text:
Back in March 2006, I had this great idea about synchronizing video with the EMR. Essentially instead of having to do all these pick lists of information, you'd just record the whole visit with the doctor and that would be all the documentation you'd need. Ok, so that won't quite work, because you need some things recorded granularly, but the idea of a video EMR was and is really interesting.
Thus, you can imagine my interest when I saw this article about a company, CareCam, that's developing a video based EMR. Here's a quote from the article:
CareCam is developing an EMR system based on video. The idea came to founder and president Shannon Pierce from her days working as a nurse. Data entry distracts clinicians from patient care, she said.
But the based in Greenville, S,C.-based company's 2009 patent on the method of documenting health records describes the technology as an electronic documentation system consisting of "documentation devices having a digital video recorder directed towards the patient."
The device will record video and audio information about the care of the patient, categorizing the data and logging it for future reference. That would be a different tack from most EMR offerings on the market, which aim to move paper records to the digital world, but without the audio and video that CareCam proposes.
EMR may eventually replace paper records altogether, but doctors, and likely their patients, will ultimately decide whether a video record is preferable to other formats. CareCam completed its first pilot in December, according to Pierce.
As I look at their website, there's not much information. However, it seems to me more like the cameras are for virtual office visits and not for recording visits in the doctor's office like it described in the quote above. Of course, these type of video cam visits from home are a popular topic and I can definitely see them becoming very popular. Especially as more and more devices start coming built in with a camera like the iPad (the iPad 2 has 2 cameras).
I'm still really intrigued by the idea of integrating an EMR with video. Video is becoming more and more popular on the web and I can see integrating video into an EMR being a very interesting next step. Most EMR systems can actually support some video today. I can easily see a dermatologist taking a video of a person's skin and uploading it to the EMR. There wouldn't be the seamless playback that would make it really cool, but it's certainly possible today. Hardest part today is getting it off the camera and into the EMR. A nice iPad or smart phone app could easily solve that problem.
Looks like I should have patented my video EMR idea back in 2006.


text:
I decided to move from blogger to a self-hosted wordpress installation, which gives me much more control. I had some issues while automatically importing all posts and images, but after some manual steps, I got it to work and the blog looks much better now!
Now you can read me at http://blog.hpenedones.org

subset: commoncrawl


text:
*Brought to you by Supercuts
Have you ever thought about owning your own business? I think this thought crossess most peoples minds but they discard it thinking it would be too difficult. How about owning a franchise? There are a ton of franchise opportunities out there so where would you start? Think about what people NEED on a regular basis and go from there. This definitely makes Supercuts an option as hair care is a need.
You don't need to be a hairstylist. You don't even have to know how to cut hair. And in this economy reasonable hair cuts could be a real winner.
Supercuts helps franchisees plan, control, and increase sales at every opportunity throughout the business.
- Manager-run: Because salons are run by experienced full-time managers, they do not require constant franchisee presence. This makes it easier to keep your job as you establish your first salon and easier to open new locations in the future.
- Professional staff: Supercuts salons are principally staffed by professional hairstylists with vocational education and training. Supported by administrative and management teams, everyone is able to put their unique talents to work ensuring excellent customer service.
- Predictable rhythm: Because Supercuts operates under proven and efficient processes, the day runs with greater predictability than in most independent salons, allowing you to serve more customers per day. This standardization also makes training, quality assessment, and continuous improvement significantly simpler.
- Regular hours: Supercuts salons operate during normal retail business hours, allowing you to maintain a level of work-life balance that will make you a better owner.
Active families prefer to have a shop they can count on, and not change salons frequently. For Supercuts franchisees, brand recognition and a great customer experience mean more customer conversions and lower turnover, which helps maintain a predictable cash flow.
Do you think Supercuts could be an option for you?


text:
Potential X Games host cities announced
More than 20 North American cities have been qualified as potential future hosts of the X Games beginning in 2014, when the contract for Los Angeles expires, and 2015, when the contract for Aspen expires, ESPN and the X Games said in a statement released last week.
Qualified hosting entities in 17 cities in the U.S. and Canada were named after formally submitting letters of intent in response to a request for proposals that was announced in October 2012; promoters in several other cities currently in the running for the three-year contracts have elected to remain anonymous until the next stage in the process.
The existing agreement with Anschutz Entertainment Group (AEG), longtime presenters of the X Games in Los Angeles, concludes with X Games Los Angeles 2013, taking place August 1-4. New summer locations being considered to host the four-day summer event from 2014 through 2016 include nearby California cities Long Beach and Pasadena, as well as Atlanta, Austin, Charlotte, Chicago, Detroit, Fort Worth, Minneapolis, Montreal, New Orleans, and Philadelphia, which previously hosted the X Games in 2001 and 2002, prior to the move to Los Angeles in 2003.
The Aspen Skiing Company -- which is hosting the X Games at Buttermilk Mountain in Aspen, Colo. this week, January 24-27, for the 11th consecutive year -- has an existing agreement through 2014 and is among the qualified entities to host the four-day winter event from 2015 through 2017. Attendance at the X Games this week is predicted to surpass the 120,000 mark, with global television broadcasts reaching an estimated 260 million homes in more than 200 countries.
"We have a long history and great partnership with ESPN and the X Games franchise, and we feel strongly that we'd like to keep it here and continue that partnership," says Jeff Hanle, director of public relations for the Aspen Skiing Company. "It's been a great run for us, and the X Games have become almost synonymous with our brand in some ways, so we're always happy to have them back."
Other potential wintertime X Games locations in consideration include Lake Tahoe, Park City, and Canada's Quebec City and Le Massif de Charlevoix.
This year the global X Games expansion will include a total of six locations, with international events in Tignes, France (March 20-22), Foz do Iguaçu, Brazil (April 18-21); Barcelona, Spain (May 16-19); and Munich, Germany (June 27-30), in addition to the North American events in Aspen, Colo. and Los Angeles, Calif.
The very first X Games were held in Newport, R.I. in 1995. San Diego, San Francisco, and Philadelphia also hosted summer X Games events before the move to Los Angeles in 2003. The winter X Games were first held in Big Bear Lake, Calif. in 1997 and were also held in Crested Butte, Colo. and Mount Snow, Vt. before moving to Aspen in 2002.
Official proposals from the potential hosts for future X Games events are due by April 2.
Use a Facebook account to add a comment, subject to Facebook's Terms of Service and Privacy Policy. Your Facebook name, photo & other personal information you make public on Facebook will appear with your comment, and may be used on ESPN's media platforms. Learn more


text:
ISLAMABAD, Oct 2 (APP): Jammu Kashmir Liberation Front (JKLF) has condemned the ongoing spree of arrests and booking of political activists under draconian Public Safety Act (PSA) in Indian Occupied Kashmir (IOK).
According to Kashmir Media on Sunday, a JKLF spokesman in a statement issued in Srinagar termed the arrests and night raids as clear sign of frustration among puppet authorities.
He said "Police arrested JKLF Kulgam district vice-president Assadullah Sheikh at Ramban when he was travelling along with his fruit vehicle towards Jammu.
He was brought to police station Devsar and immediately booked under PSA and shifted to Kuthwa jail."
The JKLF also condemned the arrest the organizer of a religious organization Moulana Arshad Qadri.
"Ailing chairman JKLF Muhammad Yasin Malik is languishing in jail from July 8, and after his arrest he has been kept in solitary confinement," the statement said.
He said JKLF Zonal President Noor Muhammad Kalwal and party activists, Fayaz Ahmad Mir from Ganderbal and Shabbir Ahmad Ganaie of Kakapora Pulwama, Mushtaq Ahmad Mir of Kupwara, and Assadullah Sheikh after being booked under PSA were shifted to Jammu.
"The JKLF vice chairman advocate Bashir Ahmad Butt along with zonal vice president Muhammad Yasin Butt and senior member Muhammad Amin Magloo are lodged at Rajbagh police station," he added.
"He said JKLF Vice Chairman Showkat Ahmad Bakhshi is lodged at Humhama police station, Ganderbal district president Bashir Ahmad Rather at Ganderbal police station while zonal organizer Bashir Ahmad Kashmiri is detained at Kothibagh police station in Srinagar," he said.
"Thousands of young and old people, students and innocent boys and children have been arrested so far and many have been shifted to different outside jails under PSA," the JKLF said while condemning the continuous curfew in Kishtwar and other areas of Pirpanjal and Chenab valley.
The spokesman also condemned the continued house arrest of Syed Ali Gilani and detention of other leaders including Mirwaiz Umar Farooq, Shabbir Ahmad Shah, Muhammad Ashraf Sehrai, Muhammad Altaf Shah, Ghulam Nabi Zaki, Ayaz Akbar, Doctor G M Hubbi and Advocate Muhammad Shafi Reshi.


text:
Jeff Greenlee, a western Oklahoma banking executive, has been elected to the Board of Directors overseeing REI Oklahoma, a statewide economic development firm.
President of NBC Oklahoma – Altus, Greenlee has worked in the banking industry since 1982. After earning an Agricultural Economics Degree from Oklahoma State University in 1984, Greenlee graduated with distinction in leadership from the Southwestern Graduate School of Banking at Southern Methodist University.
"We are very excited about Jeff's willingness to serve on the REI Oklahoma Board because his experience aligns so closely with our mission," said Gary Sherrer, REI Oklahoma board chair.
He is the past chairman of the American Bankers Association Agricultural and Rural Bankers committee, having testified before the House Agriculture Subcommittee on Conservation, Credit, Energy, and Research on credit conditions in 2007. He was instrumental in developing an alliance between the Federal Agricultural Mortgage Corporation and the American Bankers Association to help rural bankers better serve their agricultural customers with farm mortgage products. He continues to be involved in various Altus-area civic and charitable groups.
"We are very fortunate to add such a talented member to the diverse group on our board," said Scott Dewald, President and CEO. "We are appreciative of his volunteer service as well as that of each other member on our board."
Greenlee grew up in Holdenville on a peanut, cattle, and wheat farm. He is the father of three boys and his wife Lisa is the Vice President of Academic Affairs at Western Oklahoma State College in Altus. His special interests include raising cattle, distance running, golf, and anything his boys are involved in. He and his family are members of the First Baptist Church in Altus.
Through its offices in Oklahoma City, Tulsa and Durant, REI Oklahoma provides capital to help Oklahomans start and expand their business, trains aspiring entrepreneurs, and helps working families buy a home. Learn more about the opportunities REI Oklahoma creates by visiting www.reiok.org or calling 800.658.2823. Follow REI Oklahoma on Facebook, Twitter and YouTube.


