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Most clients experiencing chest discomfort use rationalization and deny that they are experiencing pain. Anger, depression, and hostility may occur, but denial and rationalization are the most common reactions.
Nitroglycerin tablets are administered one every five minutes, not exceeding three tablets for chest pain as long as the client maintains a systolic blood pressure of 100 mm Hg or above. The physician is notified if the chest pain is not relieved after administering the three tablets.
Morphine sulfate is administered to control pain in cardiac clients. The nurse assesses the client's heart rhythm and vital signs, especially noting the client's respirations. Signs of morphine sulfate toxicity include respiratory depression and hypotension. The client would be placed in the Trendelenburg position if a sudden drop in blood pressure occurs.
Troponin is a regulatory protein found in striated muscle (skeletal and myocardial). Increased amounts of troponin are released into the bloodstream when an infarction causes damage to the myocardium. A troponin I level greater than 1.5 ng/mL is consistent with a myocardial infarction. A troponin T level greater than 0.1 to 0.2 ng/mL is consistent with a myocardial infarction. Cardiac enzymes and isoenzymes may also be used to confirm myocardial infarction.
Constipation occurs as a result of inactivity and is an undesirable complication for cardiac clients because straining or bearing down triggers the Valsalva maneuver, which increases cardiac workload
Heparin is an anticoagulant, which decreases clotting time. The nurse monitors the client for signs of bleeding, such as bleeding gums, petechiae, hematoma formation, and blood in the stool and urine.
Activity restrictions are often a concern of clients following CABG. Resuming normal sexual relations will be allowed, but the physician decides when the client can safely resume this activity.
An infant who suddenly becomes pale, cries out, and draws the legs up to the chest is demonstrating physical signs of intussusception.
Ribbon-like stool, bile-stained emesis, abdominal distension, and the absence of peristalsis are symptoms of congenital megacolon (Hirschsprung's Disease)
Padded crib sides will protect the child from injury during seizure activity, if a seizure occurs. A padded tongue blade should never be used for a seizure and nothing should be placed in a child's mouth during a seizure. During a seizure, the child should be placed in a side-lying position but should not be restrained. A code cart should be available but does not need to be placed at the bedside.
A 10 month old is in the Trust vs. Mistrust stage of psychosocial development (Erik Erikson) and in the sensorimotor period of cognitive development (Jean Piaget). Hospitalization may have an adverse effect and a consistent routine accompanied with touching, rocking, and cuddling will help the infant to develop trust and will provide sensory stimulation.
After a crush injury, myoglobin released from damaged muscle cells circulates in the bloodstream and can clog renal tubules. It is important to maintain an increased fluid intake to "flush" the kidneys and minimize this occurrence.
Homes that are older than 25 years may have lead paint and will most likely have lead pipes. Living close to high traffic areas can also contribute to lead poisoning as a result of inhaling exhaust. Hyperventilation and diaphoresis are signs of salicylate poisoning, not lead poisoning. A fruity breath odor is a symptom of ketoacidosis. Pencil lead is made of graphite so it does not present a hazard. Crayons are not toxic.
Bleeding into joints is a clinical manifestation of ALL, and cold applications will decrease joint discomfort. Aspirin has anticoagulant properties and would not be prescribed. Heat application will increase blood circulation to the site, which will increase pain and bleeding if it is present.
Proper dental care should be taught to a toddler.
Digitalis glycosides must be used cautiously in clients taking a loop diuretic because electrolyte imbalances such as hypokalemia can occur increasing the risk of toxicity. The risk for toxicity can also occur in clients with an impaired ability to metabolize medication, such as occurs in hypothyroidism.
Joint immobilization will assist in preventing bleeding. NSAIDs can prolong bleeding time, and increase the bleeding and the pain due to pressure of the confined fluid in the narrow joint space. Heat application will increase blood flow to the area and increase the bleeding. Physical therapy can be helpful after the bleeding episode is under control, but during the acute period, it can increase bleeding.
The most serious side effect of the phenothiazine antipsychotics is tardive dyskinesia. Early signs of this condition are lip sucking and smacking behaviors, tongue protrusion, facial grimacing, and choreiform movements.
A high probability of rheumatic fever is indicated when there is evidence of at least two of the major or one major and two minor manifestations of the Jones criteria and evidence of a streptococcal infection. The sedimentation rate is normally increased in rheumatic fever. An elevation in antistreptolysin-O antibodies indicates a recent streptococcal infection, but does not alone diagnose rheumatic fever.
Growth takes place at the epiphysis of the long bone. A fracture at this level can destroy the layer of germinal cells of the epiphysis, resulting in growth disturbance. Osteomyelitis is an infection of the bone and would be more likely to occur with a compound (open) fracture rather than an epiphyseal fracture. Muscle atrophy may result from immobility or casting, but will resolve as activity increases. Paresthesias and paralysis can result from edema and constriction by a cast, not specifically from fracture of the epiphysis.
An asthmatic child over the age of 4 should be able to measure the expiratory flow. A drop in expiratory flow is the most reliable early sign of an asthma episode. Medications would be administered by a metered-dose inhaler or by a hand-held nebulizer if an asthma attack actually occurs. Chest percussion and postural drainage are normally used to clear air passages for children with cystic fibrosis, not asthma.
Administering around the clock dosing provides increased pain relief and decreases stresses associated with pain, such as anxiety and fear. Opioid analgesics may be addictive but this is not the concern in a client with terminal cancer.
Numerous, frequent episodes of a child staring off into space and then quickly returning to conversation or activities are a classic sign of absence seizures that can be confirmed by an EEG. Classic symptoms of ADHD include easy distraction, fidgeting, and problems following directions. School phobia includes physical symptoms that usually occur at home and may prevent the child from attending school.
In an anorexia client, Until the client begins to take adequate nutrition and is physiologically stable, the nurse cannot work with the client on other levels.
The administration of magnesium-containing antacids can cause increased magnesium levels in the client with renal failure.
Warfarin (Coumadin) is an anticoagulant and is given to maintain an INR of 2.0 to 3.0 for most conditions requiring therapy.
Digoxin is a cardiac glycoside. One of the adverse effects of digoxin is slowing of the pulse rate that occurs due to a decreased conduction at the atrioventricular (AV) node. Therefore, the nurse would check the client's apical pulse rate. Additionally, if the pulse was lower than 60 beats per minute, the medication would be withheld and the physician would be notified.
The use of a folk healer and home remedies is very common in the Hispanic cultural group.
Edema is a sign of gestational hypertension (pregnancy-induced hypertension or PIH) and should be investigated further. Other manifestations of gestational hypertension are proteinuria and hypertension.
Some cardiac medications, particularly the nitrates, dilate the body's arteries, which can increase blood flow to the brain and cause headaches. These headaches are usually transient and treatable with over-the-counter pain relievers, such as acetaminophen.
Tetracyclines are deposited in the teeth and bones of the fetus. These medications can cause permanent tooth enamel discoloration and can depress bone growth. This medication does not induce labor.
In older clients, medications are metabolized and excreted more slowly; therefore the risk of adverse effects is increased. Halcion can cause confusion and dizziness leading to impaired mobility.
In normal sinus rhythm, the rhythm is regular, the rate is 60 to 100 beats per minute, and the P-R interval is 0.12 to 0.20 second. Sinus bradycardia occurs when the sinoatrial node fires at a rate of less than 60 times per minute. Sinus tachycardia is characterized by a rapid, regular rhythm at a rate of 100 to 180 beats per minute. In atrial fibrillation, the P waves are erratic or not identifiable.
Article copyright NurseReview.org - #1 source of information to update nurses all over the world. All rights reserved. No part of an article may be reproduced without the prior permission.


