“ vows to continuously strive to set standards of the highest quality on behalf of the dme industry and business owners. ” indeed, hqaa “ listen [ s ]... act [ s ]... [ and ] stand [ s ] together and in unison to bring the whole of dme service and provision to the next level. ” there are numerous other entities participating in the certification / accreditation process, and virtually every facet of the health care system is governed and reviewed by multiple organizations. take the american hospital association, which designs and administers certification programs to recognize mastery of well - defined bodies of knowledge within health care management disciplines. the certification commission for healthcare information technology is a recognized certification body for electronic health records and their networks. even educational programs, general education or specialty education ( such as podiatric medicine ) must receive proper accreditation in a hospital setting. in addition to the list above, every hospital is subject to special regulations from its own state. health care facilities in california are licensed, regulated, inspected, and / or certified by a number of public and private agencies at both the state and federal level, including the california department of public health ( cdph, previously called the california department of health services ). state and federal agencies have separate jurisdictions, but there is overlap. for example, cdph ’ s license and certification division ( “ l & c ” ) is responsible for ensuring that hospitals comply with state law, but it also cooperates with cms to verify that facilities accepting medicare and medi - cal ( medi - cal is california ’ s version of medicaid ) payments meet federal requirements. california ’ s office of statewide health planning and development ( oshpd ) regulates hospital construction and administers programs which endeavor to implement the vision of “ equitable healthcare accessibility for california. ” these two examples serve to emphasize as well as outline the complexities of state regulations that often accompany their federal counterparts. cdph is divided into eight separate programs, including : - office of the director, or state public health officer ; - external affairs ; - policy and programs ; - center for chronic disease and health promotion ; - center for environmental health ; - center for family health ; - center for health care quality ; and - center for infectious disease. like cdph, oshpd is part of california ’ s health and human services agency. made up of six separate boards and commissions, oshpd ’ s mission is “ to promote healthcare accessibility through leadership in analyzing california ’ s healthcare infrastructure, promoting a diverse and competent


symposium takes a look at the history, education, literature, art, and civil rights struggles of latinos in the midwest by kelli andresen for iowa now while food, culture, and music are the most visible manifestations of latinos ’ presence in the midwest, their influence in the region is more widespread but less known. latino workers have harvested the region ’ s crops, manufactured its industrial goods, and processed its livestock. moreover, latino business owners have rejuvenated abandoned downtowns, while students have increased enrollments and diversified schools. the contributions of latinos to the nation ’ s heartland are the focus of the latino midwest, the 2012 - 13 university of iowa obermann - international programs humanities symposium. this interdisciplinary conference will examine the history, education, literature, art, and civil rights struggles of latinos in light of the demographic changes experienced by midwestern states with growing latino populations. “ people often think of latinos as recent immigrants to the midwest, ” says omar valerio - jimenez, associate professor of history and symposium co - director, “ but latinos have been in the region since the late nineteenth century. the symposium will showcase latinos ’ long history in the midwest and highlight their dramatic population growth, increasing political clout, and crucial economic contributions. ” the main symposium takes place oct. 11 - 13 and will include panels, lectures, performances, and literary readings. the latino midwest is organized by three faculty members in the ui college of liberal arts and sciences : claire fox, associate professor of english and spanish and portuguese, whose teaching and research interests include the literature and arts of the americas ; valerio - jimenez, who is currently working on a study of latinos in early 20th - century iowa that explores acculturation, labor, and gender relations ; and santiago vaquera - vasquez, assistant professor of spanish and portuguese, a chicano writer, and member of the creative writing section in spanish whose current research focuses on literature and art from the u. s. / mexico borderlands. related events extend beyond the main symposium. all of the events, with the exception of the lila downs concert, are free and open to the public. for a list of related events and more information, visit iowa now.


transboundary unesco biosphere reserve " mura - drava - danube " under the auspices of the ramsar cop11, representatives of the governments of austria, croatia, hungary, serbia and slovenia, iucn, icpdr, ramsar secretariat, wetlands international, wwf, other ngos and participants at the conference gathered to celebrate the new achievements on the way to designate the pentalateral unesco biosphere reserve “ mura - drava - danube ”. wwf ’ s introduction to the initiative to conserve the unique natural values of the three rivers mura, drava and the danube, and their floodplains, was followed by statements of the five countries ( austria, croatia, hungary, serbia and slovenia ) highlighting their commitment to achieve the final designation of the area as a biosphere reserve. the efforts made up to date by all parties involved were rewarded by the announcement of the first nomination of a significant part of the area ( 80 %, about 630. 000 ha ) shared by croatia and hungary, as a biosphere reserve. the importance of the initiative for nature conservation but at the same time as a framework for increased cooperation between the countries to commonly address upcoming threats from unsustainable development ( especially navigation ) was emphasized by iucn, icpdr, ramsar and wetlands international representatives. from a global perspective, the “ mura – drava – danube ” transboundary biosphere reserve would also serve as a leading example of international cooperation to save one of the last remaining natural wetland areas in europe. read more here.


key tools for tackling invasive species 31 may 2011 | news story prevention, eradication and early detection system are key tools for tackling invasive species. this was the conclusion of the conference “ the challenge of invasive species and destructive insects ” organised on the 24 may 2011 in the european parliament. the event highlighted disastrous consequences of the proliferation of invasive species and shaped the necessary tools for putting an end to this plague. “ invasive alien species should be regarded as one of the most important environmental topics in europe. to stop their spread in europe it is critical to act, and to act quickly, ” argued mep gaston franco, chair of the conference “ the challenge of invasive species and destructive insects ”. one out of every ten introduced species becomes invasive due to their ability to compete with indigenous species. this worrying problem has a major impact not only on environment but also on the economy and health. as recalled by pia bucella, director in dg environment, 12 billion euros are lost every year due to invasive alien species while at the global level it amounts to 1. 4 trillion per year. surprisingly, there is no eu comprehensive instrument to tackle this problem. local solutions are therefore implemented such as the ambitious strategy in the city of nice ( france ) to cope with the devastating red palm weevil or the program to stop the invasion of grey squirrels in some parts of the uk. everybody agreed that prevention through communication, education and full involvement of the public combined with eradication and early detection system are powerful tools. piero genovesi from iucn called for an early warning rapid response system enabling to share information globally and rapidly. whatever the solution, both animal welfare and human ethics should be taken into account, according to prof. dirk lips from the kul university. organized by the secretariat of the european parliament intergroup “ climate change, biodiversity and sustainable development ”, run jointly by the european bureau for conservation and development ( ebcd ) and the international union for conservation of nature ( iucn ), the conferencebrought together high level international, european, national and regional experts. for more information, please contact melanie lamaison from ebcd.


may be of interest to some of my readers. 1. data protection challenge of the future : what is big data? the three v ’ s - volume, velocity, and variety – are the essential characteristics of “ big data ”. while data protection and privacy laws are still busy catching up with technologies of yesterday, big data is growing at a lightning speed on a daily basis. how can companies deal with the data protection challenges brought about by big data in order to truly benefit from the opportunities introduced by big data? first, one must truly grasp what is big data. we interview jeff jonas, chief scientist at ibm entity analytics, to obtain his perspectives and definition of big data, and his experience handling big data. 2. when did data become big? big data did not become big overnight. what i think happened is data started getting generated faster than organizations could get their hands around it. then one day you simply wake up and feel like you are drowning in data. on that day, data felt big. 3. please explain and elaborate on the characteristics of big data? big data means different things to different people. personally, my favorite definition is : “ something magical happens when very large corpuses of data come together. ” some example of this can be seen at google, for example google flu trends and google translate. in my own work, i witnessed this first in 2006. in this particular system, the system started getting higher quality predictions and faster as it ingested more data. this is so counter intuitive. the easiest way to explain this though is to consider the familiar process of putting a puzzle together at home. why is it do you think the last few pieces are as easy as the first few – even though you have more data in front of you then ever before? same thing really that is happening in my systems these days. it ’ s rather exciting to tell you the truth. to elaborate briefly on the new physics of big data, i pinpointed the three phenomena of big data physics in my blog entry - big data. new physics – drawing from my personal experience of 14 years of designing and deploying a number of multi - billion row context accumulating systems : 1. better prediction. simultaneously lower false positives and lower false negatives 2. bad data good. more specifically, natural variability in data including spelling errors, transposition errors, and even professionally fabricated lies – all helpful. 3. more data faster. less compute effort as the database gets bigger. another definition of big data is related to the ability for organizations to


