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City toddler tests positive for lead poisoningBy MARK HAYWARD
New Hampshire Union Leader
August 22. 2013 11:20PM
MANCHESTER — State officials tested the Welcome Home rooming house for lead paint this week, after elevated levels of the brain-damaging toxin were found in a toddler who lives there with her family, the house manager confirmed.
The discovery prompted the advocacy group Granite State Organizing Project to say that children should not be allowed to live at Welcome Home. But manager Julio Chea said the interior of Welcome Home, a former convent at 286 Concord St., has been lead-free for 12 years.
He suspects the child, a 2½-year-old girl, was exposed while playing on the third-floor porch. Chea did not realize until this week that porch railings contained lead, he said.
Once he learned of the lead contamination, Chea posted notices throughout the structure placing the porch off limits. Signs and yellow caution tape were evident on Wednesday; however, the door to the porch was ajar during a visit this week.
"There's no lead inside the building. It's been tested and tested and tested," Chea said. He said he expects he will have to remove or encapsulate lead on the wooden railings.
Welcome Home critics
The 48-room Welcome Home has become a bone of contention with some social service agencies and the city. The rooming house accepts children, and Chea said many of the parents contend with joblessness, domestic violence or drug addiction.
City inspectors usually find violations during inspections. Chea fixes them and earns his permit.
"Everyone who works with low-income children finds it incomprehensible that the city finds it an OK place for children," said Sarah Jane Knoy, director of Granite State Organizing Project. She said previous inspections have found loose and flaking paint, pesticides, overcrowding and cleaning items within children's reach.
She also said the structure lacks a functioning kitchen.
Chea said social service agencies often bad-mouth him. But he said social workers, visiting nurses and Springfield College students visit almost daily. Just before a reporter arrived Wednesday, he said police had arrested a mother and left her three children, including an infant, in the care of him and his tenants.
"We're in the business of helping people out. A lot of families, unfortunately this is their last stop," he said.
He said about 33 children were living at the building on Wednesday. Twelve are under the age of 6 and are being tested for lead, he said.
"Julio's awesome. He takes care of the kids," said a resident who would only identify herself as Dee. "I'm sure if there was an issue here, he'd be on it."
Dr. Jose Montero, the state public health director, confirmed that the state is investigating an elevated blood-lead reading in Manchester. He said he could not provide any information about the patient. He said information on what property is involved will become public if the state demands remediation.
"Generally, we have to remove people at risk. Depending on the findings, there may be other options," Montero said.
He said the state would help any displaced families navigate the system, but Manchester Health Department would "do the heavy lifting."
City Health Director Tim Soucy said his agency works with families and social service agencies to find lead-safe housing when children are displaced.
Soucy's department is part of the Neighborhood Enforcement Team, or NET, which conducts surprise inspections of properties with serious violations of housing and safety codes. He acknowledged that the NET team does not test for lead when it inspects properties.
"I don't understand why that's the case," Knoy said, "especially in Manchester, where we know a lot of our housing has old paint that's a lead hazard."


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2 police officers receive Union Leader Hero AwardBy TIM BUCKLAND
New Hampshire Union Leader
May 08. 2013 11:36PM
MANCHESTER - City police Officer Ben Foster is unsure why he is being showered with praise for his actions to help save 30 people who were sleeping in a three-story apartment building on Barr Street when it caught fire last November.
Foster and Officer Dan Wood will receive the New Hampshire Union Leader Hero Award for going into the burning building Nov. 25, 2012, and banging on doors to get the 20 adults and 10 children out safely.
"It's very overwhelming getting this kind of publicity over one act," Foster said. "This act was so small compared to other things I've seen other officers of the Manchester Police Department do. It's kind of uncomfortable receiving the award and the attention from it."
The designation is the latest for the officers. They also received the Police Department's Life Saving Medal.
"I am extremely proud of them," Police Chief David Mara said. "They put themselves at risk and didn't even think twice about it. This is something the police officers of the Manchester Police Department do day in and day out."
Bishnu Gurung, 24, said at the time that she was sleeping when police officers started banging on her door and yelling for her to get out of the building.
"He was calling to 'Wake up,'" she said of the officer.
Gurung and her husband, Karna, 28, grabbed their 2-year-old daughter, Katrina, and headed out into the cold as the three-alarm fire burned through the roof.
Foster also tried to put out the fire, which firefighters believed started on a porch and worked its way into the building. Foster said he was shocked by electric current running through metal around a window during his efforts, but he said he and Wood never gave their own well-being much thought, even though he was "thinking rationally" and not operating on pure adrenaline.
"We knew we needed to start getting people out of the building," he said.
Firefighters at the time credited the officers with ensuring that nobody was injured or killed in the fire.
"I guess my biggest relief came when I knew that everyone was out safely, and I knew that Officer Wood got out," he said. "I'm just thankful to have been at the right place at the right time."


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So, spent some time in 'Loops this weekend, visiting a friend, and knitified the city at the same time. We made two small knitifications, including the tree sweater from YarnBombing and some little red flowers on a tree with all too few leaves. Photos coming soon.
Oh, and the black nut warmers are still in place.


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A 52-year-old city man who is co-owner of a Fitchburg driver education business has been charged with shooting out the window of an auto parts store and is suspected in several other BB gun shootings.
Dennis M. Maylin was arrested Wednesday by police investigating the shooting of a window at the AutoZone auto parts store on Timpany Boulevard. Police reports filed with court documents indicate that, because Mr. Maylin was a prime suspect in 30 other shootings of business windows and doors, after hearing about the shooting, one officer went immediately to his house and stopped him when he returned home. After jumping from his vehicle and attempting to flee on foot, he was arrested. A loaded CO2 BB pistol and ammunition were found in his car.
He was charged with malicious destruction of property over $250 and failing to stop on the signal or a police officer.
Police Lt. John Bernard said the city has been investigating a series of shootings over the past four months on Main Street and the South Gardner section of the city. Police are also investigating two incidents in which the windows were shot out of oncoming vehicles, including one vehicle which had a child seated inside.
Police have had several suspects, including Mr. Maylin under surveillance during the investigation.
Mr. Maylin was arraigned yesterday in Gardner District Court and is being held in lieu of $5,000 cash bail or $50,000 with surety. He is next scheduled to appear for a pretrial hearing Dec. 12.
Lt. Bernard said police continue investigating the other shooting incidents and expect to file more charges against Mr. Maylin. Gardner Police detectives are also working with State Police and the Fitchburg, Leominster, Westminster and Templeton Police Departments investigating similar incidents in those communities.
Lt. Bernard said State Police are investigating a BB shooting of a motorist that occurred Sunday on Route 2. The driver of a vehicle was injured when the windshield of the vehicle he was driving shattered.
Mr. Maylin is co-owner and employed by A+ Driving School in Fitchburg. Lt. Bernard said that the vehicle he was driving was used by the driving school for driver training. Police impounded the vehicle as evidence in the case. Police also sought and were granted an immediate threat suspension of Mr. Maylin's license. His license has been suspended indefinitely.


