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Psychotherapists often hear a term, medical necessity, which is somewhat unfamiliar to them.
Some renounce the concept. "That's for doctors. That's not for us." "We do therapy; what does "MEDICAL necessity" have to do with it?" "We have clients, not patients. They come in order to grow and self-actualize." "I only take cash clients. So I don't have to worry about that."
Others treat the concept pro forma, complying superficially with the requirement. They may write documentation which they guess will pass review by the insurance companies so the clients' services will be covered.
Let's take the concept seriously. Let's take a look at the criteria for medical necessity. I propose turning the concept around for therapists from one to renounce or one to out-smart to one which can guide clinicians in assessment, documentation, treatment planning, and clinical responsibility.
Medical Necessity in Authorization Requests, DHS35, and Documentation
When we submit a prior authorization request to Medicaid or another insurer which requires prior authorization, the payer wants to determine
1) that the patient has a diagnosed psychiatric condition, that is, a medical problem,
2) that an appropriate, reasonable, defined treatment procedure will be used to alleviate the condition, that is, a procedure which is based upon evidence and which a prudent professional might use to improve the condition,
3) that, therefore, medical insurance should cover the cost of the medical procedure.
Examination of a typical prior authorization form demonstrates these requirements.
*The form usually identifies the patient, the facility, and the therapist.
*The form asks for a diagnosis.
*The form asks for supporting symptoms, history, and mental status in order to show both 1) the diagnoses and 2) the degree of impairment or severity of the condition.
*The form asks for the proposed treatments and an idea of how the treatments will make a difference – the goals – in symptoms, functioning, and impairments.
In effect, the forms are asking for us to validate the medical necessity of the services.
Other insurers may not require prior authorization. Upon a chart audit, they expect to find the very same requirements have been met. The chart documentation of the diagnostic assessment, treatment plan, progress notes, and discharge summary must show that medical necessity criteria were applied, the proposed treatment was provided, and the outcome which is consistent with the purpose of the treatment.
Wisconsin Administrative Code DHS35 has the same requirements, namely, that we propose treatments or other forms of assistance for all the patient's problems and we documented how we treated those problems.
We will go over this definition and look at examples. We will stress the importance of using goals and definable procedures (treatments).
Medicare and the Definition of Medical Necessity
"Medical necessity" is a term used in the United States to represent medical procedures which meet these criteria.
- Treatments are justifiable and appropriate based upon evidence and the standard of due care.
- Reasonable for the diagnosis or illness – the treatment is consistent with the symptoms and diagnosis.
- The treatment is necessary for the improvement of the condition according to accepted standards of care (so it is not "experimental").
Hence, medical necessity includes a diagnosis, standard of due care, and evidential treatment(s).
Medicare pays for "medically necessary" services. The reverse is also the case, that Medicare will not pay for services which do not meet this standard.
Furthermore, the treatment is not given because of the desire or convenience of the parties. The duration of the treatment – also known as the dose of treatment or length of service — is predicated upon need as determined by the condition. The parameters include
- length of sessions,
- number of sessions,
- months or years of treatment,
- location of services,
- at the appropriate level of intensity which is necessary, safe, and effective.
The standard of care may be thought of as that level, type, and intensity of care, based upon credible scientific evidence, which the community of mental health practitioners would consider prudent, appropriate, and effective.
As you know from the preference for generic drugs over patented drugs, cost is also a factor in selection of treatments. The selected treatment should not be more costly than another which would produce the same result.
Upcoding means charging for a code which produces a higher level of payment than the code which is more appropriate for the treatment or charging for a code which ensures insurance reimbursement when the correct diagnosis or procedure code would not have led to a payment. For example, if outpatient sessions would be sufficient, day treatment coding should not be used in order to enhance reimbursement. For another example, the correct diagnosis is a V-code which is not reimbursed, and we charge based upon a diagnostic code which is reimbursed.
Medically Unnecessary Sevices
Medicaid law provides for fines for those who have a pattern of charging for services which are not reasonably connected to the diagnosis, which are unproven treatments, or which are not appropriate, as well as for diagnosing inappropriately merely to collect payments.
Clinical Judgment
Case law has shaped the definition of medical necessity. We tend to believe that clinical judgment is our tool as professionals for determining a treatment is necessary. Not totally so.
Our decision by itself does not establish medical necessity. Case law suggests that a community standard could be defined which establishes some objective standard of good practice to which we are expected to conform, insofar as is known in the scientific literature at the time. That case law suggests, furthermore, not only that the treatment be reasonably appropriate and accepted according to published literature, but the treatment is essential or indispensable for the welfare of the patient.
Furthermore, not providing the treatment could harm the patient; the treatment could not be omitted without affecting the patient negatively. E.g., Sarcheti v. Blue Shield of California, 729 P2d. 267 (Cal. 1987); Kinzie v. Physicians Liability Insurance Co., 750 P2d. 1140 (Okla. App. 1987); Victum v. Martin, 326 NE 2d. 12 (Mass. 1975); Fialkowski v. Associated Hospital Service, 318 NE 2c1. 26 (Wis. App. 1 982); Jacob v. Blue Cross and Blue Shield of Oregon, 758 P2d. 382 (Ore. App. 1988).
This concept compares to informed consent to treatment. You will notice that we have an obligation not only to provide or recommend the treatment which is known to help a condition, but also to warn the patient that omitting it could be harmful.