, natural variability in data including spelling errors, transposition errors, and even professionally fabricated lies – all helpful. 3. more data faster. less compute effort as the database gets bigger. another definition of big data is related to the ability for organizations to harness data sets previously believed to be “ too large to handle. ” historically, big data means too many rows, too much storage and too much cost for organizations who lack the tools and ability to really handle data of such quantity. today, we are seeing ways to explore and iterate cheaply over big data. 4. when did data become big for you? what is your “ big data ” processing experience? as previously mentioned, for me, big data is about the magical things that happen when a critical mass is reached. to be honest, big data does not feel big to me unless it is hard to process and make sense of. a few billion rows here and a few billion rows there – such volumes once seemed a lot of data to me. then helping organizations think about dealing volumes of 100 million or more records a day seemed like a lot. today, when i think about the volumes at google and facebook, i think : “ now that really is big data! ” my personal interest and primary focus on big data these days is : how to make sense of data in real time, that is fast enough to do something about the transaction while the transaction is still happening. while you swipe that credit card, there is only a few seconds to decide if that is you or maybe someone pretending to be you. if an unauthorized user is inside your network, and data starts getting pumped out, an organization needs sub - second “ sense and respond ” capabilities. end of day batch processes producing great answers is simply late! 5. what are the technologies currently adopted to process big data? the availability of big data technologies seems to be growing by leaps and bounds and on many fronts. we are seeing a large corporate investments resulting in commercial products – at ibm two examples would be ibm infosphere streams for big data in motion and ibm infosphere big insights for pattern discovery over data at rest. there are also many big data open source efforts under way for example hadoop, cassandra and lucene. if one were to divide these into types one would find some well suited for streaming analytics and others for batch analytics. some help organizations harness structured data while others are ideal for unstructured data. one thing is for sure – there are many options, and there will be many more choices to come as big data


well suited for streaming analytics and others for batch analytics. some help organizations harness structured data while others are ideal for unstructured data. one thing is for sure – there are many options, and there will be many more choices to come as big data continues to get investment. 6. how can companies benefit from the use of big data? i ’ d like to think consumers benefit too, just to be clear. to illustrate my point, i find it very helpful when google responds to my search with “ did you mean _ _ _ _ _ _ ”. to pull this very smart stunt, google must remember the typographical errors of the world, and that i do believe would qualify as big data. moreover, i think health care is benefiting from big data, or let ’ s hope so. organizations like financial institutions and insurance companies are benefitting from big data also by using these insights to run more efficient operations and mitigate risks. we, you and i, are responsible in part for generating so much big data. these social media platforms we use to speak our mind and stay connected are responsible for massive volumes of data. companies know this and are paying attention. for example, my friend ’ s wife complained on twitter about a specific company ’ s service. not long thereafter they reached out to her because they too were listening. they fixed the problem and she was as happy as ever. how did the company benefit? they kept a customer. 7. what is the trend of processing big data? i think a lot of big data systems are running as periodic batch processes, for example, once a week or once a month. my suspicion is as these systems begin to generate more and more relevant insight, it will not be long before the users say : “ why did i have to wait until the end of the week to learn that? they already left the web site. ” ; or, “ i already denied their loan when it is now clear i should have granted them that loan. ” 8. what are the complications dealing with the privacy implications brought about by big data compare to average sized data? there are lots of privacy complications that come along with big data. consumers, for example, often want to know what data an organization collects and the purpose of the collection. something that further complicates this : i think many consumers would be surprised to know what is computationally possible with big data. for example, where you are going to be next thursday at 5 : 35pm or your three best friends, and which two of


complicates this : i think many consumers would be surprised to know what is computationally possible with big data. for example, where you are going to be next thursday at 5 : 35pm or your three best friends, and which two of them are not on facebook. big data is making it harder to have secrets. to illustrate using lines from my blog entry - using transparency as a mask – ‘ unlike two decades ago, humans are now creating huge volumes of extraordinarily useful data as they self - annotate their relationships and yours, their photographs and yours, their thoughts and their thoughts about you … and more. with more data, comes better understanding and prediction. the convergence of data might reveal your “ discreet ” rendezvous or the fact you are no longer on speaking terms your best friend. no longer secret is your visit to the porn store and the subsequent change in your home ’ s late night energy profile, another telling story about who you are … again out of the bag, and little you can do about it. pity … you thought that all of this information was secret. ’ 9. what are the privacy concerns & threats big data might bring about - to companies and to individuals whose data are contained in ' big data '? my number one recommendation to organizations is “ avoid consumer surprise. ” 10. how are companies currently applying privacy protection principles before / after big data has been processed? i think there are many best practices being adopted. one of my favorites involves letting consumers opt - in instead of opting them in automatically and then requiring them to opt - out. one new thing i would like to see become a new best practice is : a place on the web site, for example my bank, where i can see a list of third parties whom my bank has shared my data with. i think this transparency would be good and certainly would make consumers more aware. 11. what is “ big data ”, according to jeff jonas? big data is a pile of data so big - and harnessed so well - that it becomes possible to make substantially better predictions, for example, what web page would be the absolute best web page to place first on your results, just for you.


thyroid cancer is cancer of the thyroid gland. this gland makes thyroid hormone, and it is found in the front of the neck. thyroid gland tumors often appear as bumps in the neck, called nodules. in most cases, thyroid nodules are not cancerous. however, those that are cancerous have the potential to spread throughout the body. there are several types of thyroid cancer, including : - papillary carcinoma ( most common type ) — it usually grows very slowly and often spreads to lymph nodes in the neck. if caught early, this type of thyroid cancer is often curable. - follicular carcinoma ( second most common type ) — it usually stays in the thyroid gland, but can spread to other parts of the body, such as the lungs and bones. it does not usually spread to the lymph nodes. if caught early, this type of thyroid cancer is often curable. - anaplastic carcinoma ( rare form of thyroid cancer ) — it quickly invades the neck and other parts of the body and is often fatal. medullary thyroid carcinoma ( mtc ) — this cancer develops from cells in the thyroid gland called c - cells. mtc often spreads to the lymph nodes, lungs, or liver before a thyroid nodule has been discovered. there are two types of mtc : - sporadic mtc - familial medullary thyroid carcinoma ( fmtc ) - thyroid lymphoma ( rare type of thyroid cancer ) — many cases occur in people who have a disease called hashimoto ' s thyroiditis. factors that may increase the risk of thyroid cancer include : - diet low in iodine - history of radiation to the head, neck, or chest, especially in infancy or childhood - family history of thyroid cancer - sex : female - age : 30 and over - exposure to radioactive fallout ( eg, exposed to radiation from nuclear accidents or exposed to nuclear testing area during childhood ) symptoms may include : - a lump in the neck - neck pain ( sometimes going up to the ears ) - difficulty swallowing - difficulty breathing - persistent cough - enlarged lymph glands in the neck the doctor will ask about your symptoms and medical history. a physical exam will also be done. this may include a careful examination of your neck to look for lumps or abnormalities. your doctor may order tests, such as : once thyroid cancer is found, staging tests are done to find out if the cancer has spread. treatment depends on the


. this may include a careful examination of your neck to look for lumps or abnormalities. your doctor may order tests, such as : once thyroid cancer is found, staging tests are done to find out if the cancer has spread. treatment depends on the stage of the cancer. examples of treatment options include : - thyroidectomy — this is the removal of all or part of the thyroid gland. - radioactive iodine therapy — this uses large doses of radioactive iodine to destroy the thyroid gland and thyroid cancer without affecting the rest of the body. - external radiation therapy — this is the use of radiation to kill cancer cells and shrink tumors. radiation is directed at the tumor from a source outside the body. if you are diagnosed with thyroid cancer, follow your doctor ' s instructions. because the exact cause of thyroid cancer is unknown, finding it early and treating it is the best way to prevent dying from the disease. your doctor may recommend screening tests for you, for example : - have a thyroid exam every three years if you are aged 20 - 39 years old - have a thyroid exam every year if you are aged 40 years or older since exposure to radiation is a major risk factor for thyroid cancer, you should : - avoid unnecessary exposure to radiation. - if you have been exposed to radiation of the head, neck, or chest, have frequent checks for thyroid cancer. - reviewer : igor puzanov, md - review date : 10 / 2012 - - update date : 10 / 31 / 2012 -


after kids or teens are diagnosed with type 2 diabetes, the next step is to create a diabetes management plan to help them manage the condition and stay healthy and active. treatment plans for type 2 diabetes are based on each child ' s needs and the suggestions of the diabetes health care team. type 2 diabetes treatment basics the blood glucose level is the amount of glucose in the blood. glucose is the main source of energy for the body ' s cells and is carried to each cell through the bloodstream. the hormone insulin allows the glucose to get into the cells. in type 2 diabetes, the body doesn ' t respond normally to insulin, so glucose is less able to enter the cells. this causes the blood glucose level to rise. treatment goals for kids with diabetes are to control the condition in a way that minimizes symptoms, prevents short - and long - term health problems, and helps them to have normal physical, mental, emotional, and social growth and development. to do this, parents and kids should aim for the goal of keeping blood sugar levels as close to normal as possible. it is also important to treat other conditions that can be associated with type 2 diabetes, like obesity, high blood pressure, or abnormal blood lipid ( fat ) levels. in general, kids with type 2 diabetes need to : eat a healthy, balanced diet and follow a meal plan get regular exercise take medications as prescribed monitor blood sugar levels regularly helping kids with type 2 diabetes switch to healthier habits is a key part of treatment. because most kids are overweight when they ' re diagnosed, it ' s important to promote healthy eating and physical activity to prevent further weight gain or to encourage weight loss while making sure they grow and develop properly. weight gain occurs when someone eats more calories, or energy, than is used up through physical activity. the body stores those extra calories as fat. over time, excessive weight gain can lead to obesity and diseases related to obesity like type 2 diabetes and heart disease. kids with type 2 diabetes who are trying to manage their weight still need energy to develop normally. to get it, they ' ll need enough calories to grow without gaining too much fat. the best way is to eat nutritious foods and exercise. many parents worry about what to feed their kids with type 2 diabetes. the key is a balanced, healthy diet. kids with diabetes benefit from the same kind of diet as those without diabetes — one that includes a variety of nutritious foods that help the body grow and function properly. the three main types of nutrients


