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Mayor Bloomberg Announces Programs to Expand the Reactivation of Brooklyn's Working Waterfront
Mayor Michael R. Bloomberg today announced a series of programs to expand the ongoing reactivation of Brooklyn's working waterfront. Through the "Sunset Park Waterfront Vision Plan" unveiled today, the City will invest more than $165 million – with an additional $105 million in State, Federal and private funds – in the industrial waterfront, activate 3.5 million square feet of industrial space, create 2,000 industrial and construction jobs over the next two years and 11,000 jobs in all, add 22 acres of open space and reduce regional truck traffic by 70,000 trips per year. Mayor Bloomberg also outlined "DiverseCity," the Administration's economic diversification strategy to spur entrepreneurship and target industries in which New York City has competitive advantages, including: certain industrial and distribution subsectors, green building and design, bioscience, media, tourism, fashion, financial services and nonprofits. Joining the Mayor at the announcement, which took place at the South Brooklyn Marine Terminal in Sunset Park, were Congressman Jerrold Nadler, Congresswoman Nydia M. Velazquez, Brooklyn Borough President Marty Markowitz, New York City Economic Development Corporation President Seth W. Pinsky, Brooklyn Chamber of Commerce President Carl Hum, and Sims Metal Management Group Chief Executive Officer Dan Dienst.
"On Brooklyn's waterfront, the City has a unique opportunity to build upon existing assets – including a talented workforce and industrial and maritime infrastructure – to create permanent industrial jobs," said Mayor Bloomberg. "Through a series of investments aimed at bringing aging infrastructure to good repair, professionalizing maritime and rail service, and increasing and diversifying job-intensive industrial uses along the waterfront, the Sunset Park Waterfront Vision Plan lays out a series of short and long-term steps to strengthen the area as a center for industrial growth. Like our efforts to bolster growth industries like media, bioscience and tourism, protecting our existing industrial jobs and taking steps to add new ones will help achieve our goal of diversifying our economy and offering opportunities to all New Yorkers."
"I applaud the Bloomberg Administration because its new Sunset Park Waterfront Vision Plan is an excellent framework for the discussion and advancement of New York City's maritime and rail infrastructure, and most importantly, is a critical acknowledgement of the importance of increasing goods movement efficiency, which will make the City far more sustainable and productive in the future," said Congressman Nadler. "The efficient movement of goods, while not a topic that captures the imagination of most New Yorkers is an issue of phenomenal and immediate importance to our City and our Region. It means more and better jobs, and a much healthier environment."
"The Sunset Park Waterfront Vision Plan sets us on a promising path toward reviving and enhancing Brooklyn's waterfront," said Congresswoman Velázquez. "I look forward to working with the City to find ways to strengthen local small businesses and foster green jobs and industry."
"Brooklyn is booming," said Borough President Marty Markowitz. "And the initiatives and projects outlined today will add to that boom. In Sunset Park, just as the strong commitment to brownfields clean-up and the opening of the waterfront to residents with a new park constitute great leaps forward—we also applaud the announcement that Phoenix, Sims and Axis will become full fledged members of the Brooklyn Waterfront community. These companies are the bellwether of future industrial growth in the area—growth that will create good jobs and utilize environmentally sustainable construction and operational practices while employing water and rail transportation to take trucks off our neighborhood streets. I commend Mayor Bloomberg on his continued faith in and attention to the borough of Brooklyn."
"We are here today recognizing how valuable the Sunset Park Waterfront is to the economy of the City of New York," said Council Member Gonzalez. "I will continue to ensure that a comprehensive vision plan addresses community needs and concerns while preserving and creating quality jobs, creating open space, reducing truck traffic, implementing green practices, and improving the business environment for existing and future industrial tenants, all of which are goals I have supported since my days as Chair of Community Board 7. At that time, I signed onto working waterfront principles with Congress members Nadler and Velázquez, which I still adhere to today."
Supporting manufacturing, industrial and distribution companies is part of "DiverseCity," the Bloomberg Administration's comprehensive, long-term strategy to strengthen the local economy. The strategy offers a wide array of opportunities with varied skills and backgrounds, while simultaneously lessening dependence on the performance of any one sector. New York City's economy is already relatively diverse: more than 3.1 million New Yorkers are employed in more than a dozen industries and sub-sectors, and no one sector accounts for more than 18 percent of total employment. The Bloomberg Administration, as part of its Five Borough Economic Opportunity Plan, is working to make New York City's economy more diverse by promoting entrepreneurship across all industries, making targeted investments and adopting long-term policies that will keep the City competitive. In addition to encouraging the growth of manufacturing jobs on the Brooklyn waterfront and across the five boroughs, the City is focusing on supporting industries where it has particular competitive advantages, including bioscience, fashion, financial services, green, media/technology, non-profit and tourism.
In recent decades, the Sunset Park industrial waterfront – developed more than a century ago –has lost much of its competitive edge as a working industrial area as a result of disinvestment and aging infrastructure. The Sunset Park Waterfront Vision Plan combines strategic investments and targeted policies to reactivate the area's industrial uses, create jobs and provide public waterfront access within the City's Southwest Brooklyn Industrial Business Zone. The plan includes both short-term projects that will create more than 2,000 permanent and construction jobs over the next two years and a framework for the long-term development of Sunset Park that will pave the way for 11,000 jobs. Through the plan, the City will: modernize industrial facilities at Bush Terminal and the Brooklyn Army Terminal, reactivate the South Brooklyn Marine Terminal, upgrade freight rail service and promote other environmentally sustainable practices, and build Bush Terminal Pier Park and improve pedestrian access to the waterfront. In developing the plan, the City worked closely with elected officials, the local Community Board and community organizations, including the Southwest Brooklyn Industrial Development Corporation.
Reactivate the South Brooklyn Marine Terminal: Central to the Vision Plan is the reactivation of the South Brooklyn Marine Terminal which was last used extensively for maritime purposes in 1985. The City is investing $80 million on infrastructure upgrades at the terminal to pave the way for two new industrial facilities. The Axis Group is investing $7 million to develop auto processing and cargo handling operations, and heavy construction is beginning now. Sims Metal Management is investing $44 million to create a state-of-the-art recycling facility for metals, plastic and glass, with site preparation commencing now and construction set to begin next year. Together the Sims Metal Management and Axis projects will create 360 new, permanent jobs.
Modernize Industrial Facilities at Bush Terminal: Sunset Park is home to existing industrial buildings, but many are aging facilities without the modern infrastructure that today's industrial businesses need and, as a result, are vacant. Beginning later this month, the City will begin investing an initial $8.6 million to upgrade City-owned buildings and infrastructure at Bush Terminal. Improvements will include critical utility installation, roadway reconstruction, and the modernization of the railroad connection through the campus. Last week, the City issued a Request for Proposals to maritime industrial businesses to redevelop Pier 6, a 5.3-acre finger pier at the Bush Terminal Industrial Campus. Revitalization of the Bush Terminal Campus will build on the success of the Brooklyn Army Terminal to the south. Built in 1918 as a primary point of embarkation for military personnel and supplies, the complex was acquired by the City in 1981. The complex's two main buildings contain approximately four million square feet. To date, the City has renovated approximately 3.1 million square feet that is now occupied by 72 industrial, back office and high-tech companies employing more than 3,000 workers.
Upgrade Freight Rail Service and Promote Other Environmentally Sustainable Practices: The Vision Plan includes new measures to promote the movement of goods by rail, which is an efficient, economical and sustainable mode of transportation increasingly attractive to industrial businesses. Later this year, the City will begin Brooklyn waterfront rail improvement projects, including the construction of rail freight infrastructure at the South Brooklyn Marine Terminal. The City will also invest $9 million to make upgrades along 1st Avenue that will allow larger, modern railcars to connect to the terminal. The City is also working to improve the reliability of rail service to local customers. By introducing rail service and promoting the movement of goods by rail and barge, the Vision Plan would result in 70,000 fewer truck trips and 5,000 fewer tons of CO2 emissions citywide every year. In addition, several of the large-roofed industrial buildings at the Brooklyn Army Terminal and Bush Terminal will be fit out with solar energy capabilities that will significantly mitigate emissions and reduce energy costs.
Build Bush Terminal Pier Park and Improve Pedestrian Access to the Waterfront: The $37 million Bush Terminal Piers Park and Remediation project – funded through City, State and Federal sources – will add 22 acres of open space to the Sunset Park waterfront, doubling the amount of open space in the neighborhood. The park will be located on a former brownfield, which is now undergoing a complete remediation. The Vision Plan also sets the stage for key corridors at 35th, 43rd, 51st and 58th Streets to become pedestrian friendly streetscapes to ensure residents safe access to the new waterfront park.
Outside the Sunset Park industrial area, the Department of City Planning has engaged the community to develop a rezoning package to protect the scale and character of the neighborhood and provide opportunities for affordable housing where appropriate. The rezoning proposal is now in the public approval process. The Sunset Park waterfront is part of the Southwest Brooklyn Industrial Business Zone. In 2005, the Bloomberg Administration designated 16 of the city's most productive industrial areas as IBZs, and the Mayor made a commitment not to rezone these areas for other uses. Through the Mayor's Office of Industrial and Manufacturing Businesses, the city offers an array of services, including providing assistance with business planning, navigating government, financing, hiring, minority and women-owned business enterprise certification, employee training and accessing incentives.