Generally, insurers are not permitted to engage in a practice of limiting medically necessary and clinically proven treatments. However, insurers usually have committees whose role is decide when a treatment has passed from experimental to proven. The care given must not relate to the payer's bottom line! So limiting care must be based upon standards, not on a benefit to the payer.
Cigna – Definition Matches Medicare Definition
Let's take one large company as an example. Quoting from the Cigna HealthCare provider manual, the definition of "Medical Necessity for other Healthcare Providers" [that includes psychotherapists] states:
Except where state law or regulation requires a different definition, "Medically Necessary" or "Medical Necessity" shall mean health care services that a Healthcare Provider, exercising prudent clinical judgment, would provide to a patient for the purpose of evaluating, diagnosing or treating an illness, injury, disease or its symptoms, and that are:
- in accordance with the generally accepted standards of medical practice;
- clinically appropriate, in terms of type, frequency, extent, site and duration, and considered effective for the patient's illness, injury or disease; and
- not primarily for the convenience of the patient or Healthcare Provider, a Physician or any other Healthcare Provider, and not more costly than an alternative service or sequence of services at least as likely to produce equivalent therapeutic or diagnostic results as to the diagnosis or treatment of that patient's illness, injury or disease.
For these purposes, "generally accepted standards of medical practice" means: standards that are based on credible scientific evidence published in peer-reviewed medical literature generally recognized by the relevant medical community,
Determinations of medical necessity must adhere to the Standard of Care of practice, not merely, the clinician's judgment. Furthermore, determinations of medical necessity reflect efficient and cost-effective care. Determinations of medical necessity are made on a case-by-case basis according to the Standard of Care.
So the CIGNA manual uses the same definition of medical necessity.
Standard of Care
The Standard of Care or Due Care is a doctrine which tries to define the level of quality of service a patient is "due" by a professional.
The Standard of Care is the level of attention, caution, and prudence that a reasonable professional would exercise given the patient's condition. Acting outside the standard of what an ordinary, reasonable, and prudent professional would do means failing to meet the standard and may constitute negligence. The standard for malpractice is determining the therapist owed a duty to the patient (that is, the person is a patient), determining the standard of care for the condition, determining the therapist was negligent by failing to meet the standard, and that, as a result, damages occurred caused by the failure to meet the standard.
There is some emphasis on acts of omission, that is, failing to provide what the standard requires. And there is emphasis on acts of commission, that is, failing to apply the treatments or the cautions that a reasonable person would apply. We are expected to apply a reasonable level of skill and care. In a court case, experts testify as to the standard of care, which would be based upon evidence from the scientific literature which is relevant to the case. The Supreme Court in Daubert v. Merrell Dow Pharmaceuticals Inc [509 U.S. 579, 589 (1993)] set the bar that the evidence should be subject to peer review or publication in a scientific journal and the treatment has been generally accepted as valid by the community of psychotherapists.
In workshops, we are often taught a treatment in which a group of professionals adhere to a theory and give testimonial results. The approach makes some sense and may even produce some results. However, we are not usually taught in these seminars or workshops that the practice is considered experimental until such time as peer-reviewed journals publish research validating the theory and/or treatment! Case studies are not evidence. Yes, it is possible for a person or group to self-promote, to recommend a treatment in which someone may benefit financially or one which is not proven by randomized controlled trials or meta-analysis.
The concept of medical necessity may be perceived by therapists as a burden imposed by third-party payers. Namely, we have to provide proof prior to treatment that we are proposing to use an evidence-informed treatment for a diagnosed condition. That is a basis for payment.
Let's turn that around. Medical necessity is not an imposition of the insurer. It is a condition for quality treatment, a basis for remuneration, and a standard in law.
On the one hand, in order to be paid by an insurer, we have to show that the treatment is proven, reasonable, and connected to a diagnosed condition. After all, we are expecting medical insurance to pay for a medically-necessary and medically appropriate treatment.
On the other hand, we have to exercise due care in the choice and application of the treatment(s). The standard of care is owed to clients even if the client is paying cash and no insurer is involved. But in the case of a cash client, the client may purchase services which are experimental – as long as the nature of the benefits and risks are fully revealed and the client makes an informed decision to use those methods. Also in the case of a cash client, the client can receive care even if the problem may not rise to the level of a diagnosable condition. We still owe the client a standard of due care, that is, reasonable skill and caution in applying the professional services we provide the client.
So rather than being only an insurer's doctrine, medical necessity is a concept which imposes a substantial responsibility upon therapists. The standard is not only what you do with clients, but what you do behind the scenes in order to prepare to accomplish it.
- Care and accuracy in diagnostic evaluation
- Knowing what the evidence-based treatments may be for the client's problems
- Knowing how to perform evidence-based treatments or to whom to refer
- Staying current on the evidence
- Discussing with colleagues the standard in the community for various conditions
- Attending local in-service training and state-wide conferences
- Knowing the published professional treatment guidelines of AACAP, APA, and others
- Being able to explain your interventions and actions at all times
- Avoiding loose, unfocused therapy
In conclusion, examining the concept of medical necessity leads us from thinking about it as an insurance industry concept to the realization the concept has more to do with therapist responsibilities in training and in focusing of therapy.