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Suddenly, and without warning, it hits like a gust of wind: that warm, earthy smell of spring that has you (mentally) skipping down the sidewalk and imagining patios, tubs of flowers and barbecues.
But even if you're still trudging through a sloppy mess at the moment, that evocative first smell of spring can stay with you - if you bring it indoors.
"Spring is the time of year when we're driven to refresh our interiors. We have this pent-up energy. I think it's really about revitalizing our environment," says author, award-winning interior designer and Style at Home decorating editor Kimberley Seldon.
While fresh colours and textures in accent pieces are important, she says any decor refresh should start by following your nose. "For an interior to be supremely successful, you want to introduce all five senses," says Seldon, who recommends choosing a lively, vibrant scent in a stylish room diffuser or essential oil that evokes not only colour, but an emotional response as well.
"You want to create a whole, cohesive approach. Diffusers have a strong initial scent, but they have a way of unobtrusively blending into a room.
When you're dealing with a perfume product, you want a whisper, not a shout."
Once a scent is chosen, she says, imagine the shades and patterns it brings to mind.
Applying that colour could mean introducing an entirely new design component such as strongly patterned curtains or cushions, but it can also be done inexpensively by adding a few flashes of colour in vases, flowers or bed linen.
"People are asking for vibrant colour - by the time we're in March and April, we're really craving it."
Wondering how to bring spring inside with scents and colours? Here's how.
What the scent evokes: A sense of calm. According to Dr. Alan Hirsch of Chicago's Smell and Taste Treatment and Research Foundation, lavender literally changes the way we feel by "increasing the alpha waves in the back of the head, which is associated with being in a more relaxed state."
How to use it: The combination of lavender with the piquancy of juniper made Seldon think of soft French blue, white and natural, woody tones in a kitchen.
"We thought about the fact that 85 per cent of Canadians have neutral kitchens," she says. "A really easy way to inject colour is with a new set of dishes, like a pretty French blue. The greenery and the sprig of purple lavender really pops out."
Dashes of colour can also be introduced with crisp greyblue or lavender tea towels, table linens or decorative table-topper, as well.
What the scent evokes: Energy. The citrusy smell of mandarin - or grapefruit, lemons and limes, for that matter - triggers a response in the face's trigeminal nerve, says Hirsch, which "causes you to be more alert and awake." Interestingly, he adds that, according to his research, the smell of pink grapefruit "makes a man see a woman as six years younger."
How to use it: The combination of linen and orange should go in a bedroom, says Seldon, because it's the place "where Canadians go to recharge their batteries" and re-energize.
"You want touches of luxury, like beautiful sheets, a beautiful vase with a sprig of orange blossoms and even something small, like a piece of art work. You don't have to have a lot of colour to make a big impression."
The one thing you shouldn't have in the bedroom? Technology. "This should be the one place where you can retreat in every sense of the word and step out of your busy life."
What the scent evokes: Relief from pain and anxiety. "Green apple has very positive effects," says Hirsch. "It can reduce the duration of migraine. It may act to reduce anxiety, which makes headaches worse. It also makes people perceive that space is larger." Plus, green apple, banana and peppermint can control appetite because it triggers the "mechanics of sensory-specific satiety."
How to use it: For Seldon, apple and the spiciness of cardamom reflect a perfect fusion of masculine and feminine. In an interior, that means marrying feminine shapes (globes, curves and softer lines) with strong angles.
"Strong lines make us feel secure. Both sexes are drawn to a masculine interior, they speak to stability," she says. Continue the balance of male-female by marrying splashes of green apple with burnt orange and brown in small architectural items.
What the scent evokes: Positive body perception. The sweet fruitiness of pineapple and spicy evergreen of tropical mangosteen make a man see a woman as 12 lbs. lighter than she really is, says Hirsch. "It's the equivalent of wearing vertical lines to look slimmer."
But the spicy-floral combination doesn't work on how women perceive men, he notes.
"Nothing significant affects a woman's view of a man. They're too good at estimating weight and age."
How to use it: Fresh and lively oranges and yellows will bring a tropical zing to your room, says Seldon. Where Canadians once eschewed bold colours, "it's really exciting when a client asks me to introduce yellow drapery.
That's something we haven't seen in a decade, but it makes sense since the colour of the year was Pantone's tangerine orange. It's on everyone's mind."
- Inject a room with colour and patterns. Using pillows, accent vases and small, inexpensive architectural pieces or artwork. "Very little colour goes a long way when it's a contrasting," says interior designer, Kimberley Seldon.
- Edit your space and de-accumulate. "When you really want to appreciate the beauty of your surroundings, you want to eliminate things that don't jive anymore," she says.
- Add a splash of paint. If you're not ready for a full paint job, choose an accent wall and add a warm colour that will accentuate sunshine coming through windows.
- And speaking of windows Do a spring cleaning, paying special attention to your windows. "Really, winter is terrible for an accumulation of dust and dirt outside," she says. "Clean the windows and let more sun in."
- Play with all the senses. Use incense sparingly - it creates a heavier scent that doesn't dissipate easily. Rather, choose essential oils or diffusers, like Glade Expressions, a new line of ultra-trendy looking room diffusers that are pretty enough to display.


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That relates to a very interesting deep ecological question: what is the evolutionary role or meaning behind the fact that when humans ingest a psychedelic plant that tickles certain brain receptors they have experiential access to profoundly meaningful altered states of consciousness? What is the evolutionary information-theoretical role of a plant molecule that interacts with specific brain receptors to give rise to a collective belief system? Naturalistically speaking, it's mind-blowing. How do we explain this?
The point you're making is the plant is ingested and it grows into a culture. It's not just an individual experience, it's a culture. You could think of a culture as like a moss or a forest. So what do you think can be brought from indigenous psychedelic healing into western psychedelic healing?
It's a challenging question because bringing ayahuasca into a western scientific context evokes a lot of resistance among traditionalists who argue that this will never work, as long as we don't adopt the indigenous belief systems or at least have a shaman guiding the process, ayahuasca alone will have absolutely no or even undesired effects. I have a different and more pragmatic opinion on this, because as a physician I have a clear ethical mission to reduce human suffering, and I believe that ayahuasca has some therapeutic potential to reduce human suffering. The West probably has to invent its own ayahuasca context – we can't just transplant the whole shamanic belief system from the Amazon into western societies. We have to find a new way how to make sense of ayahuasca in our culture, for our minds, and with our belief systems. To that, we should stay pragmatic and not dogmatic. Probably ayahuasca will work completely differently in the West compared to the traditional use in the Amazon. That's the idea behind evolution: To take something out of its original context, and put it in an entirely different context with totally different results. I have huge respect for indigenous cultures because they went through a long process of evolutionary adaptation – they experimented with ayahuasca for hundreds of years and found meaningful ways to work with that medicine. Although this body of knowledge and experience is impressive, it might not be the only meaningful way of working with ayahuasca.
Psychosis. Scary word isn't it? These days we think nothing less of a person if they publicly disclose they get depression, or anxiety. We applaud them for being brave, but they're not really risking anything. But admit you get psychotic episodes…that you hear voices…that you see things others don't see? Maybe some of us start to edge away.
