient such as hepatitis or serious rashes.
Another concern is raised by the increasing incidence of non-tuberculosis mycobacterial pulmonary infections. Many such infections produce symptoms similar to those of tuberculosis infections, but may be more difficult to identify and treat. Moreover, they may be transmitted through the same means as tuberculosis and tend to infect the same types of susceptible individuals.
The transmission of the tuberculosis bacteria is accomplished almost exclusively by infected individuals expectorating microdroplets of bacteria-containing sputum by coughing or sneezing. These microdroplets are suspended in the air and are inhaled by other individuals in the vicinity. The bacteria typically lodges in the lower lung where it proliferates, and may be disseminated to other organs as well. The microdroplets of sputum which contain the bacteria may be very small—on the order of 0.01 microns. In fact, it appears that the smallest droplets are the most effective in communicating the disease since the smallest droplets stay airborne indefinitely and are easily inhaled to the lower lung where they are not readily removed. Studies have shown that aerosol droplets on the order of 1-5 microns are highly effective vehicles for transmitting the disease.
One controversial approach to combatting the disease has been the use of vaccines. However, the efficacy of tuberculosis vaccines is debatable. Even the trials which seemed to show some efficacy have shown less efficacy among adults than among infants and children. An additional objection to widespread vaccinations is that by inducing tuberculin reactivity in the population they would confound the detection and measurement of infections through the use of skin tests, since skin tests in vaccinated individuals would presumably result in a false-positive. This would severely curtail the practice of preventive drug therapy among infected patients who have not yet developed outward symptoms.
The airborne aspect of the disease has led toward systems for preventing the transmission of the disease which focus on filtration and sterilizing devices. One approach is the use of masks. Simple surgical masks are thought to be insufficient in view of the very small size of the sputum microdroplets which are effective in communicating the bacteria. Instead, disposable particulate respirators are recommended. The use of masks is fraught with practical difficulties; they are physically uncomfortable, they impair breathing (which is already impaired for many patients), and they disrupt speaking. To be effective at all, it would probably be necessary for the masks to be worn not just by the patients, but also by noninfected individuals. In view of the long distances that airborne microdroplets containing viable bacteria can travel, it would be necessary for the masks to be worn by noninfected individuals throughout the general vicinity of a patient and not just those in the immediate presence of a patient. Moreover, it is not known for certain whether the use of masks would actually be effective even if the practical problems were tolerated or overcome.
Another preventive measure which relies on the airborne aspect of the bacteria is the use of modified ventilation systems. It is currently recommended that facilities used for tuberculosis patients undergo certain minimum air exchange rates, under the theory that dilution of infectious air with clean air will reduce the concentration of bacteria and hence the likelihood of transmission of the disease. While this approach is theoretically sound, it is problematic in implementation. Modern buildings are normally designed with fixed ventilation systems which are not easily modified to produce the requisite air exchange rate. Even if they are suitably modified, they may be rendered ineffective by an open door or by shifting air-flow patterns. A high air exchange rate also increases cooling and heating costs. Finally, there is the issue of the ultimate disposition of the contaminated air that is removed, and whether it is appropriate to simply release it outside the facility.
Another approach to reducing the transmission of the disease is the use of high-efficiency filtration systems. For such a system to be effective, however, it must employ a very dense filter to trap very small particles. This entails a powerful fan, high energy usage, loud noise, and meticulous installation and maintenance. There is also concern that the filters and the rest of the air-flow path may themselves become sites of bacteria colonization.
Yet another approach to reducing the transmission of the tuberculosis bacterial employs ultraviolet light as a germicide. It was discovered some time ago that airborne bacteria are susceptible to ultraviolet light in wavelengths of about 254 nm. Wells S. F., On Air-Borne Infection: II-Droplets and Droplet Nuclei, Am. J. Hyg. 1934 20: 611-8; Wells W. F., Fair G. M., Viability of E. Coli Exposed to Ultraviolet Radiation in Air, Science 1935; 82:280-1. That finding led to the development of systems using ultraviolet light as a germicide against airborne bacteria such as measles and tuberculosis. However, interest in such systems diminished when later investigators were unable to obtain the desired efficacy. Also contributing to the diminished interest in such systems was the recognition that ultraviolet lights produced harmful ozone and also produced skin and eye irritation. With the development of streptomycin and chemotherapy for tuberculosis treatment, the belief became prevalent that tuberculosis would be eradicated and that preventive systems would be unnecessary.
