text: Conference Organization and Objectives Assessing Quality of Care for Diabetes: Conference Final Report As discussed here, there are many remaining challenges in the valid and effective measurement of diabetes quality, as well as in the improvement of metabolic, blood pressure, and lipid control for patients with diabetes. Therefore, the Michigan Diabetes Research & Training Center's (MDRTC) Measurement Core, the Veterans Health Administration's (VHA) Quality Enhancement Research Initiative for Diabetes (QUERI-DM), and the Center for Health Policy Research, University of California, Irvine, organized a national multidisciplinary conference on diabetes quality measurement. The Agency for Healthcare Research and Quality (AHRQ), the National Institute for Diabetes and Digestive and Kidney Diseases (NIDDK), and the VA's Office of Quality and Performance provided support for the conference.The conference brought together 40 scientific and clinical experts in the fields of diabetes and quality measurement, to review the state of the art in diabetes epidemiology and quality measurement, discuss necessary next steps for measurement development, and plan essential research for improving technical and interpersonal quality measurement. The ultimate goal of the conference was to improve diabetes outcomes.The conference built upon the mission and working relationships already established through the National Diabetes Quality Improvement Alliance,® expanded the discussion by addressing recent research and clinical findings and essential issues of measurement science, and focused on developing and testing new measures designed to further improve diabetes outcomes. While the main focus of the conference was on assessment of technical quality, many of the scientific issues discussed span technical and interpersonal quality assessment. The organizers of this conference sought to set the stage for inclusion of more measures that assess self-management support and interpersonal quality of diabetes care.Specifically, the conference objectives were to:Bring together scientific and clinical experts in the fields of diabetes and quality measurement.Review the state of the art in diabetes epidemiology and quality measurement science.Recommend and plan essential research for improving technical and interpersonal quality measurement.Provide recommendations regarding new measures of technical and interpersonal quality (or refinement of current measures).Disseminate conference conclusions.The 2-day conference was held May 24-25, 2006 in Ann Arbor, MI. The conference consisted of a series of presentations by national experts in measurement science, epidemiology, and diabetes clinical care. There was ample opportunity discussion. Speakers were selected on the basis of their national reputation and expertise in the topic areas. Our goal was to include experts with a variety of perspectives in order to make the conference constructive and inclusive.Speakers and participants included key representatives from specialty societies (including the American Medical Association, the American Diabetes Association, the American Academy of Family Physicians, the American College of Physicians, and others) and measurement groups (including the National Committee for Quality Assurance, the Centers for Medicare & Medicaid Services, the Department of Veterans Affairs, the Centers for Disease Control and Prevention, and the Joint Commission on Accreditation of Healthcare Organizations).Our planning committee* helped to structure the agenda and nominated speakers and discussants for the proposed topics. The conference organizers talked by phone with each of the speakers prior to the conference to discuss conference objectives and goals, as well as the specific goals for each session. The conference organizers also spoke by phone with each assigned moderator. In addition, all participants received a CD-ROM approximately 2 weeks before the conference with conference objectives, questions for each session, and selected readings and publications.Go to Appendix A for the bibliography provided to participants. Appendix B presents a list of conference participants, and Appendix C presents the final conference agenda.*Planning committee members were Eve A. Kerr, M.D., M.P.H.; Sheldon Greenfield, M.D.; Greg Pawlson, M.D., M.P.H.; Barbara Fleming, M.D., Ph.D.; Michael Engelgau, M.D., M.S.; and Rodney Hayward, M.D. Current as of January 2008 Internet Citation: Conference Organization and Objectives: Assessing Quality of Care for Diabetes: Conference Final Report. January 2008. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/events/other/diabetescare/diabcare1.html


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Thanksgiving Place Setting Idea: Use a Polaroid Snapshot!
Dining Inspiration
For a fun twist on a traditional place card, how about a Polaroid snapshot of your guest? Snap a photo of your guests when they arrive, and then prop the pictures in glasses as place cards. (A few cranberries add a festive touch.) At the end of the night, your guests can either take their picture home or leave it for you to make an album.
This eclectic, Moroccan-inspired Thanksgiving table was styled by Devin Kirk from Chicago home goods store Jayson Home & Garden. If you don't have a Polaroid camera to snap shots in the moment, you could always use other older photos, perhaps ones that recall a good story. Remembering those shared times with the loved ones around your table is just another thing to be thankful for!
→ Read more: Thanksgiving Table: Jayson Home at Design*Sponge
Related: Our Readers' Thanksgiving Tables and Feasts
(Image: Davin Youngs via Design*Sponge)
3 Comments
If you still have an actual Polaroid camera that works, you can find film for it now made by The Impossible Project.
FujiFilm has a couple great instant cameras and still makes it's own film for them:
Instax Mini
Instax 210
I think the second part of this suggestion is much better than snapping a photo at the door.
Using one you already have and elicits a good memory is a really nice idea.