text:
76 (Requires 74)
[75] Sabotage
Stefan in Ebon Watch wants you to defeat Drakuru.
If you lose your [Ensorcelled Choker], return to Stefan at Ebon Watch to get another.
Provided Item:
The time has come to end this charade, <name>.
As valuable as your information has been, we must bring Drakuru down and bring his project to an end before his freaks are unleashed.
We've modified your scepter for the job. When the time is right, you will be able to use it on Drakuru's Blightbloods and turn them against him. It's your only hope of defeating him.
Fight well.
|[Betrayer's Choker]
|[Choker of Betrayal]
|[Choker of the Betrayer]
Have you faced Drakuru in battle, <name>?
So, it's done.
We still have much to do, but our work here will be much more manageable thanks to your efforts.
Please accept this as a token of our gratitude.
To get to the fighting stage, players need to talk to Drakuru. He takes you to the top of the necropolis, where he will stand in the middle of the large circular platform. There are four smaller platforms surrounding the large platform. Drakuru, now in fighting form, will show off his might by summoning four Blightblood Trolls on the smaller platforms. Your disguise then fails and Drakuru realises your treachery. The fight begins.
You use the [Scepter of Domination] to control a Troll and use it to fight Drakuru. After defeating him, the Lich King arrives through a portal, finishes off Drakaru, and spares the player's life once again.
You can pick up [Drakuru's Skull]. Next to it is Drakuru's Last Wish. Use it to be returned to the Reliquary of Pain. There you can summon Stefan Vadu for the last time and hand in the quest.
The scripted parts of the quest run as follows:
- Drakuru takes you to the top of the necropolis.
- Overlord Drakuru says: Behold, mon! We be creatin' da greatest Scourge army ever seen!
- Drakuru throws crystals to summon four Blightblood Trolls.
- Overlord Drakuru says: says: These be da first of many! We shall sweep across Zul'Drak like da wind....
- Your disguise fails.
- Overlord Drakuru says: What treachery is this?! You be payin' for this deceit with your life, mon!
- The Scepter of Domination grows brightly! Use it now!
Drakuru yells any of the following as you fight him:
- Overlord Drakuru yells: Your betrayal not gunna be slowin' me down none, mon.
- Overlord Drakuru yells: Ya done turned your back on destiny, mon. Now you gonna die!
- Overlord Drakuru yells: I never needed ya, mon. I can crush Zul'Drak without ya!
- Overlord Drakuru yells: Fool! Ya coulda been havin' great power, mon!
- Overlord Drakuru yells: How could dis be? Da Lich King said he be havin' great plans for you, mon...
- Overlord Drakuru yells: I shoulda known not to be trustin' nobody!
- Overlord Drakuru yells: ENOUGH!
- Overlord Drakuru yells: Dis foolish treachery has cost ya your destiny!
- Drakuru summons the Lich King.
- Overlord Drakuru says: Master, dis mortal scum be double-crossin' us. Dey must be made to suffer!
- The Lich King says: You have failed me, Drakuru!
- The Lich King says: It is you who should suffer. Be content that your death is a quick one....
- The Lich King kills Drakuru. His head lands some distance away.
- The Lich King says: As for you...
- The Lich King says: I spare your insignificant life as a reward for this amusing betrayal. There may yet be a shred of potential in you.
- The Lich King says: Be warned...
- The Lich King says: When next we meet I shall require much more to justify your life.
Completing this quest is part of Guru of Drakuru.
Note that you don't actually have to "do" this quest to complete it. You can just watch someone do it (even someone who's not from your faction) and loot the head after the fight.
To defeat him you must take control one of the Blightblood Trolls by using the [Scepter of Domination] on it. The troll will work like a Hunter or Warlock combat pet, with a small action bar above your regular action bar. See the Blightblood Troll page for a description of his abilities. Spam Powerful Strike (pet action #4) to do a large amount of damage, Concussive Blow (pet action #5) to buy your troll some more time, and Blightblood Infusion (pet action #6) to heal yourself.
More than likely, players will lose their first troll. As soon as that happens, run over to another troll, take control of it and get it in the fight. After a Troll dies and while you are busy taking control of a new one, Drakuru will hit you with his Shadow Bolts. Try to get a Blightblood Infusion heal from a Troll just before he dies, and get a heal right away from the new Troll.
Drakuru will stay in the center of the platform, but while he is not engaged by a troll he will fire his Shadow Bolt at you for about 1250 DPS. He will occasionally throw a crystal at the player (announced by an emote) which does AoE damage. You will need to get away and stay out of the affected area.
Classes with ranged damage should stay on the edge of the platform, moving around the circumference as needed. When Drakuru starts throwing crystals, step aside just far enough to avoid the AoE damage. In time, this will move you all the way around the platform, but by the time you have come full circle, the older AoE patches will have gone.
This is probably also a good strategy for melee classes. The troll will do most of the damage anyway (about 3600 DPS), and this will keep you out of the way of the crystals. If you want to stay close in, then run away when the emote comes. If you stay, the AoE spot will be close to Drakuru, making it hard to stay in melee range.
Either way it is probably the easiest to focus on the fighting abilities of the troll rather than putting in damage yourself.
Do not step on a small platform with an untamed Troll on it. It will attack you and probably quickly kill you. To gain control of one, use your [Scepter of Domination] while standing on the big platform.
Do not try to take control of a new Troll while your old Troll is still alive. You will lose control of the old one and it will attack you.
- [75] An Invitation, of Sorts... – or – [75] Darkness Calling
- [75] Near Miss – or – [75] Close Call
- [75] You Can Run, But You Can't Hide – or – [75] Silver Lining
- [75] Dressing Down – or – [75] Suit Up!
- [75] Feedin' Da Goolz
- [75] Infiltrating Voltarus
- [75] Dark Horizon
- [75] Reunited
- [75] So Far, So Bad
- [75] It Rolls Downhill
- [75] Hazardous Materials
- [75] Zero Tolerance
- [75] Sabotage
- [75] Fuel for the Fire
- [75] Disclosure
- [76] Betrayal


text:
Next Monday 3rd October, the European Parliament will discuss with the European Commission about their proposal to suspend part of the European Structural and Investment Funds (ESIF) for Portugal and Spain in 2017, as part of their non-compliance with the European Union's budgetary rules. In a letter to Members of the European Parliament, EASPD – alongside the Social Platform and Social Services Europe – strongly opposes the suspension of any ESI fund which supports human rights enjoyment, labour market integration and social inclusion.
EU law linking ESIF to macro-economic policy obliges the European Commission to propose to the European Council a suspension of up to 50% of structural funds to Portugal and Spain in 2017 for failing to commit to EU budgetary rules on time. On 3rd October, Vice President Mr Jyrki Katainen and Commissioner Ms Corina Cretu will discuss this issue with Members of the European Parliament.
Mr Luk Zelderloo, Secretary General EASPD, argues that "whilst we understand that the European Commission is legally obliged to propose a suspension, it must guarantee that any suspension will not impact the lives of those most disadvantaged in Portugal and Spain". Mr Thomas Bignal, Policy Officer EASPD, adds that "Structural Funds are essential to the budget of many social service providers who help to get vulnerable people back into jobs and allow people to be integrated into the community".
Although there is still time for Portugal and Spain to report back positively to the European Commission on their budgetary requirements, Mr Pierre Baussand, Director of the Social Platform believes that "any suspension of funds will act as a double penalty on disadvantaged groups and local communities who have already faced years of struggle, in part due to EU fiscal policy".
Following strong concerns from social service providers in Portugal and Spain, EASPD has initiated a letter to Members of the European Parliament to highlight these fears. Social Services Europe and the Social Platform also sign the letter, expressing the social sector's significant concern on this ongoing debate. EASPD calls on Members of the European Parliament to express their utmost concern about the impact a suspension of Structural Funds would have on bringing people out of poverty and social exclusion in Portugal and Spain.The European Commission must ensure that any suspension does not negatively affect the lives of persons in need of support.
Relevant Documents
- EASPD, Social Platform and Social Services Europe Letter to Members of the European Parliament
- Link to Press Release in PDF
Note to editors
The European Association of Service providers for Persons with Disabilities is a non-profit European umbrella organization, established in 1996, and currently representing over 12.000 social and health services for persons with disabilities. EASPD advocates for effective and high-quality disability-related services in the field of education, employment and individualised support, in line with the UN CRPD principles, which could bring benefits not only to persons with disabilities, but to society as a whole.
Thomas Bignal, EASPD Policy Officer
+32 2 2337723


text:
The other day, in the on-and-off pouring rain, I learned how very essential it is to stay on top of maintenance. Clients have the option of taking on the responsibility of maintaining their urban farms themselves for the most part with only monthly maintenance or however often they prefer. The time saved by not coming each week saves money but if the garden is not looked after by someone, issues can and do arise, costing more time and energy later on. Pest problems get out of control, weeds get out of control, produce goes past its prime and time, effort, and plants put into it go to waste. Here are just a couple of the things we saw that can be avoided just by spending a healthy serving of time each week in the garden:
This is an unharvested, bolted lettuce plant, meaning that it has developed one large stem and is growing up instead of producing tasty salad green leaves. After they bolt, they turn bitter and much less appetizing so they should be harvested before this point. Sometimes it can't be helped that they bolt before we can harvest them when there is too much lettuce at one time- hence the need for successional plantings.
Peas are also all ready to harvest and some that we saw had turned inedible from being left on the vine too long. These become bulky and leathery, also making them unfortunately bitter.
We ended up spending over double the time we would normally spend in a garden and had to pull and replant a lot of things which was unfortunate. Gardening is good exercise for the body, rest for the mind, and nourishment for the soul. I feel lucky to get to spend that much time in a garden (even in the rain) and I don't even get to enjoy all the goodies that come from it with a little encouragement and support. Some gardens we visit are unable to produce from lack of light or unfitting soil so some clients who check multiple times during the week cannot enjoy everything that they wanted… and then there are some that have flourishing gardens but choose not to look after them. There is an interesting range of involvement. When we work for the garden, it works for us; when we don't, we lose out on perfectly good treats… bummer. Let's not let bad things happen to good plants!