The systems that were developed using ultraviolet light as a germicide against tuberculosis were imprecise, marginally effective, and perhaps dangerous. The most common system simply employed ultraviolet lights mounted on or suspended from a wall or ceiling of a room. For example, a system employing lights suspended from the ceiling is described in some detail in Riley, R. Z., Knight, M. and Middlebrook, G., Ultraviolet Susceptibility of BCG and Virulor Tubercle Bacilli, Am. Rev. of Resp. Dis., 1976, 113:413. The problems in such a system are numerous. It relies completely on normal air circulation in the room where it is installed to bring the bacteria within range of the ultraviolet light. The normal circulation in a room may be too low for the ultraviolet light to destroy a necessary proportion of bacteria, or the normal circulation may be high enough but of a pattern that does not bring the airflow past the ultraviolet light. Moreover, there is no single test to determine whether the circulation rate and patterns are adequate or not for a given installation. Further, such systems quickly become contaminated by dust on the light bulbs which diminishes their effectiveness. From a safety standpoint, one of the greatest concerns is that the simple light shields used with such systems allow light to be reflected off the walls and ceiling and onto the skin and eyes of the occupants. The degree of danger associated with the indirect ultraviolet irradiation is disputed, but there is undoubtedly at least some danger if the period of exposure is prolonged. In explaining the necessary safety precautions, Riley, R. L. and Nordell, E. A., Clearing the Air, The Theory and Application of Ultraviolet Air Disinfection, Am. Rev. Respir. Dis. 1989 139:1286, stated:
Does germicide UV cause inflammation of skin and eyes? It can, but the standard set by the National Institute of Occupational Safety and Health (NIOSH) is very conservative. Overhead installations must be inspected for 'hot spots' (greater than 0.2 uW/cm2) with a sensitive UV meter. Installers should anticipate readjusting fixture height up or down based on meter readings. Baffles designed to prevent direct eye contact will also need adjustment after the initial installation. Excessively reflective surfaces about fixtures may contribute to excess radiation, but this can be reduced with nonreflective paint or by spraying the surface with stove black. If the intensity of UV does not exceed 0.2 uW/cm2, the likelihood of skin or eye irritation is minimal during an 8-h exposure. Persons with especially sensitive skin, with systemic lupus erythematous, for example, may need to avoid exposure or take measures to protect their skin.
This illustrates some of the difficulties and dangers of employing ultraviolet lights behind a simple light shield; the light may generate dangerous and unpredictable "hot spots", it is not appropriate for those with sensitive skin or eyes, and it requires careful consideration of the placement and the orientation and reflectivity of the surrounding surfaces. Finally, even if all those precautions are observed, the quote only indicates that skin and eye irritation is "minimal" rather than nonexistent and only for exposure periods of 8 hours. Of course, for the system to be effective against transmission of airborne disease in, for example, a patient room, it would have to operate continuously and not just for 8 hour periods. The article goes on to acknowledge that:
UV or disinfection that is inappropriately applied, poorly planned, or carelessly used may be ineffective, dangerous, and falsely reassuring. The guidelines and precautions listed above are not intended to enable a would-be user of UV to plan, purchase, install, or check the adequacy of a UV installation. Detailed instructions for UV installers have been published. However, there is currently little commercial interest in UV for air disinfection and, therefore, little expert guidance for comprehensive planning and installation. Renewed consumer interest may stimulate the UV industry to correct this deficiency.
Notwithstanding the uncertainly expressed in the Riley and Nordell article regarding the dangers of ultraviolet radiation, that article is actually more cognizant of those dangers than much of the other literature on the subject. For example, the article by Riley, Knight and Middlebrook, supra, does not even mention the dangers to the skin and eyes of ultraviolet radiation, or any precautions that should be taken to minimize those dangers.
There are number of ultraviolet germicidal systems that have been patented, but as in the case of the scientific literature mentioned above, those patents teach little about the dangers of ultraviolet radiation and how to effectively minimize the dangers, or how to position and operate the devices to achieve the requisite bacterial kill rate to prevent transmission of disease.