Mayor Bloomberg also outlined recent developments on the waterfront in Red Hook. EDC recently finalized a 20-year sublease with Phoenix Beverages for a portion of Pier 11 at Atlantic Basin, and the company is now beginning site preparation. Phoenix, a major importer of beers and other beverages, will invest $3.8 million to consolidate its operations from Long Island City and New Jersey to the new Red Hook facility, moving about 500 workers to Red Hook and hiring up to 100 additional workers over the next 18 months. Phoenix is committed to local hiring in Red Hook and has retained Southwest Brooklyn Industrial Development Corporation to recruit new employees. A local job fair is planned for this fall. Construction will begin in August and the facility will be fully operational in six months. Currently, Phoenix's container ships arrive at Port Elizabeth, New Jersey and are transported by truck over the George Washington Bridge for local distribution from Long Island City.
On Pier 12, which until five years ago was used only for salt storage, the $56 million Brooklyn Cruise Terminal continues to welcome some of the world's most prestigious cruise ships to New York City. Cunard's Queen Mary is only one of the spectacular ships that are proud to call Brooklyn their homeport. During its first three full years of operation, the cruise terminal has accommodated an average of about 50 ships and 241,000 passengers a year. At the Red Hook Container Terminal, EDC is working with American Stevedoring to identify more high volume shippers that would have a competitive advantage receiving goods by water in Brooklyn.
"Phoenix Beverages is a growing company with excellent potential to bring additional jobs to Red Hook," said Economic Development Corporation President Seth Pinsky. "Finalizing this agreement is another step forward in Mayor Bloomberg's Five Borough Economic Opportunity Plan. Reinforcing our working waterfront helps to diversify our economy, strengthen the container port, improves the environment by taking trucks off congested local roads, and ultimately reduces the costs of goods for consumers. Relocating Phoenix's operations and 500 jobs to Red Hook will be an excellent addition to Brooklyn's port, the Red Hook community and the City of New York."
"The strength of Brooklyn's economy is derived from our diversity," said Brooklyn Chamber of Commerce President Carl Hum. "It is no small wonder that our economic diversity has helped Brooklyn weather the storms of prior recessions. Today's milestones will only help fortify our borough and insure our future by making sound investments in Sunset Park's physical assets, providing growth opportunities for the industrial and manufacturing sector, creating much-needed blue-collar jobs and promoting the environmentally-friendly movement of goods. The Chamber has consistently supported our working waterfront and it is reassuring to know that the Bloomberg Administration is attentive to the business community's needs."
"The new Sunset Park recycling facility offers excellent water access and was selected in large part for that reason," said Sims Metal Management Group Chief Executive Officer Dan Dienst. "The facility will allow Sims Metal Management to expand our already extensive barge–based system of transporting recyclables on the water and not on City streets. Additionally, the facility will provide approximately 100 new jobs at all skill levels. From the beginning we have said that hiring from the Sunset Park community will be a top priority, and we look forward to working with the City and local organizations to make sure we do just that. As with all of our 230 locations around the world, these will be good, green collar jobs and our future employees will enjoy a safe, clean and a state of the art operating environment."
The Bloomberg Administration's Five Borough Economic Opportunity Plan is a comprehensive strategy to bring New York City through the current economic downturn as fast as possible. It focuses on three major areas: creating jobs for New Yorkers today, implementing a long-term vision for growing the city's economy, and building affordable, attractive neighborhoods in every borough. Taken together, the initiatives that the City has launched to achieve these goals will generate thousands of jobs and put New York City on a path to economic recovery and growth. To learn more about the plan, visit nyc.gov.
Recent announcements to diversify the economy include:
- Eight initiatives to strengthen the media industry in New York City.
- New initiatives to help support Hispanic-owned small businesses.
- The opening of China Construction Bank's New York City office.
- New international cruise activity, growing New York City's 13,000-job cruise industry.
- Steps to help New York City's bioscience companies compete for Federal funding.
- Legislation that will green buildings and create 19,000 construction jobs.
- Green projects at the Brooklyn Navy Yard are creating more than 1,700 permanent jobs.
- Comprehensive initiatives to support the nonprofit sector and its 490,000 jobs.
- New programs to provide training and resources for City's future entrepreneurs.
- 11 new initiatives to support the financial services sector and promote entrepreneurship.
Other Five Borough Economic Opportunity Plan announcements include:
- A record 10,500 job placements through the first half of 2009.
- A plan to convert unoccupied apartments and stalled sites into affordable housing.
- The opening of New Mount Hope Community Center in the Bronx.
- The purchase of the Hunter's Point South site to create a new, affordable neighborhood.
- A public campaign to help more New Yorkers get free foreclosure prevention services.
- The start of services of the Park Slope 5th Avenue Business Improvement District.
- A stimulus-funded bond program to spur commercial and industrial projects citywide.
- The City will use nearly $32 million to train 10,000 New Yorkers for jobs.
- New space for 20 small businesses in Bushwick, creating more than 80 industrial jobs.
- The citywide "Fashion's Night Out" event to support retailers in all five boroughs.
- The start to construction of the International Gem Tower, which will house 3,000 jobs.
- City's Workforce1 Centers in Harlem and Jamaica received awards for innovation.
- Food Retail Expansion to Support Health (FRESH) program to encourage grocery stores.
- City-supported loans unavailable from banks to help small businesses stay in operation.
- Three new Financial Empowerment Centers offering free, one-on-one financial coaching.
- Stimulus funding to help the City provide summer jobs for 51,000 young New Yorkers.
- The opening of New Hope Walton Project, housing for low-income residents in Harlem
- New affordable housing at Gateway Building, a long-vacant structure in the South Bronx.
- The Harlem Business Assistance Fund to help businesses relocate to the 125th Street area.
- The expansion of NYC Business Express to help businesses obtain permits and licenses.
- The "Nine in '09" campaign to promote economic activity in diverse neighborhoods.
- A Center for Economic Opportunity program put 4,000 low-income New Yorkers in jobs.
- Stimulus-funded community development projects that will strengthen neighborhoods.
- Stimulus-funded Housing Authority projects that will create jobs for 3,255 New Yorkers.
- The start of construction of 103 units of affordable housing in Brownsville.
- The opening of Home Depot in the South Bronx creating 200 new permanent jobs.
- The latest round of training funds to help small businesses train their employees.
- The placement of 50 laid-off New Yorkers into positions at entrepreneurial companies.
- New York City achieved a record 5,000 job placements through the first quarter of 2009.
- Help for a beer distributor to create 55 permanent and 30 construction jobs in the Bronx.
- Comprehensive initiatives to support the nonprofit sector and its 490,000 jobs.
- Federal stimulus transportation projects that will create or preserve 32,000 jobs.
- Steps the City is taking to help small businesses adapt to conditions and avoid layoffs.
- A plan to create and retain 400,000 jobs over the next six years
For more information, project PDFs are available for download in our Press Kit.


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Check out our team page!
Light The Night Walk is The Leukemia & Lymphoma Society's evening walk and fundraising event. It is the nation's night to pay tribute and bring hope to thousands of people battling blood cancers and to commemorate loved ones lost.
The Leukemia & Lymphoma Society (LLS) funds lifesaving research
that has contributed to major advances in the treatment of blood cancers
and treatments for other types of cancer, such as chemotherapy and stem
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A donation of $25 provides patients and their loved ones with FREE
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A donation of $1,000 makes possible one- on-one conversations with
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their health care team.
Please make a donation to support my team's participation in the Light
The Night Walk and help save lives. Be sure to check my team's Web site
frequently to see my team's progress, and thanks for your support!

subset: commoncrawl


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Lucy in the Sky
There's a point at which this joke stops being funny and turns sad, and it's very early in its over two hours runtime.
There's a point at which this joke stops being funny and turns sad, and it's very early in its over two hours runtime.
The fact that Midnight Traveler even exists is a bit of a miracle.
Roger Ebert on James Ivory's "Howards End".
"The Ballad of Narayama" is a Japanese film of great beauty and elegant artifice, telling a story of startling cruelty. What a space it opens…
An article about the 4K restoration of George T. Nierenberg's "Say Amen, Somebody" currently receiving a limited theatrical release.
An article about the second annual Ebert Symposium, "Creating an Inclusive Cinema and Media Ecosystem," scheduled for Friday, September 27th at the University of Illinois…
An article about the 4K restoration of George T. Nierenberg's "Say Amen, Somebody" currently receiving a limited theatrical release.
An article about the second annual Ebert Symposium, "Creating an Inclusive Cinema and Media Ecosystem," scheduled for Friday, September 27th at the University of Illinois…
A reappreciation of a Billy Wilder classic.
FFC Seongyong Cho looks back at Alan J. Pakula's twisty thriller Presumed Innocent.
An interview with producer Liz Trubridge and actors Michelle Dockery and Laura Carmichael about Downton Abbey.