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The EU Building Stock Observatory monitors the energy performance of buildings across Europe.
The EU has set a target for all new buildings to be nearly zero-energy by 2020.
Energy performance certificates provide information on the energy efficiency of buildings and recommended improvements.
Financial support mechanisms in EU countries can help pay for energy efficient renovations
Buildings are responsible for approximately 40% of energy consumption and 36% of CO2 emissions in the EU. Currently, about 35% of the EU's buildings are over 50 years old and almost 75% of the building stock is energy efficient, while only 0.4-1.2% (depending on the country) of the building stock is renovated each year. Therefore, more renovation of existing buildings has the potential to lead to significant energy savings – potentially reducing the EU's total energy consumption by 5-6% and lowering CO emissions by about 5%.Improving the energy efficiency of buildings can also generate other economic, social and environmental benefits. Better performing buildings provide higher levels of comfort and wellbeing for their occupants, and improve health by reducing illnesses caused by a poor indoor climate. It also has a major impact on the affordability of housing and on the concept of energy poverty. Improvement of the energy performance of the housing stock and the energy savings it brings would enable many households to escape
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are the EU's main legislative instruments promoting the improvement of the energy performance of buildings within the EU and providing a stable environment for investment decisions to be taken. As Directives, they needed to be transposed by Member States into national legislation.The 2010 Energy Performance of Buildings Directive has made it possible for consumers to make informed choices that will help them save energy and money, and has resulted in a positive change of trends in the energy performance of buildings. Following the introduction of energy efficiency requirements in national building codes in line with the Directive, new buildings today consume only half as much as typical buildings from the 1980s.On 30 November 2016, as part of the Clean Energy for All Europeans package , the Commission proposed an update to the Energy Performance of Buildings Directive to help promote the use of smart technology in buildings, to streamline existing rules and accelerate building renovation. The Commission also published a new buildings database – the EU Building Stock Observatory – to track the energy performance of buildings across Europe. In order to direct investment towards the renovation of building stock, the Commission also launched the Smart Finance for Smart Buildings initiative, which has the potential to unlock an additional €10 billion of public and private funds for energy efficiency and renewables uptake in buildings.
On 19 June 2018 Directive (2018/844/EU) amending the Energy Performance of Buildings Directive was published. The revised provisionswill enter into force on 9 July 2018. This revision introduces targeted amendments to the current Directive aimed at accelerating the cost-effective renovation of existing buildings, with the vision of a decarbonised building stock by 2050 and the mobilisation of investments. The revision also supports electromobility infrastructure deployment in buildings' car parks and introduces new provisions to enhance smart technologies and technical building systems, including automation.
Member States will have 20 months to transpose its provisions into national law (namely by 10 March 2020).
EU countries have calculated the cost-optimal minimum energy performance requirements for new as well as renovated buildings in their territory. These requirements must be reviewed every five years and, if necessary, updated in order to reflect technological progress in the building sector.
To help EU countries properly implement the Energy Performance of Buildings Directive ((EU) 2018/844) and to achieve energy efficiency targets, the European Commission has established practical support initiatives: The Energy Performance of Buildings standards (EPB standards).
These include a set of standards for a common methodology calculating the integrated energy performance of buildings, in accordance with the Energy Performance of Buildings Directive.
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Eleven noses hover over drinking glasses, their senses alive as they try to piece together these amazing smells.
A long pause ensues as they swirl, and take a swig. One of the only times this group is silent is when they tip their glasses and savor the taste of beer.
This group knows beer.
The Mesa Verde Mashers is a home brewing club in Cortez. It began with eight members in 2007 and has grown to 28 beer lovers. The core group of brewers, around 10 people, rarely miss a meeting. "Beer geeks" is how they refer to themselves.
The club meets once a month at a different member's house. They bring their latest home brews, eager for everyone to sample.
The conversation is as thick as a field of hops. And the conversation places beer at the center of the universe. Subjects like beer flavors, beer ingredients and how to make better beer — these are some pretty cool beer geeks.
Virginia Feher is the club's president. Her husband John was one of the first founding members back in 2007.
"John is the brewer," Virginia says. Then she provides a rather startling revelation: "I wasn't interested in beer when I first joined. I joined to have more time with my husband."
But when beer is the center of the conversation, beer brews a curiosity.
"Over the past couple of years, I have become very interested in beer and the brewing process. I've also met some of my best friends here," she says.
The club has couples, singles, people who don't brew and people who would want to start. Most come for the camaraderie. Randy and Kathy McKnight were some of the first members. Randy doesn't view the club as simply a place to talk beer, but a place to unwind with others with similar tastes.
"The beauty of our group is that we are not divided by politics," Randy says. "We come together because of a common interest and we have fun. We don't let the other stuff get in the way."
This large group of friends is happy to sit around, taste new beer and talk about their lives. But the conversation always returns to what's in the glass.
These beer geeks know beer and everything connected to beer.
Chris Vest, an original member, talks about which glasses accentuate beers, their traditions and history. He picks up a fat, round, stemmed glass that tapers off at the top to form a waist-like opening.
"This glass is more ideal for drinking beer because when you pour it, the beer expands at the bottom and all the flavors come to the top so you can really get your nose in there and smell it."
His knowledge is overwhelming. As a part of the geek squad, it should be.
The mashers meetings are mostly about home brew presentations and evaluations.
New member Joe Strunce, brought two home brews to his first meeting. A brown ale and a saison — a pale ale. Strunce, a Mancos resident, has been a home brewer for four years. He found the club because he wants to extend his brewing to include all-grain brews.
"All the members are great," Strunce says. "They were very helpful and kept saying if you need anything we can help you. It's more than a club. There's a great social aspect to it."
Beer has long been a conduit for bringing people together.
Strunce is eager to learn from the experts. He sought advice on ingredients and tips on bottling. Lucky for him, Dion Hollenbeck is the tech guy when it comes to brewing.
Hollenbeck, another original member, also belonged to a brewing club in San Diego before moving to Cortez. He has won numerous first-place awards from the American Home Brewing Association and over his 19 years of brewing, he's collected high-tech pieces of brewing equipment and a lifetime of knowledge.
Even with all the knowledge, there's no such thing as brewing secrets.
"This club is about sharing," Hollenbeck says. "If I give a recipe of mine to someone else, they wouldn't be able to duplicate it because everyone's brewing process and equipment is different. So there is no need for secrets."
The club thrives on helping and educating members. When Clyde Howell joined around 2008, he introduced the mystery beer, a chance for members to up their palate by guessing a beer without knowing anything about it.
Randy McKnight knows first hand about beer brewing misconceptions. Sometimes what is conceived as a mistake is actually a success.
"I had a brew that I thought came out wrong so I had Dion try it," he explains. "And he tells me, this is a great flandering red, but it was supposed to be a porter."
Learning from mistakes is rewarding for this group. There is nothing more tormenting than throwing out a bad batch. They take the bad with the good because they don't like beer — they love beer.
Hollenbeck usually kegs all of his brews but at their latest meeting he presented a bottled prunella. He tells the members it was an attempt to reproduce the first prunella, which was burned during the process to create a thick, smoky flavor.
