text:
- Research article
- Open Access
- Open Peer Review
A survey of schoolchildren's exposure to secondhand smoke in Malaysia
© Abidin et al; licensee BioMed Central Ltd. 2011
- Received: 2 February 2011
- Accepted: 8 August 2011
- Published: 8 August 2011
There is a lack of data describing the exposure of Malaysian schoolchildren to Secondhand Smoke (SHS). The aim of this study is to identify factors influencing schoolchildren's exposures to SHS in Malaysia.
This cross-sectional study was carried out to measure salivary cotinine concentrations among 1064 schoolchildren (10-11 years) attending 24 schools in Malaysia following recent partial smoke-free restrictions. Parents completed questionnaires and schoolchildren provided saliva samples for cotinine assay.
The geometric mean (GM) salivary cotinine concentrations for 947 non-smoking schoolchildren stratified by household residents' smoking behaviour were: for children living with non-smoking parents 0.32 ng/ml (95% CI 0.28-0.37) (n = 446); for children living with a smoker father 0.65 ng/ml (95% CI 0.57-0.72) (n = 432); for children living with two smoking parents 1.12 ng/ml (95% CI 0.29-4.40) (n = 3); for children who live with an extended family member who smokes 0.62 ng/ml (95% CI 0.42-0.89) (n = 33) and for children living with two smokers (father and extended family member) 0.71 ng/ml (95% CI 0.40-0.97) (n = 44). Parental-reported SHS exposures showed poor agreement with children's self-reported SHS exposures. Multiple linear regression demonstrated that cotinine levels were positively associated with living with one or more smokers, urban residence, occupation of father (Armed forces), parental-reported exposure to SHS and education of the father (Diploma/Technical certificate).
This is the first study to characterise exposures to SHS using salivary cotinine concentrations among schoolchildren in Malaysia and also the first study documenting SHS exposure using salivary cotinine as a biomarker in a South-East Asian population of schoolchildren. Compared to other populations of similarly aged schoolchildren, Malaysian children have higher salivary cotinine concentrations. The partial nature of smoke-free restrictions in Malaysia is likely to contribute to these findings. Enforcement of existing legislation to reduce exposure in public place settings and interventions to reduce exposure at home, especially to implement effective home smoking restriction practices are required.
- Secondhand smoke
- salivary cotinine
- schoolchildren
- self-reported smoke exposure
- smoke-free legislation
- enzyme-immunoassay method
There is established evidence linking Secondhand Smoke (SHS) exposures to poor health outcomes [1–4]. Among adults, exposures to SHS have been linked to outcomes such as chronic obstructive pulmonary disease [1], deficits in lung function [2], increased risk of adult-onset asthma [3], and increased risk of lung cancer [4]. SHS exposures among children have been linked with outcomes such as asthma [5], exacerbations of respiratory ill-health [6], otitis media [7], sudden infant death syndrome [8] and poor cognitive development [9].
In Malaysia, the prevalence of smoking in adults has been estimated at 25% [10]. This figure was derived from a cross-sectional study of more than 17,000 Malaysian respondents in 2004 (matching the ethnic distribution of approximately 56% of Malays, 21% Chinese and 11% Indians) and is similar to that obtained for other countries including Scotland [11]. However, unlike Scotland and the rest of the United Kingdom (UK), the Malaysian data is highly skewed by gender with a high smoking prevalence among males (47%) with significantly less among females (3%). As in many countries in the Western Pacific Region, Taiwan have a similar skewed distribution of smokers and a national survey in Taiwan reported that half of all women and children were exposed to SHS at home [12]. The percentage of homes in Malaysia where SHS exposure occurs may be similar to that found in Taiwan.
Most of the studies on tobacco smoke exposure among children identified parental smoking as the main contributor to SHS exposure at home, and in particular maternal smoking. An estimated 31.7% of children report living with a smoker in Scotland and with a similar figure reported in Wales [13, 14]. Elsewhere in the European Union, parental smoking prevalence in Greece was found to be the highest, estimated at 44% [15]. In the UK, children's exposure to SHS has been declining in recent years. The Geometric Mean (GM) of salivary cotinine as a biomarker of SHS exposures reduced from 0.6 ng/ml in 1996 to approximately 0.2 ng/ml in 2006 [16].
Article 8 in the World Health Organisation's (WHO) Framework Convention of Tobacco Control (FCTC) aims to reduce children's exposure to SHS. Ratification of the FCTC leads to the introduction of Smoke-Free Legislation (SFL) among its member countries with SFL being introduced in many countries in the last decade. The extent of SFL varies from country to country: some countries such as Scotland and Ireland have introduced complete smoke-free environments in all enclosed public spaces with very few exemptions. In Malaysia, signing of the WHO's FCTC was performed in 2003 with ratification in 2005. Legislation partially restricting smoking in public places was introduced in 2004 under the Control of Tobacco Products Regulations under the Food Act 1983 [17]. Smoking restrictions covered five types of locations in 2007 including government offices, health facilities, educational facilities, public transport and air-conditioned venues with further changes in 2008 to include a total of 19 public-space venue types as smoke-free [18]. The designated public areas where smoking restrictions are in place now include air-conditioned restaurants, public transport, internet cafes and shopping complexes. However, smoking is still allowed in some enclosed public spaces and many outdoor areas such as semi-enclosed eating establishments.
We are not aware of any literature describing the SHS exposure of Malaysian children other than a small number of publications on Malaysian adolescent active smoking [19–22]. Given the relatively low prevalence of maternal smoking in Malaysia compared to other countries, Malaysian children's SHS exposure may be lower than in other countries. One study of Malaysian university students measured urinary cotinine levels in 959 university students aged 18 to 24 years old and found a GM value among non-smokers of 4.6 ng/ml [23].
To our knowledge this is the first study of SHS exposure among schoolchildren in Malaysia and also the first study documenting SHS exposure using salivary cotinine as a biomarker in a South-East Asian population of schoolchildren.
This study is part of a larger cross-sectional survey looking at exposure to indoor air pollution and the effect on respiratory health in schoolchildren in Malaysia. Among the associated factors studied were SHS exposures from tobacco.
Data were collected during April to September 2009. The study was performed in two different areas of Malaysia, urban Kuala Lumpur and three rural districts in Negeri Sembilan. While not a strict representative sample of the Malaysian population, the two identified areas are broadly representative of Malaysian urban and rural communities. Kuala Lumpur was chosen because it represents the largest urban area in Malaysia with the city population making up approximately one quarter of the current total Malaysian population. Negeri Sembilan was selected to represent more rural or semi-rural Malaysian areas. It is located about 64 km south of Kuala Lumpur and much of the economic activity is centred around agriculture.
Ethical approval and permissions
Ethical approval was obtained from the College of Life Sciences and Medicine's Ethical Review Board, University of Aberdeen. Permission was also obtained from the Economic Planning Unit at the Prime Minister's Department in Malaysia. Approvals from respective schools were requested before the data collection commenced. Upon being granted permission to enter schools, arrangements were made with the school administrative board to ensure research was performed during a convenient time period. Written informed consent was obtained from parents.
Selection of schools and recruitment of participants
The children who took part in this survey were recruited from National (government funded) Schools listed in the Education Management Information System directory made available in the website of the Ministry of Education Malaysia. Primary educations in Malaysia consist of six years of education, Year 1 to Year 6, which begins at the age of 7 and ends at age 12. As only national schools were selected, the selections were not representative of the general school distribution in Malaysia with less representation of children from Chinese and Indian backgrounds. Forty schools in urban Kuala Lumpur and three rural districts in Negeri Sembilan namely the districts of Jempol, Jelebu and Kuala Pilah were contacted. In total 36 schools responded and gave their permission to be included in the study. In order to cover as large a geographical area of Kuala Lumpur and rural districts as possible, where responding schools were less than 2 km apart, only one was selected to participate. This selection was performed randomly. This resulted in a total of 24 schools selected to be included in the salivary cotinine part of the study. From each school, a minimum of two classrooms from the year 4 and year 5 groups were randomly chosen to be included in the study. All children in selected classes of each participating school were invited to take part in the study.
Questionnaires were completed by a parent or the guardian of the child who agreed to participate. Completed questionnaires were returned to the team of researchers within 3 days and prior to the collection of saliva samples which took place during school hours. The questionnaire collected demographic information and details of household smoking behaviours. Children were grouped into three categories by total household earnings using the classification given by the Department of Statistics, Malaysia [24]. The questionnaire was developed in English before being translated by a native Malay speaker. Part of the questions on smoking habits of parents were taken from previously validated questionnaire. All children were able to converse in Malay language. Questionnaires with missing information on gender, family structure, ethnicity, home smoking restrictions and family income were excluded from further statistical analysis.
Schoolchildren who took part were given a 48-hour location-activity diary to be completed. This diary enabled collection of location and activity data with a resolution of 30 minutes. Data collected included information on the activity and whether this was at home, in school or in another indoor or outdoor location. The diary also includes a column which enquired about the presence of SHS in the proximity of their location for every 30-minute interval. For this paper, only the information gathered from the total hours of SHS exposures for 48 hours was used for analysis to enable comparison between child self-report and parental-report of their child's SHS exposures.
Saliva sample collection
Saliva was collected from each child using a sterile dental cotton roll (Salivettes; Sarstedt, Germany) and based on a protocol similar to that used in the CHETS (Changes in child exposure to environmental tobacco smoke) and BHETSE (Bar workers' Health and Environmental Tobacco Smoke Exposure) studies in Scotland [13, 25]. Since this is a school-based study, sample collection was performed in schools in the presence of one of the research team [EZA]. Children were requested to place the cotton roll in their mouth for two minutes in order to produce an adequate volume of saliva for later analysis. Samples collected were kept in an ice box within 2 minutes of collection before being transported to the laboratory within 2 hours and being stored in a -20°C freezer pending analysis.
Cotinine analysis