For example, U.S. Pat. No. 3,975,790 by Patterson is for an ultraviolet lamp fixture used in combination with a conventional commercial vacuum cleaner, and U.S. Pat. No. 4,087,925 by Bienek is for a sterilizing hand dryer, in which ultraviolet lights are positioned within the housing of a blower that is used to dry wet hands, where the blower is of the type commonly used in commercial restrooms. The devices of Patterson and Bienek seem to include little or nothing for light baffling to prevent leakage of allowable light to outside the housing, and the patents teach nothing about optimal flow rates, air-exchange rates or other information for the effective use of the machines. The devices are obviously intended as general, and only partially effective, sterilizing tools rather than as comprehensive and predictably effective systems.
Another patent, U.S. Pat. No. 4,210,429 by Golstein, employs a "squirrel-cage" type blower which draws air into a housing through a air intake filter, through the blower, and through a sterilization chamber containing ultraviolet lights. The air leaves the sterilization chamber, passes through a second filter and a charcoal filter and finally exits through an outlet. The specification indicates that the purpose of the device is to remove "pollens, lung damaging dust, smoke, bacteria and any one of a number of other irritants and micro-organisms" and that it does so for "particles down to 0.3 microns in size with an efficiency of 99.9%". The device is characterized as an "air purifier" rather than as a germicidal device; the use of three distinct filters including a very fine filter for removing extremely small particles, a charcoal filter for removing odors and a pre-filter for removing particles, is distinguishable in design and function from the present invention. This extensive filtration would require a high-capacity blower to achieve any effective air exchange rate. The device is not specifically designed for destroying the tuberculosis bacteria or any other specific bacteria, although it would obviously be effective in doing so to some extent. Therefore, the patent teaches nothing about the use of the device for that purpose or the optimal flow rates or positioning of the device for that purpose.
U.S. Pat. No. 5,074,894 by Nelson is for a hospital room to quarantine patients with tuberculosis or other respiratory diseases caused by airborne pathogens. Although one embodiment of the system includes an air circulation circuit with ultraviolet lights, the patent is directed primarily toward negative pressure and filtering aspects utilizing high-efficiency particulate air filters.
Other patents describing the use of ultraviolet light as a germicide against airborne bacteria include, U.S. Pat. No. 4,448,750 by Fuesting, U.S. Pat. No. 4,896,042 by Humphreys, U.S. Pat. No. 4,990,311 by Hirai and U.S. Pat. No. 4,047,072 by Wertz, U.S. Pat. No. 4,990,313 by Pacosz, U.S. Pat. No. 3,072,978 by Minto, U.S. Pat. No. 4,227,446 by Sore, U.S. Pat. No. 3,347,0235 by Wiley, U.S. Pat. No. 4,786,812 by Humphreys, U.S. Pat. No. 4,990,311 by Hirai, U.S. Pat. No. 4,931,654 by Horng, U.S. Pat. No. 4,806,768 by Keutenedjian, U.S. Pat. No. 4,750,917 by Fugii, U.S. Pat. No. 3,757,495 by Sievers, U.S. Pat. No. 3,750,370 by Brauss, U.S. Pat. No. 3,745,750 by Arff, U.S. Pat. No. 3,744,216 by Halloran, U.S. Pat. No. 3,674,421 by Decupper, U.S. Pat. No. 3,576,593 by Cicirello, and U.S. Pat. No. 5,185,015 by Searle. Patents directed toward the use of ultraviolet light as a germicide against bacteria in water or other liquids include U.S. Pat. No. 4,400,270 by Hillman, U.S. Pat. No. 4,482,809 by Maarschalkerweerk, U.S. Pat. No. 5,102,450 by Stanley and U.S. Pat. No. 5,124,131 by Wekhof.
The present invention is an apparatus and process for destroying airborne pathogenic bacteria such as the tuberculosis bacteria. Ultraviolet lights of a sufficient intensity are positioned within a sterilization chamber where they irradiate an air stream containing the bacteria, typically in the form of suspended microdroplets of sputum. The sterilization chamber has an exit and an entrance, and a blower is positioned preferably at the exit to draw air into the entrance and through the sterilization chamber and out the exit. The air circulates behind an intake baffle and into the sterilization chamber having a set of ultraviolet lights. An outlet baffle at the opposite side of the sterilization chamber bounces the air that passes the ultraviolet lights back over the ultraviolet lights a second time, and around the outlet baffle to the fan. The fan then expels the sterilized air back into the room. The air passing through the sterilization chamber is virtually completely sterilized of viable tuberculosis bacteria by the chosen dosimetry of the system, which is achieved by appropriately sizing the sterilization chamber employing ultraviolet lights of the correct intensity, and utilizing the right air flow rate through the blower. The apparatus is configured to fit behind a wall in a room, or preferably, above a suspended ceiling. Air is drawn by a fan from the room into an intake duct and into the apparatus.