. the key is a balanced, healthy diet. kids with diabetes benefit from the same kind of diet as those without diabetes — one that includes a variety of nutritious foods that help the body grow and function properly. the three main types of nutrients found in foods are carbohydrates ( carbs ), proteins, and fats, which provide energy in the form of calories. foods containing carbs cause blood sugar levels to go up the most. foods that are mostly protein and / or fat don ' t affect blood sugar levels nearly as much. our bodies need many nutrients — in different amounts — to function normally. so when you and the diabetes health care team create a diabetes meal plan to help keep your child ' s blood sugar within the target range, it will include a variety of nutrients. meal plans usually consist of breakfast, lunch, and dinner with small, scheduled between - meal snacks. the plan won ' t restrict your child to eating specific foods, but will guide you in selecting from the basic food groups to achieve a healthy balance. meal plans are based on a child ' s age, activity level, schedule, and food likes and dislikes, and should be flexible enough to accommodate special situations like parties and holidays. the meal plan should make it easier to keep your child ' s blood sugar within his or her goal range. the meal plan also might recommend limiting extra fat and " empty " calories ( foods that contain lots of calories but few nutrients ). everyone should limit these foods anyway because eating too much of them can lead to excess weight gain or long - term health problems like heart disease, for which people with diabetes are already at risk. portion control — even of healthy foods — is important for kids with type 2 diabetes because they generally weigh more than kids who don ' t have the disease. as you ' re following your child ' s meal plan, be wary of special foods marketed to people with diabetes. sugar - free and fat - free foods are not always calorie - free or even low - calorie foods. a registered dietitian ( rd ) can help you choose and cook healthier foods, read food labels, and learn how much food your child should be eating in a day. the rd also can adjust meal plans depending on how your child is doing regarding meeting weight management goals. if you don ' t have a dietitian on the diabetes health care team, ask your doctor for a referral to see one. getting regular exercise exercise is good for everyone — adults


on how your child is doing regarding meeting weight management goals. if you don ' t have a dietitian on the diabetes health care team, ask your doctor for a referral to see one. getting regular exercise exercise is good for everyone — adults and kids, with or without diabetes. getting regular physical activity is also an important part of diabetes treatment. overweight kids and teens with type 2 diabetes tend to be less active, so exercise is a very important part of the treatment plan. exercise helps improve the body ' s response to insulin, which helps to control blood sugar levels. it also helps the body burn more calories, which can reduce excess body fat. and it ' s healthier for growing kids who are overweight to burn more calories through exercise than to severely restrict the food they eat. regular physical activity also can help reduce the risk of other chronic illnesses, like cancer. in addition to all of these benefits, exercise can help kids with diabetes : get and keep their heart, lungs, and blood vessels in good shape feel more normal by doing things that kids without diabetes can do kids don ' t have to be athletic to reap the benefits of physical activity. things like walking the dog, helping around the house, and playing outside with friends are great — anything that gets them moving regularly can go a long way toward helping control diabetes. to help avoid problems during exercise, kids with type 2 diabetes may need to : have an extra snack prior to activity carry snacks, water, and supplies with them when they exercise check their blood sugar levels before, during, and after exercise make sure their coaches know about their diabetes and what to do if problems occur make sure your child wears a medical identification bracelet ( this should always be worn, but it ' s even more important during exercise, sports, and and fitness activities ). the diabetes health care team will make suggestions to help your child get ready for exercise or join a sport. they ' ll also provide instructions to help you and your child respond to any diabetes problems that could occur during exercise, like hypoglycemia ( low blood sugar ) or hyperglycemia ( high blood sugar ). taking medications as prescribed sometimes, a combination of diet and exercise are enough to control blood sugar levels in kids with type 2 diabetes. other times, pills that help insulin work better also need to be taken. these pills are not a form of insulin. sometimes pills for diabetes — even when combined with diet and exercise — still aren ' t enough to keep blood sugar levels under control,


other times, pills that help insulin work better also need to be taken. these pills are not a form of insulin. sometimes pills for diabetes — even when combined with diet and exercise — still aren ' t enough to keep blood sugar levels under control, and a child with type 2 diabetes must take insulin. the acids and digestive juices in the stomach and intestines would break down and destroy insulin if it was swallowed, so it can ' t be taken in a pill. the only way to get insulin into the body is with an injection or an insulin pump. there is no - one - size - fits - all insulin schedule — the types of insulin used and number of daily injections a child needs will depend on the diabetes management plan. usually, kids inject a combination of different types of insulin to handle the sugar that circulates in the blood after eating and between meals. also, you can ' t turn off the action of insulin once it ' s been injected, so insulin doses need to be adjusted to handle the rise in blood sugar that occurs with meals and provide the amounts of insulin the body needs between meals and overnight. eating meals at regular times generally makes this easier. although eating on schedule may work well for younger kids, sticking to a routine can be a challenge for older kids, whose school, sleep, and social schedules might not be as routine. the diabetes health care team can help you work through any problems your child might have with scheduling meals and insulin injections. the promising news about type 2 diabetes is that by following a balanced diet, getting regular physical activity, and achieving a healthy weight, blood sugar levels can improve significantly. in some kids, following the treatment plan for type 2 diabetes can even eliminate the need for medication altogether. treating type 2 diabetes also involves checking blood sugar levels regularly and responding to the results. controlling blood sugar levels helps kids with diabetes feel well, grow and develop normally, and also reduces the risk of long - term diabetes complications. the diabetes treatment plan will recommend how many times a day to check blood sugar levels, which is the only way to monitor the effectiveness of your child ' s day - to - day blood sugar control. the diabetes health care team also will let you know what your child ' s target blood sugar levels are. in general, kids with type 2 diabetes should test their blood sugar levels with a blood glucose meter at least twice a day, but might need to test more frequently if they ' re taking insulin, have just been diagnosed, or are having problems with blood


in general, kids with type 2 diabetes should test their blood sugar levels with a blood glucose meter at least twice a day, but might need to test more frequently if they ' re taking insulin, have just been diagnosed, or are having problems with blood sugar control. a blood glucose meter measures the blood sugar level at the moment of testing. another blood sugar test, the glycosylated hemoglobin ( hemoglobin a1c or hba1c ) test, indicates what blood sugar levels have been over the past few months. putting it all together treating and managing diabetes can seem overwhelming at times. but the diabetes health care team is there for you. your child ' s diabetes management plan should be easy to understand, detailed, and written down for easy reference. you also should have the names and phone numbers of the health care team members in case of emergencies or if you have questions about how to take care of your child ' s diabetes. besides the standard diabetes treatments, you also might hear of alternative or complementary treatments, such as herbal remedies and vitamin or mineral supplements. although research continues into their possible benefits, studies thus far haven ' t proved their effectiveness. aside from being potentially ineffective, they could even be dangerous for kids and teens with type 2 diabetes, especially if used to replace medically recommended treatments. talk to the diabetes health care team if you have questions. each day, researchers all over the world are working to find a cure for diabetes, and many treatment advances have made treatment easier and more effective. insulin might soon be available in pill, patch, and spray forms, and scientists continue efforts to improve results of pancreas or islet cell transplants. versions of an artificial pancreas — a device that senses blood sugar and gives insulin — also are being tested. these new developments are exciting, but they still need extensive testing — especially for use in kids — before they become available.


have you ever eaten gluten? no, not glue — gluten! if you ' ve ever eaten a piece of bread, a slice of pizza, or a bowl of cereal, chances are you have. gluten ( say : gloo - tin ) is a protein found in wheat, rye, and barley — grains that are in many everyday foods. most of us eat food with gluten with no trouble. but for some people, eating gluten can cause a reaction in their bodies. someone who has this problem has celiac ( say : see - lee - ak ) disease. after you eat food, it goes to your stomach, which is part of a group of organs that make up your digestive system. an important part of the digestive system is the small intestine, which is lined with villi ( say : vil - eye ). villi are usually described as microscopic, finger - like projections. weird, huh? fingers in your intestines! but don ' t forget that they ' re microscopic, meaning they are extremely small — so small you can ' t see them without a microscope. the villi are important because they absorb nutrients into the body. for someone with celiac disease, eating gluten — in a piece of bread, for instance — causes an immune system reaction. your immune system ordinarily keeps you from getting sick, but in someone with celiac disease, the body starts damaging and destroying the villi. without villi, the body can ' t absorb vitamins and nutrients from food. without enough nutrients, a kid ' s body has a tough time staying healthy and growing properly. even if the person eats a lot, he or she still might lose weight and might develop anemia ( say : uh - nee - me - uh ) from not absorbing enough iron. no one is sure why celiac disease happens, but it appears to run in families. you have a 5 % to 10 % chance of getting celiac disease if someone in your family has it. it ' s common in people from the northern european countries and the united states. how common? about 1 in every 133 people in the united states has celiac disease. obviously, many people who have celiac disease do not know it. if all these people were diagnosed, celiac disease would be more common than type 1 diabetes. fortunately, awareness is growing about the problem, and there are better ways of testing people for it. signs and symptoms some common symptoms of