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Reviewing Your Estate Plans
If the W2's and 1099's haven't been enough of a warning, then let this provide notice that taxes will be due soon! There were a number of small changes that you'll want to be aware of as you prepare to meet with your accountant, but as long as you're taking a look at your family's financial picture, it's a good time to be reviewing your estate plans. Here are five things to do now to make sure that you are making the most of the estate plans you have in place.
1. Make sure your trusts are funded. It seems silly, but it's extremely common. A family does the right thing by meeting with an attorney to draft their estate plans, and they have living, or revocable, trusts formed. The second step, once those documents are drafted, is to actually go to your financial institutions and change the ownership of your assets into that trust. In addition, there is some paperwork that needs to be filed to change the ownership of your home into the trust.
2. Check your beneficiaries. While you have your trusts and retirement plan documents in front of you, it's a great time to check who is listed as the beneficiary of the trust, as well as your retirement accounts and insurance policies. If there have been changes to your family, or if it has been several years since you've named those beneficiaries, there may be changes, and it's critical that they are accurate.
3. Review your Fiduciaries and Trustees. The named trustees and fiduciary organizations in your estate plan will be the ones to make major decisions with regards to investment choices, distributions, and are responsible for filing important tax documents. You may have named a co-worker, neighbor, accountant, or a friend at one point in time, but it's a good idea to review those designations. Do you still maintain contact with them? Are they charging a fee? Are your heirs old enough now to take the reins?
4. Consider current Estate Exclusions. Each year, you are allowed to gift up to $14,000 per person, per recipient, or $28,000 per couple. If the gifting is made early in the year, not only have you moved any potential growth on that money out of your estate, but if something were to happen to you, that money would already have been moved out of your estate for estate planning purposes. The Illinois estate exemption remains at $4.0 Million for 2016, and the Federal estate exemption was increased slightly to $5.45 Million, per person. If you are near or exceeding those limits, it is important to take steps to reduce your estate to minimize your tax liability.
5. Stop Procrastinating! If you haven't yet created a will or any sort of estate plan, you should make it a top priority this year. The peace of mind you'll get from knowing that you have a power of attorney in place, guardianship for your children, and your estate distributed as you wish is worth the price of admission itself, not to mention being able to avoid probate and any potential estate taxes.
Ready to Take The Next Step?
For more information about any of the products and services listed here, schedule a meeting today or register to attend a seminar.