A hub for all of our content from the 2019 Venice Film Festival.
In another time and another place, "Starlet" could have inspired a short story by Chekhov or O. Henry — a story about two women, one 22, the other 85, who are linked by one of those accidental plot twists explaining why they come together. Indeed, for almost an hour, the story is all the movie is about: That, and performances so effective they're enough all by themselves, even while we know next to nothing about the characters.
Jane (Dree Hemingway) is a leggy blonde, the type who causes people to observe, "she'd be a real beauty, if only she did something with herself." She dresses carelessly, does little with her hair and makeup, lives with two roommates in an apartment building in the San Fernando Valley that you could hardly describe if you had to. She sleeps late, has the first of two or three cigarettes for the day, and takes her pet Chihuahua tooling around in search of yard sales.
She wanders into a front yard so densely planted that she almost doesn't see the old lady hidden in the shadows. This is Sadie (Besedka Johnson), plainspoken, no-nonsense, with not a shred of "sweet little old lady" about her. "Does this hold dead people?" she asks, holding up a possible purchase. "No!" says Sadie crossly. "That's a vase! It's a dollar." Jane buys it. "No refunds!" Sadie tells her.
Jane takes it home, cleans it and is surprised to find that the vase is stuffed with rolls of $100 bills, tightly wrapped in rubber bands. She spends some of the money on a fake-diamond dog halter. Her dog is a male, but the halter says "Starlet," so that becomes the dog's name. The dog doesn't care.
Jane thinks to do the right thing. She returns to Sadie's house, knocks on the door, and can't begin speaking before the old lady snarls, "No refunds!" Jane has a conscience. She trails Sadie in a taxi, pays the taxi to leave, and is waiting for Sadie when she comes out looking for it. She says she'll give her a ride home. Sadie is immediately suspicious. She's even more standoffish when Jane turns up at her table at her church's weekly bingo game. Sadie doesn't warm easily. She's not looking for a new friend.
This may be a spoiler, although the movie's promotion doesn't do enough to conceal it: Jane works for a production company that makes pornos in the Valley. It's a numbing occupation, but Jane hardly seems touched by it. Sex in general seems to mean little in her life, and apart from one mechanical scene, the movie doesn't make much of it. Sadie, in fact, is the most interesting thing that's happened to Jane in a while. She presses herself on the old lady, drives her places, asks her questions.
I learn from Variety that Besedka Johnson, playing Sadie, is a first-time actress who was discovered by the filmmakers at the West Hollywood YMCA. Dree Hemingway is the daughter of Mariel Hemingway, who also played a sexually daring role early in her career, as a Playboy Playmate of the Year in "Star 80" (1983). These two women, so very different, are the film's heart and soul, inviting us to decide for ourselves what's beneath their seemingly obvious facades.
The portrait of the porn industry here suggests a strictly-for-business existence, matter-of-fact, run out of offices filled with computers and file cabinets. Everybody seems to work by routine. Even Jane's roommates, also in porn, are more interested in playing video games. Nor does director Sean Baker seem to make any effort to exploit any particular abilities or cute tricks by the ever-present Chihuahua. This is a low-energy dog who often seems on the lookout for a nap.
All leads up to Jane discovering a way she may be able to spend Sadie's money (which she didn't know was in the vase) on her. This involves Jane's discovery of a fact about Sadie's past that, when it finally is revealed, is a little underwhelming. But the film itself deserves praise for its portraits of these two women and the different worlds they inhabit. And if they instructed Besedka Johnson to make no effort to make Sadie sympathetic, it certainly worked.
Note: "Starlet," distributed by Chicago-based Music Box Films, is nominated for seven Independent Spirit Awards.
EDITOR'S NOTE: Sometimes, Roger Ebert is exposed to bad movies. When that happens, it is his duty -- if not necessari...
A review of Netflix's The I-Land, the worst show in the streaming service's history.
This message came to me from a reader named Peter Svensland. He and a fr...
A review of the new film by Roman Polanski, which premiered at the Venice Film Festival.


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Malaria, Mosquitoes, and DDT
Malaria, Mosquitoes, and DDT
The toxic war against a global disease
This year, like every other year within the past couple of decades, uncountable trillions of mosquitoes will inject malaria parasites into human blood streams billions of times. Some 300 to 500 million full-blown cases of malaria will result, and between 1 and 3 million people will die, most of them pregnant women and children. That's the official figure, anyway, but it's likely to be a substantial underestimate, since most malaria deaths are not formally registered, and many are likely to have escaped the estimators. Very roughly, the malaria death toll rivals that of AIDS, which now kills about 3 million people annually.
But unlike AIDS, malaria is a low-priority killer. Despite the deaths, and the fact that roughly 2.5 billion people (40 percent of the world's population) are at risk of contracting the disease, malaria is a relatively low public health priority on the international scene. Malaria rarely makes the news. And international funding for malaria research currently comes to a mere $150 million annually. Just by way of comparison, that's only about 5 percent of the $2.8 billion that the U.S. government alone is considering for AIDS research in fiscal year 2003.
The low priority assigned to malaria would be at least easier to understand, though no less mistaken, if the threat were static. Unfortunately it is not. It is true that the geographic range of the disease has contracted substantially since the mid-20th century, but over the past couple of decades, malaria has been gathering strength. Virtually all areas where the disease is endemic have seen drug-resistant strains of the parasites emerge-a development that is almost certainly boosting death rates. In countries as various as Armenia, Afghanistan, and Sierra Leone, the lack or deterioration of basic infrastructure has created a wealth of new breeding sites for the mosquitoes that spread the disease. The rapidly expanding slums of many tropical cities also lack such infrastructure; poor sanitation and crowding have primed these places as well for outbreaks-even though malaria has up to now been regarded as predominantly a rural disease.
What has current policy to offer in the face of these threats? The medical arsenal is limited; there are only about a dozen antimalarial drugs commonly in use, and there is significant malaria resistance to most of them. In the absence of a reliable way to kill the parasites, policy has tended to focus on killing the mosquitoes that bear them. And that has led to an abundant use of synthetic pesticides, including one of the oldest and most dangerous: dichlorodiphenyl trichloroethane, or DDT.
DDT is no longer used or manufactured in most of the world, but because it does not break down readily, it is still one of the most commonly detected pesticides in the milk of nursing mothers. DDT is also one of the "dirty dozen" chemicals included in the 2001 Stockholm Convention on Persistent Organic Pollutants. The signatories to the "POPs Treaty" essentially agreed to ban all uses of DDT except as a last resort against disease-bearing mosquitoes. Unfortunately, however, DDT is still a routine option in 19 countries, most of them in Africa. (Only 11 of these countries have thus far signed the treaty.) Among the signatory countries, 31-slightly fewer than one-third-have given notice that they are reserving the right to use DDT against malaria. On the face of it, such use may seem unavoidable, but there are good reasons for thinking that progress against the disease is compatible with reductions in DDT use.
Malaria is caused by four protozoan parasite species in the genus Plasmodium. These parasites are spread exclusively by certain mosquitoes in the genus Anopheles. An infection begins when a parasite-laden female mosquito settles onto someone's skin and pierces a capillary to take her blood meal. The parasite, in a form called the sporozoite, moves with the mosquito's saliva into the human bloodstream. About 10 percent of the mosquito's lode of sporozoites is likely to be injected during a meal, leaving plenty for the next bite. Unless the victim has some immunity to malaria-normally as a result of previous exposure-most sporozoites are likely to evade the body's immune system and make their way to the liver, a process that takes less than an hour. There they invade the liver cells and multiply asexually for about two weeks. By this time, the original several dozen sporozoites have become millions of merozoites-the form the parasite takes when it emerges from the liver and moves back into the blood to invade the body's red blood cells. Within the red blood cells, the merozoites go through another cycle of asexual reproduction, after which the cells burst and release millions of additional merozoites, which invade yet more red blood cells. The high fever and chills associated with malaria are the result of this stage, which tends to occur in pulses. If enough red blood cells are destroyed in one of these pulses, the result is convulsions, difficulty in breathing, coma, and death.
As the parasite multiplies inside the red blood cells, it produces not just more merozoites, but also gametocytes, which are capable of sexual reproduction. This occurs when the parasite moves back into the mosquitoes; even as they inject sporozoites, biting mosquitoes may ingest gametocytes if they are feeding on a person who is already infected. The gametocytes reproduce in the insect's gut and the resulting eggs move into the gut cells. Eventually, more sporozoites emerge from the gut and penetrate the mosquito's salivary glands, where they await a chance to enter another human bloodstream, to begin the cycle again.