The sterilization chamber includes a filter on the intake side to filter out large particles such as dust, in order to minimize the contamination of the ultraviolet light bulbs. The filter is deliberately designed not to intercept small particles such as microdroplets, since the filter could then become a bacteria colony. The use of a low density filter also minimizes the resistance to air flow, thereby allowing the use of a smaller, more efficient and quieter blower. With the exception of this intake filter for removing large particulates, the apparatus preferably does not include any devices that would intercept and retain microdroplets or other small particles in a way that resists the air flow and poses the possibility of becoming a bacteria colonization site; the small particulates and microdroplets with destroyed bacteria simply pass through the apparatus and are expelled back into the environment.
Both the air intake and exhaust to the sterilization chamber are baffled so that ultraviolet light must reflect off multiple surfaces before exiting the sterilization chamber. The interior surfaces of the baffles may be light-absorptive to minimize their reflectivity and further lessen the possibility of ultraviolet light leaking from the sterilization chamber into the environment.
The apparatus is used in a space having a volume of air that results in an air exchange rate of preferably 12-15 air exchanges per hour. At that air exchange rate, it has been determined that a sufficient volume of air will circulate through the apparatus and will prevent any air stagnation in the room, that a high enough percentage of tuberculosis bacteria will be destroyed before they are inhaled by persons in the room to prevent transmission of the disease.
FIG. 1 is a pictorial cutaway view of the present invention.
FIG. 2 is a side sectional view of the present invention, taken along line 2—2 of FIG. 1, installed in a suspended ceiling.
A pictorial view of a preferred embodiment of the invention is shown in FIG. 1. The principal elements of the invention 10 include an exterior housing 40 having an air intake duct 42 and an air discharge duct 44, a squirrel-cage type blower 120 and set of ultraviolet lights 150 in a sterilization chamber 180 within the housing 40. The air intake duct 42 is preferably positioned at one end 46 of the housing and the air discharge duct 44 is positioned at the opposite end 47 of the housing 40.
As better shown in the sectional view of FIG. 2, the air intake duct 42 has positioned within it a filter 60 which substantially fills the intake duct 42 so that all air drawn through the air intake duct 42 must pass through the filter 60. The filter 60 is preferably not a high-density filter, but is instead designed to intercept and retain only fairly large particulates such as dust. The purpose of the filter 60 is not to allow the apparatus 10 to purify the air, but is merely to intercept dust over 10 microns in size that would otherwise contaminate the ultraviolet light bulbs 150. In a preferred embodiment, the filter is model no. DP1-40, available from Airguard Industries located in Louisville, Kentucky. The filter 60 is retained in the air intake duct 42 by means of clips, brackets or any other suitable retention means (not shown) that allow easy removal and replacement of the filter 60.
It is notable that in the preferred embodiment, there is no filter at all in the air discharge duct 44 or elsewhere downstream from the sterilization chamber. Therefore, the only filter in the preferred embodiment is the large particulate filter 60 positioned in the air intake duct 42. The apparatus 10 is designed to allow small particulates, including microdroplets of sputum containing bacteria that are destroyed by the ultraviolet lights as described below, to be expelled back into the environment. As a result, the apparatus does not have a site that traps and allows the colonization of bacteria, which would require frequent cleaning or sterilization. In addition, there is very little resistance to air flow, thereby allowing the use of a relatively small, low-energy and quiet motor and blower system, as further described below.
In this respect, the present system is fundamentally different from prior art devices that are designed to remove dirt, pollen and other particulates and odor from the air. Those prior art systems employ dense and multiple filters and noisy high-energy blowers to indiscriminately remove impurities from the air. But they are not specifically for the purpose of destroying pathogenic pulmonary bacteria such as tuberculosis and their efficiency in doing so is undocumented and questionable. In contrast, the present system is specifically designed for destroying bacteria such as the tuberculosis bacteria, and is highly effective in accomplishing that using a relatively small, energy efficient, quiet apparatus, but the present system makes no attempt at all to remove impurities from the air. Even the bacteria itself is released back to the environment once it is killed by the apparatus.