subset: commoncrawl


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How do I know if Suboxone is right for me?
When taken as a part of a medication assisted treatment program, Suboxone is an extremely safe and effective option for individuals struggling with addictions to opioids. Suboxone provides relief from the painful symptoms associated with withdrawal and diminishes cravings for additional opioid use. By consulting with the highly qualified medical team at Wausau Comprehensive Treatment Center, you can gain a better understanding if Suboxone is the appropriate medication to meet your individual needs.
Can I become addicted to Suboxone?
Like other medications, there is a risk of abuse when taking Suboxone. However, when patients take Suboxone as prescribed within a medication assisted treatment program, the risk for abuse is extremely low. Buprenorphine and naloxone are the main components of Suboxone and interact with the same receptors in the brain that are typically activated by prescription painkillers, morphine, and heroin. Buprenorphine provides patients with relief from cravings for additional opioids, as well as a decrease in the symptoms associated with withdrawal. Suboxone provides patients with the mental clarity required to focus on recovery without experiencing the euphoric high associated with opioid use.
Will Suboxone show up on a drug screening?
A positive result will not take place should an individual be required to complete a drug screen while prescribed Suboxone. A specific test is required in order to detect buprenorphine (the primary active ingredient in Suboxone) within a person's system. It is important for patients to remember that Suboxone is legal when prescribed within a licensed medication assisted treatment program.
How long will I need to be on Suboxone?
The length of time in which a patient will continue taking Suboxone will be a decision that needs to be made between a patient and his or her physician. Extensive research has proven that Suboxone is both safe and effective for short- or long-term use. While some patients only continue taking Suboxone for a short period of time, others will remain on it long-term. Suboxone provides patients with the ability to take part in their daily lives (such as attending work) as the prescription does not produce the same euphoric feelings that are often associated with opioid use. Patients experience a reduction in opioid cravings and uncomfortable symptoms often associated with the withdrawal process that would otherwise prevent healthy functioning. The effectiveness of Subxone does not diminish over time, which also allows patients to continue taking it as long as deemed necessary.
Does Suboxone interact with other drugs or medications?
As is the case with the majority of prescription medications, there are risks of drug interactions associated with taking Suboxone. Because of this, patients are urged to openly discuss the use of other medications prior to incorporating Suboxone into their treatment regimen in order to avoid any adverse effects from taking place. When combined with other opioids including heroin, oxycodone, hydrocodone, or codeine, Suboxone can cause strong negative reactions. Patients are also advised to refrain from using other medications or substances unless approved by their physician.
What if I no longer wish to take Suboxone? Can I stop or switch to a different medication?
While Suboxone is safe to take for long-term use, patients are not required to continue using for a long period of time unless deemed appropriate. If enough progression has been made within your treatment or if you and your physician determine that another medication would better suit your individual needs, safely weaning off of Suboxone or transitioning onto a different medication can take place if that is your preference.
What is the cost of Suboxone treatment?
The treatment provided at Wausau Comprehensive Treatment Center is extremely individualized for each patient we work with. The cost of care can vary between patients depending on the medication prescribed, the other therapeutic interventions utilized, and the payment method used. To discuss the final cost of care at our center, please contact our dedicated intake experts today.