Of the roughly 380 mosquito species in the genus Anopheles, about 60 are able to transmit malaria to people. These malaria vectors are widespread throughout the tropics and warm temperate zones, and they are very efficient at spreading the disease. Malaria is highly contagious, as is apparent from a measurement that epidemiologists call the "basic reproduction number," or BRN. The BRN indicates, on average, how many new cases a single infected person is likely to cause. For example, among the nonvectored diseases (those in which the pathogen travels directly from person to person without an intermediary like a mosquito), measles is one of the most contagious. The BRN for measles is 12 to 14, meaning that someone with measles is likely to infect 12 to 14 other people. (Luckily, there's an inherent limit in this process: as a pathogen spreads through any particular area, it will encounter fewer and fewer susceptible people who aren't already sick, and the outbreak will eventually subside.) HIV/AIDS is on the other end of the scale: it's deadly, but it burns through a population slowly. Its BRN is just above 1, the minimum necessary for the pathogen's survival. With malaria, the BRN varies considerably, depending on such factors as which mosquito species are present in an area and what the temperatures are. (Warmer is worse, since the parasites mature more quickly.) But malaria can have a BRN in excess of 100: over an adult life that may last about a week, a single, malaria-laden mosquito could conceivably infect more than 100 people.
Seven years, seven months
"Malaria" comes from the Italian "mal'aria." For centuries, European physicians had attributed the disease to "bad air." Apart from a tradition of associating bad air with swamps-a useful prejudice, given the amount of mosquito habitat in swamps-early medicine was largely ineffective against the disease. It _wasn't until 1897 that the British physician Ronald Ross proved that mosquitoes carry malaria.
The practical implications of Ross's discovery did not go unnoticed. For example, the U.S. administration of Theodore Roosevelt recognized malaria and yellow fever (another mosquito-vectored disease) as perhaps the most serious obstacles to the construction of the Panama Canal. This was hardly a surprising conclusion, since the earlier and unsuccessful French attempt to build the canal-an effort that predated Ross's discovery-is thought to have lost between 10,000 and 20,000 workers to disease. So the American workers draped their water supplies and living quarters with mosquito netting, attempted to fill in or drain swamps, installed sewers, poured oil into standing water, and conducted mosquito-swatting campaigns. And it worked: the incidence of malaria declined. In 1906, 80 percent of the workers had the disease; by 1913, a year before the Canal was completed, only 7 percent did. Malaria could be suppressed, it seemed, with a great deal of mosquito netting, and by eliminating as much mosquito habitat as possible. But the labor involved in that effort could be enormous.
That is why DDT proved so appealing. In 1939, the Swiss chemist Paul Müller discovered that this chemical was a potent pesticide. DDT was first used during World War II, as a delousing agent. Later on, areas in southern Europe, North Africa, and Asia were fogged with DDT, to clear malaria-laden mosquitoes from the paths of invading Allied troops. DDT was cheap and it seemed to be harmless to anything other than insects. It was also long-lasting: most other insecticides lost their potency in a few days, but in the early years of its use, the effects of a single dose of DDT could last for up to six months. In 1948, Müller won a Nobel Prize for his work and DDT was hailed as a chemical miracle.
A decade later, DDT had inspired another kind of war-a general assault on malaria. The "Global Malaria Eradication Program," launched in 1955, became one of the first major undertakings of the newly created World Health Organization. Some 65 nations enlisted in the cause. Funding for DDT factories was donated to poor countries and production of the insecticide climbed.
The malaria eradication strategy was not to kill every single mosquito, but to suppress their populations and shorten the lifespans of any survivors, so that the parasite would not have time to develop within them. If the mosquitoes could be kept down long enough, the parasites would eventually disappear from the human population. In any particular area, the process was expected to take three years-time enough for all infected people either to recover or die. After that, a resurgence of mosquitoes would be merely an annoyance, rather than a threat. And initially, the strategy seemed to be working. It proved especially effective on islands-relatively small areas insulated from reinfestation. Taiwan, Jamaica, and Sardinia were soon declared malaria-free and have remained so to this day. By 1961, arguably the year at which the program had peak momentum, malaria had been eliminated or dramatically reduced in 37 countries.
One year later, Rachel Carson published Silent Spring, her landmark study of the ecological damage caused by the widespread use of DDT and other pesticides. Like other organochlorine pesticides, DDT bioaccumulates. It's fat soluble, so when an animal ingests it-by browsing contaminated vegetation, for example-the chemical tends to concentrate in its fat, instead of being excreted. When another animal eats that animal, it is likely to absorb the prey's burden of DDT. This process leads to an increasing concentration of DDT in the higher links of the food chain. And since DDT has a high chronic toxicity-that is, long-term exposure is likely to cause various physiological abnormalities-this bioaccumulation has profound implications for both ecological and human health.
With the miseries of malaria in full view, the managers of the eradication campaign didn't worry much about the toxicity of DDT, but they were greatly concerned about another aspect of the pesticide's effects: resistance. Continual exposure to an insecticide tends to "breed" insect populations that are at least partially immune to the poison. Resistance to DDT had been reported as early as 1946. The campaign managers knew that in mosquitoes, regular exposure to DDT tended to produce widespread resistance in four to seven years. Since it took three years to clear malaria from a human population, that didn't leave a lot of leeway for the eradication effort. As it turned out, the logistics simply couldn't be made to work in large, heavily infested areas with high human populations, poor housing and roads, and generally minimal infrastructure. In 1969, the campaign was abandoned. Today, DDT resistance is widespread in Anopheles, as is resistance to many more recent pesticides.
Undoubtedly, the campaign saved millions of lives, and it did clear malaria from some areas. But its broadest legacy has been of much more dubious value. It engendered the idea of DDT as a first resort against mosquitoes and it established the unstable dynamic of DDT resistance in Anopheles populations. In mosquitoes, the genetic mechanism that confers resistance to DDT does not usually come at any great competitive "cost"-that is, when no DDT is being sprayed, the resistant mosquitoes may do just about as well as nonresistant mosquitoes. So once a population acquires resistance, the trait is not likely to disappear even if DDT isn't used for years. If DDT is reapplied to such a population, widespread resistance will reappear very rapidly. The rule of thumb among entomologists is that you may get seven years of resistance-free use the first time around, but you only get about seven months the second time. Even that limited respite, however, is enough to make the chemical an attractive option as an emergency measure-or to keep it in the arsenals of bureaucracies committed to its use.
Malaria taxes
In December 2000, the POPs Treaty negotiators convened in Johannesburg, South Africa, even though, by an unfortunate coincidence, South Africa had suffered a potentially embarrassing setback earlier that year in its own POPs policies. In 1996, South Africa had switched its mosquito control programs from DDT to a less persistent group of pesticides known as pyrethroids. The move seemed solid and supportable at the time, since years of DDT use had greatly reduced Anopheles populations and largely eliminated one of the most troublesome local vectors, the appropriately named A. funestus ("funestus" means deadly). South Africa seemed to have beaten the DDT habit: the chemical had been used to achieve a worthwhile objective; it had then been discarded. And the plan worked-until a year before the POPs summit, when malaria infections rose to 61,000 cases, a level not seen in decades. A. funestus reappeared as well, in KwaZulu-Natal, and in a form resistant to pyrethroids. In early 2000, DDT was reintroduced, in an indoor spraying program. (This is now a standard way of using DDT for mosquito control; the pesticide is usually applied only to walls, where mosquitoes alight to rest.) By the middle of the year, the number of infections had dropped by half.
Initially, the spraying program was criticized, but what reasonable alternative was there? This is said to be the African predicament, and yet the South African situation is hardly representative of sub-Saharan Africa as a whole.
Malaria is considered endemic in 105 countries throughout the tropics and warm temperate zones, but by far the worst region for the disease is sub-Saharan Africa. (See map.) The deadliest of the four parasite species, Plasmodium falciparum, is widespread throughout this region, as is one of the world's most effective malaria vectors, Anopheles gambiae. Nearly half the population of sub-Saharan Africa is at risk of infection, and in much of eastern and central Africa, and pockets of west Africa, it would be difficult to find anyone who has not been exposed to the parasites. Some 90 percent of the world's malaria infections and deaths occur in sub-Saharan Africa, and the disease now accounts for 30 percent of African childhood mortality. It is true that malaria is a grave problem in many parts of the world, but the African experience is misery on a very different order of magnitude. The average Tanzanian suffers more infective bites each night than the average Thai or Vietnamese does in a year.
As a broad social burden, malaria is thought to cost Africa between $3 billion and $12 billion annually. According to one economic analysis, if the disease had been eradicated in 1965, Africa's GDP would now be 35 percent higher than it currently is. Africa was also the gaping hole in the global eradication program: the WHO planners thought there was little they could do on the continent and limited efforts to Ethiopia, Zimbabwe, and South Africa, where eradication was thought to be feasible.
But even though the campaign largely passed Africa by, DDT has not. Many African countries have used DDT for mosquito control in indoor spraying programs, but the primary use of DDT on the continent has been as an agricultural insecticide. Consequently, in parts of west Africa especially, DDT resistance is now widespread in A. gambiae. But even if A. gambiae were not resistant, a full-bore campaign to suppress it would probably accomplish little, because this mosquito is so efficient at transmitting malaria. Unlike most Anopheles species, A. gambiae specializes in human blood, so even a small population would keep the disease in circulation. One way to get a sense for this problem is to consider the "transmission index"-the threshold number of mosquito bites necessary to perpetuate the disease. In Africa, the index overall is 1 bite per person per month. That's all that's necessary to keep malaria in circulation. In India, by comparison, the TI is 10 bites per person per month.
