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ITL: Physician Reviews of HM-Relevant Research

In This Edition

Literature At A Glance

A guide to this month’s studies

  1. Acute myocardial infarction risk after hip/knee surgery
  2. Preoperative alcohol cessation minimizes complications in elective surgery
  3. Early laparoscopic cholecystectomy for gallstone pancreatitis
  4. Low-dose steroids in shock patients
  5. Pharmacist intervention did not reduce post-discharge errors
  6. Hyperbaric oxygen therapy and necrotizing soft-tissue infections
  7. Worse stroke outcomes on weekends
  8. Hospital admissions from EDs increasing
  9. Avoiding intensive glucose control in acute stroke
  10. Peri-procedural bleeding with dabigatran versus warfarin

Increased Risk of Acute Myocardial Infarction after Hip/Knee Surgery

Clinical question: How long does the risk of acute myocardial infarction (AMI) last after hip or knee replacement surgery, and what factors affect the risk?

Background: AMI is a morbid, perioperative complication of hip/knee surgery. Previous studies have demonstrated an increased risk of AMI post-surgery; however, this is the first study to assess the timing and modifiers of the risk.

Study design: Retrospective cohort study.

Setting: Data from Danish national registries from 1998 to 2007.

Synopsis: All adult patients who received total hip replacement (THR, n=66,524) or total knee replacement (TKR, n=28,703) surgery, as identified by hospital discharge records during a 10-year period, were matched with three age/sex controls without a history of THR or TKR (n=286,165). Patients with prior AMI within six weeks of the index date were excluded (n=437). The patients were followed until death, THR or TKR revision, migration, or the end of the study period.

Thromboprophylaxis was received by 99.1% of THR and TKR patients. The risk of AMI was significantly elevated for two weeks in TKR patients, and for six weeks in THR patients. Age >60 significantly increased the risk of AMI for both study populations. The risk associated with a previous AMI before THR or TKR diminished with increasing time between the two events.

The study was limited by lack of controlling for some AMI risk factors, such as smoking history or BMI.

Bottom line: AMI risk is substantially elevated for six weeks after THR and for two weeks after TKR. Preoperative risk factors to consider include age >60 and AMI within a year.

Citation: Lalmohamed A, Vestergaard P, Klop C, et al. Timing of acute myocardial infarction in patients undergoing total hip or knee replacement. Arch Intern Med. 2012;172:1229-1235.

Preoperative Alcohol Cessation Minimizes Complications of Elective Surgery in Heavy Alcohol Users

Clinical question: Does preoperative alcohol cessation minimize complication rates, mortality, or length of stay (LOS) in heavy alcohol users?

Background: Alcohol abuse is prevalent worldwide and contributes to 1.8 million deaths per year. Heavy alcohol users have an increased risk of postoperative bleeding, cardiopulmonary complications, and infections. It is unknown if preoperative cessation can reduce the risk of postoperative complications.

Study design: Systematic review.

Setting: Two Danish randomized controlled trials.

Synopsis: A Cochrane review identified 671 potential studies, of which 655 were excluded after abstract review. Of the 16 studies remaining, 14 were not randomized controlled trials with preoperative intervention for alcohol cessation. In the two studies that remained (n=69), patients who received preoperative alcohol cessation had fewer postoperative complications (odds ratio=0.22, 95% CI 0.08-0.61, P=0.004). Interventions included disulfiram and medical supervision of alcohol cessation. Investigators found no significant reductions for in-hospital or 30-day mortality.

Limitations of this review include lack of blinding to the treatments, low numbers of included women, and both studies being conducted by the same author.

Bottom line: Heavy alcohol users might benefit from a preoperative alcohol cessation program, but further studies are needed.

Citation: Oppedal K, Moller AM, Pedersen B, Tonnesen H. Preoperative alcohol cessation prior to elective surgery. Cochrane Database Syst Rev. 2012;7:CD008343.

Early Laparoscopic Cholecystectomy Is Safe and Effective for Gallstone Pancreatitis

Clinical question: Does early laparoscopic cholecystectomy (<48 hours of admission) in mild gallstone pancreatitis decrease LOS without increasing morbidity and mortality?

Background: Time to laparoscopic cholecystectomy (LC) for mild gallstone pancreatitis is greatly debated. Historically, surgeons have waited for normalization of laboratory values and decreased symptoms before performing laparoscopic or open cholecystectomy. Two previous studies demonstrated LC can be performed safely within 48 hours of admission, regardless of symptoms or laboratory values.

Study design: Retrospective cohort.

Setting: Two academic medical centers in California.

Synopsis: This retrospective review of 303 patients who underwent LC for mild gallstone pancreatitis from 2006 to 2011 found 117 (38.6%) underwent early LC and 186 (61.4%) underwent delayed LC (>48 hours after presentation). No significant differences in patient demographics, laboratory values, or admission Ranson scores were found between the groups. The mean LOS was significantly shorter in the early LC group (3.4 days) compared with the delayed LC group (6.3 days), and the delayed LC group had a higher rate of preoperative endoscopic retrograde cholangiopancreatography (ERCP). No differences were found with regard to mortality, complication rates, 30-day readmissions, or conversion to open cholecystectomy.

This study is limited by its retrospective design and potential for uncontrolled confounders. In addition, it did not evaluate preoperative management, postoperative recovery time, or timing of surgical consultation, which could have affected outcomes between the groups. It also is difficult to predict mild gallstone pancreatitis on admission, as some of the Ranson criteria should be calculated at 48 hours, and 5% to 10% of mild gallstone pancreatitis will progress to severe pancreatitis.

Bottom line: Early laparoscopic cholecystectomy (<48 hours of presentation) in mild gallstone pancreatitis is associated with shorter LOS and decreased ERCP use, with no difference in morbidity or mortality.

Citation: Faylor AE, de Virgilio C, Stabile BE, et al. Early laparoscopic cholecystectomy for mild gallstone pancreatitis. Time for a paradigm shift. Arch Surg. 2012;16:1-5.

Low-Dose Steroids in Shock Patients

Clinical question: Do low-dose corticosteroids improve mortality or shock reversal in adults with septic shock?

Background: Several trials have been published to evaluate the efficacy of low-dose corticosteroids in septic shock.

Study design: Systemic review and meta-analysis of randomized controlled trials.

Setting: Not identified.

Synopsis: Seven randomized controlled trials that utilized low-dose corticosteroids and reported either mortality or time-to-shock reversal in adults with septic shock were included in this review. Shock reversal was not consistently defined across trials but included time to withdrawal of vasopressors, proportion of patients on vasopressors on Day 3, or stable systolic blood pressure of >90 mm Hg for at least 24 hours without vasopressor support.

Pooled results found a significant improvement in shock reversal after low-dose corticosteroid administration (300 mg hydrocortisone in 24 hours [relative risk=1.17, 95% CI, 1.07-1.28]). Pooled results from six studies (n=965) did not find a significant difference in

mortality among those receiving low-dose corticosteroids.

Of note, two of the seven studies represented a disproportionate number of included patients, and the search only included the MEDLINE database, so some randomized controlled trials might have been missed.

Bottom line: Low-dose corticosteroids might reverse shock faster, but they do not improve mortality.

Citation: Sherwin RL, Garcia AJ, Bilkovski R. Do low-dose corticosteroids improve mortality or shock reversal in patients with septic shock? A systemic review and position statement prepared for the American Academy of Emergency Medicine. J Emerg Med. 2012;43:7-12.

Pharmacist Intervention Did Not Reduce Medication Errors after Discharge

Clinical question: Does pharmacist intervention reduce clinically important medication errors after hospital discharge for patients with acute coronary syndrome (ACS) or decompensated congestive heart failure?

Background: Research has shown adverse drug events, including discrepancies in medication regimens and nonadherence, affect 11% to 17% of discharged patients. Pharmacist interventions reduce medication errors in hospitalized patients, but their impact on recently discharged patients is unknown.

Study design: Blinded randomized controlled trial.

Setting: Two U.S. tertiary-care academic hospitals.

Synopsis: Investigators randomized 851 patients admitted with ACS or decompensated heart failure to receive pharmacist intervention or usual care. The intervention involved pharmacist medication reconciliation (“med rec”), inpatient pharmacist counseling, low-literacy adherence aids, and post-discharge follow-up phone calls.

The primary outcome of clinically important medication errors within 30 days of discharge occurred in 50.8% of all patients. The intervention and usual-care groups had similar mean number of errors, 0.87 and 0.92 events per patient, respectively. Results by intention-to-treat analysis favored the intervention but did not meet statistical significance (adjusted RR 0.92, CI 0.77-1.09).

Both hospitals had sufficient resources to support med rec and electronic health records. The study population was well-educated, with only a 10% prevalence of inadequate health literacy, compared with 26% noted in prior literature. These factors could help explain the study’s negative findings.

Study limitations include whether the results are generalizable to other settings or noncardiac populations. Further study is needed to determine characteristics of patients and settings that could benefit from pharmacist involvement to decrease medication errors.

Bottom line: A pharmacist intervention did not reduce medication errors in cardiac patients after discharge.

Citation: Kripalani S, Roumie CL, Dalal AK, et al. Effect of a pharmacist intervention on clinically important medication errors after hospital discharge. Ann Int Med. 2012;157:1-10.

Hyperbaric Oxygen Therapy Saves Lives in Necrotizing Soft-Tissue Infections

Clinical question: Is the use of hyperbaric oxygen therapy in necrotizing soft-tissue infections (NSTIs) effective in improving patient outcomes?

Background: Studies evaluating the benefits of hyperbaric oxygen therapy (HBO2 therapy) in NSTIs are limited. The mainstay of management remains early surgical debridement and antibiotics. Given the significant risk of mortality and long-term disability from limb and tissue loss, alternative treatments need to be considered.

Study design: Retrospective analysis.

Setting: The Nationwide Inpatient Sample (NIS) database.

