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Hi fellas,
Here is a video that I put together explaining how to install Cub Weights with clear shields on top.
If interested in buying a set please send me a PM or email.
Joe Puma
Cub Weights with clear shields
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Ravens assistant G.M. Eric DeCosta said Thursday that the team has "no intentions" of letting quarterback Joe Flacco leave as a free agent and they'll start the work of keeping him pretty soon.
Mike Florio has learned that the team will have their first face-to-face meeting of the offseason with Flacco's agent Joe Linta sometime Friday night or Saturday. The two sides will be trying to hammer out a long-term contract ahead of the start of free agency in hopes of avoiding a franchise tag that would eat up cap space the Ravens might like to use to keep other players.
Should the Ravens have to use the tag, they'll be deciding between the exclusive and non-exclusive tags. The former would cost them more cap space while the latter would leave open the possibility that a team willing to spend two first-round picks could come up with an offer that steals Flacco away.
That possibility was called "negligible" by DeCosta on Thursday. He and the rest of the Ravens brass will start finding out just how negligible in this weekend's meeting.

subset: commoncrawl


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Best placed home in Sun Groves with stunning mountain views from your resort style backyard! Enjoy the view playing volleyball in the saltwater pool or heated jacuzzi. Share s'mores under the stars circled around the warm gas fire pit. If you're looking for a meticulously kept, move-in ready home to enjoy life, this is everything you've been looking for! Gorgeous, matching stainless steel appliances convey including fridge! Open flow style kitchen overlooks large family room with cozy gas fireplace. Split floor plan provides a master retreat with en suite bath and a spacious walk in closet. This home features 3 bedrooms plus a huge versatile bonus room. NEW AC, wifi water heater, wifi irrigation, variable pool pump and more! Too much too list, so much to love. Welcome home!


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Visit the showcase site for America: A Narrative History.
Norton History, your way.
Volume(s): One-Volume
George Brown Tindall (Author, late of the University of North Carolina), David E. Shi (Author, Furman University)
A book students love, now more streamlined and accessible.
America has sold more than 1.8 million copies over the past eight editions because it's a book that students enjoy reading. Effective storytelling, colorful anecdotes, and biographical sketches make the narrative absorbing and the material more memorable. The Ninth Edition includes refreshed and updated coverage of African American history and has been streamlined from 37 to 34 chapters.
Effective storytelling, colorful anecdotes and biographical sketches, and a consistent narrative voice throughout the book make the material memorable. The political history at the core of the book is enriched by significant attention to social, cultural, and economic history. A chronological, coherent narrative provides a clear path through American History, and the narrative approach highlights connections among events. These connections are reinforced by focus questions and summaries at the beginning and end of each chapter.
The Ninth Edition has been reduced from 37 to 34 chapters. The periods on the first half of the nineteenth century and the interwar years in the twentieth century have also been heavily reorganized.
The Ninth Edition includes focus questions at the beginning of each chapter, new boldface key terms, chronologies, and end of chapter summaries. New Dynamic Author Videos with David Shi demonstrate the great narrative tradition of history. These videos help to frame each chapter in a broader context, making students more astute and engaged readers. Author Videos (42 total) are available online, and explain major developments in history. Critical Reading Exercises help students identify the most important information on each page of the text, and Cross-Chapter Quizzes challenge students to make connections and comparisons across periods and trace long term developments.
America's Instructor resources give professors everything they need for dynamic classroom lectures, with a focus on primary sources. The Norton American History Digital Archive is an 8-disc set that offers roughly 1,700 images and audio and movie files arranged chronologically and by theme, and includes a new disc on African American History. Author videos with David Shi provide context and clarity and are available online and embedded in Lecture PowerPoints.
The coverage of African American history has been substantially refreshed to bring it up-to-date with contemporary scholarship in every period, from colonial slavery, the Old South, and Reconstruction, through segregation politics and social change in the 1960's.
Norton, Your Way
Streamlined Ninth Edition
African-American Content Themes
The Art of Storytelling


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Ivan Ukhov is a Russian high jumper. He's pictured above in the midst of a successful high jump. According to many reports, he's also a fan of Red Bull and vodka. No problem there. He'd be hugely popular at Rutgers. But when you combine Red Bull and vodka with a track competition? Well, it's not so successful. Click through after the jump to watch one of the lamest high-jump attempts ever.
Russian high jumper accused of jumping under the influence of red bull and vodka [FanHouse]


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Which US Cities Are Rapidly Getting Smarter?
Conventional wisdom has long held that smart people go where other smart people are — intellectual hubs like San Francisco and New York City, for example.
But a new list of cities with the fastest growth in their college-educated populations revealed the reality lately has been far different.
Using Census data from 2000-2010, it seems the overall IQ of Las Vegas has skyrocketed — Sin City's number of college grads boomed a remarkable 78 percent during the survey period.
Riverside-San Bernardino, CA came in second with a 60 percent change, followed by Raleigh, NC; Austin, TX; and Charlotte, NC.
In contrast, places with a higher cost of living that are typically considered hotbeds of smart people fared far worse. New York City? All the way down in 39th place. And San Francisco was even lower at number 48.
That said, the populations of Washington DC, San Francisco, Boston, Denver and Minneapolis boast a share of college grads that's at least 20 percent above the national average. But it seems the country's brainpower is now being spread out a lot more — often to places where you'd least expect.
1. Las Vegas, NV
2. Riverside-San Bernardino, CA
3. Raleigh, NC
4. Austin, TX
5. Charlotte, NC
6. San Antonio, TX
7. Jacksonville, FL
8. Orlando, FL
9. Nashville, TN
10. Phoenix, AZ


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If you have been waiting to justify the price for making the leap from paperback to e-ink – then the wait maybe over. Amazon's third generation of the Kindle has just launched and not only is it more affordable than ever – it's also damn adorable. The 3rd Generation Amazon Kindle form factor is smaller and slimmer than the previous Kindle models and now truly makes a great travel companion, whether you are relaxing on the beach or sitting in the subway.
Being a first time user of the Kindle I have to say I am quite smitten with it. Not only is it is easy to carry around with you, it's also incredibly easy to read. Till now I had been reading books and magazines on the iPad but I could never really enjoy reading iBooks outside in the sun because the iPad's display is almost unreadable in direct sunlight. However the Kindle Wi-Fi 3rd generation is a joy to read, whether it's resting under the bright sun or in a dark room. The same goes for lounging. Where I used to cuddle up with the iPad, as sophisticated as the iPad is – it becomes unwieldy and too heavy for long reading periods. On the other hand, the new Kindle is super light in your hands and feels more along the line of a paperback book in terms of weight. The Kindle also has a new soft rubberized back which enables you to hold onto it with a more secure and comfortable grip than ever.
[nggallery id=395 template=galleryview images=0]
In comparison to the Kindle 2's basic design scheme, nothing has changed drastically. All the buttons are in the same places and the operation of the device is exactly the same, and even the screen is the same size at 6 inches. However this newer model is 21% smaller than previous models, 15% lighter than previous models, and extremely light at 8.5 ounces in comparison to the original 10.2 ounces of the Kindle 2 model. Also, one glaring difference is the lack of number keys on the keyboard which are now located under the symbol button. That said, the 3rd Generation Kindle's keys are very easy to type on, however there is a slight lag during typing. The sliding power button has also been relocated to the bottom of the device and is no longer on the top left. On the bottom there is also the headphone jack and volume buttons. The only gripe I do have is the quality of the side buttons – they feel cheaply made and certain if you pressed hard enough, they almost feel as if they could break off.
The battery on the 3rd Generation Kindle is intended to last now from two weeks to four weeks, that is of course if you limit your wireless activity – which with a device like this I highly doubt it will be used for anything more than downloading books. The Kindle now comes with a WebKit browser that lets you search Google, Wikipedia, and the web, which are certainly nice built-in options – however the refresh and load rates can be a bit daunting when using this browser. Still, I give Amazon props for including it anyway in such a budget friendly model. The Kindle also now has support for reading PDF files – once again, this is a nice touch. In comparing it to the previous Kindle 2, the Kindle 3rd generation also has 4GB of built-in storage vs its prior 2GB capacity – that certainly provides plenty of room for hours and hours of reading. Downloading books over Wi-Fi on the Kindle took an average of a minute, but took my money very quickly! However download speeds can vary depending on how good your Wi-Fi connection is. Ather cool features include the fact that Kindle can playback MP3 and AAC files, it offers text to speech capabilities that not only applies to books but also to the menu system, it also has a dictionary look-up system, and offers notes for you to take advantage of the keyboard.