subset: commoncrawl


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Signpost (Weber, Utah), 1983-05-241
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. - - - iMiini ii r"" - - ' - -- - .-, .mn.-, , . ,.-,- Vol. 43, No. 56 U UEbER STATE ColUqE 3 iJ For fun summer ideas see the sports supplement Tuesday, May 24, 1983 II in 1! 0 Signpasl photo Rodney Wright The warmth of the sun appears too much for this student (above) to resist. He is pictured stretched out on the lawn outside of the Union Building. The blossoms (left) also had a hard time resisting the sun, as they have come out in abundance all over campus. Largest class graduates A class of 2,031 students will graduate during Weber State's 95th commencement exercises, making it the largest graduating class in Weber's history. The procession of graduates will begin at 5:40 p.m., followed by a welcome from President Rodney H. Brady. Elder Boyd K Packer, a member of the Quorum of the Twelve Apostles of the Church of Jesus Christ of Latter Day Saints, will be the commencement speaker. Dave Allen, ASWSC academic vice president will also speak. The largest number of students, 21 percent of the class, will be graduating from the school of allied health sciences, according to Dean Hurst, vice president over college relations. The schools of - education and technology each have 15 percent. The school of business and economics and general education will each be graduating 13 percent of the class. Social sciences has 12 percent of the graduates, with the remaining graduating students comming from the schools and arts and humanities, and natural sciences. There are twelve students who have successfully completed the honors program. Graduating Summa Cum Laude are nine students with a bachelor of arts, 21 with a bachelor of science and one student with a bachelor of general studies. Eleven B.A., 22 B.S. and 3 B.S.G students will graduate Magna Cum Laude. Twenty-two B.A. 60 B.S. and seven B.G.S. students will be graduating Cum Laude. Honorary doctor of humanities degrees will be given to Elder Packer; William H. Child, owner-manager of R.C. Willey Company; John B. Goddard. chairman of the board of Western Mortgage Loan Corporation and president of United Savings and Loan Association; and Dee Glen Smith, president and chief executive officer of Smith's Management Corporation. t e &:jnpost phr Lee Wanna (left) models the hair design that won Dian "Best of Show" in the recent competition held cosmotology department. e Carter by the ASWSC officers realign budgets by Kathy Kendell Gov't Affairs The peer advisement program will receive funding from ASWSC. In addition, several budgets will be reexamined in an effort to better serve the needs of the studentbody. According to ASWSC President-elect Brad Howell, the officers want to respond to their constituency and establish an open relationship with the students. "When we (the officers) were elected to office, we were told we had to have budgets submitted by a certain deadline," Howell said. "We drew up our budgets rather quickly because we were forced to meet the deadline." . According to Howell, some mistakes were made. "Part of the problem was our inexperience and the lack of time to research our budgets made the problem worse," he said. Howell also commented that by employing hindsight, the .officers were able to see some of their errors ..- "There are some changes we need to make to respond to student needs," he said. "On the issue of peer advisement, we fully intended to fund that program from the beginning. When the issue was presented in budget hearings, it was presented as under a different name faculty evaluations. Had it been presented as peer advisement, we would have voted differently." Howell added that there was not a representative from peer advisement at the hearings. "There was a lack of communication as to how the money was to be spent," Howell said. "The new council can make changes in the budget and realign funding until July 1. And even after that, changes can be instituted," stated Howell. "What it comes down to is that we as a new council were appropriating funds when we hadn't had adequate time to plan. We know the students are concerned and we as officers want to respond to those concerns," Howell continued. "Students who are upset should come in and confront us directly. We are, and will continue to be accessible to the studentbody." Forensics director has motorcycle accident A member of the WSC communications faculty was released from the hospital Monday after suffering injuries in a motorcycle accident Friday, according to Dr. Harold Hunker, communications department chairman. Randy Scott, director of forensics, was traveling home on Mountain Road from a communications department party at a faculty member's home in Fruit Heights, when he hit a pot hole .in the road and lost contol of his motorcycle. Hunker stated that Scott fractured his jaw, along with skinning up his hands and legs. He also cut his cheek and had to have six stitches in it. For the next three weeks Scott will have his jaw wired, however, he will be returning to classes on May 31 after a week's recovery period.
Object Description
|Signpost (Weber, Utah), 1983-05-24, Vol. 43, No. 56
|Weber State College
|Associated Students of Weber College; A generous grant from the Utah State Library and the Institute of Museum and Library Services.
|Weber's current student newspaper, the Signpost, first appeared on September 29, 1937. For two years prior to that time, campus news was disseminated via announcements posted on a bulletin board known as the "Signpost". As a result, the masthead of the first issue of the paper itself featured a rudimentary wooden sign with the title spelled out in rustic-looking letters. Over the years the paper has been published continuously, though the look, size and style has changed several times.
|Date Original
|College student newspapers and periodicals; Weber State College
|Digital Format
|Publisher Digital
|Stewart Library, Weber State University
|Date Digital
|University Archives LD5893.W55 S5, Stewart Library, Weber State University
|Digital Identifier
|Rights Management
|Public Domain. Courtesy of University Archives, Stewart Library, Weber State University.
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2008 Buyers Guide & Resource Directory
Looking Ahead | Transatlantic Exchanges, Brokers Put Their Money on European Options Growth | Research Technology Ready to Enter a 'Breakout Year' | Next-Generation SMAs In Search of Next-Generation Solutions | E-Mail Archiving Growth Fueled by Federal Rule Changes |
Next-Generation SMAs In Search of Next-Generation Solutions
December 17, 2007
Unified managed accounts (UMAs) are moving to the forefront of the evolving separately managed accounts (SMA) marketplace, presenting the wealth management industry with new operational challenges that will require technological innovations to overcome.
As a bellwether for SMA sponsors, industry experts point to an announcement in February by Merrill Lynch & Co.--the largest sponsor for such accounts--that it was restructuring its program to accommodate UMAs.
Boston research firm Aite Group expects that UMAs, which now represent 3 percent, or $26.5 billion, of the estimated $884 billion in assets managed through tax-efficient SMAs and multi-style portfolios (MSPs), will climb to 8 percent, or $117 billion of $1.5 trillion, by 2011.
UMAs, an extension of MSPs, can include almost every asset in an investor's portfolio--single stocks, separate accounts, mutual funds and even hedge funds. However, limitations in trading and post-trade processing have required allocations in fixed-income and foreign equities to be conducted through exchange-traded funds, mutual funds and American Depositary Receipts rather than directly.
By grouping a client's assets together instead of breaking them up across multiple accounts, UMAs make it easier to keep track of capital gains and losses and improve post-tax returns. Such account customization for risk and tax management purposes allows financial advisers to better address the needs of their high-net-worth clients.
SMAs are more complicated than UMAs because they have "many different managers trading many small accounts on lots of different sponsored platforms," said Randy Bullard, EVP of business development for Placemark Investments in Dallas. "UMAs reduce the number of moving parts because there is a single overlay manager that handles most of the complexity," explained Bullard, who spoke at a recent Financial Research Associates conference on UMAs in New York.
Financial advisers come up with asset allocation models for their customers, but responsibility for implementing the models with either the adviser or the sponsor who selects the investment managers, and overlay managers who watch over the investment process.