© Don Rosenberg


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Gitlitz Cottage
This Cottage is a neat little house situated on the banks of a small lake and marsh. It has a large screened in back porch facing the water and a smaller front porch to welcome guests. A brick walk from the front porch provides access to the single-car garage and apartment above. Upon entering through the front door of the Cottage you are welcomed by a spacious great room that combines the Kitchen, Dining and Living Rooms. One end is the "hidden" Kitchen and on the other is the fireplace with its hand-made antiqued mantle. The central area of the house is flanked on either end with the bedrooms. On the South is the Master suite complete with a luxurious bath room and a custom built wardrobe cabinet. The guest bedroom suite is on the opposite end of the house and both bedrooms as well as the great room have doors which open onto the screened porch. This home embodies everything that is true to Cottage Living.
- [13 Indigo Trail N]
- [BI Project 104]
- [BI Project 108]
- [Campbell]
- [Gitlitz Cottage]
- [Gitlitz Garage]
- [Groman]
- [Heisel]
- [Historic]
- [Ingram Garage]
- [Keller]
- [Langford]
- [Lord]
- [Lowcountry Plantation]
- [McCormack]
- [McNeil]
- [Meyer Carriage House]
- [Meyer Remodel]
- [Miller]
- [Mueller]
- [Nygaard]
- [Perkins]
- [Quirch]
- [Schuld]
- [Weiss]
- [Yeager]

subset: commoncrawl


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Welcome to As I Lay Living!
I have created this blog to share my passion for creative writing!
Simply put, I am an older gentleman who has led a full life that has been rich with experience. I have been a war resistor, a high school art teacher, a television producer, and a high school teacher of English as a Second Language.
On this site, I have posted articles and essays I have written that are sometimes humourous, sometimes reflective, sometimes political, sometimes simply observations of phenomena. I hope that my thoughts and observations may touch the human spirit, strike chords of agreement or recognition and perhaps tickle a few funnybones along the way. Simply click on the "BLOG" tab at the top of the page to read any of the 300+ entries I've made so far. Or choose a folder of your interest (humour, fiction, political, reflective) and explore it that way.
A summary of my journey to the present may be read at Bloggography, or the more recent experiences only, Confess-to-Success/. The title of this blog was taken from the longish (6000 word) autobiographical essay of the same name, As I Lay Living . If you'd really care to know more than a "little" about me, you may read that tome. If you read it, beginning to end, every word of it, you will qualify yourself to be called a bona fide masochist! Congratulations! Read every posting and you will know nearly everything about me. I hope I'm okay with that!


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Your Custom Text Here
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Fat Loss Sarms Steroid Powder Gw501516 / Cardarine For Increasing Endurance 317318-70-0
- Delivery Time3~5 days
- PaymentWestern Union, Money Gram, T/T, Bitcoin
- Shipping MethodEMS, HKEMS, FEDEX, DHL, UPS, Aramex, ETC
- GradePharmaceutical Grade
- CertificationISO 9001, USP, GMP
Fat Loss Sarms Steroid Powder Gw501516 / Cardarine For Increasing Endurance 317318-70-0
We are a multifunctional enterprise engaging in fine chemical, flavor and essence, food additive, pharmaceutical intermediates. We have authority of import and export and we have passed ISO9001 in 2008.
Basic Info
Product Name: Gw-501516
Other Name: Cardarine; Free Acid; GSK-516
Model NO.: 317318-70-0
Customized: Customized
Suitable for: Adult
Purity: >99%
Einecs: 212-729-3
Molecular Formula: C21h18f3no3s2
Melting Point: 134-136ºC
Appearance: White Powder.
Transport Package: Disguised Package or as Required
Origin: China
Certification: GMP, HSE, ISO 9001, USP, BP
Molecular Weight: 453.5
MOQ: 10gram
Trademark: Pharmlab
Usage: It had been investigated as a potential treatment for obesity, diabetes, dyslipidemia and cardiovascular disease. GW501516 could be used by athletes as an ergogenic performance enhancing drug.
GW-501516 is a unique medication officially classified as a PPAR receptor agonist (PPAR-RA). Research for this medication began in 1992 in a conjoined effort between GlaxoSmithKline (GSK) and Ligand Pharmaceuticals. Research into this product was set forth in an effort to provide treatment for various cardiovascular diseases, as well as diabetes, obesity and other conditions. It was soon discovered that the PPAR-RA was highly effective at enhancing endurance, but it was also shown to carry a high potential cost. It was discovered that GW-501516 increased the chances of cancer significantly, and as a result, GSK dropped all further research. However, the studies that produced cancerous results used doses of GW-501516 that were 500 to even 1000 times the amount that a human being would take. If cancer is a risk with standard dosing is unknown.
GW-501516 binds to the PPAR receptor, specifically a group of nuclear receptors (sensors that detect thyroid and steroidal hormones in the body) that initiates the PGC-1a enzyme. This action leads to gene expression, specifically genes that revolve around energy expenditure.GW501516 (also known as GW-501,516, GW1516, GSK-516) is a PPAR& receptor agonist that was invented in a collaboration between Ligand Pharmaceuticals and GlaxoSmithKline in the 1990s, was entered into clinical development as a drug candidate for metabolic diseases and cardiovascular diseases, and was abandoned in 2007 because animal testing showed that the drug caused cancer to develop rapidly in several organs.
In 2007 research was published showing that high doses of GW501516 given to mice dramatically improved their physical performance; the work was widely discussed in popular media, and led to a black market for the drug candidate and to its abuse by athletes as a doping agent.