And yet Africa is not a lost cause-it's simply that the key to progress does not lie in the general suppression of mosquito populations. Instead of spraying, the most promising African programs rely primarily on "bednets"-mosquito netting that is treated with an insecticide, usually a pyrethroid, and that is suspended over a person's bed. Bednets can't eliminate malaria, but they can "deflect" much of the burden. Because Anopheles species generally feed in the evening and at night, a bednet can radically reduce the number of infective bites a person receives. Such a person would probably still be infected from time to time, but would usually be able to lead a normal life.
In effect, therefore, bednets can substantially reduce the disease. Trials in the use of bednets for children have shown a decline in malaria-induced mortality by 25 to 40 percent. Infection levels and the incidence of severe anemia also declined. In Kenya, a recent study has shown that pregnant women who use bednets tend to give birth to healthier babies. In parts of Chad, Mali, Burkina Faso, and Senegal, bednets are becoming standard household items. In the tiny west African nation of The Gambia, somewhere between 50 and 80 percent of the population has bednets.
Bednets are hardly a panacea. They have to be used properly and retreated with insecticide occasionally. And there is still the problem of insecticide resistance, although the nets themselves are hardly likely to be the main cause of it. (Pyrethroids are used extensively in agriculture as well.) Nevertheless, bednets can help transform malaria from a chronic disaster to a manageable public health problem -something a healthcare system can cope with.
So it's unfortunate that in much of central and southern Africa, the nets are a rarity. It's even more unfortunate that, in 28 African countries, they're taxed or subject to import tariffs. Most of the people in these countries would have trouble paying for a net even without the tax. This problem was addressed in the May 2000 "Abuja Declaration," a summit agreement on infectious diseases signed by 44 African countries. The Declaration included a pledge to do away with "malaria taxes." At last count, 13 countries have actually acted on the pledge, although in some cases only by reducing rather than eliminating the taxes. Since the Declaration was signed, an estimated 2 to 5 million Africans have died from malaria.
This failure to follow through with the Abuja Declaration casts the interest in DDT in a rather poor light. Of the 31 POPs treaty signatories that have reserved the right to use DDT, 21 are in Africa. Of those 21, 10 are apparently still taxing or imposing tariffs on bednets. (Among the African countries that have not signed the POPs treaty, some are almost certainly both using DDT and taxing bednets, but the exact number is difficult to ascertain because the status of DDT use is not always clear.) It is true that a case can be made for the use of DDT in situations like the one in South Africa in 1999-an infrequent flare-up in a context that lends itself to control. But the routine use of DDT against malaria is an exercise in toxic futility, especially when it's pursued at the expense of a superior and far more benign technology.
Learning to live with the mosquitoes
A group of French researchers recently announced some very encouraging results for a new anti-malarial drug known as G25. The drug was given to infected aotus monkeys, and it appears to have cleared the parasites from their systems. Although extensive testing will be necessary before it is known whether the drug can be safely given to people, these results have raised the hope of a cure for the disease.
Of course, it would be wonderful if G25, or some other new drug, lives up to that promise. But even in the absence of a cure, there are opportunities for progress that may one day make the current incidence of malaria look like some dark age horror. Many of these opportunities have been incorporated into an initiative that began in 1998, called the Roll Back Malaria (RBM) campaign, a collaborative effort between WHO, the World Bank, UNICEF, and the UNDP. In contrast to the earlier WHO eradication program, RBM grew out of joint efforts between WHO and various African governments specifically to address African malaria. RBM focuses on household- and community-level intervention and it emphasizes apparently modest changes that could yield major progress. Below are four "operating principles" that are, in one way or another, implicit in RBM or likely to reinforce its progress.
1. Do away with all taxes and tariffs on bednets, on pesticides intended for treating bednets, and on antimalarial drugs. Failure to act on this front certainly undercuts claims for the necessity of DDT; it may also undercut claims for antimalaria foreign aid.
2. Emphasize appropriate technologies. Where, for example, the need for mud to replaster walls is creating lots of pothole sized cavities near houses-cavities that fill with water and then with mosquito larvae-it makes more sense to help people improve their housing maintenance than it does to set up a program for squirting pesticide into every pothole. To be "appropriate," a technology has to be both affordable and culturally acceptable. Improving home maintenance should pass this test; so should bednets. And of course there are many other possibilities. In Kenya, for example, a research institution called the International Centre for Insect Physiology and Ecology has identified at least a dozen native east African plants that repel Anopheles gambiae in lab tests. Some of these plants could be important additions to household gardens.
3. Use existing networks whenever possible, instead of building new ones. In Tanzania, for example, an established healthcare program (UNICEF's Integrated Management of Childhood Illness Program) now dispenses antimalarial drugs-and instruction on how to use them. The UNICEF program was already operating, so it was simple and cheap to add the malaria component. Reported instances of severe malaria and anemia in infants have declined, apparently as a result. In Zambia, the government is planning to use health and prenatal clinics as the network for a coupon system that subsidizes bednets for the poor. Qualifying patients would pick up coupons at the clinics and redeem them at stores for the nets.
4. Assume that sound policy will involve action on many fronts. Malaria is not just a health problem-it's a social problem, an economic problem, an environmental problem, an agricultural problem, an urban planning problem. Health officials alone cannot possibly just make it go away. When the disease flares up, there is a strong and understandable temptation to strap on the spray equipment and douse the mosquitoes. But if this approach actually worked, we wouldn't be in this situation today. Arguably the biggest opportunity for progress against the disease lies, not in our capacity for chemical innovation, but in our capacity for organizational innovation-in our ability to build an awareness of the threat across a broad range of policy activities. For example, when government officials are considering loans to irrigation projects, they should be asking: has the potential for malaria been addressed? When foreign donors are designing antipoverty programs, they should be asking: do people need bednets? Routine inquiries of this sort could go a vast distance to reducing the disease.
Where is the DDT in all of this? There isn't any, and that's the point. We now have half a century of evidence that routine use of DDT simply will not prevail against the mosquitoes. Most countries have already absorbed this lesson, and banned the chemical or relegated it to emergency only status. Now the RBM campaign and associated efforts are showing that the frequency and intensity of those emergencies can be reduced through systematic attention to the chronic aspects of the disease. There is less and less justification for DDT, and the futility of using it as a matter of routine is becoming increasingly apparent: in order to control a disease, why should we poison our soils, our waters, and ourselves?
Anne Platt McGinn is a senior researcher at the Worldwatch Institute. She is the author of Worldwatch Paper 153, Why Poison Ourselves? A Precautionary Approach to Synthetic Chemicals.


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Warren Gatland happy with tour start
British and Irish Lions coach Warren Gatland is happy with the start his side have made to the tour of Australia.
The Lions had to lift their game against a determined Queensland Reds and battled to a 22-12 victory after convincing wins against poor opposition, the Barbarians and Western Force.
Gatland has revealed he's very happy following three victories from the opening three games.
"Absolutely. I'm very, very happy," Gatland said on Sunday.
"Yesterday's game was exactly what we wanted. We would like a couple more lead-in games, and for the first two games to be a bit tougher than they were, but that's what happens on tour - you are not dealing with tough teams all the time - so we will have to see what Tuesday is like."
There are three games remaining before the first test on June 22 but the Lions have recently lost props Cian Healy and Gethin Jenkins to injury. Wing Tommy Bowe has also undergone surgery on a damaged hand and are all doubts for the first test.
They face a Queensland-New South Wales Country XV on Tuesday in what is likely to be another convincing victory. But it was a different case on Saturday when the Lions had to dig deep at Suncorp Stadium to beat Queensland Reds.
Fly-half Owen Farrell's 17-point haul made the difference after Reds backs Luke Morahan and Nick Frisby had scored tries in each half.
Set-piece control was a major factor to the Lions win as they showed a dominant scrum and effective lineout.
Gatland was impressed with the set-pieces that was the component for victory against Queensland Reds.
"I thought that (set-pieces) was the victory in the game," Gatland added. "If you look at the way the Reds played - tactically, maybe Australia will do the same thing - they kept the ball in the park and only had about four lineouts.
"It was like watching Wales play against other teams. I thought our scrum was excellent and the lineout very good defensively.
"There needs to be a huge amount of credit placed on that part of our game."
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The best software in the world for brightness control of desktop is the ScreenBright. Before download the ScreenBright see the following feature: Brightness control Contrast increasing and decreasing Color Luminance maintained Green control I have been using this software for my desktop PC since 2012. It's best you may use this…Read More »
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|Jepson Flora Project: Jepson Interchange
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Jepson Interchange (more information)
©Copyright 1993 by the Regents of the University of California
Annual, biennial, perennial herb (rarely shrub, tree), often from taproot
Stem often ± scapose, generally ribbed, hollow
Leaves basal and generally some cauline, generally alternate; stipules generally 0; petiole base generally sheathing stem; blade generally much dissected, sometimes compound
Inflorescence: umbel or head, simple or compound, generally peduncled; bracts present (in involucres) or not; bractlets generally present (in involucels)
Flowers many, small, generally bisexual (or some staminate), generally radial (or outer bilateral); calyx 0 or lobes 5, small, atop ovary; petals 5, free, generally ovate or spoon-shaped, generally incurved at tips, generally ± ephemeral; stamens 5; pistil 1, ovary inferior, 2-chambered, generally with a ± conic, persistent projection or platform on top subtending 2 free styles
Fruit: 2 dry, 1-seeded halves that separate from each other but generally remain attached for some time to a central axis; ribs on each half 5, 2 marginal and 3 on back; oil tubes 1several per interval between ribs
Genera in family: 300 genera, 3,000 species: ± worldwide, especially temp; many cultivated for food or spice (e.g., Carum, caraway; Daucus; Petroselinum); some highly toxic (e.g., Conium). Underground structures here called roots, but true nature remains problematic. Mature fruit generally critical in identification; shapes generally given in outline, followed by shape in X -section of 2 fruit halves together.