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Stories are posted on the APRN news page. You can subscribe to APRN's newsfeeds via email, podcast and RSS. Follow us on Facebook at alaskapublic.org and on Twitter @aprn.
In bid to restore Voting Rights Act, Murkowski strays from party lines
Liz Ruskin, APRN – Washington D.C.
The settlement of the Native vote lawsuit comes on the same day as news that Sen. Lisa Murkowski has co-sponsored a bill to revive the Voting Rights Act. Murkowski is the first Republican to join more than 30 Democratic co-sponsors on an issue that has divided the two parties.
State to provide language assistance to Yup'ik, Gwich'in voters
Lisa Phu, KTOO – Juneau
In a historic settlement, the state has agreed to provide increased language assistance for voters who speak Yup'ik and Gwich'in.
Emperor goose harvest: More than a memory for Kodiak subsistence hunter
Kayla Desroches, KMXT – Kodiak
Subsistence hunters want to eat the foods traditional to Kodiak Island, and that includes one bird that's been off-limits since 1987 due to low numbers: the emperor goose.
Denali Commission ekes back into the spotlight
Lori Townsend, APRN – Anchorage
After being on life support for the past few funding cycles, The Denali Commission is full of muscle again with an expanded mission to help rural Alaska. The Commission, created by the late Senator Ted Stevens to fund village energy projects saw yearly funding up to 150 million dollars at its peak. Currently the Commission's budget is around 10 million, but a mandate by the White House to help combat the effects of climate change on remote communities may help it garner more federal dollars. Joel Niemeyer is the federal co-chair of the commission.
Donation illuminates Alaska Native civil rights history
Elizabeth Jenkins, KTOO- Juneau
A recently donated collection of letters, essays, photographs and newspapers is shedding new light on the history of Alaska Native civil rights. One particularly controversial figure in the documents spent half a century advancing Alaska Native causes. He's the namesake of Sealaska Heritage Institute's new archives.
Delivery service speeds produce to table
Ellen Lockyer, KSKA – Anchorage
Many restaurants around Alaska are on board with the public's demand for locally – grown foods. But getting produce from farm to table quickly can pose a challenge for busy restaurant kitchens.
After amputation, the mobility of a sea kayak beckons
Lisa Phu, KTOO – Juneau
A spinal cord injury or amputation doesn't have to stop someone from being active on the water. A few Juneau instructors now have the know-how to modify kayaking equipment for people of all abilities after a training that wrapped up Sept, 8.


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NASHVILLE, TN – Ingram Content Group Inc., today announced that Vital Source Technologies, Inc. has been awarded two Telly Awards for their innovative work in educational video production. The prestigious Telly Award honors the finest video and film productions, outstanding cable TV commercials and programs and online commercials, video and films.
"The Telly Awards has a mission to honor the very best in film and video," said Linda Day, Executive Director of the Telly Awards. "Vital Source's winning videos illustrate their creativity, skill, and dedication to their craft and serves as a testament to great film and video production."
Vital Source is a leader in developing e-textbooks, interactive media and innovative high-quality videos for the education community. Vital Source received the awards for the TeachSource Early Childhood Education Videos produced for Cengage Learning, and a video in the America Achieves Fellows series, What Makes a Great Teacher?, developed for America Achieves.
The two 2013 awards given to Vital Source by the Telly Award organization follow five awards that were awarded to Vital Source in 2012 for excellence in video production.
A panel of more than 500 industry professionals, each a past winner of a prestigious Telly and a member of The Silver Telly Council, judged the competition. The council evaluated entries to recognize distinction in creative work. This year, the 34th Annual Telly Awards received over 11,000 entries from all 50 states and numerous countries.
"The Telly Award represents the very best in video production work in the industry, and being recognized with two awards this year is a great achievement," said Kent Freeman, Chief Operating Officer, Vital Source Technologies, Inc. "Vital Source is committed to education, and we are pleased that our video solutions have helped Cengage Learning and America Achieves develop relevant tools for educators to enhance learning."
Past Telly Award winners include Time Warner Cable, Nickelodeon, FOX SPORTS NET, Turner Studios, Walt Disney Parks & Resorts, PricewaterhouseCoopers, Outdoor Channel, Michigan State University, Bass Pros Shops Film & Video Productions, Miami Dolphins Ltd., Kansas City Chiefs, Lockheed Martin, The Goodyear Tire & Rubber Co. and others.
About Ingram
Ingram Content Group Inc. is a subsidiary of Nashville-based Ingram Industries Inc. The company provides books, music and media content to over 39,000 retailers, libraries, schools and distribution partners in 195 countries. More than 26,000 publishers use Ingram's fully integrated physical and digital distribution, logistics, and manufacturing solutions to access global consumer demand, and realize the full business potential of book content. Ingram's operating units are Ingram Book Company, Lightning Source Inc., Vital Source Technologies, Inc., Ingram Periodicals Inc., Ingram International Inc., Ingram Library Services Inc., Spring Arbor Distributors Inc., Ingram Publisher Services Inc., Tennessee Book Company LLC, Coutts Information Services, and ICG Ventures Inc. For more information, visit www.ingramcontent.com