Sponsors include Wall Street wirehouses Merrill Lynch, Morgan Stanley, Citigroup's Smith Barney, UBS and Wachovia Securities, which together hold an estimated 80 percent of the assets in the SMA market. Banks and independent broker-dealers are also scrambling to gain a foothold. SunTrust Banks of Florida, for example, recently decided to shift about $30 billion in trust assets over to a new UMA platform--a move that could lead to substantial growth in the bank channel if duplicated by competitors.
Firms such as Placemark and Seattle-based Parametric Portfolio Associates--majority-owned by Eaton Vance Corp.--serve as outsourced overlay managers for sponsors, treating each client's portfolio differently based on changing investment objectives and the performance, risk and tax characteristics of the client's assets. The overlay manager is able to consistently apply trading and other restrictions across an investor's entire account.
Management Styles
Overlay managers typically apply an active, passive or hybrid model, depending on the role they want to play in the trading process. In the active model, which is the most common, all money managers send their investment models to the overlay manager to be implemented in client accounts. In a passive approach, money managers are responsible for trading their part of the client's portfolio. A hybrid model, which is finding increased up-take, splits the trading function between the sponsor and money manager.


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Shrimp Scampi
3-4 sprigs fresh Italian parsley (rinsed)
1 lemon (for juice, rinsed)
7 cloves fresh garlic
1/2 teaspoon seafood seasoning blend
4 tablespoons butter
1 1/2 lb large peeled/deveined shrimp (thawed, if needed)
2 tablespoons Italian bread crumbs
1. Place oven rack 6 inches from broiler, then preheat oven on broil. Line baking sheet with foil (for easy cleanup).
CALORIES (per 1/4 recipe) 310kcal; FAT 14g; CHOL 290mg;
Lemon Rice
1 lemon (for zest and juice, rinsed)
1. Peel a few strips of lemon peel, without any white pith, with zester (or vegetable peeler). Chop finely for zest
CALORIES (per 1/4 recipe) 190kcal; FAT 1.5g; CHOL 5mg;
Spiced Green Beans
1 (14-ounce) package frozen whole green beans
1. Place beans and water in microwave-safe bowl. Cover and microwave on HIGH 8 minutes or until desired tenderness.
CALORIES (per 1/4 recipe) 70kcal; FAT 3g; CHOL 10mg;
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Search Tags: Krista Boyd
Agency FOIA officers discontent with House reform bill
The FOIA Act of 2014 would amend the Freedom of Information Act in 12 ways. It calls for the online portal and requires more oversight by agency inspectors general. But some agency FOIA officers say the bill only would improve the information disclosure process minimally.
Tags: management , transparency , Darrell Issa , Ali Ahmed , Lauren Barlow , Nathan Hallford , House Oversight and Government Reform Committee , Senate Judiciary Committee , FOIA , Sunshine Week , American University Washington College of Law , Jason Miller


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Just because Staind frontman Aaron Lewis has a hit country record doesn't mean he's afraid to criticize country music -- or at least one song in particular.
The tune in Lewis' crosshairs is "Redneck Crazy" by country artist Tyler Farr . It's written from the perspective of a boyfriend who finds out his girlfriend's been cheating on him -- so he stalks her and her new boyfriend to her house at 3 a.m., looking for a fight. In a fan-shot video, posted by TMZ , from Lewis' show at the Thirsty Cowboy in Medina, OH, Lewis says, "I always thought the message of this song was pretty f***ed up."
But rather than just bad-mouthing the country chart-topper, Lewis then sings it as his "buddy Zack" rewrote it -- directed toward the stalker ex-boyfriend, who he advises "to get right up and go home" unless he wants Lewis to "shoot the headlights out of [your] Silverado."
A rep for Lewis tells ABC Radio News that while the reworked version of "Redneck Crazy" hasn't yet become a staple of Lewis' live show, "it's a floating set list -- and sometimes fan favorites show back up [on that list]." The rep also says that Lewis' camp isn't aware of any reply from Tyler Farr about the parody.
Lewis is currently balancing two musical careers -- in rock and country -- and despite his willingness to parody a big country hit, he tells ABC News Radio he does worry about how he's perceived by his two audiences. "It makes me nervous about what the rock fans might think, it makes me nervous about what the country fans might think," he says.
"I'm a bit insecure and a bit of a self-doubter, myself, so that stuff always creeps into my mind," he adds. And Lewis damits he even checks out online message boards to see what fans are saying. "I'm not gonna lie and tell you...that I'm not kind of addicted to the pain of seeing what haters have to say, along with the supporters," he says. "You know, it's kind of a healthy thing to hear both sides."
The current leg of Lewis' tour wraps up this weekend in Hammond, IN.
Copyright 2014 ABC News Radio


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Name: Karin Huber
Hometown: Bloomingburg
Camera: Canon t3
Description: About two minutes before I took this picture Mary was running around... Her father was looking for her and found her like this
Send in your photo here.
If you are chosen as a Photo of the Day winner you will be entered into the monthly contest. Monthly winners will be eligible to win a grand prize of $250.


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Truck Carry Case with 6 Die-Cast Cars
Young car enthusiasts will love this cool set that features an awesome truck carry case that holds up to 12 cars – 6 on either side! The set also comes with 6 die-cast cars in a variety of colours to store in the truck, or to send racing around their bedroom.
The amazing truck with its flaming motif will delight little boys who will have hours of fun playing trucker, transporting cars, and perhaps even adding some of their own.
The truck also features a handy carry handle, just the right size for little hands, to make it easily portable should he want to take it with him when travelling or visiting friends.
Useful info:
- Suitable for ages 3+
- Truck carry case holds up to 12 cars
- Includes 6 cars
- Truck carry case with 6 die-cast cars
With 10 die-cast vehicles reproduced in glorious detail, your child can bring their high-speed games to life.
Vehicles range from a flame-detail flatbed truck, retro sports cars to flash convertibles – there are enough cars here to start a collection or to add to an existing one.
There are lots more Small Wonders sets and accessories available separately, including the superb Parking Garage Playset – see item number 3JVMQ.
