in light of recent studies that suggest the use of stored blood during transfusions may cause adverse effects in patients, the national heart, lung, and blood institute ( nhlbi ) funded a number of research projects to examine the safety of transfusing older red cells and the impact of stored blood on respiratory gases. these papers discussing potential adverse effects of stored blood and related concerns for oxygen delivery by transfusion are now available online in transfusion, a journal published by wiley - blackwell on behalf of aabb. blood banks are responsible for the collection, testing, and storage of blood to be used by the nearly 5 million americans who receive blood transfusions annually. when patients experience a loss of blood due to illness or trauma, transfusions of whole blood or individual components ( red cells, white cells, platelets, and plasma ) are administered to restore blood volume to adequate levels. according to the 2007 national blood collection and utilization survey ( nbcus ) report, 14. 7 million units of blood were administered in the u. s., with a total of 72, 000 transfusion - related adverse reactions in the prior year. " the most critical issue facing transfusion medicine is whether or not stored ( older ) blood is less safe than fresher blood, " explains paul m. ness, m. d., director of transfusion medicine at johns hopkins medical institute in baltimore, md, and editor - in - chief of transfusion. " although emerging infectious disease risks and transfusion reactions are important concerns, there is nothing more imperative to our patients than making sure the methods we use to collect and store red cells do not impair their transport of vital respiratory gases. " current food and drug administration ( fda ) standards state that red cells may be stored under refrigeration for a maximum of 42 days, or frozen for up to ten years. nbcus 2007 data reported the mean age of stored red cells at the time of transfusion was 16 days. medical evidence, however, has not been able to conclusively determine if stored blood adversely affects patients ' health. in one prior study, trauma patients who received red cells stored beyond two weeks had a significantly increased risk of mortality compared to those transfused with fresher blood ( weinberg et al., 2010 ). conversely, a study by edgren et al., analyzed close to 405, 000 transfusions between 1995 and 2002 and found no significant association between age of blood and seven - day mortality. controlled clinical trials in cardiac surgery and intensive care units are


conversely, a study by edgren et al., analyzed close to 405, 000 transfusions between 1995 and 2002 and found no significant association between age of blood and seven - day mortality. controlled clinical trials in cardiac surgery and intensive care units are under way, and are expected to provide the transfusion community with critical data regarding the adverse effects of stored blood use. " findings from these trials will not be reported for several years, " said dr. ness. " our early publication of the nhlbi grant program studies provides the transfusion community with a head start in learning more about what makes stored blood old, and provides advance opportunity for commercial industry to develop improved methods of blood storage that will mitigate adverse effects in patients. " these studies are published in transfusion. media wishing to receive a pdf of the articles may contact email @ example. com. editorial : " does transfusion of stored red cells cause clinically important adverse effects? a critical question in search of an answer and a plan. " paul ness. transfusion ; published online : april 15, 2011 ( doi : 10. 1111 / j. 1537 - 2995. 2011. 03121. x ) ; print issue date : april 2011. http : / / doi. wiley. com / 10. 1111 / j. 1537 - 2995. 2011. 03121. x editorial : " the 2010 tibor greenwalt lecture the air we breathe - - three vital respiratory gases and the red cell : oxygen, nitric oxide, and carbon dioxide. " walter h. dzik. transfusion ; published online : april 15, 2011 ( doi : 10. 1111 / j. 1537 - 2995. 2011. 03114. x ) ; print issue date : april 2011. http : / / doi. wiley. com / 10. 1111 / j. 1537 - 2995. 2011. 03114. x article : " red blood cell age and potentiation of transfusion - related pathology in trauma patients. " jordan a. weinberg, scott r. barnum, and rakesh p. patel. transfusion ; published online : april 15, 2011 ( doi : 10. 1111 / j. 1537 - 2995. 2011. 03098. x ) ; print issue date : april 2011. http : / / doi. wiley. com / 10. 1111 / j. 1537 - 2995. 2011. 03098. x article : " new frontiers


- 2995. 2011. 03103. x ) ; print issue date : april 2011. http : / / doi. wiley. com / 10. 1111 / j. 1537 - 2995. 2011. 03103. x article : " insufficient nitric oxide bioavailability : a hypothesis to explain adverse effects of red blood cell transfusion. " john d. roback, robert neuman, arshed quyyumi, and roy sutliff. transfusion ; published online : april 15, 2011 ( doi : 10. 1111 / j. 1537 - 2995. 2011. 03094. x ) ; print issue date : april 2011. http : / / doi. wiley. com / 10. 1111 / j. 1537 - 2995. 2011. 03094. x article : " harmful effects of transfusion of older stored red blood cells : iron and inflammation. " eldad a. hod and steven l. spitalnik. transfusion ; published online : april 15, 2011 ( doi : 10. 1111 / j. 1537 - 2995. 2011. 03096. x ) ; print issue date : april 2011. http : / / doi. wiley. com / 10. 1111 / j. 1537 - 2995. 2011. 03096. x article : " the transfusion problem : role of aberrant s - nitrosylation. " james d. reynolds, douglas t. hess, and jonathan s. stamler. transfusion ; published online : april 15, 2011 ( doi : 10. 1111 / j. 1537 - 2995. 2011. 03097. x ) ; print issue date : april 2011. http : / / doi. wiley. com / 10. 1111 / j. 1537 - 2995. 2011. 03097. x about the journal transfusion is the official journal of aabb and the foremost publication in the world for new information regarding transfusion medicine. written by and for members of aabb and other health - care workers, transfusion reports on the latest technical advances, discusses opposing viewpoints regarding controversial issues, and presents key conference proceedings. in addition to blood banking and transfusion medicine topics, transfusion presents submissions concerning tissue transplantation and hematopoietic, cellular, and gene therapies. for more information, please visit http : / / onlinelibrary. wiley. com /


blood banking and transfusion medicine topics, transfusion presents submissions concerning tissue transplantation and hematopoietic, cellular, and gene therapies. for more information, please visit http : / / onlinelibrary. wiley. com / journal / 10. 1111 / ( issn ) 1537 - 2995 / issues. aabb ( formerly the american association of blood banks ) is an international, not - for - profit association representing individuals and institutions involved in the field of transfusion medicine and cellular therapies. the association is committed to improving health by developing and delivering standards, accreditation and educational programs that focus on optimizing patient and donor care and safety. aabb membership consists of nearly 2, 000 institutions and 8, 000 individuals, including physicians, nurses, scientists, researchers, administrators, medical technologists and other health care providers. members are located in more than 80 countries. for more information, please visit www. aabb. org. wiley - blackwell is the international scientific, technical, medical, and scholarly publishing business of john wiley & sons, with strengths in every major academic and professional field and partnerships with many of the world ' s leading societies. wiley - blackwell publishes nearly 1, 500 peer - reviewed journals and 1, 500 + new books annually in print and online, as well as databases, major reference works and laboratory protocols. for more information, please visit www. wileyblackwell. com or our new online platform, wiley online library ( wileyonlinelibrary. com ), one of the world ' s most extensive multidisciplinary collections of online resources, covering life, health, social and physical sciences, and humanities. aaas and eurekalert! are not responsible for the accuracy of news releases posted to eurekalert! by contributing institutions or for the use of any information through the eurekalert! system.


- boka tid - barn & tonaringar - att sola - about us who has the highest risk of getting melanoma? the risk of developing melanoma is higher in somebody with fair skin that burns and freckles easily, and in those with numerous moles. a history of sunburn especially in childhood and adolescence, and a history of melanoma in another family member also contribute to a higher risk of melanoma. frequent exposure to the sun, especially for recreational purposes, also increases the danger of developing melanoma. on a universal level, melanoma is equally common in men and women. melanoma can occur at any age ; however it is extremely rare in childhood. what has caused the increasing incidence of melanoma? apart from the ozone layer depletion, people ’ s behaviour in the sun has been the main cause for the rise in skin cancer rates in recent decades. an increase in the popularity of outdoor activities and sunbathing has led to excessive uv exposure. many people consider a suntan a symbol of attractiveness and good health. however, a suntan is merely a sign of uv damage and represents the skin ’ s attempt to minimise further harm. how can the chances of surviving melanoma be improved? the key to a favourable outcome is early detection and timely surgical treatment. periodic self - examination of the skin in addition to seeking medical attention when in doubt should become standard practice if we expect to keep the mortality rate from melanoma at the lowest possible level. what are the other harmful effects of the sun on the skin? besides melanoma, the sun induces other forms of skin cancer, which though not usually fatal, often result in significant disfigurement. the sun ’ s ultraviolet rays also cause premature ageing of the skin in the form of wrinkles, blemishes, coarseness, broken veins, and scaly patches ( photodamage ). is it safe to stay in the sun for long periods as long as one is wearing sun - screen? a total sunblock in the real sense of the word does not yet exist. variable amounts of longer wavelength uv rays ( uva ) do not get filtered by currently available sunscreens in spite of the high factor formulations that exist. the cumulative effect of these unfiltered rays can still lead to skin cancer and premature ageing of the skin. one should not stay in the sun too long under the false impression that the sun ’ s rays are


factor formulations that exist. the cumulative effect of these unfiltered rays can still lead to skin cancer and premature ageing of the skin. one should not stay in the sun too long under the false impression that the sun ’ s rays are completely blocked by sunscreen. sun exposure should be avoided during between the hours of 11am to 3pm, when the sun ’ s rays are most extreme. is a fake tan safer than a suntan? a fake tan ( auto bronzing ) is by far safer than a suntan. a fake tan produces a natural looking tan through a chemical reaction in the skin. it therefore gives the desired cosmetic result in someone who is very keen to have a tan, without him or her having to sunbathe. application of fake tan needs to be carried out every 1 - 2 weeks in order to maintain the tan since the top layers of the skin are constantly being renewed. however, the actual tanning produces by ‘ fake tan ’ is not at all protective against uv - radiation and consumers should be aware of this important factor. is it ok to get an artificial tan from a tanning bed or booth? one word of warning about tanning beds and booths. these induce skin tanning by means of ultraviolet a radiation, which, though very efficient in tanning the skin without burning, still significantly increases the risk of skin cancer and is no doubt extremely efficient in causing premature skin ageing. something that perhaps most people may not be aware of is that a tan acquired from these tanning units does not protect their skin from sunburn when they go out in the sun ( since ultraviolet b rays are responsible for sunburn ).