The effects of GW-501516 are fairly significant and may be a welcomed addition to the stack for a performance athlete. Increased endurance may be the PPAR-RA's most incredible attribute. Those who use the medication will find they do not tire out as easily and can train harder and longer. The cardiovascular endurance that comes with GW-501516 is so strong it has been shown to do away with the cardio issues that surround the popular anabolic steroid Trenbolone. Many who use Trenbolone report breathing becomes a bit more difficult and that cardio becomes a more arduous task. GW-501516 seems to negate this negative effect when using Tren.
The effects of GW-501516 also help tremendously with fat loss. If nothing else, you're able to perform your cardio more intensely and longer. Further, it doesn't carry any catabolic effect that is associated with many thermogenics or fat burners, meaning muscle loss due to use is of no concern. More importantly, GW-501516 has been shown to increase nutrient efficiency. Simply put, you make better use of the nutrients you're consuming. Those who use the compound will find increased levels of glucose uptake and fat stores reduced.
The known side effects of GW-501516 primarily surround increasing the chances of cancer; however, it's not quite that cut and dry. Studies that showed increased cancer rates in rats used doses of the PPAR-RA far above and beyond what any human would take. Further, additional studies have shown GW-501516 decreased existing cancerous tumors and in effect cured the existing cancer. The truth behind the relationship with this drug and cancer is unknown at this time. Because there is a potential relationship between the medication and cancer, we may never know the truth as it's unlikely any major pharmacy group will undertake any additional study.
Based on its positive attributes, GW-501516 may be one of the single best products an athlete could buy. However, although not an anabolic steroid, numerous sporting bodies have already banned it and it will show up in sports doping tests. But when it comes to the benefits, endurance and enhancing nutrient efficiency are two benefits that are hard to beat. It's hard to beat this into the head of many athletes, recovery, endurance and food itself are the three most important factors associated with making gains or improving performance, and GW-501516 does just that.
Although the benefits of GW-501516 are undeniable, we are still left with the glaring possibility of use-induced cancer. Regardless of how much muscle you carry or how low your body fat is, cancer is going to ruin the physique you've built, not to mention your life. The odds of cancer, from looking at some of the studies that were done they do appear to be somewhat flawed, while others scream warning. It is truly hard to say what would happen if you were to try this drug, but there does appear to be a legitimate risk, and enough of one to cause a very large pharmaceutical giant to completely give up on what could have been a highly profitable drug had the cancer scare not existed.GW501516 (also known as GW-501,516, GW1516, GSK-516 and Endurobol)is a PPAR receptor.
It activates the same pathways activated through exercise, including PPAR and AMP-activated protein kinase. It had been investigated as a potential treatment for obesity, diabetes, dyslipidemia and cardiovascular disease. GW501516 has a synergistic effect when combined with AICAR: the combination has been shown to significantly increase exercise endurance in animal studies more than either compound .
An experimental drug meant to control lipids and increase the level of HDL, or good cholesterol, in the bloodstream. A cell-permeable, thiazolyl compound that acts as a potent, high affinity, PPARδ agonist.
Exhibits selectivity for PPARδ compared to PPARα and PPARγ. Does not exibit any activity against other nuclear or non-nuclear receptors. Reported to increase cholesterol efflux and ABAC1 expression in macrophages, fibroblasts, and intestinal cells.
There are two main uses with GW-501516.
The first and most common use is that of increased endurance. GW has been banned for professional athletes due to the unfair advantage it provides to endurance athletes. Anyone want a drastic increase in endurance will find that GW truly shines in this aspect. It takes effect very quickly and the results can be staggering. A common dose of 10 mg day will provide a significant increase in endurance.
Cardarine is used by athletes competing in many different sports. For instance, endurance athletes may increase exercise endurance by stacking this PPAR with the AMP analog drug AICAR, or run cardarine solo. As a result, they will have a greater ability to reach higher RPM's during their runs without hitting the maximum heart rate. This will allow the runner/cyclist/swimmer to cheat their maximum heart rates and go longer without getting winded, making this stack an incredible weapon to use in endurance sports. Actually, from personal experience I can tell that cardarine can knock over 30-45 seconds off a 5K time if used leading up to a race.
The second common usage with GW is that of fat loss. Many users turn to GW as it has shown to melt off fat while still being non-catabolic. You will find that you can still hold on to some muscle as you are losing fat. It helps when you are running it in conjunction with SARMS Ostarine and S4, to hold on to as much muscle as possible. A dosage of 10 mg a day will provide good amounts of fat loss, but an increase to 20 mg a day will provide much more in this area.
Cardarine was primarily developed to treat obesity, diabetes, lipid strain, and heart health problems. As a matter of fact, those who run blood work will notice that cardarine will magically aid with lipid strain, and their cholesterol levels will improve substantially.
Regarding the bodybuilders, cardarine can benefit them in two ways:
1. Its ability to burn fat
2. Its ability to help the athlete have harder and longer workouts, without getting winded.
GW-501516 is taken orally . The most common dosing range for this PPAR-RA is 10-15mg per day for 8 weeks. However , some reports state the medication needs to be used for 12 weeks for optimal results , with 20mg per day being well tolerated by most individuals .
Not to say that there are none , but in the last 20 years no side effects have been seen by anyone studying the drug .
GW501516 has not only been tested in healthy subjects , but also those with simulated "real life" habits (such as drinking alcoho l, stimulant narcotics , and the use of tobacco products) . It is uncertain if there are long term ramifications , but no research has been published stating otherwise .