"This is the best of the best," Howell says proudly.
They talk about the characteristics of a prunella as they fill their glasses.
The eleven noses drop to eleven glasses. Deep breaths commence and another silence falls on the room.
Time to taste.


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STOCKTON - Approximately 500 people carrying candles and heavy hearts gathered in downtown Stockton on Thursday evening to remember loved ones lost to violent crimes.
STOCKTON - Approximately 500 people carrying candles and heavy hearts gathered in downtown Stockton on Thursday evening to remember loved ones lost to violent crimes.
The Victims of Violent Crimes of San Joaquin County Support Group, a nonprofit organization that provides support to families and friends of violent-crime victims, held a candlelight vigil and march at the Weber Point Events Center. Stockton police chaplain Kevin White led a prayer, Victims of Violent Crimes of San Joaquin County President and co-founder Joyce Tuhn gave a tearful address, and people hung Christmas ornaments in honor of their loved ones.
One by one, hundreds stepped to a microphone to say the name of the family member or friend they lost to violent crimes. The procession included 7-year-old Ricardo Hernandez, who spoke in remembrance of his uncle, Roberto Hernandez, who was killed in a shooting in southeast Stockton in 2009.
"Roberto Hernandez," he said. "We love you and we miss you."
Jesus Hernandez, Roberto Hernandez's brother, said the vigil gives victims' families an opportunity to grieve with others who understand their pain.
"It helps," he said. "You see other families that are going through it, and even though you don't know them, you know what they're going through. What's sad is that it's getting worse here instead of better."
Antoine Jones, whose father, Stanley Jones, was gunned down in March, said the vigil was a nice tribute to the many victims of violent crimes in Stockton, where police have investigated a record 68 murders this year.
"It's not going to bring anyone back, but it shows people care," Jones said.
White said the vigil is therapeutic for many of the victims' relatives.
"When people have gone through the trauma of having a loved one murdered, most people's friends can't begin to imagine what that's like," said White, whose brother, Stockton police Sgt. Tim White, was beaten to death in 1990. "When you talk about trauma, it's like leaching poison out of a wound, so it can be really beneficial to be around people who can relate."
Contact reporter Jason Anderson at (209) 546-8279 or email@example.com. Visit his blog at recordnet.com/crimeblog.


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Anemia symptoms are caused by decreasing amounts of oxygen reaching important organs, such as your muscles, heart, and brain. Those organs will not be able to work as well and your heart and lungs have to work harder to deliver oxygen to these body.
Those who have nutritional anemia, especially mild anemia, may have no symptoms. If symptoms do occur, they might include:
- Loss of stamina
- Shortness of breath
- Rapid heart beat
- Paleness
- Headache
Worsening of symptoms of other diseases:
- Chest pains—angina
- Cramping in muscles when they are being used—claudication
In addition:
- People with iron-deficiency anemia may have cravings for ice or clay.
- People with anemia due to vitamin B 12 deficiency may experience confusion, clumsiness, or even dementia.
- People with either B 12 or folic acid deficiency may have a very smooth and sore tongue or other sores in the mouth.
- Those whose deficiency is due to bowel disorders may have diarrhea, unusually smelly stools, and/or weight loss.
Revision Information
- Reviewer: Marcin Chwistek, MD
- Review Date: 09/2017 -
- Update Date: 11/03/2017 -


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Tom Lantos Innovation in Community Service Awards 2012 Winners
PHA congratulates those below who have been awarded funding to implement their innovative approaches to awareness-raising and developing new and creative services for the PH community. We are grateful to everyone who submitted a proposal to the Tom Lantos Innovation in Community Service Awards program and to Gilead Sciences for making this program possible.
We look forward to the unique contribution each of the following projects will make to the lives of PH patients.
J. Paul Adams
Unionville, Ontario, Canada
Paul, the uncle of a Canadian PH patient, wrote and recorded a music video inspired by his niece's experience with PH. His Lantos project, "Let Me Breathe – The Whole World Will Be Listening," will carry the song's optimistic message to the global PH community. Paul will perform his song, "Let Me Breathe," and screen the video at PHA's 10th International Conference and Scientific Sessions June 22 in Orlando. All Conference attendees will receive the song on CD. Paul's project will also include a website where people who have seen the video or heard the song can make a post, illustrating the spread of this message.
Abraham Babu
Karnataka, India
Abraham's project is developing a "Pulmonary Hypertension Manual," a printed guide explaining PH, its symptoms and treatments, and the importance of physical activity for PH patients, an area of Abraham's professional expertise. The manual will be translated into various regional languages and will be a resource at home for patients who must travel long distances to PH care centers. It will be distributed to patients through PH physicians in India. Read more
Hyuk-Jae Chang
Seoul, Korea
Working with PHA Korea, Hyuk-Jae's project, "Social Awareness of PH," will create posters and an updated Korean language edition of PHA's Pulmonary Hypertension: A Patient's Survival Guide. The book and posters will expand the previously limited educational opportunities for patients, caregivers and medical care providers in Korea. These resources will expand educational opportunities in Korea and will aim to draw more people into the Korean PH community. Hyuk-Jae hopes the project will help identify patients in Korea who have not yet been diagnosed with PH. Read more
Mineliz Colon
Carolina, Puerto Rico
Mineliz's "Phenomenal Me" project presents PH patients with a series of 24 challenges per year to help them feel more in control of their lives despite their illness. The challenges focus the patient on raising awareness about PH as a way to dispel the pain and loneliness of having this disease. Some challenges will have patients contacting neighbors, friends and other patients. Others will help patients manage their feelings through writing, drawing and other activities. Patients will blog about their experiences and will keep track of challenges completed in a "passport."
Rosanne Huber
Grayslake, Ill.
Rosanne's project, "A Run for Hope, A Run for A Cure," will encourage the PH community to be present to support her in running the Milwaukee Lakefront Marathon on October 7, 2012. Rosanne, a dedicated runner who has exercise-induced PH, will seek media attention for her story to build awareness of PH in the surrounding area. She hopes that this will be the start of an annual marathon and the growth of a PH running team.
Melissa Johnson
Oklahoma City, Okla.
Melissa's project "What About PH?" will spread awareness of PH using table-top signs in restaurants throughout her area. The table toppers will present PH patient stories and will direct people to PHA. Melissa will also hang posters around the community listing the restaurants participating in this PH awareness program.
Sally Mackey
Sumter, S.C.
Sally's project, "Living with PAHzazz!" will use her quilting skills and involve her quilting friends in creating beautiful quilts to lift the spirits of PH patients. The quilts will be raffled off at PH-related special events. Sally and her quilting circle will also produce fabric-covered key chains, pin-on buttons, ponytail holders and other accessories with the PHA periwinkle ribbon logo to help raise awareness of PH.
