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One of David Gorczynski's legs is shorter than the other, and he has finished last in every race during his three years on the Orchard Park High School cross country team. But that never stopped him from competing.
Neither did his other disabilities, including an autism spectrum disorder, keep him from reaching the finish line, where his teammates often wait to cheer for him.
"He was smiling every time he crossed the finished line, and everyone was clapping," said Jacob Eneix, last year's team captain.
But Gorczynski's fourth and final year on the Quakers cross country team is very much in doubt. Unless a judge intervenes, Gorczynski has run into an obstacle that will keep him off the team during the coming school year: a state regulation.
The state has refused to grant the 20-year-old autistic student a waiver to participate in the team sport again.
"David is part of a team. He is part of something. If the state takes that away from him, it would destroy him," Eneix said. "I like to think of Orchard Park cross country as a family, and it wouldn't be the same family without David. He is a great kid, and it would kill me if he couldn't run."
State education law permits a high school student to participate on school sports teams until the last day of the school year during which the student turns 19 years old.
Gorczynski, 20, was allowed to join the Quakers cross country team last school year under a waiver the state grants to students whose education has been delayed because of their disabilities.
Gorczynski will turn 21 in January, and he needs another waiver to participate in cross country during the coming school year. But state education law provides for a waiver for one year – not for a second year.
When Mary Ellen Gorczynski requested another waiver for the 2013-14 school year, the state Education Department told her and the school district that he could not receive a second waiver. So she has asked for a State Supreme Court ruling allowing her son to compete with the Orchard Park High School cross country team during the coming school year. She has sought an injunction preventing the defendants – the New York State Education Department, the Orchard Park Central School District and the New York State Public High School Athletic Association – from enforcing the age restriction.
Each of the defendants asked the court to dismiss the motion.
Mary Ellen Gorczynski declined to comment for this story.
But in an affidavit for court case, she said: "It is very important that cross country is an integrated activity where David gets an opportunity to socialize with nondisabled peers outside of school, especially as David's classes except for gym are with all special needs students."
Gorczynski's court papers contend that the decision not to grant a second waiver violates the Americans with Disabilities Act, the New York Civil Rights Law and the New York and U.S. constitutions.
"But for David's disability, he wouldn't be in this predicament," said Linda J. DeTine of Neighborhood Legal Services during a hearing last week before Justice John L. Michalski.
The state allowed him to compete as a 20-year-old, she pointed out.
"None of the defendants have given you any reason you'd treat a 21-year-old any different," she said.
Gorczynski has attended the high school since the 2010-11 school year, but due to his disabilities, he remains an ungraded student. The coming school year will be his last in the high school. He has participated in cross country for three years.
DeTine called his participation in the school sport "a wonderful model of inclusion."
The other members of the team have embraced him, she said.
'Our hands are tied'
Jill Yonkers, an attorney representing the Orchard Park Central School District, told Michalski the district is simply following a state regulation.
"It's not Orchard Park's regulation," Yonkers said. "It's nothing Orchard Park has done."
"It is a very sympathetic case, but our hands are tied," she told The News.
If state regulations provided for a second-year waiver, and Gorczynski met the criteria, the district would allow him on the team again, she said.
"If the regulation says you get one waiver, you get it," she said. "If it says two waivers, we'll do it."
But since the state regulations only allow for one waiver, the school district has done all it can do for Gorczynski, she said.
"Orchard Park gave all the relief it could last year" when he got a waiver to participate in the sport, she said.
In the court hearing, Yonkers countered Gorczynski's constitutional claim.
"There is no constitutional right to play sports," she said.
Renee James, a lawyer for the New York State Public High School Athletic Association, told Michalski that the voluntary association has "no authority to override" the state regulation.
Assistant Attorney General Benjamin K. Ahlstrom, representing the state Education Department, asked Michalski for a quick decision, given that cross country practice starts next month.
"The question is not whether you agree with the regulation or think it's wise," Ahlstrom told the judge. "The question is whether the regulation discriminates against those with disabilities."
Ahlstrom said the regulation does not discriminate and gives "equal treatment."
After hearing from the lawyers at Wednesday's hearing, Michalski reserved judgment.
Team embraces Gorczynski
Gorczynski is classified as a student with multiple disorders by the Orchard Park Committee on Special Education, which provides an individual education plan for him, according to court records.
Because of that plan, his participation in cross country "rises to a level of a right," said DeTine, Gorczynski's lawyer.
The Orchard Park High School cross country team has a no-cut policy, so he has been able to participate on the junior varsity team for all three of his high school years. And no other student has been displaced from the team because of his participation.
In meets, only the fastest runners' scores count, so no matter how long it takes him to finish a race, his times do not count and his last-place finishes do not count against the team's overall score.
In court papers, his running form was described as a "galloping gait" rather than running, because of his disabilities.
In her affidavit, Gorczynski said: "I have seen David interact with the nondisabled team members. They go out of their way to interact with him, and he responds very positively. Even David's first year on the team, the other boys and girls on his team would get permission from the meet officials to go back on the course after finishing their own races in order to 'run David in,' meaning they would run alongside him yelling encouragement."
And how does she know that he likes running with the team?
"David has sensory issues. He hates rain, he hates mud, and he hates wearing his wind breaker pants," she said in the affidavit. "David will run cross country in his wind breaker pants in the rain on the muddiest course without quitting. This is also how I know he really likes it."
Eneix, the captain, agreed.
"This kid has been running for as long as I can remember," he said. "I see it on his face: He loves it."
Because of his athletic achievements – he has broken the five-minute mile – Eneix signed a letter of intent to run cross country and track at Mercyhurst University in Erie, Pa.
But he and other teammates rooted for Gorczynski just as much – if not more – than anyone else on the team.
"He was part of the team, from Day One," Eneix said. "As captain, I wanted cross country to be a place kids could go and have the time of their lives and be accepted."
But the state regulation, for now, will keep Gorczynski from being part of the team again.
"That just kills me," Eneix said, that "they would allow that."
email: firstname.lastname@example.com


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The Markádia Camping is a natural park in the middle of Alentejo owned by a lovely Dutch couple who carefully planned the park and cared to keep it preserved for many years.
The park is located in the Odivelas Dam near Alvito and last year, during the month of July, we spent there our weekends enjoying this great place. We had great fun and my kids loved it, of course we will return this year for another set of great weekend getaways. Spending great time like this with the family is priceless, this will be on our memories for a long time.
Pictured above is a one of a series of Panoramas that I shot during our dinners at sunset. My robotic camera rig was shooting around while we where enjoying the family dinner at open air in this fantastic scenery, isn't life great?

subset: commoncrawl


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Intel's Sandy Bridge CPU architecture is set to hit mainstream PCs by 2011 and it will be known as 2nd Generation Core. The improvements over the current mainstream Core i7 series CPUs largely relate to media processing. The graphics processor and I/O components have been integrated onto the same piece of silicon as the CPU itself, and improvements have been made to Turbo Boost and power management.
Read PC World's full coverage of Intel Developer Forum 2010
Intel Developer Forum 2010 attendees flock around the star of the show: Sandy Bridge
Sandy Bridge uses a 32nm manufacturing process and packs in more than 1 billion transistors. It has four CPU cores, an integrated graphics controller and a system agent that includes a two-channel memory controller, a PCI Express controller (1x 16 or 2x 8 lanes), the connection to the south bridge (DMI) and a DisplayPort controller. All of these parts have been designed from scratch to be integrated on the same die rather than on separate dies in within the same package. This differs from the design of the current Core processors in which the CPU, graphics and memory controllers are in the same physical package, but located on separate pieces of silicon.
One of the benefits of having all of the CPU's components on the same die is that power sensors can rapidly change the way that power flows to and from those components, thereby lowering the overall power consumption of the chip. The graphics controller and the four CPU cores have their own variable power planes, but the system agent has a fixed, low-voltage power plane. The display agent has been taken out of the graphics controller and put into the system agent. Because of this, the graphics adapter can be put into a sleep state when all a laptop is doing is displaying images from a frame buffer onto a screen. In previous designs where the display agent was located in the graphics controller, the graphics controller could not be powered down in such a scenario.
2nd Generation Core Processor, block diagram.
A key feature of Sandy Bridge is a ring connection architecture that allows the integrated graphics processor to access the same last level cache (LLC) as the four cores of the CPU. The graphics processor can put regularly accessed data into the cache in a bid to increase bandwidth (by up to four times) and also to reduce the latency that is inherent when storing data in external DRAM instead. By finding data in the LLC and not having to constantly access DRAM, overall power consumption can be reduced.
Turbo Boost can provide more headroom than it does in the current Core generation. When required, the CPU can produce a burst of speed that is above the thermal design power (TDP) specification of the CPU, but only for 10-20 seconds. It's designed to give a short, instantaneous power boost when launching applications, for example, and then it tempers back to a regular Turbo Boost speed. The extra Turbo Boost kicks in after algorithms have determined the capability of the CPU, the platform's power delivery specifications, operating system performance requests and the current workload that's running. The CPU frequency will not be unnecessarily raised if the algorithm determines that a particular action won't yield a boost in performance.
Up to a dozen new 256-bit extensions in the 2nd Generation Core Processor are present to accelerate tasks such as photo editing and video processing. The new AVX 1.0 (Advanced Vector Extensions) are claimed to deliver over the twice the performance of current generation Core i7 products using SSE 4.2 extensions.
Full specifications and platform features were not disclosed but the message is clear: the 2nd Generation Core Processor is designed to be faster at performing media tasks while at the same time cutting down on power consumption.
Elias Plastiras flew to San Francisco as a guest of Intel.