not know it. if all these people were diagnosed, celiac disease would be more common than type 1 diabetes. fortunately, awareness is growing about the problem, and there are better ways of testing people for it. signs and symptoms some common symptoms of celiac disease are diarrhea, decreased appetite, stomachache and bloating, poor growth, and weight loss. many kids are diagnosed with it when they ' re between 6 months and 2 years old. it makes sense because, at this time kids are getting their first taste of gluten in foods. for some people, the problems occur gradually and the symptoms may be terrible one week and not as bad the next. because of this, some people aren ' t diagnosed with celiac disease until they ' re older. the problem is chronic, which means that although symptoms may come and go, people who have celiac disease will always have it. someone with celiac disease may feel tired and could be irritable. some also have skin rashes and mouth sores. the problem is sometimes mistaken for other digestive problems called inflammatory bowel disease or lactose intolerance. and in some cases, a kid won ' t have any symptoms and then will all of a sudden start having problems during a time of stress, such as after an injury. someone who has a lot of stomachaches, diarrhea, weight loss, or any of other symptoms of celiac disease should talk to a doctor. it may or may not be celiac disease, but a doctor can help sort this out and will usually order a screening blood test. if the screening tests show a person might have celiac disease, the next stop usually is to see a gastroenterologist, a doctor who specializes in digestive problems. this specialist may decide to take a sample of the small intestine to look at under the microscope. this small sample is called a biopsy. if a biopsy is done, the doctor will give some special medicine to help the person stay comfortable during the procedure. how is it treated? celiac disease is treated by not eating gluten. this can be difficult because gluten is in many foods, but a dietitian can help adjust someone ' s diet to cut out gluten. it is important not to start a gluten - free diet unless you are truly diagnosed with celiac disease. following a gluten - free diet allows the small intestine to heal. but that doesn ' t mean the person can


. it is important not to start a gluten - free diet unless you are truly diagnosed with celiac disease. following a gluten - free diet allows the small intestine to heal. but that doesn ' t mean the person can start eating gluten again. for someone with celiac disease, gluten will always irritate the intestines and, if this happens, the diarrhea, stomachaches, and other problems will return. if you ' re diagnosed with celiac disease, it can be a challenge to learn which foods contain gluten. you may not be able to remember them all, but you can keep a list with you and ask about menu items at restaurants before digging in. before you know it, you ' ll be a pro at knowing which foods are safe and which are not. here ' s a quick quiz : which of these foods contain gluten? if you said all three, you ' re right! pizza was the easiest choice because you know the crust is bread. but did you know that battered foods like fried chicken and even some french fries contain gluten? pasta also contains gluten because it is made from wheat. luckily, you can make or buy gluten - free pizza crust, make fried chicken with a gluten - free batter, and find gluten - free pasta. in fact, nearly all of the foods we eat can be made gluten free. in addition to foods that contain gluten, you ' ll need to watch out for foods that may have been contaminated with gluten. that means a food doesn ' t contain gluten as an ingredient but came into contact with gluten - containing foods. this is most likely to occur at home in your own kitchen — for instance, wheat bread crumbs in the toaster, the butter, or peanut butter. if you have celiac disease you will need your own toaster and you should also have separate spreads and condiments to avoid this cross - contamination. some foods are contaminated during processing, so your mom or dad can help you by finding certified gluten - free foods. for instance, gluten - free oats are now available for people with celiac disease. the best approach is to read labels, but here are a few foods to steer clear of until you can verify that they are gluten free : packaged rice mixes there ' s also a labeling act that requires the labeling of wheat - free products


. the best approach is to read labels, but here are a few foods to steer clear of until you can verify that they are gluten free : packaged rice mixes there ' s also a labeling act that requires the labeling of wheat - free products. but a " wheat - free " food isn ' t necessarily a " gluten - free " one because wheat - free products may have barley and rye ( gluten - containing grains ) in them. a diagnosis of celiac disease does not mean giving up all your favorite foods. it just means adapting them to be gluten free. many different gluten - free products, baking mixes, and recipes are available. a support group is a great resource for finding out which recipes and products are best. a support group can help keep you up to date as well. for instance, a few years ago it was recommended that distilled vinegar be completely avoided on a gluten - free diet. now we know that the gluten molecules do not appear in the distillate. huh? what this means is that distilled vinegar is now an ok ingredient. that made a big change in the allowed foods someone with celiac disease could eat. if you ' re part of a support group, you hear of these kinds of changes right away. a support group is also a great place to get to know other kids who have celiac disease and to learn that you ' re not alone.


ah, summer camp. the mosquitoes, the swim races, the friendships, the bug juice, the postcards home. what child wouldn ' t benefit from the fun and structured freedom camps provide? kids with special needs are no exception. but the idea can seem challenging to parents and kids alike — how can you be sure that your child will get the attention he or she needs? will your child be able to participate fully? what about the other kids? will your child make friends? will they understand your child ' s special needs? the good news is that there are many camp choices for kids with special needs. from highly specialized camps to regular camps that accommodate kids with special needs, options abound. different types of camps when it comes to camps, kids with special needs have as many choices as other kids. the americans with disabilities act ( ada ) requires all camps to make reasonable accommodations ( such as the installation of wheelchair - accessible ramps ) so that kids with special needs can attend. so, camps that previously couldn ' t host kids with special needs might now be on your list of possibilities. inclusionary ( or mainstream ) camps do just what their name implies : they include kids with special needs in their groups of children with regular needs. these camps may have started out serving only a general population of kids, but they ' ve gradually changed as the needs of the families they serve have changed. some camps are designed just for kids with special needs, including kids who have learning or behavioral problems, those with specific chronic illnesses, and kids with mental or physical impairments. many accept kids with a variety of needs, but some only accept kids with specific problems ( such as camps for kids with diabetes, cancer, speech or hearing impairment, cystic fibrosis, cerebral palsy, epilepsy, etc. ). within all of these categories, you ' ll have even more choices to consider regarding length of stay, philosophy, and cost. there are nonprofit and for - profit camps, religious camps, camps run by national organizations, private camps, day camps, camps that run weekend sessions, and sleepover camps that accept kids for the entire summer. the benefits of camp for kids with special needs are often the same as for any child : increased confidence and independence activity and exercise the opportunity to interact with other kids, develop friendships, and build relationships positive role modeling by adults a chance for parents to have a much - needed break independence is an important camp benefit. for example, an overnight mainstream camp can give special - needs kids the chance to


interact with other kids, develop friendships, and build relationships positive role modeling by adults a chance for parents to have a much - needed break independence is an important camp benefit. for example, an overnight mainstream camp can give special - needs kids the chance to be without parents, doctors, or physical therapists for a week. they ' ll do more things for themselves and learn how to ask friends to help, which can boost problem - solving and communication skills. also, camp provides the physical benefits of increased activity. many kids with disabilities or chronic illnesses are sedentary and don ' t get to participate in the sports or recreational activities that their peers do. they therefore miss out on the social and health benefits that exercise brings. camp provides a variety of activities such as swimming, wheelchair racing, dancing, tennis, or golf. these give immediate health benefits ( such as improved cardiovascular fitness ) and recreational options that can carry over into adult life. many camps combine learning environments with these physical activities, giving kids with behavioral or learning problems the chance to develop, or catch up on, needed skills during the summer. starting your camp search to find a camp, make lists of the basics you ' re looking for : a list of goals, a list of caretaking priorities, and a list of other considerations ( such as cost ). then consider which type of camp might best suit your child : inclusionary ( or mainstream ) camps camps for kids with a specific special need camps for kids with many different kinds of special needs consider whether your child has ever been away from home, for the weekend or even longer, and what experiences might have helped prepare him or her for camp. this will help you to decide not only the type of camp, but whether your child is ready for a day camp or a sleepover ( residential ) camp. involving kids in the camp search will help to ensure that they get the most out of the camp selected. so, ask your child : what do you want to get out of summer camp? what are your preferences? do you want to go to a coed camp, or just be around kids of the same gender? are there any activities you really want to try? would you be more comfortable going to a camp with kids who do or don ' t have special needs? are you comfortable being away from home? if so, for how long? do you have classmates or friends who have gone to a summer camp? if so, which ones? and did they like it? if it turns out that the idea of camp is a


comfortable being away from home? if so, for how long? do you have classmates or friends who have gone to a summer camp? if so, which ones? and did they like it? if it turns out that the idea of camp is a bit overwhelming for both you and your child, you might want to try starting small, like weekend sessions at a special - needs camp. whatever type of camp you ' re leaning toward, it ' s important to do your research. many places offer information — the american camp association ( aca ), for example, has an online listing of special - needs camps broken down by the types of camps, cost, length of stay, state / region, and campers ' ages. the site is also loaded with general and age - appropriate advice for parents of would - be campers. you also can call local chapters of major disability organizations about camps in your area. many organizations publish lists of camps and can connect you with camp directors and former campers. you might have a special - needs camp fair in your area. check the calendar listings in your local newspapers and monthly parenting magazines. many of these are held in january or february, which means that you need to start your camp search early. of course, part of your research will involve figuring out what you can afford. the cost of camps varies widely, with some high - end special - needs camps costing thousands of dollars for multiple - week sessions. you can help fund your child ' s camp experience by applying for scholarships — experts say to do so from december through march, because the money is gone by april or may. you can contact charitable organizations and fraternal organizations ( such as the lions, kiwanis, and rotary clubs, all of which sponsor special - needs camps ). and depending on your child ' s specific special need, he or she may be eligible for financial aid from your state. other sources of scholarships include religious or ethnic charities. one thing to know : you usually first need to find a camp that can take your child — most of these organizations send the scholarship money to the camp in the child ' s name, not to the parents directly. so, how do you narrow down your choices and pick the camp that ' s right for your child? some basic and special - needs - specific questions you ' ll need to have answered include : how long are the sessions? what ' s the cost? are scholarships available? is it coed, girls - only, or boys - only? what ' s the age range