So being a virgin to this whole crazy world of the Amazon Kindle I have to say I may actually enjoy its delectable delights. Not only is the Kindle Wi-Fi 3rd generation super adorable and a great travel companion, the battery life is impressive, it offers more storage space than ever, and you'll actually be able to read it comfortably in bright sunlight without the issue of glare – unless the sun is really just beaming over your head and directly into your eyes. Overall, the Kindle continues to be a great device for those who love to read and want to carry something around that is portable – affordable – and won't make you cry if you lose it or drop it. I did find myself however at times touching the screen (force of habit) and maybe for future generations a touch screen surface will be included. The lack of color was also a bit disconcerting and so was the refresh issues when going from page to page of a book, as well as the lag between what is typed in versus what appears on the screen. But overall, the construction is solid for the price and minor improvements certainly add value. For those who were discouraged by the Kindle's previous generations' price tags, this new pricing makes it more enticing than ever to finally get an ebook reader. At the end of the day – this latest Kindle has gotten some decent upgrades, a great price point, and is the perfect standalone device for those who love books. The only thing that might want to hold you back is the fact that many color ebook readers are finally starting to pop up, and we're sure that within 6 months, the market will be saturated with them. That said, the Kindle has years of experience to build on and continues to remain a quality product with a large library of books to purchase, blogs, newspapers, and magazines to read. The Amazon Kindle Wi-Fi 3rd Generation – Graphite (2010) retails for $139 and the Amazon Kindle Free 3G + Wi-Fi 6″ (2010) retails for $189.
The Good: New smaller and slimmer size. New higher contrast display is better than ever, makes books super easy to read in any environment. WebKit browser is a nice touch. Now with a 4GB internal memory. One word – PRICE!
The Bad: Interface is a bit sluggish and not very fluid. Side buttons feel a bit cheap. Memory is not expandable and battery is sealed in device.


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CHAPEL HILL � North Carolina�s good stretches often come followed by less-desirable spans and it has coach Roy Williams sometimes going from delighted to gloomy.
In the last 11 games, the Tar Heels have been outscored in the second half in eight of those games.
So the rallying cry for a full 40 minutes of solid play has been mentioned repeatedly by Williams and his players.
�We weren�t able to maintain it,� guard Marcus Paige said after the sluggish second half in an eventual victory against Maryland on Saturday. �We got a little complacent. � We were a little excited we played such a good half.�
Paige called the first half the best half of the season for the Tar Heels, who take on visiting Georgia Tech on Wednesday night.
Williams said some second-half miseries have dampened the mood.
�We feel good, but we don�t feel good about the way we played the second half,� he said. �I want to show them on tape the second half and learn from it and hope to get better. � I�m about as ticked off about the second half as I can be.�
The exceptions to being outscored in the second halves in the last 11 games came in victories against Alabama-Birmingham (Tar Heels were plus-12 after halftime), McNeese State (plus-3) and Florida State (plus-3).
�I�d like to know that answer so we get that changed as soon as possible,� Paige said.
Maryland coach Mark Turgeon saw improvement from his team in the second half against North Carolina, but that might not have meant a whole lot.
�Maybe North Carolina wasn�t concentrating as much as if the score had been tied,� Turgeon said. �I think North Carolina is pretty good. Were they good earlier in the year? No. But they were good on Saturday.�
The Tar Heels are striving to be good all of the time � or at least most of the time.
�When you�re younger, you see a 22-point lead and you think everything is going to be rosy,� Williams said. �But this is the ACC and no one in this league is going to stop.�
The latest lesson came in the 62-52 triumph against Maryland, so it wasn�t a lost cause.
�I would say we kind of took a break in the second half, kind of took off the gas,� North Carolina guard P.J. Hairston said.
�I thought we did kind of get complacent,� teammate James Michael McAdoo said. �Great teams can�t do that. It�s us being young and something we�ve got to learn and keep coming out and being aggressive.�
The concept of completing the task with better second halves doesn�t seem all that complex to Williams.
�I�ve got a saying, �If you can do it once, you can do it more than once,� � he said.
Who: Georgia Tech (10-6, 0-4) at North Carolina (12-5, 2-2)
When: 9 Wednesday night (ESPN)
Where: Smith Center, Chapel Hill
Series: North Carolina leads 61-24
Notes: This will mark Georgia Tech�s third game in the Triangle in a 15-day span after losses at North Carolina State and Duke.


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Studies have indicated that the prevalence of obstructive sleep apnea-hypopnea syndrome (OSAHS) is similar between white and African American patients, but it is unclear if there are differences in the severity of OSAHS. We hypothesized that in patients with diagnosed OSAHS, African Americans would have higher apnea-hypopnea index (AHI) and higher mortality than white individuals.
We analyzed a prospectively collected database of 512 patients studied between July 1996 through February 1999. Inclusion criteria included age ≥ 18 y, AHI ≥ 5/h, and full-night PSG. Statistical analysis was performed to determine the association between race and AHI while controlling for the effect of confounders and effect modifiers, which included gender, age, body mass index, and comorbidities.
The database included 340 African American and 172 white patients. AHI was higher in African American patients (median 32.7/h IQR 3.3-69.2) than white patients (22.4/h IQR 12.8-40.6, p = 0.01). Age, sex, and BMI were found to be effect modifiers and were included in final models. In the final model, African American men younger than 39 years and between 50 and 59 years were found to have a higher AHI than white men in the same age ranges.
African American men younger than 39 years and between 50 and 59 years have a higher AHI compared to white men of the same ages after correcting for confounders and effect modifiers. There was no difference in mortality between African Americans and whites with OSAHS in this cohort.
Pranathiageswaran S; Badr MS; Severson R; Rowley JA. The influence of race on the severity of sleep disordered breathing. J Clin Sleep Med 2013;9(4):303-309.
Epidemiologic studies suggest that race may influence the prevalence and outcome of chronic illness. There is evidence that the prevalence of obstructive sleep apnea/hypopnea syndrome (OSAHS) is higher in younger (< 25 years) African Americans than younger white individuals, with no difference in prevalence in the middle-aged1 or in the elderly (> 55 years).2 In contrast, there is evidence that the prevalence of severe OSAHS (defined by an apnea-hypopnea index [AHI] > 30) is increased in African American elderly.2 Overall, it is unclear whether race is a determinant of sleep apnea severity and outcome.1–3 Moreover, a racial difference may be due to increased prevalence of obesity and hypertension in African Americans, both of which have been associated with increased OSAHS severity.4,5 The purpose of this study was to determine whether the severity and mortality of sleep apnea were higher in African American patients with OSAHS compared to white individuals. To study this hypothesis, we compared polysomnographic variables of OSAHS in a cohort of African American and white patients diagnosed with OSAHS in an urban clinical sleep center and determined survival of the members of the cohort after approximately 10 years.
The Human Investigation Committee of Wayne State University approved this study. Consent was waived as the study was an analysis of a database.
Current Knowledge/Study Rationale: Previous work has shown differences in the prevalence of obstructive sleep apnea (OSA) between whites and African-Americans but there is less data as to whether there is a difference in severity of OSA between the races. We aimed to compare apnea-hypopnea index and mortality between white and African-Americans diagnosed with OSA in an urban sleep center.
Study Impact: In addition to gender and age, AHI also varies by race being more predominant in African-American men. The interaction between gender and race suggests that both neurochemical and anatomic factors contribute to the severity of OSA.
We analyzed a computerized database of patients with an AHI ≥ 5/h, studied in the sleep center between July 1996 through February 1999. Patients from this time period were selected as we had self-identified racial demographics during this period, as many of these patients were also included in a previously reported study from our center.6 We chose not to include patients with an AHI < 5/h because we were interested in the influence of race on the AHI in patients with OSA, not the predictors of OSAHS in patients presenting to a sleep center, which have been determined.1,7–9 We excluded patients who underwent a split-night polysomnography to compare sleep architecture between the groups. Because there were very small numbers of other racial and ethnic groups, only African American and white patients were included in the analysis.
The following variables were included in the analysis: gender, self-identified race, age, body-mass index (BMI), neck circumference measured in the sleep center at the time of the sleep study, and comorbidities. The following comorbidities were identified as they have been associated with OSAHS: hypertension,10 diabetes mellitus,11 and heart disease.12 Presence of lung disease was also included. Comorbidities were considered present if the patient provided the diagnosis as part of the medical evaluation or if the patient was on a medication consistent with one of the comorbidities. Zip codes were used to estimate the patient's median income using the website, http://homeadvisor.msn.com. In March 2009, the Social Security Death Database (Social Security Death Index search results using http://ssdi.rootsweb.ancestry.com/cgi-bin/ssdi.cgi) was used to determine if each patient was alive or had died since the initial PSG.