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COLUMBUS | Columbus officials are considering a plan to build a public restroom beneath a bridge that would cost more than the value of many Georgia homes.
The Columbus Ledger-Enquirer reports that the project is estimated to cost $244,000, with almost $160,000 for the restroom itself.
The city Planning Department is expected to bring the proposal before the Columbus City Council Tuesday night.
If approved, the restroom would be beneath the Frank Martin Memorial Bridge.
Of the $243,861, the state Department of Transportation would pay 80 percent, or about $195,000. The city's portion would be about $49,000.
At least one city councilor has raised concerns about the price. Rick Jones, director of the city's planning department, said the difficult location and special materials to be used contribute to the cost.


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Microbial Life in Alkaline EnvironmentsCreated by Sarah Bordenstein, Marine Biological Laboratory
There are no precise definitions of what characterizes an alkaliphilic or alkalitolerant organism. Several microorganisms exhibit more than one pH optimum for growth depending on the growth conditions, particularly nutrients, metal ions, and temperature... Therefore, the term "alkaliphile" is used for microorganisms that grow optimally or very well at pH values above 9, often between 10 and 12, but cannot grow or grow only slowly at the near-neutral pH value of 6.5.
- Horikoshi, Koki. 1999. Alkaliphiles: Some Applications of Their Products for Biotechnology Microbiol. Mol. Biol. Rev. 63(4):735-750.
Microbial Life in Alkaline Environments
Mark Twain once referred to the alkaline Mono Lake as "nearly pure lye" and commented that it contained "nothing, in fact, that goes to make life desirable." 125 years later, scientists have shown that the lake is actually teeming with an abundant diversity of microbial life. Microbes have been found thriving in many other alkaline environments as well, including the slag dumps of the Lake Calumet region in southeast Chicago, Octopus Spring in Yellowstone National Park, and the East African Rift Desert.
Major Challenges in an Alkaline Environment
Cells face many challenges in an alkaline environment. Of greatest significance is the ability to maintain internal pH. If cells are to survive in an alkaline environment, they must make their cytoplasm more acidic to buffer the alkalinity. In addition, enzymes—both excreted and surface located - must be resistant to the effects of extreme pH. Finally, the pH gradient must be reversed to carry out ATP synthesis.
Survival in an Alkaline Environment
What types of adaptations allow organisms to survive these extremely high pH environments? While alkaliphilic taxa have been identified in each of the three domains of Life (Eukarya, Archaea, and Eubacteria), the bioenergetics of alkaliphilic bacteria are perhaps the best understood.Homeostasis in Alkaliphilic Bacteria
Internal pH maintenance is achieved by both active and passive regulation mechanisms in alkaliphilic bacteria. Cytoplasmic pools of polyamines and low membrane permeability are two modes of passive regulation, whereas sodium ion channels drive the active regulation.
In the first instance of passive pH regulation, some cells have been found to contain cytoplasmic pools of polyamines. Particularly rich in amino acids with positively charged side groups (lysine, arginine, and histidine), these cells are able to buffer their cytoplasm in alkaline environments. Low membrane permeability is another mode of passive regulation as it ensures that fewer protons move in and out of the cell.
Typically, protons enter and leave a cell via diffusion at about the same rate, therefore not having much impact on homeostasis in an extreme pH environment. Some alkaliphilic bacteria, however, have developed sodium ion channels that actively drive the entry of protons across the membrane, thus decreasing the overall pH of the cytoplasm.
- A sodium-ion symporter provides the mechanism for entry of Na+, which is an essential substrate for antiport
- Na+/H+ antiport: when there is a build-up of Na+ in the cytoplasm, it will be expelled in exchange for protons (H+)
Enzyme Stability
There is evidence that alkaliphiles have evolved pH stable enzymes; these are often used in the manufacturing of detergents.Reversal of the pH Gradient
Alkaliphilic bacteria compensate for reversal of the pH gradient by having a high membrane potential or by coupling Na+ expulsion to electron transport for pH homeostasis and energy transduction.
Industrial Applications of Alkaliphilic Enzymes
Alkaliphilic enzymes have many industrial applications.
- Proteases are used as detergent additives (detergent enzymes account for about 30% of total worldwide enzyme production) and in the hide-dehairing process.
- Starch-degrading enzymes, such as amylase, hydrolyze starch to produce glucose, maltose, and maltotriose.
- Pullulanaseis a good candidate for a dishwashing detergent additive.
- Cellulasesare used as laundry detergent additives.
- Xylanasesare a possible application in biologic debleacing processes (i.e., in pulp-milling factories).
- Pectinases improve the production of paper by making it high-quality, nonwoody, and stronger. They are also used in waste treatment.
Proteases are a group of enzymes whose catalytic function is to hydrolyze (breakdown) peptide bonds of proteins (also called proteolytic enzymes or proteinases; proteinase K is a common protease used in laboratory DNA extractions). Proteases are extracellular. They are capable of digesting insoluble polymers such as cellulose, protein, and starch. The products of digestion are then transported into the cell where they are used as nutrients for growth.
Alkaline proteases have an optimum pH greater than or equal to 9.0. They hydrolyze proteins and break them down into more soluble polypeptides or free amino acids. Alkaline proteases are the most widely used enzymes in the detergent industry. They remove stains such as grass, blood, egg, and human sweat. For an enzyme to be used as a detergent additive it must be stable and active in the presence of typical detergents ingredients, such as surfactants, builders, bleaching agents, bleach activators, fillers, fabric softeners, and various other formulation aids. While alkaliphilic bacteria are not the only source of alkaline proteases, Bacillus subtilis (neutrophilic) and Bacillus licheniformis (alkaliphilic) are major players in the detergent industry.
In addition to detergent additives, alkaline proteases are used in the hide-dehairing process, where dehairing is carried out at pH values between 8 and 10. These enzymes are also commercially available from companies.
Alkaliphile Collections
General Collection: Resources such as news articles, web sites, and reference pages provide a comprehensive array of information about alkaliphiles.
Advanced Collection: Compiled for professionals and advanced learners, this collection includes resources such as journal articles, academic reviews, and surveys.
For Educators: This collection includes activities, assignments, and reading materials created specifically for educators.
Additional Resources
For additional resources about Alkaliphiles, search the Microbial Life collection.


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Ben Liebenberg/NFL
Quarterback - Tom Brady
Huge surprise. The three-time Super Bowl champion and two-time league MVP might be the greatest quarterback ever. I guess you could say Brady's stiffest competition for this spot would be fan favorite Steve Grogan. But yeah, not much of a competition.
National Football League
Running back - Jim Nance
Nance was a hoss. I still remember the shock I experienced in reading the back of his football card and seeing that he ran for 1,458 yards in 1966. No one put up those kinds of numbers back then. Nance was the best RB in the AFL in '66 and '67.
National Football League
Fullback - Mosi Tatupu
Tatupu played tailback and fullback and was a special teams stud for New England. He ran under punts and kicks and ran the football for 13 years with the Patriots, leading the NFL in yards per carry (5.5) in 1983.
Aaron M. Sprecher/NFL
Wide receiver - Wes Welker
Welker has defined the relatively new slot receiver position with his incredible productivity. In six years with Patriots, Welker averaged 112 catches per season, earning a Pro Bowl nod in each of his final five campaigns in New England.
Mike Kullen/Associated Press
Wide receiver - Stanley Morgan
"Stanley Steamer" is the best true wideout in Patriots history. While Welker has made his living in the slot, Morgan could stretch the field or play the possession game. His 10,352 yards and 67 receiving touchdowns remain franchise records to this day.
James Rogash/Associated Press
Tight end - Ben Coates
What a great football player Coates was for the Patriots. The two-time first-team All-Pro posted seasons of 96, 84, 62, 66 and 67 catches from 1994 to '98, the most among tight ends in that span.
Gene J. Puskar/Associated Press
Offensive tackle - Matt Light
An anchor for the Patriots' Super Bowl teams of the early 2000s, Light protected Brady's blind side for over a decade. With three Super Bowl rings, three Pro Bowl nods and a fine reputation as a reliable player, Light was an easy choice.
Gerald Herbert/Associated Press
Offensive tackle - Bruce Armstrong
A 14-year starter in New England, Armstrong suited up in 212 regular-season contests for the Patriots. He made six Pro Bowl teams and started Super Bowl XXXI.
National Football League
Offensive guard - John Hannah
Perhaps the greatest offensive lineman ever, Hannah was anointed as such on the cover of Sports Illustrated in 1981. He was a seven-time first-team All-Pro, even earning the honor in his final season (1985), which also saw him start in Super Bowl XX.
Ric Tapia/NFL
Offensive guard - Logan Mankins
Nine years into his NFL career, Mankins is still going strong. He's made six Pro Bowls while starting two Super Bowls. He was the very last pick of the first round of the 2005 NFL Draft, and is still probably the best ever taken at that slot.
National Football League
Center - Jon Morris
Morris enjoyed quite a start to his career in 1964, making the Pro Bowl right out of the gate for one of the AFL's best teams -- and he went on to make it the next six years, too. His legacy is underscored by recognition on the All-Time AFL Team.
Winslow Townson/Associated Press
Defensive end - Richard Seymour
Seymour was one of those rare breeds who could play inside or outside, in a 3-4 or 4-3. During his eight years in New England, Seymour made seven Pro Bowls, earned three first-team All-Pro nods and won three Super Bowls.
Associated Press
Defensive end - Larry Eisenhauer
He is a forgotten Patriot. What a D-line the Pats had in the '60s with Eisenhauer, Houston Antwine, Jim Lee Hunt and Bob Dee. Eisenhauer beats out Julius Adams for this spot by virtue of being a regular first-team All-AFL honoree.
Elise Amendola/Associated Press
Defensive tackle - Vince Wilfork
New England greatly missed Wilfork's services in 2013, as a torn Achilles tendon cost the five-time Pro Bowler most of the season. A 10-year vet, Wilfork is considered one of the best nose tackles ever.
National Football League
Outside linebacker - Andre Tippett
In the 1980s, two outside linebackers truly struck fear in opponents' hearts: Lawrence Taylor and Andre Tippett. The latter posted 35 sacks over a two-year period (1984-85) and made the Pro Bowl five times.
Doug Mills/Associated Press
Outside linebacker - Willie McGinest
McGinest's name has come up in Hall of Fame talk over the past couple of years, but at this point, being one of the greatest Patriots ever will have to do. He holds the NFL record for postseason sacks (16) and won three Super Bowls with the franchise.
National Football League
Inside linebacker - Steve Nelson
Nelson was the ultimate New England Patriot, playing through some of the best and worst times in franchise history during his 14-year tenure -- earning three Pro Bowl nods in the process. The club has him credited with a ridiculous 1,776 tackles.
Associated Press
Inside linebacker - Nick Buoniconti
Known to many as a Miami Dolphin -- by virtue of his role as a leader on the undefeated 1972 team -- Buoniconti developed his game in Boston. Buoniconti's presence on the All-Time AFL Team is mostly due to his time with Pat Patriot.
Dave Martin/Associated Press
Cornerback - Ty Law
Law was a master craftsman at his position, intercepting 36 balls in his 10 seasons with New England and generally establishing himself as one of the premier corners in the league. He led the NFL with nine picks in 1998.
Pro Football Hall of Fame
Cornerback - Mike Haynes
Haynes was as good as it gets at corner, as evidenced by his spot on the NFL's 75th Anniversary Team. He was named to the Pro Bowl in six of his first seven seasons -- including his rookie campaign -- before being traded to the Raiders in 1983.
Hans Deryk/Associated Press
Safety - Lawyer Milloy
Milloy opened up his NFL career with a fine seven-year run in New England, making the Pro Bowl four times while logging 26 takeaways. He also nabbed a first-team All-Pro designation in 1999. Milloy's leadership contributed greatly to the upset win over the St. Louis Rams in Super Bowl XXXVI.
Associated Press
Safety - Ron Hall
Perhaps the one guy on this team that even some diehard Patriots fans haven't heard of, Hall played the safety position at a very high level for the club in the 1960s. His 11 picks in 1964 are still a team record.
Keith Srakocic/Associated Press
Kicker - Adam Vinatieri
No one has made more big kicks than Adam Vinatieri. There is some sentiment that, in addition to being the top kicker in franchise history, he ultimately could get inducted into the Pro Football Hall of Fame.
National Football League
Punter - Rich Camarillo
One of the most prolific punters of his era, Camarillo booted the ball all over the park in Foxborough from 1981 to 1987. During that time he averaged 42.6 yards per punt and made the Pro Bowl in 1983.
J. Pat Carter/Associated Press
Returner - Troy Brown
Brown did everything in New England, from being a go-to wide receiver to playing defensive back to ... well ... returning kicks. He ranks 17th in NFL history in punt return yards and took one to the house in the 2001 AFC Championship Game.
More Photo Essays:
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- Best Photos from Week 6 of the 2019 Season