All analysis was performed at the Specialised Diagnostic Unit, Biochemistry Laboratory at Institute of Medical Research in Kuala Lumpur, Malaysia. The concentration of salivary cotinine was determined using an Enzyme Immunoassay kit (EIA Cozart Bio-Science Ltd.). The concentrations of salivary cotinine were obtained by extrapolating optical density values from standard curves graphs obtained from analysis of standard concentrations from the standard cotinine calibrator set manufactured by Cozart. Cotinine concentrations were expressed in ng/ml. The analytical limit of detection for this method of analysis was derived from using a value which is three times the standard deviation of the blank standard concentration. The limit of detection is 0.1 ng/ml. For comparison purposes in our analysis we identified samples that had cotinine concentrations of 1.7 ng/ml and above. This value has been reported to be associated with impairment of endothelial function in children [26]. We also classified samples in relation to cotinine concentrations of 3 ng/ml and higher, a value representing the average salivary cotinine concentrations measured in highly exposed non-smoking bar workers prior to the implementation of smoke-free legislation in Scotland [25].
Statistical analysis
Data were entered and analysed using a commercial statistical programme (PASW Statistics version 18). Group data were explored and due to the skewness of cotinine distribution arising from a large number of lower cotinine concentration values, group cotinine concentration is expressed in GM. Samples with cotinine concentration of less than a limit of detection (0.1 ng/ml) were assigned an imputed value randomly sampled from the left tail of a truncated log normal distribution [13]. The differences of cotinine concentrations between two different groups were tested using the independent t-test and the differences between more than two groups were tested using ANOVA test and were further tested using post-hoc tests. Categorical variables were tested using the chi-square test with significance assigned where the p-value is less than 0.05. Variables found to be significant in the univariate analysis were then included in a multiple linear regression to identify predictors of the distribution of cotinine concentrations.
Response rates
Study information packs including questionnaires were distributed to 2775 children in 16 urban schools and 8 rural schools.
A total of 2018 (72.7% response rate) study packs were returned with 1785 of these having completed questionnaires and permission forms. However, from that figure, 1254 of the children had additional parental permission to participate in the saliva collection element of this study. Due to logistical difficulties and classroom absence on the day of data collection we managed to collect samples from a total of 1172 (93%) of children for whom we had consent to collect saliva. From this set 1064 (91%) saliva samples were successfully analysed by the laboratory to yield cotinine concentrations.
Characteristics of participants
Description of the selected sample population of Malaysian schoolchildren
Number opted out of study
(n = 721)I, a
Number consented to salivary cotinine study
(n = 1785)
Mean age (years ± SD)
10.7 ± 0.6
10.7 ± 0.6
10.7 ± 0.6
316 (43.8)
448 (42.1)
764 (42.8)
380 (52.7)
605 (56.7)
985 (55.2)
25 (3.5)
11 (1.0)
36 (2.0)
Family structure
Both parents
651 (90.3)
997 (93.7)
1648 (92.3)
Single parent
21 (2.9)
27 (2.6)
48 (2.7)
30 (4.1)
40 (3.8)
70 (3.9)
19 (2.6)
19 (1.1)
635 (88.1)
958 (90.0)
1593 (89.2)
67 (9.3)
106 (10.0)
173 (9.7)
19 (2.6)
19 (1.1)
435 (60.3)
688 (64.7)
1123 (62.9)
286 (39.7)
376 (35.3)
662 (37.1)
Home smoking characteristics ++
Non-smoking households
377 (52.3)
446 (41.9)
823 (46.1)
Smoking households
290 (40.2)
501 (47.1)
791 (44.3)
54 (7.5)
117 (11.0)
171 (9.6)
Family income ++
319 (44.2)
529 (49.7)
847 (47.6)
274 (38.0)
326 (30.6)
601 (33.7)
88 (12.2)
144 (13.5)
232 (13.0)
40 (5.5)
65 (6.1)
105 (5.9)
Distribution of SHS exposure
Salivary cotinine concentrations ranged from less than LOD to 12 ng/ml. Previous work has used a cut-off point of more than 15 ng/ml of salivary cotinine levels as evidence of active smoking [12] and so using this definition all study participants were classified as non-smokers.
The overall GM of salivary cotinine for the schoolchildren in this study is 0.46 ng/ml (95%CI 0.42-0.50) with a median of 0.72 ng/ml. Schoolchildren were categorised into two groups to discern whether they were living in non-smoking or smoking homes. From a total of 1064, the number of schoolchildren that could be included into further analysis is reduced to 947 due to missing information on household smoking characteristics.
Household smoking and children's salivary cotinine concentrations
Malaysian children's geometric mean salivary cotinine concentration categorised by adult smoking within the home
Smoke exposure at home (number of smokers at home)
GM cotinine
Total GM cotinineIII
(95% CI) ng/ml
Total (%)
Urban (n)I
Rural (n)II
Neither parent smokes (0)
0.38 (322)*
0.22 (124)*
0.32 (0.28-0.37)++
446 (47.1)
Father only smokes (1)
0.80 (240)*
0.50 (192)*
0.65 (0.57-0.72)++
432 (45.6)
Father and mother smokes (2)
1.54 (2)
0.60 (1)
1.12 (0.29-4.40)
3 (0.3)
Extended family member smokes (1)
0.73 (23)
0.42 (10)
0.62 (0.42-0.89)
33 (3.5)
Father and extended family member smokes (2)
0.86 (13)
0.63 (20)
0.71 (0.40-0.97)++
33 (3.5)
0.54 (600)
0.38 (347)
0.47 (0.42-0.50)
The presence of one or more adult smokers in the home was associated with higher GM cotinine concentrations when compared to children living in non-smoking households (0.32 v 0.65 ng/ml, p < 0.0001). Among children living with non-smoking parents, the GM salivary cotinine concentration was 0.32 ng/ml (95%CI 0.28 to 0.37). Children who live in households where only the father smokes had GM cotinine concentrations of 0.65 ng/ml (95% CI 0.57-0.72). Levels of cotinine concentrations were higher when more than one family member smokes, with the highest concentrations in the three children who had both a smoking mother and father with cotinine concentrations of 1.12 ng/ml (95% CI 0.29-4.40). Schoolchildren who lived with an extended family member who was a smoker had cotinine concentrations of 0.62 ng/ml (95% CI 0.42-0.89) and children living with a father and a family member who smoked had cotinine concentrations of 0.71 ng/ml (95% CI 0.40-0.97).
Relationship of salivary cotinine concentrations with socio-demographics and household characteristics
GM cotinine concentrations (GM cot (ng/ml)) and univariate analyses by different socio-demographic characteristics in Malaysian schoolchildren
Socio-demographic and household characteristics
Urban (n)I
Rural (n)II
Total (n)III
GM cot
GM cot
GM cot
Geometric mean
0.54 (688)*
0.36 (376)*
t = 4.069
p < 0.0001
Gender T
0.58 (284)
t = 1.144
0.35 (164)
t = -0.454
0.48 (448)
t = 0.559
0.51 (396)
p = 0.253
0.37 (209)
p = 0.650
0.46 (605)
p = 0.576
Education of father ++a
Middle school
0.81 (29)
0.36 (26)
0.57 (159)
High school
0.59 (399)*
p = 0.013
0.35 (245)
p = 0.035
0.49 (590)
p = 0.019
Diploma/Technical cert.
0.54 (81)
0.60 (45)*
0.58 (117)
0.38 (129)*
0.25 (44)*
0.35 (159)*
Occupation of father ++b
Manual non-skilled
0.46 (180)
0.40 (156)
0.45 (280)
Skilled worker
0.45 (101)
p < 0.0001
0.45 (64)
p = 0.122
0.44 (149)
p < 0.0001
Armed forces
0.91 (179)*
0.25 (30)
0.77 (198)*
0.41 (180)*
0.29 (79)
0.37 (242)
Family income ++
0.55 (262)
0.38 (209)
0.46 (528)
0.57 (225)
p = 0.163
0.35 (83)
p = 0.869
0.49 (327)
p = 0.269
0.41 (96)
0.36 (38)
0.39 (144)
SHS in household T
0.38 (322)*
t = -6.23
0.22 (124)*
t = -5.323
0.32 (446)*
t = -7.329
0.80 (278)*
p < 0.0001
0.51 (223)*
p < 0.0001
0.65 (501)*
p < 0.0001
Child's sleeping area ++c
Own room/share siblings
0.89 (207)
0.55 (162)
0.72 (369)
Living room
0.60 (52)
p = 0.169
0.84 (32)
p = 0.582
0.54 (84)
p = 0.067
Share with parents/adults
0.49 (18)
0.79 (28)
0.40 (46)
Use of air-conditioner ++d
0.59 (462)*
0.38 (295)
0.51 (702)*
Living room
0.35 (42)
p = 0.007
0.21 (11)
p = 0.490
0.34 (49)
p = 0.010
Child's sleeping area
0.36 (83)
0.28 (25)
0.32 (101)*
The use of exhaust system T
0.58 (508)*
t = 2.485
0.38 (314)
t = 1.511
0.50 (756)*
t = 2.699
0.41 (146)*
p = 0.013
0.28 (55)
p = 0.132
0.36 (184)*
p = 0.007
Smoking restriction in homes ++e
0.51 (437)
0.35 (233)*
0.45 (667)*
0.65 (139)
p = 0.117
0.38 (94)
p = 0.099
0.52 (230)
p = 0.032
0.75 (33)
0.71 (19)*
0.74 (52)*
The education and occupation of the father, the use of air-conditioner and exhaust fans were all found to be significantly associated with the GM cotinine concentration in univariate analysis. Having a father with a Diploma/Technical certificate as opposed to a College/University level education (0.58 v 0.35 ng/ml, p = 0.0019) and who worked in the Armed forces as opposed to those who were Managers/Professionals was positively associated with GM cotinine concentrations (0.77 v 0.35 ng/ml, p < 0.0001). The use of air-conditioning in the child's sleeping area was also associated with a significantly lower GM cotinine concentration compared to those who did not use air-conditioners (0.32 v 0.51 ng/ml, p = 0.010). Finally, the use of mechanical ventilation such as an exhaust fan in the home was associated with lower GM cotinine concentrations when compared to homes without the additional exhaust fan (0.36 v 0.50 ng/ml, p = 0.007).
Salivary cotinine concentrations were categorised into three groups of home smoking restrictions being practised in the households of the schoolchildren. The three categories were: 1) smoking not allowed (total ban), 2) smoking allowed with exceptions (limited area) and 3) smoking allowed without exceptions (no restriction). A significant difference in cotinine concentrations was shown between children who lived in households with total or no smoking restrictions (0.45 v 0.74 ng/ml, p = 0.032).
Parental perception and children's self-report of SHS exposures
Parental perception of their child's SHS exposures daily in comparison with SHS exposures reported by their child
Exposure hours to SHS daily
Parental-reported exposure
GM cotinine (n)~
1 to 3 hours
> 3 hours
Self-reported exposure
142 (61.7+%)
80 (34.8%)
8 (3.5%)
0.37~ (230)
1 to 3 hours
174 (44.2%)
184 (46.7%)
36 (9.1%)
0.51~ (394)
> 3 hours
17 (23.9%)
42 (59.2%)
12 (16.9%)
0.83~ (71)
GM cot (n/%) ++
0.38++ (333/47.9%)
0.59++ (306/44.0%)
0.69++ (56/8.1%)
GM cotinine concentrations distributed according to parental-reported SHS exposures were significantly different across all three categories of exposure hours. Similarly, self-reported SHS exposures were too found to be significantly different between the three groups. Cross-tabulation was performed and significant differences in the distribution of frequency between the parental-reported and self-reported exposures of SHS daily were observed from the Chi-square test. Of children who reported no SHS exposure (n = 230), approximately 38% (n = 88) of their parents reported that their child had some SHS exposure. Children were less likely to agree with parents who reported their child having zero SHS exposure. For the 333 parents who reported their children having no SHS exposure, some 69% (n = 191) of these children recorded at least one 30-min exposure in the previous two days.
Predictor of salivary cotinine concentrations
Multiple linear regression coefficients
Variable in the model
Unstd. B
Std. Error
Std. Beta
Rural (Ref)
Father only smoker
Father and Family smoker
Neither Parents smoke (Ref)
Occupation of Father
Armed Forces
Manager/Professional (Ref)
Education of Father
Diploma/Technical cert.
Degree/College (Ref)
Parental-reported exposure hours to SHS
1 to 3
None (Ref)
Air-conditioning in home
Living room
Child's sleeping area
None (Ref)
This study found that 52.9% of Malaysian schoolchildren were exposed to SHS at home, a much higher figure compared to studies in the UK [13–15]. Data from a previous study in Negeri Sembilan in Malaysia indicated that adolescents were exposed to parental smoking in 40% of homes [21]. In another study on smoking among young women in a private educational institution in Kuala Lumpur, Malaysia smoking among fathers was estimated at 50.9% [19], a value similar to that found in this study. We have compared our results to data from a study of salivary cotinine levels of similarly aged schoolchildren in Scotland [13]. We have compared our data to that available in Scotland because of the direct comparability of the age group sampled and the similar cross-sectional study design. Data from Scotland was gathered around the time SFL was implemented there in 2006 during a period of societal changes in attitudes towards SHS. Our data was collected during changes to Malaysian SFL and represents the exposure of children to SHS within a system of partial restrictions.