- needs - specific questions you ' ll need to have answered include : how long are the sessions? what ' s the cost? are scholarships available? is it coed, girls - only, or boys - only? what ' s the age range of campers? where is it located — and how far away from your home is it? what ' s the staff - to - camper ratio? how old are most of the counselors? what type of certification do the counselors have? what ' s the turnover rate? do kids and staff come back? what ' s the camp ' s philosophy? does it fit with your goals for your child? what ' s the camp ' s transportation system like? if physical accessibility is an issue, what ' s the layout of the camp? what provisions has the camp made ( or can it make ) for wheelchairs or crutches? if your child needs a special diet, can the camp provide appropriate meals? if not, can you provide food for your child? do staff members have a background working with kids with special needs? do the counselors have first - aid training? what kind of medical staff is available in the infirmary and during what hours? can the staff administer any medications your child needs? if your child has behavior problems, what ' s the training and experience of the available staff to help? and how does the camp staff handle behavioral problems? what ' s the procedure if your child develops a complication related to his or her medical problems? how far is the nearest hospital? if your child needs specialized treatment, is it available at that hospital? although you can get some of this information through phone calls, emails, brochures, and websites, experts recommend visiting the camp. you can talk to the director, visit the site, and get a comprehensive picture of where your child will be. probably the only way to get a true feel for the camp is for you and your child to visit it together. this is especially important if your child is going to a regular ( inclusionary or mainstream ) camp where they haven ' t hosted many children with special needs, because it gives you the opportunity to point out changes they might need to make and to gauge the reaction of the camp ' s staff to your requests. if you can ' t visit a camp, interview the director and some staff members to get a feel for the place. ask them to describe the physical layout and the kinds of activities your child will do. you should also ask to speak with other families whose kids


adenoids and tonsils are often talked about together. you can see your tonsils in the back of your throat, but where are your adenoids? for that matter, what are your adenoids? let ' s find out. what are adenoids? the adenoids ( say : add - eh - noids ) are lumpy clusters of spongy tissue that help protect kids from getting sick. they sit in the back of the nasal cavity and are above the roof of the mouth. although you can easily see your tonsils by standing in front of a mirror and opening your mouth wide, you can ' t see your adenoids this way. a doctor has to use a special telescope to get a peek at your adenoids. the doctor can also get an idea of the size of the adenoids by getting an x - ray of your head. like tonsils, adenoids help keep your body healthy by trapping harmful bacteria and viruses that you breathe in or swallow. adenoids also contain cells that make antibodies to help your body fight infections. adenoids do important work as infection fighters for babies and little kids. but they become less important once a kid gets older and the body develops other ways to fight germs. adenoids usually shrink after about age 5, and by the teenage years they often practically disappear. when adenoids swell because adenoids trap germs that enter the body, adenoid tissue sometimes temporarily swells ( gets puffier ) as it tries to fight off an infection. the swelling might go away on its own, but sometimes medical treatment is necessary. adenoids can get so walloped by a bacterial invasion that they become infected themselves. swollen or enlarged adenoids are common. when this happens, the tonsils may also get swollen, too. swollen or infected adenoids can make it tough to breathe and cause these problems : a very stuffy nose, so a kid can breathe only through his or her mouth snoring and trouble getting a good night ' s sleep sore throat and trouble swallowing swollen glands in the neck tell a grownup if you have any of these problems, so he or she can take you to the doctor. at the doctor ' s office, the doctor will ask you how things feel in your ears, nose, and throat, and then take a look at these parts. your doctor will also feel your neck near your jaw. your doctor may use a flexible telescope to look at your adenoids, and might also send you for an x - ray. if it looks your adenoids


then take a look at these parts. your doctor will also feel your neck near your jaw. your doctor may use a flexible telescope to look at your adenoids, and might also send you for an x - ray. if it looks your adenoids are infected, the doctor may give you an antibiotic ( a germ - fighting medicine ) to take. when adenoids come out sometimes doctors recommend removing the adenoids if medicine doesn ' t help or if they ' re making a kid sick a lot. this means going into the hospital and having surgery. sometimes, a kid ' s tonsils and adenoids are removed at the same time. that ' s called a tonsillectomy ( say : tahn - suh - lek - tuh - me ) and adenoidectomy ( say : add - eh - noid - ek - tuh - me ). both are common surgeries for kids to have. during these surgeries, kids get special medicine that makes them fall asleep and ensures that they don ' t feel any pain while the operation is being done. usually, neither operation requires stitches. the cut areas will heal on their own. it takes a little time, though. after surgery, a kid will have a sore throat and will need to eat soft foods for a while. most kids are feeling back to normal in less than a week. and do they miss their adenoids? not one bit!


do allergies cause asthma? do allergies cause asthma? the answer to this question is : yes and no. people who have certain kinds of allergies are more likely to have asthma. which kind of allergies? usually, the type of allergies that affect your nose and eyes, causing problems like a runny nose or red, itchy eyes. whatever causes an allergic reaction, such as pollen or dust mites, can also trigger asthma symptoms. but not everyone who has allergies develops asthma. and not all cases of asthma are related to allergies. about 23 million people in the united states have asthma. of these, about 70 % have an allergy to something. many of these people find their asthma symptoms get worse when they ' re exposed to certain allergens ( things that can cause allergic reactions ). common allergens include dust mites, mold, pollen, and animal dander. parents who have allergies or asthma often pass along the tendency to have these conditions to their kids. if you have allergies, your immune system reacts to these allergens as if the allergens were invading the body. to fight the allergen, your immune system produces an antibody called immunoglobulin e ( ige ). when the ige combines with the allergen, a process is set in motion that results in the release of certain substances in the body. one of the substances released is histamine, which causes allergic symptoms that can affect the eyes, nose, throat, skin, gastrointestinal tract, or lungs. when the airways in the lungs are affected, symptoms of asthma ( such as coughing, wheezing, or difficulty breathing ) can occur. the body remembers this reaction, so each time the allergen comes into contact with the body, the same thing can happen. because of that, allergies can make it difficult for some people to keep their asthma under control. if you have asthma, it ' s a good idea to look at whether allergies may be triggering your symptoms. talk with your doctor about how to identify possible triggers. your doctor might also recommend a visit to an allergist to help you find out if you ' re allergic to anything. but even if you are allergic to something — or a whole list of things — it doesn ' t mean that those allergies are causing your asthma symptoms. it does allow you and your doctor to start investigating the connection, though.


new research reveals that obesity can actually drive you crazy most of us are fully aware that obesity causes all sorts of health problems including diabetes and high blood pressure, but now shocking new research shows that being overweight can actually lead to insanity. a research team consisting of staff from inserm, the french research institute in paris and university college london in england, discovered that people suffering from metabolically abnormal obesity were more at risk for experiencing a rapid decline in mental function than those individuals with a healthy weight. researchers say that the term “ metabolically abnormal ” is one they use to classify individuals who are taking medication for diseases like diabetes, high blood pressure and lower good cholesterol levels. the study consisted of more than 6, 000 people of all shapes and sizes well into their 50 ’ s at the time the study began. their initial bmi and risk factors for disease were then documented prior to undergoing cognitive tests three times a week over the course of the next decade. what researchers found was that out of the 582 obese participants, 350, or roughly 60 percent, could be classified as metabolically abnormal, and those individuals experienced a decline in mental ability that was nearly 23 percent faster than participants with a normal weight. while study experts say more research is needed to look closely at the effects of genetic factors and the duration of a person ’ s obesity and metabolic risk factors, they hope that this study will assist in better understanding the link between obesity and cognitive function, such as thinking, reasoning and memory.


japanese - style rooms are covered with tatami mats. tatami is made of straw and rush. the filling is made of hard - packed straw, and the smooth facing is made of woven rushes. the long sides of tatami have a cloth edging. tatami is a very good material for floors because it ' s so humid in japan. tatami is derived from a verb tatamu which means to fold or to pile. it shows us that the original tatami was used in different way. the oldest description is seen in kojiki, the oldest history book in japan written in 712. in the heian period ( 794 - 1191 ) it has been used only by high status people. when you see the pictures of " hyakunin isshu " ( japanese traditional cards ), you will find emperors or nobles sitting on tatami which was placed on the wooden floor as isolated pieces. in the muromachi period they began to cover the whole floor with tatami. tatami are arranged by the following rules : 1 : the corners of four tatami mats should not meet at one point 2 : there should not be a line that bisects the tatami layout either vertically or horizontally ( a line like this resembles an image of harakiri ) 3 : only one half size tatami should be used per room.