Synopsis: This study evaluated 45,913 patients in the NIS from 1988 to 2009, of which 405 patients received HBO2 therapy. Overall, those receiving HBO2 therapy had a lower mortality rate (4.5% vs. 9.4%). After adjusting for predictors and confounders, those receiving HBO2 therapy had a statistically significant lower risk of mortality, but they did have higher hospital costs and longer LOS.

The NIS database does not capture several predictors and confounders for NSTI patients. Additionally, the lack of data regarding the number of HBO2 therapy sessions received makes it impossible to estimate a dose response.

Bottom line: This retrospective analysis of NSTI patients found HBO2 therapy was associated with significantly lower mortality but higher hospitalization cost and longer LOS.

Citation: Soh CR, Pietrobon R, Freiberger JJ, et al. Hyperbaric oxygen therapy in necrotizing soft tissue infections: a study of patients in the United States Nationwide Inpatient Sample. Intensive Care Med. 2012;38:1143-1151.

Worse Stroke Outcomes on Weekends

Clinical question: Does the day of admission alter the quality and safety of care received by stroke patients?

Background: There is growing concern of disparities in care between weekday and weekend admissions in many health conditions. Recent studies have sought to determine if such a disparity exists for stroke patients.

Study design: Retrospective cohort study.

Setting: National Health Service public hospitals, England.

Synopsis: This study evaluated six quality-safety indicators among 93,621 stroke admits from April 1, 2009, to March 31, 2010. Investigators found performance on five of six indicators was significantly worse on weekends. Specifically, the percent of same-day brain scans was 43.1% on weekends, compared with 47.6% on weekdays, and seven-day in-hospital mortality for Sunday admissions was 11%, compared with an overall mean mortality of 8.9%.

It is possible that some of the observed effect could be due to unmeasured differences in patients admitted on weekends compared to weekdays.

Bottom line: This study suggests that, similar to other clinical conditions, significant disparities might exist between weekend and weekday care of stroke patients.

Citation: Palmer WL, Bottle A, Davie C, Vincent CA, Aylin P. Dying for the weekend: a retrospective cohort study on the association between day of hospital presentation and the quality and safety of stroke care. Arch Neurol. 2012;9:1-7.

Hospital Admissions from Emergency Departments Increasing

Clinical question: What proportion of current hospital admissions use the ED as an admission portal?

Background: Historically, outpatient providers’ offices admitted clinically stable patients with acute problems. From 1997 to 2007, ED visit rates increased by more than a third. Currently, a quarter of all acute-care outpatient visits occur in the ED.

Study design: Retrospective, observational cohort study.

Setting: The Nationwide Inpatient Sample (NIS) database, with approximately 8 million annual hospital stays, weighted to produce national averages.

Synopsis: NIS data from 1993 to 2006 showed the number of hospital admissions increased by 15%, while the proportion of admissions from the ED increased by 50%. The total proportion of inpatients entering from the ED increased to 43.8% from 33.5% (P<0.001). Twelve of the 13 most frequent inpatient clinical conditions also had a proportional increase in admissions from the ED (P<0.0001).

Possible explanations for the increases include difficulty arranging timely outpatient sick visits and overuse of the ED for issues that could be more appropriately addressed by primary-care offices. Furthermore, public education campaigns for heart attack or stroke emphasize early emergency care. Patients and providers expect rapid specialized care and early treatment that is readily available in ED.

More efficient use of inpatient resources is a focus of the Affordable Care Act. To inform health policy, research is needed to determine the drivers of admission trends, as well as the value and cost of emergency care.

Bottom line: The proportion of hospital admissions from the ED is increasing, but the implications for healthcare delivery are inadequately understood.

Citation: Schuur JD, Venkatesh AK. The growing role of emergency departments in hospital admissions. N Engl J Med. 2012;367(5):391-393.

Avoiding Intensive Glucose Control in Acute Stroke

Clinical question: Is intensive insulin treatment beneficial in patients with acute stroke?

Background: Although post-stroke hyperglycemia is associated with worse outcomes in acute stroke patients, it is unknown if intensive insulin treatment improves prognosis or infarct size.

Study design: Unblinded randomized controlled trial.

Setting: Single academic medical center in France.

Synopsis: Study authors randomized acute stroke patients (NIHSS from 5 to 25) to intensive insulin treatment or subcutaneous insulin therapy within 24 hours of admission. Initial median blood sugars were ~120 mg/dL in both groups. Mean blood sugars of <126 mg/dL were achieved at 24 hours in 95% of the intensive group and 67% of the subcutaneous group. The MRI infarct size at follow-up scanning was significantly larger in the intensive insulin group, but there were no differences in functional outcomes, serious adverse events, or mortality between the groups.

The study might have been underpowered to detect meaningful clinical differences between the groups.

Bottom line: Intensive blood sugar control cannot be recommended in acute stroke patients.

Citation: Rosso C, Corvol JC, Pires C, et al. Intensive versus subcutaneous insulin in patients with hyperacute stroke: results from the randomized INSULINFARCT trial. Stroke. 2012;43(9):2343-2349.

Peri-Procedural Bleeding with Dabigatran Versus Warfarin

Clinical question: Is dabigatran more likely to result in periprocedural bleeding when compared to warfarin?

Background: In a randomized clinical trial (RE-LY), dabigatran had a lower risk of major bleeding compared with warfarin. However, given that the anticoagulant effect of dabigatran is difficult to measure and there is not an effective antidote, it is unknown if dabigatran is associated with higher periprocedural rates of bleeding compared with warfarin.

Study design: Post-hoc analysis of the RE-LY trial.

Setting: Multicenter randomized controlled trial.

Synopsis: Patients enrolled in the RE-LY trial all had urgent or elective-invasive procedures recorded. The protocol recommended cessation of warfarin based on local practice, and cessation of dabigatran 24 hours before the procedure; the protocol was amended in 2008 to recommend cessation of dabigatran 24 hours before low-bleeding risk procedures, but two to five hours before high-bleeding-risk procedures (depending on renal function). Periprocedural bleeding was defined as seven days prior and 30 days after the procedure. Dabigatran was interrupted a mean of 49 hours before the procedures, and warfarin for 114 hours. There was no significant difference in major bleeding rates between dabigatran (150-mg dose) and warfarin, which occurred in 5.1% versus 4.6% patients, respectively.

Bottom line: Warfarin and dabigatran have about the same rate of periprocedural bleeding rates, but interruption duration is shorter for dabigatran.

Citation: Healey JS, Eikelboom J, Douketis J, et al. Peri-procedural bleeding and thromboembolic events with dabigatran compared with warfarin: results from the randomized evaluation of long-term anticoagulation therapy (RE-LY) randomized trial. Circulation. 2012;126(3):343-348.

Clinical Shorts

The FDA approved a test that detects the dengue virus from a blood sample (as opposed to older antibody tests). It is easy to perform and likely will be readily available in the near future.

Citation: Centers for Disease Control and Prevention. Centers for Disease Control and Prevention briefing. Centers for Disease Control and Prevention website. Available at: Accessed Sept. 3, 2012.

This prospective cohort of critically ill patients on antibiotics and CVVHD found wide variability of trough levels of various antibiotics, necessitating routine checking of levels to avoid under- and overdosing.

Citation: Roberts DM, Roberts JA, Roberts MA, et al. Variability of antibiotic concentrations in critically ill patients receiving continuous renal replacement therapy: a multicenter pharmacokinetic study. Crit Care Med. 2012;40(5):1523-1528.

This large prospective analysis of patients with gross hematuria found no pathology in ~50% but found cancer in ~20%, necessitating a full workup in these types of patients.

Citation: Mishriki SF, Vint R, Somani BK. Half of visible and half of recurrent visible hematuria cases have underlying pathology: prospective large cohort study with long-term follow-up. J Urol. 2012;187(5):1561-1565.

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January 19, 2019

Archives for February 24, 2015

Water Fluoridation May Increase Risk of Underactive Thyroid Disorder

COF-COF Special News FindBy: Douglas Main, Newsweek.com, United States 24-Feb-2015 –A large study that looked at data from nearly every general medical practice in England suggests that water fluoridation may increase the risk of developing hypothyroidism, or underactive thyroid. This condition, in which the thyroid gland doesn’t produce enough hormones, is associated with symptoms such as fatigue, obesity and depression.

The study found that locations with fluoridated water supplies were more than 30 percent more likely to have high levels of hypothyroidism, compared to areas with low levels of the chemical in the water. Overall, there were 9 percent more cases of underactive thyroid in fluoridated places.

Fluoride is added to the water of about 10 percent of England’s population—and to the taps of about two-thirds of Americans—for the purpose of preventing cavities. It has proved controversial ever since being adopted by American public health authorities in the 1950s, and then spreading to some other countries; supporters say it is a boon for dental health, while critics say it may lead to a variety of health problems.

The paper, published today in the Journal of Epidemiology & Community Health, also directly compared the fluoridated city of Birmingham with the city of Manchester, which doesn’t add the substance to the water. After controlling for factors such as sex and age (women are more likely than men to have the condition, and the elderly more likely than the young), the researchers concluded that doctor’s offices in Birmingham were nearly twice as likely to report high levels hypothyroidism, says study co-author Stephen Peckham, a researcher at the University of Kent.

“It raises a red flag,” says Dr. Philippe Grandjean, an environmental health researcher and physician at Harvard University, “that possible interference with thyroid function needs serious consideration when regulating fluoride levels in drinking water.”

The findings are all the more important since this is the “largest population ever studied in regard to adverse effects of elevated fluoride exposure,” says Grandjean, who wasn’t involved in the study. Data was collected from 99 percent of England’s 8,020 general medical practices, and the study found that a total of 3.2 percent of the population had hypothyroidism, a 14 percent increase from 2008.

“The study is an important one because it is large enough to detect differences of potential significance to the health of the population,” says Trevor Sheldon, a medical researcher and dean of the Hull York Medical School. Sheldon, who has authored numerous studies in this field, no longer thinks (as he once did) that the “case for general water fluoridation” is clear.