This is what makes Cardarine so incredibly popular and usable over long periods of time . In certain studies , there have even been signs showing the reversal of diabetes , obesity, Dyslipidemia and many other diseases .
The half life of cardarine is 20-24 hours. This means that once a day dose is totally fine. Some athletes like to use all the 20 mg an hour before their workout session, and others will split the dose in half in the AM and PM.
It is best to squirt the liquid into your mouth, swallow, and then chase down with some juice or water.
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No matter what the problem is, no matter where it is, no matter whom it concerns, you have no one to change but yourself, and you have neither opponent nor helper in bringing about the change within yourself.
You have nothing to do but convince yourself of the truth of that which you desire to see manifested.
As soon as you succeed in convincing yourself of the reality of the state sought, results follow to confirm your fixed belief. You never suggest to another the state which you desire to see him express; instead you convince yourself that he is already that which you desire him to be.
Realization of your wish is accomplished by assuming the feeling of the wish fulfilled.
You cannot fail unless you fail to convince yourself of the reality of your wish. A change of belief is confirmed by a change of expression. Every night as you drop off to sleep feel satisfied and spotless, for your subjective lover always forms the objective world in the image and likeness of your conception of it, the conception defined by your feeling.
The waking two-thirds of your life on earth ever corroborates or bears witness to your subconscious impressions. The actions and events of the day are effects; they are not causes. Free will is only freedom of choice. "Choose ye this day whom ye shall serve" is your freedom to choose the kind of mood you assume; but the expression of the mood is the secret of the subconscious. The subconscious receives impressions only through the feelings of man and in a way known only to itself gives these impressions form and expression. The actions of man are determined by his subconscious impressions. His illusion of free will, his belief in freedom of action, is but ignorance of the causes which make him act. He thinks himself free because he has forgotten the link between himself and the event.
Man awake is under compulsion to express his subconscious impressions. If in the past he unwisely impressed himself, then let him begin to change his thought and feeling, for only as he does so will he change his world. Do not waste one moment in regret, for to think feelingly of the mistakes of the past is to re-infect yourself. "Let the dead bury the dead."
Turn from appearances and assume the feeling that would be yours were you already the one you wish to be.
Feeling a state produces that state. The part you play on the world's stage is determined by your conception of yourself. By feeling your wish fulfilled and quietly relaxing into sleep, you cast yourself in a star role to be played on earth tomorrow, and while asleep you are rehearsed and instructed in your part.
The acceptance of the end automatically wills the means of realization. Make no mistake about this. If, as you prepare for sleep, you do not consciously feel yourself into the state of the answered wish, then you will take with you into the chamber of her who conceived you the sum total of the reactions and feelings of the waking day; and while asleep you will be instructed in the manner in which they will be expressed tomorrow. You will rise believing that you are a free agent, not realizing that every action and event of the day is predetermined by your concept of self as you fell asleep.
Your only freedom then is your freedom of reaction. You are free to choose how you feel and react to the day's drama, but the drama the actions, events and circumstances of the day have already been determined.
Unless you consciously and purposely define the attitude of mind with which you go to sleep, you unconsciously go to sleep in the composite attitude of mind made up of all feelings and reactions of the day. Every reaction makes a subconscious impression and, unless counteracted by an opposite and more dominant feeling, is the cause of future action. Ideas enveloped in feeling are creative actions. Use your divine right wisely. Through your ability to think and feel you have dominion over all creation.
While you are awake you are a gardener selecting seed for your garden, but
"Except a corn of wheat fall into the ground and die, it abideth alone; but if it die, it bringeth forth much fruit."
Your conception of yourself as you fall asleep is the seed you drop into the ground of the subconscious. Dropping off to sleep feeling satisfied and happy compels conditions and events to appear in your world which confirm these attitudes of mind.
Sleep is the door into heaven. What you take in as a feeling you bring out as a condition, action, or object in space. So sleep in the feeling of the wish fulfilled.
"As in consciousness, so on earth."
All things gravitate to that consciousness with which they are in tune.
Likewise, all things disentangle themselves from that consciousness with which
they are out of tune. Divide the wealth of the world equally among all men and
in a short time this equal division will be as originally dis portioned. Wealth
will find it's way back into the pockets of those from whom it was taken.
Instead of joining the chorus of the have-nots who insist on destroying those
who have, recognize this changeless law of expression. Consciously define
yourself as that which you desire.
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Friday, June 22, 2007
" Feeling is the Secret" by Neville Goddard, part 6
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|| Home. | Universe Galaxies And Stars Archives. |
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Swirling Cloudtops of Saturn.
The newest image from NASA's Cassini spacecraft was taken on May 18, and shows beautiful swirling clouds in Saturn's southern hemisphere. This image was taken with the spacecraft's narrow angle camera at a distance of 23.4 million km (14.5 million miles) using a special filter that's sensitive to the absorption and scattering of sunlight from methane gas in the Infrared spectrum.
Saturn's bright equatorial band displays an exquisite swirl near the planet's eastern limb. This image was taken with the narrow angle camera on May 18, 2004, from a distance of 23.4 million kilometers (14.5 million miles) from Saturn through a filter sensitive to absorption and scattering of sunlight by methane gas in the Infrared (centered at 889 nanometers). The image scale is 139 kilometers (86 miles) per pixel. No contrast enhancement has been performed on this image.