superstorm sandy : before, during and beyond tue november 20, 2012 thousands of trees gone, ripped out by sandy originally published on tue november 20, 2012 5 : 14 pm new york city lost almost 10, 000 trees from the winds of superstorm sandy and the nor ' easter that followed. that ' s far more trees lost in the city than in any other storm for which tree damage was recorded. walking through central park, ken chaya peers past a stone arch, observing the damage and uprooting of about 800 trees. he knows more about the park ' s trees than just about anybody else ; he created a map that charts every single one of the roughly 20, 000 trees. " looking over glen span, i can count 1 - 2 - 3 - 4 - 5 — at least five — fresh cuts of mature trees, " he says, also noting the number of tree crews. the city ' s parks and recreation department, which looks out for street trees as well as those in parks, went on alert way before sandy arrived. five days before the storm, the department was already making arrangements with tree crews from around the country. for several years, the department has noticed dramatic changes in weather. bram gunther, chief of forestry, horticulture and natural resources for the department, notes the unprecedented string of natural disasters in the last two years : two tornadoes, a freak storm that took down 500 central park trees, an unusual early winter storm and tropical storm irene. " when that happened, that really opened our eyes, and it opened our eyes to the power of these storms which we had not experienced directly in new york city, at least since i was a child, " gunther says. irene took down about 3, 400 trees throughout the city, while sandy claimed three times that amount. many of those trees were old, beloved and as large as 6 feet in diameter. " the bigger the tree, the more carbon it captures, the more particulate matter it filters, the more storm water it captures, " gunther says, " so it ' s a huge number in terms of environmental benefits and what it does for a community. " a study from the u. s. department of agriculture shows that the city ' s more than 5 million trees remove 42, 000 tons of carbon and about 2, 000 tons of air pollution per year. they also have a whopping monetary value of $ 5. 2 billion. twenty - four hours after the storm, the department sent people walking, riding and bicycling all 33


carbon and about 2, 000 tons of air pollution per year. they also have a whopping monetary value of $ 5. 2 billion. twenty - four hours after the storm, the department sent people walking, riding and bicycling all 33, 000 blocks of new york city with handheld computers, reviewing damage and putting in work orders. " we do every single one to assess and evaluate the damage of the trees and the safety of that particular block, " explains gunther, who monitored all the computers from his mobile command center. in central park, chaya points to a 75 - year - old black locust. " its trunk was just yanked out of the ground by the wind, " he says. nearby, a downed tree has pulled up a huge rock — a piece of manhattan schist, the 450 - million - year - old bedrock that lies beneath manhattan. chaya says there is only a little layer of soil over the bedrock and trees can ' t sink a deep tap root, so they branch out horizontally. in a storm, many of the trees just topple over. the city is already ahead of schedule in its commitment to plant 1 million trees by 2017. because newly planted trees are small, chaya says, it ' ll be years before the city can truly be what he calls an urban forest. " our urban forest, it ' s fading, we ' re losing it, " he says.


midwest energy news : “ can airports be green? with solar farm, chicago argues they can. ” aviation is a carbon intensive industry, with air travel and transport contributing two percent of global greenhouse gas emissions, according to the intergovernmental panel on climate change. but airports around the world are making significant efforts to reduce their carbon footprints, and chicago o ’ hare international airport is among the leaders. in addition to other environmental measures, o ’ hare is planning a new solar farm, slated for completion in 2016, that could provide five to 10 percent of the airport ’ s electricity needs, according to chicago department of aviation spokesperson karen e. pride. since 2007 chicago has hosted an annual international “ airports going green ” conference which began as a one - day seminar and “ has become more than just a conference – it ’ s a movement, ” in pride ’ s words. seriously? a solar power project supplying maybe 5 to 10 percent of the airport ’ s electricity constitutes going green? how much in carbon emissions are avoided by a solar power project, and at what cost, and how much would be avoided by, for example, some ground control improvements that shaved 1 minute off the time each plane idles before taking off. the article does observe that airports are the source of about 5 percent of the industry ’ s carbon emission, so 5 to 10 percent of that amounts to a 0. 25 to 0. 5 percent shift if every airport made a similar investment. and, again, at what cost this small step? the article does also point out that larger potential environmental effects can come from air traffic systems changes, but notes those actions are more the responsibility of the federal government and airlines. but on - the - ground organization, airfield layout, and at least some takeoff and landing matters are dictated by airport management, and making improvements in these areas could reduce airplane emissions on the ground. the article highlights the easy - to - promote idea of solar pv over what are likely to be more effective actions elsewhere. one “ feels good ” and the other would make people better off. guess one gets the press?


shots - health news blog fda approves first drug to prevent preterm births the biggest reason why the united states has higher infant mortality than other developed countries is that american women are more likely to deliver prematurely – before 37 weeks. and, for unknown reasons, the us rate of preterm delivery has been going up in recent years. that ' s why it ' s a pretty big deal that the food and drug administration has okayed a drug, called 17 - hp, that experts say could make a dent in the preemie problem. not a huge dent, but a significant one. the march of dimes calculates that if all the women eligible to get the newly approved drug actually did, there would be 10, 000 fewer preemies a year – out of more than half - a - million born that way. " although that may seem like a small percent, it ' s really a very extraordinary ability to impact on what is really a major public health problem, " dr. alan fleischman, the march of dimes medical director, told shots. according to the best research, the drug reduces the risk of premature birth by one - third among women who are at high risk because they had a previous preterm birth. the drug is not for women whose prior premature births were of twins or other multiple births, or who are carrying more than one fetus in their current pregnancy. nor is it for women who have other conditions that raise their risk of preterm birth, such as high blood pressure or infection. and even for the 30, 000 or so women who are eligible, 17 - hp, which will be marketed as makena, isn ' t a magic bullet. the study showed that 37 percent of women who got weekly injections of it delivered prematurely, compared to 55 percent of women who got injections of a placebo. interestingly, the drug is not new — it ' s just taken a long and circuitous route to approval. in 1956, the fda approved 17 - hp for the treatment of certain cancers and other hormonal disorders, under the brand name delalutin. but its manufacturer withdrew it from the market in 2000 " for reasons unrelated to safety, " as the fda puts it. in fact, as a federal register posting last year chronicled, there have been questions raised about whether 17 - hp caused birth defects of various kinds. in the 1970s, the fda required warnings on drugs containing progesterone, as 17 - hp does, because of an increased risk


posting last year chronicled, there have been questions raised about whether 17 - hp caused birth defects of various kinds. in the 1970s, the fda required warnings on drugs containing progesterone, as 17 - hp does, because of an increased risk of birth defects. they later revoked them. the fda is apparently satisfied that 17 - hp is safe, but it ' s requiring its sponsors kv pharmaceuticals and therrx to conduct further studies of women who have taken it and children exposed during pregnancy. everyone in this field is mindful of the long - running tragedy of vaginal and other cancers and male urinary disorders that resulted from the last drug thought to prevent premature birth – a synthetic estrogen called diethylstilbesterol, or des. in 1971 researchers realized children exposed to des in utero had a higher incidence of vaginal and breast cancers, and males were subsequently found to have urinary - tract problems. fleischman, the march of dimes official, says there ' s no such risk from 17 - hp, partly because it ' s not used before the 16th week of pregnancy, when fetal organs have already formed. " we have been very aggressively tracking all the data, " fleischman says, " and we have no reason to believe that this drug will increase birth defects. " copyright 2011 national public radio. to see more, visit http : / / www. npr. org /.


tue march 5, 2013 study finds climate change to open arctic sea routes by 2050 originally published on tue march 5, 2013 11 : 22 am climate change will make commercial shipping possible from north america to russia or asia over the north pole by the middle of the century, a new study says. two researchers at the university of california ran seven different climate models simulating two classes of vessels to see if they could make a relatively ice - free passage through the arctic ocean. in each case, the sea routes are sufficiently clear after 2049, they say. the study, published monday in the journal pnas by laurence c. smith and scott r. stephenson, found that the sea ice will become thin enough that a " corridor directly over the north pole " will open up. " the shortest great circle route thus becomes feasible, for ships with moderate ice - breaking capability. " ( a great circle route is the shortest distance between two points on the surface of a sphere, such as the earth. ) smith and stephenson conclude that the opening of the new routes " heightens the urgency for a mandatory international maritime organization regulatory framework to ensure adequate environmental protections, vessel safety standards, and search - and - rescue capability. " according to the guardian : " the northern sea route has been shown to save a medium - sized bulk carrier 18 days and 580 tons of bunker fuel on a journey between northern norway and china. shipowners have said it can save them €180, 000 - €300, 000 ( $ 235, 000 - $ 390, 000 ) on each voyage. a direct route over the pole could save up to 40 percent more fuel and time. " arctic sea ice has shrunk to its smallest extent on record in recent years, which has already opened up a seasonal northern route over canada. last year, a solo sailor in a 27 - foot fiberglass sailboat was one of 18 private yachts to make the voyage.