Considering the comprehensiveness of this study—it covered nearly the whole of England—regional differences in fluoride intake or other confounding factors are unlikely to have played a role in the striking results, says Kathleen Thiessen, a senior scientist at the Oak Ridge Center for Risk Analysis, a company that does human health risk assessments for a variety of environmental contaminants.

But John Warren, a professor and researcher in the department of dentistry at the University of Iowa, disagrees. He points out that the study merely shows correlation, not causation. It also “assumes that since one group lives in a fluoridated community, they have higher exposure to [the substance] than those in the non-fluoridated area,” he says. This is significant flaw, he says—to draw a valid connection between fluoride and hypothyroidism, you’d have to measure individual exposure to the chemical and show that those with the condition had higher levels of exposure.

But other researchers interviewed for this story disagreed with this point, saying that such group studies are a valid way to begin to assess health effects of chemical exposure and make up the bulk of the scientific basis for fluoridation; this paper uses a much larger sample size than the vast majority of studies showing positive effects of fluoride, Thiessen says. Collecting individual data from tens of thousands of people is also not very feasible, they say.

“It’s unlikely that other sources of fluoride exposure—from tea, swallowed toothpaste, a few types of foods—would be distributed amongst the population of England in a way that would bias the results in one direction or another,” says Chris Neurath, senior scientist with the Fluoride Action Network, which opposes adding the substance to water.

Moreover, several other studies have suggested that fluoride in water accounts for a majority of an individual’s exposure to the chemical in the United States, and Peckham says this is also probably true in the United Kingdom. Thus it stands to reason that people in areas with higher levels in the water are generally exposed to more of it, Peckham says.

The connection between fluoridation and thyroid problems has not been widely studied, says Thiessen, who wasn’t involved in the paper. But the research that does exist shows that at a certain dose fluoride does indeed impair the activity of the thyroid gland, through an as-yet-unclear mechanism, she says.

In fact, fluoride was used to to treat hyperthyroidism (or an overactive thyroid) in the 1950s. It may put a damper on the gland’s activities by suppressing the activity of various enzymes, causing physical damage or interfering with the absorption and use of iodine, a substance that is critical for thyroid health, Thiessen says.

In 2006, the U.S. Environmental Protection Agency convened a panel that recommended lowering the maximum allowable level of fluoride in water; Thiessen was amongst that group and helped write sections of the report regarding health effects on the thyroid. Nine years later, the EPA is still considering whether or not to revise its fluoride standards.

Grandjean’s work has shown that high levels of fluoride—above the concentrations found in most fluoridated water—are associated with reduced IQ measures in children in China and India. Based on that work, he and a co-author listed fluoride as a developmental neurotoxin in a 2014 study in The Lancet.

“We don’t know how fluoride may cause the decreases in IQs in children, but this new study suggests that thyroid toxicity could be a very relevant mechanism,” Grandjean says. The thyroid produces hormones that are vital for proper metabolism, growth and brain function, and children of mothers with thyroid problems can suffer deficits in these areas, he adds.

The Centers for Disease Control and Prevention, which lists fluoridation as one of the top 10 public health initiatives of the 20th century, declined to comment on the study. The Food and Drug Administration referred questions about the study to the EPA, which didn’t respond by publication time. Public Health England maintains that fluoridation is “ a safe and effective public health measure.”

But some researchers aren’t so sure. “This study illustrates that there are potential harms [with fluoridation] that need large scale studies to explore; at the same time it is not a reason for panic,” Sheldon says.

Trouvailles Médiatiques 300 x 300Par: Charles Côté, La Presse, 24-février-2015 La fluoration augmenterait le risque de contracter une maladie de la glande thyroïde.

L’ajout de fluorure dans l’eau du robinet augmente les risques de contracter une maladie de la glande thyroïde, selon une recherche parue hier dans le Journal of Epidemiology and Community Health. L’ajout de fluorure dans l’eau du robinet est lié à un taux significativement plus élevé d’une maladie de la glande thyroïde. C’est la conclusion d’une recherche parue hier dans le Journal of Epidemiology and Community Health, publié par le British Medical Journal. Cela donnera des arguments supplémentaires à ceux qui s’opposent à la fluoration de l’eau, une mesure pourtant jugée efficace et peu coûteuse pour combattre la carie dentaire.

Les chercheurs de l’Université du Kent ont étudié la clientèle de 7935 médecins de famille d’Angleterre. Les médecins de famille anglais qui participent au régime de santé public sont incités financièrement à vérifier le fonctionnement de la glande thyroïde.

Environ 10% de la population britannique est desservie par un réseau d’aqueduc dans lequel du fluor a été ajouté à l’eau potable. Il y a donc une masse de données propice à l’analyse de type épidémiologique. Résultat: la probabilité que la clientèle d’un médecin souffre d’un taux élevé d’hypothyroïdie augmente de 40% à 60% selon la teneur en fluorure de l’eau.

Une plus grande proportion de la population est alimentée par de l’eau fluorée au Canada et aux États-Unis, où cette pratique à grande échelle a commencé dans les années 50.

Au pays, 42% de la population est alimentée par de l’eau fluorée. En Ontario, c’est 76%, autant qu’aux États-Unis (75%). Mais au Québec, c’est seulement 3%.

En 2006, le gouvernement du Québec se donnait l’objectif que d’ici 2012, 50% de la population de la province ait accès à de l’eau potable dont la concentration en fluorure est optimale. L’objectif est loin d’être atteint. En fait, on s’en éloigne, avec l’abandon de la fluoration à Québec en 2008 et, plus récemment, à Bécancour.

Alors qu’est-ce donc que l’hypothyroïdie? Tout part de la glande thyroïde, qui sécrète des hormones qui contrôlent le niveau du métabolisme des cellules du corps. Selon Passeport Santé, quand cette glande sécrète moins d’hormones, les personnes peuvent prendre du poids et ressentir de la faiblesse, de la fatigue, de la confusion, des crampes musculaires, de la frilosité et une foule d’autres symptômes diffus.

Les femmes sont de deux à huit fois plus susceptibles d’en souffrir. La prévalence augmente avec l’âge. La maladie touche 1% des adultes au Canada, mais 10% des 60 ans et plus.

Selon les chercheurs, c’est la première fois que la corrélation entre l’exposition au fluor et les effets sur la glande thyroïde est étudiée à l’échelle de la population.

Cependant, ils mentionnent que l’on connaissait l’effet du fluor sur la thyroïde depuis longtemps: dans les années 50, on traitait le goitre – l’hyperthyroïdie – avec une dose de fluor semblable à celle à laquelle on est exposé si on boit 1,5 litre d’eau fluorée par jour. Les symptômes du goitre sont souvent à l’opposé de ceux de l’hypothyroïdie: nervosité, tremblements, rythme cardiaque rapide, perte de poids, etc.

Toujours recommandé au Québec

Les chercheurs affirment que leurs «résultats de recherche ont des implications importantes pour les politiques de santé publique au Royaume-Uni et dans d’autres pays où le fluorure est ajouté à l’eau».

Mais pour sa part, la Direction de la santé publique (DSP) du Québec continue de prôner la fluoration, y compris dans un avis de 2012 sur cette question.

On y affirme que les enfants québécois ont 40% à 50% plus de caries que les Nord-Américains du même âge. Et il y a plus d’«édentés» au Québec qu’ailleurs au Canada. Dans ce même avis, la DSP affirme qu’«aucune donnée scientifique ne démontre de lien entre la fluoration de l’eau de consommation et un problème de santé particulier».

Une affirmation qui devra peut-être être nuancée.

À l’instar de la DSP, la plupart des autorités de santé publique et des associations dentaires continuent de prôner la fluoration de l’eau, sur la base de centaines d’études qui n’ont pas mis au jour d’impact négatif.

Mais ses bienfaits pour la santé dentaire sont de plus en plus difficiles à discerner, selon un rapport publié l’an dernier par le Centre de collaboration nationale en santé environnementale (CCNSE).

«Il y a de multiples sources de fluor, les soins dentaires s’améliorent ainsi que l’hygiène dentaire individuelle», affirme-t-on.

The addition of fluoride in tap water increases the risk of contracting a disease of the thyroid gland, according to research published yesterday in the Journal of Epidemiology and Community Health. The addition of fluoride in tap water is connected to a significantly higher rate of a disease of the thyroid gland. This is the conclusion of research published yesterday in the Journal of Epidemiology and Community Health, published by the British Medical Journal. This will give additional arguments to those who oppose water fluoridation, a measure nevertheless deemed effective and inexpensive to fight tooth decay.

Researchers at the University of Kent studied customer 7935 Family Physicians of England. The English family physicians participating in the public health system are financial incentive to check the functioning of the thyroid gland.

About 10% of the UK population is served by a water system in which fluorine was added to drinking water. So there is a mass of data conducive to the type of epidemiological analysis. Result: the likelihood that the customer of a doctor suffers from a high rate of hypothyroidism increases from 40% to 60% depending on the fluoride content of the water.

A greater proportion of the population is supplied by fluoridated water in Canada and the United States, where the widespread practice began in the 50s.

Nationally, 42% of the population is supplied with fluoridated water. In Ontario, it is 76%, as the United States (75%). But in Quebec, only 3%.

In 2006, the Quebec government gave itself the goal that by 2012, 50% of the provincial population has access to safe drinking water with fluoride concentration is optimal. The objective is far from being achieved. In fact, one walks away with the abandonment of fluoridation in Quebec in 2008 and more recently in Bécancour.

So what is it that hypothyroidism? Any part of the thyroid gland, which secretes hormones that control the metabolism of the body cells. According to Passport Health when this gland secretes less hormones, people can gain weight and feel weak, fatigue, confusion, muscle cramps, nervousness, and a host of other diffuse symptoms.

Women are two to eight times more likely to suffer. The prevalence increases with age. The disease affects 1% of adults in Canada, 10% of 60 and over.

According to the researchers, this is the first time that the correlation between fluoride exposure and effects on the thyroid gland is studied across the population.