The Cassini-Huygens mission is a cooperative project of NASA, the European Space Agency and the Italian Space Agency. The Jet Propulsion Laboratory, a division of the California Institute of Technology in Pasadena, manages the Cassini-Huygens mission for NASA's Office of Space Science, Washington, D.C. The imaging team is based at the Space Science Institute, Boulder, Colorado.
For more information about the Cassini-Huygens mission, visit http://saturn.jpl.nasa.gov and the Cassini imaging team home page, http://ciclops.org.
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Fallout from a meatpacking industry scandal in Brazil, the world's biggest exporter of beef and poultry, widened on Monday as China, the EU, South Korea and Chile curtailed meat imports from the country after inspectors were accused of taking bribes to allow sales of tainted food.
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(all dressed up and nowhere to go)
It was so good to see family. Thank you all for coming to spend time with us. We miss you all already!
I guess the visit must have worn both Cain and Brad out. After everyone left I was able to capture a picture of both of my boys resting peacefully.
After Cain and his Daddy had their nap they spent some time talking. The following picture is Cain telling his Daddy about the dreams he had during his nap. As you can see, he has on another one of his cute "outfit" bibs.
(Daddy I caught a fish that was THIS BIG)
Sunday afternoon Cain had more visitors stop by to see him. Thanks Julie, Mike, Vicki and Chad for all coming to see us. We really enjoyed visiting with everyone this weekend. Cain felt special to have so many friends come see him.
Cain is doing great and has handled all his feeds really well. We were told during rounds this morning that if Cain continues to do well we should be discharged tomorrow. We will be so happy to be out of the hospital and have Cain back at home.
Since tonight will hopefully be our last night here Brad had to make himself one final Coke float. There is a nourishment center on Cain's floor that happens to have vanilla ice cream. Brad has taken advantage of the "nourishment" and enjoyed many coke floats during our time in the hospital.
We've got to make the best of staying in a hospital for 33 nights...right?
(Brad's nightly "nourishment")


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"One of my parting words to him will be: 'If I can help you, let me know,'" Bush said.
Monday, December 1, 2008
Great! Pick up a broom
In an interview with ABC's Charles Gibson, President Bush says he will reach out to incoming Barack Obama:
Posted by John at 12:02 PM
Labels: epic fail, George W Bush
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Brandon Chase – Managing Editor
Lucie Salhany, former Chairwoman of Fox Broadcasting, will deliver the commencement address to the Class of 2013 when graduation ceremonies take place on Taylor Field Sunday, May 19. Salhany has Boston-area roots. Her husband, John Polcari, is the owner of the world-famous North End-based Regina Pizzeria.
Salhany took over as Chairwoman in 1993. When Fox appointed her, she was the first woman ever to run a major broadcasting network. Salhany's career in the media spans many decades, including working at television stations in her hometown of Cleveland, Ohio, and being named the CEO of United Paramount Network (UPN) in 1995.
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Salhany and President Alexander have good rapport, as they served together on the Board of Directors for the USA Network.
The selection process for the commencement speaker is the job of the college's Senior Management Team. Alexander said there was a list of about 15 potential speakers, but "the team seemed to coalesce around Lucie."
This selection comes after the two previous speakers, U.S. Senator Scott Brown and U.S. Representative Barney Frank, were politicians. Frank's address to the Class of 2012 was known for being more of a partisan rant than words of wisdom.


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Designed with an eclectic décor that blends original art with vintage furniture and plenty of comfort, the Artist Residence boutique retreat offers its guests the perfect home away from home. The hotel is located in a historic Georgian house in West Cornwall, UK.
Guests can stay in one of the 19 rooms or in a separate cottage. The five artist rooms have been decorated by British and Cornish artists, while the other rooms feature a combination of vibrant colors, pastel tones and eclectic furniture pieces, with handpicked artworks decorating the walls. The charming cottage contains a fireplace, kitchen, dining room, and open plan living room, providing sleeping spaces for up to six people. After exploring the gorgeous town of Penzance, guests can enjoy a meal at the hotel's smokehouse which serves authentic cuisine made with local, fresh products that include seasonal and foraged ingredients. Close to gorgeous beaches, an art museum and a centuries-old castle, this boutique hotel is the ideal location for a relaxing, art-inspired vacation by the sea. Photo credits: Artist Residence.


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CellMonitor for third party use or bespoke applications.
The knowledge required to recover GSM and 3G cell site data off air and understand the data takes time to accumulate and then more time to understand and interpret the data recovered. Some end users and companies wishing to enter the market, don't have the required knowledge or expierience to accurately recover all the data.
CellMonitor engine is a hardware system that can be purchased to facilitate the development of independant cell site analysis products that meet the same standards and performance criteria as that provided by our CellMonitor system. Thus, users of the CellMonitor engine can be assured that they meet the same standards as the most eminent UK Govt and Police organisations that specified CellMonitor. We impose no restrictions on the use of the engine or the sale of any product that may compete with our own.


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[... C]arbon emissions [of Queen Elizabeth II's] flights to, from and within the United States will be offset for the first time. Exact figures were still being worked out, [a] spokeswoman said.
Carbon offsetting involves individuals or organisations compensating for the amount of carbon dioxide generated through travel and energy use through for example financial donations to environmentally-friendly projects such as tree-planting.
The move comes after the queen's son and heir, Prince Charles, announced in December last year that he was to reduce the impact of overseas royal visits on the environment by "greening" his transport and the way his office is run.