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ISIS fighters told lay down guns or die
THE Iraqi Prime Minister has warned Islamic State militants fighting in Mosul to lay down their weapons if they want to live.
However, IS fighters have ignored Haidar al-Abadi's warning, launching ferocious counter-attacks in territory Iraqi special forces captured in Mosul's eastern edges, highlighting the tough battle ahead as troops push into crowded neighbourhoods.
Fighters from the armed group emerged from deeper in the city to target Iraqi soldiers with mortars and suicide car bombs.
Street battles continued with both sides firing mortar rounds and automatic weapons at each other's positions, while Iraqi troops also responded with artillery.
Lieutenant-Colonel Saad Alwan, from Iraq's counter-terrorism unit, told Al Jazeera the street battles were ferocious.
"We're facing fierce resistance. They're digging trenches and using car bombs," Lt-Col Alwan said.
Speaking on a visit to the front line to the east of the city, Mr Abadi said government- led forces "will not retreat and will not be broken".
He said his message to the people of Mosul was "we will liberate you soon".
"Be ready, any minute now we will enter Mosul and cut off the head of the IS snake," he said. "My message to IS, if they want to save their lives, they should lay down their weapons now."
More evidence of daunting fortifications emerged on Saturday, with satellite images showing IS had set up defences to bog down advancing forces, including rows of concrete barricades, earth berms, and rubble blocking key routes leading to the centre of the city.
Advances towards Mosul have been slower from the south with government troops still 35km away, yet some progress has been made, Iraqi forces say. They assaulted ISIL positions in the town of Hammam al-Alil on Saturday, which lies along the Tigris river about 15km from the southernmost parts of Mosul.
Kurdish television channel Rudaw broadcast live footage of Iraqi troops and armoured vehicles amassing outside the city as an attack helicopter fired rockets.
Truckloads full of as many as 1,600 civilians may have been forcibly moved from Hammam al-Alil to Tal Afar earlier this week, and may be transferred onward into Syria for possible use as human shields, the office of the UN High Commissioner for Human Rights warned on Friday.
Another 150 families from the town were moved to Mosul itself, it said.
Iraqi Prime Minister on what state television said was a visit to forward lines near Mosul, urged ISIL fighters to surrender.