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Tricie necesitaba un nuevo diseño de logotipo y lanzó un concurso de diseño en 99designs.
Un ganador ha sido elegido entre 70 diseños de 31 diseñadores freelance.
I'm an experienced, passionate and energetic coach and facilitator. I'm looking for a logo that will grab the attention of professional women 35-55 years old, who are searching for a more wholistic approach to life - mind, body, spirit. They seek life balance; feeling of empowerment- choice; and take the opportunity to renew and reconnect with their inner wisdom in order to live life and work more authentically...Design a logo that will ignite JOY, PASSION, TRUST, EXCITEMENT AND EMPOWERMENT. Thank you
Wisdom in One
I'm currently going through a re-branding after being in practise for over 11 years. As part of this I have renamed my business in order to reflect the evolutionary process of my coaching and facilitation practise. My philosophy starts with having an approach to living that includes all our intelligences - that of the mind, body (physical), emotion, spirit (otherwise akin to inner wisdom). I'm looking for a logo that will ignite a sense of joy, excitement, empowerment, trust and passion. Strong but peaceful. A connection with their spirit - the inner wisdom that we all have but under-value because society values knowledge-based living so much more. A person has inner wisdom and a person connects with others through the 'synregy' that exists between all living things. My services particularly as a coach will take (women) clients on a journey of self-discovery and reconnection with their authentic-selves, which may be different than the self society has moulded them into. As a coach I am passionate about supporting women reconnect with their passions, their joys and their dreams. They can start a journey of self-awareness and self- discovery in order to make conscious decisions about their lives with vision.
- Vibrant yet peaceful colours
- strong confident feel without being too corporate
- a link with eyes( as the window to your soul??)
- wholisitc feel
- cosmic feel?
- goddess feel without being to alternative
- .
- no rainbows
- no flowers
- not gimmicks
Descubre cómo funciona un concurso de diseño u obtén más información sobre nuestros servicios de diseño de logo.


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Free Audio to download from Carrigaline Baptist Church.
You can either play the audio directly in your web browser (requires flash plugin to be installed) or else click on the 'download' link to save it to your computer.
Active filter: Book: 1 Thessalonians (x)
Book: Matthew (1), 1 Thessalonians (1).
Sermons (1)
|Be Alert, Keep Watch
|1 Thessalonians 5:1-11 (Part of the Exposition of 1 Thessalonians series).
|Preached by Jonathan Bateman on August 19, 2012 (Sunday Morning).
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Carrigaline Baptist Church Audio by Carrigaline Baptist Church is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License.


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High-heeled shoes are a fashion statement for many women. They define the calf muscle, make legs appear longer, and cause the buttocks to protrude slightly. While most women who wear high-heeled shoes know that they're not the most supportive footwear option, a new study shows that they have a much more profound effect than previously thought. Published in the Journal of Applied Physiology, a recent study shows that high-heeled shoes change the mechanics of walking in a habitual user, even when the user is walking barefoot [1].
Regular Use of High-Heeled Shoes Changes Mechanics of Walking
March 5, 2012 | by
Image credit: Walking in high heels via Shutterstock


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As we've noted countless times in this space, EMRs aren't going to get any better unless vendors and doctors communicate freely. But what about catering to the needs of patients. But given that by Stage 3 of Meaningful Use, EMR data will need to be accessible to and available for comments by patients and caregivers, it's time patient needs were taken into account.
In that spirit, here's my list of a few EMR features that might benefit patients and their caregivers. Bear in mind that this is me speaking as a patient and family caregiver, but perhaps that's a good thing.
Patient data needs
* Multiple views of the data: Doctors are used to standardized reports, but patients and their families will still be learning the game. Patients should be able to do pull data by history, by current status, by lists of drugs, allergies and other key factors affecting current care, as well as by a simple overview similar to patient discharge papers. It should be possble to pull down these reports into Word, PDF, Excel and other popular formats for re-use.
* Access to contextual data: Being able to fit data into a larger context is very helpful. As a caregiver, I'd want to know if the pulse ox number my asthmatic son was low relative to other asthma patients, particularly pediatric asthma patients. I'd also want to compare his current number to numbers from the past, preferably in easy-to-read chart form.
* Links to medical information: If I'm reading a report on my care, and I run into medical terminology I don't recognize, I should be able to pull up a pop-up window and search for the definition of that term. I should also have access to full-length reports on my condition — from validated sources such as WebMD — to give me a broad understanding of my care.
* Ability to comment on data and notes: While I realize this could become very time-consuming for doctors, it might be worth the trouble to give patients the ability to comment on elements of the data or notes. (A Microsoft Word-style comment function would probably be sufficient.) To contain the time doctors need to spend, comment functions could be constrained to medical notes and other areas where impressions could be clarified or corrected — rather than the entire EMR data set.
* Portal: Portals, of course, are on the way regardless. But I wanted to underscore, as the caregiver to two chronically-ill family members, that accessing data through an organized interface will be a welcome method for skimming key indicators and raising the questions I need to ask doctors.
* Mobile access: Another obvious one. Patients are as likely to access data on the road as physicians are. Patients need an adequate mobile app which offers a reasonable amount of access to key EMR data on a real-time basis.
Readers, what other types of data access do you think patients and caregivers need to participate effectively in care?


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Did you hear that gossip blogger Perez Hilton is a new dad? If not, here you go. Hilton has released photos on his website showing off new son, Mario Armando Lavandeira, III, who was born in February via a surrogate. (He's also showing off his pecs and abs in a number of the shots.)
Hilton talks about parenthood, being a single dad and turning over a new leaf in a new interview in the Los Angeles Times, in which he says, "I don't have to give people nasty nicknames anymore. I don't have to say people are stupid, or people are fat, or people are ugly. I don't need to draw inappropriate things on photos or out people. I can still be sassy and fun and do my job."
Hat tip to our colleague Dana Guhtrie at Chron.com for the photos.


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This year, 292 skiing Santas have registered at Maine's Sunday River
NEWRY, Maine (AP) � Nearly 300 skiers and snowboarders decked out in red and white are preparing to hit the slopes at Sunday River.
This weekend, the ski resort in western Maine is hosting its annual skiing Santas event. Spokeswoman Darcy Morse says 292 of them have pre-registered for Sunday's event.
The 13th annual Santa Sunday raises money for the Bethel Rotary Club's annual holiday toy drive.
Those who registered have to show up in a Santa outfit and donate $10 or more to the toy drive. Participants get to ski free for the day while also receiving another lift ticket good through Dec. 14.