That included replacing carbon-heavy private planes and helicopters with scheduled flights and trains "where appropriate."
I hope Her Majesty sets an example that everyone will follow.


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Jenny L. Merris
- email@example.com
Jenny is an Associate with PIB Law and focuses her practice on the representation of financial institutions in connection with financial services litigation and complex commercial litigation. Jenny's practice encompasses all aspects of litigation and she has successfully represented financial institutions and private companies in both State and Federal Courts. She has also represented clients in appellate matters, in both California appellate courts and the 9th Circuit.
Prior to joining PIB Law, Jenny served as an Associate at AlvaradoSmith, where her practice focused on the representation of financial institutions. Jenny has also represented corporate clients in commercial and business litigation matters, real estate related disputes, and construction disputes.
Professional Activities
Community & Professional
Pepperdine University School of Law, Straus Institute for Dispute Resolution, Certificate of Alternative Dispute Resolution
Blog Posts
- U.S. Supreme Court Upholds Enforceability of Arbitration Agreements in which Employees Agree to Arbitrate Individual Claims Against an EmployerThe PIB Legal Blog, 06.15.2018
- The PIB Legal Blog, 06.14.2018
Practice Areas
- California
- Central District of California
- Northern District of California
- Southern District of California
- Eastern District of California
Pepperdine University School of Law, J.D.
- Alternative Dispute Resolution Journal


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Just reflecting on the last two days, this is some of what I learned:
- It's the most hospitable city, and the Nerve Centre the most hospitable venue. So much of the success of the event was down to City of Culture help, Nerve Centre technical, catering, logistics. But more than that..
- …having an international film education seminar in Northern Ireland is the most appropriate setting …
- …because the Centre is often at the Margins (Derrida might have said this, but didn't; my partner did, and does, often). Think about it; it works both ways..
- And integrating your film education strategy across sectors reaps (triple) rewards
- Even on one hour's sleep, Mark Cousins burns for film with an illuminating passion – maybe it's the lack of sleep that does it!
- Trust children to speak their minds, their hearts, their fears, their dreams – so we can learn from them (the Dear George Melies story)
- The artist's mother can tell you more than anyone where and how the artist was made
- Mobile cinemas – much bigger on the inside
- let's not be afraid of high-minded experiences for children (thank you Noreen)
- The count to 10 game (thank you Maria; maybe you can explain it in a Comment below)
Add to this, if you learned anything, below in Comments, or new posts


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With the unlimited chances of features, place workouts, along with colors, your home could be customized to suit your special wants and requirements. Your aims is going smoothly in the event that you have some opportunity to make use of these hints before starting your house construction experience.
Inch. Simply take tours of new homes. There are many layouts and fashions of homes accessible now it's not possible to learn all your choices by taking a look at a couple home construction magazines or novels. Arrange to consider a few tours of new homes in your region, specially homes built within the previous six weeks. These homes give the most up-to-date in features and certainly will present you a fantastic notion of the latest improvements in home design and building. Maintain an open mind because you glance at those houses. Features that you believe unnecessary today can prove to be precisely what you require.
2. Pick the ideal location. It's extremely easy to become swept up in the delight of building and designing a brand new residence, however it is going to probably pay off in the future should you step down and have a practical look in your plans before making your last choice. Your house's location has become easily the main factor. May be your newest home's location suitable for your family members? Would you love this positioning? In the event you choose to market your home in five decades, what'll potential buyers think of the positioning? Rethink your house construction decision in the event that you're not content with the positioning.
3. Think beforehand. If your plan is to remain in your home for several decades, consider the potential life changes in front of you. You might need to have an additional bedroom or 2 when there are kids on your long run. Take a Look at the design of Your Home. Can you need a two-story dwelling in twenty five decades? Will the chambers become too small or too big for the household in a couple of decades?
4. Get several quotes. Speak to 2 contractors to find yourself a fantastic notion about exactly what the home will cost. Remember that for some homes, the true cost exceeds the quote. If you're making plans to create a home in yet another half a year to a calendar year, you'll want to bring a second three to six percentage to the expense to take into account inflation.
5. Ask everybody you know for remarks. Family members and friends may be great resources of fair details. Ask them if they've been aware about one's contractor or the contractor's subcontractors. Discover what their main homebuilding mistake was. Gather a few ideas for dwelling designs and extra capabilities. Make use of the knowledge and expertise of some people who have "been around" and may assist you by discussing their own adventures.
6. If at all possible, put extra cash in to your kitchen and baths. If you have to reduce on the price to build your home, attempt to get concessions in areas besides your own kitchen and baths. These chambers will provide the maximum to the significance of one's house and is likely to also be the most significant selling things in the event that you opt to relocate a couple of decades.


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Chassis Innovation & Systems Concept Engineer // // PermanentJob Reference: J0012569
Job Title: Chassis Innovation & Systems Concept Engineer
The Role:
• To provide support for the concept definition of new chassis systems including but not limited to mounts, links, knuckles, springs, dampers and steering systems into new and existing vehicles/platforms.
• To provide tuning, development and sign off support with regards to the aforementioned when required yet also be a lead engineer to develop and project manage new technologies/systems for the Company.
Key Responsibilities:
• For AE Delivery projects (A4-A1 gateways) & Pre A4 advanced technical development & innovation
• Responsible for delivery of chassis system concepts from first principles with support from senior engineers for new and existing vehicle projects/Architectures
• CATIA V5 3D & 2D CAD creation with appropriate data management and release.