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How Access to Mobile Internet Is Ushering In A New Era for Africa
As internet adoption becomes a reality in more African countries, the cost of computers is still something that the continent has not been able to fully deal with. Computers today are still quite pricey. Even though the urban African population can mostly afford to purchase a laptop, many in the rural areas cannot even consider it.
The idea of having low cost computing is something that has been tried by a few but, is not spreading as fast as it could. Here is why.
Computers for Education
In mid 2000, companies like Computer for Schools were well known for donating used computers from abroad to schools for learning. The organization has done well to stock schools which have access to electricity with computer labs, hence enhancing student's ability to access computers. It is now the norm to have computer studies in most secondary schools.
Preceding the 2013 Kenyan general elections in March, the Jubilee Alliance (which subsequently won the elections) promised that they would supply laptops to all the students joining class one. This was their flagship project, underlining the importance of computing in enhancing the quality of education.
After the elections, the process to implement the project was met by hurdles, including the rejection of such technology by the teachers themselves. Even though this would have given students the much-needed chance to have good education, teachers had to be integrated, as they were the stewards of the project. Unfortunately, little was done on this side.
The idea of computing also goes hand in hand with electricity reach, which is poor in rural Kenya. It meant that the government would need to pull electricity to schools in the villages or use solar technology to power the gadgets.
But the biggest challenge was the government procurement procedures. Olive Telecom from India was selected to manufacture and deliver the laptops by last year. But after a long court battle, it was decided that the company did not meet the requirements of the tender.
Recently, the government announced that it would abandon this idea and implement computer labs instead.
There is an important lesson to be learned. Even though Kenya is moving fast in technology adoption, very many factors such as security, electricity connection, and collaboration with all stakeholders need to be taken into account to implement such ambitious projects.
Another project that is seen to be making strides, albeit slow, is Keepod. Keepod is a project that aims to reuse old computers, using USB sticks with an Android OS to reboot them. Every user can have their own USB sticks, so they have a private computing experience even if they share computers.
The USB sticks cost US$7, while the old computers could cost as much as US$50. This makes computing for poor communities a reality.
Keepod has already created a hub in one of Nairobi's slum areas, Mathare, where they host several reusable computers and admit the locals to surf the web and learn other computer programmes.
Their pilot project has been a success and could serve as a guiding example for peri-urban and rural communities.
Mobile Phone: The True African Computer
One technology that is greatly giving Africans access to computing capabilities is the mobile phone. It is well know that Africa is a mobile first continent. Internet enabled phones have helped Kenyans defer their desire to own a computer, instead browsing the major social sites and accessing news and email through one gadget.
In Kenya, 99 percent of users access the internet from a mobile phone. This has greatly opened up the access to information, and will continue to grow as more smartphone brands lower their price points.
The influx of Chinese brands such as Tecno, Infinix, and France's Wiko have greatly driven down the cost of adoption for smartphones in Africa. Today it is not unusual to see majority of people walking around with what were known as high price smartphones only a few years ago.
For software developers in the continent, mobile usage cannot be underrated as it reaches more people than desktop and laptops.
The Benefits of Computer access in Africa
The benefits of access to technology in Africa should not be underestimated. Knowledge is something that drives every economy, and that is what access to computing gives.
Africa's computer, the mobile phone, has acted as a source of information, education and communication at the same time. And this is increasing as more and more websites become mobile friendly. It simply means users can read, learn, communicate, shop, play games and do everything one could do on a laptop or desktop.
Mobile application such as TotoHealth and MedAfrica have helped mothers and the population in general to access important health information.
Currently, every bank in Kenya has the ability to use mobile money to deposit, withdraw and send money anywhere in the country. These developments have greatly improved the financial access to those who are in remote areas of the country.
The adoption rate of social media in Kenya and Africa as a whole has been fuelled by the mobile phone penetration, and now smartphone penetration.
Such penetration of internet and gadgets heralds a new era in Africa where we will see African-centric applications both on mobile phones and on desktops.
Moving to the next level
However, for Africa to have great applications and adoption, education, both formal and informal, is needed.
Kenya and its neighbouring country of Rwanda have been on the forefront to digitize government processes. Currently, the payment of some taxes can be done through the computer and mobile phone. Drivers can now renew their license online and pay with mobile money, avoiding the previous hassle of lining up and paying the fees manually.
The Nairobi Country government has also enabled parking fees in the city centre to be paid through an online portal by the use of Visa cards or mobile money.
Such moves steer the citizens to adopt and learn computing skills which eliminates waste of time. More education is needed for both senior and junior citizens in Africa but this could soon be achieved with proper planning.
High level education will also see market ready computer applications manufactured locally, and hence create a budding industry with the potential of generating employment for many people.
Access to computers can have a huge difference in the African continent. So far, we have seen economies grow, and more young people are getting access to job opportunities they would otherwise not have.


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Registration open for the annual Rome marathon.
The 22nd edition of the Maratona di Roma, which begins and ends at the Colosseum, takes place at 08.40 on Sunday 10 April.
More than 16,700 athletes from 115 different countries are registered for the 42km-race, including 9,250 Italian runners. The foreign country best represented is once again France, with almost 2,000 athletes participating, while Britain comes next with just over 1,000 runners, followed by Spain with 640 participants.
The 2016 race features 37 runners who have taken part in each of the 21 previous editions while the youngest contestant is a British athlete from Essex who will celebrate her 20th birthday on the day of the race, accompanied by her 29 friends.
The winners of the men's and women's titles last year were both Ethiopians: Abebe Negewo Degefa with a time of 2:12:23 and Meseret Kitata Tolwalk with 2:30:25.
The time limit for crossing the finish line is seven hours, and anyone who fails to reach the halfway mark within three and a half hours will be required to give up. Those who last the distance however will be rewarded with a medal, a goody bag and a foil wrap to stay warm.
In addition to the main event there is the non-competitive "Stracittadina" 5-km fun run in the Circus Maximus area.
The marathon will result in numerous traffic diversions and street closures, for details see the Muoversi a Roma website nearer the time. For full details including registration see marathon website.


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My name is Wendy Noble, I have lived in Oliva for 10 years, I worked in the Marketing and Advertising industry for 25 years and in the last 3 years have worked closely with other estate agents and lawyers, electricity companies, builders, plumbers and all facets of buying a property in the La Safor region.
I am here for you every step of the way. Customer service and results are my passion, relieving some of the stress that goes hand in hand with buying a property in Spain.
I am always available to help you, because property matters – to me.