Todor Mangarov
Todor's project is called "Creating PH Community in Bulgaria and Meeting of PH Patients." Its purpose is to increase the feeling of community among the 37 PH patients in Bulgaria, where treatment is available but patients do not feel connected to one another. Todor will hold a meeting to discuss the disease and share information on modern treatment methods and ways to live and cope with PH. This meeting is designed to reassure patients that they are not alone, that help is available and that one can continue living positively even with PH. The project can also be a model to other countries wishing to organize their PH communities. Read more
Bonnie Patricelli and Ryan Juntti
Clementon, N. J.
Bonnie and her son Ryan are raising awareness with their project "Hot Holders for Hope." They will print and distribute 50,000 hot beverage cup sleeves to coffee shops in areas such as college campuses, train stations, airports, major city centers and tourist attractions. The sleeves will carry a message about PH awareness and will send people to the PHA website to learn more. Bonnie and Ryan's research in applying for this project found that the average consumer of a hot drink spends 45 minutes with the drink and that the message on the sleeve is viewed by approximately six other people who are sitting, chatting, or passing by.
Brenda Reynolds
Hamilton, Mont.
Brenda's project "PHAmerica Honors" is a website designed to name PH "ambassadors" all over the globe in an effort to promote a positive outlook within the PH community. The website will offer fun projects and contests for people affected by PH. Ambassadors will spread awareness while encouraging patients and families to take up the challenges. Brenda's goal is to create a "global network of positivity."
Sean Wyman
Bloomington, Calif.
Sean's project, "Lips Painted Blue—An Animated Series," will create short animated videos to be used as a resource and educational tool for children, parents, and medical professionals. In a child-friendly way, this series will explain PH, its symptoms, what to expect, and how to cope and have fun while living with PH. Sean developed this idea to fill a gap in material about PH that is presented in terms meaningful to children.
Visit this page for updates on the progress of all of these unique programs and look for reports in PHANews and Pathlight.


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Granite Status: What is Sen. Ayotte up to on immigration reform bill?
June 16. 2013 7:54PM
REVERSING COURSE. If it wasn't such a serious issue, it would be pure entertainment.
Here was Kelly Ayotte being criticized by conservatives and praised by liberals and moderates for her sudden support for the "Gang of Eight" immigration reform bill.
Was this a change of heart (some might say flip-flop) for Ayotte, who was a staunch opponent of amnesty and supporter of tough border security as a candidate in 2010?
At an Americans for Prosperity Forum three years ago, Ayotte said, "For the people who are here illegally, I don't support amnesty; it's wrong. It's wrong to the people who are waiting in line here, who have waited for so long. And we need to stop that because I think that's where the administration is heading next."
Ayotte spokesman Jeff Grappone says she is being consistent with her stand as a candidate.
"She believes the status quo is de facto amnesty, which is unacceptable," he said. "Instead of President Obama issuing more executive orders that circumvent the will of Congress and the American people, she supports enacting legislation that will send illegal immigrants to the back of the line and stop the dangerous flow of illegal immigrants into our country through greater border security, more effective enforcement, and a vigorous employment verification program."
Grappons said, "During the campaign she said that she would bring a 'results-oriented' approach to this issue, and that's what she's doing."
Was Ayotte influenced in her decision to back the bill by her "amigos," John McCain and Lindsey Graham, two of the four GOP members of the "Gang of Eight?"
Could it be that she is trying to stake out a moderate position on a key issue after pleasing conservatives and upsetting moderates with her April vote against expanded gun background checks?
Grappone said Ayotte "makes up her own mind based on her examination of each issue, and it's ridiculous for anyone to suggest otherwise."
The contrast in reactions to her immigration announcement was striking.
The web site "Town Call.com" had a detailed piece on how Ayotte during her 2010 campaign repeatedly voiced opposition to amnesty.
National Review Online opined, "Thoughtful is one thing her support for that bill is not. In an op-ed published on her website, Ayotte shows no sign of knowing what the main objections of the bill's critics are, much less of having grappled with them."
The Washington Examiner's Byron York wrote, "All in all, the Kelly Ayotte of 2010 did not seem likely to turn into a supporter of today's 2013 Border Security, Economic Opportunity, and Immigration Modernization Act ... If Ayotte recognized any of the problems in the bill that she might have objected to in 2010, she didn't say. Indeed, the striking thing about Ayotte's endorsement was how little it engaged the substance of the Gang of Eight bill."
The New Hampshire Union Leader, which often agrees with Ayotte, disagreed on this one, editorializing, "Her high hopes for the bill are not supported by its text."
On the other hand, the Boston Globe editorial was entitled, "Kelly Ayotte Shows Leadership on Immigration," adding, "after decades of debate, no solution on immigration will ever pass without bold, bipartisan moves like Ayotte's, and others should take notice."
She was also lauded by The Telegraph of Nashua, the Concord Monitor and by former state Democratic chairman George Bruno.
Grappone said Ayotte "is independent-minded and votes based on what she thinks is right for the country, regardless of who she angers on the right or the left."
She was praised by the New England Council big business group and blasted by NH Labor News. The President Barack Obama "Organizing For America" Twitter account cited her announcement.
Four former state Republican chairs, at least two of whom (Steve Duprey and Jayne Millerick) are friends of McCain, praised Ayotte for her immigration stand at a news conference last Thursday.
Not there were former chairs John H. Sununu and Jack Kimball.
Sununu told us he had no comment on the immigration issue. Period.
Tea Party leader Kimball, however, had an email Friday on "the Amnesty Bill.".
"No Republican should be supporting anything in this bill unless it calls for securing our borders as its first priority," he wrote. "Secondly, if passed, this bill will forever change the political dynamic of our Country for within a very short period of time it will virtually guarantee that we will not see a Republican Administration.
"Why? Because the vast majority of those who will become Legalized will vote for the Democratic Party. Further, besides adding anywhere from 11-15 million new voters to the rolls these folks will also be able to add some of their extended family. This will be a disaster for the Republican Party as well as our Country," wrote Kimball.
His email did not mention Ayotte, but urged his fellow "Patriots" to contact their "representatives in Congress and tell them NOT to support the Amnesty Bill as written and to demand that our borders be completely secured before any further discussion is allowed to happen on this topic. If they ignore you then we will resolve that problem at the ballot box."
As for the senator, Kimball told us, "I truly believe she is way too close to John McCain. I'd like to see her stand on her own two feet a lot more."
Ayotte was among the leaders of the state GOP hierarcy who called for Kimball's ouster as party chair back in 2011. So his criticism of Ayotte did not exactly shock her supporters.
"Unfortunately, Jack doesn't seem to understand this bill, which doesn't automatically grant citizenship that would create new voters," Grappone said. "Those seeking a green card would have to wait a minimum of 10 years, and they'd have to go to the back of the line, pass background checks, learn English, pay fines, pay taxes, and hold a steady job. This timeline would be dependent on first meeting border security and E-Verify objectives."
He continued, "With 11 million illegal immigrants living here without any consequences, the situation we have now is de facto amnesty. The bill Sen. Ayotte backs will stop the dangerous flow of illegal immigrants into our country through greater border security, more effective enforcement and a vigorous employment verification program. This legislation will also help grow our economy by modernizing our legal immigration system to allow high-skilled and other needed immigrants to work here legally, addressing a critical need she has heard frequently from New Hampshire's business community."