Sleep-study variables included: total sleep time (TST), time in bed (TIB), sleep efficiency, percentage of the TST for different stages of sleep, and multiple indices of sleep disordered breathing including the apnea index (AI), hypopnea index (HI), apnea-hypopnea index (AHI), and the percentage of sleep time with a saturation < 90%.
Polysomnography was performed as previously described.6,12 Respiration was monitored throughout the night with thermo-couples at the nose and mouth and thoracic strain gauges. Oxy-hemoglobin saturation was obtained with an oximeter. Sleep stage scoring was performed using standard criteria in use at that time.13 Apnea was defined as complete cessation of airflow for ≥ 10 sec and labeled as obstructive if there was effort noted in the strain gauge channel and central if effort was absent. Hypopnea was defined as a reduction in the airflow ≥ 10 sec associated with either an arousal or a 3% drop in the oxyhemoglobin saturation. The AHI, apnea index (AI), and hypopnea index (HI) were calculated using standard definitions.
Prior to the statistical analysis, AHI, race, and other variables were checked for missing values and their suitability (normality of the variable dataset) for multivariate analysis. One subject had a missing value for BMI which was replaced by the mean value for all subjects. There were no other missing values. As the AHI was not normally distributed, a natural log transformation was applied. Demographic and sleep study variables were compared between the 2 groups using the Mann-Whitney rank sum test for continuous variables or χ2 test for nominal variables.
The goal of the statistical analysis was to determine the association between race and AHI while controlling for effects of confounders and effect modifiers. To achieve this goal, multivariate linear regression was used to assess the effect of race on AHI, while controlling for confounding and effect modification. In the first model, logeAHI was the dependent factor and race the independent factor. In subsequent models, a potential effect modifier, such as BMI, was added both individually and as an interaction term computed by multiplying race and the potential modifier (race*BMI). The following effect modifiers were added to the basic model: age, BMI, sex, presence of hypertension, diabetes mellitus, heart disease, and lung disease. The interaction terms were statistically significant for age (p = 0.019), sex (p = 0.011), and lung disease (p = 0.011).
Linear regression was also used to assess potential confounders. The risk estimate (or geometric mean ratio, 1.32) associated with race was compared between a model including only race and a model including both race and the potential confounder. Sex, age, BMI, presence of hypertension, diabetes mellitus, heart disease, and lung disease were assessed as potential confounders. If the risk estimate for race differed by > 5% between the 2 models, that covariate was considered an important confounder and was included in the final model.
Variables found to be both a confounder and an effect modifier were treated as effect modifiers in the final model. As age and sex were found to be effect modifiers, age and sex stratified regression models were run with logeAHI as the independent variable and race and BMI as independent variables.
Cox regression analysis was run to identify the predictors of the mortality for the patients with the AHI > 5. Death was considered as the outcome of interest. The period of follow-up was calculated from the date of the patient having PSG to the date of death for the participants with the event, while for those without the event, the period of follow-up was calculated from the date of the PSG to date that they were checked for the mortality data. Sex, age, BMI, median income, presence of hypertension, heart disease, lung disease, diabetes mellitus, logeAHI, and logeAI were run as covariates.
During the time period, 867 patients presented for evaluation. Of these, 272 were excluded for AHI < 5/h, and 123 were excluded for split-night studies. This resulted in 472 charts for analysis. There were 244 (52%) men and 228 (48%) women. Among the 340 African Americans, there were 152 (45%) men and 188 (55%) women. Among the 132 white patients, there were 92 (70%) men and 40 (30%) women (Table 1). The prevalence of hypertension was higher in the African Americans (46.2% v. 12.5%, p < 0.001), but there was no difference in the prevalence of diabetes, heart or lung disease between the 2 groups.
Patient demographics
(more ...)
Sleep architecture and indices of sleep disordered breathing were compared by running a nonparametric test (Mann-Whitney rank sum; see Table 2). Whites and African Americans differed significantly in %Stage 1, %slow wave, AHI events/h, and SpO2 during REM; they did not differ in time in bed (TIB), total sleep time (TST), sleep efficiency, %Stage 2, %REM, AI (events/h), HI (events/h), and SpO2 in NREM.
Sleep study architecture and indices of sleep disordered breathing
To ascertain the independent effect of race on AHI, we built several multivariate linear regression models to assess the potential confounding and effect modification of the relationship between race and increasing AHI by age, gender, HTN, DM, heart disease, lung disease, BMI, and income (Table 3). In evaluating effect modification, we found that the relationship between race and AHI severity varied by age level (interaction p = 0.019), by gender (interaction p = 0.011), and by whether or not the patient had lung disease (interaction p = 0.011). In further modeling, the interaction term for race and lung disease was not significant, so this term was dropped. Thus, we retained interaction terms for race*age and race*gender in all future analyses. When we evaluated potential confounding (Table 4), there was a 12.1% decrease in the main effect term for race when BMI was included in the model. Based on these findings, we subsequently included BMI in all further models.
Measures of potential modifiers of the effect of race on sleep disordered breathing
Measures of potential confounders of the effect of race on sleep disordered breathing, sleep disorders center
Age and gender specific regression models were run with race and BMI as the independent variable and logeAHI as the dependent variable (Table 5). In the age and gender stratified model, being an African American male ≤ 39 years increased the logeAHI by 1.17 or AHI by 3.21/h (p < 0.05) compared to a white male in the same age range with the same BMI. For the age group of 50-59 years, being an African American male increased logeAHI by 1.03 units or increased AHI by 2.79/h compared to a white male in the same age range with the same BMI.
estimates of the risk (risk estimate) of a one unit increase in the apnea hypopnea index in African Americans compared to whites, stratified by age and sex
Univariate estimates of the risk (risk estimate) of a one unit increase in the apnea hypopnea index in African Americans compared to whites, stratified by age and sex
The mean follow-up period was 10.5 ± 5.3 years. During the follow-up period, 20 white patients died (11.6% of group; 11 men, 9 women); in the African American group, 57 (17.1% of cohort; 34 men, 23 women) patients died. In the Cox regression analysis (Table 6 and Figure 1) for the whole cohort, only heart disease (p = 0.002), diabetes mellitus (p = 0.005), age (p < 0.001), and male gender (p = 0.027) were identified as significant predictors of the mortality for patients with AHI > 5. Baseline AHI and race were not identified as independent predictors.
Multivariate analysis of the risk (hazard ratio) of death associated with AHI, race, and other covariates
There was no difference in survival between the two groups.
Kaplan-Meier survival curves for African American (dashed line) and white (solid line) patientsThere was no difference in survival between the two groups.
In summary, AHI was higher in African American males younger than 39 years, and between 50-59 years of age. There was no difference in AHI between African American and white females. Longitudinal analysis of mortality found that race and severity of OSA were not predictors of increased mortality in patient with sleep apnea.
Our study demonstrated the following novel findings: (1) Sleep apnea severity, expressed as AHI, was higher in African American males (age ≤ 39 years and 50-59 years), even after controlling for BMI. (2) Race and AHI were not identified as independent predictors of mortality in this cohort of patients with OSAHS.
Our study demonstrated higher AHI in African American patients relative to white patients with OSAHS. Our study corroborates previous epidemiologic studies addressing the relationship between race and AHI. Data from the Cleveland Cohort Study indicated that African Americans had a higher AHI at younger ages but a similar AHI between the ages of 50 and 60 years.1 In a cohort of elderly patients, Ancoli-Israeli et al. found no difference in the overall AHI between African Americans and whites, though they did find that the AHI was higher in African Americans with severe OSAHS (AHI ≥ 30).2 Both of these studies were community-based cohorts including subjects with and without OSAHS. Our study extended the previous findings by demonstrating that the severity of OSAHS is influenced by race, age, and gender.
Epidemiologic studies have shown significant cardiovascular mortality disparities between African American and white populations.14–17 These disparities have been found to be associated with disparities in other chronic illnesses, such as diabetes and hypertension.17 There is also evidence that the degree of disparity is greater in younger than older individuals.16 OSAHS is an additional chronic illness that could contribute to mortality and, possibly, the racial disparities in cardiovascular mortality. Recent epidemiologic studies have shown that individuals with OSAHS have increased mortality compared to individuals without OSAHS.18–20 These studies have generally shown that the increased mortality was seen in individuals with severe OSAHS, generally defined as an AHI ≥ 30/h, with one of the studies showing that the effect of mortality was primarily observed in men under the age of 70 years.20 Thus, we were surprised that race and AHI did not predict mortality, even among younger African American men who had significantly higher AHI. Thus, while young and middle-aged African American men have a greater burden of disease, as measured by AHI, this burden does not translate into increased mortality when other demographic and comorbidities are considered.