text:
order here and pickup at our store immediately
Your Price: $149.00
On its own or as part of layering system, the Adahy Hoody provides insulation for spring and summer backpacking and trekking. The lightweight, soft Torrent™ fleece's stretch improves ergonomic freedom and helps hold the trim fit close to the body for maximum fabric efficiency and layering comfort. A snug fitting hood adds warmth. Minimalist by design, it is light, easily packed, and integrates with other Arc'teryx Traverse products to create an efficient clothing system for backcountry travel.
Sign up to be on our mailing list
for news and discounts.


text:
At the Center for Excessive Sweating, we offer every treatment option available for axillary hyperhidrosis, including miraDry.
We have been performing miraDry since 2011. Our technique is perfected such that > 86% of our patients require a SINGLE miraDry procedure. This is where experience counts ! A meticulous and thorough reduces the likelihood of requiring a 2nd miraDry procedure.
Dr. Karamanoukian has written a book about the miraDry procedure which is available for free reading on our website.
For a consultation, call 716-626-7700 or 716-839-3638.


text:
Price: $5.00
Quantity: 1 available
Book Condition: Good+
142p. SP259. Spine slanted, no creases on spine but crease on front near spine, cover edges scuffed, check mark on first page. A Western Heritage Library Book.
Title: GUNS OF THE LAWLESS
Categories: WESTERNS,
Publisher: New York, Popular Library: 1963
Binding: Mass Market Paperback
Book Condition: Good+
Item: 1.00 Item
Seller ID: P4264


text:
Many times over the past few months, I have talked with people that are looking forward to the economy coming back - a return to the way things were. There were times when I found myself feeling this same way. Will things every "come back" to the way they were? I don't think they will.
We are now in a new time. Companies have been forced to reduce staff, look for new ways of doing things and get more results from fewer people, lower costs and less effort. Once a company is able to see there are better ways of operation, there is no need to return to anything that was done before.
The hope of the future isn't to return to some past time. The hope of the future is to improve every process, train everyone in the company to improve himself or herself and continue to do that over and over and over. The future belongs to the companies and the individuals that can do more with less and still improve performance. We plan as a company to be a part of that future.


text:
Research & Evaluation Services
Research and Evaluation Services
In addition to conducting rigorous evaluations of our curricula, programs and professional development services, SREB's division of Research and Accountability also offers a broad range of fee-based research and evaluation services to states, districts and schools.
- Student and teacher surveys offer authentic feedback, college-ready core completion data and a detailed picture of school and classroom experiences in sites participating in High Schools That Work, Making Middle Grades Work or Technology Centers That Work. We also offer stakeholder surveys on demand as part of our curriculum and instruction reviews and career pathway reviews.
- Annual school progress reports based on feedback from collaborative leadership teams empower schools implementing SREB's Making Schools Work key practices for middle grades schools and high schools to develop action plans for school improvement.
- Assessments and assessment reports help Advanced Careerprograms measure student achievement.
- Analyses of accountability, career pathway and workforce data can be conducted at the state, regional or district level.
- Comprehensive needs assessments of Perkins-funded CTE programs emphasize the alignment of career pathways with workforce demand.
- Program evaluations help states, districts and schools assess the impact of their K-12 instructional initiatives.
- Survey development and assessment development services are available upon request.
Notice Regarding Human Subjects and Data Privacy
SREB promotes ethical research practices for the protection of human subjects, as established by the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research.
SREB also adheres to data governance policies for the protection and privacy of student information, as outlined in the Family Educational Rights and Privacy Act.


text:
Many here enjoy playing arcade-like games or at least games with some kind of "easy gameplay" (level based). So we fans of complex games (RTS, simulations, ...) are surely some kind of minority. We would like to see games made in these genres.
So what we basically need to do is gag Derron and his unrealistic expectations of a quick game then we can all have a crack at a Maze themed game, right? I do have an idea for a maze game in fact. Although it doesn't involve Pacman or munching dots...As for the number of voters, we have enough to get some solid input on our creations. We're not even doing it for any financial incentive this time - just for fun, and the kudos of maybe creating something great.Shall we do this, people?Yes, please leave that gag on Derron, please.
For example, if we use "maze/labyrinth" as the theme, one person can make a retro Pac-Man clone, another could do a 3d first person procedurally generated find your way through the Minotaur's labyrinth game, and another could make a text adventure type maze game. Just so long as it is recognized as a maze.
Haha, I am guessing Derron is on-board with the maze/labyrinth theme?
Bad Behavior has blocked 971 access attempts in the last 7 days.
Page created in 0.116 seconds with 26 queries.


text:
For the first time in their 12-year history the Dutch Rabobank team find themselves defending the lead of the Tour de France.
The Dutch bank is one of the longest serving sponsors in professional cycling, but their squad has never been in this position before. Marc Wauters held the yellow jersey for them in 2001 but the team subsequently made little effort to defend it.
Michael Rasmussen's small lead over Alejandro Valverde, Iban Mayo and Cadel Evans will now test the team as the race heads towards three crucial stages in the Pyrenees. Today the team were given the easy task of pegging a break that contained no danger men at ten minutes. The rest of the race is unlikely to be so simple.
If Rasmussen still holds the jersey after Saturday's long time trial in Albi, Rabobank's job will become much tougher. The Dane has looked the strongest climber in the race so far, but if he's isolated in the mountains he will struggle to contain the challenge from his rivals.
Rasmussen now has seven team mates left. Michael Boogerd and initial team leader Dennis Menchov will be his strongest allies in the mountains, while, Bram de Groot, Juan Antonio Flecha, Grischa Niermann, Pieter Weening and a patched up Thomas Dekker will be the workers on the flat.
However, it's Rasmussen's leadership skills that are really going to be put to the test.
The Dane is famously reclusive, he prefers to train alone and even separates himself from his team during stage races, preferring to spend time on his mobile phone rather than bantering at the dinner table. Lance Armstrong's seven straight Tour wins were a lesson in team leadership, but Rasmussen seems to have little or no such attributes.


text:
Cat and Dog Surgery
Cat and dog surgery is an important aspect of your pet's care. When a condition or emergency requires surgery, rest assured your pet is in the best of hands with us. At Green's Creek Veterinary Hospital in Dublin, we provide a wide range of surgical services in a state-of-the-art hospital. Furthermore, we use the most exceptional surgical tools and monitoring equipment to oversee your pet's safety.
Anesthetic Procedures
When your pet undergoes a surgical procedure at our hospital, we use state-of-the-art anesthesia services to ensure that your pet is as safe as possible. We go to great lengths to ensure the safety of each and every one of our surgical patients by recommending pre-surgical blood work and utilizing complete monitoring processes. We anesthetize all of our animals with a very safe intravenous medication. After the IV shot, we intubate all animals with an endotracheal tube and put on oxygen/isoflurane gas anesthesia.
Safety Measures
We closely monitor animals at all times by a surgical technician. Furthermore, a pulse oximetry unit reads the animal's pulse rate and oxygen saturation levels. Once the procedure is done, all patients are placed in our surgical recovery cages to be closely monitored throughout the day. We offer a complete line of surgical services from routine spay and neuter to complicated orthopedic procedures and more. Call us at (254) 445-0440 for more information.


text:
Brexit vote 'Pandora's box', says Spanish economy minister
"Staging a referendum is a mistake, we have opened a Pandora's box," Guindos told a business forum late Monday.
"I am convinced Brexit will not happen, I am convinced that the British will be rational," he added.
"Please let's not get into this situation again, because it can have effects in other nations where populism is advancing very quickly."
De Guindos said the decision to call the referendum has "a component of populism."
If Britain votes to leave the EU it would be "a political failure" for British Prime Minister David Cameron's conservative government, he said.
His comments come as polls suggest the outcome in Thursday's vote could go either way. Analysts have predicted a Brexit could unleash a domino effect within the 28-nation bloc.


text:
My Home Equity Line of Credit (HELOC) was reduced or frozen. What can I do to have the credit line reinstated? What can I do to appeal the decision?
Federal law provides two options. The first is, the lender can require you to request reinstatement of your original credit line when the circumstances permitting the reduction or freeze have changed, so long as it informs you how to request such reinstatement. If your bank notified you of the process for requesting reinstatement of your credit line, you should follow that process. If you are uncertain about the information your bank requires, you should contact the bank. However, be prepared for the bank's requirement for an updated appraisal at your cost.
The second option is the lender can monitor the HELOC on an ongoing basis to determine whether the circumstances permitting the reduction or suspension continue to exist. If the bank is monitoring the HELOC, you do not have to request reinstatement of the original credit line.


text:
I'm now full term!! It's hard to believe that I am 37 weeks pregnant and we'll have a baby in our arms in less than 3 weeks! We are getting more and more excited about Paxton's arrival every single day!
We went to the doctor Monday, the baby's head is down (which was the only thing I was concerned about!) I was not checked and he has not estimated Paxton's weight (two questions that have been frequently asked!) He said he'll check for dilation at 38 weeks…I go back this coming Monday and will be 37 weeks, 5 days so I'm not sure if he will check or not!
I feel good still! In fact, I've had a burst of craftiness this past week! I've been making things for Paxton! So far I've made a set of 3 cloth blocks, 3 burp cloths, a taggie blanket & 3 "pee pee tee pees"! I hadn't made him anything so I was glad I had this energy for sewing! (I'll soon be posting pictures of my projects!)
I've been told to expect contractions and my belly has been tightening occasionally but I have yet to experience any pain. The past two nights have been rather sleepless and my hips have been aching and I feel pressure on my pelvis (but I don't experience these discomforts during the day!) I'm actually looking forward to the contractions picking up and going into labor at this point! I'm just so excited about meeting this baby boy!
My friend Jennifer sent us 5 personalized onesies for Paxton that we received yesterday! They are adorable:
We love these two FFA themed onesies! John David and I met through the FFA and we're hoping that one of these days Paxton will love FFA too!!
And this one is my favorite! How adorable is that? He'll be the cutest advertising for his mama's blog!!
His nursery is finished (it is lacking wall decorations but I haven't had much luck finding things that I really love!) Hopefully sometime this week I will give you a tour of the nursery!