the evolution deceit the ability to think is one of the greatest blessings granted to people because only by thinking can people be aware of allah ' s boundless power and the beauty of the universe he created. only a thinking person realizes that the world has been created by divine wisdom in every detail, that death is near, and that there are certain obligations that are required to be met in this life. we are told in a large number of qur ' anic verses that only thinking people can heed advice and that they alone are capable of seeing the proofs of allah ' s existence. indeed, the very purpose of the revelation of the qur ' an is for people to think carefully about its verses, as is stated here : " it is a book we have sent down to you, full of blessing, so let people of intelligence ponder its signs and take heed. " ( surah sad : 29 ) however, a large proportion of humanity regards thinking as a hardship. these people even believe that thinking is damaging to their lives and their set ways. according to this opinion, " the greatest damage " lies in reminding people of their responsibilities in this life and taking them out of the slumbering, empty minded state of heedlessness in which they find themselves. like a kind of magic spell, this sleep makes people forget why they exist, that there is a purpose in life, and that one day they will die. another form of this sleep is to be inundated by the daily routines. perhaps these people feel they spend a great deal of time thinking, making decisions and finding answers, but in fact what they think about does not go beyond the details of their day - to - day needs and impulses. their thoughts are not related to the purpose of human creation, how the world came into being or the fact that one day every living thing will be buried in the ground. actions, statements and behaviour learned by rote, taught, and become accustomed to, have such a hold on these people that they do not even feel a need to think about more fundamental realities. just as they evade thought, so too do these people escape hastily from warnings given by others ; they turn their faces from belief in allah, thinking about the verses of the qur ' an, and living by his guidance. but nothing and nobody has been put on the face of the earth for an empty purpose. allah created every detail in the universe for people to think about. in fact in the qur ' an, allah announces that he created " … death


his guidance. but nothing and nobody has been put on the face of the earth for an empty purpose. allah created every detail in the universe for people to think about. in fact in the qur ' an, allah announces that he created " … death and life to test which of you is best in action … " ( surat al - mulk : 2 ) in this fleeting life, one is put to the test by all his or her deeds. a person has a great responsibility towards allah who created him and will resurrect him after death and call for an accounting for his deeds. reading the qur ' an, taking heed of it, thinking about the verses and comprehending and applying them are amongst every person ' s principal responsibilities. allah draws attention to this truth with the verse which reads, " do they not ponder these words? has anything come to them that did not come to their ancestors the previous peoples? " ( surat al - mu ' minun : 68 ) thinking people will conclude that such fine detail in the universe and its examples of flawless design mean that it cannot have come into being by accident and that there exists a creator of all things. by thinking deeply about the miracles created around them and other proofs of allah ' s existence, and observing the divine wisdom in the details which he has created, they will give themselves over to him and live solely for the purpose of earning his approval. aware of this truth, satan wants them to live their lives in heedlessness, keep away from allah ' s verses and hence to refrain from thought. allah describes this purpose of satan ' s in a verse of the qur ' an : [ satan said ], " … i will lie in ambush for them on your straight path. then i will come at them, from in front of them and behind them, from their right and from their left... ( surat al - a ' raf : 16 - 17 ) in order to achieve this ultimate aim, satan prepares very special situations to sink people into a state of heedlessness. for this purpose, he makes plans using people ' s weaker aspects, and attempts to make evil deeds attractive to people ' s egos. unlike the faithful, people distanced from religious morality can end up in a state of spiritual heedlessness by forgetting allah and not thinking about their purpose in life. for example, satan can easily waylay people in places of entertainment, because such places are conducive to wasting time and not thinking about anything.


state of spiritual heedlessness by forgetting allah and not thinking about their purpose in life. for example, satan can easily waylay people in places of entertainment, because such places are conducive to wasting time and not thinking about anything. in these places what assumes the most importance are the clothes and accessories people wear, the money they spend, and the people around them. with the music so loud that people cannot hear one another, the air so full of smoke they cannot see one another, exploding flashbulbs, loud conversation and yelling, an environment is formed in which people who have no fear of allah certainly cannot concentrate their attention or think. of course it is a great blessing for people to enjoy themselves and come together with others they enjoy talking to. but these days places of entertainment are not those where the name of allah is mentioned and where people recall their purpose in life. the purpose of creation is entirely forgotten. people who feel no fear of allah in their hearts and spend their time in such places experience an atmosphere of heedlessness and are left in no condition to consider or understand warnings. in fact, one of the reasons why such people prefer these places is to forget everything and avoid thought, and they often say so. while a person who comes to such a place to, as he expresses it, escape from the troubles of the world, may have been behaving sensibly ten minutes earlier, now he starts to regard any excess as normal. in the name of enjoying themselves, these people see immorality of all kinds as reasonable and become insensitive to what is happening around them. in fact, in environments of this type, breaking plates, overturning tables, throwing napkins, attacks on others with obscene language, and fights reflect only a small part of the kind of heedlessness and immorality into which people can sink. concert arenas, football stadiums and other places where large crowds gather only magnify this effect of heedlessness. a large number of people go to such places not to enjoy themselves or to watch an entertaining game or to listen to a beautiful voice but to shout, to fight and to cause trouble, in short to display ugly behaviour of every kind. in such environments, it is utterly impossible for people with no fear of allah to extract from their minds a single useful thought. it only remains to be said that people in such an uncontrolled environment that encourages violence and immorality, are wide open to the whisperings of satan so


people with no fear of allah to extract from their minds a single useful thought. it only remains to be said that people in such an uncontrolled environment that encourages violence and immorality, are wide open to the whisperings of satan so that the obedience of people to satan ' s " don ' t think! " order is ensured. allah draws attention to this method of satan ' s with this verse : " stir up any of them you can with your voice and rally against them your cavalry and your infantry and share with them in their children and their wealth and make them promises!.. " ( surat al - ' isra : 64 ) people whose lives are filled with work and going out to such places of entertainment, where heedlessness reigns, forget that one day they will meet the angel of death. and when they do, it is too late, because this person has passed his worldly life in pursuit of empty practices and has fled from consideration of the verses of the qur ' an. for a person who thinks about death, the transitory nature of life and his responsibilities towards allah, it is impossible ever to accept such a heedless state. a person who knows that allah can take his life at any moment and that there will be a reckoning for his every word, thought and action never lets these realities slip his mind in any environment whatsoever and does not surrender to heedlessness. for a person to continue a life of heedlessness resembles his seeing a truck with brake failure hurtling towards him and failing to get out of the way - even though this is possible - while being fully aware that it is going to hit and crush him. during his life, a person can indulge in excess hundreds or thousands of times, can even spend his entire life in this way, but when death takes him, everything he has experienced is left behind. if a person has passed his time in heedlessness of the existence of allah, he will realize on the day of his death that this way of life, described in ignorant societies as " making the best of life, " has brought him nothing but loss. he will feel regret for all the excesses he indulged in because he forgot allah and the day of judgement. but heedless people ignore allah ' s warnings : mankind ' s reckoning has drawn very close to them, yet they heedlessly turn away. no fresh reminder comes to them from their lord without their listening to it as if it was a


storage area networks ( san ) the management of storage has become a key issue for it systems in the last few years. as the amount of storage increases and the demands for high availability of storage becomes more prevalent, having disparate pools of storage across many servers becomes ever more complex to manage. in the last few years, we have seen an increase in the availability of the storage area network ( san ). in simple terms, this takes all the local disk storage usually found in servers and consolidates it into a single, large pool. however, these devices are more than just a simple nas box. they concentrate on making that storage highly available as well as providing the tools to carve it up into appropriate capacities. one of the biggest management headaches with traditional server storage is we typically find large pools of unused storage, while pools on other servers are bursting to the seams. a lot of support time can be spent relocating data and then having to change application configurations ( which point to that storage ), user short - cuts, shares and drive mappings as well as backup configurations. the san allows these key servers to be provisioned with only a small amount of local storage to hold the operating system. using a high performance network data access protocol ( iscsi ), the required storage is then carved out on the san and accessed across the network by the server. the san devices can be made redundant and a well designed solution will be able to suffer the outage of a san server with no downtime or performance impact to the network. san is also a key component in designing a redundant vm network. the virtual machine hard drives are placed on the san storage. the virtual hosts then run the virtual machines from the san. systems like vmware vmotion then allow these virtual machines to be moved from one host to another in real - time while they are operating. after a significant amount of market research, exmos selected lefthand networks ( now part of hp ) as their partner for san. left hand networks were the first san oem to provide high performance iscsi on their devices ( having been built for iscsi from the ground up ). as well as providing traditional san server appliances, hp lefthand also makes their san solution available as a virtual machine ( vm ). while initially this may seem a somewhat strange idea, it is the ideal starter solution for building a fully redundant vm network running on as few as two traditional servers ( whereas with appliances it would require two san appliances and two servers ). this