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Continuing Education
CEs for Social Workers, Nurses, & Administrators, and case managers.
Have you ever wanted more out of your Continuing Education experience? We do – which is why we created the Solutions Series CE Program. We first start by mining social media, literature, and advocacy partners to find a hot topic that is timely and relevant to the clients that you serve. We then put practical tools at your finger tips to assist your patients.
* Griswold offices providing services through a Medicaid waiver program are not eligible to offer free CE programs. Contact your local office for details.
Please see the 'Course Overview' on the learning website for more details about this course.


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The agency's top lawyer contradicts earlier denials from the likes of Google, Apple, Microsoft and Facebook.
Tag Archives: Prism
NSA Whistleblower Edward Snowden: Keep Their Hands Off Our Data
Snowden said it's the responsibility of technologists to educate others about how to protect our data online.
European Cloud Users Could Shun U.S. Cloud Services Altogether
Fed up with the continuing stream of news about U.S. intelligence efforts to monitor cloud services, valuable E.U. customers may just use their own local clouds
Living in a Cloudy Post-PRISM World, Where Do We Go From Here?
Now that we know our data is being watched, what are the next steps for the enterprise?
Get PRSM, The Social Network To Monitor Your Life
A new satirical site prompts users to question the security of their digital world with an offer too good to be true.
Relationships With Telecoms Gets NSA 75% Of Internet Traffic
Programs with telecoms can watch over nearly three-quarters of U.S. Internet communication.
NSA Surveillance Rife With Legal Problems, Lack Of Oversight
Problems abound, according to leaked internal audit documents. And the court supposedly monitoring the NSA can't keep up.
PRISM Could Cost U.S. Cloud Vendors Billions
Update: When international—and domestic—customers avoid U.S. cloud services, the damages will be costly. Possibly near $200 billion.
Death Before Dishonor: Secure Email Services Shut Down Rather Than Comply With Feds
Lavabit and Silent Circle don't want to expose their users' secrets.
Encrypting Your Data May Be Moot Thanks To Government Pressure
What good is encrypting your data if the government has the encryption keys?
Microsoft Ratchets Up Its Defensive Rhetoric On PRISM Allegations
Microsoft insists the Constitution is suffering (oh, and so is Microsoft) with all this NSA and PRISM talk.
Judge Orders Disclosure Of Classified Surveillance-Court Documents
It's a victory for Yahoo, which says the classified court filings will document its fight against giving customer data to the feds.
Microsoft Denies Skype-Spying Allegations
Microsoft claims it has never granted any government direct access to Skype or any other products.
Skype: Reportedly Funneling Your Calls To PRISM Since 2011
The privacy-touting communication platform has allegedly circumvented its privacy features for the NSA since 2011.
PRISM Fallout: U.S. Internet Companies Stained By Intelligence Actions
Is the cloud about to be geo-fenced into Balkanized collections of data thanks to PRISM?
Celebrate The 4th Of July The Old-Fashioned Way—With An Anti-Spying Rally
In the wake of the NSA scandal, StopWatching.Us and Restore The Fourth are urging people to hit the streets on America's birthday.
New Slides Show PRISM Reach Directly Inside Internet Companies
On-premise assets contradict denials from Google, Microsoft and other named PRISM participants.
Just How Closely Can The NSA Really Watch You?
If the NSA is really using Hadoop and big data tools to run surveillance, how much could it know… and when?
Google Cites First Amendment In Challenge To FISA Secrecy Order
Google formally protests a secret court's gag order, saying it has a constitutional right to speak about information the government compels it to provide.
Yahoo Reports Its Data Request Numbers
In a rush to clear itself from the implications of PRISM, Yahoo shines a light on data requests.


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ANCHORAGE, Alaska (AP) – Alaska Airlines and American Airlines have announced they will scale back their mileage plan partnership early next year.
The Alaska Journal of Commerce reported Wednesday that Alaska Airlines mileage plan members will not be able to earn miles on American Airlines international flights beginning March 1.
Officials say Alaska Airlines passengers will also no longer be able to use miles for award travel on American flights.
The airlines say Alaska plan holders will still be able to earn mile-for-mile value on American flights with Alaska flight numbers to locations in the Midwest, the East Coast and parts of Canada.
Prior to the Oct. 2 announcement, American Airlines was Alaska's final domestic mileage plan partner, meaning Alaska plan members will not have another major carrier on which to use miles.