text:
Are you fed-up with hearing "The money Is In The List", when you don't have an email marketing list yet? That's all about to change according to YourLuckyList promoters of an opt-in list building system.
I find their claims of building an opt-in list of "100,000 by next Monday" a little difficult to accept, but it might be worth checking out. You have nothing to lose because it's free to join. Of course after you sign up, you are given a "one-time" opportunity to upgrade for all kinds of additional benefits that are hard to turn down.
The developers claim that YourLuckyList is like no other list building system ever created. It has an exclusive "dual-matrix" list-builder, so that you benefit you from your own efforts, and from the efforts of the thousands of others in the matrix. As a result, you don't have to worry about finding yourself at the bottom of the matrix.
The "Lucky Matrix" is randomly re-built every week, and with each re-build you have a chance to be put right up at the top! And, even if you're not in the top position, you could still find yourself sitting on top of a huge list of hundreds, if not thousands of prospects every single week.
Imagine waking up next Monday to a brand-new list of 20,000 prospects! I suppose that could indeed happen-if you were lucky.
And that's just the start. They're also going to flood everyone's list with fresh, targeted, double-opt-in prospects.
You'll get access to an opt-in Email marketing list right now, and be building your own list for profits tomorrow.
Join today and start building your list absolutely FREE!
Why settle for one list, when you can have THREE? Thousands of Targeted, Responsive, Double-Opt-in leads are just waiting to hear from you. Join now for free, and start earning today!
P.S. Think about this ... if you are considering NOT joining, how serious can you be about building your own list and Email marketing? This is a system that will GIVE you a Email marketing list today, and build your list with real opt-in leads at absolutely no cost. Isn't that worth the 30 seconds it'll take you to sign up now.
From eMail marketing, RETURN TO AUTOMATION TABLE OF CONTENTS