Useful info:
- 10 car accessory pack
- Each 3 inches long
- Fantastic detail, moving wheels
- Small Wonders die-cast vehicle set
Warning: Not suitable for children under 3 years.
Small Wonders 3-piece Service Vehicle Set
- In Stock
2 reviews
- Delivery
- Next day delivery available
Fire you child's imagination with this great Small Wonders 3-piece Service Vehicle Set.
There's a whole world of fun waiting with the digger, refuse truck and tow truck so your little one can dream up their very own road adventures.
Useful info:
- Small Wonders 3-piece Service Vehicle Set
- Includes digger, refuse truck and tow truck
- Fire their imagination
- Suitable for age 3 and above


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no trees
No Trees Brand Development, Marketing, Web Solutions, Responsive Website Design (RWD) & Digital Media Specialists - Penrith, Western Sydney, Australia
No Trees... were harmed by a few words about us
No Trees is a team of Sydney based Brand Developers, Marketing, Web solutions specialists, Website Designer / Developers & Digital Media Specialists - Penrith, Western Sydney, Australia.
Specialising in the customisation and development of digital media & web based solutions, we are committed to providing companies and individuals with a professional and effective user friendly end product.
Offering our clients paperless marketing, digital media & business solutions.
No Trees... just doing our bit to save the planet!
Note: most of our designs are printable, although we recommend broadcasting via digital media and encourage our clients to work towards a paperless workplace and or the use of recycled materials where possible.
Some companies will try to sell you a gimmick instead of help you create a brand that leaves its marque.
At No Trees, we develop your brand and positioning from the inside-out. We help you discover your bigger purpose, define your business mission and develop your positioning in the market place through outstanding message communication and branding. As Brand Guardians we can train your staff to be walking examples of your mission, and turn every client into an advocate.
Evidence based and grounded in cutting edge, psycho-neurology and epigentics, this approach makes traditional marketing and branding approaches look stone-age.
No Trees are also Turnaround Experts, and can provide Interim Business Management to get your business back on track, or mentor your existing team through a crisis.
View a full list of our Services
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Contact no trees
(No Trees formerly known as INFIN8SOLUTION.com)
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Stories Tagged with "michael wall" from 2010
2014 - 1 story
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2010 - 1 story
NJIT President Robert A. Altenkirch and Greater Newark Enterprises Corporation Executive Director Michael A. Wall were honored at the Brick City Development Corporation's Recognize Newark event for their contributions to the economic development accomplishments in the City of Newark. Wall, a member of the NJIT Board of Overseers, is the honorary chair of the Executive Dinner Committee at Celebration, NJIT's annual black-tie fundraiser, on Nov. 12, 2010. >>


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The Bhopal Medical Appeal made a statement about cleaning up at Glastonbury this year.
Michael Eavis has recently become a patron of the BMA and, thanks to this fantastic news, we were able to substantially raise our game at Glastonbury this year.
We had 80 litter pickers this year and we arranged for them to bring certain of the litter back to our marquee, just beside the Leftfield stage, for recycling into sculptures.
The scupltures included various over-sized figures representing Bhopali people collecting water plus one giant sized skull- all built to light up at night.
As an aside, we were also cleaning the hands of passers by with a special organic, chemical and alcohol-free hand sanitizer of our own making.
We were cleaning up Glastonbury. Nobody is cleaning up Bhopal.


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MADISON, WI (WSAU) Some of Wisconsin's most notable football players will not take part in Saturday's annual Spring Game in Madison.
Ever since Lee Evans tore a knee a decade ago, the Badgers have been cautious about letting their stars play in their biggest off-season scrimmage. And new coach Gary Andersen won't change that now.
Receiver Jared Abbrederis will sit out Saturday – along with running back James White, offensive lineman Ryan Groy, and defensive standouts Chris Borland, Dezmen Southward, and Ethan Hemer.
Defensive linemen Brendan Kelly and Beau Allen will also miss the Spring Game with minor injuries. Running back Jeff Lewis is also out, after he hurt his left arm and right foot during a scrimmage yesterday. He's expected to be ready for Wisconsin's pre-season camp this summer.
Melvin Gordon and fullback Derek Watt are expected to get a number of carries on Saturday.


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Discover Author
Deborah E. Lipstadt is Dorot Professor of Modern Jewish and Holocaust Studies and director of the Institute for Jewish Studies at Emory University. She is the author of Denying the Holocaust: The Growing Assault on Truth and Memory.
Copyright © 2014 HarperCollins Publishers. All rights reserved.
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Region: Vineyards in the Rapel, Curico and Maule Valleys of Chile
Grape Variety: 90% Merlot, 10% Cabernet
Description: Violet red, bright. Herbs, berries and pepper. On the palate, the wine is soft, tanninous, medium body, rounded and harmonic with a good finish. Very smooth.
This soft, dry red wine is excellent with a variety of meat and pasta dishes. Merlot provides forward fruit and easy drinkability while Cabernet Sauvignon offers structure and longevity. Serve at room temperature or slightly chilled.
Founded in 1883, Viña Concha y Toro is Latin America"s leading producer and occupies an outstanding position among the world"s most important wine companies, currently exporting to 135 countries worldwide. Uniquely, it owns around 9,500 hectares of prime vineyards, which allows the company to secure the highest quality grapes for its wine production. Concha y Toro"s portfolio...Read More About Concha y Toro
Long and thin, Chile has a lot of land north to south. The wine region here is a series of districts based near Santiago. The vineyards are protected by the Pacific on the west and the Andes mountains on the east. This could help explain why the climate changes more from east to west than north to south - also why the country has remained phylloxera free....Read More About Chile
No second fiddle
Merlot is coming back into its own. High popularity led to mass production, which then led to a backlash towards the variety (remember Miles in Sideways?). But passionate Merlot producers, and of course the right bank of Bordeaux, continued to produce quality versions of this grape. Merlot remains the principle grape of top chateaux in St...Read More About Merlot
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Georgetown transfer Benimon scores 31
Last year as he suffered through the most humbling season of his career, winning one game, Towson coach Pat Skerry was so convinced that better days were ahead, he researched the NCAA record for a single-season turnaround.