We intended to study the influence of race on sleep apnea severity and mortality, we are cognizant that race is primarily a social construct. Therefore, considering racial differences in biological processes that influence OSAHS,3,21 race may represent a marker rather than a specific biologic risk factor for increased severity of AHI.22 In addition, other relevant factors, such as socioeconomic status,16,23 educational status,15 degree of urbanization,24 and access to care25 are significant determinants of morbidity and mortality and contribute to the apparent racial disparities. For this cohort, we used median income data (based upon home address zip codes) as a surrogate for socioeconomic status, but did not find that socioeconomic status was a confounder or effect modifier in this population despite the clear difference in median income between the two groups. However, income may not be sufficient to detect disparities in access to care.26 Finally, the use of race in this context could limit the generalizability to populations with different racial demographics or evolving and/or complex social settings.
Group differences in the prevalence and severity of OSAHS are generally attributed to group differences in either anatomic factors or neurochemical control of breathing during sleep.27 Previous work has shown that there are differences in craniofacial structure, as indicated by cephalometrics1 and anthropometric facial features,28 between African American and white men. In particular, the evidence suggests that hard tissue anatomic risk associated with shape and size of the skeletal components of the upper airway may be relatively more important in whites, while soft tissue structures may be more important in African Americans.28 We hypothesize that these anatomic differences may predispose to differences in upper airway mechanics and collapsibility between African Americans and white subjects. However, to our knowledge, there are no published reports to support this hypothesis.
Alternatively, the increased AHI in African Americans compared to whites could suggest that African Americans have an increased apneic threshold (are more susceptible to developing apnea) compared to white subjects; however, there is no experimental proof of such a difference, and preliminary data from our group does not indicate a difference in the apneic threshold.29 However, it has been shown that African American individuals have a greater ventilatory response to hypoxia21 and an increased peripheral response to hypercapnia compared to white individuals30 during NREM sleep, suggesting that differences in neurochemical control of breathing could contribute to the increased AHI in African Americans.
Our study found a significant interaction between gender and race, with the increased in AHI being found only in African American men. The above discussion on the differences in the pathogenesis of OSA suggests a potential explanation for this finding. We speculate that an increased susceptibility to hypocapnic apnea (men)31 in combination with differences in upper airway mechanics (African Americans) could result in a risk of OSA that is greater than either risk factor alone. This is, however, a hypothesis awaiting experimental proof.
In addition to pathophysiologic mechanisms, there could be cultural reasons for a difference in AHI. Specifically, reduced access to care or cultural differences in reporting symptoms of OSAHS could result in delayed presentation and higher AHI. However, in the Sleep Heart Health Study, African American women were more likely to report snoring than white women with no difference between African American and white men.32 However, there is evidence that African Americans answer and interpret elements of the Epworth Sleepiness Scale differently than whites,33 suggesting that cultural differences could exist in reporting of symptoms.
Epidemiologic studies have found an increased prevalence of OSA with increasing age.2,8,34 Ware and colleagues found that age was a significant predictor of AHI in a clinical sample.35 In this study, we found that the racial differences in AHI were most apparent in certain age groups, similar to other investigators who also found an increased AHI in younger African Americans.1 The reasons for age being an influence on AHI in only certain age ranges are unclear. Several studies of the influence of age on upper airway mechanics and control of breathing do not show an aging effect36–39 and of those that do, the decrement in function is present in an older age group, not younger.40,41
We included comorbid conditions in the analysis because of known associations between several medical conditions and OSA, including heart disease12 and hypertension.10,11 While we did find associations for several of the comorbidities to AHI, the final regression models did not include any of these factors. There are several potential explanations. First, comorbidities other than hypertension were self-identified by the patients, and it is conceivable that patients did not disclose all relevant associated diagnoses. Second, the comorbidities could have been present but undiagnosed at the time of presentation to the sleep center. Third, the comorbidities analyzed could be either independent of or secondary to the OSA and therefore not predictive of OSA severity. For instance, comorbidities could be coexistent because of the common factor of obesity. Finally, it should be noted that we found that comorbidities such as heart disease and diabetes to be associated with a decreased risk of mortality; generally these comorbidities are associated with an increased risk of death. However, we note that those associations are generally from epidemiologic studies and ours is a clinical study. We speculate that the patients with these comorbidities were being actively treated, thus causing a potential protective effect.
Referral bias could result in our clinic population not being representative of patients with OSA. We note that in our clinic population the ratio of men to women is nearly 1:1, in contrast to the usual 3-5:1 reported in other clinic based population studies.35,42,43 Our patients are also extremely obese (mean BMI > 35 kg/m2), which also contrasts to previous clinic-based population studies. However, both of these demographic characteristics are consistent with the urban community our sleep center serves and previous studies from our center.6,44
We were unable to analyze the effect of neck circumference in this population because we only had this measurement in a subset of patients with disproportionate data collection between the gender and racial groups. Several previous studies have shown the importance of neck circumference in the prediction of sleep apnea,44–46 and some have suggested that it is a better predictor of OSA severity than BMI. It is conceivable that substitution of neck circumference into our regression analyses could have changed the results. However, in a recent study from our center, we found that both neck circumference and BMI are independent predictors of AHI in a patient population very similar to that in this study.44
O'Connor and colleagues found that men were more likely to have supine dominant OSA.42 Therefore, it is possible that the increased AHI in our study were secondary to the African American men spending more time in the supine position than white men. We do not have body position data for our patients so cannot disprove this hypothesis. However, we do not know of study that has shown that members of different races or cultures spend different amounts of time supine.
We limited our sample to patients with full-night sleep studies and those with an AHI ≥ 5/hour. We included only full-night studies so that we could compare sleep architecture between the two groups and so that all REM periods would be included in the analysis of sleep disordered breathing indices (important for patients with more mild REM-associated events). In theory, exclusion of patients with split-night studies removed patients with more severe OSAHS, thus minimizing differences between the two groups. However, split-night studies in our center can be performed for a wide range of AHI, thus minimizing this limitation. We excluded patients with AHI < 5/h, to better compare AHI in patients with sleep disordered breathing, not all patients presenting to a sleep center. However, limiting the population in this way could have introduced selection bias and favored the results showing a difference in AHI between the two races. In theory, the methodological design of a cross-sectional or longitudinal would be better suited to eliminate selection bias. In addition, that AHI was analyzed as a continuous variable, excluding patients with AHI < 5/h, could have contributed to the lack of significance in AHI predicting mortality. Finally, while the calculated power of the mortality data was 0.8, it should be noted that the sample size was determined not by a power calculation, as this was a convenience sample of patients with self-described race and sufficient follow-up.
In summary, we have extended previous findings by showing that African American men have a higher AHI than white men in certain age ranges, with no differences between African American and white women. The interaction between gender and race suggests that increased severity of sleep disordered breathing may require both an increased susceptibility to hypocapnic apnea (men) and a smaller upper airway (African Americans).
This was not an industry supported study. The authors have indicated no financial conflicts of interest.