The air discharge duct 44 is preferably positioned remotely from the air intake duct 42, so that the exhausted air circulates into the environment rather than being immediately drawn back into the apparatus 10. In the embodiment shown in FIGS. 1 and 2, the positioning of the ducts 42 and 44 on opposite ends of the housing produces a circulatory effect through the environment of the apparatus 10 by drawing air into the apparatus 10 through the air intake duct 42 and expelling air from the apparatus 10 through the air discharge duct 44, roughly in the direction of the arrows shown in FIG. 2. The air discharge duct 44 may be covered with a grill (not shown) to prevent the introduction of hands or objects into the air discharge duct 44 and to diffuse the air stream exhausted from there. A door 183 is positioned in the bottom of the housing 40 as shown in FIG. 2 and is attached to the housing 40 by a hinge 185 or other suitable attachment means. The door is positioned to allow ready access to the ultraviolet lights 150 and to the filter 60 to allow them to be changed or cleaned.
The sterilization chamber 180 is baffled on the upstream side by an intake baffle 182, and on the downstream side by a pair of exhaust baffles 184 and 187, to prevent ultraviolet light from leaking from the sterilization chamber 180 out the air intake duct 42 or air discharge duct 44 and into the environment where it could damage the skin and eyes of patients and other persons. The baffles also improve the circulation of the air over the ultraviolet bulbs in the manner described below. The intake baffle 182 in the preferred embodiment is an S-shaped element fabricated from sheet metal or other appropriate material that is not degraded by ultraviolet light. The lower portion of the intake baffle 182 is curved away from the air intake duct 42 to receive the incoming air, while the upper portion of the intake baffle 182 is curved toward the sterilization chamber 180 to allow the incoming air to flow smoothly over the top of the intake baffle 182 and into the sterilization chamber 180. The intake baffle 182 may be attached to the housing 40 at the bottom of the intake baffle 182 or at the ends.
The exhaust baffles 184 and 187 form a channel therebetween for the air to leave the sterilization chamber 180, as best shown in the sectional view of FIG. 2. Both exhaust baffles 184 and 187 are curved with the inner side of the curve away from the sterilization chamber 180. The air passes under the lower edge of the upper exhaust baffle 184, through the channel defined by the upper baffle 184 and 187, and over the upper edge of the lower exhaust baffle 187.
The upper exhaust baffle 184 may be attached to the housing 40 at the top of the upper exhaust baffle 184 or at the ends. The lower exhaust baffle 187 may be attached to the housing 40 at the bottom of the lower exhaust baffle 187 or at the ends.
It can be appreciated that for any ultraviolet light to escape from the sterilization chamber 180 through the air discharge duct 44, it must reflect off the walls of the sterilization chamber 180, reflect through the channel defined by the upper and lower exhaust baffles 184 and 187, and then through the blower 120 and out the air discharge duct 44. For any ultraviolet light to escape through the air intake duct 42, it must reflect off the walls of the sterilization chamber 180, into the space between the air intake duct 42 and the intake baffle 182, through the air intake filter 60 and through the air intake duct 42. The possibility of light escaping can be further reduced by applying an absorptive coating or paint to the interior surfaces of the baffles 182, 184 and 187 and the other interior surfaces of the housing 40.
Although the baffling described above to prevent ultraviolet light from escaping presents a circuitous route for the passage of air from the air intake duct 42 through the sterilization chamber 180 and out the air discharge duct 44, the baffles are still designed to minimize the resistance to air flow. Thus, as shown by the arrows in FIG. 2, the air can flow reasonably smoothly with limited turbulence loses, thereby allowing a small, quiet and efficient blower system.
An important aspect of the embodiment shown in FIGS. 1 and 2 is that the baffles 182 and 184 and sterilization chamber 180 are configured such that the air passes the ultraviolet lights twice. As shown by the arrows of FIG. 2, the air passes the ultraviolet lights a first time immediately after it passes over the top of the air intake baffle 182 and into the sterilization chamber. The air pathway is blocked on the opposite side of the sterilization chamber by the air exhaust baffle 184. The inclined and curved surface of the air exhaust baffle, together with the top wall of the housing 40, define a space 186 to receive the air after it passes the ultraviolet light a first time. The air then reflects off the air exhaust baffle 184 and out of the space 186 and back toward the ultraviolet lights for a second pass. The air is then drawn out of the sterilization chamber 180 by passing under the exhaust baffle 184 and into the blower 120.