However, they mention that we knew the effect of fluoride on thyroid long time: in the 50s, was treated goiter – hyperthyroidism – with a dose of fluoride similar to that to which one is exposed if you drink 1.5 liters of fluoridated water per day. The symptoms of goiter are often the opposite of those of hypothyroidism: nervousness, tremors, rapid heart rate, weight loss, etc.

Always recommended in Quebec

The researchers say that their “research results have important implications for public health policy in the UK and in other countries where fluoride is added to water.”

But for his part, the Public Health Department (PHD) in Quebec continues to advocate fluoridation, including a notice of 2012 on this issue.

It states that Quebec children have 40% to 50% more cavities than North Americans of the same age. And there’s more “toothless” in Quebec and across Canada. In this opinion, the DSP asserts that “no scientific evidence demonstrating a link between the consumption of water fluoridation and a particular health problem.”

A statement which may have to be qualified.

Like DSP, most public health authorities and dental associations continue to advocate fluoridation of water, based on hundreds of studies that have not revealed any negative impact.

But its benefits for dental health are becoming more difficult to discern, according to a report last year by the National Collaborating Centre for Environmental Health (NCCEH).

“There are multiple sources of fluoride, dental care and improved individual hygiene,” it is said.


New Dim Sum for lunch Head to Dynasty to enjoy 25% off our lunch7.jpg

Avid Cantonese food lovers will know that quality dim sum buffets don’t come cheap, which could explain why it’s a meal generally enjoyed with family. But here's some good news if you've been craving a proper dim sum session, Centara Grand at CentralWorld’s Dynasty restaurant is offering a 25% discount on their all-you-can-eat dim sum buffet—originally priced at 850++ baht—allowing you to enjoy a lunch of endless dim sum with friends at an absolute bargain!

The buffet features some of the best from chef Kongsun Sae-Liang’s repertoire of small dim sum plates, such as steamed zucchini with prawn, shrimp dumplings with Beijing sauce and even steamed snow fish in black bean sauce. In addition to being able to help yourself to as many steamer baskets of dim sum as your heart desires, the lunch deal also comes with two appetiser choices of a traditional Chinese soup, rice or noodle dish and dessert. And, if you want, you can get a Peking duck in the form of spring rolls for just an extra 400 baht.

Steamed shrimp dumpling with Beijing sauce.JPG

Steamed snow fish with black bean sauce.JPG

Steamed shrimp dumpling with Japanese pumpkin.JPG

Steamed zucchini with prawn.JPG

The discount applies every lunch from 11:30am-2:30pm, until the end of June. Make reservations at 0-2100-6255.

Tags: dim sum, Centara Grand, CentralWorld, Dynasty, Chinese food


Deep Neural Nets for Embedded Big Data Applications

We explore the use of deep neural networks (DNN) for embedded big data applications. Deep neural networks have been demonstrated to outperform state-of-the-art solutions for a variety of complex classification tasks, such as image recognition. The ability to train networks to both perform feature abstraction and classification provides a number of key benefits. One key benefit is that it reduces the burden of the developer to produce efficient, optimal feature engineering, which typically requires expert domain-knowledge and significant time. A second key benefit is that the network's complexity can be adjusted to achieve desired accuracy performance. Despite these benefits, DNNs have yet to be fully realized in an embedded setting. In this research, we explore novel architecture optimizations and develop optimal static mappings for neural networks onto highly parallel, highly granular hardware processors such as many-cores and embedded GPUs.


The Reliquier is a beautiful country house in the historic centre of Vallfogona de Ripolles. Its privileged location gives us magnificient views over a unique natural surrounding and at the same time it is the perfect place to start hiking or mountain biking, or simply seek peace and quiet. It is ideal to stroll and discover the town with enormous charm.

Dating from 1794, the house has two separate apartments with common access to the garden and pool. The original structure has been respected, trying not to alter its genuine essence. Its interior and decoration is made of natural materials, respecting its country character and giving it a chic vintage touch with shabby influences. Our aim is to make our guests feel at home, enjoy their stay and live it as a unique experience in itself.

The Reliquier should be rented entirely per house or one of the houses separately but in its whole, without catering. However, at arrival guests will receive a little gift that will make their stay more comfortable. Besides, there are two restaurants in the town which offer typical food of fresh products from the area.

The Abril House has got 2 double bedrooms (in one of them could stay a third guest if wished), a bedroom for children, (with bulk bed) a complete bathroom, a living-room with a fireplace, and a dining-room annex kitchen. In total there would be accommodation for 7 people.

The Bruna House is a charming apartment, like a studio with its own kitchen and bathroom. It has accommodation for 3 persons (2 adults and a child). They both have heating. There is a common hall to the garden and the swimming pool with a small bathroom at the side.

A Reliquier used to be very small building which used to be next to the churches where villagers conjured storms and evil spirits in old times. In Vallfogona, close to the old temple of Sant Julià is still a Reliquier (in Catalan), a small building of the 17thC, which collapsed in the 80s, but it was rebuilt in 1985, using many of the original parts.

We wanted to make a modest tribute to this type of building, forgotten today, almost magical and moving.


Electricity could be a completely crucial issue and can not be separated from human existence. Due to the fact without strength, human paintings will have many problems. The invention of strength may be stated to be the greatest discovery in the records of human existence. Believe, the whole floor of the earth can be pitch darkish, human civilization will by no means development as it’s miles now.

Nowadays, the utilization and development of energy in the world of science and technology is increasingly advanced. People have done a whole lot of studies and test then use it on diverse equipment that requires strength in principle work. Inside the international of training too, electricity isn’t always best limited to study the float, taggant, and limitations. However already include numerous matters.

Thinking about the importance of power in all elements of human existence. There’s no damage in knowing how electric records changed into located and who scientists are locating it. Thanks to their services the sector of strength has loads to persuade science and generation to this present day. Their discoveries have been applied nearly all over the globe.

Power improvement in Indonesia from 12 months to 12 months has also made tons progress. In this paper also discusses the development of strength in the world. And the way the history of the start of the electrical enterprise in all international locations.

Joyce James, Colin Baker, and Helen Swain endorse. That strength is a drift or movement of electrons is a negatively charged particle discovered in all atoms.

Energy is also a supply of electricity furnished through cable or other vendors. Strength is electricity that can be transformed into any other power. Generating heat, light, climax, or movement (mechanical).

The records of the inventor of Electricity strength

There are numerous variations.

First, the energy changed into located in the days of historic Egypt.

The principle that strength was recognized and used in European glory become wrong. So The Egyptians who found it, however, the Europeans best popularized.

The key to this entire theory lies hundreds of kilometers east of Egypt. There are a few extraordinary pots discovered in Iraq. Some copper cylinders are glued into the hollow using asphalt. In the middle of the cylinder, there is an iron rod. The diggers determined the first pot in 1936 and were convinced that the pot changed into a galvanic element, a primitive battery. Then The reconstruction does show that it’s far possible to create energy.

The next fact is discovered inside the temple at Dendera, tens of kilometers north of Luxor. Some experts discover mild. Then A Norwegian electrical engineer sees objects displayed on relief. on the pinnacle of this page can work as a lamp. An Austrian buddy was capable of building a working model. And famous authors at AAS, Peter Krassa, and Rainer Habeck may want to even work out the real theories these days.

After pieces of evidence were removed now we have to take a better look at the item itself. The “technical” guide, the following description explains Egypt’s technology of power. The book “lighting fixtures of the Pharaohs” via Austrian author Krassa & Habeck. Then They write the most popular thesis summary. After analyzing an e-book that layman might ask, why ancient Egypt let Egyptian history inclusive of rubbish as it appears that the history of Egypt is absolutely exclusive. A lot of Egypt’s records in keeping with the author’s well-known shows unfastened discovery.

Secondly, power changed into determined with the aid of Thales of Miletus and the 0.33, power located by Faraday.


Ann Weathersby

    Exhibition: Flicker

    Hermit Lane, 2004

    Digital video Still

    Ann Weathersby turns the camera on herself and engages elements of video, sculpture and performance, using the body to provoke a physical, psychological and emotional experience. In Hermit Lane, a woman tunnels through an empty house using a sledgehammer and an axe. As she ruptures surfaces, creating crawlspaces from room to room, the unsteady hand of the camera operator fuses a rhythm with the steady swings of her arm.
    PO Box 6259, 32-01 Vernon Boulevard
    Long Island City, NY 11106
    T 718 956 1819 / F 718 626 1533
Socrates is open 365 days a year from 9am to sunset.
Currently ° and at Socrates
Socrates is open 365 days a year from 10am to sunset.


100 Years of Architectural Drawings

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100 Years of Architectural Drawings

Sprache: Englisch Erscheinungsjahr: 2013 Bindung: Hardcover Seiten: 320 Verlag: Laurence King Maße: L: 25.5cm B: 23.5cm H: 3cm

This beautiful book brings together 300 of the best architectural drawings from the last century by the world's most prestigious architects, creating both a history of the genre and a survey of twentieth-century architecture.

The book is divided into five chronological sections that are prefaced by short essays that highlight the trends and styles of that period. Each drawing is captioned with key information about the architect, the project, and the drawing.

This dazzling visual feast will appeal to all students and practitioners of architecture as well as anyone with an interest in the subject.

* inkl. MwSt., zzgl. Versandkosten


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Why We Choose Thermal Insulating Sheet?

Insulating sheets are flexible heat insulating sheets composed of proprietary silica aerogel and fiber. The thermal properties of insulating materials are usually known or can be measured accurately. This has a lower thermal conductivity than air which provides high heat insulation. Thermal insulating sheets offer countermeasures against heat when combined with other thermal management products.

At roughly 1/10th of the thickness of standard insulation materials, thermal insulating sheet has the performance specs. The sheet is thin enough to add in to small package devices with high power requirements and the thickness ranges from 100um to 1000um. Wrapped in polyester tape, thermal insulating sheet adds flexibility to an engineers’ toolkit.