Redline S, Tishler PV, Hans MG, Tosteson TD, Strohl KP, Spry K, authors. Racial differences in sleep-disordered breathing in African-Americans and Caucasians. Am J Respir Crit Care Med. 1997;155:186–92. [PubMed]
Ancoli-Israel S, Klauber MR, Stepnowsky C, Estline E, Chinn A, Fell R, authors. Sleep-disordered breathing in African-American elderly. Am J Respir Crit Care Med. 1995;152:1946–9. [PubMed]
Cakirer B, Hans MG, Graham G, Aylor J, Tishler PV, Redline S, authors. The relationship between craniofacial morphology and obstructive sleep apnea in whites and in African-Americans. Am J Respir Crit Care Med. 2001;163:947–50. [PubMed]
Newman AB, Nieto FJ, Guidry U, et al., authors. Relation of sleep-disordered breathing to cardiovascular disease risk factors: the Sleep Heart Health Study. Am J Epidemiol. 2001;154:50–9. [PubMed]
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Jolly S, Vittinghoff E, Chattopadhyay A, Bibbins-Domingo K, authors. Higher cardiovascular disease prevalence and mortality among younger blacks compared to whites. Am J Med. 2010;123:811–8. [PubMed]
Wong MD, Shapiro MF, Boscardin WJ, Ettner SL, authors. Contribution of major diseases to disparities in mortality. N Engl J Med. 2002;347:1585–92. [PubMed]
Young T, Finn L, Peppard PE, et al., authors. Sleep disordered breathing and mortality: eighteen-year follow-up of the Wisconsin sleep cohort. Sleep. 2008;31:1071–8. [PubMed Central][PubMed]
Marin JM, Carrizo SJ, Vicente E, Agusti AG, authors. Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet. 2005;365:1046–53. [PubMed]
Punjabi NM, Caffo BS, Goodwin JL, et al., authors. Sleep-disordered breathing and mortality: a prospective cohort study. PLoS Med. 2009;6:e1000132[PubMed Central][PubMed]
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Kanjilal S, Gregg EW, Cheng YJ, et al., authors. Socioeconomic status and trends in disparities in 4 major risk factors for cardiovascular disease among US adults, 1971-2002. Arch Intern Med. 2006;166:2348–55. [PubMed]
Erwin PC, Fitzhugh EC, Brown KC, Looney S, Forde T, authors. Health disparities in rural areas: the interaction of race, socioeconomic status, and geography. J Health Care Poor Underserved. 2010;21:931–45. [PubMed]
Zhang X, Geiss LS, Cheng YJ, Beckles GL, Gregg EW, Kahn HS, authors. The missed patient with diabetes: how access to health care affects the detection of diabetes. Diabetes Care. 2008;31:1748–53. [PubMed Central][PubMed]
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Badr MS, author. Pathophysiology of upper airway obstruction during sleep. Clin Chest Med. 1998;19:21–32. [PubMed]
Rowley JA, Badr MS, authors. Determinants of the hypocapnic apneic threshold: influence of race. Am J Respir Crit Care Med. 2007;175:A995
Bobat I, Mateika JH, Qureshi T, Badr MS, authors. Peripheral not central chemoreflex responsiveness is enhanced in African-Amercians compared to Caucasians during wakefulness. Am J Respir Crit Care Med. 2004;169:A60
Zhou XS, Shahabuddin S, Zahn BR, Babcock MA, Badr MS, authors. Effect of gender on the development of hypocapnic apnea/hypopnea during NREM sleep. J Appl Physiol. 2000;89:192–9. [PubMed]
O'Connor GT, Lind BK, Lee ET, et al., authors. Variation in symptoms of sleep-disordered breathing with race and ethnicity: the Sleep Heart Health Study. Sleep. 2003;26:74–9. [PubMed]
Hayes AL, Spilsbury JC, Patel SR, authors. The Epworth score in African American populations. J Clin Sleep Med. 2009;5:344–8.[PubMed Central][PubMed]
Ancoli-Israel S, Kripke DF, Klauber MR, Mason WJ, Fell R, Kaplan O, authors. Sleep-disordered breathing in community-dwelling elderly. Sleep. 1991;14:486–95. [PubMed Central][PubMed]
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Browne HA, Adams L, Simonds AK, Morrell MJ, authors. Ageing does not influence the sleep-related decrease in the hypercapnic ventilatory response. Eur Respir J. 2003;21:523–9. [PubMed]
Browne HA, Adams L, Simonds AK, Morrell MJ, authors. Impact of age on breathing and resistive pressure in people with and without sleep apnea. J Appl Physiol. 2001;90:1074–82. [PubMed]
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An article in the Huffington Post recently addressed President Obama's public comments on expanding access to opioid treatment, particularly medication-assisted treatment (MAT) like methadone or buprenorphine (suboxone).
Many members of the treatment industry and recovery community do not have a realistic grasp on the role that medication-assisted treatment can play in recovery from severe opioid addiction. Historically, the recovery community has not regarded those utilizing methadone or suboxone as truly in recovery. They emphasize total abstinence, even from methadone, despite the fact that methadone and buprenorphine have restored individuals to normal functioning and even saved lives in many cases.
There was a time some years ago, in the 12 step community, when individuals were chastised for taking psychotropic medication for depression or other mental health disorders. This criticism came from a fundamental lack of knowledge about the biological basis for many mental health disorders. Similarly, medication-assisted treatment interventions have been the subject of misunderstanding and unwarranted rejection by those with limited education on varied treatment approaches.
As America's opioid problem continues to grow, we need real solutions rooted in medical science and research. At this point in time, medication-assisted treatment has been in use long enough to clearly demonstrate its usefulness in facilitating personal recovery from addiction.
In 2015, we saw numerous local and national political figures rally around families that have been impacted by heroin overdoses and the heartbreaking loss of loved ones. Opioid addiction has finally come into focus within the mainstream media, and even current Presidential candidates have begun to address this as an important issue which commands attention and a solution.
More: Question and Answers on how methadone works


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Tag Archives: Warriors
Playoffs…Are you kidding me…Playoffs?
As the NBA's regular season is coming to an end, and playoffs are about to begin, I have decided to discuss and compare the different playoff formats for popular sports. Much discussion has surfaced over the years as to which … Continue reading
Posted in Sports Tagged Basketball, Boston Celtics, Brett Favre, Chicago BUlls, Drew Brees, Dwight Howard, Kobe Bryant, Landon Donovan, Lebron James, Los Angeles Lakers, Miami Dolphins, MLS, NBA, NBA Finals, NCAA, New England Patriots, New York Yankees, NFL, Playoffs, Soccer, Tom Brady, USA, Warriors, World Cup, World Series 1 Comment


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Welcome to our registration-themed issue for Spring 2009. Want to know what new classes are available for fall? Need the final scoop on the new Experimental Psychology/Foundations of Social Research pre-requisite for many upper-level Psychology courses? Looking for an internship, RA, or TA for next semester? How about a $500 scholarship? Well, read on because we have just the stories for you!
· Breaking News: New Courses for Fall 2009
· P/HD Club News: Peace Psychologist and New Officers
· Psi Chi News: Initiation, Rock Band, and Tutoring
· Summer Classes Still Open!
· Registration Alert: Research Course Prerequisites for Fall and Waiver Request Procedures
· Recycling Registration Resources
· Advisors: Take Time to Meet With Yours
· The Pink Flamingo Mailbox: How Do I Deal with Post-Spring Break Sadness?
· The Human Development Diversity Course: Why Isn't It Showing Up in SIS?
· Call for Applications: The Fergus & Bonnie Hughes Scholarship for Human Development & Psychology
· Careers of the Month: April 2009 Edition
· Career Tip of the Month: Investigate Career Services
· Graduate School Tip of the Month: Attend our GRE Information Session
· Student News to Celebrate
· Top Ten List: Your Instructors' Favorite Exam Questions
· Want Ads: RAs, TAs, and Internships


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High-brow shows in high def at Quick Center
An international "high-def" weekend is on the itinerary at Fairfield University, with "stops" planned at three major performing arts venues in London, New York and Moscow.
The arts-cinema weekend kicks off with two viewings Friday, Nov. 1, of London's National Theatre Live award-winning production of "Frankenstein" by Nick Dear.
On Saturday, Nov. 2, Dmitri Shostakovich's "The Nose" will be presented twice as part of "The Met: Live in HD" series.
The feature on Sunday, Nov. 3, is "Live from Red Square," with soprano Anna Netrebko and baritone Dmitri Hvorostovsky.
"The opportunity to add this particularly marvelous high-definition broadcast to our schedule was too enticing to pass," said Gary Wood, director of the Quick Center for the Arts, where the broadcasts will be shown.
"Thus, we found a date in our schedule to make it work. The Quick Center for the Arts has a very large and enthusiastic opera audience, and `Live From Red Square' features some of the most exciting and charming singers in opera today. ... The theater here at the Quick Center is a particularly wonderful venue for such viewings, so we anticipate a very special (afternoon) of extraordinary music and gorgeous visuals."
More InformationFairfield University's Quick Center for the Arts, 200 Barlow Road entrance to campus. Tickets may be purchased in advance or prior to showtime at the box office. 203-254-4010, 877-278-7396.
Here's the schedule:
High-definition broadcasts of "Frankenstein" will take place at 2 p.m. (encore), and 7 p.m. (encore) on Friday, Nov. 1. Tickets are $25, $20 seniors, $15 students. The university asks that adults take note: "Given graphic elements in the production, it is strongly advised that the presentation is not appropriate for ages 15 and under." Winner of the 2012 Olivier Award for best actor for Benedict Cumberbatch and Jonny Lee Miller. The Quick Center's 2 p.m. broadcast features Miller as Victor Frankenstein and Cumberbatch as the Creature. The 7 p.m. performance will have the lead actors swap roles.
"The Nose," a satirical adventure of a bureaucrat who goes searching for his missing nose, will be presented at 1 p.m. (encore) and 6 p.m. (encore) on Saturday, Nov. 2, from Lincoln Center. Tickets are $25, $20 seniors, $10 children/students. Paulo Szot reprises his acclaimed performance as the bureaucrat in a production based on Gogol's comic story. Valery Gergiev conducts. "The Nose" is a co-production of the Metropolitan Opera, the Festival d'Aix en Provence and the Opera National de Lyon, both in France.