why you should know what iso does iso is one of three factors which determine the exposure of a photo, along with aperture and shutter speed. to really get the most out of your photos you need to know what all 3 do and how you can use them. read this post to gain a more in depth knowledge of how to use your camera properly and start taking expert photos. section 1 – what exactly is iso? the iso ( international standards organization ) determines the sensitivity of the sensor in your camera, which in turn affects the exposure of your photos. the iso scale typically starts at 100, and continues to double from this point to the boundary of your camera ’ s capabilities : 100, 200, 400, 800, 1600 … the starting and ending points of this range and how well the camera handles the iso depends solely on the camera that you ’ re using. most modern cameras these days have many more points at which you can set the iso in between those that i ’ ve mentioned. the international standards organization are those responsible for setting this widely used standard and all you need to know is included in the information below. section 2 – how does iso affect exposure? iso is one of three factors which determine the exposure of a photo, along with aperture and shutter speed. these two affect the lens and exposure time respectively, with the iso affecting the sensor ( or film ). to be more specific, the iso determines how well exposed a photo will be by changing the sensitivity. the iso scale is similar to shutter speed in the sense that, when doubled, the exposure is also doubled ; they are proportional to one another e. g. a low iso number would give a low exposure and a high iso would give a high exposure ; much simpler then aperture. this is much easier to demonstrate using actual photos as you can see in the slideshow below. the photos are displayed in the following order : 100, 200, 400, 800, 1600, 3200. the aperture and shutter speed remains constant throughout these photos with only the iso changing so that you can clearly see its effect on a photo. the ideal exposure is shown in the fourth photo, which was taken at iso 800. as you may have noticed by now, nothing affects the exposure in one single way. there are consequences to using different iso ’ s. section 3 – how does iso affect the quality of photos? as a general rule, the lower the number, the better the quality of the photo. by doubling the iso, you ’ re effectively doubling the exposure taken by the camera and in turn,


section 3 – how does iso affect the quality of photos? as a general rule, the lower the number, the better the quality of the photo. by doubling the iso, you ’ re effectively doubling the exposure taken by the camera and in turn, doubling the digital noise. this noise reduces the detail of a photo by making the image appear grainy and uneven. lower number = lover sensitivity = finer quality photos to best demonstrate how the iso affects the quality of the image, i ’ ve taken another series photos and displayed them below. for the purpose of this experiment, i have changed the shutter speed and aperture of each photo rather than simply changing the iso to produce an even exposure so that it is easier to compare the difference in quality. the photos are displayed in the following order : 100, 200, 400, 800, 1600, 3200. as you can see, the higher the number, the stronger the unsightly noise becomes. there is noise reduction software that can help to correct this, but you ’ ll find that it only really smooths out the noise, which can result in an airbrushed effect on faces, reducing the detail in a photo, like the one below ( cropped to 1 % of actual image ). clearly, it has it ’ s uses but should be used in moderation and with consideration to what the photo is being used for. cameras with larger sensors handle noise better as they allow more light into a photo, but as technology improves, the difference between sensor size and noise is reducing. what used to be a big problem is much less of a one now in high quality cameras. all cameras are different so i suggest taking yours into low light conditions in order to discover the maximum iso that you ’ d be comfortable using. enhancing the exposure in post production has the same effect as increasing your iso, so make sure you get the exposure right in the camera the first time round in order to avoid this. now that you know what the iso does, let ’ s take a look at situations where it might be used. section 4 – which iso and when? iso 100 - 200 : your photos will have the most detail and the best quality ; great for shooting in daylight as there is no need to boost the iso any higher. shooting at 1600 in bright conditions would be a waste as easily avoidable grainy results would be achieved. iso 1600 - 3200 : again, event photographers will use this range for live gigs, but it ’ s also used in extreme low light conditions where using a tripod is


now confidential government files from spring 1982 reveal how the then prime minister margaret thatcher stood four square with her troops in the diplomatic battles behind the scenes. they detail how the iron lady held firm against american president ronald reagan when he urged her to go soft on the enemy. she is also seen at her fighting best, demanding that france, another ally, postpone the sale of missiles which were certain to be used against our troops. the dossiers, published under the 30 - year rule at the national archives in kew, south - west london, also give a glimpse of her heartache at the 10 - week conflict. but her determination to show as much grit as the british task force was evident in a heated late - night telephone call with mr reagan, her friend and ally. he had telephoned no 10 downing street on may 31, as the battle for the falklands capital port stanley was starting and the war had two weeks to run. a memo recording their conversation says : “ president reagan said the us considered it imperative that the uk should show it was prepared to talk before the argentinians were forced to withdraw. the president had spoken to the president of brazil who shared his view that the best chance for peace was before complete argentine humiliation. as the uk now had the upper hand militarily, it should strike a deal now. ” but mrs thatcher refused even to allow the un to occupy the islands. the memo continues : “ the prime minister stressed that britain had not lost precious lives in battle and sent an enormous task force to hand over the queen ’ s islands immediately to a contact group. “ the immediate priority after argentinian withdrawal would be to restore british law and administration, to carry out reconstruction and development. as britain had had to go into the islands alone, with no outside help, she could not let the invader gain from his aggression. " the prime minister asked the president to put himself in her position. " she had lost valuable british ships and invaluable british lives. " she was sure the president would act in the same way if alaska had been similarly threatened. ” twenty - four hours before the showdown, mrs t had confronted president francois mitterrand over france ’ s deal to supply exocet missiles to peru. some had been used to lethal effect by argentine forces and victims included hms sheffield, sunk with the loss of 20 crew. london and paris knew that if sold to peru, any further missiles would fi nd their way to its ally argentina and be used against britain. i just say it


by argentine forces and victims included hms sheffield, sunk with the loss of 20 crew. london and paris knew that if sold to peru, any further missiles would fi nd their way to its ally argentina and be used against britain. i just say it was the worst, i think, moment of my life. mrs t cabled mitterrand, saying : “ i must ask you with all the emphasis and urgency at my command to find a means of delaying the departure of these missiles from france for at least a further month. ” she warned if argentina was able to use france ’ s weapons against their allies, anglo - french relations would be in tatters. “ i greatly hope therefore that for the time being you will be able to find some way of keeping these missiles in france. ” a day later she had some unwelcome help solving the threat from attorney general sir michael havers, who wanted to recruit a middle man to infiltrate a network supplying the missiles. he wrote to her : “ the risk of resupply to the argentines of further air - sea missiles justifies consideration of all options to prevent this, even the most way - out which may be thought to be more appropriate to a james bond movie. ” however, by the time she was handed the note by an aide sir michael had thought better of such a scheme and backed away from it. her horror at the war unfolded before the franks committee which held an inquiry into whether it could have been avoided in autumn 1982. she compared the invasion to the start of the first world war, saying : “ i just say it was the worst, i think, moment of my life. ”


deer tend to avoid some plants and relish others. while no plant can be guaranteed to be " deer - proof, " some types of plants are less tasty to a deer. try planting the following kinds of plants which are less attractive to deer. tree suggestions include white fir, colorado spruce, pinyon pine, common juniper, rocky mountain maple, hackberry and honeylocust. shrub possibilities are lead plant, potentilla, austrian copper rose, quince, ' blue mist ' spirea, winged euonymus, golden currant, lilacs, oregon grape holly and pyracantha. ground covers to be tried are creeping mahonia, english ivy, thyme and snow - in - summer. perennial flowers that may be of use are purple coneflower, peony, blazing star, shasta daisy, mexican hat coneflower, lily - of - the - valley and russian sage. deer - resistant herbs include marjoram and lavender. native plants growing in their native habitats may be less appealing to deer than highly fertilized and highly watered garden plants. any plant may be attractive to some individual deer or deer in some seasons. more extensive lists may be obtained from some municipalities or local colorado state university extension county offices. for more information, see the following colorado state extension fact sheet ( s ). do you have a question? try ask an expert! updated friday, april 19, 2013


a retinal detachment is a serious and sight - threatening event, occurring when the retina – the light - sensitive inner lining of the back of the eye – becomes separated from its underlying supportive tissue. the retina cannot function when it detaches and, unless it is reattached soon, permanent vision loss may result. signs and symptoms of retinal detachment if you suddenly notice spots, floaters and flashes of light, you may be experiencing a retinal detachment. your vision might become blurry, or you might have poor vision. another symptom is seeing a shadow or a curtain coming down from the top of the eye or across from the side. these symptoms can occur gradually as the retina pulls away from the supportive tissue, or they may occur suddenly if the retina detaches immediately. there is no pain associated with retinal detachment. if you experience any of the above symptoms, consult your eye doctor right away. immediate treatment increases your odds of regaining lost vision. what causes retinal detachments? an injury to the eye or face can cause a detached retina, as can very high levels of nearsightedness. extremely nearsighted people have longer eyeballs with thinner retinas that may be more prone to detaching. on rare occasions, retinal detachment may occur after lasik surgery in highly nearsighted individuals. in a study of more than 1, 500 lasik patients, just four suffered retinal detachment ; their pre - lasik prescriptions ranged from - 8. 00 d to - 27. 50 d. cataract surgery, tumors, eye disease and systemic diseases such as diabetes and sickle cell disease may also cause retinal detachments. new blood vessels growing under the retina – which can happen in diseases such as diabetic retinopathy – may separate the retina from its underlying support tissue as well. treatment for retinal tears and detachments surgery is the only effective treatment for a torn or detached retina. the procedure or combination of procedures your doctor uses depends on the severity and location of the problem. also called photocoagulation, laser surgery is generally used for retinal breaks and tears that have not yet become retinal detachments. the surgeon directs a laser beam into your eye through the pupil to “ spot weld ” the damaged retina to its underlying tissue. photocoagulation requires no surgical incision and causes less irritation to the eye than other treatments. in this treatment, the surgeon applies