The overall GM value (0.46 ng/ml) of salivary cotinine from our sample of over 1000 Malaysian school children can be compared with other studies of children internationally. Delpisheh and colleagues measured salivary cotinine among children age 5 to 11 years old from low socio-economic areas in England and reported a GM of 0.37 ng/ml [27], while more recent data after the implementation of national smoke-free restrictions in the UK have produced GM salivary cotinine concentrations in 10-11 year old school children of 0.22 ng/ml in Scotland [13] and of 0.15 ng/ml in Wales [14]. Willers and colleagues measured cotinine concentrations among children aged 8 to 13 years old in Sweden and found median concentrations of 0.62 ng/ml among children who presented with asthmatic symptoms [28] lower than the median salivary cotinine value in our study (0.72 ng/ml).
An overview of selected studies looking at cotinine concentrations among children and youth globally
Authors and country
Type of study and cotinine sample
Size of population
Information of study
GM cotinine concentrations
Serum cotinine
Lazcano-Ponce et al. 2007
Mexico [31]
National Health Survey year 2000
76 and 83 children (<5 years)
Non-smoking homes and smoking homes
0.10 and 0.60 ng/ml for non-smoking and smoking homes respectively
Dove et al. 2010
National Health and Nutrition Examination Survey 1999-2006
11 486 non-smoking children/youth (<19 years)
Divided into 3 groups of extensive, limited and no SFL coverage
0.03 and 0.84 ng/ml for non-smoking and smoking homes in county with extensive SFL, 0.05 and 0.90 ng/ml for limited SFL, 0.07 and 1.13 ng/ml for no SFL coverage
Marano et al. 2009
National Health and Nutrition Examination Survey 2003-2006
5518 children/adolescents (3-19)
Non-smoking homes and smoking homes
0.05 and 1.05 ng/ml for non-smoking and smoking homes respectively
Salivary cotinine
Akhtar et al. 2007
Scotland [13]
National Survey from 111 schools
2559 and 2424 children (11 years) surveyed in 2006 and 2007 respectively
Children represented exposure before and after the implementation of SFL
0.14 and 0.07 ng/ml for children living in non-smoking homes before and after SFL
0.57 and 0.32 ng/ml for children living in smoking homes (father only smokes) after the SFL
Whitrow et al. 2010
England [32]
Survey in 2003-2004 among children from 51 schools in London
2311 children (11-13 years)
To differentiate exposure of SHS among whites and other ethnic groups
0.30 ng/ml and 0.84 ng/ml among White children living with no smokers and smokers (father only smokes) respectively
Jarvis et al. 2009
England [33]
Survey among children between year 1996 to 2007
13365 children (4-15 years)
Relationship between cotinine and smoking restriction in homes
0.22 ng/ml for non-smoking homes, 0.37 ng/ml (one smoker) and 0.71 ng/ml (two smokers) for smoke-free homes
1.67 ng/ml (one smoker) and 2.46 ng/ml (two smokers) for homes with no smoking restrictions
a Delpisheh et al. 2007
England [27]
Survey among children in low socioeconomic area in 2004
425 children (5-11 years)
Relationship between cotinine and respiratory symptoms
0.37 ng/ml for all children, 0.56 ng/ml among children living with a smoking mother and 0.38 ng/ml among children living with a smoking father
Holliday et al.
Wales [14]
National Survey from 75 schools
1750 children (10-11)
Children represented exposure before and after the implementation of SFL
0.17 ng.ml for all children before the SFL
0.15 ng/ml for all children after the SFL
Figure 1 illustrates the distribution of Malaysian children's salivary cotinine levels as compared to two important and relevant levels derived from two separate studies [25, 26]. The 1.7 ng/ml level has been implicated as a level where cardiovascular changes can be observed in children, while the 3.0 ng/ml figure reflects the average value found in heavily SHS-exposed non-smoking bar workers in Scotland prior to smoke-free legislation. From the findings of this study, 1 in 5 schoolchildren have cotinine concentrations at or above the 1.7 ng/ml threshold. The present study also found that approximately 1 in 20 Malaysian schoolchildren have salivary cotinine concentrations at or above the 3 ng/ml level. It is of concern that approximately 5% of 10-11 year olds in Malaysia may be experiencing SHS exposures of similar duration and intensity to those experienced by hospitality workers prior to smoke-free restrictions.
Children living in non-smoking homes in Malaysia (0.32 ng/ml) have GM salivary cotinine levels nearly 5 times higher than those of Scottish children (0.07 ng/ml) [13]. This finding is suggestive of the fact that the partial nature of smoking restrictions practiced in Malaysia leads to considerable non-home exposure when compared to Scottish children. Exposures of SHS among children living with non-smoking parents have been shown to be reduced where comprehensive smoke-free legislation is introduced [13]. Smoke-free legislation can play an important role in reducing the intensity and duration of children's exposure to SHS in settings outside of the home.
In the multiple regression analysis, one of the strongest predictor of children's GM salivary cotinine concentration was having a father who smoked. The skewed gender distribution among parents in this study confirms what is already known about the smoking characteristics of adults in Malaysia [10]. This study however reports a lower prevalence of maternal smoking (0.3%) compared to the Malaysian National Health Morbidity Survey III (1.6%) [34].
Household smoking 'rules' or restrictions have commonly been used in other studies as a means of assigning potential exposures [33, 35]. Children living in homes with total smoking restrictions had GM cotinine concentrations that were approximately two-thirds of children living in homes with no smoking restrictions (0.45 v 0.74 ng/ml). There is a greater difference in rural homes than urban homes, suggesting more outside home exposure to SHS in urban children. From the multiple linear regression living in the urban areas was one of the strongest influences on the levels of salivary cotinine concentrations in children. We do not know why this may be but some possibilities include the possibility that urban-living parents smoke more and/or the fact that urban children have more outside home exposure to SHS during transport to school or within cafes and restaurants commonly available in urban areas.
This study reports disagreement between children's and parental report of exposure hours to SHS. The differences observed for the exposure hours in this study could be explained by parental awareness of negative implications associated with SHS exposure which may have lead to the under-reporting of exposures, especially among parent who are smokers themselves. One study have mentioned that parental-reported SHS exposures may be unable to identify exposures occurring outside of home during time spent away from the parent [36]. This study indicates that parental report used in many studies looking at children's exposure to SHS smoke may underreport actual exposure to SHS and this point should be considered in future epidemiological studies [37, 38].
Limitations of study
The schools selected in this study under-represent children of Chinese and Indian backgrounds. As the Malay population has been reported to have the highest prevalence of current smokers (28.9%) compared to the Chinese (18.7%) and Indians (16.8%) in Malaysia, it is likely that the findings of this study over-estimate the exposure of Malaysian schoolchildren at a national level [10]. Additionally, cotinine concentrations were found not to be significantly associated with family earnings unlike studies in the UK [13, 27]. It is acknowledged that a larger portion of the respondents in this study comes from families categorised within the lower socio-economic levels according to the self-report of family income data however the differences were not significant. The participants in this study are over represented by schoolchildren coming from low to middle socio-economic levels. The percentage of non-smoking households observed among participants who were not involved in providing saliva samples were found to be higher than the participants who were involved in providing the saliva samples. The percentage of non-participating children who lived in non-smoking households was 56.5% compared to 47.1% of participating schoolchildren. Schoolchildren who provided saliva samples in this study were thus more likely to come from households with smokers and so again it is more likely that this study may over estimate cotinine concentrations of the wider population of Malaysian schoolchildren. For these identified reasons, it is important that the results from this study are interpreted with care and not generalised to the whole of the Malaysian population.
Children's smoking status was defined as non-smoker on the basis of their salivary cotinine levels being less than 15 ng/ml. Our study did not enquire about the smoking status of children directly as this would have been culturally sensitive. However, we note that only 2 out of 1064 schoolchildren have cotinine concentrations above 10 ng/ml and only 15 out of 1064 have cotinine concentrations above 5 ng/ml. Thus, we do not think smoking was common among this population.
The findings of this study provide new and important information on salivary cotinine concentrations among schoolchildren in Malaysia. Over half of schoolchildren in Malaysia live with one or more adult smokers. The GM of salivary cotinine concentrations of Malaysian schoolchildren after the implementation of smoke-free legislation in Malaysia is 0.46 ng/ml and is significantly higher among schoolchildren living with smokers at home when compared to children living with non-smokers.
Overall, Malaysian schoolchildren living in non-smoking households have higher salivary cotinine concentrations than children of similar ages in other countries, suggesting a significant amount of Malaysian children's SHS exposure occurs outside the home. The partial nature of smoking restrictions in semi-enclosed public areas in Malaysia may be one possible explanation for this. More research is required to identify the sources of exposure of Malaysian children to SHS. There is a need to examine the proportion of children's SHS exposure that arises during home life and that from time spent in public places. Given that about 5% of Malaysian children have salivary cotinine values comparable to heavily SHS-exposed bar workers there is also clearly a need for policies and interventions to reduce children's SHS exposure in Malaysia. From the findings of this study, it is legitimate to consider whether current Malaysian smoke-free legislation is sufficient to protect children from SHS exposure in public spaces.
Authors' information
EZA is a PhD student in the field of Environmental Medicine at the University of Aberdeen. SS is a senior lecturer based in the Environmental and Occupational Medicine group at the University of Aberdeen. AO is a biochemist in the Institute of Medical Research, Malaysia. HAR is an associate professor at the Department of Community Health, Faculty of Medicine and Health Science, University Putra Malaysia. SWT is a paediatrician and senior lecturer at the Department of Child Health, University of Aberdeen. JGA is the director of the Institute of Occupational Medicine, University of Birmingham.
Acknowledgements and funding
We thank the Institute of Medical Research, Malaysia for the technical expertise and the use of their facilities for analysis purposes. We thank Dorothy Currie for the help given on the statistical analysis of the cotinine concentrations.
This study was supported by the Scottish Centre for Indoor Air, University of Aberdeen, the Ministry of Higher Education Malaysia and Department of Community Health, Universiti Putra Malaysia.
Authors' Affiliations
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Pre-publication history
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