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That shouldn't surprise you. The original Drake's Fortune set the bar for visuals and third-person adventures on the PlayStation 3. Uncharted 2: Among Thieves greatly improved on that, added multiplayer and climbed its way to the 2009 IGN Game of the Year award. Developer Naughty Dog spent the two years since then making bigger moments -- think platforming in a capsized cruise ship and surviving a cargo plane crash -- and working on the few complaints from the last title. Complaints primarily stemming from the fact that, to some, Uncharted 2 felt too much like the original Uncharted.
Uncharted 3's tale sounds familiar. We have the same cast of characters in our handsome hero Nathan Drake and his seasoned mentor Victor "Sully" Sullivan and the same general idea of a lost city that needs finding before the bad guys get there. But this isn't the games that came before. Uncharted 3's greatest strength is its unpredictability.
From the barroom brawl that opens the game and introduces its new melee system to a mid-game conversation between villainess Katherine Marlowe and Drake that literally redefines a pillar of this franchise, I didn't know what to expect in Uncharted 3. Naughty Dog sets aside the betrayal/twist formula used in the first two games and focuses on Nate and Sully's relationship. It takes you to the precipice of the Uncharted hallmarks you might expect, let's you stare at them, and then veers off in another direction.
Yes, the gameplay still revolves around climbing walls and shooting bad guys, but refinement found those mechanics. For the first time, the words "fun" and "useful" describe melee combat. Uncharted 2's clumsy stealth parts no longer exist. Running through levels and taking cover doesn't get old because Naughty Dog has done so much to merge the gameplay with the story, perfecting the pacing and making everything look fantastic in the process thanks to cutting edge graphics and excellent cinematography. The end product rises above what the buttons do and how you maneuver Drake. Calling it a game sells Uncharted 3 short. This is an experience, a complete package.
When I rant about why Uncharted 3: Drake's Deception
is better than just about anything on the market -- about why I think it's my new favorite game of all time -- I don't talk about the firefights, the new ability to throw grenades back at enemies or collecting the game's 101 well-hidden treasures. I talk about the heart-wrenching section where Drake is by himself and completely lost. He's on his last legs, he's desperate, and I'm right there with him. I'm pushing him through the journey at hand and it's clear that it's a game, but as he stumbles, seeks shelter and loses hope, my heart breaks.
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Uncharted 3: Drake's Deception - Game of the Year Edition - Playstation 3$19.90on Amazon
In a way, this is what Naughty Dog has been building to for the last four years. Players know the Uncharted cast. Most love the banter between Drake and Sully, the love affair between Elena and Drake or the one-liners Drake shouts to himself as the game goes on. Naughty Dog created a universe here that players feel connected with, but, again, the developers toy with that. They insert things that take the mentor/pupil relationship to another level. They flesh out backstories, they break bonds, and they make us face the characters' worst fears. And, no, those fears aren't clowns.
If you buy something through this post, IGN may get a share of the sale. For more, learn more.
In This Article
Uncharted 3: Drake's Deception Review


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The standard for the New England Patriots is impossibly high.
That's just the way it is when Tom Brady's your quarterback and Bill Belichick's your coach.
The preface is necessary because, through seven games of the 12th season of the Brady/Belichick era, it's clear that New England has issues, some more fixable than others. The Patriots are 4-3 now, in large part because of an inability to close games, and things could be worse if Willis McGahee and/or Stephen Hill did a better job hanging on to the ball in the fourth quarter.
Looking at this group on paper back in August, some folks thought 16-0 was possible. Then, the games started.
And while Brady himself has become a target for some, it's clear to those with a trained eye the problems reside in places other than under center.
"He's a damn good player," one NFC personnel executive said. "What's happened with him is the O-line is suspect, there's no consistent run game. And there's no one to run the deep routes. They've got the tight ends and Wes (Welker). So you can't stretch the defense, and that leads to pressure, and for any quarterback, that's not good."
A second NFC exec said, "I don't think (Brady) has slipped at all." An AFC personnel exec mirrored his counterpart in adding, "I wouldn't say he's slipped at all."
So, where's the problem? According to these guys, there are three primary ones: The team's secondary, the pass rush and the offensive line.
As the second NFC exec said, "The issue starts at corner."
New England tried to play more man-to-man in 2011; that failed miserably, and the corner situation hasn't changed appreciably since. The Patriots' best man cover guy is Kyle Arrington in a secondary built to play tough and, more poignantly, play zone.
"The pass game in general is very problematic for them," the AFC executive said. "They're getting no pass rush in some of these situations, and with the matchup situation and concerns in coverage, they've been exposed on the back end. They're better against the run than they were last year, but the liability remains there. You block them up -- the Jets went max-protect -- and the Patriots can't stop you."
Rookie defensive end Chandler Jones arrived to much fanfare, and has come through with five sacks in his first seven games. Even so, the pass rush still hasn't consistently applied enough pressure to cover for a lackluster secondary.
"The game has changed, you're in the nickel package a lot, and it's tough just to find two corners," the first NFC exec said. "If you're not getting pressure up front, it's even harder."
On offense, the second NFC exec flatly said, "It looks like they miss Brian Waters." The line hasn't been the problem some feared it would be in August, but it still has Brady seeing "ghosts" -- rushers that aren't there -- at times. The running game looks better on the surface, but has feasted mostly on defenses geared back for Brady or thrown off by a breakneck pace, and hasn't proven it can produce in have-to-have-it situations.
It's important to remember that the Patriots still rank first in the NFL in total offense. But that only makes the late-game stall-outs more perplexing. I asked Brady last week if it might be that, at this point, the offense lacks an identity, something to fall back on in crunch time.
"You're searching for ways to score points every week, and whatever you have to do to do that, that's what you fall back on," he told me. "It's gonna change week-to-week. You say, 'OK, this is what we need to do to win in Week 1,' and if you win, it's great. And if you lose, it's not so good, and you say, 'We gotta change that, that didn't work.' If you win, you say, 'OK, great, we have to do more of those things.' And hopefully by the 16th week of the year, you're at a point where you say, 'We've tried all these things and we've settled into what we do well.' "
For a group with plenty of returnees from a Super Bowl team, it's been the few changes that have made all the difference. The losses of Waters and Matt Light, and the spotty health of country-tough All-Pro Logan Mankins have been felt on the offensive line. And the transition at offensive coordinator from Bill O'Brien, whom scouts say liked to play an inside-out game, to Josh McDaniels, who's more comfortable playing outside-in, hasn't been entirely smooth.
Trying to turn Brandon Lloyd into a deep threat hasn't worked to this point. As the first NFC exec said, "He's not a RAC (run after catch) guy, not a top-end speed guy, and you don't worry about him running by you; if he's your third guy, you've got a receiving core." The AFC exec called Lloyd "an average No. 2 receiver." But the real problem here might just be something that, the Patriots would hope, naturally works itself out.
"I just don't think those two tight ends are healthy," the AFC exec said. "Those guys are the matchup guys. Outside the numbers, no one poses a real matchup threat. The biggest problem they pose is the tight ends and Welker; it's a middle-of-the-field offense. Once those guys are healthy again, they'll be good. They're moving the ball. I just think the tight ends need to be healthy."
Now, for some perspective. The Patriots are 4-3. Last year, they were 5-3 at the midway point, and didn't lose again until the Super Bowl. The way the schedule sets up, it's not all that difficult to envision New England going into a Monday night showdown with the Houston Texans in December at 9-3.
All of this, of course, isn't according to plan. But maybe Brady said it best in our conversation: "I mean, everyone thinks they have an idea of what they are at the start of the year. But sometimes you have to adjust to your personnel. The teams you're playing are different. You're searching for a way."
On offense, the Patriots still need find their way. On defense, they'll have to patch it together, like they did last year, with personnel problems that aren't going away.
When you add it all up, the Pats still figure to be there in January. How they grow now will decide what happens when they get there.
Players on the spot
Dallas Cowboys ILB Dan Connor: Losing Sean Lee creates an all-hands-on-deck situation for Dallas, starting on Sunday against the rival New York Giants. Defensive coordinator Rob Ryan has called Lee the defense's "brain." Bruce Carter takes over the calls and checks. Connor gets the snaps. One Cowboys official called Connor a "smart player. Not the same athlete, or as instinctive, but physical and tough. Sean Lee is rare, and hard to replace with one guy." Still, Connor will be vital.
New York Jets LT D'Brickashaw Ferguson: Last week, the Jets prioritized keeping Mark Sanchez's jersey clean, going max-protect often. Until the end, when a sack closed the game, they handled the Patriots fine. This Sunday's test is stiffer for Ferguson, facing turbo-charged Miami Dolphins rusher Cameron Wake. The blueprint to beat Sanchez has always been to get licks on him early. A division rival like Miami knows that well.
Seattle Seahawks CB Richard Sherman: Seattle's received attention for the size of its corners, but the guys running the team know there's a trade-off in quickness. If you can get off the line, you can test them, and Calvin Johnson isn't bad at shedding defenders. Sherman has dubbed himself "Optimus Prime" on Twitter this week, since he's covering Megatron. If he's equal to the task, the Detroit Lions could struggle with Seattle's D.
Pittsburgh Steelers ILB Lawrence Timmons: The sixth-year foundation block was integral to Pittsburgh's ability to slam the brakes on Mike Vick and the Philadelphia Eagles' offense three weeks ago. And if the Steelers are going to contain Robert Griffin III, Timmons is likely to play a major role as, perhaps, the only guy in that front seven who can run with the rookie dynamo.
Coaches in the spotlight
Arizona Cardinals offensive line coach Russ Grimm: It's easy to blame the quarterbacks for Arizona's three-game losing streak -- and the deficiency at that position is glaring -- but it's also not hard to realize how tough those guys have had it. The Cardinals have yielded a staggering 29 sacks over the last four weeks. Yes, they're undermanned. But with the San Francisco 49ers up next, they have to find a way to stick a Band-Aid on the issue.
San Diego Chargers head coach Norv Turner: I'm told the league hasn't found much to incriminate the Bolts in the stickum investigation. But after what happened 10 days ago, that'll hardly allow Turner to escape criticism. The Chargers are still in first place, but Denver's schedule is about to soften up, and the Bolts badly need a bounceback. If they fail to deliver that in Cleveland on Sunday, look out.
Something to spot on Thursday night
• Thursday, Dec. 13, 8 p.m. ET
• Watch on NFL Network and NFL.com/LIVE
Thursday Night Football Xtra
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The Minnesota Vikings' running game: Adrian Peterson exploded for 153 yards and a touchdown in last week's win over the Cardinals and seems to be rounding into shape, having exceeded 4.5 yards per carry in each of the last four weeks. The going gets a bit tougher on Thursday Night Football (8:20 p.m. ET), with the Tampa Bay Buccaneers' third-ranked run defense coming to the Metrodome. And it'll give us all a good gauge for where Peterson is at midseason.
Spot check
The Detroit Lions' defensive line: Detroit ranks 16th in the NFL against the run, but yielded 171 yards on the ground last week against the Bears. For a group loaded with talented, and pedigree, the defensive front has to do better than that in a big division game.
This week, they'll get a chance to make up for it, when they host Marshawn Lynch and the Seattle Seahawks.
Follow Albert Breer on Twitter @AlbertBreer.