at a glance why get tested? to determine lithium levels in the blood in order to maintain a therapeutic level or to detect lithium toxicity when to get tested? when beginning treatment with lithium as the dose is adjusted to achieve therapeutic blood levels ; at regular intervals to monitor lithium levels ; as needed to detect low or toxic concentrations a blood sample drawn from a vein in your arm test preparation needed? the test sample what is being tested? this test measures the amount of lithium in the blood. lithium is one of the most well - established and widely - used drugs prescribed in the treatment of bipolar disorder. bipolar disorder is a mental condition that is characterized by alternating periods of depression and mania. these periods may be as short as a few days or weeks or may be months or years long. during a depressive episode, those affected may feel sad, hopeless, worthless, and lose interest in daily activities. they may be fatigued but have trouble sleeping, experience weight loss or gain, have difficulty concentrating, and have thoughts of suicide. during a manic episode, those affected may be euphoric, irritable, have high energy and grandiose ideas, use poor judgment, and participate in risky behaviors. sometimes affected people will have mixed episodes with aspects of both mania and depression. bipolar disorder can affect both adults and children. lithium is prescribed to even out the moods of a person with bipolar disorder ; it is often called a " mood stabilizer " and is sometimes prescribed for people with depression who are not responding well to other medications. it is a relatively slow - acting drug and it may take several weeks to months for lithium to affect a person ' s mood. dosages of the drug are adjusted until a steady concentration in the blood that is within therapeutic range is reached. the actual amount of drug that it will take to reach this steady state will vary from person to person and may be affected by a person ' s age, general state of health, and other medications that they are taking. lithium levels are monitored on a regular basis because blood levels must be maintained within a narrow therapeutic range. too little and the medication will not be effective ; too much and symptoms associated with lithium toxicity may develop, such as nausea, vomiting, diarrhea, confusion, and tremors. extremely high levels can lead to stupor, seizures, and can be fatal. how is the sample collected for testing? a blood sample is obtained by inserting a needle into a vein in the arm. note : if undergoing medical tests makes you or someone you care for anxious,


stupor, seizures, and can be fatal. how is the sample collected for testing? a blood sample is obtained by inserting a needle into a vein in the arm. note : if undergoing medical tests makes you or someone you care for anxious, embarrassed, or even difficult to manage, you might consider reading one or more of the following articles : coping with test pain, discomfort, and anxiety, tips on blood testing, tips to help children through their medical tests, and tips to help the elderly through their medical tests. another article, follow that sample, provides a glimpse at the collection and processing of a blood sample and throat culture. is any test preparation needed to ensure the quality of the sample? no test preparation is needed. however, timing of the sample collection may affect results. generally, lithium blood levels are performed 12 - 18 hours after the last dose ( also known as a " trough " level ). tell the laboratorian who is drawing your blood when you took your last dose so that the results can be interpreted correctly. ask a laboratory scientist this form enables you to ask specific questions about your tests. your questions will be answered by a laboratory scientist as part of a voluntary service provided by one of our partners, american society for clinical laboratory science. if your questions are not related to your lab tests, please submit them via our contact us form. thank you. * indicates a required field note : this article is based on research that utilizes the sources cited here as well as the collective experience of the lab tests online editorial review board. this article is periodically reviewed by the editorial board and may be updated as a result of the review. any new sources cited will be added to the list and distinguished from the original sources used. sources used in current review tietz textbook of clinical chemistry and molecular diagnostics. burtis ca, ashwood er and bruns de, eds. 4th ed. st. louis, missouri : elsevier saunders ; 2006, pp 1271 - 1272. harrison ' s principles of internal medicine. 16th ed. kasper d, braunwald e, fauci a, hauser s, longo d, jameson jl, eds. mcgraw - hill, 2005 pg 2557. ( updated march 24, 2009 ) lee d, gupta m. toxicity, lithium from medscape. available online at http : / / emedicine. medscape. com / article / 815523 - overview through http : / / emedicine. medscape. com. accessed


toxicity, lithium from medscape. available online at http : / / emedicine. medscape. com / article / 815523 - overview through http : / / emedicine. medscape. com. accessed september 2009. ( january 15, 2009 ) medlineplus medical encyclopedia. bipolar disorder. available online at http : / / www. nlm. nih. gov / medlineplus / ency / article / 000926. htm. accessed september 2009. ( january 4, 2009 ) mayo clinic. bipolar disorder. available online at http : / / www. mayoclinic. com / health / bipolar - disorder / ds00356 through http : / / www. mayoclinic. com. accessed september 2009. national alliance on mental illness. medications, lithium. available online through http : / / www. nami. org. accessed september 2009. ( jan 14, 2009 ) lloyd a. netdoctor : lithium. available online at http : / / www. netdoctor. co. uk / diseases / depression / lithium _ 000290. htm through http : / / www. netdoctor. co. uk. accessed september 2009. sources used in previous reviews thomas, clayton l., editor ( 1997 ). taber ' s cyclopedic medical dictionary. f. a. davis company, philadelphia, pa [ 18th edition ]. pp 1121. spearing, m. updated ( 2006 february 17, updated ). bipolar disorder. nimh [ on - line information ]. available online at http : / / www. nimh. nih. gov / publicat / bipolar. cfm # bp6 through http : / / www. nimh. nih. gov. goldberg, j. and citrome, l. ( 2005 february ). latest therapies for bipolar disorder, looking beyond lithium. postgraduate medicine online v 117 ( 2 ) [ on - line journal ]. available online at http : / / www. postgradmed. com / issues / 2005 / 02 _ 05 / goldberg. htm through http : / / www. postgradmed. com. geddes, j. et. al. ( 2004 february ). long - term lithium therapy for bipolar disorder : systematic review and meta - analysis of randomized controlled trials. am j psychiatry 161 : 217 - 222 [ on - line journal ]. available online at http : / /


al. ( 2004 february ). long - term lithium therapy for bipolar disorder : systematic review and meta - analysis of randomized controlled trials. am j psychiatry 161 : 217 - 222 [ on - line journal ]. available online at http : / / ajp. psychiatryonline. org / cgi / content / full / 161 / 2 / 217 through http : / / ajp. psychiatryonline. org. newport, d. j. et. al. ( 2005 november ). lithium placental passage and obstetrical outcome : implications for clinical management during late pregnancy. american journal of psychiatry 162 : 2162 - 2170 [ on - line abstract ]. available online at http : / / ajp. psychiatryonline. org / cgi / content / abstract / 162 / 11 / 2162 through http : / / ajp. psychiatryonline. org. schapiro, n. ( 2005 ). bipolar disorders in children and adolescents. medscape from j pediatr health care. 2005 ; 19 ( 3 ) : 131 - 141 [ on - line information ]. available online at http : / / www. medscape. com / viewarticle / 504584 _ 1 through http : / / www. medscape. com. menon, l. ( 2005 august, updated ). lithium. national alliance for the mentally ill [ on - line information ]. available online through http : / / www. nami. org. walling, a. ( 2005 january 1 ). evidence - based guidelines for bipolar disorder therapy. american family physician [ on - line journal ]. available online at http : / / www. aafp. org / afp / 20050101 / tips / 19. html through http : / / www. aafp. org.


today is the 145th anniversary of the ending of the american civil war. here ’ s the description from answers. com : apr 9, 1865. at 1 : 30 pm general robert e. lee, commander of the army of northern virginia, surrendered to general ulysses s. grant, commander in chief of the union army, ending four years of civil war. the meeting took place in the house of wilmer mclean at the village of appomattox court house, va. confederate soldiers were permitted to keep their horses and go free to their homes, while confederate officers were allowed to retain their swords and sidearms as well. grant wrote the terms of surrender. i thought this might be a good opportunity for another “ the best … ” list. you might also be interested in : the best resources about president ’ s day ( to explore the resources on abraham lincoln ) here are my choices for the best sites for learning about the american civil war ( and are accessible to english language learners ) : to start - off with, i ’ m going to direct you to my united states history classes blog. you can find my entire year ’ s curriculum there, though here are links to the lessons specifically about the civil war : in addition to the multiple activities and links in those posts, here are a few more resources : the best civil war photos from life. how stuff works has countless short online videos about the civil war. the history channel has a similar video collection. here are a number of online activities for english language learners that are related to the war. the story of the monitor is an interactive exhibition on the ironclad that fought for the union during the civil war. key parts, but not all, of the interactive provides audio support for the text. there are also excellent images. these are two school - oriented websites with a variety of accessible info on the civil war : slave narratives from the museum of the african diaspora. el civics on the civil war. “ the price of freedom : americans at war ” is a smithsonian multimedia interactive on each war in united states ’ history. videos ( with transcript ), images and text are included. in pictures : faces of us civil war is a slideshow from the bbc. the bbc says : virginia collector tom liljenquist has donated nearly 700 photographs from the us civil war to the library of congress. library curators say the photos are an invaluable depiction of the ordinary men who fought the war. thinkfinity has a number of useful lessons on the civil war. a civil


photographs from the us civil war to the library of congress. library curators say the photos are an invaluable depiction of the ordinary men who fought the war. thinkfinity has a number of useful lessons on the civil war. a civil war interactive timeline from the new york times 150 years later : civil war anniversary stirs controversy is an interactive from the associated press the civil war is from mr. nussbaum civil war : 150th anniversary is from the history channel faces of the civil war is a washington post slideshow decisive battles of the civil war is a u. s. news interactive how stuff works has many civil war related videos african - americans and the civil war is a slideshow from npr. faces from the civil war is a slideshow from time magazine. civil war 150 is from the history channel. who am i? is an interactive from the smithsonian. the civil war is from shmoop. the top 10 civil war innovations is a slideshow from discovery. the kids guide to the civil war is a student - created site. the civil war comes from parade magazine. on war : the 150th anniversary of the civil war are photographs from the denver post. here ’ s a video from msnbc showing newly discovered photos from the civil war : hundreds of civil war photos unearthed comes from msnbc. 150 years on, 3 - d civil war photos unveiled also comes from msnbc. civil war photography is a slideshow from discovery. of course the civil war was about slavery is from miller - mccune. photo essay : the civil war : between the battles is from the pbs news hour. here are several civil war - related slideshows from life. resources | abraham lincoln and the civil war comes from the new york times learning network. then and now : civil war battlefields is from cnn. blogging history : interpreting civil war - era primary sources is from the new york times learning network. battles and casualties of the civil war is an interactive from the washington post. civil war timeline : fury unleashed is another interactive from the post. five myths about why the south seceded is from the washington post. 3 - d ‘ motion pictures ’ from the civil war is a series of really cool “ animated ” photos from the civil war. you really should check them out. russel tarr, who has created a ton of great online learning activities, has just unveiled another one — an interactive simulation of the american civil war. it seems quite engaging, and i ’ ll try using it in my u. s.