The blower 120 in the preferred embodiment is of the "squirrel-cage" type. The blower 120 draws air through its ends and propels the air out the middle and into the exhaust duct 44. The exact size of the blower and the motor for the blower depend on the desired use of the machine and the size of the environment in which it will be used, as further discussed below. The motor is preferably of the normal alternating current type and is in communication with the electrical system (not shown) of the apparatus, which also powers the ballasts for the ultraviolet lights 152. The electrical system is ordinary, and the details of it will be apparent to those skilled in the wiring of lights and motors, and it is not further described herein.
The apparatus 10 is preferably positioned in the suspended ceiling 191 of a patient room as shown in a preferred arrangement in FIG. 2. Cutouts in the ceiling 191 are provided for the air intake duct 42, air discharge duct 44 and access door 183. The microdroplets from the patient are expectorated from the patient into the surrounding air where they are suspended. The air currents produced by the apparatus 10 draws air into the apparatus 10 from intake duct 42. The filter 60 traps large dust particles, but allows small particles to pass including the micro droplets of small bacteria-containing sputum. The air with the suspended microdroplets passes through the sterilization chamber where the bacteria are destroyed by passing twice over the ultraviolet lights, and the air along with the suspended microdroplets with the then-killed bacteria are expelled from the apparatus 10 back into the room through the air discharge duct 44. Because the air discharge duct 44 is preferably positioned at one end 46 of the apparatus 10 while the air intake duct 42 is positioned at the other end 47 of the apparatus, the air being drawn into the air intake duct 42 and expelled from the air discharge duct 44 produces a circulatory effect through the room which increases the flow of new unsterilized air into the apparatus. This circulatory effect also helps prevent the air from short-circuiting the circulation pattern by leaving the apparatus 10 through the air discharge duct 44 and immediately re-entering the apparatus 10 through the air intake duct 42 without passing through the room.
It has been determined experimentally that transmission of the tuberculosis bacteria from an infected patient to an uninfected person can be effectively prevented by ensuring that there are approximately 10 to 15 air changes per hour in the patient room using the apparatus and positioning described above. The phrase "10 to 15 air changes per hour" means a circulatory effect through the apparatus in which the total volume of air through the apparatus per hour equals the air volume of the room multiplied times a number between 10 and 15, inclusive. For example, one air change per hour in a 1,000 cubic foot room would require an apparatus through which 1,000 cubic feet of air pass per hour. Therefore, in a patient room having dimensions of 10 by 10 by 10 feet for a total volume of 1,000 cubic feet, or other dimensions for a total volume of 1,000 cubic feet, the apparatus should be capable of circulating through it at the rate of 10,000 to 15,000 cubic feet of air per hour.
The exact dimensions of the apparatus to achieve such a flow rate in a preferred embodiment include a housing 40 having a length of about 48 inches, a height of about 15.5 inches, and a depth of about 36 inches. The air intake duct 42 is roughly 6 inches by 24 inches and the air discharge duct 44 is roughly 6 inches by 18 inches. The opening between the top of the air intake baffle 182 and the housing 40 is about 4 inches, and the opening between the bottom of the air exhaust baffle 184 and the housing 40 is about 4 inches. The motor is a 115 volt, 1,725 rpm motor, and the blower 120 includes 4 by 9 inch blower wheels. The ultraviolet lights 152 are model D-36-3 by American U.V. Co.
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|Jul 28, 2005
|Liang Michael Y.
|Method and apparatus for sterilizing air in large volumes by radiation of ultraviolet rays
|May 6, 2004
|Nov 10, 2005
|Odumuye Olubunmi A
|Ultraviolet air purifier
|Jun 17, 2005
|Jan 5, 2006
|Cumbie William E
|Prevention and treatment of skin and nail infections using germicidal light
|Jun 30, 2005
|Jan 12, 2006
|Chi-Hsiang Wang
|Ultraviolet air purifier having multiple charged collection plates
|Jul 12, 2005
|Jan 26, 2006
|Jensen Erick C
|High-intensity UV-C gun and methods of use
|Sep 2, 2004
|Mar 2, 2006
|Horne Joel E
|Ultraviolet germicidal irradiation system
|Aug 22, 2005
|Jul 6, 2006
|Fink Ronald G
|UV target for an environmental air sterilization apparatus
|Jul 21, 2005
|Aug 3, 2006
|Cumbie William E
|Alteration of the skin and nail for the prevention and treatment of skin and nail infections
|Apr 4, 2005
|Oct 19, 2006
|Kalous D S
|Air filtration and purification apparatus
|Nov 18, 2005
|May 24, 2007
|Mark Glazman
|System and method for medical treatment
|Dec 1, 2005
|Jun 7, 2007
|Powell George P
|Air purification apparatus and method
|Apr 16, 2007
|Nov 1, 2007
|Cumbie William E
|Method and device to inactivate and kill cells and organisms that are undesirable
|May 24, 2007
|Nov 29, 2007
|American Innovative Research Corp.