Perennial, taprooted, cushion-forming, generally coarsely hairy or tomentose
Stem 0
Leaves: lowest bladeless sheaths; upper blades narrowly ovate to round, pinnately or ternately dissected, segments lanceolate or oblong
Inflorescence: umbels compound, head-like, spheric or hemispheric; peduncles spreading; bracts 0; involucel 1-sided, bractlets fused to nearly free; rays fewmany, spreading to spreading-ascending; fertile pedicels very short, sterile > fruit
Flower bisexual, staminate, or sterile; calyx lobes conspicuous or not; petals spoon-shaped or oblanceolate, generally white or yellow, or becoming purple, early deciduous, tips narrowed; projection atop ovary 0
Fruit ovate to round, slightly compressed side-to-side or cylindric, hairy; ribs subequal, thread-like; oil tubes per rib-interval several; fruit axis divided to base
Seed: face deeply grooved
Species in genus: 3 species: high mtns of CA-FP
Etymology: (Greek: mountain dwarf)
Reference: [Shevock & Norris 1981 Fremontia 9:2225]


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My brief flit toward Linux Mint underscored how much faster Crux was than anything else I've tried. As soon as I was finished exploring the Mint underpinnings (and trying to break it, because that's fun to me 😈 ), I blanked the drive on the world's ugliest laptop and reinstalled Crux.
I put together much the same setup as before, with a minimal Openbox system and a few utilities — Leafpad, emelFM2, Sakura and Firefox. (Believe it or not, Firefox is actually quite usable on this system.) With GTK Change Theme and ObMenu rounding out the utilities, I have an excellent backup system poised to attack … anything that might cross it's path, that is.
The downside is that I now have a 450Mhz machine that boots 3 seconds quicker than a machine that's rated at more than twice its CPU speed. My Arch system is still clocking in at around 27 or 28 seconds to boot.
And the downside of that is that I'm starting to throw an askance look at the little parts of Arch that I otherwise abide. Like that 10-second udev uevents lag — what can I do to get rid of that? Move back to static /dev? And how does one do that exactly?
I already recompile a kernel that stays tighter to this machine, and keeps all the drivers in the kernel, rather than loading them. And I chip away at every loose corner I can find, like tacking on a timeout flag to the /sbin/udevsettle command inside /etc/start_udev.
Still, it's hard for me to ignore a machine running a less than half the speed of this one, and booting faster. These are the things that keep me up at nights. Sigh. The life of a speed freak, I guess. 🙄


text: It is one of the oldest festivals, not only in China but also hroughout th上海龙凤品茶微信e world, with a history of more than 2,000 years. In 2006, the traditional festival was listed as part of China's national intangible cultural heritage. In 2008, it was recognized as a public holiday in the Chinese mainland. The Dragon Boat Festival commemorates the death of Qu Yuan, a Chu state official and poet who lived during the Warring States Period (475-221 BC) before the reu nification of China under the Qin Dynasty (221-206 BC). He was exiled after opposing his king's decision to ally wit h the neighboring state of Qin, and when Chu was finally conquered by Qin, he committed suicide by drowning in the Miluo River on the fifth day of the fifth lunar month. The Chu people, who admired Qu Yuan for his loyalty and integrity, th rew rice dumplings into the river to feed the fish so they would not eat the body of their po et hero. People then started dragon boat racing to scare off the fish. Since then, the fifth day of the fifth month on the lunar calendar is cel brated as the Dragon Boat Festival. The following are some customs for the festival. www.shoppingfair.org


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Eastbourne Borough will play National League outfit Braintree Town in the first round proper of the FA Cup.
Borough, who beat the National Premier's Aldershot 2-1 last Saturday to progress, will travel to Cressing Road, Essex to take on Hakan Hayrettin's men who are fourth from bottom in their league.
Whitehawk, who got to the second round last season, were handed a home draw against Stourbridge of the Northern Premier League.
Lowest ranked team Westfield were drawn against York City or Curzon Ashton.
The ties for the first round proper will take place over the weekend of 4-7 November.


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Amantadine for the Treatment of Traumatic Brain Injury Irritability and Aggression: A Multi-site Study
|The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
|ClinicalTrials.gov Identifier: NCT00779324
Recruitment Status : Completed
First Posted : October 24, 2008
Last Update Posted : September 12, 2014
- Study Details
- Tabular View
- Results Submitted
- Disclaimer
- How to Read a Study Record
|Condition or disease
|Brain Injury Aggression
|Drug: Amantadine Hydrochloride Drug: Placebo
|Not Applicable
PURPOSE OF PROJECT: To study the effect of amantadine 100 mg administered twice daily compared to placebo on irritability from baseline to treatment Day 28.
SUMMARY OF PROJECT: It is anticipated that 168 subjects with 168 corresponding subject informants will be recruited for the study. Carolinas Rehabilitation, the lead center, and 5 collaborating centers will enroll approximately 28 subjects each.
Subjects will be recruited primarily from the clinics. Also, letters will be sent to patients in our data base. If the first encounter with research personnel is by telephone, the research assistant will obtain verbal (telephone) consent from the subject's informant for the Neuropsychiatric Inventory (NPI) for subject irritability. The score on this questionnaire must be ≥ 6 for qualification. This allows pre-screening to take place and avoid an unnecessary clinic visit.
Subjects who consent and qualify will be randomized in a 1:1 ratio, amantadine to placebo. Stratification to randomization group will occur based on the presence of depression defined by a Beck's Depression Inventory-II (BDI-II) score ≥ 13. Randomized subjects will receive amantadine or placebo 100 mg twice daily every morning and 12 Noon. There will be 4 clinic visits. Visits will occur at baseline, for consenting and screening, day 28, day 60 and day 90. At all 4 clinic visits, both the subject and the informant will be given questionnaires regarding the subject's behavior and mood. Follow up phone calls will occur each week that the subject is not seen in the clinic until the end of the study. Follow up phone calls will assess for study medication compliance, adverse events and concomitant medication changes. Day 60 ends the period of the Randomized Clinical Trial phase of the study and the subjects will begin the 1 month continuation phase of the study when all participants receive active amantadine.
The following questionnaires will be used as measures of irritability for the subject and the informant: Neuropsychiatric Inventory (NPI), State Trait Anger Expression Inventory (STAXI-2), and Global Impression of Change.
The following questionnaires will be dispensed to the subject only: Short Form -12, Satisfaction With Life Scale, Patient Health Questionnaire, Beck Depression Inventory, Brief Symptom Inventory, Family Assessment Device, Fatigue Impact Scale, and tests of cognitive function. The Glasgow Outcome Score-Extended will be completed by the research assistant using information obtained primarily from the informant.
The Investigator will complete the Clinical Global Impression of change at Visits 1, 2, 3, and 4.
History and Physical Exam, creatinine level (kidney function) will be obtained for safety and tolerability. Serum pregnancy tests will be drawn at screening for females of childbearing potential.
|Study Type :
|Interventional (Clinical Trial)
|Actual Enrollment :
|168 participants
|Intervention Model:
|Parallel Assignment
|Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
|Primary Purpose:
|Official Title:
|A Multi-Center, Parallel-Group, Randomized, Double-Blind, Placebo-Controlled Trial of Amantadine Hydrochloride in the Treatment of Chronic Traumatic Brain Injury Irritability and Aggression: A Replication Study
|Study Start Date :
|August 2009
|Actual Primary Completion Date :
|April 2013
|Actual Study Completion Date :
|May 2013
Experimental: Amantadine
Amantadine 100 mg every morning and Noon
Drug: Amantadine Hydrochloride
100 mg every morning and noon
Other Name: Symmetrel
Placebo Comparator: Placebo
Placebo tablets
Drug: Placebo
one placebo tablet every morning and 12 Noon
- Neuropsychiatric Inventory Irritability Domain [ Time Frame: 28 days ]
- Neuropsychiatric Inventory Aggression Domain [ Time Frame: 28 days and 60 days ]
- State Anger Aggression Expression Inventory -- II [ Time Frame: 28 and 60 days ]
- Neuropsychiatric Inventory Irritability Domain [ Time Frame: 60 days ]
- Neuropsychiatric Inventory Caregiver Distress Score for Irritability and Aggression Domains [ Time Frame: 28 and 60 days ]
- Clinical Global Impressions [ Time Frame: 28 and 60 days ]
- Global Impression of Change [ Time Frame: 28 and 60 days ]
- Short Form-12 [ Time Frame: 28 and 60 days ]
- Satisfaction With Life Scale [ Time Frame: 28 and 60 days ]
- Patient Health Questionnaire - 9 [ Time Frame: 28 and 60 days ]
- Beck Depression Inventory II [ Time Frame: 28 and 60 days ]
- Neuropsychologic tests [ Time Frame: 28 and 60 days ]Digit Span, Trail Making Test, Controlled Oral Word Association Test, California Verbal Learning Test, Processing Speed Index
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.