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Cambridge, 3 November 2011 -- Over 75 educators, students, higher education faculty, members of non-profit organizations, representatives from national teacher unions, and other stakeholders participated in the conference Building a Strategy for Human Rights Education in U.S. Schools, which took place in Cambridge, MA, on September 16th-17th. The event was co-sponsored by the Harvard Graduate School of Education, the Carr Center for Human Rights Policy of the Harvard Kennedy School of Government, HREA, the National Education Association and the University of San Francisco's School of Education.
The sharing and planning work of the conference resulted in the development of a draft national strategy for HRE. Moreover, a decision was taken to initiate a new network for human rights education in the U.S.A., which is anticipated to be formally launched in 2012. At the present time, an Interim Steering Committee is working closely with conference members in laying the institutional foundation for this new network. In the meantime, voluntary regional representatives have already begun work in different parts of the country in organizing local events and coordinated efforts are anticipated in relation to the forthcoming Human Rights Day (December 10th) and the anticipated passage of the UN Declaration on Human Rights Education and Training by the General Assembly in New York in December.
The overall purpose of the network will be to promote the capacity of members to integrate human rights principles into the formal and non-formal learning environments for youth, with a central focus on schools. This work will involve engagement with curricular standards, pedagogy and learning materials, public awareness raising, teacher training, and scholarship. Those interested in learning about forthcoming Network developments and events are welcome to send their contact information to email@example.com.
Eighty educators and policy makers gather at Harvard University to develop collaborative efforts in human rights education (15 September 2011)