The Quick Center presents "a once-in-a-lifetime chance to witness two of Russia's greatest opera singers ... performing in their homeland in a high-definition broadcast" on Sunday, Nov. 3, at 3 p.m. Tickets are $25, $20 seniors, and $10 children/students. Netrebko and Hvorostovsky are shown performing on June 19 for 7,500 people in Russia's landmark Red Square. Included in the program are popular arias and duets from some of the world's best-loved operas, including Giacomo Puccini's "Tosca," Pyotr Ilyich Tchaikovsky's "Eugene Onegin," and Giuseppe Verdi's "Il Trovatore." The two singers were accompanied by conductor Constantine Orbelian, Russia's State Academic Symphony Orchestra and a large chorus.


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Land Debate Looms Over Williamstown Farmer's Future Harvest
Farmer Kim Wells relies on acreage being considered for affordable housing to raise feed for his cattle.
WILLIAMSTOWN, Mass. — Driving around his Henderson Road farm in an all-terrain vehicle on a crisp January morning, Kim Wells points out everything he and his wife have done to build up the operation.
He shows you the barn they rebuilt on a foundation that was stripped when the farm's former owner went broke, the miles of electrified fence he installed to pen his livestock, the shelters he and a welder friend fashioned to protect his pigs from the elements.
"When we bought it, we got the house, which was a wreck, and the Federal Land Bank had sold the big barn," Wells explains. "We got the small barn, the house and the foundation for the big barn.
"We bought it in 1982. I was 27 years old. It was a great opportunity if you could afford it. We bought it from the Federal Land Bank. The real estate agent we used said she was embarrassed to show it."
Today, Wells is proud to show it off.
Some pigs come up to nuzzle him when he steps inside their enclosure, the cattle amble up a small hill to check out the stranger sitting beside Wells in the ATV, and Wells' border collie runs along behind the vehicle.
It's a good day. But as often is the case these days at East Mountain Farm, the conversation turns to the issue that looms over the farm an haunts Wells' nights: the potential that a land development plan will take away access to a town-owned field Wells has hayed since 1991.
The parcel in question, known as the Lowry Property, is located about three miles from Wells' East Mountain Farm. Lowry is conserved land under the auspices of the town's Conservation Commission, which allows Wells to work the land under a license agreement for a minimal fee.
It is fertile farmland that yields about 4,200 bales of hay each year on about 22 acres of the 30-acre property, Wells says.
In November, it was announced that the town intends to pursue Lowry as a site for developing affordable housing to replace housing lost in the flood-prone Spruces Mobile Home Park. The plan has angered residents in two camps: conservationists who want to see the land remain protected and some current Spruces residents who want to see the park remain open.
Town officials argue that the park cannot be protected from future floods. The company that owns the park says it cannot afford to operate it after most of its sites were deemed uninhabitable after Tropical Storm Irene. And affordable housing advocates say that using town-owned land to address a pressing need in town makes more fiscal sense than spending limited funds to acquire new land.
In the last three months, there have been letters to the editor, the birth of a new conservation group, an Open Meeting Law complaint against the Board of Selectmen to the commonwealth's attorney general and tense exchanges at usually sleepy town committee meetings.
As a member of the town's Agricultural Commission and a businessman, Wells has attended many of those meetings. But his curiously mild-mannered demeanor has left some wondering what his stake in the issue really is.
One of his colleagues on the Ag Comm even said some in town have misread Wells' equanimity to mean he is not really upset about the development talk.
He laughs about such a conclusion.
"My wife says I'm being very diplomatic," Wells said. "And I guess I'm forcing myself to be. I can't begin to tell you the sleep I've lost, the angry conversations I've had with myself about seeing it happen and most of all going to the (Affordable Housing Committee) meeting where they sowed the conceptual plan (for Lowry) and just this sinking feeling in my stomach. I could visualize better than anyone there those houses sitting up there.
"No matter how it's sugar-coated, it's a loss of farmland.
"So to say that I've not been angry about it, well, you haven't hung around with me back with the pigs or something like that."
Key to Economic Success
Lowry and another parcel, the Burbank Property, are the only town-owned sites where Williamstown has issued Special Use Permits for agricultural use. Winthrop Chenail of Mount Williams Dairy Farm holds the permit on Burbank.
Wells readily admits that the $150 per year he pays for the right to hay Lowry is not a large sum.
"They're not getting rich off of me," he says.
But it is not like $150 is all he pays for the hay he takes.
There is a lot of labor, a lot of fertilizer and a lot of luck that goes into those 4,200 bales of hay.
A mountain of hay in Wells' barn. He harvests about 4,200 bales a year.
"That's where I laugh at people who say I got a good deal here," Wells said. "Yeah, as long as I'm smart enough to figure out when it's going to rain and how much I can cut and all the equipment works."
In a stop at East Mountain Farm's small lower barn, Wells shows the mower and baler he tows down to Lowry three times each summer – at least he hopes that he gets to do a third cut each haying season.
During three-day windows starting in May each year, Wells can usually mow, ted, rake and bale between 600 and 800 bales. It varies each year, but to get to a typical 4,200-bale crop, that means he needs about six or seven such three-day windows when the weather will be right for harvest.
"You don't want to get hay rained on," he explained. "That's the killer. Once it gets rained on, it's shot. Then you're looking for a landscaper to take it off your hands for mulch."
Not all the hay from Lowry ends up feeding livestock at East Mountain Farm.
The first-cut hay, which is coarser and not quite as high in energy, is not as beneficial to his cattle herd but is prized by horse owners because the coarser grass is better for a horse's digestion, he says.
He sells most of the first-cut hay in a typical year. The second-and third-cut yield from Lowry and nearby privately-owned field he hays for the landowner are enough to sustain his herd at East Mountain Farm, Wells said.
It is not uncommon for small farmers like Wells to grow a "cash crop" aside from their main operation. In fact, it is the only economic model that keeps most small farmers in business.
In Wells' case, he has two cash crops aside from the beef, pork and chicken at the core of his farm: hay from Lowry and the nearby Carver field and firewood from 128-acre property at East Mountain Farm. Only about 10 acres of the farm are in pasture; the rest is woodland.
"With seven to 10 acres (of pasture) and the feed source, I'm OK," he said.
"As a farmer, you need to have cash crops. The length of time from when you get the animal to when you get paid for the animal is months. You're laying out an incredible amount for fertilizer, feed, fuel costs. And they have all exploded. You need to have a source of cash – a product you can make and sell and get paid for, unless you're set up like a CSA (community-supported agriculture).
"The Chenails have sweet corn and pumpkins. ... For me, those two cash crops are firewood and hay."
Over the last 10 years, hay sales have accounted for 23 percent of East Mountain Farm's gross income, on average, Wells said. The last two years, that percentage has slipped to 17 percent thanks to an increase in the beef herd and a sub-par hay crop last year.
Wells gets enough from his second and third cuts of hay to feed his modest herd of cattle. In a given year, he takes between 14 and 16 animals to slaughter, he said.
Could he buy enough hay to feed those animals? Perhaps, but do not expect him to do it if he loses access to the Lowry Property.
"I can't see going out and buying feed," Wells said. "I wouldn't do it. That's how (East Mountain Farm's former owners) got in trouble. All they did was go out and buy all their feed, and they lost the farm. It's not a good model.
"That's what's been so good about having Lowry. This farm is pretty small, and having Lowry sort of made it into a better launch point. You could do more with what I had here."
If the Lowry Property on Stratton Road was taken out of conservation and Wells lost his license to hay there, the effect would be detrimental but not fatal to East Mountain Farm, he said.
"If this had happened to me 15 years ago, I'd be in real trouble because that was really helpful," he said. "I could probably deal with it now. I'm going to have to look around and see if I could find some other fields, because I don't think there's enough at Carver's to even feed the beef I've got.
"It's too bad because beef is something I've been expanding the last few years as people have gotten more interested in locally grown beef.
"The cash crop end of it would be gone, and that helps pay the bills. The actual beef operation would have to plateau, I guess, at where I am."
A Trend of Acreage Decline
At public meetings and during the private tour of his farm, Wells is quick to frame the issue not in terms of the impact on his operation but in terms of the loss of arable land in town.
"The only point I'd make at a town meeting is this: This piece of property helped a young farmer become a farmer and create a farm," said Wells, a 1978 Williams College graduate who worked on farms in Kentucky before returning to Williamstown in '82. "And I don't think you want to take that opportunity away from someone else because our food system is coming back home, and the more it does, the more you're going to need places like this."
"Places like this" are increasingly hard to find — both nationally and here in the Berkshires.
Pittsfield-based non-profit Sustainable Berkshires reports that between 1997 and 2007, Berkshire County acreage in production decreased by 82 acres. A Washington, D.C., advocacy group, the American Farmland Trust, says the nation loses more than an acre of farmland every minute of every day on average.
The national trend is blamed on "development." The former is linked to the aging farmer population, according a senior planner at the Berkshire Regional Planning Commission who staffs Sustainable Berkshires.