|Ages Eligible for Study:
|16 Years to 75 Years (Child, Adult, Older Adult)
|Sexes Eligible for Study:
|Accepts Healthy Volunteers:
Inclusion Criteria:
- Closed head injury (defined as impaired brain function resulting from externally inflicted trauma without penetrating injury) at least 6 months prior to enrollment
- Irritability that is either new or worse than the level of irritability before the traumatic brain injury, by report of the Observer or person with TBI
- Age at time of enrollment: 16 to 75 years
- Voluntary informed consent and authorization of participant and informant
- Subject and informant willing to comply with the protocol
- Informant-rated NPI Irritability Domain score 6 or greater (moderate-to-severe irritability)
- Medically and neurologically stable during the month prior to enrollment
- If taking antidepressant, anxiolytic, hypnotic, or stimulant medications, no change anticipated in these medications during the month prior to enrollment or during the 90-day participation
- No change in therapies or medications planned during the 90-day participation
- No surgeries planned during the 90-day participation
- Vision, hearing, speech, motor function, and comprehension sufficient to complete interviews
- Observer (e.g.: family member, close friend, employer) with whom subject interacts sufficiently to observe occurrences of irritability. The observer interacts with the participant for a period long enough and of a nature to be able to judge the participant's irritability. The interactions would need to be adequate to judge observer distress over the irritability, severity of irritability and frequency of irritability on the following scale: < once weekly; once per week; several times per week, but not every day; essentially continuous.
Exclusion Criteria:
- Previous participation in the Carolinas TBI Model System amantadine irritability study
- Ingestion of amantadine hydrochloride during the month prior to enrollment
- Potential subject without a reliable informant
- Penetrating head injury as defined by head injury due to gunshot, projectile or foreign object
- Injury < 6 months prior to enrollment
- Inability to interact sufficiently for communication with caregiver
- Clinical signs of active infection
- Diagnosis of seizure in the month prior to enrollment
- Creatinine clearance <60 mL/min
- Pregnancy (Beta-HCG + females of child-bearing potential) and lactating females
- Concurrent use of first generation neuroleptic agents or phenelzine
- History of schizophrenia or psychosis
- Active concern of schizophrenia or psychosis
- Diagnosis of progressive or additional neurologic disease that affects brain function, except stroke that occurs at th same time as the TBI
- Previous allergy or adverse reaction to amantadine hydrochloride
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00779324
|United States, Indiana
|Indiana University and the Rehabilitation Hospital of Indiana
|Indianapolis, Indiana, United States, 46254
|United States, Massachusetts
|Spaulding Rehabilitation
|Boston, Massachusetts, United States, 02114
|United States, North Carolina
|Carolinas Rehabilitation
|Charlotte, North Carolina, United States, 28203
|United States, Ohio
|The Ohio State University
|Columbus, Ohio, United States, 43210
|United States, Texas
|TIRR Memorial Herman
|Houston, Texas, United States, 77030
|United States, Washington
|University of Washington
|Seattle, Washington, United States, 98195
|Principal Investigator:
|Flora M Hammond, MD
|Carolinas Rehabilitation
Additional Information:
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
|Responsible Party:
|Flora Hammond, Principal Investigator, Atrium Health
|ClinicalTrials.gov Identifier:
|NCT00779324 History of Changes
|Other Study ID Numbers:
|First Posted:
|October 24, 2008 Key Record Dates
|Last Update Posted:
|September 12, 2014
|Last Verified:
|August 2014
traumatic brain injury
Brain Injuries
Brain Injuries, Traumatic
Wounds and Injuries
Brain Diseases
Central Nervous System Diseases
Nervous System Diseases
Craniocerebral Trauma
Trauma, Nervous System
Behavioral Symptoms
Antiparkinson Agents
Anti-Dyskinesia Agents
Antiviral Agents
Anti-Infective Agents
Dopamine Agents
Neurotransmitter Agents
Molecular Mechanisms of Pharmacological Action
Physiological Effects of Drugs
Analgesics, Non-Narcotic
Sensory System Agents
Peripheral Nervous System Agents


text:
From the upcoming edition of The Catholic Key:
Instead of Being President, May I Simply Take a First Lady?
By Santiago Ramos
The Adjustment Bureau
Directed by George Nolfi
Written by George Nolfi (screenplay), Philip K. Dick (short story "Adjustment Team")
Starring Matt Damon, Emily Blunt and Florence Kastriner
One coherent idea can be wrested from this silly movie, and with it, one fundamental mistake. The Adjustment Bureau claims that the notion of "a calling" is incompatible with free will; it confuses vocation with fatalism. It is a cheap sci-fi flick that will make a lot of money, but its metaphysical statement makes it the anti-King's Speech, and thus a more significant film than it deserves to be. It requires an explanation so that it may be explained away.
The actual Adjustment Bureau is a mysterious organization of intelligent life forms that look just like you and me, but live for much longer. The length of their lives allow them to monitor the progress of human history and to surreptitiously nudge human events towards progress, peace, and the fulfillment of personal talents. But how do they know in which direction to nudge? They carry little electronic books—they look a lot like leather-bound Kindles, actually—which bear self-updating diagrams mapping out the future of every human life. The (always off-screen and reverently referenced) Chairman—who all men call God—writes a plan for each and every human being; the Adjustment Bureau case officers shepherd the most important human beings (politicians, artists, and I would assume, CEOs) to their destiny. Sometimes, the case officers find it necessary to adjust events to make sure that the important people don't fall off course and mess up the Chairman's plan.
According to a senior member of the Adjustment Bureau, who is summoned by his inferiors once things get complicated in Act Two, humanity is not truly free. The Bureau guided humanity from its caveman beginnings to the height of Roman imperial greatness; at that point, free will was respected once again and… the Dark Ages persisted for several centuries. Once again the Bureau got to work: they enlivened humanity with the Renaissance, the Enlightenment, the Scientific Revolution, allowing us to be free once again in 1910. You know what happened after that. Sometime in the mid-1960s, the Bureau decided that two world wars and one Cuban missile crisis were enough, and they took control once again.
There is not much to be gained by listing the different ways in which the above conceit is ridiculous and stupid. Rome was built by genius, yes, but also by conquest and slavery. The North American slave trade, the Thirty Year's War, colonialism, the Reign of Terror, all occurred between… No, no. Too much work. There are enough absurdities to be derived from the plot.
The plot consists of a challenge to the Adjustment Bureau orthodoxy. One man falls in love against the Chairman's plan and…perhaps free will is good after all! Matt Damon plays David Norris, a handsome and smart young politician whose meteoric rise to power has been handicapped by a series of bad decisions—for example, getting arrested in a bar fight on the evening of an election. Nevertheless, he is brilliant and important enough that he merits personal attention by the bureau. His case officer is named Harry Mitchell (Anthony Mackie).
The Chairman's original plan for Norris included a lifelong relationship with a talented ballerina named Elise Sellas (Emily Blunt), whom Norris meets on the night in which he loses his first election for Senate. It is love at first sight, but this is no good because the Chairman has changed Norris' plan. According to the new plan, Norris is meant to be a great political leader and save America without Elise; she would ruin that, for some mysterious reason. But Norris is so infatuated, and he comes so close to messing up his own life, that the Bureau has to reveal its own existence to Norris in a radical effort to put things in their right place. Yet Norris is a hopeless romantic and he refuses to accept his fate.
Free will means "I love Elise" and fate means "You are called to be a great leader." That is the simple dichotomy that the movie offers us, overlooking obvious complicating objections, such as the fact that it was the Chairman ("fate") which brought Elise to Norris in the first place, and that even if Norris is fated to be a great leader, he has to accept his fate—he has to will it with his own self. No amount of free will could have created Elise, and the Chairman would never actually force Norris to run for office (in fact, even though he has been nudged in one way or another, Norris is always free).
The climax of the movie occurs once Case Officer Harry decides that all of this is just too heartbreaking, and he helps Norris to escape the clutches of the Bureau, whisk Elise away from a rival suitor, and reclaim his free will. But it also means that the Chairman has changed plans once again: there is no more plan for Norris. I'm not sure if that means that rest of us are going to enter into the dark ages again, but perhaps there will be a sequel.
In The King's Speech, one man attempts to overcome the obstacles that keep him from fulfilling his call to become the leader of his people. In order to overcome those obstacles, he needs and is given a friend. Freedom and a calling. Freedom and companionship as necessary for choosing to heed a calling, and for having strength to do so.