(Kimball, by the way, is rallying fellow Granite Staters to Wednesday's Tea Party "Audit the IRS" rally in Washington. "Let's let them all know that we will not accept BIG BROTHER any longer," Kimball wrote, urging supporters to carry signs calling for the impeachment of the President.)
A PRO-KELLY NEW AD. Ayotte is praised for "courage and independence" in a new TV ad jointly sponsored by Americans for a Conservative Direction, which is funded by Mark Zuckerberg- and Bill Gates-backed FWD.us, and InSPIRE STEM USA, which is co-chaired by former Sen. John E. Sununu (son of John H., of course), and Maria Cardona, a former senior advisor to Hillary Clinton.
The ad will air for about a week on WMUR and local cable. The buy is about $200,000.
InSPIRE STEM USA and FWD.us are bipartisan political groups advocating for "comprehensive immigration reform," focusing on a need for more highly skilled workers in the high-tech and other modern industries.
FWD.us funds not only Americans for a Conservative Direction, which is focused on "conservative political outreach," but also the Council for American Job Growth, which is focused on "independent and progressive political outreach and activity," according to a spokesman.
Former NHGOP chair Millerick is a consultant for FWD.us in New Hampshire.
LOOKING AHEAD. Ayotte does not stand for reelection until 2016, and there's a good chance she'll be in the mix for vice presidential consideration.
Who knows what the issues will be by then? Guns and immigration will certainly be issues, but will they be top, voting issues?
Next year, though, there's another U.S. Senate race as Jeanne Shaheen defends her seat, and Ayotte has set the stage for questions to whoever runs on the GOP side.
Particularly on immigration, will GOP candidates — state Senate Majority Leader Jeb Bradley maybe — stand with Ayotte in favor of immigration reform or stand with the conservative base of the party opposed?
For now, Bradley is focused on the State House, where it's crunch time with committees of conference on the budget, state alignment with the Affordable Care Act and voter identification among the myriad of issues on the table.
But congressman Bradley and congressional candidate Bradley was a immigration hawk, saying, for instance, in 2008, "if you reward people who have broken our immigration laws with an incentive, which is amnesty, which would be citizenship or the indefinite right to stay in this country, that's the wrong answer, and we can't go down that road because we will just have more illegal alien problems in the future."
It's unclear if Bradley will run. But whoever does will either be with Ayotte and against much of the conservative base on immigration, or with that faction and against the GOP's only federal and statewide officeholder.
Interesting dilemma.
HELLO, MARCO. Steve Duprey joined fellow former state GOP chairs Fergus Cullen, John Stabile, Wayne MacDonald and Wayne Semprini in a recent opinion piece calling for support for the "Gang of Eight" reform bill.
Duprey told us that last Wednesday night, he got a call from one of the "Gang," and it wasn't his friend McCain.
"It was Marco Rubio," said Duprey.
The Florida senator and possible GOP presidential contender "said he had read the opinion piece and just wanted to say 'thanks' for the support for the bill," said Duprey.
Duprey said he told Rubio that the next day, he'd be part of a news conference praising Ayotte's support for the "Gang" bill.
According to Duprey, Rubio did not express frustration with the fact that she didn't withhold her announcement until he worked to strengthen the bill's border security provisions.
And by the way, Duprey said Rubio "we'd be happy to welcome him back to New Hampshire at any time."
ON THE WEB. Republican former state Sen. Jim Rubens last week set up a web site to coincide with his exploration of a possible run for the Senate.
And the state Republican Party is expected to have a new site up this week to replace its current 4-year-old site. Its platform allows local GOP committees to base their sites on the state site.
O'BRIEN'S BOY? The Democrats were having a field day last week with the announcement by conservative state Rep. George Lambert that he is exploring a run for governor.
Lambert, of Litchfield, a self-described social liberal and fiscal conservative, was allied with former New Hampshire House speaker Bill O'Brien on fiscal issues. O'Brien named him to the Legislative Administration Committee and the former Redress of Grievances Committee, which no longer exists.
"In 2012, the voters of New Hampshire rejected this extreme and out-of-touch ideology," wrote NHDP Chair Raymond Buckley in a fund-raising email that tried to link him to O'Brien.
HIT ME, PLEASE. Candidates, political organizations and operatives allied with both parties and all ideologies just love being attacked by their opponents.
And why not? It's a money-maker. Not personal, but for their causes.
Sen. Shaheen turned an "attack ad" by GOP operative Mike Biundo's Citizens for a Strong Economy into a fund-raising email.
State Democratic National Committee member and former state Democratic Chair Kathy Sullivan returned fire on Biuindo in an op-ed in the New Hampshire Union Leader.
Biundo quickly responded with a fund-raising email for Citizens for a Strong New Hampshire, feigning outrage over the Sullivan criticisms.
It's the new normal. And the beat goes on.
AN OVERDRAFT FEE. Democrats last week tried to exploit the state Republican Party's far-less-than-flush federal fund-raising report for April, saying it includes "overdraft fees" and had a low balance.
Turns out there was a single bank overdraft fee of $39. But the report listed only six donors and reported only $19,000 on hand for that month.
But, in fairness, this was before the party's big fund-raiser on May 20 that featured Rand Paul and Reince Priebus. So we'll see soon what May brought in.
What were the comparable Democratic numbers? We'll have to wait a while.
The NHDP, after years of being a monthly filer with the Federal Election Commission, notified the FEC in February that it had become a "semi-annual" filer, meaning that it won't have to disclose its finances for the first half of this year until July 31.
CUZZI LANDS A BIG ONE. David Cuzzi, a former top legislative staffer for former Sen. John E. Sununu, appeared last Thursday at the pro-Ayotte news conference expressing the need to attract and keep highly skilled immigrants.
Cuzzi's Prospect Hill Strategies, launched last year, is raising its profile and resume as a player among the state's public affairs and lobbying firms. The firm announced last week it has landed a top state client, BAE Systems.
Cuzzi held senior government relations and business development positions with the defense giant before starting his own firm.
Prospect Hill Strategies will handle all New Hampshire state and local government relations consulting and lobbying for BAE. The state's largest manufacturer, BAE employs about 4,500 people in Nashua, Hudson and Merrimack.
BAE Systems joins another big New Hampshire company, Velcro USA, and a handful of smaller firms, as Prospect Hill clients.
HONORING BASS. Next Friday, June 21, the Committee to Elect (state) House Republicans will hold a fund-raiser to salute former U.S. Rep. Charlie Bass and his family at the Grappone Center in Concord. Ticket prices range from $250 for two to $2,000 for a block of 10.
John DiStaso is senior political reporter of the New Hampshire Union Leader and New Hampshire Sunday News. He can be reached at firstname.lastname@example.com. Follow him on Twitter: @jdistaso.


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Former state rep campaigns against a union president in Manchester race
March 17. 2013 10:17PM
MANCHESTER - Voters in Hillsborough County District 9 Manchester Ward 2 will choose a new state representative Tuesday.