laser beam into your eye through the pupil to “ spot weld ” the damaged retina to its underlying tissue. photocoagulation requires no surgical incision and causes less irritation to the eye than other treatments. in this treatment, the surgeon applies a freezing probe to the outer surface of the eye over the area of defective retina. the scarring that occurs from the freezing reattaches the retina to its support tissue. this surgery is generally used to treat a retinal detachment in the upper half of the retina. the surgeon injects an expandable gas bubble inside the eye, positioning the bubble over the torn and detached retina. as the gas bubble expands, it pushes the detached retina against its support tissue. the surgeon then may use laser photocoagulation or cryopexy to firmly reattach the retina to the underlying tissue. over time, your body absorbs the gas bubble. until that occurs, certain precautions are necessary. in a variation of pneumatic retinopexy, the surgeon may inject silicone oil rather than expandable gas into the eye to press the detached retina against its support tissue. in this procedure, the silicone oil must be removed from the eye after the retina is reattached. this is the most common surgery used to treat a retinal detachment. in this procedure, the surgeon places a soft silicone band around the eye, which indents the outside of the eye toward the detached retina. the band is sutured against the tough outer white coating of the eye ( the sclera ). the surgeon then drains any fluid between the retina and its support tissue, and reattaches the retina with laser photocoagulation or cryopexy. in about 90 % of cases, detached retinas are successfully reattached with a single surgery. however, this does not mean your vision will return to normal. patients who have the best visual outcomes from retinal detachment surgery are those who seek attention immediately upon noticing symptoms and have detachments that do not involve the central retina ( the macula ). article ©2012 access media group llc. all rights reserved. reproduction other than for one - time personal use is strictly prohibited.


rise and fall regardless of the obscurity of their origins, it is clear that a distinctive etruscan culture evolved about the 8th cent. b. c., developed rapidly during the 7th cent., achieved its peak of power and wealth during the 6th cent., and declined during the 5th and 4th cent. etruria had no centralized government, but rather comprised a loose confederation of city - states. important centers were clusium ( modern chiusi ), tarquinii ( modern tarquinia ), caere ( modern cerveteri ), veii ( modern veio ), volterra, vetulonia, perusia ( modern perugia ), and volsinii ( modern orvieto ). the political domination of the etruscans was at its height c. 500 b. c., a time in which they had consolidated the umbrian cities and had occupied a large part of latium. during this period the etruscans were a great maritime power and established colonies on corsica, elba, sardinia, the balearic islands, and on the coast of spain. in the late 6th cent. a mutual agreement between etruria and carthage, with whom etruria had allied itself against the greeks c. 535 b. c., restricted etruscan trade, and by the late 5th cent. their sea power had come to an end. the romans, whose culture had been greatly influenced by the etruscans ( the tarquin rulers of rome were etruscans ), were distrustful of etruscan power. the etruscans had occuped rome itself from c. 616 b. c., but in c. 510 b. c. they were driven out by the romans. in the early 4th cent., after etruria had been weakened by gallic invasions, the romans attempted to beat the etruscans back. beginning with veii ( c. 396 b. c. ) one etruscan city after another fell to the romans, and civil war further weakened etruscan power. in the wars of the 3d cent., in which rome defeated carthage, the etruscans provided support against their former allies. during the social war ( 90 – 88 b. c. ) of sulla and marius the remaining etruscan families allied themselves with marius, and in 88 b. c. sulla eradicated the last traces of etruscan independence. the columbia electronic encyclopedia, 6th ed. copyright ©


last modified : 2011 - 09 - 02 by bruce berry keywords : eritrea | united nations | wreath | links : fotw homepage | search | disclaimer and copyright | write us | mirrors image by mark sensen and dov gutterman, 25 may 2002 this image of an historical flag of eritrea can be found in " flags through the ages and across the world " by whitney smith [ smi75 ]. it has a light blue background with a green wreath in the center. chris pinette, 11 july 1996 according to the flag bulletin [ fbn ] of may / june 1996, the eritrean flag with the " un blue " field and green emblem was adopted in 1952 and used until the territory was absorbed into ethiopia in 1959. it continued in use as a " flag of liberation " until 1993 when independence was nick artimovich, 11 july 1996 according to page 88 of flags of the world by william crampton ( 1990 ) [ cra90 ], this flag was also used as the flag of the eritrean liberation front ( elf ), which i am assuming was the political movement for eritrean independence. randy young, 29 january 1999 the elf was founded in 1958, and started the armed struggle three years later. in 1971, eritrean people ' s liberation front ( eplf ) was founded due to disagreements the elf. eplf soon became the main liberation movement. ole andersen, 30 jan 1999 the opposition movements with eritrea still use the 1952 flag, as can be seen the national " emblem " in green over light blue dov gutterman, 25 may 2002


african nuclear - weapon - free zone treaty ( treaty of pelindaba ) the african nuclear - weapon - free zone ( anwfz ) treaty, known as the treaty of pelindaba, prohibits contracting parties from conducting research on, developing, manufacturing, stockpiling, acquiring, or possessing any nuclear explosive devices. similar to the treaty of rarotonga, the treaty of pelindaba also bans the dumping of radioactive material anywhere in the region and allows each party to decide for itself whether to permit the visit or transit of foreign ships and aircraft through its territory. however, pelindaba goes beyond the treaties of tlatelolco and rarotonga with some of its provisions. it prohibits research and the seeking of assistance for research on nuclear explosive devices. the treaty also calls for the dismantlement and destruction of any nuclear explosive device manufactured before the treaty ’ s entry into force ; “ the physical protection of nuclear materials, facilities and equipment to prevent theft or unauthorized use ; ” and “ the prohibition of armed attack by conventional or other means against nuclear installations in the zone. ” to verify compliance, each party to the treaty must apply full - scope iaea safeguards to its nuclear activities. the treaty also provides for the establishment of the african commission on nuclear energy ( afcone ) to supplement the safeguards. the treaty lists several protocols that require the signature and ratification of extra - zonal parties : ( 1 ) it calls for all npt - designated nuclear weapon states ( nws ) to refrain from using or threatening to use nuclear explosive devices against any party to the treaty ; ( 2 ) it prohibits nws from testing or assisting the testing of any nuclear explosive device within the anwfz ; ( 3 ) spain and france — two countries responsible for territories in the zone — are required to apply the treaty ’ s prohibitions to their respective territories. the treaty of pelindaba was opened for signature on april 11, 1996, when 47 of the region ’ s 53 states signed. all of the nws — with the exception of russia — signed the treaty ’ s first two protocols on that day. russia ’ s unwillingness to sign the protocols resulted from an ambiguity it saw in the u. s. and u. k. position on the militarization of diego garcia island in the indian ocean. the united states and the united kingdom maintain that neither the treaty nor its protocols apply to the island and, therefore, do not preclude the presence of u. s. nuclear weapons there. russia eventually signed protocols


garcia island in the indian ocean. the united states and the united kingdom maintain that neither the treaty nor its protocols apply to the island and, therefore, do not preclude the presence of u. s. nuclear weapons there. russia eventually signed protocols i and ii on may 11, 1996. france has signed and ratified protocol3 ; however, spain has done neither. as of 2001, china, france, and the united kingdom have all ratified protocols i and ii of the treaty. u. s. and russian ratification of these protocols is still pending. as per article 18, the treaty entered into force on july 15, 2009, when burundi became the twenty - eighth state to deposit its instrument of ratification. african nuclear - weapon - free zone ( treaty of pelindaba ). ( 2010, june 22 ). center for nonproliferation studies. retrieved from http : / / www. nti. org / e _ research / official _ docs / inventory / pdfs / anwfz. pdf graham, t., & lavera, d. j. ( 2003 ). treaty of pelindaba. in cornerstones of security : arms control treaties in the nuclear era ( pp. 24 - 30 ). seattle, wa : university of washington press. jones, r. w., mcdonough, m. g., & spector, l. s. ( 1998 ). appendix e : nuclear - weapon - free zones. in tracking nuclear proliferation : a guide in maps & charts, 1998 ( pp. 301 - 305 ). washington, dc : carnegie endowment for international peace. retrieved from http : / / www. carnegieendowment. org / files / tracking _ appe. pdf regehr, e. ( 2009 ). africa as a nuclear - weapon - free zone. the ploughshares monitor, 30 ( 3 ). retrieved from http : / / www. ploughshares. ca / libraries / monitor / mons09e. pdf


more education, socio - economic benefits equals longer life a study by researchers at university of illiniois shows that despite advances in health care and increases in life expectancy overall, americans with less than a high school education have life expectancies similar to adults in the 1950s and 1960s. " the most highly educated white men live about 14 years longer than the least educated black men, " lead author of the study s jay olshansky said. " the least educated black women live about 10 years less than the most educated white women, " he added. the researchers examined life expectancy by race, sex and education and examined trends in disparities from 1990 through 2008. " over the last couple of decades, almost all longevity boats have risen, " said olshansky, but there have been some subgroups that have had a drop in life expectancy. " " it ' s as if americans with the least education are living in a time warp, " he said. the least educated black men are living in 1954, black women in 1962, white women in 1964, and white men in 1972. according to researchers white women with less than 12 years of education can expect to live five years less than their counterparts did in 1990 ( a decline from age 78 to 73 ). black women with less than 12 years education can expect to live to age 74, up from age 73 two decades ago. " there are essentially two america ' s, " said olshansky. one subgroup of the population is highly educated, doing well, be the first to comment.