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Getting chickens out of battery cages has long been a goal for animal rights groups. But what if chickens are no happier wandering free? A new study by a Sydney University research team found that caged hens and free-range hens had the same levels of the stress hormone corticosterone in their eggs. While penned-up hens are subject to crowding, cannibalism, and physical injuries, hens that roam outdoors are prone to predators, manure-borne diseases and parasites, and extreme temperatures.
London Times editorial contributor Ross Clark isn't surprised:
Occasionally I walk past a free-range chicken farm in Norfolk and have always been amazed by how few of these liberated birds actually bother to venture out of doors; most choose to stay crammed in their sheds.
Blogger DaveH, who lost almost all of his free-range chickens and ducks to coyotes in the spring, says animal rights activists tend to "anthropomorphise animal behavior":
[W]hat most 'activists' fail to realize is that if a farmer mistreats their stock, they will not make as much money. It is in the farmer's own best financial interest to see that their stock (and their crops) are grown under optimal conditions, a good sized population but not overcrowded (most stock are highly social and really need companions) and decent air, light and water.
Unfortunately, anthropomorphizing is exactly what the Times commentator does as well, as Ross's piece continues:
All I know is that if chickens are even slightly like humans the last thing they would want to do, to use the fashionable expression from animal welfare regulations, is to 'express natural behaviour.' How many of us, given the choice between a life of foraging for nuts and berries, stark naked in the rain, and living in a small, centrally heated flat with a fridge full of food, would choose the former?
Until we develop that long-awaited poultry mind-reading technology, our best bet, the study's authors suggest, is breeding mellower hens.


text: Isla Lang Fisher (; born 3 February 1976) is an Australian actress and author, who began her career on Australian television. Born to Scottish parents in Oman, she moved to Australia at age six. After appearing in television commercials at a young age, Fisher came to prominence for her portrayal of Shannon Reed on the soap opera Home and Away from 1994 to 1997, garnering two Logie Award nominations.


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Step out in style with this MomToBe Maternity Wear, MomToBe maternity clothes are crafted from finest pregnancy friendly fabric to ensure you look and feel the best all the time, Flaunt your belly or hide it with adjustable belt, MomToBe maternity wear is designed in a way that you can wear it post-delivery as feeding wear or just your regular dress as well. MomToBe is a leading choice of millions of Indian MomToBe.
You Can refer to our detailed size chart for accurate purchase.
Product Info:
Prussian Blue in Colour.
Softest International standard Rayon.
Cherry print all over that make it highly appealing.
Round neck and 3/4th sleeves give a sharp look.
Style Tip: Team up with a pair of sandals to look your best.
MomToBe Women's Rayon Cherry Printed Maternity Dress
Size Chart
- Just slip into this Cherry print Maternity dress by MomToBe and flaunt your baby bump!
- Made with smooth and soft rayon fabric which gives you and your baby a comfort zone.
- Adjustable belt to Flaunt or hide your belly as you desire. Nursing Zippers for easy feeding.
- Designed to be Stylish, yet comfortable and complementing through all stages of pregnancy as well as postpartum period.
- Refer to MomToBe Size Chart in images for accurate sizing and perfect fit.
Size chart is in inches


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We would like to thank McGee's Stamp and Trophy for all their support, awards, and donations! You may recognize some of their great work at the awards ceremony after the Main event!
To McGee's Stamp and Trophy, the reward for hard work can go a long way. Whether you run a large business or coach a little league baseball teams, it is important to make sure that accomplishments do not go unnoticed. Get the best quality awards from McGee's Stamp & Trophy Co.
Starting out as a just a rubber stamp shop, the six McGee siblings have evolved the business into a center for custom framing, trophies, and more. From exclusive acrylic awards to custom promotional product and apparel designs, the possibilities are endless at our shop.
50 years experience producing awards that last.
Our awards are designed to capture a special moment in your colleague's career. When you want a quality design, put your trust in McGee's Stamp & Trophy Co., where we do not let anything leave our shop that is short of exceptional.
McGee's Stamp and Trophy Website


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$79.95 $169.00
IMPORTANT TIP: We recommend that an anti-slip pad such as Supa Rug Grip is used underneath rugs to prevent slippage between the rug and the surface it is placed on.
Please Note: This item cannot be delivered to a PO Box, only to a street address.
If you enjoy vivid colours, choose a trendy rug from this collection. These distinctive contemporary rugs lead today's decorating trends with their saturated hues and solid combinations. The Polypropylene fiber ensures colours in these rugs won't fade or bleed. Their great looks make them modern rugs that everyone can enjoy.
• Easy care polypropylene fiber
• Colours won't run or bleed
• Ultra modern design
• Anti static pile
Please note:
Allow for a slight variation of colours depending on monitor settings
Delivery Fees Customer Feedback A contemporary classic this cross-back chair can be used...
Luxurious and substantial, this chesterfield bed head brings a sense of grandeur to any bedroom...
Delivery Fees Customer Feedback A luxurious and elegant velvet cushion that is a staple in any Hamptons...