subset: commoncrawl


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Morning Light – March 14th, 2016
Today: [Job Ten] Was it Necessary for Job to Suffer? In this chapter Job insists that God is plaguing him unfairly. Job's friends on the other hand insist that Job is in sin otherwise he would not be going through all of his trouble. Which is correct? Is Job a righteous man being tested by God? Or is he in sin and being punished by God? Is this God, or the Devil? Or is there another place where Job's vulnerability to suffer originates that could suggest that none of what he went through was even necessary?
[Job 10:1-22 KJV] 1 My soul is weary of my life; I will leave my complaint upon myself; I will speak in the bitterness of my soul. 2 I will say unto God, Do not condemn me; shew me wherefore thou contendest with me. 3 [Is it] good unto thee that thou shouldest oppress, that thou shouldest despise the work of thine hands, and shine upon the counsel of the wicked? 4 Hast thou eyes of flesh? or seest thou as man seeth? 5 [Are] thy days as the days of man? [are] thy years as man's days, 6 That thou enquirest after mine iniquity, and searchest after my sin? 7 Thou knowest that I am not wicked; and [there is] none that can deliver out of thine hand.
In the previous chapter and in this chapter Job continues to answer Bildad. Bildad in his remarks echoes the criticism of Job and the insistence that Job must be in sin because (in Bildad's view) the suffering of Job is at God's hand and therefore Job must have done something to provoke God's anger and is being justly punished.
In this chapter Job again expresses his exhaustion. He has suffered great loss and his body is also ravaged with boils. In verse two he addresses not the men with him but God Himself. He askes God not to condemn him. He asks God to show him what he has done to provoke such terrible suffering which Job (in agreement with his friends) believes originates with God as well. If you read what the commentators say about this book you will find they also agree with Job, Bildad, Elipaz and Zophar that it is God that is plaguing Job. Of all the contention in the book itself and in the views of the various scholars in the book the majority seem to agree on this – whatever the reason Job is suffering it is God doing it to him.
First of all is God mad at Job? In Job 1:8 we see that is not true. In this verse when Satan challenges God concerning Job – the Father describes him as an upright man, even a perfect man, who fears God and declines from evil. So whatever Bildad and Job's other friends may believe we know from the perspective of the divine narrative that God is not made at Job. What can we learn from this? Just because someone is suffering does not mean they are suffering because of wrongdoing in the eyes of God. When you go through a trial it is natural to ask "what did I do wrong?" The fact is that suffering is no indiciation that you have done anything wrong. We live in a fallen world. This world is a battlefield spiritually speaking and there are many factors that come into consideration regarding the origin of human suffering.
Is one of the factors of human suffering that it originates with God. Job asks God to explain why He is contending with Him. Job and his friends agree that it is God doing this. Is this true. When Job uses the word "contention" to describe God's posture toward him – he is describing God as an opponent and an adversary. Is this true? Is God the adversary or is the devil the adversary? What do we see God doing in the book of Job? The only thing we see God doing in the book of Job is putting a hedge around Job (Job 1:10). When Satan challenges God and calls on God to harm Job God's reply in Job 1:12 is to point out that Job was already in Satan's hand (which was why God was protecting him). Why was Job in Satan's hand? Because Job 3:25 shows Job confessing fear – in fact saying that the thing he feared had come upon him.
In verse 3 Job says that God is oppressing him. Is this true? Is God the oppressor? In verse 6 he accuses God of putting him through these sufferings in order to find something wrong with him. Is this true? Is God oppressing Job? No, we have shown in the paragraph above this is not true. Is God testing Job to see if he will sin? James wrote that God does not do this:
[Jas 1:13 KJV] 13 Let no man say when he is tempted, I am tempted of God: for God cannot be tempted with evil, neither tempteth he any man:
In thinking that God is tempt him Job reveals his view of God. He sees God as having a predilection to condemn man rather than to love man. In v. 7 Job insists that God knows he is not in sin and knows that he is not wicked, however Job continues, even though God knows he is a just man He is brutalizing him anyway (unfairly in Job's eyes) and therefore there is no escape.
8 Thine hands have made me and fashioned me together round about; yet thou dost destroy me. 9 Remember, I beseech thee, that thou hast made me as the clay; and wilt thou bring me into dust again? 10 Hast thou not poured me out as milk, and curdled me like cheese? 11 Thou hast clothed me with skin and flesh, and hast fenced me with bones and sinews. 12 Thou hast granted me life and favour, and thy visitation hath preserved my spirit. 13 And these [things] hast thou hid in thine heart: I know that this [is] with thee. 14 If I sin, then thou markest me, and thou wilt not acquit me from mine iniquity.
In v. 8 Job acknowledges that God made him and fashioned him and doesn't understand why then God is working to destroy him. Note the exaggeration: is Job destroyed? No. Is God working to destroy him? No. Who is the destroyer? Satan. Many people would argue with this and quote many scriptures where they see God raining down just destruction upon hapless victims, however remember the following verse:
[Luk 9:56 KJV] 56 For the Son of man is not come to destroy men's lives, but to save [them]. And they went to another village.
When Jesus came the purposes of God henceforward were constrained within the limits of His character and He plainly says it is not his will to destroy. So if you are going through something destructive it is not God doing it. If you see someone else suffering, even if you think they are suffering for rejecting Christ or committing evil it is not God doing it. From the day that Jesus was born God has done nothing outside of Christ and Jesus states plainly that he is not the destroyer.
Job goes on to ask God to remember that he is but flesh and blood. He suggests that God has overlooked his frailty as a mere man. Is this true? Is God ignoring the humanity of Job? Heb. 4:15 tells us that God is touched through Christ with the feeling of our infirmities and in Ex. 20:6 that he shows mercy and lovingkindness to thousands. In both the Old and New Testament God consistently is seen as a merciful God who is mindful of our limitations. Therefore in fact God has not forgotten Job's human frailty. It is not God putting Job through this. Job placed himself through unreasoning fear in a place of vulnerability that attracted Satan to him. The only thing we see God doing is lifting the hedge off of Job – not because He is mad at him but because of Job's persistent fear that eventually places him in a position that God would have to violate his own character to continue protecting him from the fear that he won't let go of.
[2Ti 1:7 KJV] 7 For God hath not given us the spirit of fear; but of power, and of love, and of a sound mind.
The fear that Job had concerning the destruction of his family did not come from God. Job entertained ungodly fear. He was a worrier. Worry consumed him. Rev. 21:8 says that fear is a sin and not some unchangeable psychological defect. Why is fear a sin? Because it challenges the understanding of the love of God and suggests that God cannot be trusted. Therefore because Job allowed this fear to continue day by day eventually in spite of all that God did to bless Job and prove His goodness consequences would result – not because God was being unreasonable but because Job chose to be unwilling in fact to see himself as unable to eliminate the fear in his life.
Was Job unable to remove fear in his life? What about you? Are you a worrier? Do you fear problems? Are you always waiting for "the other shoe to drop?" Is this an attack of the enemy causing you to fear or is it something you are responsible for? Should others feel sorry for you because you are in fear or should you take responsibility and do something about it? Paul said this:
[2Co 10:5 KJV] 5 Casting down imaginations, and every high thing that exalteth itself against the knowledge of God, and bringing into captivity every thought to the obedience of Christ;
In the bible you will find 365 "fear not" statements. One for every day of the year. This is obviously then something that we can do something about and something that Job could have but did not deal with. God is not plaguing Job. God is not mad at Job. God is not persecuting an innocent Job. Job has sown thoughts of fear that he did not deal properly with and is therefore suffering unnecessarily.
15 If I be wicked, woe unto me; and [if] I be righteous, [yet] will I not lift up my head. [I am] full of confusion; therefore see thou mine affliction; 16 For it increaseth. Thou huntest me as a fierce lion: and again thou shewest thyself marvellous upon me. 17 Thou renewest thy witnesses against me, and increasest thine indignation upon me; changes and war [are] against me. 18 Wherefore then hast thou brought me forth out of the womb? Oh that I had given up the ghost, and no eye had seen me! 19 I should have been as though I had not been; I should have been carried from the womb to the grave. 20 [Are] not my days few? cease [then, and] let me alone, that I may take comfort a little, 21 Before I go [whence] I shall not return, [even] to the land of darkness and the shadow of death; 22 A land of darkness, as darkness [itself; and] of the shadow of death, without any order, and [where] the light [is] as darkness.
In verse 15 Job declares that he is confused about the whole ordeal he is facing. In v. 16 he tells God that He is hunting him as a fierce lion who will not relinquish the prey. Is God hunting Job as a lion? Is there anyone who does enter our life in such a way? Peter no doubt was thinking of the book of Job when he penned the following words:
[1Pe 5:8 KJV] 8 Be sober, be vigilant; because your adversary the devil, as a roaring lion, walketh about, seeking whom he may devour:
So what is Job doing? He is attributing the works of the devil to God. This is very nearly the classic definition of blasphemy. Blasphemy is attributing the works of God to the devil. Job comes very close to this as do we all when we see the work of the devil and say that it is God doing it. Is God the roaring lion preying upon the souls of men? No – this is the work of the devil. It is the devil that is tormenting Job and unfortunately Job and his friends all think without pause that it is God doing it. There is at this point in Job no indication that they even believe the devil exists much less that it is he that is harming Job because of Job's failure to deal with fear, unreasoning fear in his own life.
In v. 17 Job declares that God is bringing witnesses against him as a prosecutor. Is God doing this? Is God the accuser or is the devil? Job conclused his remarks by wishing for death and describing the world around him as being without order in complete chaos. Is the world around Job in chaos. No God is still in control. What is going on then? Job has made himself vulnerable by unreasoning fear and worry and therefore is suffering unnecessarily.
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Nice to Brodie Croyle staying in for 3 whole quarters before getting injured.
Speaking of consistency...what were the Seahawks expecting when they signed Julius Jones? If he could only average 3.6 yds a carry last year behind Dallas' offensive line, did they expect better from him behind the Seahawk's line?
Kellen Clemens won't be a Jet this time next year. Just a hunch.
I'm sure Roger Federer, winner of his fifth straight U.S. Open, would like to personally thank each and every one of the writers who said he was finished, and tell them to kiss his posterior, softly and gently.
Reggie Bush had a good day catching 8 passes out of the backfield, including a nice catch and run through the flat for a TD. But, even with a 26 yard run to his credit, Bush still only averaged 3.6 yards a carry and needed a guy named Pierre Thomas (who averaged 5.2 yards a carry) to cover him for the runs up the middle. Bush might be an exotic weapon for the Saints to utilize, but I can't see him ever being a reliable running back.
The series of the Rays-Red Sox is really exciting and should be heck of a lot of fun to watch—but ultimately irrelevant, because the Angels take the AL, hands down.
The official Andaplayertobenamedlater.com Man of the Week Award goes to Michael Turner of the Atlanta Falcons, for his completely sick day he had on Sunday. 220 yards on the ground, with 2 TDs and a whopping ten yards per carry average. Granted it was against the Lions, but still...an awesome day. Congrats, Michael.
And finally...has anyone noticed the NFL Networks use of Morrissey's 'Every Day Is Like Sunday" as their new theme song. First of all, it's a lame faux-country, peppy remix of Morrissey's ballad of depression, now used as a rallying cry for football fans everywhere—sorta like using the Ramones "I Wanna Be Sedated" for a anti-depression drug commercial. Anyway, here are the lyrics for the song, and let me know if you think the NFL is retared for using this song.
Trudging slowly over wet sand
Back to the bench where your clothes were stolen
This is the coastal town
That they forgot to close down
Armageddon - come armageddon!
Come, armageddon! come!
Everyday is like sunday
Everyday is silent and grey
Hide on the promenade
Etch a postcard
How I dearly wish I was not here
In the seaside town
…that they forgot to bomb
Come, come, come - nuclear bomb
Everyday is like sunday
Everyday is silent and grey