Republican former state Rep. Win Hutchinson and Democrat Bill O'Neil are running for the seat in the city's northeast section after Robert Thompson, who was elected in November, resigned and moved to Florida.
O'Neil, the president of the International Brotherhood of Electrical Workers Local 2320, is running for public office for the first time while Hutchinson is seeking reelection for the second time in five months. Hutchinson was an incumbent last fall, but was unseated when Democrats Linda DiSilvestro and Thompson won both seats in November.
Both candidates have been campaigning, although Hutchinson already knows many of the voters because of his previous election.
The winner will be sworn in and vote on critical budget issues, including casino gambling and the proposed gas tax increase.
O'Neil would support a temporary gas tax under certain provisions. "I'd vote for a short-term usage tax to repair roads and bridges that have been closed or in need of immediate repair," he said. "It would be a short-term fix and then we'd work on a long-term fix."
Hutchinson is leaning against the gas tax because he fears the money will not be spent as intended. "I can't see us throwing another 15 cents on a gallon of gas at a time like this and have no guarantee that money will go to roads and bridges." Hutchinson said he would support gambling, but he takes issue with Gov. Maggie Hassan's proposed budget already including revenue from it while the budget still needs approval.
A group called Citizens for a Strong New Hampshire is trying to play a role in Tuesday's election, sending out two mailings critical of O'Neil, who says the group can't get its facts straight, but is clearly anti-labor.
The first mailing claims that, as president of Local 2320, O'Neil and the union supported a plan that raised electric rates by over 34 percent. The pamphlet cites a Jan. 1 New Hampshire Union Leader article about the Public Utilities Commission approving a rate increase for Public Service of New Hampshire customers, but the article makes no mention of IBEW.
O'Neil said the allegation was even more preposterous because Local 2320's membership consists of communications workers.
The second mailing said in big bold letters "Facts IBEW President Bill O'Neil doesn't want you to know about Obamacare." O'Neil said he is president of a local chapter of IBEW, not the national union president, and is quite far removed from the controversial national health care plan.
Hutchinson said he is not in any way affiliated with the group and does not condone its methods.


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The EPA's friend: It has a loyal ally in Shea-PorterEDITORIAL
May 17. 2013 1:22AM
In a May 6 editorial, we criticized U.S. Rep. Carol Shea-Porter for taking Washington's side in the controversy surrounding the EPA's nitrogen emissions standards for the Great Bay. Shea-Porter responded in a column we published on Monday, which we thought proved our point perfectly well.
The EPA has set a stringent nitrogen standard that will cost municipalities hundreds of millions of dollars, all told, to meet. Several municipalities have sued the EPA, saying the standard is far too restrictive. They want one that will reduce emissions, but not quite as much as the EPA demands.
We pointed out that Shea-Porter has not taken the local communities' side in this dispute. Instead, she sides with the EPA, as she made clear during a forum on the issue in Greenland. In her response, she wrote, "I share concerns about the cost of these projects for local communities, and I have consistently fought for increased federal resources to address challenges surrounding environmental and water protection."
She went on to blame Republicans in Congress, saying that if they had not banned earmarks, she could have secured some federal money for the towns and cities to help defray the costs of meeting the EPA's standards.
With that clever rhetorical trick, Shea-Porter dodges entirely the real issue: The EPA's bullying. The EPA's science is questionable, as the suing communities have shown. The issue is whether its tough nitrogen standards are necessary at all. Shea-Porter ignores that central question and pretends that the real matter at hand is the Republican ban on earmarks.
By dismissing the suing municipalities' contention, Shea-Porter makes clear that she sides with Washington, not New Hampshire.


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An apparent feud between two black market pharmacies has shed light on a shady global industry.
"Rx-Promotion and SpamIt probably are responsible for upward of 50 or 60 percent of spam that you and I got in our inboxes over the last five years," said Brian Krebs, a cyber-security reporter who chronicled the alleged feud on his website. "It's just a ridiculous amount of problems that these two guys cause for everybody."
As part of a dispute between the pharmacies' owners, the digital files of both companies — once two of the largest black market pharmacies in the world — were hacked and ended up in Krebs' hands.
"We're talking about the contact information, the bank account information, the email addresses, phone numbers, sometimes passport information for many of the biggest spammers in the planet," said Krebs. "Not only that, but all the personal information of all the people who ever bought pills through these spam sites over four years."
This information offered a unique look at an industry that's typically shrouded in secrecy. Overwhelmed by the amount of information, Krebs shared the data with academic researchers, including Stefan Savage, a professor of computer science and engineering and University of California, San Diego.
Savage used this data to analyze the industry's business model and co-wrote a research paper this summer with his findings.
At the center of these operations are these international pharmacies, often in countries like Russia.
Because these sites operate in the black market, selling prescription drugs without prescriptions, they've historically turned to spam and other shady advertising practices to get the word out about their medications.
"We wouldn't call what they're doing legitimate; it's illegal in this country," said Savage. "But the fundamental practice is, they are trying to advertise this product."
The spammers are typically independent contractors paid on commission by the pharmacy for the sales they generate — something like 30 or 40 percent of the purchase price.
But once a customer goes to the pharmacy site and chooses his or her drug of choice, the pharmacy takes over. It finds someone to process the credit card payment, which is difficult given the nature of the transaction. Then, it has to get the drugs to the customer.
"They don't actually typically warehouse any drugs themselves," Savage said. "So they'll contract with third parties who have access, usually, to generic drug manufacturing in India and China."
In the course of Savage's research, he and his team placed over 800 test orders and typically received their chosen medications in a timely fashion.
"We've maybe only had one time where we didn't get anything," said Savage. They tested some of the drugs they received, and all had the proper amount of the active ingredient.
Savage says the vast majority of customers are ordering erectile dysfunction drugs. Others order painkillers or stimulants for recreational use. But up to 15 percent of orders come from people seeking medications to treat chronic health conditions, likely because they can't afford to purchase them through legal avenues.
Dave Keck turned to an online pharmacy when he was dropped from his parents' insurance and decided his acne needed prescription-strength help from a medication called Accutane. He researched different international pharmacies and chose one in Latvia that didn't require a prescription.
"I called Walgreens, and they said it was going to be about $600 for a month's supply of what I researched is what I should take," said Keck. "And on this online pharmacy, I think it was like $40 for the same amount, so that was a no-brainer."
Keck knew the risks, both of taking a very strong anti-acne drug without a doctor's supervision and of ordering drugs from abroad. It's technically illegal in the U.S., and he worried it might be a scam. But he decided to place an order. He watched his credit card for extra charges, and then three weeks later he received a padded yellow envelope from Turkey.
"What I got from this pharmacy was in kind of a binder," said Keck. "And they included one [box] of the actual medicine, but the rest was taped down to the inside of this binder. It looked pretty suspicious."
But the pills were all in sealed blister packs with branding that looked more legitimate, though the writing was in Turkish. Keck decided to try taking the medication. He figured it was either real Accutane or a sugar pill.
"After I'd taken it for about a week, I was 100 percent sure it was the real deal, just based on the side effects," said Keck.
His skin dried up, his lips got really chapped, and his acne went away.