The Adjustment Bureau has the same story: one man called to be a leader and he is given a friend (well, a case officer) to help him overcome the obstacles that get in his way. But now one of those obstacles is a woman who is for some reason incompatible with his calling. (She is "enough", says Harry, she would extirpate all the emptiness, and fulfill all the desires in Norris' heart and he would not see any need pursue politics. No pressure, Elise!) So Norris decides he'd rather do his own thing and… screw humanity? Not explicitly. But is humanity screwed? Well, that's uncertain—the Chairman decides to give Elise and Norris a clean book, complete free will, so that means that America might never get to have its awesome president in the future. But does that mean…?
Nothing. It means nothing. The movie makes no sense. It just says "Free will is cool", "Chance encounters are weird," and "A pretty girl is the answer to all questions and wants, ever." Oh, and, "That'll be twelve dollars."
Santiago Ramos is pursuing graduate studies in philosophy at Boston College.


text:
Bullying played a part in the death of a 15-year-old girl from New York's Staten Island who walked in front of an oncoming bus with a suicide note in her pocket, according to her relatives.
Amanda Cummings, a sophomore at New Dorp High School, wrote Facebook messages in the weeks before her death that her realtives said showed a distressed girl crying out for help. Cummings died Monday from injuries sustained in the bus crash on Dec. 27.
Her uncle, Keith Cummings, told ABC-owned station WABC that bullying contributed to her suicide.
"Amanda begged her mother not to say anything for the simple fact that she'd be picked on more, or they'd make fun of her more," Cummings said.
He said that girls at Cummings' high school had been tormenting Amanda, and continued to leave inappropriate comments on her Facebook profile even as she lay in a coma at Staten Island University Hospital.
The bullying was apparently never reported to the school. New Dorp High School did not immediately return calls from ABC News seeking comment about Cummings' case or its bullying policies.
The note found in Cummings' pocket after the crash, according to her relatives, spoke of a failed relationship with a boyfriend, which family members believe added to the girl's stress. In the note, Cummings said, according to her relatives, that she could not live without the boyfriend. The New York Police Department confirmed that a note was found on Cummings at the time of the crash, but would not comment on its contents nor on the accusations of bullying in Cummings' death.
In the weeks and months leading up to her death, Cummings repeatedly expressed her unhappiness on her Facebook profile, saying she felt alone and sick of her life, and that she wanted to die.
"I'll just go f**k myself, just like u said baby, then ill go kill myself, with these pills, this knife, this life has already done half the job. -___-," she wrote in early December. The messages of despair stretched back at least to September.
Cummings' suicide is the latest in a string of recent youth suicides, including those of Massachusetts high school student Phoebe Prince and Rutgers University freshmen Tyler Clementi, who was bullied for his romantic encounter with another man. Prince hanged herself in a closet, and Clementi jumped of the George Washington Bridge in New York, bringing widespread outcry for schools to crack down on bullying.
Since Clementi's death, New Jersey has lead states around the country to enact tougher anti-bullying prgorams, including stricter punishments and better preventative education, in school districts.


text:
The honor of my first GWA recommendation goes to Flickr. What? Did you think I'd start with one of Google's many services? Nah. Flickr's creativity, history of innovation, and its ability to enable people makes this photo sharing service a joy for me to recommend to everyone. Why is Flickr amazing? Besides its many powerful features, Flickr is […]
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About GWA Author
I'm Pashmina. I'm super passionate about Internet marketing and web apps. They can make our lives simpler, and easier. And our work more powerful and enjoyable.
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text:
"Sandro Pertini" Turin - Caselle airportWebsiteDistance from the city centre: 16 km from Turin city centre. How to reach the city centre:
Rent-a-car services
Air Italy recommends Europcar to rent a car.
Book now!
Taxi servicesPronto taxi :phone number 011.5737.Radio Taxi : phone number: 011.5730 - 011.3399. CTA phone number/fax 011.9963090.
Train servicesTo Turin Dora GTT station from Turin Caselle airport is available a train service.Trains leaves every half an hour: to the airport, from 05.13 a.m. until 07.43 p.m. ; and to Turin, from 06.49 a.m. until 09.19 p.m. The journey lasts 19 minutes.Information:GTT - Phone number: 011.2165352 / 800-019152. Information
The Air Italy Group does not assume responsibilty for material or contents that may be present in third party web sites which are reachable through links present on this web page.


text:
In the first two installments of our 3-part Allergy Series, we've covered food allergies and inhalant allergies (atopy). This time, we'll go into a little more detail about what allergies are, and how to prevent and deal with them; and we'll reveal the most common allergy of all!
Allergy = Immune Hypersensitivity
An allergy is an over-reaction of the immune system to an allergen (usually a protein). There are four major types of hypersensitivity reaction:
- Type I or "immediate" hypersensitivity, also known as anaphylaxis. An example is the potentially life-threatening reaction to vaccines in sensitive animals. The type of reaction usually occurs within 30 minutes, but always within 12 hours. The problem usually occurs in tissue that has direct contact with the outside world, such as the skin, respiratory tract, and gastrointestinal system. This is the most common type of reaction seen in pets. Food allergies, atopy (inhalant allergies), and fleabite allergy usually fall into this category.
- Type II or cytotoxic hypersensitivity is what we think of as an autoimmune reaction, where antibodies attach to the body's own tissues, causing inflammation and tissue destruction. Transfusion reactions and vaccine-induced autoimmune hemolytic anemia are examples. The reaction begins within 3-10 hours.
- Type III or immune complex hypersensitivity occurs within 3-10 hours of exposure to the allergen. While relatively rare in animals, systemic lupus erythematosis in dogs is an example.
- Type IV or delayed hypersensitivity is the reaction we commonly think of as a "contact" allergy, such as a reaction to poison ivy. For instance, a dog may develop an allergy to the stuffing in, or the detergent used to wash, his dog bed, and develop a rash on his belly and paws (which have the least amount of fur and are thus in direct contact with the bed). This type of allergy typically takes days to develop, and is relatively uncommon in pets.
Diagnosing allergies
Diagnosing allergies can be difficult. First, your veterinarian needs to rule out other diseases or problems that cause those symptoms. For skin reactions, other causes include parasites, autoimmune disease, and skin infections. Diagnosis may include skin scrapings to look for mites (several species commonly infect dogs and cats); fungal culture for ringworm; or even biopsy to look for skin and gland abnormalities. In the case of gastrointestinal reactions, there are dozens of other potential causes, such as parasites; viral, bacterial, or fungal infections; toxins; liver or pancreas disorders; neurological problems; and cancer. The pet's history may also provide clues: atopy and fleabite allergy are more seasonal, while food allergies tend to be constant.
There are two major tests specifically for allergies manifesting as skin problems: intradermal skin testing, and blood tests.
- Intradermal skin testing involves injecting dozens of allergens into the skin to assess the degree of reactivity. The animal must be anesthetized for this process.
- Blood tests check for antibodies to a variety of allergens.
These tests are not 100% accurate, but they may help narrow down the list of suspects so that treatment can be targeted more efficiently. These tests are best reserved for dogs who will be getting immunotherapy (hyposensitization), which involves giving frequent injections of a combination of allergens in order to minimize the immune system reaction.
Food trials are also a way of diagnosing allergies, since symptoms of food allergy may involve either the skin or the gastrointestinal tract. It is worth keeping in mind that food allergies are far less common than other allergies, but food can still contribute to symptoms. The trial food should contain ingredients the pet has not been exposed to before, and should be fed exclusively for 8-12 weeks! Digestive symptoms typically resolve sooner than skin symptoms.
This "FAD" is the Top Allergy
FAD, or Flea Allergy Dermatitis, is the most common allergy of dogs and cats. The usual suspect is the cat flea, Ctenocephalides felis, which is just as likely to infest dogs as their namesake cats. Fleas inject their saliva as they feed on the pet's blood; and that saliva contains histamine-like compounds and other proteins. These components make fleabites extremely itchy on their own; but in some animals, they cause an allergy that is itchy to the extreme.
The most typical sites for FAD to show up are the lower back, base of the tail, inner thighs, and lower belly; although a severely allergic pet may be itchy all over.. The fur in affected areas may be stained brown from the pet's licking, and the skin can become hairless, crusty, thickened, or even blackened from chronic irritation. Hot spots (areas of moist, reddened skin) can also be the result of FAD. Secondary infections of the skin with yeast or bacteria are common.
Most people, confronted with a potentially flea-allergic pet, will adamantly deny that there is a flea problem in their homes—and most of them are probably correct. But you don't have to see fleas to have a flea problem. Fleas may be lurking in the yard, on the beach, or in the dog park. If your pet has a flea allergy, it only takes a single fleabite to produce a severe and long-lasting reaction.
In addition to causing itching and allergies, fleas can transmit tapeworms, roundworms, and the bacteria that cause bubonic plague, cat scratch disease, typhus, and Lyme disease. Many of these diseases can also be transmitted to humans. It is important to stay vigilant if you are in a flea-prone area.
For more information on fleas and how to combat them naturally, please see these articles:
Click here to read the second article in our allergy series on Inhalant Allergies (Atopy)