|Positive air pressure isolation system
|Aug 17, 2007
|Feb 21, 2008
|Trojan Technologies Inc.
|Fluid treatment system
|Oct 18, 2007
|May 1, 2008
|Clayton Armstrong
|Air purification system and apparatus
|Oct 18, 2006
|May 29, 2008
|Giles Enterprises, Inc.
|Ultra-violet recirculating exhaust hood system
|Feb 13, 2007
|Aug 14, 2008
|Marentis Rodger T
|Novel HVAC pathogen neutralization system
|Feb 28, 2008
|Aug 28, 2008
|Cumbie William E
|Phototherapy Treatment and Device to Improve the Appearance of Nails and skin
|Apr 14, 2011
|Oct 13, 2011
|Oy Halton Group Ltd.
|Fume treatment method and apparatus using ultraviolet light to degrade contaminants
|Feb 27, 2012
|Jul 12, 2012
|Airistar Technologies, Llc
|Air filtration and purification apparatus
|Mar 15, 2013
|Jan 9, 2014
|Paul C. Burke
|In Line Air Filtration and Purification Apparatus
|Apr 3, 2012
|May 15, 2014
|Masaru Shiotani
|Water server and air sterilizing chamber for use in water server
|Sep 5, 2014
|Mar 5, 2015
|Seoul Viosys Co., Ltd.
|Air purifier using ultraviolet rays
|Nov 26, 2003
|Jun 17, 2004
|Novatron, Inc.
|Uv flux multiplication system for sterilizing air, medical devices and other materials
|U.S. Classification
|International Classification
|Cooperative Classification
|European Classification
|Dec 22, 1994
Owner name: NATIONAL JEWISH CENTER FOR IMMUNOLOGY AND RESPIRAT
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:PALESTRO, RICHARD P.;MORGAN, DALE R.;ISEMAN, MICHAEL DEE;AND OTHERS;REEL/FRAME:007279/0858;SIGNING DATES FROM 19941102 TO 19941123
|Jan 24, 2005
|Fee payment
Year of fee payment: 4
|Feb 2, 2009
|Maintenance fee reminder mailed
|Jul 16, 2009
|Surcharge for late payment
Year of fee payment: 7
|Jul 16, 2009
|Fee payment
Year of fee payment: 8
|Jan 16, 2013
|Fee payment
Year of fee payment: 12


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Geographics CARD BUSINESS 25/PK WH (47378S)Item#: 40398703 | Model#: 47378S
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Cathy Basterfield is an experienced Speech Pathologist, with a background of 28 years working with people with Complex Communication Needs and developing Easy English.
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Seton Hall University
Approximately 12 months previous Admissions work experience. Conducts and assesses interviews of prospective students for admission.
1 day ago Admissions Representative
Aviation Institute of Maintenance
Prefer prior admissions experience at a private for profit college or technical school. Henderson, Campus Director of Admissions.
9 hours ago Foreign Credential Processor I
University of Texas at Dallas
This position will serve as a member of the international admissions processing team. Attend required meetings and participate in UTD events as assigned..
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Ramapo College of New Jersey
The College also offers eight graduate programs as well as articulated programs with Rutgers, The State University of New Jersey, New York Chiropractic College.
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Cleveland State University
College or university admissions recruitment; College admissions counseling at the high school or college level; College student activities..
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Roadtrip Day 258
3/22 Tuesday
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Swell evening of soup, sandwich and salad.


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Southeast Missouri State University RN degrees
Think about what career is best suited for you, and where you want to study. Request more information now.
Think about what career is best suited for you, and where you want to study. Request more information now.
Think about what career is best suited for you, and where you want to study. Request more information now.