rare clouded leopard cubs born at nashville zoo back in march, the national zoo ' s conservation and research center announced the birth of two clouded leopard cubs. the cubs ' birth was big news, in part because clouded leopards are severely endangered and in part because the species presents unique problems to those attempting to breed it in captivity. ( male clouded leopards are prone to behavior so aggressive that they often wind up killing their potential mates. females are known for, whether intentionally or accidentally, killing their cubs shortly after they ' re born. ) the national zoo ' s cubs represented the first successful breeding of clouded leopards in any north american zoo in six years. their parents, hannibal and jao chu, were one of two breeding pairs imported from thailand last year. the other breeding pair went to the nashville zoo, where three cubs were born may 30! the cubs - - two males and one female - - are in good health, as are their parents, jing jai and arun. like the national zoo ' s clouded leopard cubs, they are being hand - raised by keepers rather than by their parents. hand - raising the cubs is, in part, for their own protection. it ' s also expected to make things simpler down the line, when the cubs reach maturity and become part of the breeding program designed to save their species from extinction. " we ' ve learned how to reduce fatal attacks by hand - raising cubs and introducing males to mates at a young age, " nashville zoo president rick schwartz explained. plans are already underway to introduce the nashville zoo ' s female cub to one of those born at the national zoo ( both of those are males ) when she ' s about 6 months old. - - lindsay barnett photo credit : jim bartoo / associated press


by hilarie meyers, development and communications intern over the past year, numerous positive advancements have been made in the realm of hiv / aids prevention and treatment, such as the development of various microbicides, the empirical success of pre - exposure prophylaxis ( prep ) pills, and even the pope ’ s recent statements regarding the role of condoms in hiv prevention efforts. yet, there is still work to be done. in honor of world aids day, which is held annually on december 1st, consider diving into the world of aids activism, if you haven ’ t already. click here for a list of ways to contribute to the fight against aids. while an annual day of activism is a great way to get people involved, it ’ s even better if people begin to incorporate such activism into their daily lives. my recommendation on where to get started : get tested! the 2010 edition of the unaids report on the global aids epidemic estimates that there are 1. 2 million americans living with hiv / aids, with an estimated 54, 000 new infections in the us alone during the year 2009. women account for one - half of all people living with hiv / aids worldwide and more than a quarter of those in the us. latinas and african american women are particularly affected by hiv / aids. although latinas and african americans make up only 25 % of the us ’ s female population, they make up over 80 % of ( or 4 out of 5 ) females living with hiv / aids in the us. according to the henry j. kaiser family foundation, latinas account for 16 % of new hiv infections among women in the us. furthermore, the rate of new hiv infections for latinas is nearly 4 times that of white women. aids is also the fourth - leading cause of death for latinas between the ages of 35 and 44. an individual ’ s personal reasons for getting tested may have little to do with whether or not the medical community considers him or her to be “ at risk ” for hiv infection. while undoubtedly such categories can be useful when designing campaigns or allocating resources, they also can be misleading and stigmatizing. in fact, labeling certain people and behaviors according to their level of “ risk ” can actually inhibit treatment and prevention efforts, particularly when it comes to testing. in “ women and hiv / aids : an overview, ” elinor nauen and bonnie goldman explain : women alive [ a los angeles - based nonprofit organization created by, and for, women living with hiv / aids ] found that the concept of


. in “ women and hiv / aids : an overview, ” elinor nauen and bonnie goldman explain : women alive [ a los angeles - based nonprofit organization created by, and for, women living with hiv / aids ] found that the concept of “ sexual risk ” tripped up the very people who were supposed to improve women ’ s access to hiv testing. the testers refused services to many women because they didn ’ t fit into traditional high - risk groups … when los angeles county looked at the data relating to women, ‘ they discovered that 40 % to 60 % of african - american women and latinas testing positive did not fit in those risk groups. ’ the center for disease control recommends that all adults between the ages of 13 and 64 be tested for hiv “ as a routine part of their medical care. ” because early diagnosis is a crucial component in both prevention and treatment efforts, testing for hiv needs to be emphasized as a priority for everyone. the well project explains : if you test positive, you can take [ steps ] to prevent passing the virus on to others, including during pregnancy. and while there is no cure yet, many hiv + women are living longer and stronger lives thanks to effective care and treatment. once diagnosed, individuals can take the actions necessary to preserve their own health and well - being, as well as the health and well - being of the people around them. research shows that people who are diagnosed with hiv sooner rather than later have a lower risk of developing aids and thus typically have better health outcomes. however, approximately 27 % of the 1. 2 million americans living with hiv / aids are unaware of their status. women in particular tend to be “ late - testers ”, and are often only diagnosed after developing symptoms or during pregnancy. despite the overwhelming benefits of hiv testing and early diagnosis, data from the cdc shows that only about 45 % of us adults reported ever being tested for hiv. a number of complex factors influence a person ’ s decision to get tested. however, both stigma and fear play a large role in deterring people from hiv testing. as a fact sheet from the latino commission on aids explains, “ the stigma that is attached to female sexuality often prevents … women from accessing reproductive and sexual health services, screening, and information. ” as long as hiv is associated with “ deviant ” and “ risky ” behaviors, these stigmas will prevent people from getting tested, thereby limiting the effectiveness of treatment and prevention efforts. while individuals may do their part by getting tested, institutions, such as health clinics


this work presents a myth - busting account of how class conflict and economic development, and not only interstate rivalry, led to the emergence of the modern state system. inspired by the groundbreaking historical work of robert brenner, teschke argues that property relations provide the key to unlocking the changing meaning of ' international ' across the medieval, early modern and modern periods. challenging the reification of the treaty of westphalia, teschke shows that international politics remained under the control of dynastic and absolutist political elites that were rooted in feudal property regimes. the book rejects a commonplace of european history : that the treaties of westphalia not only closed the thirty years ’ war but also inaugurated a new international order driven by the interaction of territorial sovereign states. benno teschke, through this thorough and incisive critique, argues that this is not the case. domestic ‘ social property relations ’ shaped international relations in continental europe down to 1789 and even beyond. the dynastic monarchies that ruled during this time differed from their medieval predecessors in degree and form of personalization, but not in underlying dynamic. 1648, therefore, is a false caesura in the history of international relations. for real change we must wait until relatively recent times and the development of modern states and true capitalism. in effect, it ’ s not until governments are run impersonally, with no function other than the exercise of its monopoly on violence, that modern international relations are born. | the myth of 1648 - benno teschke | | 14. 84 mb |


probable repeal of eighteenth amendment on december 5 repeal of the eighteenth amendment will take place, it may now be predicted with virtual certainty, on december 5, nine months and one - half following submission to the states of the twenty - first, or repeal, amendment on february 20, 1933. virginia became on october 3 the 32nd state to vote in unbroken succession for repeal of federal prohibition. florida is expected to take similar action on october 10. on november 7 the voters of six more states — kentucky, north carolina, ohio, pennsylvania, south carolina, and utah — will go to the polls to record their verdict on the question, making 39 states in all that will have acted by that date. ratification conventions will be held in four states — - ohio, pennsylvania, south carolina, and utah — on december 5. since this formal action will have been taken before that date in all but three of the necessary number of states, one of these four will in all probability be the 36th state to ratify, thus completing the process of taking prohibition out of the constitution. the repeal amendment becomes effective immediately upon ratification. since the authority under which congress legislated against the manufacture, transportation, and sale of liquor in the states will thereby be withdrawn, the regulatory sections of the volstead act will automatically expire so far as they apply in the states, though they may remain in force, pending further congressional action, in the district of columbia, the panama canal zone, and the virgin islands. in alaska and hawaii local prohibition acts will probably still be effective, while prohibition may be, continued by the naval authorities in guam and samoa. puerto rico ' s prohibition law has been repealed, and that territory will be wet. the philippine islands have never been subject to american prohibition laws. while there is a possibility that congress will be summoned to washington in advance of the regular january session, in order to revise taxes and tariffs on wines and liquors, the president has not yet indicated any intention of calling a special session. certain emergency taxes imposed by the national recovery act will, under the terms of that law, be removed on january 1 by reason of previous repeal of the eighteenth amendment, liquor taxes being counted upon to yield an equivalent or greater revenue. since the revised imposts on liquor sales and imports will presumably be higher than those fixed by existing laws, the federal government will lose potential revenue until congress has an opportunity to act upon new rates. the interim period between the prospective date of repeal and the time when a new law can be enacted in the normal course of