 Thermally Insulating Sheet

Thermal Insulating sheets are well known for high dielectric strength, flexibility, mechanical toughness and resilience. Suitable for wearable devices, smartphones and many other small electronic devices, the flexibility of the insulation sheet allows them to bent and used in narrow spaces. These materials can work together to create staggering results in both heat reduction and heat isolation at the same time. With a thermal conductivity rating of 0.015 W/mK whereas the thermal conductivity rating can go down to as low as .014 W/mK.

The insulation sheets are made by fibers and mineral materials with high mechanical strength with good insulation property. There are various types of insulating materials that offer specific thermal conductivity values that can be used to measure their insulating effectiveness. Tensan have different pads for thermal slution .It has flame retardant, high chemical and solvent resistant properties. Thermal Insulation sheets are widely used in the majority of electrical equipment applications. They are tested for their strength and durability during manufacturing process for better applications. Availed in various sizes and thickness, this has excellent resistance quality to heat.

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Startup Wichita Bringing connections and collisions to the entrepreneur, startup, and tech communities in Wichita, Kansas.

Startup Wichita

Startup Wichita began as a side project for a group of local developers to build a site that connect tech people in Wichita, Kansas.

When work on this site began to stagnate, Tortugas Consulting was brought in to continue the development. Security enhancements were made while also working on new feature sets.


July  11 - 13 , 2019

The Catcher
dir. by Cassie Guidry  / USA / 3 min.

A Soldier suffering with PTSD seeks the aid of a Dreamcatcher Weaver to save him from his nightmares.

by Graham Annable / USA / 6 min.

Working on the weekend can really blow.

Agent Bird
dir. by Ethan Yazel  / USA / 2 min.

Just another day's work for this avian secret agent. Bullet dodging, acrobatic, and a whole lot of waiting.

Clues & Socks
by Jonah Safer  / USA / 3 min.

When a sock goes missing under suspicious circumstances, Zak Huh?! and his team of animal investigators are on the case.

Home Grown
dir. by William Reynish  / Denmark / 21 min.

The 12-year-old girl Darya was once evacuated from a nuclear disaster, and now returns to her hometown to look for her father. When she arrives, everything has changed. The town is grown over by amazing nature, and wild animals have moved in. Darya travels down memory lane and in the overwhelming town she succeeds to find her father. But also he is completely changed and it forces Darya to leave the past behind her and try to adapt to a new world.

Animated Shorts

Shorts Block # 1

Screens Friday, July 6, 2018 at 3:00 pm

74 min. TRT

The Why
dir. by Ben Miller  USA / 14 min.

When a recent widower finds himself acting as a wingman to his deranged friend, he gets pulled into the meat market at the local YMCA. The YMCA is a surreal world full of hyper-competitive and super lonely retirees, and the widower finds himself torn between the desire to meet women before his diagnosis of impending erectile dysfunction becomes a reality, and grieving for his wife.

Mogu and Perol
by Tsuneo Goda  / Japan / 9 min

A story about two friends living on Yummy Island, where delicious food can be found everywhere! Whenever Mogu is cooking, Perol just pops up and eats the yummy meal. One day Perol finds a very tasty looking Brrrr-berry that Mogu was about to pick. Perol doesn't wait for a second to taste the berry which brings about an unexpected quarrel between the two.

Under the Walnut Tree
dir. by Leah Bedrosian Peterson  / USA / 6 min.

This stop motion animation is about a young boy who has been displaced during the genocide of his people. After wandering alone for days, he is ready to give up but fights to continue to safety.

by Meinardas Valkevičius  / Lithuania / 4 min.

Human activity does not always have a positive effect on our planet. The short animated film Look explores natural cycles of exchange between humans and animals. Dare to look and change the world.

Soggy Flakes
dir. by Jon Affolter, Thomas Affolter, Heath Affolter, Nathan Affolter  / Canada / 6 min.


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UCD Australian Studies Centre

Ionad Léann na hAstráile UCD

Australian History Modules

Modules on offer for 2017-18

The Centre run modules which draw upon the research interests of its staff. A 2nd year module provides the introductory basis for a broad engagement with Australian history, while a 3rd year module allows students to have a deeper engagement in the major historiographical issues and primary sources.

HIS21070: Australian History and its Afterlives

This module surveys the history of Australia since colonisation, and considers how key moments in Australian history have been remembered and debated in the public domain. Drawing upon contemporary commemoration, memorial and museum practices, its themes include: the history and memory of early European exploration and colonisation; the agency of indigenous people in national history; the frontier experience and race relations; the transition from self-governing colonies to federated nationhood; histories of migration; experiences of war; the shift to multiculturalism; and the changing nature of Australian identity in a globalised world. In doing so, it will compare representations of Australian history with other nations of the Anglo settler world, and consider some of the ways in which historical imagination is shaped both within and beyond Australia.

HIS31850: Contested Histories in Australia

This module surveys important controversies in Australian history, and situates them within a comparative context of historical contestations that have unfolded within other western democracies. Through a case study approach, students will engage debates about the place of history in the production of national identity, and undertake guided research and analysis of a chosen topic. Topics for consideration include: pioneer origins; historical evidence of frontier wars; the nature of the rule of law; the Anzac legend and Australia’s role in world war; indigenous rights; and Australia’s relationship to Europe and to the Asia-Pacific region.

 Previous Modules

HIS21010: Identity Culture and Politics: Australia and Ireland in the 20th Century

At the beginning of the 20th century Australia and Ireland  were, in effect, dependent colonies of Great Britain. However, during the course of the century they both developed into independent nation states. In doing so they often took different paths, despite their common heritage. This course examined the events and the processes by which this nation-building occurred in each country. The aim of the course was to provide students with an understanding of how Australia emerged after 1901 as a independent democratic nation by  comparing how it and Ireland responded to the political, cultural and economic challenges that their peoples faced during the course of the 20th century.

HIS31770: Home and Away: Australia at War 1914-1918

In 2014 we commemorated the centenary of the start of the First World War, a war that had a profound effect on the Australian nation. This course examined the conflicts on the battlefield, covering the major battles in which Australians fought, as well as the conflicts at home during this critical period in Australia’s history. The aim of the course was to provide students with an understanding of Australian defence policy before the war, the raising of the Australian Imperial Force and its performance during the war, the main battles in which Australians fought, the effect of the war at home on the social, economic and political life of the country, Australia’s role in the peace conference, and the consequences of the war for Australia.

HIS 20920 Australia's World

This unit examined Australia's relations with the world in the post-war era. It explored the historical themes which shaped Australia's response to a rapidly changing international environment: loyalties to race and empire; communities of interest and culture; the 'Free' versus the 'Communist' worlds; the rise of Asian nationalism, the alliance with America and Australian military engagements from Korea to Vietnam. It also investigated the making of Australia's foreign and defence policy from the 1980s to the present, including debates over engagement with Asia and the war on terror.

HIS 30340 Post-Imperial Australia: Into the Void

This unit examined the intersection between political culture and nationalism in Australia, with particular attention to the question of when (and if?) Australia became an 'independent' nation. Taking as its starting point the content and character of British race patriotism in Australia before 1945, it then looks in detail at the gradual unravelling of the British myth in the post-war period, and the attempts by successive governments, along with writers, pundits, artists and film makers, to find a new, more authentically robust idea of the 'nation'.  Among other issues, the unit explored the end of 'White Australia', the rise of multiculturalism, Aboriginal reconciliation and the rise and fall of republicanism.


Legal Issues When Conducting Workplace Interviews

Vince Scopelliti - Wednesday, August 29, 2018

legal issues

In conducting an interview process, key legal issues include:

  • The creation of statements
  • Audio recordings
  • Support person

Procedural fairness and privacy

  • Proceedings are not delayed unnecessarily.
  • All relevant witnesses are interviewed.
  • Exculpatory and inculpatory evidence is taken into account.
  • All evidence is considered in an unbiased and impartial manner.

tips for successfully conducting an interview

Analysing Evidence: The Key Step of Workplace Investigations

Vince Scopelliti - Wednesday, August 15, 2018

One of the most challenging and important tasks undertaken by a workplace investigator is the analysis of the evidence that has been gathered during the course of the investigation.

Key questions to consider include: What evidence should be contained in the investigation report? How do I analyse what I have gathered? How does this connect with the findings I make in the investigation report?

Here's how to effectively and transparently analyse the evidence.

WHAT evidence should be included?

There is a simple answer to this question: ALL relevant evidence collected in the course of the workplace investigation will need to form part of the analysis, the findings and the final report. The act of leaving evidence out without explanation can - intentionally or otherwise - indicate a lack of thoroughness or even worse a prejudgement about a fact in issue. A piece of evidence might ultimately prove to be of little consequence, but this should be at least acknowledged and noted. So if in doubt don't leave it out.

Exculpatory and inculpatory evidence

One way to begin marshalling material is to consider if the evidence is exculpatory or inculpatory. If we think of the allegation in question - let's say sexual harassment in the workplace - we can begin to analyse the evidence in terms of those items that most likely indicate that the conduct occurred, and those that point to the opposite conclusion.

Evidence that indicates or tends to indicate that something occurred is known as inculpatory evidence. Conversely if evidence vindicates or tends to clear the alleged harasser of the wrongdoing, then this is known as exculpatory evidence.

It is unlikely that you will have two neat piles from the start! However, this formal approach to organising the evidence can assist in creating a logical report that withstands future scrutiny.

Analysis of the evidence

For each piece of evidence examined, investigators need to determine how strong or weak it is in the overall context of the investigation. Strong evidence will be consistent, reliable and in terms of witness statements, believable, probable and credible.

Considering that a workplace investigation often reflects strong emotions and internal allegiances within the organisation, it is important to make an objective assessment of the reliability of statements made and items presented. Investigators will be on the lookout for statements that might be self-serving, or made a long time after the event in questions, for example.

Other factors to consider will be internal anomalies in statements or possible collusion between witnesses. An element of triangulation of the data will be required - the investigator is looking to detect where dubious connections indicate a weakness in evidence, or conversely where consistent evidence is noticeable across a number of different sources, including documentary evidence.