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MARTINEZ — The sentencing of a man headed to Death Row for the 2009 Richmond-San Rafael Bridge toll plaza murders was postponed Tuesday because County Jail workers erroneously revoked the privileges he's afforded as a self-representing defendant.
Nathan Burris, a 49-year-old Richmond man, is now scheduled to be sentenced Jan. 18 for the Aug. 11, 2009, ambush killings of Caltrans toll taker Deborah Ann Ross, 51, and Golden Gate Transit bus driver Ersie "Chuckie" Everette, a 58-year-old San Leandro resident.
A Contra Costa County jury on Nov. 20 recommended that Burris be sentenced to death after convicting him of two counts of first-degree murder and special circumstances that made him eligible for capital punishment. Burris acted as his own attorney and presented no real defense. He was unapologetic about killing his ex-girlfriend and her friend because he suspected the two had become romantically involved.
As a so-called "pro per" defendant acting as his own attorney, Burris is afforded access to a law library and a telephone to maintain contact with his advisory counsel.
It is the policy of the Contra Costa County Sheriff's Office to terminate such privileges seven days after a pro per defendant is sentenced. In Burris' case, those privileges were revoked by mistake seven days after his jury reached its death verdict, Chief Assistant District Attorney Harold Jewett said.
"It's not my fault that I didn't have time to prepare myself," Burris said Monday at what was supposed to be his sentencing hearing. "This is against the Constitution."
Judge John Kennedy ordered the Sheriff's Office to reinstate Burris' pro per privileges and rescheduled the sentencing. The judge noted the delay is a hardship to all of the victims' relatives.
"We just want to have closure and move on from this," Ersie Everette's brother, Ron Everette, said while leaving the courthouse.
Contact Malaika Fraley at 925-234-1684. Follow her Twitter.com/malaikafraley.


text: 1956 was Elvis Presley's breakthrough year. Opening a time capsule to reveal the legendary performer on the brink of superstardom, this program captures the sights and sounds of that pivotal year using photographs shot on tour, kinescopes of Elvis' controversial TV appearances ("The Milton Berle Show," "The Steve Allen Show," and "The Ed Sullivan Show"), newsreel clips, and radio interviews. Features digitally remastered recordings of such classics as "Blue Suede Shoes," "Love Me Tender," "Ready Teddy," and more. Narrated by Levon Helm (The Band).


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It's okay to be quiet. You don't need to give the full report just yet, you may not need to give it at all. Reporting requires understanding, and sometimes you just need to follow the path and see where it leads before you know where you are.
It's okay to be quiet. You can declare your hope in a loaf of bread you bake by hand, you can put unnecessary things on the stoop as an act of faith in future provision. You can let the apple pie you're making invite company, and the space you're preparing for friends invite joy.
It's okay to be quiet. You can say all you really need to say with one look, with one touch. You can express your gratitude for his love in the way you smile when you see him come into the room. You can let them know how they melt your heart in the tenderness of your kiss on their foreheads.
The words are the last thing to arrive, but the love is here all along.


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Every day this week a shooting, lockdown or scare jolted five campuses across the nation.
5) Friday: South Carolina State University was locked down for several hours Friday afternoon after a fatal shooting outside a dormitory left one student dead. Authorities are searching for at least four suspects off campus, University Police Chief Mernard Clarkson told reporters.
4) Thursday: Columbine High School, where 12 students were killed in a 1999 shooting, was placed on "lockout" for several hours as police investigated telephone threats made to the school, in Littleton, Colo.
The lockout, which was lifted several hours later, prevented anyone from entering or leaving the school but classes remained in session.
3) Wednesday: A reported shooting at the University of Oklahoma prompted a campus lockdown, emergency text alerts to students and a police response. Authorities determined there was no sign that shots were fired and no reported injuries in what turned out to be a false alarm.
2) Tuesday: At Purdue University in West Lafayette, Ind., Andrew Boldt, 21, a teaching assistant, was stabbed and shot to death in an engineering building classroom. Cody Cousins, 23, a fellow TA, has been charged with murder in the killing.
1) Monday: At Widener University, a small college near Philadelphia, a student was shot and injured Monday evening near the campus athletic center.
University spokesman Dan Hanson told the Los Angeles Times in an email that "all indications are that this was not a random act of violence."
Over the last year, high schools, middle schools and even elementary schools have been crime scenes. Many students who arrive at college campuses today are familiar with lockdown drills, Times staff writers Molly Hennessy-Fiske and Matt Pearce reported.
Under federal law, police must notify campus communities of possible threats, sometimes before investigators have time to learn whether the threats are credible.
Alert lifted at Columbine High School
What's at issue in Texas battle over brain-dead pregnant woman
25 dead pilot whales found off Florida: 5 things to help understand it
Twitter: @saba_h


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SLOPOST is a charitable non-profit organization 501(c)3 encouraging parks, open space and trails in San Luis Obispo County.
Our Mission
Working for hikers, bicyclists, equestrians, runners, walkers, dog owners, trails, community parks, and enhancement of open space
To acquire, develop and maintain multi-use trails, including special trails for the handicapped, particularly where local government is slow to accept dedications.
To involve landowners, related organizations and the general public in parks, open space and trails issues.
To educate users to maximize their enjoyment and safety on multi-use trails.
To advise administrators of parks, open space and recreational areas within San Luis Obispo County.


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Programs & Centers
Alternative Dispute Resolution Program
Moritz Law is widely regarded as having one of the nation's finest programs in the area of Alternative Dispute Resolution (ADR). The program was established in recognition of the need for future lawyers to be trained in an array of dispute resolution methods beyond litigation, including negotiation, mediation, and arbitration. The importance of alternative dispute resolution methods continues to increase as courts explore other means of solving the volume of cases before them. ADR Program web site
Center for Interdisciplinary Law and Policy Studies
The Center for Interdisciplinary Law and Policy Studies at the Ohio State University's Moritz College of Law is committed to the promotion of interdisciplinary research, teaching, and public outreach designed to shed light on the nature and operation of law and legal institutions, as well as the impacts of law on society and culture. CILPS web site
Democracy Studies
The Democracy Studies series is a collaboration among The Ohio State University Moritz College of Law, the Mershon Center for International Securities Studies, the departments of History and Political Science, and other units at the University.
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Distinguished Practitioners in Residence in Business Law
The Distinguished Practitioners in Residence Program in Business Law course series was launched in the fall of 2005. This program brings to Moritz Law judges and practitioners as adjunct professors to teach one-credit, concentrated courses in advanced aspects of business law. Distinguished Practitioners in Residence Program web site
Election Law @ Moritz
Election Law @ Moritz is a web publication that covers developments in the law of election administration-- laws dealing with voter registration, voter ID, early and absentee voting, provisional balloting, poll workers and polling place procedures, recounts and election contests, and other related issues. Our primary target audience includes lawyers and legal scholars who focus on these issues, as well as journalists in the elections field. Through our work, we hope to help this audience better identify and understand the true issues confronting the world of election administration. Election Law @ Moritz web site
Judicial Externship Program
Ohio State law students have the opportunity to gain first-hand insight into the judicial system through the college's Judicial Externship program. As externs, students earn academic credit for conducting legal research and drafting legal documents for justices of the Ohio Supreme Court and for judges on the U.S. Court of Appeals for the Sixth Circuit; the U.S. District Court for the Southern District of Ohio; the Bankruptcy Court for the Southern District of Ohio; the Domestic Relations Division of the Franklin County Court of Common Pleas; and a variety of other Supreme Court commissions. Judicial Externships web site
Justice for Children Project
The Justice for Children Project engages in research and law reform while providing law students with exciting opportunities to explore the legal issues pertaining to children. Justice for Children Project web site
Kirwan Institute for the Study of Race and Ethnicity
The Moritz College of Law is a co-sponsor for the Kirwan Institute for the Study of Race and Ethnicity. The Kirwan Institute is a university-wide interdisciplinary research institute. Its goal is to deepen our understanding of the causes of and solutions to racial and ethnic disparities and hierarchies. This includes an explicit focus on Ohio and the United States, but also the Americas as a whole and our larger global community. Kirwan Institute web site
Law and Capital Markets
Law and Capital Markets @ Ohio State is a program of The Moritz College of Law at The Ohio State University. The nonpartisan program aims to further the study of capital markets and corporate law, to enhance their regulation and operation.
Master in the Study of Law (M.S.L.)
Moritz Law began offering a Master in the Study of Law (M.S.L.) degree in autumn 2004. The M.S.L. is designed for those possessing or pursuing a Ph.D. in non-law fields who wish to expand their expertise in areas of law germane to their discipline. The M.S.L. provides the opportunity for scholars and professionals in other disciplines to acquire both a background in legal principles and an understanding of our legal system. M.S.L. web site
Master of Laws (LL.M.)
The Moritz LL.M. program is designed for foreign lawyers who wish to advance their legal education in a stimulating academic environment. The College offers the dual advantages of a highly-regarded law curriculum at a major U.S. university and a LL.M. program of limited size that allows for individualized attention and support. LL.M. web site
Moot Court Program
During the first semester of their second year, all students must participate in the Moot Court Program by satisfactorily completing Appellate Advocacy I. In Appellate Advocacy I, students write an appellate brief on a case under the supervision of Professor Mary Beth Beazley and practicing attorneys. Students then argue their case before panels of judges, which may include faculty members, practicing attorneys and third-year students. Appellate Advocacy I is required of all second-year students. Students receive two semester hours of credit. Moot Court Program web site
Oxford Study Abroad
The Moritz College of Law offers three study-abroad programs in Oxford, England; a semester program, summer program and a pre-law program. Oxford Programs web site
Program on Law and Leadership
Established in the fall of 2007, the Program on Law and Leadership is the umbrella for all activities related to leadership at the Moritz College of Law. We are deeply committed to the idea that leadership education is a lifelong endeavor combining theoretical knowledge, practice, and applied skills. Program on Law and Leadership web site
Service & Public Interest Programs
The Moritz College of Law is fortunate to have a community of faculty, students, alumni, staff, and administration who continually develop new and exciting opportunities for community outreach and public service. Service & Public Interest Programs web site
Washington, D.C. Summer Law Program
Since 2003, approximately 20 students each year have had the opportunity to work in externships in D.C. accompanied by a high-quality academic program and a summer in the nation's capital. Read More on the DC Program