text:
Appendix B
Primer on Human Immunodeficiency Virus, Acquired Immune Deficiency Syndrome, and Antiretroviral Therapy
This primer is intended to provide the reader with a broad overview of HIV, AIDS, and antiretroviral therapy and guidelines for adults and adolescents in the United States. For a more complete review of antiretroviral therapy and guidelines, including for pregnant women and children, the reader is directed to the U.S. Department of Health and Human Services November 2003 Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents and the January 2004 Guidelines for the Use of Antiretroviral Agents in Pediatric HIV Infection. Both documents are available at: http://aidsinfo.nih.gov/.
Human immunodeficiency virus (HIV) is a single-stranded RNA virus of the Retroviridae family. When a person becomes infected with this virus, that person develops a lifelong condition resulting from this virus' ability to integrate its genome into the genome of certain human cells. Without treatment, this virus causes a progressive weakening in the host's immune system, culminating in the acquired immune deficiency syndrome (AIDS), and death over a period of years.
The virus consists of a core and an envelope. The core contains two copies of single stranded RNA. The virus particle also contains several viral
(and host cell) proteins that assist with replication. The three main enzymes are reverse transcriptase, protease, and integrase. The envelope contains proteins that allow the virus to attach to and enter its main target cells in the body: the CD4+ T lymphocyte (also known as CD4+ T cell or CD4 cell) and the macrophage. The CD4+ T lymphocyte is a critical element in or-chestrating the normal immune response to a wide range of infectious agents. Once inside the CD4+ cell, the virus replicates. Early in this process, HIV viral RNA is transcribed to double stranded DNA by the virus' reverse transcriptase enzyme. This newly produced viral DNA is integrated into the DNA of the host's CD4+ T lymphocyte and becomes known as "proviral DNA." As infection depletes CD4+ cells, the immune system becomes compromised and the person develops AIDS; this process typically occurs over the course of years in an otherwise normal adult. When the immune system becomes debilitated to the point of the AIDS, the person can develop a range of opportunistic infections (OI), like tuberculosis, pneumocystosis, cryptococcus, toxoplasmosis, and certain cancers, like Kaposi's sarcoma and lymphoma.
An HIV-infected person is categorized as having AIDS when the CD4+ white blood cell count drops to below 200 cells/mm3 (normal counts vary significantly but typically range between around 500 and 1500 cells/mm3) or when he or she develops opportunistic infections or cancers. The complete criteria for diagnosing AIDS may be found in the December 1992 Morbidity and Mortality Weekly Report article (Centers for Disease Control and Prevention, 1992).
While there is no cure for HIV or AIDS, treatment is now available. This includes antibiotics to prevent and treat OIs and specific antiretroviral (ARV) therapy to control HIV viral replication itself. In resource-rich countries where ARVs have been available and affordable for several years, HIV infection has ceased to be considered an automatic death sentence. With carefully managed therapy and a motivated patient, HIV infection is a serious but treatable chronic disease that does not necessarily preclude additional decades of good quality life.
The Goals of Antiretroviral Therapy
The use of antiretroviral therapy for HIV infection has become complex as more has been learned about the virus and its ever-changing response to therapeutics and about patient factors affecting therapy. The goals of therapy are to inhibit viral replication while minimizing toxicities and side effects associated with the available drugs. This inhibition of virus replication permits restoration of the immune system. Viral eradication from the host genome is not achievable; thus a cure for HIV is not yet possible. By using an appropriate antiretroviral treatment regimen it is
possible to minimize the morbidity and mortality associated with HIV, to delay or prevent the onset of AIDS, and to allow those infected to lead a productive life.
Goals of Antiretroviral Therapy
Restoration of immune function and suppression of viral replication have been assessed largely by laboratory criteria. The goal of therapy is to achieve a CD4 cell count of greater than 200 copies/mm3 and an "undetectable" viral load (less than < 50 copies/mL). Within 4–6 months of starting antiretroviral therapy, these goals should be achieved. Failure is multifactorial; some issues will be highlighted in this report.
The Four Classes of Therapy: Mechanisms of Action
Drugs used to treat HIV principally belong to hree main classes, each based on a different mechanism of action; a fourth class was recently added. Three of the classes affect viral enzymes. The fourth class affects the ability of the virus to enter target cells in the body. The first class developed was the nucleoside analogue reverse transcriptase inhibitors (NRTIs). The first drug in this class (zidovudine [AZT or ZDV]) was introduced in 1987. The NRTIs compete with physiologic nucleosides—the building blocks of host and viral DNA—for binding to the reverse transcriptase enzyme. This has the effect of interrupting viral DNA chain elongation. There are eight FDA approved drugs in this class. The next two classes of drugs were introduced in late 1995 to mid-1996. One of these is the nonnucleoside reverse transcriptase inhibitors (NNRTIs). The NNRTIs bind to the reverse transcriptase enzyme and change the "shape" of the enzyme thereby preventing the enzyme's action of transcribing viral RNA into viral DNA. There are three FDA-approved drugs in this class. The other class of drugs that was introduced is the protease inhibitors (PIs). The PIs work at a later stage of new virus production. The PIs inhibit the viral enzyme that cleaves a polypeptide protein necessary to produce new mature infectious virus particles. Virions treated with PI's do not become infectious. There are eight
FDA-approved drugs in this class. The fourth and newest class of drugs available for HIV treatment is the entry inhibitors (also known as fusion inhibitors). The sole FDA-approved fusion inhibitor, enfuvirtide (T-20), has generated the most limited experience in treatment of HIV since it was only approved for use in 2003. Unlike the other classes of drugs that work by affecting viral enzymes, this class of drugs prohibits the entry of HIV into the host target cell, like the CD4+ lymphocyte. Also, unlike the traditional drugs used to treat HIV, this drug is not available in oral form. It requires twice-daily subcutaneous injection. When added to regimens containing the other classes of drugs taken by treatment-experienced patients with advanced disease with resistant virus, this therapy was shown to reduce viral load and increase CD4 counts after 6 months of observation (Kilby and Eron, 2003; Lalezari et al., 2003).
Lessons Learned: More Is Better Than One
Over the past 20 years, many lessons have been learned in the developed world about the selection, timing, and combination of drugs used to treat HIV. The first medication used to treat HIV was (AZT, ZDV, a NRTI approved for use in 1987. This drug was used as monotherapy for HIV and, during initial years of use, allowed for increases in CD4 cell counts (or delays in decreases in CD4 counts) and prolonged survival. It was soon learned that these effects were transient, with benefits not lasting much longer than 2 years. Nearly 10 years after the introduction of AZT, the PIs and NNRTIs were approved. Based on clinical trials using these newer drug classes, it was quickly learned that combination therapy was superior in reducing viral load, delaying the emergence of HIV drug resistance, slowing the rate of immune destruction (i.e., CD4 cell decline), and slowing the rate of disease progression. By 1997, there was a 47 percent decrease in HIVrelated mortality rates and a 60–80 percent reduction in AIDS-defining diagnoses and hospitalizations for patients using combination therapy (Bartlett, 2004).
It is now known that the most effective and recommended way to use the drugs to treat HIV is in at least triple combination. Mono- or dualtherapy, which was used at the start of the epidemic, has now been proven to be less effective and have limited long-term durability and, therefore, should be avoided. Highly active antiretroviral therapy (HAART) refers to the use of three or more drugs in a daily regimen. The three drugs used in a HAART-based regimen should come from at least two different classes. Of note, while there are 20 FDA-approved drugs, not all combinations that could be formed result in an effective regimen. In fact, certain combinations of drugs are antagonistic and must be avoided. See "Selecting a Regimen" for guidance on HAART design.
Balancing the Risks and Benefits
Lifelong Treatment
While curing HIV with antiretroviral therapy is not yet possible, halting further viral replication and production and restoring immune function remain the goals of therapy. These goals must be balanced with the consequences of receiving antiretroviral therapy: toxicities, side effects, and viral resistance development limiting further therapy options. Furthermore, as morbidity and mortality have decreased with antiretroviral therapy, patients are living longer; HIV has thus become a chronic disease requiring lifelong treatment. With the experience of over a decade of use of these therapies, it has become clear that long-term use can result in metabolic derangements with potentially serious non-immunologic long term implications. This is particularly relevant with the PI class, which has been shown to cause hyperglycemia and hyperlipidemia (U.S. DHHS, 2003). Conflicting data exist associating these metabolic derangements with an increase in cardiovascular morbidity and mortality; longer observations may clarify this (Sklar and Masur, 2003). In recognition of long term adverse effects resulting from long-term treatment, clinicians are no longer encouraged to abide by the "hit early, hit hard" strategy; more thoughtful and thorough risk-benefit analyses between physician and patient should be addressed prior to therapy initiation (Sepkowitz, 2001).
Side Effects
There are class-specific toxicities and side effects, in addition to unique toxicities and side effects of individual antiretroviral drugs. Different drugs within the NRTI class are associated with lactic acidosis and hepatic steatosis, peripheral neuropathy, pancreatitis, and anemia. Of note, abacavir (ABC) has been associated with a life-threatening hypersensitivity reaction requiring immediate and permanent discontinuation of the drug. Drugs within the NNRTI class are associated with rash and hepatotoxicity. Of note, efavirenz has been associated with psychiatric side effects such as insomnia and vivid dreams and nevirapine has been associated with hepatotoxicity and the Stevens-Johnson syndrome. Drugs within the PI class are associated with nephrolithiasis and gastrointestinal side effects such as nausea and diarrhea. Metabolic derangements, as described above, also are more frequently associated with this class of drugs. Based on early clinical trial studies of the newest class of drugs, the fusion inhibitors, adverse events associated with the drug in this class include: local injection-site reactions such as the development of painful, pruritic subcutaneous nodules; eosinophilia (rarely associated with systemic hypersensitivity); and an
increased incidence of bacterial pneumonia. For a more comprehensive listing of drug-specific side effects, see Table B-1.
Resistance and Its Determinants
In deciding to initiate or change antiretroviral drug therapy, an understanding of the concept of drug resistance is important, since the benefits of therapy can be compromised if drug resistance develops. Because HIV undergoes high rates of replication and turnover, there is potential for genetic variation leading to HIV variants that are no longer susceptible to the mechanisms of action of existing drugs. Resistance develops during drug therapy (Clavel and Hance, 2004). If virus continuously replicates in the presence of drug therapy (i.e., incomplete viral suppression in the presence of selective drug pressure), drug resistance will emerge (Deeks, 2002; Hirsch et al., 2003). Mutations conferring resistance are selected and maintained by drug pressure (Hirsch et al., 2003; Petrello et al., 2002; Richman et al., 2004).
There are two approaches to measuring HIV drug resistance. Phenotypic assays measure inhibition (or lack of it) of viral replication in presence of a given drug. Genotypic assays detect the presence of mutations in the viral genome previously determined to account for resistance with the phenotypic assay. Drug-resistant HIV can be resistant to individual drugs or to the whole class within a given class. As aforementioned, any regimen that does not completely inhibit viral replication can lead to the emergence of resistance (Bennett et al., 2000). It is estimated that 50 percent of patients receiving antiretroviral therapy in the United States have a virus that is resistant to at least one drug in the armamentarium (Richman et al., 2004).
There are many factors that can lead to the development of HIV resistance to antiretroviral therapy. As noted above, if complete suppression of viral replication is not achieved, resistance mutations will develop and the virus may become clinically resistant. Suboptimal exposure of the virus to the drug is an important mechanism by which drug resistance develops. Suboptimal exposure can result from underdosing, improper prescription of antiretroviral regimens, poor adherence, altered drug metabolism, and the presence of tissue sanctuaries where virions "hide" from the action of drug therapy (Deeks, 2002). While all mechanisms operate, the one factor that most critically depends on the patient is adherence. If at least 95 percent of doses are taken, there is a greater than 80 percent probability of achieving a viral load of less than 500 copies/mL; if less than 95 percent of doses are taken, less than 50 percent achieve this goal (Bartlett, 2004).
TABLE B-1 Antiretroviral Drugs and Selected Side Effects
Generic Name
Trade Name
Comments and Common Side Effects
Nucleoside Reverse Transcriptase Inhibitors (NRTIs)
Abacavir (ABC)
rash with or without hypersensitivity reaction; those that develop hypersensitivity reactions must not be rechallenged
Didanosine (ddI)
Videx EC
peripheral neuropathy; pancreatitis; avoid alcohol
Emtricitabine (FTC)
active against hepatitis B
Lamivudine (3TC)
active against hepatitis B
Stavudine (d4T)
peripheral neuropathy; lipodystrophy
Zalcitabine (ddC)
peripheral neuropathy; oral ulcers
Zidovudine (ZDV, AZT)
initial "flu-like" symptoms; anemia; myopathy
renal insufficiency (rare)
Protease Inhibitors (PIs)
rash; diarrhea; perioral paresthesia; hyperlipidemia
similar to amprenavir
nephrolithiasis; nausea; hyperlipidemia
hyperbilirubinemia, nausea, diarrhea
gastrointenstinal intolerance; hyperlipidemia
nausea; diarrhea; numb lips; hyperlipidemia
diarrhea; hyperlipidemia
Saquinavir (soft gel) (hard gel)
Fortovase Invirase
Gastrointestinal intolerance; hyperlipidemia
Nonnucleoside Reverse Transcriptase Inhibitors (NNRTIs)
transient rash; increase in liver enzymes
transient rash; insomnia; vivid dreams; rare suicidal/homicidal ideation
transient rash; hepatitis
Fusion Inhibitors
Enfuvirtide (T-20)
injection-site reactions; eosinophilia; rare hypersensitivity reaction
aTenofovir is a nucleotide reverse transcriptase inhibitor.
SOURCES: Schutz and Wendrow, 2001; U.S. DHHS, 2003.
The goal in selecting a treatment regimen is to select a combination of drugs that will have additive or synergetic effects in viral suppression and immune stabilization or reconstitution. An overlying goal is to select a regimen that will minimize the development of drug resistance—especially to an entire class of drugs—thus leading to limited future treatment options. Other factors that are to be considered include: pharmokinetic and toxicity profiles and characteristics that favor adherence. There are many considerations in selecting a regimen. The text below will highlight examples of such considerations based largely on research endeavors from the developed world. For a more thorough review of regimen options and associated advantages and disadvantages, the reader is directed to the U.S. Department of Health and Human Services November 2003 "Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents" available at http://AIDSinfo.nih.gov.
What Not to Do
The first principle in designing a regimen is knowing what to avoid. Mono or dual therapy combinations should be avoided because of their inferior antiretroviral activity and high risk of fostering resistance. A combination therapy with three or more drugs—from different classes—is the recommended treatment regimen. There are certain combinations of antiretroviral drugs that are antagonistic and, therefore, should be avoided. The most notable combination to be avoided is zidovudine (ZDV, AZT) with stavudine (d4T) (Bennett et al., 2000; U.S. DHHS, 2003). Other combinations should be avoided because of pharmokinetic interactions. Didanosine cannot be taken with antiretrovirals requiring an acidic milieu for absorption; therefore, didanosine should not be combined with indinavir (Bennett et al., 2000). Didanosine also should also not be taken at full dosage with tenofovir. Toxicity profiles also should be considered when selecting a regimen. For example, didanosine, stavudine, and zalcitabine used in various combinations increase the risk of peripheral neuropathy (U.S. DHHS, 2003). As adherence to antiretroviral therapy can affect clinical outcome, thought should be given to the number of pills prescribed per day, food requirements, and to side effects. (There are many psychosocial determinants of adherence that are outside the scope of this review.) The combination formulation containing zidovudine with lamivudine (Combivir) allows two pills to be simplified to one pill. Indinavir and nelfinavir have fluid or food requirements that may need to be taken into account when using either of these in a regimen (U.S. DHHS, 2003).
What to Do
As previously noted, HAART—a three or more drug combination—should be used with the goal of suppressing viral replication, restoring immune function, and delaying morbidity and mortality. Based on regimens for which the most extensive clinical trial data are available, the U.S. Department of Health and Human Services recommends three categories of regimens for first-line therapy use (U.S. DHHS, 2003):
1 NNRTI + 2 NRTIs
(PI-sparing regimen)
1-2 PIs + 2 NRTIs
(NNRTI-sparing regimen)
3 NRTIs
(PI and NNRTI-sparing regimen)
The objective is to select a combination that is potent, tolerable, and to which the patient is mostly likely to adhere. Clinical studies have found that using one of these combinations of drugs can result in viral suppression in 80–95 percent of patients.
When to Start
As described throughout this report, there are many considerations in selecting a regimen and many possible complications that can arise with any given regimen. The "hit hard and hit early" approach that was used when HAART became available in the mid-1990s has been replaced by an approach that takes into account the many lessons learned about antiretroviral therapy use in the developed world (see Box B-1).
At this time, based on clinical trials and prospective studies, U.S. recommendations for starting therapy based on laboratory criteria are (U.S. DHHS, 2003) :
CD4 ≤ 200 mm3
Start therapy
CD4 > 200 mm3 but < 350 mm3
Offer therapy, weigh risks or benefits
CD4 > 350 mm3 and viral load > 55,000
Consider therapy
CD4 > 350 mm3 and viral load < 55,000
Defer therapy and follow CD4 count
Any values and patient with symptomatic
Start therapy
These laboratory parameters should be used as a guide. Ultimately, the decision should be made by the clinician and the patient after discussion of the goals of treatment and the risks and benefits associated with it.
SOURCES: Bartlett, 2004; U.S. DHHS, 2003.
The developed world experience with treatment for HIV/AIDS has helped guide other nations in developing treatment plans and goals. While many of the considerations in initiating and selecting therapy have no borders, there are certain issues that developing nations must weigh more heavily in the treatment of HIV/AIDS. As the treatment for HIV/AIDS can be lifelong, continuous access to drug therapy is one such issue. In developing nations, access can be hindered by cost; drug delivery, supply, and storage; counterfeiting; and infrastructure to administer the therapy. Fortunately, many pharmaceutical manufacturers have lowered the prices of ARV drugs for the developing world. Some drugs may require a cold chain, which is not be available in parts of the developing world. Resistance profiles vary across borders and this also has an impact on regimens of therapy that may be selected. Factors affecting adherence may be affected by culture and, therefore, differ among communities and nations. The stigma associated with having HIV/AIDS may hinder adherence to therapy. The ability to use laboratory testing to monitor toxicities may influence the regimens chosen in the developing world where technological infrastructure may be limited. Finally, pharmacological interactions between antiretroviral and antituberculosis drugs is a more common concern in resource constrained settings.
Recognizing the many barriers the developing world may face as ARV treatment is made available to millions across the globe, the World Health Organization (WHO), in its ambitious "3 by 5" initiative has recommended
four first-line regimens. (For the WHO's recommended criteria for when to initiate therapy, see Appendix C.) The WHO has decided upon these regimens based on clinical trial and observational study data, experience with use of ART in resource constrained settings—including efficacy and side effect information, and cost and availability of drugs (WHO, 2003a). The four regimens are all PI-sparing.1 The WHO decided to spare PIs in their first-line recommendations for several reasons which include: higher cost, higher pill burden, food and water needs, cold chain requirements, and short- and long-term side effects that may require more intensive monitoring (WHO, 2003a). The four regimens recommended as first-line therapy in resource limited settings are:
stavudine + lamivudine + nevirapine
zidovudine + lamivudine + nevirapine
stavudine + lamivudine + efavirenz
zidovudine + lamivudine + efavirenz
The first two regimens listed are available as fixed dose combinations (FDCs) in which all three drugs are combined into one tablet. FDCs have several advantages and disadvantages (MSF, 2004; WHO, 2003a,b). Advantages include: promoting patient adherence; improving health care worker adherence to treatment standards; minimizing prescription errors; and simplifying drug supply, management, and distribution. Disadvantages include: addressing the need to individualize the dosing of individual drug components and the differential half-life of the drugs and allergies to a component.
While the United States relies heavily on laboratory criteria to determine when to start and how to monitor therapy, limited infrastructure in resource-constrained settings may preclude this. The WHO recognizes this fact and recommends using clinical criteria and, when available, laboratory criteria to initiate and monitor therapy for HIV-infected persons in these constrained settings.
For further information regarding the advantages and disadvantages of the WHO-recommended regimens and the criteria used to start therapy, the reader is directed to the WHO 2003 Revision of Scaling Up Antiretroviral Therapy in Resource-Limited Setting: Treatment Guidelines for a Public Health Approach available at http://www.who.int/3by5/publications/documents/arv_guidelines/en/.
Over the past two decades much has been learned about the virus that causes AIDS and the natural history of the disease. Much research that guided success in treating HIV has been done in the developed world. The virus's pathogenic mechanisms are still being investigated. Research continues to develop improved and additional therapeutics to combat HIV and AIDS. As the epidemic knows no borders, it will be important that research on antiretroviral therapies and their advantages and disadvantage continue to be conducted around the globe.
Bartlett J. 2004. Antiretroviral treatment. In: Gorbach SL, Bartlett JG, Blacklow NR, eds. Infectious Diseases. 3rd Edition. Philadelphia, PA: Lippincott, Williams & Wilkins. Pp. 1028–1038.
Bennett JE, Dolin R, Mandell GL. 2000. Mandell, Douglas and Bennett's Principles and Practice of Infectious Diseases. 5th Edition. Philadelphia, PA: Churchill Livingstone.
Centers for Disease Control and Prevention. 1992. 1993 revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults. Morbidity and Mortality Weekly Review Weekly 41(51):961–962.
Clavel F, Hance A. 2004. HIV drug resistance. New England Journal of Medicine 350(10): 1023–1035.
Deeks S. 2002. Treatment of antiretroviral-drug-resistant HIV-1 infection. Lancet 362(9400): 2002–2011.
Hirsch MS, Brun-Vezinet F, Clotet B, Conway B, Kuritzkes DR, D'Aquila RT, Demeter LM, Hammer SM, Johnson VA, Loveday C, Mellors JW, Jacobsen DM, Richman DD. 2003. Antiretroviral drug resistance testing in adults infected with human immunodeficiency virus type 1:2003 recommendations of an international AIDS society-USA panel. Clinical Infectious Diseases 37:113–128.
Kilby JM, Eron JJ. 2003. Mechanisms of disease: Novel therapies based on mechanisms of HIV-1 cell entry. New England Journal of Medicine 348(22).
Lalezari JP, Henry K, O'Hearn M, Montaner JS, Piliero PJ, Trottier B, Walmsley S, Cohen C, Kuritzkes DR, Eron JJ Jr, Chung J, DeMasi R, Donatacci L, Drobnes C, Delehanty J, Salgo M; TORO 1 Study Group. 2003. Enfuvirtide, an HIV-1 fusion inhibitor, for drug-resistant HIV Infection in North and South America. New England Journal of Medicine 348(22):2175–2185.
Lazzarin A, Clotet B, Cooper D, Reynes J, Arasteh K, Nelson M, Katlama C, Stellbrink HJ, Delfraissy JF, Lange J, Huson L, DeMasi R, Wat C, Delehanty J, Drobnes C, Salgo M; TORO 2 Study Group. 2003. Efficacy of Enfuvirtide in Patients Infected with Drug-Resistant HIV-1 in Europe and Australia. New England Journal of Medicine 348(22): 2228–2238.
MSF (Médecins sans Frontières). 2004. Two Pills a Day Saving Lives: Fixed-Dose Combinations (FDCs) of Antiretroviral Drugs. Geneva: Médecins sans Frontières.
Petrello M, Brenner B, Loemba H, Wainberg MA. 2002. HIV drug resistance implications for the introduction of antiretroviral therapy in resource-poor countries. Drug Resistance Updates 4:339–346.
Richman DD, Morton SC, Wrin T, Hellmann N, Berry S, Shapiro M, Bozzette S. 2004. The prevalence of antiretroviral drug resistance in the United States. AIDS 18:1–7.
Schutz M, Wendrow A. 2001. Adapted from "Quick Reference Guide to Antiretrovirals." [Online]. Available: http://www.law.duke.edu/aidsProject/400_01/GuideAntriRetros.pdf [accessed September 2, 2004].
Sepkowitz KA. 2001. AIDS: The first 20 years. New England Journal of Medicine 344(23):1764–1772.
Sklar P, Masur H. 2003. HIV infection and cardiovascular disease: Is there really a link? New England Journal of Medicine 349(21):2065–2067.
U.S. DHHS (United States Department of Health and Human Services). 2003. Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents. [Online]. Available: http://AIDSinfo.nih.gov [accessed August 23, 2004].
WHO (World Health Organization). 2003a. Scaling Up Antiretroviral Therapy in Resource-Limited Settings: Treatment Guidelines for a Public Health Approach. [Online]. Available: http://www.who.int/3by5/publications/documents/arv_guidelines/en/ [accessed August 23, 2004].
WHO. 2003b. Emergency Scale-up of Antiretroviral Therapy in Resource-Limited Settings: Technical and Operational Recommendations to Achieve 3 by 5. [Online]. Available: http://www.who.int/3by5/publications/briefs/arv_guidelines/en/ [accessed August 23, 2004].