abhijit v banerjee and esther duflo in their book poor economics — rethinking poverty & the ways to end it write a very interesting story about a woman they met in the slums of hyderabad. this woman had borrowed rs 10, 000 from spandana, a microfinance institution. they write : “ a woman we met in a slum in hyderabad told us that she had borrowed rs 10, 000 from spandana and immediately deposited the proceeds of the loan in a savings bank account. thus, she was paying a 24 percent annual interest rate to spandana, while earning about 4 percent on her savings account ”. the question, of course, was why would anyone in their right mind do something like this? borrow at 24 percent and invest at 4 percent? but, as the authors found out, there was a clear method in the woman ’ s madness. “ when we asked her why this made sense, she explained that her daughter, now 16, would need to get married in about two years. that rs 10, 000 was the beginning of her dowry. when we asked why she had not opted to simply put the money she was paying to spandana for the loan into her savings bank account directly every week, she explained that it was simply not possible : other things would keep coming up … the point, as we eventually figured out, is that the obligation to pay what you owe to spandana – which is well enforced — imposes a discipline that the borrowers might not manage on their own. ” the example brings out a basic point that those with low income find it very difficult to save money and, in some cases, they even go to the extent of taking a loan and repaying it, rather than saving regularly to build a corpus. this includes a lot of very small entrepreneurs and people who do odd jobs and make money on a daily basis. such individuals have to meet their expenses on a daily basis and that leaves very little money to save at the end of the day. also, the chances of the little money they save, being spent are very high. as abhijit banerjee told me in an interview i did for the economic times : “ the broader issue is that savings is a huge problem. cash doesn ’ t stay. money in the pillow doesn ’ t work. ” hence, as the above example, showed it is easier for people to build a savings nest by borrowing and then repaying that loan, rather than by saving regularly. another way building a savings nest is


money in the pillow doesn ’ t work. ” hence, as the above example, showed it is easier for people to build a savings nest by borrowing and then repaying that loan, rather than by saving regularly. another way building a savings nest is by visiting a bank regularly and depositing that money almost on a daily basis. but that is easier said than done. in a number of cases, the small entrepreneur, or the person doing odd jobs, figures out what he has made for the day only by late evening. by the time the banks have closed for the day. the money saved can easily be spent between the evening and the next morning when the banks open. also, in the morning, the person will have to get back to whatever he does, and may not find time to visit the bank. banks also do not encourage people depositing small amounts on a daily basis. it pushes up their cost of transacting business. but what if the bank or a financial institution comes to the person everyday late in the evening, once he is done with his business for the day and knows exactly what he has saved for the day. it also does not throw tantrums about taking on very low amounts. this is precisely what subrata roy ’ s sahara group has been doing for years, through its parabankers who number anywhere from six lakh to a million. they go and collect money from homes or work places of people almost on a daily basis. the sahara group fulfilled this basic financial need of having to save on a daily basis for those at the bottom of the pyramid ( as the management guru ck prahalad called them ). the trouble, of course, was that there was very little transparency in where this money went. the group has had multiple interests ranging from real estate, films, television, and now even retail. a lot of these businesses are supposedly not doing well. over the last few years, both the reserve bank of india ( rbi ) and securities and exchange board of india ( sebi ) have cracked down on the money - raising schemes of the sahara group. in a decision today, the supreme court of india has directed that the sahara group refund more around rs 17, 700 crore that it raised through its two unlisted companies between 2008 and 2011. the money was raised from 2. 2 crore small investors through an instrument known as optionally fully convertible debentures. the money has to be returned in three months. sebi had ordered sahara last year to refund this money with 15 percent interest


the money was raised from 2. 2 crore small investors through an instrument known as optionally fully convertible debentures. the money has to be returned in three months. sebi had ordered sahara last year to refund this money with 15 percent interest. this was because the fund - raising process did not comply with sebi rules. sahara had challenged this, but the supreme court upheld sebi. the question that arises here is : why has sahara managed to raise money running into thousands of crores over the last few decades? the answer probably lies in our underdeveloped banking system. in a november 2011 presentation made by the india brand equity foundation ( a trust established by the ministry of commerce with the confederation of indian industry as its associate ), throws up some very interesting facts. a few of them are listed below : - despite healthy growth over the past few years, the indian banking sector is relatively underpenetrated. - limited banking penetration in india is also evident from low number of branches per 100, 000 adults. the branched per 100, 000 adults ratio in india stands at 747 compared to 1, 065 for brazil and 2, 063 for malaysia - of the 600, 000 village habitations in india only 5 percent have a commercial bank branch - only 40 percent of the adult population has bank accounts what these facts tell us very clearly is that even if a person wants to save it is not very easy for him to do so because chances are he does not have a bank account or there is no bank in the vicinity. this is where sahara comes in. the parabanker comes to the individual on a regular basis and collects his money. as a reuters story on sahara points out, “ investors in sahara ’ s financial products tend to be from small towns and rural areas where banking penetration is low they see sahara on television everyday as sponsor of the cricket team and that leads them to believe that this is the best company, ” said a spokesman for the investors and consumers guidance cell, a consumer activist group. ” sahara has built trust over the years by being a highly visible brand. it sponsors the indian cricket and hockey team. it has television channels and a newspaper as well. hence people feel safe handing over their money to sahara. the irony of this, of course, is that rbi, which has been trying to shut down the money raising activities of sahara, is in a way responsible for its rise, given the low level of banking penetration in the country. vivek kaul is a writer and can be reached at first


fundamentals of thermal - fluid sciences rrp us $ 123 us $ 69. 97 save us $ 53. 03 ( 43 % ) free shipping worldwide ships from uk supplier | format : | | paperback, 1152 pages, international studen edition | | published in : | | united states, 01 january 2012 | the fourth edition in si units of " fundamentals of thermal - fluid sciences " presents a balanced coverage of thermodynamics, fluid mechanics, and heat transfer packaged in a manner suitable for use in introductory thermal sciences courses. by emphasizing the physics and underlying physical phenomena involved, the text gives students practical examples that allow development of an understanding of the theoretical underpinnings of thermal sciences. all the popular features of the previous edition are retained in this edition while new ones are added. this edition features : a new chapter on power and refrigeration cycles ; the new chapter 9 exposes students to the foundations of power generation and refrigeration in a well - ordered and compact manner. an early introduction to the first law of thermodynamics ( chapter 3 ) : this chapter establishes a general understanding of energy, mechanisms of energy transfer, and the concept of energy balance, thermo - economics, and conversion efficiency. learning objectives : each chapter begins with an overview of the material to be covered and chapter - specific learning objectives to introduce the material and to set goals. developing physical intuition : a special effort is made to help students develop an intuitive feel for underlying physical mechanisms of natural phenomena and to gain a mastery of solving practical problems that an engineer is likely to face in the real world. new problems : a large number of problems in the text are modified and many problems are replaced by new ones. some of the solved examples are also replaced by new ones. upgraded artwork : much of the line artwork in the text is upgraded to figures that appear more three - dimensional and realistic. media resources : limited academic version of ees with selected text solutions packaged with the text on the student dvd. the online learning center offers online resources for instructors including powerpoint [ registered ] lecture slides, and complete solutions to homework problems. mcgraw - hill ' s complete online solutions manual organization system allows instructors to streamline the creation of assignments, quizzes, and tests by using problems and solutions from the textbook, as well as their own custom material. table of contents chapter 1 introduction and overview part i thermodynamics chapter 2 basic concepts of thermodynamics chapter 3 energy, energy transfer & general energy analysis chapter 4