• Ensure that concepts are optimised and balanced to meet the best targets for the project;
-Performance - including kinematics and simulation
-Cost & Quality
-System functionality and performance
-Ease of manufacture
• Engage stakeholders and customers where necessary to resolve issues and progress the delivery
• Component design, development and test to optimise chassis performance
• Develop global relationships with AE Chassis & Chassis department in Asia to promote global working – leverage services from these departments where skills/resources are not available in the UK
• Prioritising and managing personal workload to ensure objectives and timing are met
• Lead and support in new research projects and assist with aspects such as Design Failure Modes and Effects Analysis (FMEA)
• Procurement of parts, liaison with prototype manufacturers & external suppliers to ensure timely support of the project gateways/timings
• Defining and managing project scope, change control and escalating issues where necessary
• Drive the generation of innovation projects
• Specific Technical job skills required:
-Excellent CAD skills – CATIA V5, ability to use kinematics is desirable, able to develop chassis axle concepts from first principles with senior engineer support, taking advise from chassis technical experts where required
-Full capability to operate in Team Centre environment and use Vis-Mock-up tools
-Capability in parametric tools to enhance quality and improve efficiency is desirable
-Knowledge of front and rear axle systems, ability to assess strengths/weaknesses of options and provide recommendations for use within a vehicle architecture
-Understanding of technical aspects of systems/component development (e.g. DFMEA's, DVP, Materials, Finish specifications)
-Capability and experience to understand chassis system effects on BIW and associated load path and structural performance
-Understanding of basic vehicle dynamics and how the axle systems will affect overall vehicle dynamics
-Understanding of the Architecture Development Process and Global Vehicle Development Process
• Supporting job skills required:
-Ability to lead multi-functional design reviews
-Ability to present reports/CAD data accurately and coherently and at a senior level – Manager/Chief Engineer Level
-Ability to lead meetings – specifically internal design/package reviews
-Good communication skills, ability to work globally and develop global partnership(s)
-Flexible, committed and motivated to work on more than one vehicle system at a time – ability to motivate team players
-Ability to support business trips (and potentially longer term working) in Asia
-Degree/HND or equivalent in Mechanical / Motorsport or Automotive Engineering
-Enthusiasm and drive for bringing new technologies/products to market
-Minimum 3 years' experience of chassis related design, development and implementation ideally including new technologies within an Advanced Engineering environment
Excellent package and opportunity. Call Rachel Adams NOW on 07810 000924 or apply online.


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Editor's Note: You hear a lot of "what did you put in your hair?" and "I love your shoes!" around the NaturallyCurly offices. Personally, I am always finding inspiration in what my colleagues are wearing to the office and on their Instagrams, so we're starting a new series to share what we're loving with the rest of our community - beyond our hair! #OOTD
I would describe my style as minimalistic, classic, comfortable, effortless and feminine. Though I admire great style, comfort is a priority I will not sacrifice no matter how fabulous an outfit maybe. So that means you'll usually see me rocking a jumpsuit, midi dress, romper or jeggings. What's the point of wearing an amazingly stylish outfit you can't breathe in? Believe me, it's not worth the hassle. Keep scrolling as I share my summer obsessions, tips on maintaining a blowout in sweltering conditions and how to take your look from day to night effortlessly.
What's the point of wearing an amazingly stylish outfit you can't breathe in?
I'll admit, I'm slightly obsessed with jumpsuits. Can you blame me? They're flattering, effortless and comfy. Jumpsuits take the work out of contemplating what to wear, it's an easy one and done! Being that I have several jumpsuits in my closet, majority black, when I saw this one I knew I had to make it mine. I love the bold print, off-the-shoulder details, and it has pockets. I mean come on, it's fully functional and sexy, I feel like this was seriously made for me!
What I love about this jumpsuit is the endless options it offers! It can be worn to work, on a dinner date or it would make for a stylish beach look on your next vacation. The palm trees print screams tropical vibes and is breathable enough to wear on even the hottest days of Summer. Depending on the occasion you can dress this jumpsuit up or down, by switching out your shoes. I wore open toe block heels, but if you're looking to dressing it down a bit, you can wear a flat sandal or flip flops. I felt like the bold and colorful print was enough of a statement, so I added minimal jewelry with a red lip.
To get the most out of my blowout I wear a silk wrap at night. Being that I'm a lazy natural, I understand the struggle of getting the energy to wrap your hair, but believe me, by wrapping your hair you're saving so much time styling your hair the next day.
I usually prefer to workout before I start my day which consists of a two-mile run around my neighborhood and a lift. Anytime I work out I wear a wrap to keep my hair up and to keep any residue from products from running down my face. I try my best to work up a good sweat and challenge myself, which also means that my hair gets sweaty. To keep from re-applying heat on my hair daily, I'll blow dry my hair on low and add some edge control to tame my baby hairs. My go-to is the Curls Blueberry Bliss Curl Control Paste, it leaves my edges laid without the flaky residue.
When I want to add volume to my bone straight look, I'll wand or curl my hair once a week, then bobby pin it at night to hold the curls without having to put too much heat on my hair.
How do you rock your work look from day to night? I'd love to know, share your thoughts in the comments below.
For more style inspiration, follow Alexandra on Instagram @queensconquer
Jumpsuit: Melodrama
Shoes: Aldo
Photography: Cassandra J. Klepac