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This Indonesia Agriculture page provides a variety list of latest Indonesia Agriculture products, manufacturers and suppliers. Here you can browse all manufacturers of Indonesia Agriculture. Each of the keywords links to a variety list of latest Indonesia Agriculture products, manufacturers and suppliers. Browse keywords such as coconut, fertilizer, coconut fiber, organic, coffee and more in this popular Indonesia Agriculture category to find the best quality Indonesia Agriculture products.
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|SOURCE: CIA - The World Factbook
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|Petroleum and Natural Gas, Textiles, Apparel, Footwear, Mining, Cement, Chemical Fertilizers, Plywood, Rubber, Food, Tourism
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|Machinery and Equipment, Chemicals, Fuels, Foodstuffs
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|Japan 20.2%, US 9.5%, Singapore 9.4%, China 8.5%, South Korea 6.7%, India 5.2%, Malaysia 4.7% (2008)
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|Singapore 16.9%, China 11.8%, Japan 11.7%, Malaysia 6.9%, US 6.1%, South Korea 5.4%, Thailand 4.9% (2008)
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If you are preparing to add to your family through the process of adoption, there are a few things you need to know about taking leave after your little one comes home.
What you need to know
As most of us are all well aware, the U.S. falls pitifully low on the whole "providing adequate maternity leave for moms" thing. The Institute for Women's Policy Research breaks down just how bad we are doing, pointing out that the U.S. "is one of only four countries globally, and the only high-income country, without a statutory right to paid maternity leave for employees."
And while maternity leave is continually debated and discussed (although not really taken action on, one can notice), there is a whole other level to the maternity leave challenge — adoption.
Adoption in the U.S.
According to the Intercountry Adoption organization of the U.S. Department of State, there were 8,688 children adopted by U.S. families in 2012, with the overwhelming majority of those children at age 1 or younger. The Child Welfare Information Gateway published a 2008 report of adoption statistics, reporting a total of 136,000 children who were adopted in 2006 and 2007 alone — a number which includes both intercountry and domestic adoptions).
The study also found that adoption is on the rise — there was a 6 percent increase from 2000 to 2008 in adoptions across the board.
So with adoption on the rise and more parents growing their families through adoption, you would think that parental leave to care for adopted children would be a given, right?
Well, not exactly.
It turns out there are a few stipulations.
The rules about parental leave and adoption
First of all, according to American Adoptions, parents adopting domestically have to arrange a stay in the state that their child was born from anywhere to 7 to 10 business days in order to comply with the Interstate Compact on the Placement of Children (ICPC) regulation. So, not only do they have to arrange for maternity or paternal leave, but they have to add in the extra regulated days to ensure that they follow the correct adoption procedures.
Fortunately, when it comes to the legal aspect of maternity or paternal leave in an adoption, the federal law does not discriminate. All eligible employees are legally entitled for up to 12 weeks to care for a family member under the Family Medical Leave Act.
However, the big "but" with the FMLA is that it only applies to "eligible" employees — which, under the rules, includes very few U.S. workers. Not only does an eligible employee have to work at a place of employment that even offers FMLA in the first place, they also have to have been employed for at least a year and have worked a certain amount of hours to qualify.
And the biggest problem?
Any "protection" for parental leave offered under FMLA is not paid — basically, FMLA only guarantees that you can legally take 12 weeks off without losing your job. So if any type of leave will be a paid leave — whether for the birth of a child, the adoption of a child, or to care for a sick child — is solely up to the discretion of your employer.
For adoptive parents, who are already paying hefty fees for the paperwork and processing of the adoption, travel, and expenses, the lost income from missing work can be especially troublesome.
However much room for improvement there may be and laws pertaining to maternity and paternity leaves, one thing is clear — there is no distinction to be made between how much time is necessary to welcome a new member into your family.
As Melissa Reamer, a mother who adopted three children and whose husband took time off from his job to care for them says, "A new baby is a new baby!"
More articles on adoption
Adoption photos: The moment I became a mom
The realities of adopting from foster care
Helping your adopted child bond to you


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Special Opportunity today only! Due to some last-minute cancellations we have space available to publish new advertisers our website next week. You can promote your business, product or service. You can promote a YouTube Video, a Facebook Profile, your website, or any other social media accounts. The submission fee to advertise on our website is only $2 for a limited time. This is a massive 80% discount off of our normal listing fee! Submit your ad content for approval and our production team will immediately follow up with you to promote your profile on our website. This offer expires at 5pm so hurry and submit your info now!
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You're a wee bit late roadcc. This sold out last year and is now removed from Rapha's product list!
The Rapha Winter Base Layer is a toasty merino offering with a unique design that'll help to keep you cosy.
When it comes to base layers, merino's king. The fine fibres make for a garment that's light, wicking and warm even when wet, without the itchiness associated with other, coarser wool variants. This winter base layer from Rapha takes all of those positives and combines them with a close, form hugging fit to create a base layer perfect for the very coldest of days.
Rapha are known for their quality merino base layers, and this winter base layer isn't going to change that perception. The 100% merino content and fine, 18.9 micron weave results in a garment with tremendous insulating power for its weight. Flatlock seams eliminate any potential areas of irritation from the design, as does the Raglan sleeve construction.
Styling is typical Rapha - classy and understated with just a couple of simple logos. As such, you can just about get away with wearing this off the bike if you've got the figure for it.
The fit is athletic and tight, as any base layer should be. The danger here is that any issues with the fit get amplified as there's no extra material to hide any poor design. Not so with the Winter Base Layer though, as I found the length in both the arms and body to be perfect for both on and off-bike use. The rear hem is dropped subtly to increase coverage when on the bike, but not overly aggressive as it make it look ridiculous off the bike. The arms are cut on the long side, enabling riders with a larger ape index (arm span to height ratio) to size down and get a tighter fit over the torso.
Despite the figure hugging fit, the inherent stretchiness of the merino used means that there is some wiggle room in the sizing. If you've enjoyed the Christmas period a little too much, don't despair.
Where the Winter Base Layer distinguishes itself from the crowd is the inclusion of the roll top neck – a sort of integrated Buff if you will. This is long enough to cover the entire neck and chin which makes a big difference in warmth. I was a little worried that the extended neck would cause some irritation out on the bike, but the softness of the material meant this was never an issue.
Due to the quality merino and the roll top neck, I found the Winter Base Layer to be ideal for the very coldest days. At temperatures of around 5C, I felt comfortable wearing just the base layer with a mid-weight windproof jacket over the top. For anything colder, the additional of a mid-layer and proper winter jacket has me pedalling comfortably down to -3C, or about the coldest it's gotten this winter down south.
As with all things Rapha, there is a premium to be paid over most of the competition, though it isn't outrageous in this case. Ultimately, if you're after something to keep you warm and dry in the coldest weather, you can't really go wrong with this one.
Warm, well fitting merino base layer that ticks all the boxes.
If you're thinking of buying this product using a cashback deal why not use the road.cc Top Cashback page and get some top cashback while helping to support your favourite independent cycling website
road.cc test report
Make and model: Rapha Winter Base Layer
Size tested: Small, black
Tell us what the product is for, and who it's aimed at. What do the manufacturers say about it? How does that compare to your own feelings about it?
Described as "essential layering for extremely cold conditions", the Winter Base Layer is intended to keep you warm and comfortable on those days when, really, you should still be in bed with a hot cup of tea
Tell us some more about the technical aspects of the product?
Soft, versatile roll neck
100% merino (18.9 micron)
Raglan sleeves
Shaped rear hem for improved insulation
Flatlock seams
Excellent. The weave is so fine that it doesn't really feel like wool at all.
For its weight, it delivers a massive amount of heat. The roll neck is a great idea and adds a couple of degrees to its useable temperature range.
No signs of wear so far, despite a hard winter's use and subsequent washing machine cycles.
Despite its warmth, the Winter Base Layer is light and not at all bulky.
Whether it's the fit or the material, or more likely, both, the Winter Base Layer is like a second skin in that you don't notice it at all.
Expensive, but then it works and looks good.
Tell us what you particularly liked about the product
Fit and roll neck.
Did you enjoy using the product? Yes.
Would you consider buying the product? Yes.
Would you recommend the product to a friend? Yes.
About the tester
Age: 20 Height: 190cm Weight: 70kg
I usually ride: Giant TCR Advanced 2 My best bike is: Canyon Ultimate CF7
I've been riding for: Under 5 years I ride: Every day I would class myself as: Expert
I regularly do the following types of riding: road racing, sportives, mtb,
For 5 years, racing was my life and I went all the way from a newbie bonking after 40 miles, to a full-timer plying my trade on the Belgian kermesse scene. Unfortunately, the pro dream wasn't meant to be and these days, you're more likely to find me bimbling about country lanes and sleeping in a bush on the side of the road.
10 comments
Also, I appreciate the arm length/body size they use. I'm fit with really long arms (16.5 - 37 XXslim dress shirt), and the Rapha stuff comes the closest I've found to fitting me right (outside of custom-sized kit from someone like Vie13). With most of their stuff, large gives me enough arm and is a bit big on the body, and medium is race fit with maybe 1-2cm of missing arm length.
This is true Crikey
i literally have dozens of merino base layers and they are super to wear all day or even sleep in them !
But as riding base layers on long days they will get damp and take considerably longer to dry than synthetics.
They are great in the sense of not whiffing though.
i reckon you are better off with Rapha s merino collar / Buff and a normal base layer because often you warm up and can remove the buff.
The dhb merino long sleeve has a good design with a very high neck which unzips when you get warm. The merino is not as nice as howies or Rapha stuff, but still very good at around half the price.
It's a wooly jumper, and it gets wet and stays wet in use.
True, but I find merino stays warm even when its a bit damp and wicks very well. It's not as good as a synthetic for wicking, I agree, but it is hugely superior on whiff factor. I've found Sportswool combines the properties of both quite nicely. There are some interesting antibacterial fabrics out now with silver threads etc. in them which could be interesting for a baselayer.
I've never got the wiff factor thing. I arrive back from a long ride and chuck stuff in wash, i've never stunk so bad during a ride i've actually noticed let alone thought I must do something about my clothing.
I have a 20 mile commute and hang stuff up around my desk during day, i've never owned anything merino and nothing has ever smelled.
When does this lack of wiff come into play?
I guess we're all different and some will pong more than others.
I'm starting to think it's my washing machine as any merino top I've owned has absolutely reeked. As did any synthetic base layer, to be perfectly honest.
Mind you, I've never stumped out for anything too expensive as using the bike day and daily, I'm used to falls and the occasional crash. This could be part of it.