"Most people don't have someone they know who they an pass the farm onto or they're unsure whether someone will keep it as a farm," Amy Kacala said. "Farmers (in the county) are older than in other regions of the state. As we look at people retiring, that's their retirement fund, the land.
"I know of a few farms in North County that are on the market as people are preparing to sell them. There are some farmers who don't participate in the (state's) tax incentive program for agriculture because they want the flexibility to be able to sell.
"The impression of people who have talked to farmers is they are just a few years out (from selling) and that we could have a drastically different landscape."
In an area like the Berkshires, small farms like Wells' East Mountain Farm are the core of the agricultural landscape.
The same Sustainable Berkshires report, based on data from the U.S. Department of Agriculture's 2007 Ag Census, found that the 35 percent of the county's farms are sized between 10 and 49 acres; 31 percent are between 50 and 179 acres — a group that includes East Mountain Farm.
Although Wells has no full-time employees, some farms do. And if agriculture production in the region maintains current levels — or better yet, expands — ag advocates and planners like Kacala envision regional food processing facilities that would create even more jobs. Currently, Wells takes his animals to Eagle Bridge Smokehouse, a custom slaughterhouse 24 miles away in New York's Washington County that produces private-label meat for farmers around the region.
Then there is the hidden economic impact of lost farmland.
"What does that mean to us as a region in terms of tourism dollars?" Kacala asks. "What happens to the sense of character and what makes the Berkshires the Berkshires?
"How many tourism dollars are associated with natural beauty and open land? The Berkshire Tourism Bureau is digging into that, and those dollars are not insignificant."
Meat You Can Trust
Wells is not the only one who stands to lose if he has to cut back or "plateau" production at East Mountain Farm.
The other losers are his customers: the loyal ones who have been buying meat from him for a quarter century, the restaurants who tout "locally grown" food on their menus and those yet to discover the prepackaged meat that Wells has begun selling out chest freezers in his large barn.
Much of the beef he sells goes out by the quarter side or full side, Wells said. But the smaller packages — a two-pound steak or a pound of bacon — represent a potential growth market for East Mountain Farm.
Restaurateurs who purchase his meat include North Adams' Gramercy Bistro and Mezze and Williams Inn in Williamstown.
The front page of Mezze's website features its connection to local farms, and the site lists East Mountain Farm as one of several dozen small farms in Massachusetts, Vermont and New York who supply the high-end eatery.
"It's about connecting people and building community," reads a quote from Mezze co-founder Nancy Thomas. "We are thrilled to be working side-by-side with our local farms."
Perhaps there are is bigger devotee of Wells' beef, pork and pasture-raised chicken than Paola Gentry, a Williams alumna and New Paltz, N.Y., resident who stocks up on visits to her alma mater to see her many friends in the area.
"We get, I would say, 95 percent of our animal protein from Kim," Gentry said.
Gentry is part of the growing "locavore" movement. According to the USDA, direct-to-consumer marketing of locally-produced agriculture amounted to $1.2 billion in sales in 2007, more than twice its share of the industry just 10 years earlier.
"I like going to the farm and seeing where our food comes from," Gentry said. "It drives me nuts that people don't realize where their food comes from.
"We're very respectful of the animals and very respectful of the food we eat. We feel better knowing how they were raised."
Gentry said she and her husband, also a Williams grad, frequently take their children to Wells' farm to see how food is produced.
"We tell them the animals live a beautiful life and just have one sad moment," she said. "It's all part of the circle of life.
"We watch a lot of 'The Lion King,'" she adds with a smile in her voice.
Gentry has been buying from East Mountain Farm for about six years.
Williamstown resident Audrey Thier started buying her meat from Wells 26 years ago.
A locavore like Gentry, Thier buys as much of her produce as she can from the Caretaker Farm CSA and shops at local co-op Wild Oats.
Like many local farmers, Wells relies on 'cash crops,' firewood and hay in his case, along with the farm's staples of beef and pork.
Although she acknowledges that meat from East Mountain Farm may be more expensive than similar products at the grocery store, a small premium is worth it in her estimation.
"Honestly, I don't even pay attention to [price]," she said. "It's important to me to have meat raised the way I want it raised and to have it local. ... If there is a premium, I'd be willing to pay it. It's not something I'd consider."
Thier points to recent incidents of food safety problems in large commercial slaughterhouses as evidence of the value in locally-produced food.
"Two minutes up my road are very happy cows, and they're living good lives up there," she said. "I know they're healthy, and I know the meat will be healthy as a result."
Competing Values
Wells was not surprised by November's announcement that the town was going to try to take the Lowry Property out of conservation and use it for affordable housing. It's not like the idea is entirely new.
"As soon as Irene hit, I didn't have to look at the paper," Wells said. "As soon as it hit, I knew Lowry would be in play. It always is when there's an affordable housing thing."
After Irene, Wells said he stopped doing things like adding the soil amendment potash to keep potassium levels high on the Lowry site. He hated to do it because in the long run it will make the land less productive, but given the current level of uncertainty, it makes less sense to invest heavily in the land.
"If you're not giving back something, you're exhausting the soil of all its nutrients," Wells said. "A lot of guys do that, and pretty soon you see the grass is four inches high, and weeds can grow in that environment. The whole idea is to provide a good soil so the grasses can compete with the invasive weeds like bedstraw and things like that.
"I stopped doing some of the things that if I knew I was going to be there I would be doing."
The whole Lowry Property issue would be more cut and dried if the development planned was a strip mall.
The BRPC's Kacala, while not commenting on the specifics of Wells' situation, noted it is difficult to weigh the need for agricultural land against Williamstown's widely recognized need for affordable housing.
The town's 2002 Master Plan identified a need for 164 more units of affordable (or subsidized) housing. In the intervening 10 years, the town has added fewer than 10 more units, and it lost 153 units of affordable (but unsubsidized) housing sites after the 2011 flooding at the Spruces.
Wells does not deny the need for affordable housing is acute.
At the last Ag Commission meeting, he proposed the panel issue a statement supporting affordable housing development — but with an eye toward brownfields development that keeps agricultural land in tact.
For its part, the Affordable Housing Committee remains focused on a variety of sites, including Lowry and previously developed, or brownfields, locations like the site of the former town garage on Water Street and the former PhoTech Mill property on Cole Avenue.
"I feel Lowry should be saved as farmland," Wells said. "But I also feel like if you solve the affordable housing problem, you take the pressure off it. That's the big thing. I don't think it's fair to say it shouldn't be developed and then not answer the question of how you're going to address the affordable housing thing.
"If we got serious about funding affordable housing, then Lowry would be out of play."
Tags: affordable housing, agriculture, development, farming, farmland,


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This story has been updated.
YONKERS, N.Y. - Police in Yonkers are investigating a fatal shooting that took place in the vicinity of the intersection at Warburton and Lamartine Avenue Wednesday afternoon.
Shortly after 2:15 p.m., police were dispatched to the area, where there was a reported shooting, Police Sgt. Dean Politopoulos said. One male victim was taken to a local hospital for treatment. When found, he was down on the ground, bleeding heavily with an apparent gunshot wound to the abdomen, police said.
Officers immediately rendered aid and called for an ambulance which transported the victim to a local area hospital.
The 31-year-old victim, a Yonkers resident, was subsequently pronounced dead at the hospital. His identity has not yet been released, pending family notification.
Officers established a crime scene and an intense investigation is currently underway.
Detectives from the Major Case Squad and Crime Scene Unit are actively investigating this incident, interviewing witnesses, canvassing for surveillance video, and processing forensic evidence. Preliminary information yields that the victim may have been targeted.
As this is an active and on-going investigation, no other information will be released at this time.
Anyone with information regarding this incident is encouraged to contact the Yonkers Police Detective Division at (914) 377-7724. All calls will remain confidential.
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Mplus Home
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Two Levels of Repeated Measures
Mplus Discussion
Multilevel Data/Complex Sample
Timothy Ballard
posted on Tuesday, December 08, 2009 - 7:54 pm
Hi Readers,
My group recently ran an experiment where participants completed 10 trials of a task with 5 repeated measures observations within each trial. We are interested in examining the growth processes within each trial as well as across trials (but still within individuals). In HLM terms, we have a 3-level dataset, with level-1 representing the within-trial level, level-2 the between-trial level and level-3 the between-person.
I'm wondering how MPlus will handle the fact that levels 1 AND 2 are repeated measures. Can Mplus perform a 3-level HLM-type multilevel analysis? Is this even appropriate here?
We'd also like to account for autocorrelation at both of the repeated measures levels. Can autocorrelation only be examined using the multivariate growth modelling approach? If this is the case and we were to use a TYPE = COMPLEX analysis, does that mean that only the within-trial level will be analysed using the multivariate approach and the between-trial level will be analysed using the univariate approach? What are the implications of this?