text: Jeffrey Epstein described himself as "radioactive", and then he died in prison. But right before that, he was a friend and confidant of many of America's most powerful politicians, billionaires, and entertainers, some of whom apparently shared a common interest: trafficking underaged girls. In "BROKEN: JEFFREY EPSTEIN" host Ariel Levy (The New Yorker) and Special Correspondent and Executive Producer Julie K. Brown (The Miami Herald) tell the full story of Epstein, his accomplices, and the broken systems that enabled his crimes.


text:
Search the Community
Showing results for tags 'g'.
Found 2 results
Why Do People Hate On The VK 16.02 Leopard
theangrytoast posted a topic in GermanyI recently purchased the Leopard after having a seriously heated debate with one of my friends whose general impression of the tank is that it is a steaming hot pile of German shit. However, after playing about 20 (with a 70 xTe) games in it, I could not disagree more with him. I love it! I just want to know if the German light tank line gets even better and also why people hate that tank so much.
Visiting for the nostalgia
8112204 posted a topic in ShenanigansComrade tankers, Darkest were the days of 1941 when we ground through the T-34 line, clanless and alone. Then we saw the light of the Forum Warriors channel, from which came offers of platoons and friendship. We remember how we became one with PBKAC and fought our campy Swamp battles in Europe. We can still vividly hear the IOC's order on Fisherman's Bay: "one-two line, begin yer push". We recall our victory with a half-baked fascist box strat on Ruinberg and our obscene defeat from "dick in facce" on Cliffs. We were there to witness the conception of hardcore PBKAC Himmelsdorf strats, where once we stacked meds on the hill only to lose to a capfast. We had our moments farming lame points with BULBA in the Americas and doing our giddy M60 count-ins to farm pubbie tears. And of course, who can forget the thunderdome, the fast-bois strongholds, and the anime club. Nowadays the war is over and the soldiers don't know where to go. The WarGods removed all-chat and so we bid farewell to the days of smack-talking baddies. CR/D is dead and gone, forever buried deep in the ground alongside Chairinabasket. We wonder where the veterans from old PETCO are now and what new hip game they play today. We tried the PTSD-inducing Red Orchestra 2, fighting the Great Patriotic War as a conscript with only a rifle and bayonnet, but the community there was small, they didn't insult each other much, and there was neither stat padding nor metagame. We tried League of Legends, finding some of the memes and airhorn-inducing MLG plays entertaining, but it lacked the euphoric feeling of a 3-unicorn hard-carry; there was none of the "us versus them" mentality as the game just makes good players fight other good players. We miss the days of WoT; terrible as the game is, the people playing it are second to none. We dream of fighting with you unicorns in the halls of Valhalla, forever pursuing the 99.9% winrate and surfing on the waves of the Red Sea. Thank you all for our time together. We are here to read through old posts and we would love to chat and reminisce. 8112204 (2011 - 2015)