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Colin Mutchler necesitaba un nuevo diseño de logotipo y lanzó un concurso de diseño en 99designs.
Un ganador ha sido elegido entre 64 diseños de 13 diseñadores freelance.
Help create the brand identity for LoudSauce, a new social venture that lets friends buy ad space for their favorite causes.
We are two social entrepreneurs that have lived across the US, Latin America, Europe and Asia, and wondered why so many inspiring projects have limited awareness and poor marketing. So we're creating LoudSauce for groups of people to buy ad space to amplify these organizations' efforts, therefore broadening and deepening their ultimate impact.
We're committed to crowdsourcing our venture, and engaged the Namethis.com community who voted on the name LoudSauce. Now we are inviting the 99designs community to take the next step to design our brand in time to present as finalists at the WeMedia Changemakers contest on March 9-11th for a chance to win 25k in seed funding.
LoudSauce needs to appeal strongly to young style, culture and thought leaders (18-35 yrs old) willing to invest time and some of their own money to pushing media and art that they believe in. Sites targeting this audience well are http://kickstarter.com and http://worldchanging.com/
The second audience is leaders of social businesses and startups, who will likely be the initial clients of LoudSauce. They are somewhat skeptical of flashy advertising, and want to ensure LoudSauce is an authentic brand of real people committed to promoting their work.
The target audience also considers itself part of a global generation, which therefore requires clean design and clear communication that is easily understood across cultures.
We're looking for a logo that is fresh, clear and bold. It should bring energy and vitality, and be elegant enough to inspire. Since "loudsauce" implies that we are the sauce that amplifies your cause, we would love to incorporate a bottle of hot sauce (like the iconic Tabasco bottle) or a hot pepper in some way (see attachments), but we are open.
Some things to think about:
1. We want it to be playful but not cheap or childlike
2. The logo or mark should be able to be used as a mark in the bottom corner on LoudSauce supported ads. Would be great if an all black or all white version could work.
3. Be creative on colors. A balance of fun and elegant, positive and forward looking, and bold.
4. The logo & colors will be used to guide the design of the online and mobile experience, so you have an opportunity to create the overall brand identity.
5. Any ideas for additional brand elements such as the tag line "spice up your cause" or symbols for "fund this ad," "funding progress bars" or other navigational elements would be strongly appreciated.
Here are a few examples of logos that we like:
Creative Commons (logo & site): http://creativecommons.org/
SoundCloud: http://fr.readwriteweb.com/wp-conte…d_logo.gif
Seedcamp: http://seedcamp.com/themes/seedcamp…edcamp.png
Here are a few examples of what we are trying to avoid:
Squidoo: http://www.squidoo.com/
Splice: http://static.squidoo.com/resize/sq…_small.png
Descubre cómo funciona un concurso de diseño u obtén más información sobre nuestros servicios de diseño de logo.


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Introducing Cisco Intelligent Automation for Cloud – Version 3.1
Just the other morning, my 3.5 year old daughter said "Daddy, can you make me a waffle?" And like any self-respecting parent, I of course responded with "Poof. You're a waffle."
It reminded me of something we frequently hear from customers: they effectively ask us to "make my data center a cloud." Now we could wave our arms and say "Poof. It's a cloud." But it's not that easy. Despite what some cloudwashers may say, virtualizing your data center does not mean you have a cloud – and self-service provisioning of VMs is not cloud computing. Real clouds require much more.
Fortunately, we have solutions to help our customers deploy real clouds – with market-leading compute, network, and management products in our Unified Data Center portfolio as well as our cloud enablement services. In fact, today we introduced yet another innovation in our Unified Computing System (UCS) portfolio with Cisco UCS Central.
I'm pleased to also announce the latest release of our cloud management software solution today: Cisco Intelligent Automation for Cloud version 3.1. This release introduces several exciting new features, and I've highlighted a few of these new product capabilities below.
Virtual Data Centers – In simple infrastructure-as-a-service use cases, virtual machines and other resources may be provisioned from a shared pool of resources on-demand. In more advanced infrastructure-as-a-service use cases, virtual data centers (VDCs) can be established to provide project teams or departments with a dedicated resource pool of compute, storage, and network capacity for their own organization. I've written in the past about this concept of a virtual data center and this is what Cisco IT deployed for our own internal private cloud.
Now, with version 3.1, you can take advantage of these best practices in your own deployment. When a business unit, department, or project team needs infrastructure resources, they can order their own VDC from a menu of options (with pre-set capacity allocations – e.g. small, medium, large – to enforce consumption limits) in the self-service portal. And on an ongoing basis, they can manage their own dedicated pool of physical blades, virtual machines, virtual CPU, memory, and storage – by increasing the capacity, adding a physical blade with Cisco UCS Manager, adding a network, etc. This is differentiated capability that goes far beyond self-service VM provisioning, and it provides our customers with greater agility and flexibility for real world, large-scale cloud deployments.
CloudSync – With version 3.1, we've also introduced new infrastructure discovery and resource tracking: a feature we call CloudSync. With CloudSync, you can automatically discover, track, and manage all of the infrastructure elements within your cloud environment and the systems connected to them. You can run discovery of the infrastructure inventory on-demand or on a scheduled basis. Your cloud administrators can keep track of infrastructure resources, assess capacity, and prevent sprawl; they also have the visibility and control they need to ensure security and policy compliance. See below for an example screenshot.
Network Services Manager – The network is the long pole in the infrastructure-as-a-service tent, but many organizations neglect to take this into account when building their cloud. With version 3.1, Cisco Intelligent Automation for Cloud now includes Cisco Network Services Manager. By bundling Cisco Network Services Manager in our cloud management solution, we're providing a foundation for network-as-a-service. It may start with basic scenarios such as ordering network resources (e.g. a VLAN) from the self-service portal; over time, it can be extended to advanced network automation and provisioning.
In addition to these new features in the 3.1 release, we're continuing to develop product extensions that are designed to ensure that Cisco Intelligent Automation for Cloud can meet our customers' unique needs. With these product extensions, you can configure the workflows for your specific environment and preserve the ability to upgrade from the next software release without losing these changes.
Extensibility – We now offer more than 200 extension points for the software, ranging from integrations with your service desk system to open and close tickets, to providing showback or chargeback support, to integrating with third-party monitoring and service assurance tools. This extensibility allows our customers to deploy their cloud within the reality of their own existing IT practices, business policies, and infrastructure systems.
We also recently introduced a new Multi-Cloud Acceleration Kit that extends Cisco Intelligent Automation for Cloud software to manage multiple cloud environments such as OpenStack, Amazon EC2, and VMware vCloud Director. Now you can create virtual data centers, on-board tenants, and provision cloud services from within our Cisco Intelligent Automation for Cloud solution – whether your cloud is running on VMware or OpenStack, or if you're using the Amazon Web Services public cloud. We featured this at the recent OpenStack summit in San Diego and you can read more about it here.
Cisco is delivering the capabilities that our customers need to build real private clouds, public clouds, and hybrid clouds. We recognize that it's not as easy as "Poof, you've got a cloud". We offer the software, infrastructure, partners, and services to help you get started – with a pragmatic roadmap for your cloud journey. This past spring, we introduced the 'starter edition' of Intelligent Automation for Cloud:
Now, with Cisco Intelligent Automation for Cloud version 3.1, we're providing the tools to help you in the next phase of your journey to cloud computing – for large-scale cloud deployments. Our customers can start with simple infrastructure-as-a-service use cases, and then upgrade and extend their deployment to include support for virtual data centers and more advanced use cases in a multi-cloud, heterogeneous environment.
In an effort to keep conversations fresh, Cisco Blogs closes comments after 60 days. Please visit the Cisco Blogs hub page for the latest content.
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Designed to work with CONMED's IM8000 Camera Console, all of CONMED's True HD Camera Heads feature the latest 3MOS chip technology:
IM8120 Eyecup
As CONMED's most popular camera head, these are used in multispecialty procedures and connect to industry standard Eyecup scopes, used for Laparoscopy, Arthroscopy, ENT, GYN and Thoracic.
IM8121 Cartridge
As CONMED's Proprietary IP, designed for a fog-free camera experience with unique scope interface in surgical procedures where fluid destination is required. The low profile design provides an ergonomic user-experience, allowing for scope rotation (posting) to provide optimal surgical views.
IM8123 Urology
CONMED's specialty camera head is ergonomically designed with a free rotating coupler (12 o'clock orientation) and camera head cable 90° to the body with a smaller optical lens for full-circle image on the monitor.
CONMED is committed to providing our customers with best-in-class customer service. Below are some quick links to CONMED product information that is easily accessible online. For additional assistance or to speak to a CONMED Customer Service Representative to order these CONMED products click here.
Quick Links:


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Shipping to: Malta
TROPIC HEAT Special Offer
A fun, soft and roomy make-up bag designed exclusively by LEITMOTIV in line with the collection's style. Practical and ideal for travelling and for carrying the Tropic Heat products with you everywhere.
The cheerful, spring-inspired pattern sets apart this handy and spacious bag, perfect for keeping all of your Tropic Heat products handy while you're out and about. Washable exterior and lining.
The cost varies depending on the delivery service and the destination country of the order. For more details see the "Delivery information and costs" page.
More information
Shipping times may vary depending on the service chosen. In the countries served by Swiss Post (Asendia) only, delivery takes an average of 6-7 working days (up to a maximum of 10) from the order being dispatched. In countries where the Skynet service is also available, the shipping time is 2-4 days after being dispatched by courier. More information
Purchases made on KIKO are secure and guaranteed. All information relating to payments, including personal information and credit card information, is protected through an advanced encrypted data transmission system. Under no circumstances will KIKO file your credit card number, nor will it use or keep the information you provided on its own systems.
You have 14 business days from the date you receive the items in which to exercise your right to return the goods. Please let Customer Service know about any problems relating to the goods received.
To use a promotional code, select "Have you got a promotional code?" on the shopping cart page and insert the characters indicated in the appropriate field. If your code is inserted correctly, the amount and/or content of the Shopping Cart will be recalculated based on the promotion applied.
A package of 25 make-up remover wipes for the face, eyes and lips
Neceser floreado
Ein Traum


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No Record
Official Publication of Houston Methodist DeBakey Heart & Vascular Center
Dietary Supplements: Facts and FallaciesSee More
Drs. Raizner and Cooke Take the Lead in Special Issue on SupplementsSee More
Recent Clinical Trials Shed New Light on the Cardiovascular Benefits of Omega-3 Fatty Acids
Supplemental Vitamins and Minerals for Cardiovascular Disease Prevention and Treatment
Coenzyme Q10
Red Yeast Rice for Hypercholesterolemia
Inorganic Nitrate Supplementation for Cardiovascular Health
Vitamin D and Calcium Supplements: Helpful, Harmful, or Neutral for Cardiovascular Risk?
Advanced Cardiac Imaging for Complex Adult Congenital Heart Diseases
149 Fontan Conversions
Simultaneous Transfemoral Mitral and Tricuspid Valve in Ring Implantation: First Case Report with Edwards Sapien 3 Valve
Uneventful Follow-Up 2 Years after Endovascular Treatment of a High Flow Iatrogenic Aortocaval Fistula Causing Pulmonary Hypertension and Right Heart Failure
Device-Related Thrombus: A Reason for Concern?
Retained Coronary Balloon Requiring Emergent Open Surgical Retrieval: An Uncommon Complication Requiring Individualized Management Strategies
Do I Look Fat in This? Multimodality Imaging Findings of a Cardiac Lipoma
The Kidney in Congenital Cyanotic Heart Disease
Talking Statins with Antonio Gotto
Lipids and Renal Disease
Addressing the Feedback Loop Between Depression, Diabetes, and Cardiovascular Disease
Letter to the Editor in Response to "Cardiac Autonomic Neuropathy in Diabetes Mellitus"


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June 22nd, 2013, 03:58 PM
I am about to head to Paris for two months. (I know, I know, rough duty.) Staying in the Marais district, 4th Arrondissement. Have never been. Has anyone ever swum in Paris? I don't really need Masters' workouts, as I swim alone mostly. Just need access to pool for workout purposes. Eager for insights if you got 'em. Thanks!


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Blind Faith: Madison Square Garden, July 14, 1969 Review
Blind Faith Group Sings
New York Times, July 14th 1969
By Mike Jahn
Blind Faith, the British rock group succeeding Cream, which became very popular in the last few years, played an impressive opening Saturday at Madison Square Garden.
Blind Faith presents Eric Clapton on guitar, Ginger Baker on drums, Steve Winwood, guitar and keyboards, and Rick Grech, bass and electric violin.
The group packed the Garden in its first United States appearance. As usual, the Garden sound system was bad, and the breaks between songs were punctuated by indignant shouts to that effect. Considering the acoustics and the size of the house, Blind Faith did rather well.
Mr. Clapton and Mr. Baker play loosely structured, emotional music. Mr. Winwood leans toward tightly structured but soulful rock. Putting together such intensely individual artists as those three men is a risky business. Blind Faith emerges as more versatile and precise than either cream or the rival British group Traffic, but unfortunately not as exciting as either.
Mr. Winwood's vocals were taut and effective as usual. Mr. Baker contributed an explosive, imaginative drum solo that was the emotional high point of the night.
Also on the program were Delaney & Bonnie and Friends, an exciting soul-and-gospel group from Los Angeles.


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Leavitt's Healthy Vision
PALM SPRINGS, Calif. -- For most of the American public, Health and Human Services Secretary Michael Leavitt is best defined by his role defending President Bush's controversial veto of the State Children's Health Insurance Program.
Leavitt, along with the president, has argued that the bipartisan bill is too ambitious and too expensive, encroaching on the private insurance market. For his pains, he has been characterized as an ogre, standing in the way of better treatment for millions of youngsters in cash-strapped families.
That is not the man I got to know and admire in his years as governor of Utah and a leader in the National Governors Association. And it is not the man I heard address a conference of health-care insurers and providers here last week.
Leavitt, who on this occasion said not a word about the SCHIP veto override attempt then looming before Congress, instead described what he and his colleagues are doing to prepare for the coming revolution in health care in this country. It is a story that, while less publicized than the SCHIP fight, holds promise of a better day not just for children but for all Americans.
What I learned about Leavitt in his years as governor is that he is blessed with vision that sees future policy challenges and developments more clearly than most politicians. In this case, he is visualizing a radically different kind of medical marketplace, in which families armed with specific information about the treatment success and prices of hospitals and doctors can shop at will for the best quality and most affordable care.
That kind of marketplace is probably a decade away, Leavitt says, but for certain widely experienced conditions, the groundwork is being laid. Ten group practices -- multi-specialty clinics and hospitals -- around the country have begun to measure the outcomes of alternative treatment models for common diseases and are being paid by Medicare not by the volume of patients or office visits but for the outcomes. Medicare is linking its own evaluation results to those of the 10 groups, building a database from which national standards can be derived.
Leavitt, as much of a "federalist" as Fred Thompson or the Founders of the Republic, has a mantra of "national standards but local control." He envisages a system in which the best practices would be defined by national groups of physicians and business economists but local committees would do the ratings of doctors and hospitals. Such local judgments would be necessary to build public trust, he says.
In communities, such groups of business, labor, physicians, hospitals and other key players are beginning to form. In the next two months, Leavitt plans to designate the first of these organizations with the most complete representativeness and set of skills as a "community leader," making it eligible for federal subsidy and requiring it to share its expertise with other groups being formed. When there are enough of them, linked electronically in a network of networks, the United States will have, in effect, national standards for measuring the delivery of health care.
We are a long way from that now, and getting there will require continued leadership from the federal government. But Leavitt's view is that the government should not own health care; instead, it should organize the health-care marketplace and then let competition based on full information proceed.
This is completely consistent with the proposal I wrote about last week from the business-dominated Committee for Economic Development, a model of individual insurance with a public subsidy replacing employer-financed insurance. It is also -- do not faint -- consistent with the plan described by Hillary Clinton, the leading Democratic candidate for president.
Despite the partisan warfare over SCHIP, we may be closer to agreement on the outlines of the next stage in health reform than most people realize. If that is the case, Mike Leavitt will be seen as a hero in the struggle -- not a villain. And the main concern voiced by the experts at the meeting here was: When a new administration starts in January 2009, will Leavitt's successor continue the initiatives he has begun?