It wasn't a pie-in-the-sky dream. Tuesday night at George Mason, Skerry's efforts proved prophetic. With Georgetown transfer Jerrelle Benimon scoring a career-high 31 points, Towson came within one victory of achieving Skerry's unlikely goal with an 85-81 win in overtime before 3,956 at Patriot Center.
With a victory Saturday at home in its season finale over lowly Hofstra, Towson (17-13, 12-5) will achieve the largest turnaround in NCAA history.
"We had a couple guys from last year. They worked their hearts out," Skerry said. "We had good players sitting out, and we added good players. So we felt like we had a chance."
Towson is ineligible for the postseason but is thoroughly enjoying its last few games, winning seven of its last eight. With each success, it seems, Towson is breaking down another barrier. In Saturday's win over Drexel, Towson clinched its first winning season since 1995-96. Tuesday's victory was the Tigers' first in 15 tries at Patriot Center as a member of the CAA.
"I'm a little bit bittersweet," Skerry said. "Unfortunately the NCAA and the league has taken away the tournament for us. But they couldn't take away tonight. They couldn't take away last Saturday. They won't take away this coming Saturday."
Providence transfer Bilal Dixon (seven points, 10 rebounds) scored the go-ahead basket on a put-back with 37 seconds left, and junior Marcus Damas (23 points, nine rebounds) made two free throws with seven seconds left to secure the victory. No player is enjoying this year's success more than Damas, a 6-foot-7 forward and the top scorer from last year's 1-31 team.
"He's worked incredibly hard on his game," Skerry said. "He's a warrior. He's enjoying it. It's hard to express. I've been around coaching for a while. He's worked as hard as anyone I've been around."
The night belonged to Benimon, a 6-8 junior, who hit 10 of 14 shots, including a trio of 3-pointers, and added seven rebounds and four assists. It was a stunning turnaround from his performance in Towson's loss to George Mason a month ago when he went 5-of-15.
If anything, Towson has shown resilience. It was on display Tuesday when George Mason (17-12, 10-7) rallied from a seven-point deficit to tie in the final 50 seconds. Freshman Patrick Holloway made two 3-pointers and sophomore Anali Okoloji capped the rally with a 3-pointer with 1.9 seconds to go, sending the game to overtime.
The Patriots had the crowd and the pedigree on their side and took the lead in overtime on a jumper by Corey Edwards (10 points, three assists). But after that, Towson, the best rebounding and field goal percentage defense in the conference, held George Mason scoreless the rest of the way.
"You're gonna take punches on the road against good teams in tough environments," Skerry said. "I just thought Marcus Damas took over in the huddle about, 'Turn the page. Next play.' He jumped guys pretty good. We play off emotion, energy. I like that."


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Above and Beyond: 'Two Ways Out' may save your lifeby jmaloni
by Ray Pauley
Public Information Officer
Grand Island Fire Co.
This year's fire prevention and life safety theme is "Have Two Ways Out" when you are faced with a fire emergency at home, work or school. This message will be given to Grand Island elementary school students by firefighter teams during the week of Oct. 8 through 12, according to Assistant Chief Mark Sadkowski of the Grand Island Fire Co.
As program coordinator, he has also arranged for many fire and police agencies to contribute their equipment and operational expertise during the Fire Prevention Open House at fire headquarters, 2275 Baseline Road, from 5 to 8 p.m. on Friday, Oct. 12.
The ever popular "Ride to School in a Fire Truck" drawing will also be repeated this year, with winners chosen from St. Stephen School, and Huth Road, Kaegebein, and Sidway elementary schools. In addition, the GIFC Ladies Auxiliary will conduct its hot dog/hamburger cookout, as well as a special basket raffle.


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I saw a very similar style counter stool at a local design store for nearly 2x as much!!
It is risky buying a stool without sitting in it - feels impossible! A bar or counter stool is all about the comfort and fit. I read other people's positive reviews that spoke about the comfort of these and decided to take the risk by ordering them. So happy that I did! You can sit in these comfortable stools for hours and feel great. Everything about them is just right: cushiony, footrest, size, fabric is just as pictured and durable, and the nail heads add the special interest I was looking for! Perfect!
This chair is the perfect chair to use at my vanity. I needed it a few inches lower for my custom vanity and knew that a 24 inch chair would not fit. After reading a few reviews,and seeing that it was closer the 22 inches, I felt that this chair would work. I ordered it and it came quickly and it was packaged well. It is absolutely a perfect fit! The color is more grayish then beige, but my bathroom is a very light beige and it looks great.
I love these counter stools! I ordered 3 to put at my kitchen island. They arrived in perfect condition -they were packaged and protected very well. I bought them right before Thanksgiving, and when we had people over for Thanksgiving dinner, I got several compliments on them. I know some reviewed and said they were too short, but this are NOT bar stools, they are counter stools. They are meant to be counter height, come on people. I measured before I purchased so I knew what size I needed. So needless to say, I think this were perfect all around - quality, color, size, etc.... The only thing is I wish maybe they came scotch guarded. I will need to do that because I am paranoid my kids are going to stain them!
After searching and not finding what I was looking for in counter height I settled on these stools. The material is cheap and scratchy and for the price I expected better quality. The are way too short for counter island and going to return. I measured the seat at 22". I suppose if you measure the fluff of the seat before anyone sits you could squeeze another inch but this is not going to work.
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Award-winning YA author Brian Katcher has posted an early review of THOU SHALT NOT ROAD TRIP. And boy, does he do a great job of summarizing what's going on!
Incidentally, if you haven't checked out Brian's books, PLAYING WITH MATCHES and ALMOST PERFECT, you should do so right now. Believe me, there's a reason both books won major awards.


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GrovTec Snap Hook Multi Adapter Steel Black Package of 2
Product #: 283955 GrovTec #: GTSW-281 UPC #: 811071012812
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The GrovTec Snap Hook Adapter converts push button type swivel bases to accept snap style hooks. The steel stud quickly inserts in the push button bases and allows all an snap hook to be quickly clipped to the firearm. These adaptors can be used with the included push button bases or with any standard push button type bases that are already installed on the gun.