Get the facts about Southeast Missouri State University RN degrees, and registering for elective seminars and lectures. Which college degrees give you the best chances of finding employment after graduation? Qualifications for nursing programs vary widely. Learn about the various medical specializations available within technical training programs. Concentrating on Southeast Missouri State University RN degrees, for example, you may gain an advantage in job recruiting on-campus. Check with the RN department for course registration deadlines, and registered nurse program requirements. Please use the form above to request admissions info for Southeast Missouri State University.
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Certification requirements include board certification by the American Nurses Credentialing Center (ANCC) and the American Academy of Nurse Practitioners (AANP). The license period varies by individual state, but is usually valid for either two or three years, at which time you'll need to renew. Registered nurses (RNs) are not required to be certified in a particular specialty by state law. For example, it isn't necessary to be a Certified Medical-Surgical Registered Nurse (CMSRN) to work on a hospital Medical-Surgical (MedSurg) floor, and most MedSurg nurses are not CMSRNs. To keep your license current, you must take continuing education courses, and renew your license every few years. There are a fixed number of credits that each state requires, and if you work in a hospital facility, these courses may be offered on-site. Beyond major requirements within the RN department, you may consider Saint Paul University dining services as a complementary elective to your primary course of study.
Case Manager
Click here to review the benefits associated with this position. The RN Case Manager utilizes a collaborative process of assessment, planning, implementation..
5 hours ago LVN III
Corpus Christi State Supported Living Center
Experience in nursing work. Provides complex vocational nursing work. Assists the RN Supervisor with on-the-job Nursing instruction and training of other new..
15 hours ago Registered Nurse - RN Surgery
St. John Medical Center
Notes and carries out physician and nursing orders. Diploma and/or Associates degree in Nursing required and Experience not required.
11 hours ago Full time LPN School Nurse job!
ProCare Therapy
Experienced with nursing care (pediatric preferable). Nursing responsibilities could also include providing support and assistance to the in-class students and..
5 hours ago Registered Nurse (RN) - Healthcare Nursing Staff RN
The Evangelical Lutheran Good Samaritan Society
As a Registered Nurse you will be responsible for administering healthcare to ill, injured, convalescent, or disabled patients. You may advise patients on
5 hours ago Case Management Travel Nurse (RN) (CASE)
Tailored Healthcare Staffing
Graduate from an accredited school of Nursing, BSN preferred. We are one of the nation's fastest-growing travel nursing agencies, for good reason.
5 hours ago


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Words containing arault
Found 1 words containing arault. Browse our Scrabble Word Finder, Words With Friends cheat dictionary, and WordHub word solver to find words that contain arault. Or use our Unscramble word solver to find your best possible play! Related: Words that end in arault
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To schedule an appointment with Rebecca Ehrich please call 816-453-0900.
Accepting new patients.
In addition to preventative medicine, Ms. Ehrich's professional interests include women's health and travel health.
Rebecca Ehrich, RN, A.P.R.N. completed her graduate studies at The University of California-Los Angeles. Ms. Ehrich is a Board Certified Family Practice Practitioner by the American Nurses Credentialing Center who has lived all over the world when she was working for the Peace Corp. She now resides in Gladstone, Missouri.
2700 Clay Edwards Drive, Ste 240, North Kansas City, MO 64116
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Red (Bluray)(Blu-ray) (Bilingual)
Starring Bruce Willis, Morgan Freeman
Description & Features+
Based on the cult D.C. Comics graphic novels by Warren Ellis and Cully Hamner, RED is an explosive action-comedy starring Bruce Willis, Morgan Freeman, John Malkovich, Mary-Louise Parker and Helen Mirren.
Frank (Bruce Willis), Joe (Morgan Freeman), Marvin (John Malkovich) and Victoria (Helen Mirren) used to be the CIA's top agents – but the secrets they know just made them the Agency's top targets. Now framed for assassination, they must use all of their collective cunning, experience and teamwork to stay one step ahead of their deadly pursuers and stay alive. To stop the operation, the team embarks on an impossible, cross-country mission to break into the top-secret CIA headquarters, where they will uncover one of the biggest conspiracies and cover-ups in government history.
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Created on 2011-12-26 13:44:31 (#1276161), last updated 2014-03-16 (183 weeks ago)
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I'm lizas_lines over on LJ.
21, Australian, childcare worker.
I like games and alcohol and webcomics.
21, Australian, childcare worker.
I like games and alcohol and webcomics.
8tracks, adventure time, baking, cocktails, harry potter, his dark materials, homestuck, mass effect, mixtapes
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