this guide looks at medical errors and steps you can take to protect yourself. a medical error is when a mistake is made that can negatively affect the patient. examples can include errors in diagnosis or in a surgical procedure, mistakes in giving medications or in the use of medical equipment, misinterpretation of a test or lab results, and others. a medical error can involve the failure to carry out a plan of action or use of the wrong plan. an individual can cause the error or it might happen because of a failure in the system. medical errors can take place in health care facilities, pharmacies, your doctor ’ s office, and even in your home. they can involve complex systems like how a hospital tracks the medical services given to patients, or common tasks like giving food high in salt to a patient who needs a salt - free diet. while advances have improved medical care and extended the lives of many people, the complexity of the american health care system also contributes to medical errors. poor communication between patients and their health care providers can lead to mistakes as well. you can play an important part in patient safety by being actively involved in your own health care and the health care of your loved ones. this guide will look at some of the problems and the actions each of us can take. health care team safety in health care facilities and in home care prevention of infections prevention of falls health care team most people no longer have one physician who takes care of them throughout their lives and knows their entire history. you might change primary care physicians, visit various specialists, or find yourself in a hospital emergency department. at your doctor ’ s office you might see the doctor, nurse practitioner, or another professional. you might receive your care through a clinic where you see a different provider each time you visit. the one constant in this care is you. you are an important member of your health care team. you know your history, medications, allergies, illnesses, and surgeries. part of your responsibility is to educate yourself about your conditions and treatments and to share important information about your health with your health care providers. communication between you and your health care providers is an important part of patient safety. you have the right to ask questions and to have matters explained to you in a way you understand. you have the right to know what treatment choices are available for your care. in addition you may find yourself being an advocate for loved ones because they are unable to make health care decisions, or a loved one may need to represent you if you are unable to


have the right to know what treatment choices are available for your care. in addition you may find yourself being an advocate for loved ones because they are unable to make health care decisions, or a loved one may need to represent you if you are unable to speak for yourself. tips for being a part of your health care team : - inform all of your health care providers of your medical history including any treatments, surgeries, medications, allergies, or medical conditions. - tell all of your providers about every medication you take, including prescriptions, over - the - counter medicines, vitamins, and herbal supplements. - write down questions and take them to your appointment. you might want to take notes during the visit or take someone with you as your advocate. they can help you speak up, ask questions, and write notes. later you can talk with this person about your situation and choices. - if you need to have medical care, ask what treatment choices you have. - if something is said you don ’ t understand, ask for a clearer explanation. - if tests are performed and you don ’ t receive results, call the office and ask for them. you can also request a copy of the results. - if you want another opinion about a diagnosis or treatment, request one from another doctor. ask if your health insurance will pay for a second opinion. - if you ’ re not satisfied with your health care provider you may want to choose another one. - if you have a medical condition, are getting a certain treatment, or are taking medications, educate yourself in these matters. ask your health care provider for educational materials and use your local library or the internet to learn more. health care surrogate designation if you ’ re unable to be active in your health care due to physical or mental incapacity ( like being in a coma or developing dementia ) and if you don ’ t have a health care advance directive, health care decisions may be made for you by a guardian appointed by the courts, your spouse, adult child, parent, adult sibling or, under certain circumstances, another adult relative or close friend. if you would like someone to represent you if you are unable to make decisions yourself you can designate a health care surrogate. further information can be found in the pamphlet health care advance directives. actively managing and learning about your medications is an important part of patient safety. following are suggestions to better protect yourself and your loved ones when taking medications. do your health care providers know all of the medications you take? some medicines and supplements


directives. actively managing and learning about your medications is an important part of patient safety. following are suggestions to better protect yourself and your loved ones when taking medications. do your health care providers know all of the medications you take? some medicines and supplements may cause harm if used together. learn about the medications and supplements you take and any interactions they may have. at least once a year review all of your medicines ( prescription and non - prescription ) and supplements ( vitamins and herbs ) with your health care providers. whenever you are prescribed medication ask if the new medicine will interact with other medications or supplements you currently take. can you read your prescription? if you can ’ t read your prescription the pharmacist may misread it and give you the wrong medicine. florida law requires that the prescription be written clearly, so make sure you ask for a clearly written prescription. however, many doctors now use electronic prescribing so your prescription may be sent to the pharmacy through a secure internet connection. learn more at e - prescribe. before leaving the pharmacy check the medication label to see that it is written to you and it ’ s the same name and strength as written on the prescription. check this every time you fill a prescription. be familiar with how your medicine looks. if it looks different than what you took before talk with your pharmacist before taking it. do you read your medication label and insert? the label will tell you how much to take, when and how long to take it, and if there are restrictions. for example, the label might say you shouldn ’ t drink alcohol while taking the medication, stay out of the sun, or avoid certain foods or other medications. the insert will include information about safety precautions and side effects. ( a side effect is, for example, when an allergy or cold medicine might also make you sleepy. ) if you have questions about the label directions, safety precautions, or side effects talk with your pharmacist. if you cannot clearly read the label ask the pharmacist to use larger type. if you don ’ t understand the directions ask the pharmacist to explain. is there a danger of buying medication that has been altered or that isn ’ t what the label says it is? a good way to protect yourself is to confirm that the pharmacy where you buy your medication is licensed by the state of florida. each pharmacy is required to post the company ’ s license as well as the license of the pharmacy manager. if you buy prescription medication over the


to protect yourself is to confirm that the pharmacy where you buy your medication is licensed by the state of florida. each pharmacy is required to post the company ’ s license as well as the license of the pharmacy manager. if you buy prescription medication over the internet, or by mail order, it is important to be a wise shopper. first see your own health care provider for a prescription. check to see if the company is licensed in the state in which it operates or if the national association of boards of pharmacy ( nabp ) certifies the company through its vipps program ( verified internet pharmacy practice sites™ ). visit the nabp website nabp. net or call ( 847 ) 391 - 4406. be cautious buying medications over the internet or by mail order. if the company is not legitimate, you may end up with fake, altered, or expired medication that will not help you and may cause harm. in addition, the website or mail order company may appear to be based in the united states, but actually be operating outside of the u. s. where quality and safety controls may not be available. is there a danger in taking over - the - counter ( otc ) medications? some otc medications should not be used with certain prescription drugs. read your medication label and insert, and talk with your pharmacist if you have questions. also compare active ingredients before taking more than one medication at the same time. many otc and prescription medications contain the same active ingredient, which means you could take more than the recommended dose. for example, if you take a pain medication along with a cough, allergy, or sleep medicine, they may contain the same drug and the combination may be more than is safe to take at one time. while your health care provider or pharmacist can alert you to unsafe combinations of drugs, you can also watch for the following two common ingredients : - acetaminophen is used in over 600 products, especially headache and cold medicines. taking more than is recommended can lead to liver damage or failure. - nsaids ( nonsteroidal anti - inflammatory drugs ) are common pain relievers. overuse, or when used in combination with some drugs, can lead to stomach bleeding or kidney damage. otc medications are meant for temporary relief. if you need to use a medication longer than it says on the label, see your health care provider. you may have a serious medical condition or your provider may recommend another form of treatment. why is it


otc medications are meant for temporary relief. if you need to use a medication longer than it says on the label, see your health care provider. you may have a serious medical condition or your provider may recommend another form of treatment. why is it important to know the correct dosage to take? medications can make you sick, injure you, or sometimes cause death when taken incorrectly. do not take more of the medication than is recommended. some things to watch out for : - over - the - counter ( otc ) medications come in a variety of strengths. for example, pain relief medication may be regular, extra strength, or time - release ; they may be pills, liquid, or capsules. follow package directions for - some people mistakenly think taking three pain relief pills at one time will relieve the pain more quickly. or they take too many pills within a 24 - hour time or for too many days. taking more than the recommended dose can be dangerous. - if you take prescription medication do not change the dosage before discussing it with your health care - an adult dosage of medication should not be given to children. follow directions prescribed by your child ’ s doctor and for otc medications buy the children ’ s strength and follow the directions. an incorrect dosage can quickly have a dangerous effect on children because of their smaller size. - some seemingly harmless otc medications may not be appropriate for children. for example, the american college of pediatrics recommends that aspirin not be given to children. - the elderly can also be more sensitive to medications and their side effects. check with your physician if you become drowsy, confused, dizzy, or have other side effects, as your physician may be able to adjust or change tips on safe handling of medications : - put medications in a safe place away from children ( and animals ) and keep them in childproof bottles. - if there is an adult who has difficulty reading labels or in knowing when to take medication, have another adult oversee the medication. - if medication poisoning occurs call your doctor or the poison information center at ( 800 ) 222 - 1222 or, if life threatening, call for emergency assistance which in most areas is 911. - do not store medications in your bathroom as the moisture and heat could change or destroy their effectiveness. if you store medication in the kitchen protect it from heat and moisture. find out if your medication should or should not be stored in the refrigerator. - at least once a year review all of your prescription and over - the - counter medications,


effectiveness. if you store medication in the kitchen protect it from heat and moisture. find out if your medication should or should not be stored in the refrigerator. - at least once a year review all of your prescription and over - the - counter medications, as well as vitamins and supplements. do not continue to use medications that have changed color, consistency, or odor. safely throw away any that have expired, that you no longer use, or whose labels you can ’ t read. - throw out old medicine in a sealed, outdoor trash can in a manner that children, animals, or other adults cannot take it. used syringes and needles should be placed in a hard container ( like a used laundry soap bottle ) with a tight lid and then thrown into the trash. to dispose of controlled substances, like narcotics, you may want to ask your pharmacist or health care provider for advice. - if you take several medications you may want to keep a list and schedule of when you take each one. some people keep track of their medications by using a pill organizer they fill once a week. ask your pharmacist about pill organizers or other tracking aids. - if your medications are delivered by mail or another delivery service make sure they don ’ t sit outside your home for a lengthy period of time, they ’ re not exposed to heat or cold, and they won ’ t be tampered with or stolen. safety tips on taking medications : - if you have an allergic reaction call your health care provider, or if life threatening, call for emergency assistance which in most areas is 911. - learn about possible side effects of your medication, what you can do about them, and when they might be dangerous or life threatening. - if you forget to take your medicine, as scheduled, immediately taking the missed dose may not be the best thing to do. read the package insert or call your pharmacist for advice. - some people do not take their prescribed medications because they can ’ t afford them. if you do not take your medications or you skip doses, you may be able to get less expensive drugs by comparing the pharmacy prices in your area. view the state of florida prescription drug price website at myfloridarx. com. the site has price information on the top most commonly used prescription drugs in - if you cannot afford your medications talk with your health care provider as he or she may recommend a less expensive medicine or may have free samples. also, you may be eligible for prescription assistance programs ( see the next