text:
Earthborn®; Earthborn was founded as a small, independent British brand over 15 years ago with the aim of providing a true environmentally friendly alternative to conventional paints. They have worked hard to build a trusted reputation for performance with style. We love their credentials and reckoned they would sit well with our existing brands, whilst bringing this major player to Penwith! We stock all 72 samples of the Classic range and a selection of the Eco Chic Furniture Clay Paint, along with a range of sundries to help you complete your project.
If you have a house decoration or renovation project, we can advise on the range from Claypaint for the DIYer to Ecopro for the tradesperson and order your requirements. We stock the Casein Fillers and Isolating Primer.
Earthborn paints are special. They do not believe you should have to sacrifice quality or style to protect your health or the environment. By carefully selecting ingredients and using technologically advanced manufacturing processes and formulations, they create outstanding products that prove their point. Earthborn provide stylish, high performance products that are safer to use and sound for the environment. Perhaps more importantly, it is not only what goes into a paint but also what comes out of it that matters.
Classic Paint Colours:
EcoPro Emulsion Colours:
EcoPro Masonry Paint Colours:


text:
Keche Dazzles Patrons At TV3's Tigo 'Music Music' Show
This past weekend saw afro-pop, hiplife duo Keche made up of Andrew and Joshua, steal the show at the Tigo 'Music Music' show during their electric performance.
Backed by their official turntable master, DJ Sid Keche performed back-to-back hits close to 20-30mins with patrons simply left thrilled.
The rejuvenated fashion trendy duo turned the studio into a party frenzy zone as they had audience jamming to their songs.
The tempo in the TV3 studios went up a notch when Keche performed the lady's favorite 'Diabetes', singing note for note to the pleasure of patrons.
As tribute to all who lost their lives during the recent unfortunate flood rains and fire incidents in Accra, Keche performed a new song titled ''Farewell''.
In response to the love shown by fans during their performance, the duo via social media thanked TV3 & Tigo Music for making the event possible.
In addition, Keche announced they will be releasing their most anticipated Highlife song coming this friday.


text:
The Milwaukee Root Canal | Press Release
Root canal press release from Dr. Tony Cigno of Cigno Family Dental
Tony Cigno, Wisconsin family dentist, shares the details of his Milwaukee root canal procedure including who needs one and what to expect.
Greenfield, WI — February 28, 2016 — Wisconsin dentist Tony Cigno recently published a new blog post, "So You've Been Told You Need A Root Canal Milwaukee? Wondering - What Is A Milwaukee Root Canal and What Will It Be Like?"
In the article, Tony seeks first to reassure the reader that a root canal is not an unusual procedure. He goes on to add if you've been told you need a root canal, you can take solace knowing this is a very common procedure.
As Tony Says, "Millions of people have a root canal procedure or endodontic dental services every year. The good news is a root canal done by a top dentist in Milwaukee – or endodontist – can save your teeth and your smile! There is no better smile makeover than actually being able to smile!"
Dr. Cigno goes on to share the details of when a root canal becomes a necessity and outlines the specific root canal process. He explains how the pulp of the tooth gets infected and/or inflamed and causes severe damage to the tooth root and the tooth itself. This then causes ongoing pain and possibly, abscess.
The entire article can be found here: http://www.cignodental.com/so-youve-been-told-you-need-a-root-canal-milwaukee-wondering-what-is-a-root-canal-and-what-will-it-be-like/
Dr. Antonio (Tony) Cigno has been practicing dentistry for 25 years. He received a DMD from the Washington University School of Dental Medicine in St. Louis, Missouri. He is also finishing a Fellowship and Mastership at the Academy of General Dentistry and has written several published articles.
Dr. Cigno is a member of the Academy of General Dentistry, American Association of Functional Orthodontics, and the International Association of Orthodontics. He was also Wisconsin's very 1st and Premiere Provider of Fastbraces and one of 10 senior master affiliates in the world.
Dr. Cigno is committed to continuing education and has completed over 600 hours of additional courses in implant dentistry, orthodontics, endodontics, periodontics, fixed prosthodontics, myofascial pain/occlusion and operative dentistry. He also has another 400 hours in interpersonal communication training.
[ebs_seo_cp_contact_only] [ebs_seo_cp_map_only width="750" height="250"]


text:
Our Services Maintenance
We take pride in building our ORC power generation solutions as smart, compact and tough as possible, and they usually require low-impact maintenance spread over a long time. No equipment, however, can live long without an appropriate and sensible maintenance plan. So, to keep our systems operatina at peak performance, Zuccato Energia offers its clients a wide range of post-sale maintenance services and plans which include:
- Scheduled maintenance services, i.e. periodic inspections, checks, programmed spare parts substitutions and software updates to make sure your Zuccato Energia system always operates at top efficiency.
- Unscheduled maintenance services: quite simply, if it breaks, you call us and our technicias come and fix it, taking care of all possible malfunctions and failures.
- Full-service maintenance: the payment of an annual forfait guarantees both ordinary and extraordinary maintenance with a fixed down payment that simplifies accountancy;
- Personnel training: Zuccato Energia ORC modules are built to run mostly without intervention on the customer's part, and an extended start-up phase is performed by our personnel, working side by side with the client's employees, thus giving them a hands-on field training. This ensures that the client's personnel acquires the know-how and manual skills required for day-to-day operation and ordinary maintenance tasks performance (e.g. periodic filter cleaning) in full autonomy. Zuccato Energia can however, at the client's request, organize further training courses to bring new staff up to date.
- Custom maintenance plans: designed together with the client, they may include a mix of all of the above or include/exclude some elements.
The Importance of Remote Maintenance
All of Zuccato Energia's ORC modules are equipped with an integral telecontrol and telediagnostic systems that gives both the client and - if necessary - our technicians full remote control of the ORC system, making it possible to perform preventive maintenance (i.e. spare parts substitution before the part actually fails). The client may also delegate full plant operation and supervision to Zuccato Energia in exchange for an annual payment, thus having the certainty of continued efficiency and qualified supervision.


text:
By Walter Broeckx
Oh how easy it is sitting the studio. Comfortable while looking at some big screens. Where you can look back at things. And use all kinds of nice graphic tricks to show what a complete fool or brilliant mind (depending on the situation) a player has been. Or even nicer…to show what a fool a manager has been because he couldn't stop a player from scoring against his team.
They sit there and put circles around players. Connect those circles with lines. Follow runs with dotted lines. All the tricks in the media books of real and upper class football punditism. Does this word exist? If not, I will claim it now.
In the past we had the "Alan Shearer Project". Wasn't there a band the Alan Parsons project once? They sure were more successful than the managerial career of Alan Shearer. The pundit who managed to take Newcasle to the championship in his short spell near the touchline.
A few months ago it was a bit of a bang. Former Manchester United leg kicker and now TV pundit Gary Neville became manager of Valencia. That was on December 2, 2015. Now we would see the real genius of this former player as a manager.
Despite Neville saying a few good things about Wenger he also has been critical calling him naïve. Now I must confess I didn't know what else he said for the rest as I am one of those happy people who don't watch all those talk shows about football where people highlight the stupidity of the managers out there.
But let us have a look at how ex-pundit Neville is doing in reality at Valencia.
Valencia played 9 matches so far under Neville in the Spanish league. And the record shows… 0 (that is zero yes) wins. 6 draws and 3 defeats.
Now I still remember his first match against Barcelona. A 1-1 draw. I do remember this because after that draw the media as usual focussing on the latest result only, almost declared Neville as the best thing since sliced bread. Genius Neville getting a point against Barcelona.
Okay, getting a point against Barcelona is not bad of course. But that was in his first match and you sometimes get a short boost in the team with players fighting for their place under the new manager.
Watch Arsenal Live Streams With StreamFootball.tv
But since then….. zilch results. A win percentage of 0% (zero again). Of the 27 total points he could have won in his period as their manager (together with his brother by the way as assistant manager) he won 6 points. Valencia since his appointment is slipping down the league table. Currently sitting in 12th place. Some 5 points above the relegation zone. Will we witness another Alan Shearer show at Valencia?
Now I must admit that he did manage to qualify for the Spanish Copa del Rey as it is called over there. Beating Granada who is one of their fellow strugglers in the lower regions of La Liga with two high scores. And then even beating Las Palmas another struggle in La Liga. But credit has to be given for reaching the next round where they will play Barcelona in the semi-final in the coming weeks.
But his record in the league can be called ridiculously bad. And that for a pundit. Again. Just as Shearer found; leaving the comfort zone of the TV studio, it suddenly isn't that easy any more.
But when those pundits talk their rubbish a part of the audience believes every word they say. And use it to blame Wenger when things don't go as planned.
A few dotted lines on the TV screen, a few circles around players is enough to make a fool of the manager sitting on the bench. How on earth did he let that happen? Implying of course that if they would have been the manager it wouldn't have happened at all. Intelligent people of course know that they are just talking with the benefit of hindsight.
And that benefit is based on the rule that whoever won the match will be praised to high heaven even if they have been rubbish and could only win a match with one shot on goal that took seven deflections before passing the goal line and having been saved 17 times with shots hitting crossbar and goal posts. No, the winner takes it all is the norm in punditry. The loser is there to be ridiculed.
But once such a pundit takes the real field and has to show what he can do as a manager… it seldom leads to success. That is one of the reasons I dread Thierry Henry becoming our manager in the future. It's all well and fine to be a hindsight manager but that is not what a manager is about at all.
And in the meanwhile Arsène Wenger is just doing his job. And has proven that not one of those pundit experts is even fit to tie his laces. Yet it is Wenger who gets the abuse and unwarranted criticism from the pundits. An abuse that is quickly repeated by those who claim to be Arsenal fans but not supporters.
Being a manager is not an easy job. I wouldn't even start doing it for the money they give Wenger to be honest. Ok, I might think about it when offered. But seriously to have done what Wenger has done in his career at Arsenal… Having to fight all kinds of enemies. Some in the open on the field and some not so open on the field where you had to look carefully to see the enemies. Fighting against the money teams with no resources.
Wenger really is the greatest of the all. And no pundit has ever proven that they are even worth to say one negative word about Wenger. First do better than Wenger has done in the same circumstances and then come back to tell Wenger what to do. But when you would use that as a criteria the nobody would fill that criteria.
Neville, the next pundit who fails as a manager? It sure looks like that.
- Valencia lose Spanish Cup semi-final first leg 7-0. "One of the worst results in our history," Suso García Pitarch, Valencia's Sporting Director.
Two anniversaries (more details on the home page)
4 February 1911: Swindon 1 Arsenal 0; FA Cup 2nd round. Crowd 14,861. Swindon were Southern League champions and had such played Man U in the Charity Shield, and had also played in an early European Cup competition.
4 February 1922, The Duke of York attended Arsenal 2 Newcastle 1. With Sir Henry Norris and William Hall unavailable, directors Jack Humble, Charles Crisp and George Peachey, did the honours.
The Untold Books
The latest Untold book is Arsenal: The Long Sleep 1953-1970 with an introduction by Bob Wilson, available both as a paperback and as a Kindle book from Amazon. Details of this and our other titles can be found Arsenal Books on this site.