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Report to Congress - Nov 2002
For Laurie Gable, it's all about recovery, from drugs and alcohol - 7 years plus - and from attention deficit disorder, on a daily basis. "I am in recovery, but for today I consider myself recovered," she says.
Ms. Gable, 46, coordinates projects funded by the CSAT Recovery Community Support Program at Easy Does It Inc., a transitional housing program in Leesport, Pennsylvania for people in early recovery. "I believe I was born addicted," she says. Further, she was caught up in the 1960s spirit of drugs and sex. "It was part of my passage into young adulthood," she notes. Later, as a young married mother, Ms.Gable took a night job. Stopping by the bar after a shift seemed natural.
"It began with a little beer and within a year I lost everything-my home, my kids, my husband," Ms. Gable says. She later became addicted to cocaine. She spent 17 days in a residential program and has been clean since. But another disorder lurked for 5 years.
"I was at a conference on attention deficit disorder and all of a sudden I said, `That's me.' What I heard was that people with ADD are calmed by cocaine," Ms. Gable says. "Cocaine made me normal, while it made other people very, very high."
To deal with the ADD, she keeps a close eye on her habits, moods, and pace, and takes time off to regroup when necessary. Self-care fits with her recovery from her addictions. "The most important aspect of my recovery is my faith," Ms. Gable says.
Co-occurring substance abuse disorders and mental disorders1 are both common and highly complex phenomena that have been estimated to affect from 7 to 10 million adult Americans in any one year (U.S. DHHS, 1999b; SAMHSA National Advisory Council, 1998). Children, youth, and older adults also may experience co-occurring substance abuse disorders and mental disorders. According to the U.S. Surgeon General in the 1999 report on mental health: "Forty-one to 65 percent of individuals with a lifetime substance abuse disorder also have a lifetime history of at least one mental disorder, and about 51 percent of those with one or more lifetime mental disorders also have a lifetime history of at least one substance abuse disorder" (U.S. DHHS, 1999b). Although limited co-occurring prevalence information is available on older adults, it is known that like their younger counterparts, older adults with mental disorders may be especially prone to the adverse effects of drugs or alcohol. The presence of severe mental illness may create additional biological vulnerability so that even small amounts of psychoactive substances may have adverse consequences for individuals with schizophrenia and other brain disorders (Drake et al., 1989).
Co-occurring disorders have been called many other terms over the years, and many of these are still in use in the literature and in the field. While some of these terms represent an attempt to identify which problem or disorder is seen as primary or more severe (CSAT, in press), many have been criticized for insufficient specificity, accuracy, and sensitivity (Osher and Drake, 1996). They include: mentally ill chemically addicted (MICA); chemically abusing mentally ill (CAMI); mentally ill substance abuser (MISA); substance abusing mentally ill (SAMI); mentally ill chemically dependent (MICD); co-occurring addictive and mental disorders (COAMD); dually diagnosed; dually disordered; and addiction and co-occurring disorders (ACD).
More recently, the research literature has seen the growing use of the term "dual diagnosis." Drake and Wallach (2000), however, argue that this term is an "unfortunate misnomer." First, the term has been used to refer to people with other combination of illnesses, such as individuals with mental illness and developmental disabilities. Second, individuals rarely experience only two disorders. Rather, they have "multiple interacting disabilities, psychosocial problems, and disadvantages" (Drake and Wallach, 2000).
Drake and Wallach (2000) also posit that the use of the term "dual diagnosis" tends to ignore the broad range of psychosocial issues that are interrelated with co-occurring substance abuse disorders and mental disorders - issues such as risk and protective factors at the levels of family, community, and society. Such issues become important since, as with other chronic illnesses, co-occurring substance abuse disorders and mental disorders need to be monitored and reassessed on a regular basis to promote recovery and prevent relapse despite an individual's changing life circumstances and ongoing risk and protective factors.
This report defines "co-occurring disorders" consistent with the definition developed by the expert consensus panel that crafted SAMHSA's revised Treatment Improvement Protocol (TIP), Substance Abuse Treatment for Persons with Co-Occurring Disorders (CSAT, in press). According to the consensus panel, people with co-occurring substance abuse disorders and mental disorders are
individuals who have at least one mental disorder as well as an alcohol or drug use disorder. While these disorders may interact differently in any one person (e.g., an episode of depression may trigger a relapse into alcohol abuse, or cocaine use may exacerbate schizophrenic symptoms), at least one disorder of each type can be diagnosed independently of the other.
The panel observed that while some individuals' mental health problems may be sub-clinical and not meet DSM-IV criteria for a specific mental disorder, such individuals may still benefit from the full range of services available to those whose conditions meet the DSM-IV criteria for co-occurring substance abuse disorders and mental disorders. The same may be true for those individuals who may have transitory conditions such as substance-induced mood swings (CSAT, in press).
Co-occurring disorders may vary among individuals, and in the same individual over time. Both disorders can vary along the dimensions of severity, chronicity, and degree of impairment in functioning. Both disorders may be severe or mild, or one may be more severe than the other. Either or both disorders may reflect episodes of acute symptom exacerbations or a chronic condition and may change over time. (CSAT, 1994)
Co-occurring disorders may include any combination of two or more substance abuse disorders and mental disorders identified in the Diagnostic and Statistical Manual of Mental Disorders - IV (DSM-IV). There are no specific combinations of substance abuse disorders and mental disorders that are defined uniquely as co-occurring disorders. As Osher (2001) notes, "Any drug of abuse may combine with any mental disorder to produce a wide range of symptoms and disability." For example, co-occurring substance abuse disorders and mental disorders may include major depression with cocaine dependence, alcohol abuse with panic disorder, alcohol and poly-drug abuse with schizophrenia, and borderline personality disorder with episodic poly-drug use (CSAT, 1994). Drake and Wallach (2000) point out that "the population of persons with co-occurring mental illness and substance use disorders...includes individuals with less disabling mental illnesses such as anxiety disorders, those with different severe illnesses such as schizophrenia and bipolar disorder, and those with either substance abuse or substance dependence." Thus, the range of disorders may vary widely among people with co-occurring substance abuse disorders and mental disorders. In addition, substance abuse and mental health problems (such as binge drinking by people with mental disorders) that do not reach the diagnostic threshold also are part of the co-occurring disorders landscape - problems that may offer opportunities for early intervention.