top most commonly used prescription drugs in - if you cannot afford your medications talk with your health care provider as he or she may recommend a less expensive medicine or may have free samples. also, you may be eligible for prescription assistance programs ( see the next section ). - some medications should not be cut in half, chewed, or have the capsules opened as this will affect the medication and could cause harm or with some medications can even result in death. read the insert or ask your pharmacist if you have questions. - if you arrange for your child to be given medication at day care or school, ask about the procedures for storage, administration, and record keeping. every so often confirm that your child is being given the medication - do not take medication for recreational use or use medication prescribed to a friend or family member, even if you have the same illness or symptoms as that person. doing so is illegal and can be dangerous or deadly. - because older established drugs have been on the market longer more is known about their effectiveness and side effects. when you ’ re prescribed a medication ask your physician how long it ’ s been on the market. if there are medication choices ask which will best serve your needs. prescription assistance programs the following programs may offer assistance if you meet their eligibility requirements : - medicare part d prescription drug assistance is an insurance benefit to help people with medicare pay for prescription drugs and is provided through medicare approved private health plans. for more information contact medicare ’ s toll - free number ( 800 ) 633 - 4227 or tty ( 877 ) 486 - 2048 or visit medicare. gov. - sunshine for seniors, a state sponsored program, is for people 60 years or older. it provides referral to drug assistance programs, helps seniors choose the best program, and can help with the application process. call the elder helpline toll - free number ( 800 ) 963 - 5337. - the national council on aging has a referral service for people 55 years or older. visit benefitscheckup. org. - some drug companies offer low or no cost medicine to low - income individuals. ask your pharmacist if he or she knows of programs or do a search on the internet of the companies that make your medicines. some programs can also be found at medical help resources on you may also want to read understanding prescription drug costs. safety in health care facilities and in home care as a patient or resident in a facility or a person receiving home care services it might be challenging to be an active


be found at medical help resources on you may also want to read understanding prescription drug costs. safety in health care facilities and in home care as a patient or resident in a facility or a person receiving home care services it might be challenging to be an active member of your health care team. you may not feel well. you may be given medication that makes you drowsy. you may be frail and find it difficult to speak up for yourself. but even with these challenges you still play a very important part in your health care team and you have the right to be involved in your care. it ’ s important to have clear communication with your health care providers. if you think you may not be able to be clear, due to a temporary condition or to longer term declining health, you may want to have a loved one be your advocate and speak up for you. you may also want to designate someone as your health care surrogate as mentioned before entering a health care facility or receiving services from a home care provider you may want to learn more about the choices you have and the following resources on floridahealthfinder. gov can provide helpful - learn about nursing homes through the florida nursing home guide. - you can read the consumer guides : assisted living in florida, home health care in florida, nursing home care in florida, and long - term care. - compare florida hospitals and ambulatory surgery centers, hospice providers and health plans. on the same website you can find a list of facilities and home care providers licensed, registered, or certified by the agency for health care administration. - the federal medicare program also provides information on nursing homes, hospitals, home health agencies, and dialysis facilities that serve medicare patients. to learn more visit medicare. gov. while receiving care : - you have the right to review records related to your care. if you ’ re receiving medical care under a physician ’ s orders you will have a plan of care that describes your treatment. if a plan of care is not required other kinds of records may be kept. - when you are admitted, transferred, or discharged from a health care facility review your medications with your physician. find out if there were medication changes and if you need to throw away any unused medicine that was replaced by a different drug or dosage. - if you ’ re in a facility where you have an identification ( id ) bracelet, check that it can be read and correctly identifies you. if your id bracelet doesn ’ t have the correct information, if it comes undone or if it can ’ t be read


’ re in a facility where you have an identification ( id ) bracelet, check that it can be read and correctly identifies you. if your id bracelet doesn ’ t have the correct information, if it comes undone or if it can ’ t be read ask that it be replaced. - when you ’ re given medication, ask the person to check the medication, the order, and your identification so you receive the correct medicine and dosage at the correct time. - be familiar with how your medicine looks and if it looks different than what you were given before, talk with the nurse or aide before taking it. - ask what hours you are scheduled for medications. tell the nurse or aide if a medication time passes and no one has brought your medication. - before a medical test or procedure is done, ask the person to check the order and your identification. ask what is going to be done and why. - tell your nurse or physician if you have a reaction to your treatment or if your symptoms get worse. - if you are bed bound ask what safeguards are in place to prevent blood clots and skin ulcers. - while staying in a hospital or ambulatory surgery center, try to have a family member or friend with you at all times, if possible. while receiving care in a health care facility : - if you have a loved one with alzheimer ’ s disease or dementia in a health care or long - term care facility ask what safety precautions are in place for patients who wander. - ask the facility what procedures are in place should the facility need to be evacuated due to an emergency or natural disaster, like a fire or hurricane. - ask the facility what their policies are concerning restraints and seclusion of patients or residents. while receiving care in your home : - when receiving services in your home try to have a backup plan if the caregiver does not show up for the scheduled appointment. a home health care provider is required to provide all scheduled visits, so tell the agency ’ s director of nursing or administrator if someone doesn ’ t show. if the problem continues you may want to change agencies. - if you need medical equipment and supplies, your home care provider is required to train you and your loved ones in the correct use of the equipment. keep written instructions and the company ’ s phone number nearby. call them if you have questions or problems. if the equipment has alarms or error messages learn what these mean and what you need to do. - the home care provider is required to give you a phone number to call when you


s phone number nearby. call them if you have questions or problems. if the equipment has alarms or error messages learn what these mean and what you need to do. - the home care provider is required to give you a phone number to call when you have questions or problems. if you ’ re receiving nursing or therapeutic services or if you ’ re on life - support equipment the company must be on - call 24 - hours a day, 7 days a week. - if you have a physical or mental condition that will require help with evacuation and sheltering during a disaster, like a hurricane, the home care provider must help you register with the florida division of emergency safety tips for surgery & medical procedures : - if you have a choice, pick a health care provider and facility that have experience with the surgery / procedure you are having. by using the hospitals and ambulatory surgery centers comparison tool on floridahealthfinder. gov you can view the number of visits and range of charges on over a 150 medical conditions and procedures performed at ambulatory surgery centers and the number hospitalizations and range of charges for hospitals. additional information on hospitals includes average length of stay as well as rates for readmissions, complications and infections, and mortality. the hospital comparison tool provides comparison of pediatric care as well as adult care, and a patient - carefully follow directions about what you need to do prior to the surgery or procedure. if you don ’ t understand the directions ask them to be explained to you. - ask your health care provider if you need to stop any of your medications prior to the surgery / procedure, plus ask what you can eat or drink. - make sure it is clear who will perform the surgery / procedure, what exactly will be done, and what to expect during and after the surgery / procedure. - ask what safeguards are in place to ensure the correct surgery / procedure is done at the correct site on the correct patient. - ask if you will need a blood transfusion and what safety precautions are in place to assure you receive the correct blood type. if possible, you may want to donate your own blood prior to the surgery / procedure. tell your doctor if you have ever had a reaction to a blood transfusion. - ask if there ’ s a risk of complications after your surgery / procedure and what symptoms you should watch - have a loved one available during your surgery / procedure to be your advocate. tell your physician if you want your loved one consulted, if needed, and to report to them once the surgery / procedure is complete.


procedure and what symptoms you should watch - have a loved one available during your surgery / procedure to be your advocate. tell your physician if you want your loved one consulted, if needed, and to report to them once the surgery / procedure is complete. - learn about your follow - up care including healing of the surgery site ; how much rest you will need ; what medications, food, and activities to avoid ; and when you can return to work and other activities. - make sure your health care provider answers all your questions and concerns. safety tips for anesthesia : when preparing for a surgery or procedure you will also want to learn about anesthesia. anesthesia is medication that keeps you from feeling pain and sensations during a surgery / procedure. ask exactly who will give you anesthesia and monitor your vital signs. tell your doctor and the anesthesiologist if you have ever had a reaction to anesthesia. tell them all the medications you take ( prescribed, over - the - counter, vitamins, and herbal supplements ) and any allergies you have. also, let them know if you have any medical problems and, though this may feel personal, if you have a drinking problem or use drugs recreationally. this information is very important for safe anesthesia care. ask about restrictions on medications, food, and alcohol before and after the use of anesthesia. after surgery under general anesthesia ( the kind that puts you to sleep ) you may continue to feel drowsy, tired, or weak for a few days and you may have problems with coordination and thinking clearly. for at least 24 hours after receiving general anesthesia don ’ t drive, use machines, or do things that could be dangerous if you are not alert. if you have a complaint : if you have a complaint about your health care provider or health care facility talk with them first to see if the matter can be resolved. if you are still not satisfied and want to file a complaint with the state of florida call the toll - free number ( 888 ) 419 - 3456. prevention of infections the centers for disease control ( cdc ) states that about two million people a year get an infection during their stay in a hospital in the united states. a person can also get an infection in non - hospital settings like nursing homes, dialysis centers, physicians ’ offices, or in their own home. data is available on infection rates at florida hospitals. if you are going to receive care or treatment in a hospital you may want to check your hospital ’ s infection rates or