text:
Skip to content Ontario.ca Français
Ministry of
Children, Community and Social Services
You are here > Home > Adoption > I've decided to adopt > Public adoption
All public adoptions are handled by children's aid societies (CAS). You will first need to contact a CAS in your local community.
You will be asked to attend a CAS orientation session. Here you will learn about becoming an adoptive parent of a child who is in the permanent care of a CAS. This child is known as a Crown ward.
You will then be asked to complete an application form that formalizes your intent to adopt. It provides the CAS with your adoption preferences.
The Structured Analysis Family Evaluation (SAFE) assesses your skills, readiness to raise an adopted child and home environment. It helps you to better understand what is involved in becoming adoptive parents and raising an adopted child.
This is a mandatory process and can consist of four to six interviews spanning over three to eight months. The homestudy helps to determine whether you are ready to be an adoptive parent and what type of child you are best suited to adopt.
Learn more about the documents you must provide as part of the homestudy and what to expect during the homestudy.
Adoption Preparation
The Parent Resources for Information and Development and Education (PRIDE) program helps to prepare you for the responsibilities involved in raising adopted children. This is a mandatory and standardized training program that has a 27-hour curriculum. It can be completed at the same time as your homestudy.
Find more detailed information about the PRIDE program and the topics that will be covered.
Your CAS adoption worker will work with you to match a child with your family.
There are resources available to improve the chances of finding a match. This includes applying to be added in the Adoption Resources Database and the Adoption Resource Exchange Conference. Regardless of how a match is found, the most important consideration is whether the match is in the best interest of the child.
These are some programs that can help you find a match:
When a match has been found, you will be given the social and medical history of the child and their birth family. You will be given time to consider the placement.
If you decide to move forward, the child will make several visits to your home. This allows the child to get to know your family and surroundings before moving into your home. These visits are called pre-placement visits.
Adoption probation
Once a child is officially placed in your home, an adoption probation begins. This lasts for at least six months to ensure that the placement is appropriate for both your family and the child before the adoption is finalized.
The adoption worker will visit your home regularly during the probationary period. They will to provide support, resources and assess how the child is adjusting into your family. Usually, the probationary period lasts six months, but it can be longer.
The adoption can be finalized once the probation period is over and the match is determined to be a good fit for both your family and the child., It is then finalized in an Ontario court and you will become the legal parent of your adoptive child.
Financial assistance
Families may be eligible for financial support when they adopt a child from a CAS. It is evaluated and provided on a case by case basis through your CAS.
Financial support may be available to help parents cover identified needs and special needs, if parents are unable to meet those costs. You can talk to your local CAS about financial help.
Eligible families who adopt or take legal custody of specific groups of Crown wards will receive subsidies from a CAS to help with the cost of caring for these children. Families must meet the following criteria to be eligible for subsidies:
Eligible families will receive $1,035 per month or $12,420 annually for each eligible child up until the child turns 21.
Open adoptions allow for some form of on-going contact between the child and individuals from the child's birth family that is of benefit to the child. Open adoptions are decided by the court. They are voluntary agreements that allowing consent for continued contact between the child and individuals from the child's birth family.


text:
Two years ago today, 276 girls were abducted by Boko Haran. Fifty-seven escaped, but from the rest … silence. The world stood in horror. The Church prayed. The First Lady got involved. And we all cried out "Bring back our girls!"
And the mothers are still crying. With gaping holes in their hearts they wonder if their girls have been raped, sold, wrapped in explosives and used to bring terror and death to others.
A proof-of-life video has surfaced showing 15 of the girls.
Two mothers have identified their daughters, Saratu and Hauwa, and another mother has identified five more of the girls.
While the video is still being authenticated, it is the first sign of hope these mothers have had in months.
Can you imagine?
The easiest thing to do when you hear stories like this is to shut it down and move on. It's painful. It's hard. And we feel powerless to do anything to help. I want to ask you to choose a different way. I want to ask you to dare to care.
Here are 6 Ways You Can Dare to Care.
1. Learn boldly. We are inundated with so much information. And so much of our "news" is entertainment. Would you choose to look at one video or read one article today about these girls? Here's a link for you.
2. Pray boldly. Two years is a long time to pray when it doesn't seem like much (anything) is happening. But would you choose today to pray boldly that God would, even now, "bring back our girls?" Pray boldly.
3. Share boldly. This is a "downer" of a story. We like puppies and kittens and hilarious videos of wisdom teeth, brothers, and zombies. But could you share with a friend or two and perhaps pray together right then, right there that God would orchestrate a rescue? Share boldly.
4. Give boldly. There is no organization related to this particular situation that is raising funds. So, do not give to anyone to bring back our girls. However, do give boldly toward social justice initiatives around the world. International Justice Mission is a place you can start. Give boldly.
5. Feel boldly. Allow yourself to imagine yourself as one of these mothers. Allow yourself to feel the feelings, to grieve, to be angry, to empathize. But rather than being paralyzed by compassion, let it move you to action. Feel boldly.
6. Act boldly. Be done with the day of doing nothing and do something. Perhaps today you can't actively work to bring home these girls, but there is something you can do in your corner of the world today. Open your eyes. Look around. Is there someone hurting, vulnerable, in need? What can you do to help? Act boldly.
My heart breaks for the 219 that are still missing. Can you and I dare to care for these girls today? Please join me today over at my Facebook page. Link articles that you read about the girls or their families. Write out prayers for the girls. And share any ideas you have about how you and I together can dare to care.
Arise, O Lord; O God, lift up your hand;
forget not the afflicted.
Why does the wicked renounce God
and say in his heart, "You will not call to account"?
But you do see, for you note mischief and vexation,
that you may take it into your hands;
to you the helpless commits himself;
you have been the helper of the fatherless.
Break the arm of the wicked and evildoer;
call his wickedness to account till you find none. Psalm 10:12-15


text:
epic,inspiring, dramatic track with really beautiful solo cellos and horn. Instruments: spiccato, staccato and full strings, brass, solo cellos and horn, drums, percussion, piano. This is really good and perfect track for your media projects,trailer and many else.
This soundtrack will be perfect for action, adventure videos or movies, extreme and tensieve scene like GoPro or any sport video (downhill, skydiving, rope jumping, wingsuit, fly suit, racing).
Ideal for beautiful epic moments, landscapes, nature, drone video, panarama, motivational products and achievements.
This versatile beautiful and dramatic music will be relevant to many videos, slideshows, background for photos, ads, video game reviews.
Enjoy and be happy!
|Last Update
|January 11, 2018, 10:16 am
|Looped Audio
|Bit Rate
|320 kbps
|Sample Rate
|16-Bit Stereo, 44.1 kHz
|Tempo (BPM)
|YouTube Content ID Registered


text:
We have an exciting opportunity for a Senior Risk Consultant to join our industry-leading team of 60 data scientists and analysts.
We have an exciting opportunity for a Machine Learning Consultant to join our industry-leading team of data scientists and analysts.
We have an exciting opportunity for an Analytical Consultant to join our industry-leading team of data scientists and analysts.
We're looking for a versatile writer who loves big ideas as much as bitesize social copy.
We need a passionate, experienced CRM Campaign Manager. In this role, you'll be responsible for developing, executing and improving the agency's CRM and lead generation/nurture strategy. This is with the aim of driving engagement and sales through our direct channels, like email, as well as other online and print mediums. You'll build a strong strategy for our plans and activity, which should generate quality sales-ready leads, stirring up interest and engagement in Jaywing's wide range of services. This strategy should also nurture leads and opportunities, to the point of conversion. Your role will encompass reaching out to new prospects, as well as engaging existing clients in innovative ways, to improve cross-sell, retention and lifetime value.
Jaywing's Performance and Media Science team is at the heart of the Jaywing business. The Head of Paid Media will help shape the paid media product offering for the agency, working closely with the Operations Director to drive this area.
As Jaywing's Business Development Director, your main objective is to generate GP growth in the Financial/Professional services vertical. You'll need to maximise close rates, and nurture a prospect network, all while continually improving opportunity qualification, and pitch delivery. Working closely with the Demand Generation Manager, who creates an active pipeline of prospects, it'll be your job to qualify these prospects in or out of the pitch process, and maximise close rate by employing your own consultative selling techniques.


text:
Wegrammi Promotions
The latest vouchers, promo codes, discounts and deals from Wegrammi.com
We offer promotions as a way of saying thanks. So promotions are just one way we try to reward you.
Always Good news
You don't have to dig in search engines through a bunch of dodgy, ad-heavy sites hoping you might find a code that works (and ending up time wasting). Just scroll down to the bottom of almost any of Wegrammi page on our website and sign up for our mail list. If you're eligible for a discount, and you're signed up for our email list, we'll deliver it directly to your inbox.
Need Help Deciding?
Help, Support & Consultation
Contact our team, to see how we can help or get your project moving!
Receive Premium Support 24/7
Subscription Plan - Cancel Anytime - Terms Apply.


text:
'Dancing With The Stars' helps students learn mathOctober 17, 2016
At New York's Greece High School, teacher Courtney Larkin uses the television show Dancing with the Stars as a platform to help her students master multiplication, division, decimals, percentages and other math concepts. "The students relate to it very well," Larkin says. "They're engaged and having fun – which is the best thing for a teacher." Larkin's example is one of many creative approaches teachers use to support learning to higher standards. Rigorous, consistent education standards do not force teachers into a rigid model for classroom instruction, 21 State Teachers of the Year wrote previously. "Teachers have greater flexibility… and can, for the first time, take advantage of the best practices from great teachers in other states."