A significant lack of prevalence data on co-occurring disorders exists. The best data available on the prevalence of co-occurring substance abuse disorders and mental disorders are derived from two extensive surveys conducted and analyzed over the past two decades: the Epidemiologic Catchment Area (ECA) Survey, initially administered in the period 1980 to 1984 (Regier et al., 1990), and the National Comorbidity Survey (NCS), administered between 1990 and 1992 (Kessler et al., 1994). Both surveys document high prevalence rates for co-occurring substance abuse disorders and mental disorders in the general population 2.
The ECA Survey focused on five geographical areas and assessed substance abuse disorders and mental disorders in more than 20,000 people living in the community and in various institutional settings, such as psychiatric hospitals, nursing homes, and jails or prisons. It provided the Nation's first quantitative information on co-occurring disorders. Because this report to Congress focuses heavily on annual prevalence rates, it relies somewhat more heavily on the more recent NCS data.
The NCS, a nationally representative, face-to-face household survey carried out between 1990 and 1992, was designed to build upon the results of the ECA Survey. The NCS estimates are based on a stratified, multistage area probability study of people age 15 to 54 years in the non-institutionalized population. The survey examined prevalence rates for co-occurring substance abuse disorders and mental disorders, as well as the temporal relationship between these disorders and the extent to which 12-month co-occurrence is associated with service utilization (Kessler et al., 1996).
Results of the NCS support the high prevalence rates for co-occurring substance abuse disorders and mental disorders among the general population described in the ECA Survey. The results also confirm the increased risk for people with either a substance abuse disorder or mental disorder for developing a co-occurring disorder. The NCS found that:
· 42.7 percent of individuals with a 12-month addictive disorder had at least one 12-month mental disorder.
· 14.7 percent of individuals with a 12-month mental disorder had at least one 12-month addictive disorder.
The ECA Survey found that individuals with severe mental disorders were at significant risk for developing a substance use disorder during their lifetime. In particular:
· 47 percent of individuals with schizophrenia also had a substance abuse disorder (more than four times as likely as the general population).
· 61 percent of individuals with bi-polar disorder also had a substance abuse disorder (more than five times as likely as the general population).
Estimates from both studies reveal that during a 12-month period, 22 to 23 percent of the U.S. adult population - 44 million people - have diagnosable mental disorders (U.S. DHHS, 1999b). About 15 percent (approximately 6.6 million) of adults with a diagnosable mental disorder have a co-occurring substance abuse disorder. More specific findings follow, along with some initial data from the National Comorbidity Survey Replication (NCS-R).
The reader is cautioned, however, that these prevalence studies are based on data that was collected between 15 and 25 years ago. Within the next year, the NCS-R, now underway, will provide new and more current estimates for adults and adolescents that are both comprehensive and more refined. New estimates based on the replication are expected to be closer to the lower end of the 7 to 10 million adults range (U.S. DHHS, 1999bb; SAMHSA National Advisory Council, 1998) found in previous studies. The replication relies on the classification and description of disorders found in the fourth edition of the American Psychiatric Association's Diagnostic and Statistical Manual (DSM-IV; American Psychiatric Association, 1994), which has more restrictive diagnostic criteria than the earlier manual, DSM-III-R, the nosology of which was utilized in the original NCS study. Balanced against these changes, however, is the continuing growth of the U.S. population, which will tend to increase the estimates.
The 2001 National Household Survey on Drug Abuse (NHSDA), for the first time in the Survey's history, included questions for adults and youth that measure serious mental illness (SAMHSA, 2002e). The survey found a strong relationship between substance abuse disorders and mental problems. Results are based on a scientific sample of the Nation's civilian non-institutional population and can be generalized to this population. As such, it does not include individuals in long-term institutions such as prisons and State mental hospitals.
According to the NHSDA, in 2001 there were an estimated 14.8 million adults age 18 or older with serious mental illness (SMI).3 This represents 7.3 percent of all adults. Of those with SMI, 6.9 million received mental health treatment in the 12 months prior to the interview. Among adults with SMI, 20.3 percent were dependent on or abused alcohol or illicit drugs; the rate among adults without SMI was 6.3 percent. An estimated 3 million adults had both SMI and substance abuse or dependence problems during the year.
Overall, an estimated 16.6 million persons age 12 or older were classified with dependence on or abuse of either alcohol or illicit drugs in 2001 (7.3 percent of the population). Of these, 2.4 million were classified with dependence or abuse of both alcohol and illicit drugs, 3.2 million were dependent or abused illicit drugs but not alcohol, and 11 million were dependent on or abused alcohol but not illicit drugs. In the 12 months preceding the NHSDA interview, an estimated 3.1 million persons age 12 or older (1.4 percent of the population) received some kind of treatment for a problem related to the use of alcohol or illicit drugs. Of this number, 1.6 million received treatment through a self-help group. An estimated 6.1 million persons age 12 or older needed treatment for an illicit drug problem in 2001. During the same period, 1.1 million persons received treatment for this problem at a specialty facility. However, overall the number of persons needing but not receiving treatment was estimated at 5 million. Of the 5 million people who needed but did not receive treatment in 2001, an estimated 377,000 reported that they felt they needed treatment for their drug problem. This includes an estimated 101,000 who reported that they made an effort but were unable to get treatment and 276,000 who reported making no effort to get treatment.
Children and Adolescents. The presence of co-occurring substance abuse disorders and mental disorders is not limited to adults. A substantial number of children and adolescents also experience substance abuse disorders, mental disorders, or co-occurring disorders. A study of mental health service use among youth reveals that nearly 43 percent of youth who receive mental health services in the United States have been diagnosed with a co-occurring disorder (CMHS, 2001). Data from the NCS indicated that the median age of onset for a mental disorder was 11 (Kessler et al., 1996). In her study of a nationally representative sample of 12 to 17-year-olds, Greenblatt (2000) noted that substance use increases dramatically with youth in the 11 to 15 year age group. Moreover, tobacco dependence is a gateway drug for other substances and is also a gateway drug for co-occurring disorders (Lasser et al., 2000; Ziedonis 1995).