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Your entire life history is your most valuable resource and our action-oriented mentoring, coaching, and counseling are here to support your growth.
Buy James' Video Education Series!
This series is James' way of getting his teachings to everyone around the world. This six episode series encompasses all the different aspects of James' methodologies. If you want to learn more about your ADHD, your loved ones ADHD, or how to better treat it as a professional, this series is for you!
Find out more here!
Share Your Story!
Do you have a mental or emotional storm so epic or unbelievably chaotic you have to tell someone? Well now you can! Submit your story at the Storm Stories tab to become apart of our online ADHD community. Also, each month, James will pick a story submitted to the page to feature on his podcast, The Complex
The Emotional Distress Syndrome of ADHD
The Emotional Distress Syndrome (EDS), identified and coined by James Ochoa, is the cumulative effect of the neurological processing differences and behavioral challenges associated with ADHD. The chronic, lifelong nature of ADHD–related stress can increase to such a level that it becomes a syndrome akin to post-traumatic stress disorder (PTSD).
If you'd like to learn more about EDS and techniques to lessen its effects on your life, be sure to check out James' book Focused Forward and his podcast The Complex
As you come to terms with your ADHD, post this list somewhere you'll see it to remind yourself of why you're on this journey of understanding
Action-Oriented Mentoring, Coaching and Counseling
Do you seek to embrace your life as never before? Welcome to The Life Empowerment Center (TLEC), where founder and director James Ochoa, LPC combines mentoring, coaching and counseling to help ADHD adults devise custom-tailored solutions for their challenges. We strive to maintain an atmosphere of openness and acceptance; we pledge to keep the insights coming. At TLEC, we take on ADHD in a way we believe is truly new–with you, the client, as our collaborator and valued assistant. In short: there's hope. Even if you don't have ADHD, you will benefit from our services. In today's world of higher stress, overwhelm and chaos, all our services could help you reach greater potential. Again, welcome.
Click one of the links below and let us show you around.
Listen to James give his best tips On The Right ADHD Trail
The Video Education Series is done!
Listen to James' Podcast - The Complex
James is published in The Huffington Post!
"James Ochoa is a fantastic teacher. He explains complex issues and concepts in a way I'm able to understand. His mentorship and coaching have helped me grow exponentially. His office staff is exceptionally friendly, and his office is relaxing and inviting.
"James is a talented business and life coach. He has an uncanny ability to think outside the box, and he holds each of his clients accountable to their goals and objectives."
"James is a gifted therapist and innovator–Austin's answer to Attention Deficit Hyperactivity Disorder."
"I knew that I was suffering from PTSD from a sequence of traumatic events that spanned 7 years. I had seen several therapists, and found some support and comfort, but nothing that seemed to help me find my way back to the person I once was. However, in just 2 sessions with James, I felt better and stronger than I had in years. James explained how my ADHD was contributing to my trauma, creating an obstacle to my recovery. I feel like I've gotten my fight back."
"James is effective–he does not waste time! He identified my problems and moved quickly to workable solutions. Any executive wanting personal or professional traction should strongly consider working with James."
"James has been the biggest positive influence in my career.He has also been my
personal coach and mentor for the past twelve years. I highly recommend his integrity
and know-how."


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Road Construction Exploding in North County, Sets Foundation For Future Growth
Ted Owen/San Diego Business Journal
One of the advantages of living in North County is that every day when you head to work something new has happened overnight. The construction crews along with California Department of Transportation teams have been wearing night-vision goggles for a long time now. It is hard to believe, but in the black of night they can build billion-dollar freeways, bridges and on- and off-ramps. I live in Escondido and travel each day to Carlsbad. As I approach the freeway on-ramp at Via Rancho Parkway I have to slow to a snail's pace to see where the ramp has been moved to overnight. The other day I saw four cars go the way they thought was correct and ended up looking at the busy end of a giant bulldozer.This small example of growing pains is just one in dozens going on across the county. Here are two examples of interconnecting arteries that at one time did not even exist:
• In San Marcos the new extension of Twin Oaks is slated for a ribbon-cutting ceremony Sept. 6. The No. 1 goal of the roadway is to connect the 8,000-resident community of San Elijo Hills with the rest of the city. Nearly one-third of the city has had to find alternative routes to travel in an east-west direction. San Marcos leaders expect more than 25,000 vehicles to use the new 2.4-mile route by 2010. Rancho Santa Fe Road has been the alternative of choice during the endless wait for the new connector. The $25 million project was originally penciled to open in the summer of 2006. The terrain used for the carving out of the new artery was some of the toughest in the region to traverse. READ THE ENTIRE SAN DIEGO BUSINESS JOURNAL ARTICLE


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Why so sad, Sara?
In Wednesday's episode of CSI on CBS, Sara (Jorja Fox) will deal with her long-distance marriage with Gil (William Petersen) in an episode titled "Forget Me Not."
"The implication is that they have been having a sort of beautiful … if not stuck … romantic, long-distance marriage," Fox tells EW exclusively. "He's been on the move, leading his nomadic life. But there comes a time when you can't leave a pivotal story suspended forever. All these characters around her are enjoying flirtations and romances. Sara is too young to sleep alone!"
Does that mean she doesn't want Gil anymore? Fox is predictably coy, though she admits there are still plenty of fans out there who want Petersen, who was last seen on the show via a Skype conversation in 2011, to return. "When I go out in the world, people continue to ask when Grissom is coming back. It's extraordinary," she tells EW. "You never really know, which is true. We labored so intensely over the Sara and Grissom arc from seasons 3 to 8 and we never really imagined there would be a season 13. And here we are with the opportunity to open a new chapter that we never thought we were going to get. Along with the darkness and violence, somewhere there is love and peace."
But will that be the case for Sara? See for yourself.


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Friday, October 5, 2012
Melody Club - Crossfire (studio-version)
New Melody Club's single "Crossfire" is already tested on the radio and here we can finally listen to it in a studio-quality. As it could be heard from band's performance at Nyhetsmorgon the song co-written by Oscar Holter and Jakke Erixson has actually become "The Hunter"'s follow-up with its arena feeling and very strong entry for Melody Club's compilation released last week.
- Ярлыки: Crossfire, Melody Club
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Автор: Damian на 5:02 AM
Ярлыки: Crossfire, Melody Club
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What It Takes To Become A Heavy Equipment Operator
Do you dream of becoming a heavy equipment operator? It doesn't matter if you're male or female as this job is not gender biased and an operator's job is not limited to handling heavy tipping truck only. If you have the ability to operate heavy and large equipment, can work in a team, have exceptional communication skills, and can accept suggestions and feedbacks then a flourishing career as a heavy equipment operator is waiting ahead for you.
Some of the machines commonly operated by heavy equipment operators are bulldozers, excavators, power shovels, scrapers, backhoes, graders, loaders, heavy duty tippers, vibratory road rollers, drilling machines, cranes, forklifts, asphalt pavers, pipe layers, and many more. These operators are required to operate, maintain, and adjust huge and heavy machineries that are commonly used in construction, mining, logging, fishing, pipeline, road building, forestry, commercial, and institutional industries. Some operators start with their own businesses, whilst others with experience obtain jobs as safety officers or supervisors.
Aside from the qualities mentioned above, a heavy equipment operator must be a safety-conscious and a responsible individual with physical strength and stamina, good hearing and vision, the ability to work independently, aptitude for computer and mechanic skills, manual and finger dexterity with eye-hand and foot coordination, good reflex skills, and must be self-disciplined. He must be at least 18 years old and must have a commercial driver's license, a certification for specific equipment, and preferably with experience. Drug and alcohol tests may also be required during the screening.
Training and skills are also required before one can operate and maintain these huge and powerful heavy machineries. These skills can be acquired through apprenticeship programs that includes classroom and on the job trainings as well as maintenance and servicing. At the same time, in this apprenticeship program one has to complete a mandatory number of hours to get a Certification of Qualification, which may extend from one up to five years depending on the specific trade.
After completing all the requirements, passing the certification examination, and receiving the Certificate of Qualification, a person then becomes eligible to work as an operator. This type of work is often seasonal and can involve long hours depending on the type of weather. Normally, heavy equipment operators work for eight hours a day and five days in a week. One may be required to work overtime if the work increases. Safety is always the main priority when training and at the workplace.
Useful Links:


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I was dismayed to see that last week's story on the School Administrative District 51 School Board meeting did little to clarify facts and much to perpetuate the ongoing divisiveness that has been the hallmark of this board.
I do not need to reiterate the details of the security system that have been discussed at no fewer than three board meetings. What has been missing from these discussions is the acknowledgement that our superintendent, Robert Hasson, has an exceptional record of improving student achievement in our district and an outstanding reputation as an educational leader in our state. He has earned our trust, and when he admits that he made an error in keeping the board informed about changing recommendations, it is time to accept the apology, pay the bill and focus on the school's mission rather than personal agendas.
Last September, I joined a large contingent of citizens who expressed deep concern over the lack of respect and civility on the board. Clearly, the issues have not been resolved, the political gaming continues, and back-room deals have become the norm. I will reiterate my statement from the fall:
We expect board members to put the students first and to focus on the established priorities in collaboration with the superintendent. Respecting the resources of the community is commendable; putting cost containment above the interests of the students is reprehensible.
Tara M. Hill


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Book Review : The Watch That Ends the Night
The Watch That Ends the Night by Allan Wolf. 2011.
The news of the sinking of the Titanic shook the world, and now, almost a century later, the event still fascinates people. And with the 100th anniversary of the disaster coming up in April 2012, I've been excited to see a number of new titles, both fiction and nonfiction, about the doomed ship.
The events in The Watch That Ends the Night by Allan Wolf begin before the Titanic sets sail. The subtitle—Voices from the Titanic—exactly describes this free-verse novel, which is told by 24 different people and objects that played a part in the days before and after the sinking. Some of the voices are from well-known historical people—Captain Smith, Bruce Ismay of the White Star Line, John Jacob Astor, Margaret "Molly" Brown, wireless operator Harold Bride. Others are not so well known or are fictional, and they include crew members and passengers from all levels of society, and even the rats on board ship.
And the iceberg itself has a voice, as it is "calved…with a splash in Baffin Bay. / Since then I've traveled southward many weeks, / for now that my emergence is complete, / there is a certain ship I long to meet."
Most accounts of the Titanic disaster end with the rescue of the survivors by the RMS Carpathia, or with their arrival back on land. But Wolf takes us back to the disaster site with the ship MacKay-Bennett as its crew recovers the bodies. John Snow, a local undertaker from Halifax, Nova Scotia, traveled on this ship, in order to try to identify the bodies and to keep track of their personal items. Personally, I have never read—or thought—about how the bodies were retrieved, but Wolf gives Snow a chance to be heard.
The Watch That Ends the Night is very readable, but intense. I have such a love-hate relationship with the story of the Titanic: it is fascinating, exciting, dramatic…and so sad. When my older son Alex was almost 4, I read him a book about glaciers (we received a book each month in the Let's-Read-and-Find-Out Science series), which talked about icebergs and mentioned the Titanic. We also happened to watch the National Geographic video about the disaster and Bob Ballard's discovery of the Titanic's resting place. Alex was fascinated and would watch the video every day, but I never got used to it. (Alex watched it so much that it didn't help for me to go into another room, because I knew what was happening from hearing the music.) But this book was mesmerizing, and I read it in two days, all 456 pages, including author's notes.
These notes at the end of the book provide a huge bonus for those who want facts. Over twenty pages of notes explain what happened to the owners of the voices as well as the fates of all historical people mentioned in the text. The Morse code alphabet is provided, with translations of the messages that are coded in the text. There are several pages of miscellaneous facts about the Titanic…everything from how many rivets were on the ship to the number of dogs aboard (and that survived) to the time it took for the ship to reach the ocean floor*. (Note to Mackin Collection Development staff: Guess what the trivia questions at our next staff meeting will be about.) And finally, pages and pages of resources are included for those who want to learn more.
In his author's note, Wolf states that his aim in writing this book was not to present history, but to present humanity. The people whose voices we hear "lived and breathed and loved. They were as real as you or me. They could have been any one of us. And that is why, after a century, the Titanic still fascinates."
*3,000,000 rivets, 12 dogs (3 survived), 30 minutes


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Wild West Cabin (Cabin 9)
Enjoy a game of pool...
or check out the wonderfull view from the back deck...
Or just take it easy and get cozy by the fireplace to enjoy watching the game on the flat screen in HD!
The Wild West cabin is a high end two story cabin. Everything is top notch from the fixtures to the oak wood flooring to the tile work in the bathrooms. The cabin sits on a mountain top with a breathtaking view.
The Wild West Cabin Includes:
- 2 large queen beds, 1 queen sofa sleeper, 1 large full bed, 1 large twin bed
- Brunswick pool table
- 4 LCD flat screen TV's each with built in DVD players
- Satellite TV with movie channels, living room TV is High Definition
- Samsung HE washer and dryer with complimentary laundry detergent
- Fully equipped kitchen which includes a full size oven/range, hood style microwave over range, dishwasher, refrigerator/freezer with ice maker, coffee maker, all necessary dishes and cookware
- Remote operated Gas Fireplace
- Complimentary coffee
- Complimentary Soap/Shampoo/Conditioner
- Charcoal Grill
- All Linens Provided
- All wood interior, rustic cedar log beams, no sheetrock
- Max of 9 Occupants
- $255 per night - rates are based on 4 occupants, additional persons are $10 per night, Kids 12 and under free
- 2 Night Minimum
- NO PETS - No pets in cabins or on premises, under any condition
- NO smoking in cabins.
- Must be 21 or older to rent cabin.
- Not handicap accessible
Cancellation Policy:
- 10 Day Cancellation Policy: If you cancel 10 days prior to your reservation date we will attempt to rent your cabin for the days that you are booked. If we can not rent your cabin, your credit card will be billed for the full amount of your cabin reservation.
- If you leave early during your stay we will attempt to rent your cabin. If the cabin is rented we will credit your card. If we can not rent the cabin your card will not be credited.
(Click A Photo To Enlarge)


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I'm totally doing some self diagnosis here. But I think I'm getting a case of post-marathon blues. I told this to my husband and he laughed, he said "it's B.S". (trust a guy who works with kids to use a "proper" version of a swear word). Hey I don't think it is. Why else would there be 11400 results on google?
So yes, I've been feeling a little down the last few days. Not as motivated. I'm sure the lack of running is not helping. Nor is the (almost) unexplained knee pain that had me decided to take a few days off running. But I can't blame it all on allergies or car problems now, can I?
I think that going from the rigid marathon training for four months, followed by the runner's high, followed by well, almost nothing, is mentally hard. Where do I go from there? While I would love to sign up for another marathon, I know it's not in the books for this year. Bad timing for us. And let's be honest with myself. While I would love to cross another 26.2 finish line, I'm not sure I want to put myself through the rigorous training so soon. I'd like to enjoy running for running. I want to feel the joy of the trails. I want to run more often and spend time running with my husband. Running for a marathon is a big time commitment. You think, breathe, eat marathon.
I'm hoping my knee feels better by next week. I'm ready to train for a fun 15k. I'm ready to shrug off the marathon blues and just feel the joy of the run.
How do you deal with post race blues?


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Extended Trips!
The Bensenville Park District offers a variety of Extended Trips for ages 21 and up. Our trips include roundtrip transportation to and from your destination via our comfortable "Be a Part of the Fun" mini-coach, motor coach or train. Our professional staff takes all the necessary safety measures and makes sure you are at ease on your excursion with us.
Extended trips are 2 day to 2 week getaways and include transportation. These organized trips may include hotel stays, meals, sightseeing tours and more. Make sure to read the descriptions in the Bensenville Park District Program Guide for detailed information.
Notes About Our Trips
- Our mini-coach is wheelchair accessible. Indicate your needs at time of registration.
- Trip registration is taken on a first-come, first-served basis, when accompanied with payment.
- If a trip is full, we strongly encourage you to put your name on the wait list. Many times there are cancellations, additional tickets can be acquired, or an additional date can be scheduled.
- If the deadline has passed, please call to check for availability.
- All trips depart from the East side of the Deer Grove Leisure Center.
- Check-in for trips is in the Oak Room at Deer Grove Leisure Center.
- Please arrive 15 minutes prior to the published trip departure time.
- Staff reserves the right to change the type of bus used on the trip.
- Return times are approximate due to road construction, traffic, weather, etc.
- All refunds incur a $5 refund fee.
- Cancellations after the deadline will receive a refund only if a substitute can be found, minus the $5 refund fee.
- We encourage trip participants to bring their own re-usable water bottle in an effort to support our environment.