homes, dialysis centers, physicians ’ offices, or in their own home. data is available on infection rates at florida hospitals. if you are going to receive care or treatment in a hospital you may want to check your hospital ’ s infection rates or compare several hospitals in your area. you can find infection rates on the hospital comparison tool on floridahealthfinder. gov. tips on infection prevention : - a patient can be at risk of getting an infection, so if you are ill do not visit a person who is sick at home or in the hospital. if a patient has an infection, he or she may transfer it to others, so take precautions to - the cdc states that clean hands are the most important part in preventing the spread of infection. - if you are giving care be sure to wash your hands before and after, and if you are receiving care don ’ t be afraid to ask your health care providers if they washed their hands. - as a patient it ’ s also important to keep your hands clean, particularly after handling soiled items or after using the bathroom. - if you are visiting an ill person, wash your hands before and after the visit. - gloves should be worn if coming into contact with body fluids, soiled items, or when inserting any invasive devices ( like a catheter ). hands should be washed before and after using gloves. the gloves should be thrown out after caring for a patient. - if you have a drainage tube or a catheter that comes lose, immediately tell your caregiver or health care provider. a drainage tube might be inserted to drain a wound ; a catheter might be a foley catheter ( a thin tube inserted to remove urine from the bladder ) or an intravenous line ( or iv ) that is inserted into a vein to give fluids. - if you have either a catheter or a wound, keep the skin clean and dry around your iv catheter dressing or wound dressing. if the dressing gets wet or comes lose tell your caregiver or health care provider. - long nails and artificial nails can continue to hold infectious germs even after a good hand washing. if a patient is at risk of getting an infection the cdc states caregivers should keep their nail tips to ¼ inch in length and should not wear artificial nails. - other ways germs can spread are through droplets ( from an infected person coughing, sneezing, or talking, etc ) ; airborne transmission ( which may require special air handling and ventilation for


inch in length and should not wear artificial nails. - other ways germs can spread are through droplets ( from an infected person coughing, sneezing, or talking, etc ) ; airborne transmission ( which may require special air handling and ventilation for treatment ) ; items that have picked up germs like medical equipment or any item that can then spread infection ; or when animals or bugs transmit infection ( like mosquitoes, flies, or rats ). - sometimes it may be necessary for the patient, staff, or visitors to wear protective masks or gowns. - under certain circumstances a patient may be placed in isolation in a hospital to protect the patient and to prevent the spread of infection. patients placed in isolation will have signs posted outside their hospital doors. before entering the room ask the hospital staff about visiting restrictions and any protective requirements for the patient, staff, or visitors. - some medical equipment and items may require special handling during and after use, for example, needles, catheters, or items soiled with body fluid ( like blood on a bandage ), etc. some items can be thrown in the regular trash, but others may need to be placed in a biohazard waste container. other items may be able to be sterilized or disinfected for future use. - ask your health care provider about proper use and disposal of gloves, gowns, masks, medical equipment, - the patient ’ s bed linens and clothing should be changed and washed regularly or if they become soiled. the patient ’ s surroundings should be kept clean. - tell your health care provider if you show signs of a possible infection, like a fever, chills, pain, redness, swelling, a discharge, or other symptoms. - if you are diabetic you have a higher risk of developing an infection. be careful about controlling your blood sugar and especially talk with your health care provider about your diabetic care needs if you have surgery, need wound care, will be bedridden, or other situations that might lead to infection. - if you are given antibiotics for an infection, use all the medication until it is finished. even if you feel better do not stop taking the antibiotic. prevention of falls injuries from falls are of particular concern for the elderly and for patients who might be frail or disoriented from illness, recovering from surgery, or on medication. whether you ’ re in a health care facility or your own home, check for the following to help prevent falls : - if you ’ re in


patients who might be frail or disoriented from illness, recovering from surgery, or on medication. whether you ’ re in a health care facility or your own home, check for the following to help prevent falls : - if you ’ re in a hospital bed the side rails may need to be kept up. ask your caregiver to lock the brakes on your bed. and, if needed, call for help to get out of bed. - make sure throw rugs and floors aren ’ t slippery. keep the floor clear of clutter. - use shoes that give good support and are not slippery. - use a walker, cane, or wheelchair if needed and learn how to use them correctly. - eyeglasses or a change in eyeglasses may help as poor vision can contribute to falls. - make sure there is good lighting. - consider a bedside commode if walking to the bathroom in the middle of the night is difficult. - use chairs and a bed that are easy to get in and out of. - grab bars in the bathroom, a raised toilet seat, shower chair, and non - slip mat in the tub or shower are good safety features. - stairs should have handrails on both sides, have good lighting, and be clear of objects. - ask your physician if an adjustment in your medications could improve coordination. - an exercise program, even for the frail elderly, can help improve balance and strength and help prevent falls. you may want to consult an exercise trainer or participate in an exercise program geared towards your skill review your surroundings and see what other actions can be taken to help prevent falls. additional consumer guides include : a patient ’ s guide to a hospital stay assisted living in florida end - of - life issues – a practical planning guide health and human services programs health care advance directives home health care in florida nursing home care in florida understanding prescription drug costs note : this is not designed to offer medical or legal advice. please consult with your physician for medical advice and an attorney for legal advice. information is current as of september 2012. this may be copied for public use. please credit the agency for health care administration for its creation. if you have comments or suggestions, please call ( 850 ) 412 - 3730.


planting instructions by flower name - hardy zones : 3 - 8 - spacing : 36 " - height : 24 - 30 " - blooms : late spring to early summer - planting depth : plant with eyes 1 " below soil surface sarah bernhardt peony peonies are in the peony family, paeoniaceae, and native to temperate eurasia. they have been in cultivation for over 2000 years. individual plants may live up to 50 years. they will not flower the first year of planting, and can take up to two years to produce their showy, fragrant blooms. named after the pioneer silent movie actress, the sarah bernhardt peony will produce large, double, pink flowers. peonies are long - lived and resent disturbance, so choose the site carefully and prepare the soil well. choose an area that receives full or filtered sunlight and is not near large trees or shrubs that will compete for space and nutrients. for best results, dig the planting hole 18 ” deep and 18 ” wide. fill the bottom 4 ” with organic matter, such as compost or well - aged manure, mixing in a couple cups of bone meal or plant food. fill the hole with soil, amending with organic matter if necessary. the soil must be well - draining. plant the roots near the surface, making sure the “ eyes, ” the pink growth tips, are facing upward and about 1 ” deep. if planted more than 2 ” deep, the plant may not flower. spread the roots outward and gently firm the soil around them. water well. peonies will not bloom the first year. when they do flower, they require staking to support their large, heavy blooms. install a stake or flower support when growth begins in the spring. when leaf growth starts, feed with a well - balanced fertilizer and mulch with organic matter to retain moisture and keep the soil cool. feed again midway through the growing season. when dry, water deeply. remove faded flowers to divert energy into next year ’ s blooms. peonies are quite hardy and actually require a cold dormancy period for successful blooming. when the foliage dies back in the autumn, cut the stems back to 3 ”. remove the old mulch and cover with a fresh dressing for the winter, such as loose straw or evergreen boughs.


law school piece is the best short summary i have found of the various insanity defenses. the mcnaughton rule - - not knowing right from wrong the first famous legal test for insanity came in 1843, in the mcnaughton case. englishman daniel mcnaughton shot and killed the secretary of the british prime minister, believing that the prime minister was conspiring against him. the court acquitted mcnaughton " by reason of insanity, " and he was placed in a mental institution for the rest of his life. however, the case caused a public uproar, and queen victoria ordered the court to develop a stricter test for insanity. the " mcnaughton rule " was a standard to be applied by the jury, after hearing medical testimony from prosecution and defense experts. the rule created a presumption of sanity, unless the defense proved " at the time of committing the act, the accused was laboring under such a defect of reason, from disease of the mind, as not to know the nature and quality of the act he was doing or, if he did know it, that he did not know what he was doing was wrong. " the mcnaughton rule became the standard for insanity in the united states and the united kingdom, and is still the standard for insanity in almost half of the states. the durham rule - - " irresistible impulse " monte durham was a 23 - year - old who had been in and out of prison and mental institutions since he was 17. he was convicted for housebreaking in 1953, and his attorney appealed. although the district court judge had ruled that durham ' s attorneys had failed to prove he didn ' t know the difference between right and wrong, the federal appellate judge chose to use the case to reform the mcnaughton rule. citing leading psychiatrists and jurists of the day, the appellate judge stated that the mcnaughton rule was based on " an entirely obsolete and misleading conception of the nature of insanity. " he overturned durham ' s conviction and established a new rule. the durham rule states " that an accused is not criminally responsible if his unlawful act was the product of mental disease or mental defect. " the durham rule was eventually rejected by the federal courts, because it cast too broad a net. alcoholics, compulsive gamblers, and drug addicts had successfully used the defense to defeat a wide variety of crimes. the model penal code : turning responsibility to the jury the american law institute - model penal code. in 1972