Thanks in advance for your help.
Bengt O. Muthen
posted on Wednesday, December 09, 2009 - 10:15 am
The most complex approach would be to model it as a single-level, doubly wide analysis where you have 5 x 10 = 50 variables. You can then have all kinds of autocorrelations (see the UG for autocorrelation modeling using Model Constraint). Here you could formulate 10 growth models where the 10 sets of growth factors are related in some way - for example the intercept growth factor could have a growth model over trial, and so could the slope. This approach would require a sufficient sample size.
An alternative is to simplify. If you drop the autocorrelation on the trials level (middle level) you can model this as a 5- variable wide twolevel model where the cluster variable is the individual and the trials are the observations within individual. You can evaluate the autocorrelation between trials using factor scores. Alternatively you can create a within level predictor such as the average of the previous trial and use it in the growth model for the within level - that also takes care of the autocorrelation on the trial level. Of course you can model the autocorrelation on level 1 with model constraints.
Timothy Ballard
posted on Tuesday, November 02, 2010 - 8:05 pm
Hi Bengt,
To give you a bit more information about the model I'm trying to test, the primary purpose is not to model the growth, rather to control for it when assessing the influence covariates. At both the between-trial (middle) level and the within-trial (lowest) level, we have six variables at each time point that form a mediation chain. So at each level we have a model that might look like
a -> b -> c -> d -> e -> f
So if running a doubly wide growth model with 50 outcome variables, we would also have to include 5 x 50 = 250 covariates. I'm guessing this is not even feasable with a sample size of just 130 at the highest level?
In that case, I'm interested in running a multilevel growth model as you suggested aboce. This would essesntially collapse across trials and reduce the number of variables in my model to 30 or so.
The only issue with this would be controlling for autocorrelation at the between-trial level. You suggested creating a variable that represents the score at the previous time point and controlling for it. The problem I'm getting with this is that including these lagged variables in my model creates a lot of misfit.
The other option you suggested would be to evaluate autocorrelation using factor scores. I'm not familiar with this method, would you be able to give me a bit more detail about how this can be done?
Thank you,
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Posted by Smokey Stover on November 16, 2003
Sent to the Archives on another mission, I stumbled on a laundry list of Dutch this and that, most of which was attributed to the English bias against the Dutch. Dutch treat (which antedates and explains "go Dutch") refers to the frugality for which the Dutch were once famous. I grew up in a town founded by Dutchmen and full of their descendants, and there were stories (apparently true) circulating in town about frugality gone wild. One example: a man worked as a hired hand on a farm down the road, and was driven to his job every day by his employer. (Both had Dutch names.) At the hired hand's death it was discovered that he had in his garage a brand new car, which he had never been seen to drive. The theory was that if he drove it, his employer would stop driving him to work. #Dutch courage: the English obtained their gin from ports which in those days were Dutch, like Antwerp. Dutch courage is more gin than Dutch. Dutch uncle, I believe, refers to a scolding uncle whose nephews are also Dutch, especially since the usual usage is in a simile, such as "...like a Dutch uncle...." Double Dutch, also mentioned in the Archive, is now used for a type of urban rope skipping using two ropes. I don't know how that gets to be Dutch.


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Stung by such advance criticism, I have decided not to do a review but a reprise of my favourite chapter from the book (with shades of my second fav chapter thrown in, for good measure). Arnab talks about the five films that made him who he is.
Well, these are mine...
Dharam Veer
The biggest disservice that one can do to the memory of Manmohan Desai is to call him a formula-driven entertainer. It can't get any further from truth. His films - under its veneer of entertainment and convoluted formulae - hid deep undertones of deviant sexuality.
And there can't be a better example than Dharam Veer.
Bondage. S&M. Cross-dressing. Trans-gender role-playing. You name it and you get it. A surprisingly advanced film for its times, it even lifted the veil off homosexuality at a time it was considered taboo.
The homosexuality has been described in considerable detail here. The hero tied up in a dungeon almost naked and the heroine whipping him is not something ordinary filmmakers have depicted easily. The second hero's frilly ribbon-laced satin shirt (that looks like a blouse), arousal of horses to perform beyond potential, taming of wild women - *shudder*
A few weeks back, my wife walked in when Dharam Veer was on. She took one disbelieving look at the screen and asked, "Dharmendra in mini skirt. Zeenat in pants. What kind of film is this?"
Yes, really - what kind of film is this?
Awwal Number
I have written about this film several times already. Once, as a sports film. Then, as an Aamir Khan film. But still, I cannot get over the stupendous campiness of the film that had Aamir Khan blowing kisses and hitting sixes intermittently.
It had Pariskhit Sahni as a national selector, wearing a sleeveless t-shirt. It had the fantastic "Yeh hain cricket! Howzzat!" song, performed on screen by Dev Anand and Aditya Pancholi - that made mincemeat of all rhymes and meters but is quite crappily memorable nevertheless. It had an Indian team, who looked like truck drivers and the eleven (or thereabouts) faces changed in every scene. It had Australian cricketers looking exactly like the Indian ones. It had terrorists. It had vamps. It had a helicopter flying over a stadium to bomb it while a cricket match was on.
It also had an ex-cricketer, a Chairman of selectors and a Police Commissioner. The last three named was actually one person, who was also the director and producer of the film. You will never know the meaning of multi-tasking if you don't watch Awwal Number.
Mithun Chakraborty is like Shakespeare. Millions of followers have intensely studied him for centuries (okay, okay - decades, you pedants!) but they are still finding newer and more interesting stuff. Like Shakespeare, obscure canons are being discovered.
In between the flourish of Kanti Shah and his ambitious tackling of global issues, there have been directors who have spread the gospel in a low-key yet effective manner. Dalaal - in Bengali - is one such effort. Directed by Partho Ghosh (of 100 Days fame), the film is a scathing indictment of flesh trade and human trafficking in present day India.
My memory fails me when I try to remember the circumstances in which I ended up seeing this film in my mother tongue but it remains crystal clear when it comes to the scenes. And iconic songs.
And of course, there is the gem of a dialogue - "Ami duto jinish shojjho kortey parina. Ek, amar gramer apamaan. Aar, amar gamchhar apamaan." (Two things of mine can't be defiled. My village. And my towel.)
Yes, yes, I know - a gamchha is not a towel. Just watch the film.
Rarely, very rarely do we come across a work of art that changes us physically. People have joked that lifting War and Peace (or for that matter, A Suitable Boy) has built muscles. But those were just jokes.
Aankhen is that kind of art for me. With three double-roles, three heroines, two Chief Ministers, two water-drenched songs, one monkey and one leather-clad vamp, it expanded my bladder capacity substantially - since I could not tear myself away from the film even for a leak!
With the voluminous Shilpa Shirodkar entreating Govinda to 'come to her home' since her 'doors' and 'backyards' were free and elaborate plastic surgeries being executed to create lookalikes of CMs, I almost stopped breathing. I think I watched this film after a drinking session at a cheap-and-cheerful joint called Green Palace and the intense pressure on my bladder and brain for 180 minutes has made me a better - and sturdier - person.
You know you have started to grow up, when you start recognising heroines in films. And usually, there is a specific point which you can look back upon as your first childhood crush. For me, Saagar was that film and Dimple Kapadia that heroine.
Before people get scandalised completely, let me hasten to add that I saw the film some time after its release and not as the 11-year old I was when it came out.
Kamalhaasan's Tamil-infested Hindi, Rishi Kapoor's chubby goodness, RD Burman's scintillating score just paled into insignificance as Dimple took her early morning swim in the shimmering black swimsuit and emerged from the sea in her full glory. Add to that a song in a red chiffon saree that clung to her body then and to my mind ever since, you have hormonal dynamite.
There hasn't been a more impactful heroine in Hindi film history.
So, those are my five films.
You have to read MIHYAP for the five films that turned a Computer Engineer called Arnab Ray into a Global Dementor called GreatBong. But, is that all that there is to the book?
Well, Arnab writes honestly and vividly. And he writes about topics that are very dear - and close - to me. But then, I have read several books like that.
What sets MIHYAP apart and what I am really grateful to Arnab for is the fact that he is unapologetic about growing up in Calcutta and in the 1990s. He has actually made my adolescent world cool. What more could I have asked for?
So, those are my five films.
You have to read MIHYAP for the five films that turned a Computer Engineer called Arnab Ray into a Global Dementor called GreatBong. But, is that all that there is to the book?
Well, Arnab writes honestly and vividly. And he writes about topics that are very dear - and close - to me. But then, I have read several books like that.
What sets MIHYAP apart and what I am really grateful to Arnab for is the fact that he is unapologetic about growing up in Calcutta and in the 1990s. He has actually made my adolescent world cool. What more could I have asked for?