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#1. Metallica - Master of Puppets
Metallica are a band that opened many doors for a lot of fans/bands. They also opened many doors and provided a lot of listeners with a gateway to other more extreme bands. Sadly, much of their material post "the black album" hardly qualifies as heavy metal, but in their prime this band dealt out thrash metal that was second to none! Just listen to "Damage Inc." or "Battery" and even today they still stand up against what has come along.
#2. Iron Maiden - Number of the Beast
It is of no surprise that IRON MAIDEN comes close to the top spot. Culling fans from all areas of the metal spectrum, Iron Maiden, clearly are one of the true innovators in heavy metal. The intro to the track "Number of the Beast" has become one of the "prayers" of heavy metal with just about every fan knowing it word for word.
#3. Metallica - Ride the Lightning
Arguably Metallica's heaviest album, the glorious RIDE THE LIGHTNING comes in at #3! This was the album that really started getting Metallica recognized around the world. It was followed up with MASTER OF PUPPETS which is really what put them on the map. However, the impact of RIDE THE LIGHTNING was definitely felt with "hits" like "Fade To Black", and "For Whom The Bell Tolls" to lesser hailed (but equally memorable) tracks like "Escape" and "Creeping Death" .
#4. AC/DC - Back in Black
Some of you youngsters will no doubt say "WTF is a classic rock band doing in a heavy metal list?" It is true that AC/DC has become darlings of the classic rock radio circuit, also their recent performance with the Rolling Stones in Canada to several hundred thousand people only goes to show that their appeal extends well outside of the metal realm. All this aside, that does not mean that their contribution to heavy metal in the 70's and 80's should be ignored! BACK IN BLACK is not only one of the best heavy metal albums of all time, it is also one of the best selling "normal" albums of all time as well!!
#5. Slayer - Reign in Blood
REIGN IN BLOOD is hailed by many as the definitive Slayer album. Clearly most of us here at Metal-Rules.com agree, as the album comes in at #5. As I've said before, listening to this album is like a religious experience. "Angel of Death" is one of the best Slayer songs ever written. The whole album plays like the soundtrack to hell. Learn the sacred words of praise, hail SLAYERRRRRRR!!!
#6. Iron Maiden - Powerslave
Iron Maiden's POWERSLAVE is a monster of an album. After the success of NUMBER OF THE BEAST and its follow up PIECE OF MIND, Iron Maiden was hard pressed to deliver an album that would match its predecessors. They would not disappoint as POWERSLAVE, with its instant classic tracks including "2 Minutes to Midnight" and the epic "Rime of the Ancient Mariner" would cement Iron Maiden at the forefront of the metal world and spawn the massive and seemingly never-ending World Slavery Tour.
#7. Iron Maiden - Piece of Mind
Maiden again? Yes, again...making for the third entry in our top 10! Many people consider this the pinnacle of Maidens career and with tracks like "The Trooper", "Still Life", "Die With Your Boots On" and "Flight of Icarus" it is hard to disagree. Piece of Mind turned 20 years old this year and forever will be a classic of the metal genre.
#8. Dio - Holy Diver
Ex-Rainbow, ex-Sabbath vocal god Ronnie James Dio comes in at #8. Pushing to his 60's, this old goat can still easily kick the ass of the majority of singers on the scene.
#9. Slayer - Seasons in the Abyss
SEASONS IN THE ABYSS is considered by some to be the last "classic" Slayer album. Songs like the evil title track and speed metal masterpieces like "Born of Fire" and "War Ensemble" have become fan favorites standing shoulder to shoulder alongside the band's past material.
#10. Judas Priest - Screaming For Vengeance
Rounding out the top 10 is SCREAMING FOR VENGEANCE, the quintessential Priest album in the eyes of many. Fronted by the "metal god" Rob Halford, Priest have been one of the defining bands of the metal movement. "You've Got Another Thing Coming" helped to create a new generation of metalheads and showed to the world that Metal Rules!!


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J.M. Field Marketing Introduces Benefits of New Video Services
South Florida marketing firm J.M. Field Marketing is now using Video Services to encapsulate the trends of technology and online marketing and increase brand awareness for clients.
March 26, 2014 – J.M. Field Marketing announces the increase in video services to be used by clientele. A strong demand and the emerging technologies have allowed the Video Services Department to continuously grow. The marketing industry as a whole has experienced a similar insurgence with video. The use of video provides an alternative for companies looking to minimize costs of explanations, tutorials, product demonstrations and webcasts.
The benefits of video services are large, for videos can be made to demonstrate almost anything. The majority of the consumer audience is more likely to purchase, make decisions or be persuaded by video than regular text. Research shows that after watching an online video, 73% of viewers are more likely to purchase from the brand or product being advertised.
"I recommend video to our clients as a great opportunity to display new product updates, events, a website launch, and SEO initiatives," states Joni Kullgren, Senior Design Manager. "We have seen the benefits of video services help reduce labor and costs for various industries. Our clients have rented out our studio space, which is very helpful in regard to cost, time and resources in the creation of video."
The increased usage of YouTube and other video social networks have increased user demand for video. With the growing use of handheld devices like smartphones and tablets, the same video message is able to be viewed across multiple sources seamlessly. The ease of watching videos has shifted the way decisions are made in terms of purchasing and the influence businesses have on consumers. With video services, businesses have an increased opportunity to expose their brand in multiple interactive online locations. Not only does video help assist consumers in making their decisions toward a brand or learning information about a topic, but video also assists in the communication between businesses to business. Technical employee training has become one of the largest reasons to create video. Businesses use videos for product demonstrations and infomercials to educate vendors on their product. As well, webcasts are also utilized by businesses to help communicate a message quickly and efficiently to personnel and industry members.
Across the board, no matter the industry, intent of the video or the video's purpose, research shows that viewers are much more responsive when the video has a clear, concise message. We find it important to storyboard each video before planning anything else to account for this. In product demonstrations for businesses, it is important to display a 360-degree view of the product in the best light, demonstrating what the product can do. With the studio space and custom sets built here, clientele in the restoration and beauty industries, have been able demonstrate use of their products.
In keeping with online marketing strategies, we have utilized video for SEO purposes. The benefits of adding video to a company website with the proper search terms are that it boosts traffic to the video and to the website. Video is not only increasing awareness of the company, but is also assisting in the company website's placement in search engines. Simply setting up a video sitemap and optimizing the pages the video is housed on will add search value to the company's online visibility.
"We plan to increase our clients and open up more opportunities in the coming months," states Alexis Kovic, Creative Director at J.M. Field Marketing.
With all the benefits of Video Services, we want to take the opportunity to increase their implementation of video services within existing marketing strategies for clients. The team looks forward in building out new marketing strategies involving video in order to increase the web presence of their clients.
About Us
We offer a seamless integration of marketing solutions, from design and printed collateral to marketing materials, product fulfillment, web-based inventory management, data collection, inventory systems and call center services. The company's mission is to work as a direct extension of its clients' brand – providing the services every business needs to help increase revenue in today's competitive market. With over 205,000 square feet in storage capacity, our pick and pack services provide assistance and advantages to our clients in materials production, online order processing and web-based inventory management.
Our clients include the banking industry, travel industry, entertainment industry, security industry, hair care products and more.


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Human trafficking is a serious violation of human rights. Get informed, and get involved.
Here are some valuable resources for learning more about this global epidemic, and for taking action.
United Nations Resources: Latest
Read the latest policy papers by the Inter-Agency Coordination Group against Trafficking in Persons (ICAT)
International Legal Frameworks Concerning Trafficking in Persons
Preventing Trafficking in Persons by Addressing Demand
Additional United Nations Resources
What is human trafficking? Get the facts here.
Read the most recent U.N. global report on trafficking in persons.
Access the August 2014 report by the U.N. Secretary-General on trafficking in women and girls.
Read the draft resolution "Trafficking in Women and Girls" (U.N. General Assembly, October 2014)
Download anti-trafficking tools and publications.
Access the human trafficking case law database.
Other questions about human trafficking? You might find the answer here.
U.S. Governmental Resources
Read the Trafficking in Persons (TIP) report from the U.S. State Department. The TIP report is a comprehensive resource of anti-human trafficking efforts by governments around the world.
The Anti-Trafficking in Persons Program (ATIP), under the U.S. Department of Health and Human Services, identifies and helps victims of trafficking.
European Commission Resources
Access additional resources from the European Commission.
Civil Society Resources
Gift Box is a collaboration between STOP THE TRAFFIK and the United Nations Global Initiative to Fight Human Trafficking.
STOP THE TRAFFIK: People Shouldn't Be Bought or Sold.
The NGO Committee to Stop Trafficking in Persons supports the END IT Movement.
Stay informed about the movement to end human trafficking. Read the Stop Trafficking! newsletter.


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NY Daily News Blind Item
Which rehabbed starlet's wallet turned up in the Financial District, with her driver's license, black American Express card and several bags of blow?
Which rehabbed starlet's wallet turned up in the Financial District, with her driver's license, black American Express card and several bags of blow?
Posted by ent lawyer at 9:12 AM
Labels: NY Daily News Blind Item
lilo. i feel like this has happened to her before tho like a couple years ago
la lohan def.
Kiki Dunst?
Mary Kate is in town.
my first thought was ll as well...but maybe that's too obvious...
While this screams Lohan, she was allegedly in L.A., check Lainey's site for the details.
has paris been to rehab? (altho i don't think you can rehab the gift that keeps on giving).
I agree, in what world does she still hold a black amex?
How about an Olsen?
definitely Mary Kate. Ho Han doesn't have enough cash for a black card.
If you go to snopes this is something that has been aroung for years regarding Lindsey.
I hate to say it, but it could be all of the above.
Whoever it is, it's awesome.
I say Eva Mendes. Black amex cards prolly self destruct to save themselves when around Lilo.
How do you fit several bags of blow into your wallet?
Tara Reid
There was definitely a similar story re LL a couple yrs ago. The woman who found it had to go through hell to give it back to Lilo, who apparently freaked the fuck out.
They could just be re-hashing it, otherwise i would def say MK for this one.
This does sound way too much like the old LiLo story.
In the old story the coke was rolled up in a twenty.
i like the mk guess. she still qualifies as starlet right?
oh, you can qualify easy if you buy and return later.
half a mil per year is easy to spend. just for the regular folks, there is no taking back for gucci sunglasses since you are not successfully photographed when exiting the store...
Yeah, JJ and Blah. Mary Kate.
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