It is important to compare and contrast evidence from different sources: Which parts of the evidence consistently support the view that the events in question occurred and which indicate that it did not occur. Once this is done, the weight or value of each part of the evidence can be assessed.

writing up the analysis

Those new to workplace investigations can sometimes become daunted by the task of reporting on findings made. It is important to be clear about the methodology, about the manner in which the evidence was handled and how you have arrived at your findings.

Take a methodical approach, which will assist your own thinking as well as allow any reader a logical progression through the document. Some organisations will require the report to be set out in a particular manner and it is important to ascertain if this is the case.

Above all - make your findings clear. If your finding is that an event occurred, then state this clearly. It will be necessary to explain why you consider certain claims to be substantiated or where there is insufficient evidence to draw a conclusion on a contended point. This document could well be used in a number of forums including court and tribunal proceedings. It should be a reflection of the fact that the workplace investigation was fair, that all relevant evidence was considered and included, and that findings are based upon well-balanced evidentiary analysis.

A workplace investigation is a systematic process for establishing facts and circumstances surrounding a complaint or allegation. If you need assistance with conducting an investigation, or would like support in analysing your evidence gathered, WISE provides both supported and full investigation services.


International Synthesizer Day is May 23, the birthday of synthesizer pioneer Robert Moog.  Some of the first artists to use a Moog synthesizer were The Electric Flag, The Doors, The Monkee's and the Byrds. Trent Reznor of Nine Inch Nails talks about buying his first synthesizer at New York Music in downtown Youngstown. (THAT KICKS IN AT ABOUT 1:31 ON THE VIDEO)

  Organizers of the day say " The Synthesizers’ contribution to the world stretches far beyond that of a musical instrument; it has changed the way we construct and use instruments, broke the boundaries and limitations of the way we compose music and challenged our ideas of listening at large. It had become a major force in shaping the identity of the current generation, by contributing to the making of musical creation accessible to the masses.

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For this New Years 'Resolution Say "Cascadia"

For your new years resolution this year, rather than Pacific Northwest, or some other random name - use the word Cascadia!

From the wonderful mind of Ryan Moothart, author of Towards Cascadia.

“The number one obstacle to the growth of the Cascadia movement is very simple: awareness. A vast majority of people in the region simply don’t know what Cascadia is and haven’t heard of it in any significant context before. That’s a big obstacle that’s difficult to remove, but the solution itself is easy: make sure more people are aware of Cascadia.”

Cascadia is a regional identity created by those who live here, and it happens when people know the bioregion, and self identify with the idea, the values and place. As a grassroots movement we are all working to build it. And for only a second of your time, you can do something about this.

This year, for a new years resolution, when anything regarding the “Pacific Northwest” comes up, say “Cascadia” instead.

That is literally all you have to do and it will have a very real impact. By doing this, a topic of conversation goes from this:

Other Person: “We’re getting a lot of rain recently. More than usual for the Pacific Northwest.”
You: “I don’t mind. It helps keep the Pacific Northwest green.”
Other Person: “True.”
[End of topic]

To this:

You: “I don’t mind. It helps keep Cascadia green.”
Other Person: “Cascadia? What’s that?”
You: “Cascadia. It’s the name for the Pacific Northwest. It’s here. It’s us.”
Other Person: “Why not just say ‘Pacific Northwest’ then?”
[Expand upon importance of Cascadia]

In this example, you’ve just introduced someone to our region’s name and explained why it’s important. That other person is now aware. Maybe s/he becomes intrigued and wants to know more, maybe s/he doesn’t. Often times, someone might not resonate with the idea until the conditions are right. Maybe it takes a few years, maybe a few months - or maybe it never clicks. Regardless, you can bet the term “Cascadia” is going to come up again for this person in some context and s/he won’t remain ignorant or just cast it aside; s/he will remember than time you mentioned “Cascadia” and what it meant.

But why is it so important to use the term Cascadia?

Names are incredibly important. They are signifiers that express relationships and power.

Cascadia Sightline Map Small.jpg

The Pacific Northwest is a term that describes our relationship to a political center thousands of miles away. Rather than names representing far off people or places, Cascadia highlights the importance of the water we all rely on, and the cascading cascades as the the first drop hits the ground, through evergreen forests and desert canyons, as it journeys on its way to the eastern rim of the Pacific Ocean.

Just as it’s a new name, it gives us a new opportunity to forge something new, something positive together, from a culture rooted in place and the shared values that arise from sharing our home. Just as the people who have lived here for thousands of years, Cascadia is an opportunity to connect to the practices that have thrived, developed and adapted from this region, break down the ones we find negative, and forge a new shared vision for what is possible.

“Where are you from?” she asks. “From the Northwest,” he replies automatically, without thinking. Then she shoots back, “Northwest of what?”

So, in 2016, commit to this: replace “Pacific Northwest” with “Cascadia”. The more you say it, the more natural it becomes. It’s important and empowering. We’re more than just a distant part of the United States and Canada. We have a unique region based in environment with a corresponding identity that the rest of continent does not possess. The more you say “Pacific Northwest” after acknowledging this fact, the more you reinforce the notion that we don’t matter. So, say “Cascadia” instead.

Have a happy and safe new year. Be part of the change Cascadia needs.

A big thanks to Ryan Moothart and his original post from 2015 to say Cascadia this year.


Ethernet Switches

Industrial Ethernet Switches are used in control panels and machines to allow multiple Ethernet devices to communicate with each other. We provide a large selection of Industrial Managed and Unmanaged Ethernet Switches, in both metal and plastic cases. They are very robust in harsh industrial environments and they can survive in extreme temperatures.

Industrial Ethernet Switch Application Diagram


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Responsible artificial intelligence

  • #Artificial Intelligence (AI)

As Artificial Intelligence (AI) systems are increasingly making decisions that directly affect users and society, many questions raise across social, economic, political, technological, legal, ethical and philosophical issues. Can machines make moral decisions? Should artificial systems ever be treated as ethical entities? What are the legal and ethical consequences of human enhancement technologies, or cyber-genetic technologies? How should moral, societal and legal values be part of the design process? In this talk, we look at ways to ensure ethical behaviour by artificial systems. Given that ethics are dependent on the socio-cultural context and are often only implicit in deliberation processes, methodologies are needed to elicit the values held by designers and stakeholders, and to make these explicit leading to better understanding and trust on artificial autonomous systems. We will in particular focus on the ART principles for AI: Accountability, Responsibility, Transparency.

Speakers in this session

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How to Convert Audio to Sheet Music

By Matthew Anderson ; Updated September 15, 2017

Things Needed

  • Song recording
  • Staff or tab paper or a sheet music program
  • Audio player (ideally one designed for music transcription)
  • Headphones (optional)
  • MIDI program (optional)
Convert Audio to Sheet Music

Transcribing in music refers to both listening to a song and writing down the score or adapting a song into sheet music for a particular instrument or ensemble. The process for either is the same, and often it is easier to make an adaptation after writing out the original score. Depending on the complexity of the song, this can be a fairly long process. However, with methodical work, it is not a particularly difficult task. Transcribing songs also provides insight into the songwriter's thought process in writing the song, as well.

Determine the basic song structure. Find out what order the sections (verse, chorus, intro, etc.) go in and how many musical bars are in each. Define these sections for the full song out on the sheet music of the transcription.

Transcribe the percussion track. Isolating out the lower EQ sections can be helpful. Having this section done first gives a skeleton to the transcription and is helpful for getting the note durations in other sections.

Transcribe another instrument, but be sure to choose one to focus on at a time. Adjusting the EQ and balance on the player can help to isolate that instrument. Since each instrument has its own pitch range and balance on the recording, these settings need to be played with.

Transcribe each instrument one at a time until the score is completed. Usually it is a good idea to go from simple to more complex, but this varies based on the song and transcriber.

Test the score out against the track to make sure there are no discrepancies. Alternatively, the sheet music can be programmed into a MIDI program and played to see if it sounds correct.

Adapt the major parts of the song to a desired instrument or ensemble if making an adaptation. Depending on the nature of the adaptation, the parts used in the transcription can vary. The main melody and basic bass line will almost always be used.

Most commercial sheet music or scores are not exact transcriptions and are usually simplified. However, these can be very good starting points and greatly speed up creating a more accurate transcription by providing the basic information about the song.

MP3 files are smaller in size than CD tracks because the audio is slightly lower quality. This difference might not be noticeable while listening to the song, but when transcribing it, there might be some issues as you isolate parts of the song. Often it is better to use a CD track than an MP3 or at least increase the quality of the MP3 file being used (programs that rip CD tracks usually have a quality option).

Each ear interprets sound slightly differently. Sometimes switching your headphones around or playing one side of the stereo in both ears can be helpful.

About the Author


Starting something new…

arms_open_by_waitingforemma-d4chrhkArms Open by ~WaitingForEmma on deviantART

For several years now a project, an idea, has been brewing in my mind. A growing desire to create a space for something that I need, while providing that same space for others who may also need. All the way back in 2011 when I wrote “Carving out more Worship”  it was this new space and project that was on my mind. Now I am literally days away from enacting it. 2013 it seems, is the year of fulfilling a lot of promises, and making vows.

As those of you who read this odd little blog may know or at least summize, I am a public priestess. For several years now I have worked with CAYA Coven and the Bloodroot Honey Priestess Tribe putting on countless rituals. No literally countless, I have loss track. Our Coven puts on 8 sabbats, 9-13 full moon rituals, 8 pan-dianic sabbats, and a smattering of other rituals in the minuscule inbetweens. Learning ritual coordination and creation in this dynamic group with Yeshe Rabbit’s excellent example has been one of the highlights and true blessings of my public priestess path.

Even with all those rituals, and the calendar year packed, I still felt little tug that something was missing. See CAYA rituals are fantastic, and dynamic and always changing. Always learning. With all those people with their different ideas, paths, and ways the stream of creativity is truly astounding. But on the flip side CAYA rituals are eclectic, and interfaith and most the time do not speak to my specific path. They certainly fulfill my community needs but I knew that I would eventually need to be more of a public priestesses for my gods specifically, in some way.