Not all online pharmacies operate in the black market; the Food and Drug Administration says Americans should only order from sites that are licensed and located in the U.S. Otherwise, there may not be proper oversight or quality control on these medications. And if these drugs wind up making customers sicker in the long run, it's actually not such a bargain.
A lot of the email spam that winds up in people's mailboxes promises cheap medicines online. Viagra is among the drugs for sale this way. Many people who receive these emails may wonder who's selling this stuff and if anybody is really buying. Turns out the emails come from partnerships between spammers and rogue online pharmacies.
Tracey Samuelson of NPR's Planet Money Team reports on the dark side of the Internet.
TRACEY SAMUELSON, BYLINE: The inner workings of these industries actually emerged from a feud between two competing black-market pharmacies. In their heyday, they were two of the biggest rogue pharmacies in the world. Then someone hacked their digital files and they ended up in the hands of Brian Krebs, who reports on cyber security for his own site, Krebs on Security.
BRIAN KREBS: We're talking about the contact information, the bank account information, the email addresses, phone numbers, sometimes passport information, for many of the biggest spammers on the planet.
SAMUELSON: Plus the order history and credit card information of over a million customers of these two black market pharmacies, Rx-Promotion and SpamIt.
KREBS: These two programs, Rx-Promotion and SpamIt, probably are responsible for upwards of 50 or 60 percent of the spam that you or I got in our inboxes over the last five years. It's just a ridiculous amount of - of problems that these guys caused.
SAMUELSON: Stefan Savage, a professor of computer science and engineering at U.C. San Diego, also got a look at this data. And he used it to study the business model behind this usually hidden industry. At the center are these international pharmacies, often in places like Russia. But because they're in a shady business, selling prescription drugs without prescriptions, they can't simply run ads on TV. They need some other way to get the word out about their product, their pills. And historically, that's meant spam.
STEFAN SAVAGE: We wouldn't call what they're doing legitimate, it's illegal in this country, but the fundamental practice, is they are trying to advertise this product.
SAMUELSON: The spammer is like an independent contractor, they get paid on commission. And in these leaked documents, you can actually read conversations where an online pharmacy employee tries to recruit a hot new spammer to his team.
Hey. How about spamming for us? The employee asks in instant message. What are the payment conditions, the spammer replies? Well, the employee says, most people get to keep about 30 percent of their sales. But the spammer, he counters that he's really good at his job, that he has the ability to send 500 million spam emails in a single day. Eventually, the spammer and the online pharmacy employee, they agree the spammer will keep 40 percent of his sales.
So that's the advertising piece. But once a customer has chosen their drug of choice, then the pharmacy takes over. They find someone to process the credit card payment. And then, they actually have to get the drugs to the customer.
SAVAGE: They don't actually, typically, warehouse any drugs themselves. So they'll contract with third parties who have access, usually to generic drug manufacturing in India and China.
SAMUELSON: So now one question you might be asking is, are these drugs actually real? A guy named Dave Keck had that question as well when he ordered an acne medication called Accutane from a pharmacy in Latvia.
DAVE KECK: I called Walgreen's and they said it was going to be about $600 for a month's supply of what I researched is what I should take. And on this online pharmacy, I think it was like 40 bucks for same amount. So that was a no-brainer.
SAMUELSON: Keck knew the risk - both of taking a very strong drug without a doctor's supervision and of ordering drugs from abroad - it's technically illegal and he worried it might be a scam. But he decided to give it a go. He watched his credit card like a hawk for extra charges and then a few weeks later, he got a package from Turkey.
KECK: What I got from this pharmacy was in like kind of a binder. And they included one packaging of the actual medicine, but the rest was just kind of taped down to inside of this binder. So it looked pretty suspicious.
SAMUELSON: But the pills were in a sealed blister packs with branding that looked more legitimate. Just in Turkish. So Keck wondered whether the pills were real medicine or not. He figured no one would go through all this effort to just poison him.
KECK: No. I was thinking poison was going to be more expensive. These people probably just want to make money. So it's going to be a sugar pill or the real deal. And after I'd taken if for about a week, I was 100 percent sure that it was the real deal, just based on the side effects.
SAMUELSON: His skin dried up, his lips got really chapped, and his acne went away. So a lot of people who order from these pharmacies are ordering erectile dysfunction drugs like Viagra, but Stefan Savage, the researcher, says up to 15 percent of orders come from customers like Keck - people who turn to these sites to treat everyday health problems, likely because they can't afford legal avenues to buy their medications. And according to Savage, people seem to mostly get what they pay for.
SAVAGE: I'll say, over 800 orders, we've maybe only had one time when we didn't get something. For legal reasons, we can't buy every drug and we're not equipped to test everything. I will say the drugs that we have tested, the right active ingredient has appeared in the right amounts.
SAMUELSON: Not all online pharmacies operate in the black market, but the Food and Drug Administration says Americans should only order from sites that are licensed and located in the U.S. Otherwise, there might not be proper oversight. And if these drugs wind up making you sicker in the long run, it's actually not such a bargain.
Tracey Samuelson, NPR News.
INSKEEP: It's MORNING EDITION from NPR News. Transcript provided by NPR, Copyright NPR.


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Benjamin Labreque
May 07. 2013 5:26PM
The U.S. Marshals Service District of New Hampshire/Joint Fugitive Task Force has named Benjamin T. Labreque as New Hampshire's fugitive of the week.
Labreque, 20, is wanted on warrants from Hillsborough County Superior Court for probation violations stemming from an original conviction and sentence for robbery, criminal threatening and resisting arrest.
He is described as 5-feet-6, 126 pounds, with blue eyes, brown hair and a scar on his forehead. He is known to have family, friends and associates throughout the Manchester area.
The U.S. Marshals Service advises the public not to attempt to apprehend a fugitive, who should be considered armed and dangerous. Instead, report any information to the U.S. Marshals Service's Concord office at 225-1632.
For more information visit usmarshals.gov/district/nh


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February 05. 2013 8:48PM
Right-to-work bill finding little support in NH House
CONCORD - The House Labor, Industrial and Rehabilitative Services Committee dealt a blow to the latest attempt to pass right-to-work legislation in New Hampshire.
The committee voted 13-5 to recommend House Bill 322 be killed when the full House takes up the measure.
Former House speaker William O'Brien, R-Mont Vernon, the prime sponsor of the House Bill 322, pushed right-to-work legislation the last two sessions, only to have former governor John Lynch veto the bill and the House fail to override it in 2011. The Senate was not willing to engage in the debate last year, saying the outcome would be the same.
HB 322 was debated last week at the public hearing, with supporters saying right-to-work will help spur the state's economy and set the state apart in the Northeast.
But opponents said HB 322 is an attack on organized labor that will drive down wages and destroy middle-class families.
Like the bill, now dubbed the Franklin Partin right-to-work act, the arguments in support and opposition changed little from the last two years.
The bill would prohibit employers and labor organizations from including fees for non-union members in collective bargaining agreements. Unions collect the fees to pay the cost of negotiating and maintaining the collective bargaining agreement from non-union members.
The earliest the House could take up the bill would be next week.