When you are elbow deep in public ritual it’s hard not to start creating your own, imagining different flavors you would try, the things that are important to you, the things you would probably not do. And as a Celtic Polytheist who has yet to experience a Celtic-centered ritual that she was truly happy with, the thought “put up or shut up” began to circle round and joined forces with another reality.

In the Bloodroot Honey Priestess Tribe every HPS is expected to create and maintain a project that benefits and brings forth the Divine Feminine into the world. These are our Legacies. For the past two years my Legacy was High Priestessing the Goddess Sabbats that the Tribe put on. That meant maintaining, coordinating, and helping wherever needed with the 8 sabbats we put on every year. The “put up or shut up” had teamed up with a whisper of  “what if you did your own rituals for your Legacy?” The threads began to come together.

During my many Dark Moon outings with Temple Witch to our beloved beach another tugging became known. That of the soul satisfying rush of worshiping outside. There are many pagans whose path is not nature based, I’m not one of them. The three realms, Land, Sea, and Sky, and the mysteries and balance found within them are things that get my blood up. Nothing so easily puts me into alignment than being in the alignment of the realms. It feels whole and right to create a relationship with the local places. To see the subtle changes of a place. To notice when people have been less than kind to it, to do what you can to make amends (cleaning up trash).

Another layer, perhaps the most eye opening layer, was the freedom that came with worshiping freely within the eyesight and earshot of whomever. Creating the normalcy of it all.

I have to say I am damn lucky to live in the part of the country where that is even possible. Where no one intrudes and asks what I’m doing while bent over intently by my serpentine rock altar.  And while a few eyebrows may be raised as Temple and I wander out into the cold waves with out silver chalice singing our songs and laughing, no one heckles. No one shouts. There is no danger.

That’s simply not true everywhere.

In Florida, Kyjra Withers has been experiencing escalating attacks on her home.  While it there is no official stance on who or why, but evidence seems to point to her being targeting for her being an out witch. It’s sort of hard to imagine such things happening now and in this country. Especially when you live in a liberal area, and work at a metaphysical store, and in general have never experienced any harassment for being a pagan.

The knowledge of this inspires a sense of responsibility in me. That this freedom, that should be available to all, needs to be utilized, cared for and nurtured. Because it needs to be protected. It needs to grow.

Thus were the small pieces that came together and became a vision for rituals, for a platform that I’m calling the Temple of the Open Sky.

The Temple of the Open Sky is founded on the belief that freedom of religion is a right that needs to be practiced when and where it can be. Here in the SF Bay area we are privileged with a freedom from fear of retaliation for outward expression of differing religious beliefs that is not found elsewhere in the USA, let alone in the World. It is this truth that brought forth that need to create a space where the Gods names were spoken outside of closed doors, without hiding, witnessed under the open sky.

In that vein, the Temple of the Open Sky seeks to create a platform for pagan worship and devotion that is supportive of the many and varying methods of finding the divine. To create a safe container, free from shame, to be out in the world with our spirituality.

For me being a Celtic Polytheist, and the founder of these rituals, it means that for now the rituals are going to be Celtic-centric. I’m not aiming for reconstructionism  but for culturally founded and modernly adapted. But the underlying goal is creating a space for authentic expression of worship and normalization of that worship. In the future I hope that other priests and priestesses in the area might wish to share their rituals, and speak their gods names aloud for all to hear.

An important aspect of the Temple is once again bringing feasting into ritual space. It’s not an easy aspect to work in modern times, especially in public rituals. While it would be easy to host a ritual and feast for a small party in a home when you know how many guests you are expecting, opening things to the public complicates matters. Dietary needs, and just the basics of feeding an unknown number of people quickly turn the idea to a dream out of reach. But the feast is such a central part of the Celtic celebratory ritual, and is the part that I  long for the most. Food being a central foundation of my practice. If we release the idea of trying to feed an unknown number of people without a budget and acknowledge the fact that we will be outside away from a kitchen anyways, an obvious solution presents itself. Picnic! A completely acceptable and long held American tradition, easily rolled into pagan worship. That simplicity really is the structure that I’m building on and hope others will enjoy as well.

But for now it’s just me, which means all Celts. The first ritual is scheduled for this coming Saturday and will be a devoted to Brighid. The next will be in June or July and devoted to Manannan Mac Lir. August or September will be in honor of Epona, and we will end the year feasting to the Dagda.

I plan on posting more about the process, how each of the events go, and even the outlines should anyone be interested in them.

Gotta say I’m a little nervous. But I know this is what I’m suppose to do.

Sacrifice, Food, the Gods and me

Celtic sacrifice by immersion, detail of the Gundestrup Caldron, c. 1st century bc; in the Nationalmuseet, Copenhagen.

This is one of those posts that have been a long time coming. It’s one of those hot button topics in Pagan circles, and please go ahead with the knowledge that as with everything on this blog, this is all my personal spiritual belief system, disagreements, questions, points of contention all welcomed. What sparked this post was a post that came across my dashboard on Tumblr and the discussion that followed (you can read the original post here if you would like). I stand by all that was said there but want to expand further, past a simple conversation between two disagreeing people. To the different notions of sacrifice, to our societies inherent disvalue of food, to how that just does not work for me.

Cursory use of the internet to find the root of the word sacrifice tells us that it wasn’t until recently that it became attributed to “doing without something” or “giving something up” which tends to be its common association today. An association that continues to be retrofitted to ancient peoples and society, and perhaps wrongfully so. With this common societal association comes what appears to be the mainstream point of view of sacrifice and offerings in the modern Pagan community: That is something given of value with intention to the Gods.

No arguments there. But that is a fairly broad and wide plank to stand on and does not hint at the foundation of “Why?” or even what “value” is. Here is where I see the arguments, and not without reasoning, that animal sacrifice is no longer valid. This argument is usually coupled with the idea that sacrifice is to the Gods of things you wish to have more of, and the assigned value that meat and animals no longer have any. It is both of these things that I take a severe left turn from.

For me sacrifice and offerings have long since past the stage of being only about ensuring things that I want. In the beginning I approached sacrifice with the same understanding of it being something that I was giving up for a greater purpose, but after several years of steady offering I’ve come to wonder if that is not just a remnant understanding of the word from a belief system that I do not hold with.   After-all it is Christianity that is choked full of its abstaining for the glory of God, of sacrifice bringing us closer to the Divine (whether this is a flawed understanding of Christianity I cannot say, but it is the prevailing one in my life). But is this a pagan thought process? Is this a Celtic one? Is this something that the ancient people of Ireland would have held with? I have to wonder. Or is this merely the point of view that I was raised with and never realized was coloring my perspective? I am going to make it a point this year to go back and see what I can find of pre-christian thought on sacrifice. But even without that academic knowledge I realize that I no longer view my practice in that light.

Offering to the Gods

Chicken Livers prepared as offering

 Whether it’s before my altar or within the glory and the presence of the Land, Sky and Sea, I do not sit and take pains over my offerings with the idea or feelings of humbling myself before the Gods. It is not an act of subjugation. Even at it’s most difficult and trying, it is something that I do with great pride and devotion. It is akin to the pride and care that I take in giving gifts to my friends and family, in preparing meals for guests, in prepping for a feast. All that times vastness of the stars in the sky. In short my friends, sacrifice and offerings are about hospitality and loyalty for me.  Hospitality and loyalty on the divine scale.

It then goes rather rationally that I never once stopped to question or even ponder over the fact that the majority of my offerings to my Gods were of a consumptive nature. More precisely food. Because what is the cross-cultural symbol of hospitality? The act in which we do for each other to show we care?  Sharing and giving food. We are mortal, without food we would die. This is a fact that is overlooked in American society but is still a fact none-the-less. It is an act of good will to feed the Gods and any spirit we wish to commune with. An act that is unique unto us. Obviously other tokens of offering are equally worthy, but no other offering besides food seems to be brushed aside so much on the internet at least.

I understand where the point of view comes from, but I feel like it is a iffy one. If I were to believe that the Ancient Celts were a bunch of mud-covered barbarians eeking out survival in the hill sides, then I can easily see how the privileged of today could lead you to believe the simple offering of bread and beer paltry in comparison to the days before.  But I don’t believe that, the more I learn about the Ancient world in general the more this view of third-world standard just doesn’t seem to hold. True, life and death were much nearer and dearer then. Yes there were those poor who lived like that. But I wonder more and more if it was in fact the majority. The Celts were people of trade, of commerce, of agriculture, of war. These things do not lend themselves to such a rudimentary thinking. If I were to follow that logic, “because we live in modern times and food doesn’t have the same life or death value, so it won’t have the same meaning”, then sacrificing or making offering of little handmade crafts and goods does not equate the same meaning either. In fact in order to equate the same meaning (the meaning that value is something that is crucial to the livelihood of the person) then the only fit sacrifice would be large sums of ones income or maybe ones vehicle.

Thankfully I do not hold to this notion of sacrifice, or to the lack of value to food. Anyone who knows me, knows that I HIGHLY value food. A value I believe that was shared by the ancient world. Because while there are many wonderful and beautifully made artifacts of monetary value that have been found that were ritually sacrificed, never has that eclipsed the offering of food.  But America is a strange place now, a place that does not value food and yet is obsessed with it. Obsessed with the over eating of it, of the process of making it faster and better, of reclaiming it, of any laundry list of things to do with it and yet…the FDA just announced it’s giving up on regulating antibiotic abuse in the meat industry, we have a meat and dairy industry that is abhorrent,  cities take the notion that home grown veggies are too ugly to look at and should be illegal, the government has allowed companies to gain a monopoly on seeds in the farming industry, process foods reign supreme, the young and grown suffer from horrible eating disorders, bizarre and unhealthy diets continue to make the front page in magazines around the nation. All of this leads to an atmosphere that it is no wonder a majority of people have an unhealthy relationship with food. But does all that mean that food has no spiritual value anymore?

Not to me. To me food will always be one of those basic building blocks of creation, of magic, of alchemy. We put the pieces together, all the ingredients, prepare it, consume it. And in turn it helps us grow, aids us in our self-healing, keeps us alive. On a spiritual level it brings us together, creates bonds, symbolizes and holds up so much of cultural structures. There simply must be power in it. Being the somewhat animist I am it goes to follow that the more hands on, the more connected with it (as with any offering) you can get, the more strength and power it has. It is why all my food offerings are made with as little processed food as possible. It’s why when given the chance to go and make offering to the fruit trees and harvest the fruit myself before making it into bread or otherwise, I JUMP at the chance. It enhances the magic, it enhance the relationship, the connective thread of hospitality. From there it is just a small and tiny jump to wanting to be able to prepare and see through the process of life and death for my meat and for my Gods. There is a mystery, an initiation that comes with seeing the cycle of life and death through. Of taking it into your body, of being the one responsible for insuring its sanctity and humane nature. It is one of my goals in life to live in such a place that is possible. Now I can see how if you did not eat meat, for whatever reason, that then the act of animal sacrifice and offerings of meat would follow to be irrelevant to your practice. But to those who eat meat and still say that animal sacrifice is meaningless and invalid today, to me are also saying that offering and sacrifice of food is meaningless and invalid. I simply cannot agree.

Obviously these principles of offering, of sacrifice, are deeply sacred and personal things.  They should be considered at length and frequently. At the moment I am content and solid in coming to this understanding of sacrifice separate from the one that prevailed before. It brings me great feelings of rightness to know that my sacrifices are not made solely under the pretense of need on my part or my deities part. But out of joyful devotion to them, and reciprocated respect.  That I accept the fact that I eat meat, that my Gods enjoy it as well, and that when the time comes I am willing to see that through to its end. I continue to hope and strive for a world where traditions and faiths that can practice their values (that are within just laws) without recourse. And that in the end we come to an understanding of letting people worship what Gods they will.

The Value of Money

Had an interesting experience that lead to an interesting thought the other day. I work in a metaphysical shop, whose patron deities are some of the Orisha. Not a pantheon that I work with personally, but certainly one whose energies I’ve come to recognize. The Orisha are very popular in my community so it was kind of hard not to.  I admit that at first I was a little afraid it would be weird lighting their candles and tending their altars at the store regularly. But quickly came to find that polite reverence is a welcomed thing.

One day when I was working a got a particularly odd phone call. The short of it was that someone was wanting me or someone at the store to help them put a curse on someone. It was a person that didn’t seem to understand no and got off the phone saying they would come explain it to me in person. Okay…

Now I was not and am not opposed to telling people that we aren’t that kind of store and send them on their way.  But I was on my own that day and being the general prepardeness kinda gal I realized that it would probably just be all around better if said person didn’t find the time to make it to the store. So I light up some delicious sage, do the rounds, and decide to grid some black & brown tourmaline on doorway. It was in putting those pieces down that I took note of Papa Legba’s altar, sitting there happy as you please.

Due to his immense popularity in my social circles, I’m sure in part to him being the gatekeeper of his people, I’m not completely ignorant of his likes and dislikes. And while some people attract Trickster gods, or storm deities, throughout my life it’s been the Chieftains/King/Father Gods that take a shine to me (and I am not complaining one wit). So the thought of asking Papa for help shielding his store was not uncomfortable to me.  But what to give as an offering?

This is where I have one of those moments of realization that investment in a pack of cigarettes or smoking tobacco to just keep in my purse as emergency offering material  is a brilliant idea. But alas no tobacco, and being at work no alcohol either. Standing there staring at the jovial candle burning I’m hit with the smell of spices. I could easily go to the herbs and find something appropriately spicey and it may very well work as it would be an offering from the store on behalf of the store, yet I’d still like to offer something of my own and I don’t even have a stick of cinnamon gum on me. Meditating on his altar I see the glint of copper and remember. I’d witness many of his followers make offerings of change, and I knew that his number was three. Problem solved I went and dug out three of my shiniest pennies, asked him to watch the store front and asked to set that person on a path elsewhere. Feeling better I went on with my day, and said person never showed up on my shift. I’m fairly certain they didn’t show up at all.

But the whole thing got me thinking about money and offerings.

What a person offers to a Deity, spirit or otherwise is usually dependent on historical precedent, personal experience, and to some extent common sense. It’s fairly easy to know what to give to the Deities that we are familiar with, live with, or worship. Less so to those outside of our sphere. There is historical precedents for leaving money as offerings for most ancient cultures. There is certainly precedents for money as offering for the Orisha, most of the altars that I have seen for them have various amounts of money on them. Everything from high dollar bills to the humble penny.

But I have to admit it was the first time that I had ever given money as an offering. My gods had never asked or shown an interest in money for an offering. In fact the idea kinda tasted sour in my mouth.

 But why? It’s not that there isn’t historical precedence for it. The Celts are generally agreed to have worn their wealth. With Ireland specifically having traded and dealt with specific weights of gold and silver rings or bracelets. The finding of such rings and bracelets in bogs and under standing stones throughout Ireland sets the stage for money being an appropriate offering.

But perhaps the hitch is in the details.  In Ireland gold was relatively abundant, and in Britain and other sectors of the Celtic world money-rings were made of gold, silver, iron, and copper. All metals with power and energies. Metals that we, as human beings have been attracted to since discovering them.

Comparatively money of today, in America seems paltry. Coins are a combination of (VERY SMALL amounts) Copper, Zinc, and Nickel. Coinflation is a website that gives you the melt down value of your coins. It’s kinda eye opening. Then there is paper money, which in of itself is just paper that we as a society have assigned value to. We could make the argument that all money, even gold and other precious metals are assigned their value based on society. But that argument is going to get us no where fast. For me at least the precious metals hold a certain energy that our modern base metals don’t. Just as plastic doesn’t ring energetically for me.

It may be in part that my Gods worship did not follow into modern day as others have. So modern money’s value isn’t apparent, I’d imagine if I were use to gold cache’s as an offering suddenly being presented with a $20 would be confusing. In the same way that I try very hard not to make offerings of processed foods because it just seems to have less spiritual value to them.

I guess it comes down to preference. Whether or not the symbolic value of modern money is important to you and your deities, or if it’s more about the spiritual value of the materials. Overall it was a very interesting thing to think about lol, and I’d love to hear other people’s take on whether or not they find modern money to be a good offering for their deities.

Penny for your thoughts? lol

The Heart of the matter

At some point in the future I’m sure that there will be a post that does into the nuts and bolts of what exactly it is that I believe and what I practice and how that differs from my public priestessing. I have no doubt on this. At the moment however this is not that post. So instead I’ll just give you the bits you need to know.  I’m a Gaelic Polytheist, I believe in many gods, I came to reverence of the gods of the Irish pantheon through the reverence of ancestors. As such the act of offering in worship has always been a corner-stone of my practice. Little things, big things, singing while cooking a meal and offering a portion. Water on all the altars. Bread, flowers bought and picked, artwork done in honor. Honey, coins, the list goes on and on. The change came when we moved out to the Lodge. Living out in the country, above a horse stable, I suddenly felt more connected to my gods than ever before. Being able to step outside and feel dirt, see creatures, plants everywhere. Doing ritual outside I felt more charged, more power in the connection. I started leaving offerings outside more and more, making little shrines to the creek sprites and the crows. With these offerings came little gifts,  feathers, bones, a gnarled branch of oak, horse hair. The power and the beauty in these natural things really took my breath away. I’ve always been a little averse to artificial things in spiritual practice but this really solidified it for me. Then came Samhain…lol

As I said I am a public priestess aside from my personal practices. With my coven we put on eclectic drop-in rituals for a diverse and thriving community. Our Samhain ritual is aspecting heavy (I believe that some people call it “Calling down”) and last Samhain I was asked to aspect Macha. For some good information on the various Macha’s in the Irish tradition you can start here. Another bit you need to know is that I am dedicated to the Morrighan, and I’m sure at some point I’ll have to go into how I see the Morrighan and work with her (is it a Title of  several goddesses? A triple goddess? Some combination thereof?), but suffice to say that I have and do work with all the names and goddesses that fall under the Morrighan name. It was in working with Macha that opened up a new look at what to offer, it had just never occurred to me before to give any of my deities meat, or blood. But it fit, a heart for Macha (ok in actual fact she wanted a head but that was trickery to get and I ran out of time). The quest for the heart brought its own revelations, on how ridiculous “butcher shops” are now a days (they don’t “butcher” anything other than a tenderloin into steaks) and the mere reaction the thought of raw meat as an offering garnered. But that first offering was the stepping stone to a deeper more fulfilling path and I haven’t looked back since. Even though I have since moved away from my peaceful Lodge and back into the urban world of the City, I still feel that strong connection. I just have to work a little harder for it.

Now I go to the sea. Where the land, sky and sea all meet and lay my offerings down after a climb over the mighty rocks to the perfect spot. This time it was a HIGH lofty rock jutting out into the sea, it was a glorious view from up there. Breathing in the clean air with a bit of adrenaline (it would have been very dangerous if I’d slipped climbing up) Under the watchful eyes of the Ravens, I pray, sing and loving prepare my offering. This time, since it was not only the dark moon but an eclipse,  it was a beautiful whole beef heart with homemade oatmeal drizzled with honey and mixed with yogurt, and my always offering of an apple, a token of my love and appreciation.  When I was done, turned to be greeted by the watchful gleaming eyes of the Raven Brothers. They know me well enough now to know that I have delicious for them and are impatient for me to leave, but not without swooping down gloriously close and showing off their beautiful selves.

I live for these days. The care and preparation that goes into deciding the next offering, gathering the items blessing and caring for them. The drive out away from the city in itself revitalizing. Then being there at the nexus where all the worlds meet. Watching the Ravens come in greeting, and the pelicans in the distance. Building a fire, having a simple meal, communing, worshiping. It is simple, it is glory.