Researchers have found a link between mental/emotional and behavioral disorders and substance abuse disorders in youth. Data from the SAMHSA 1994-96 National Household Survey on Drug Abuse indicated that alcohol or illicit drug dependence was reported by approximately 13 percent of adolescents with significant emotional problems (SAMHSA, 1999).
Adolescent treatment studies conducted by SAMHSA's Center for Substance Abuse Treatment, likewise, show a high rate of emotional disorders, including behavioral problems, among adolescents entering substance abuse treatment, 62 percent for males and 83 percent for females (CSAT 1997-2002). This includes conduct disorders, attention deficit hyperactivity disorders, major depressive disorder, generalized anxiety disorder and post traumatic stress disorder; for these populations of adolescents, multiple problems are the norm.
The 2001 National Household Survey on Drug Abuse found that an estimated 4.3 million youths age 12 to 17 received treatment or counseling for emotional or behavioral problems in the prior 12 months. This represents 18.4 percent of this population and is significantly higher than the 14.6 percent estimate for 2000. The reason cited most often by youths for the latest mental health treatment session was "felt depressed" (44.9 percent of youths receiving treatment), followed by "breaking rules or acting out" (22.4 percent), and "thought about or tried suicide" (16.6 percent). The rate of mental health treatment among youth who used illicit drugs in the past year (26.2 percent) was higher than youths who did not use illicit drugs (16.3 percent) (SAMHSA, 2002e).
The likelihood that a child or adolescent with a mental disorder will develop a subsequent substance abuse disorder varies by the kind of mental disorder being experienced. Costello et al. (2000) found that adolescents with behavioral disorders (e.g., conduct disorder, attention deficit hyperactivity disorder) were most likely to develop substance abuse disorders. Adolescents with depression were four times as likely as those without to develop substance abuse disorders, and those with anxiety disorders were twice as likely to develop substance abuse disorders.
The literature provides little information on which groups of adolescents with mental disorders are at greater risk than others for developing a substance abuse disorder. However, Costello and colleagues found that the presence of multiple mental disorders accounted for much of the increased risk for developing a substance abuse disorder (Costello et al., 2000).
Data from the NCS indicate that the onset of a mental disorder may precede the substance abuse disorder. According to this survey, almost 90 percent of those with a lifetime co-occurring disorder had at least one mental disorder prior to the onset of a substance abuse disorder. Generally, the mental disorder occurred in early adolescence (median age 11), followed by the substance abuse disorder 5 to 10 years later (median age 21) (Kessler et al., 1996).
The time between the onset of a mental disorder and a subsequent substance abuse disorder represents an important "window of opportunity" in which a co-occurring disorder may be prevented (Ziedonis, 1995). It suggests not only the value of early diagnosis and treatment of mental disorders in youth, but also the critical role for alcohol and drug testing as important tools for prevention, early identification and intervention.
Researchers have offered explanations for high prevalence rates of substance abuse disorders among individuals with mental disorders but the etiology is not yet clear. Schuckit (NASMHPD/NASADAD, 1999) has outlined three ways in which substance abuse disorders and mental disorders may relate to one another: 1) the disorders may occur independent of each other; 2) the mental disorder may place an individual at greater risk for substance abuse disorders (e.g., schizophrenia and anti-social personality disorder); and 3) drug abuse intoxication or withdrawal may result in temporary mental disorder syndromes.
Mueser et al. (1998) reviewed two decades of etiological theories related to co-occurring substance abuse disorders and mental disorders. Based on that analysis, they offered 4 general models that synthesize current thinking in the field regarding the etiology of co-occurring substance abuse disorders and mental disorders (Anthony, 1991; Kosten and Ziedonis, 1997; Kushner and Mueser, 1993; Lehman et al., 1989; Meyer, 1986; Weiss and Collins, 1992):
· Common factor models. High rates of co-morbidity are the result of risk factors 4 shared across both severe mental illness and substance abuse disorders.
· Secondary substance abuse disorder models. Severe mental illness increases a person's chances of developing a substance abuse disorder.
· Secondary mental/psychiatric disorder model. Substance abuse precipitates severe mental illness in people who would not otherwise develop a severe mental illness.
· Bi-directional models. Either severe mental illness or substance abuse disorders can increase a person's vulnerability to developing the other disorder.
The researchers found modest support for a connection between antisocial personality disorders and increased comorbidity (an example of the common factor model), and for a secondary substance use model in which a person with a mental disorder is biologically vulnerable to develop a substance abuse disorder if they use even small amounts of alcohol or other drugs (Mueser et al., 1998). However, the lack of longitudinal assessment data limited evaluation of these models. Further, they noted that different models may account for co-occurrence in different people and that more than one model may apply to a given individual and that some of the models have not been examined systematically (Mueser et al., 1998).
For other individuals, substance abuse disorders may precede or precipitate the onset of a mental disorder. Data from one study reveal that mood and anxiety disorders diagnosed in individuals with a substance abuse disorder may be an artifact of their substance abuse and may improve with recovery from substance abuse (Verheul et al., 2000). This study found little support, however, for the theory that personality disorders also may be secondary to substance abuse.
Schuckit (1996) and Schuckit and Hesselbrock (1994) examined the relationship between lifelong alcohol dependence and anxiety disorders. They found that even though depressed or anxious people who also are alcohol dependent may believe they drink to relieve symptoms of sadness or nervousness, research does not unanimously support the contention that severe depressive or anxiety disorders are the usual cause of alcoholism (Schuckit, 1996). The researchers conclude that high rates of comorbidity of anxiety and alcoholism may reflect a mixture of true anxiety disorders along with temporary substance-induced anxiety syndromes (Schuckit and Hesselbrock, 1994).
RachBeisel and McDuff (1995) note that depression and psychosis may be precipitated by substance abuse. However, they caution that differentiating a substance-induced or secondary mental illness from a primary disorder is complex and imprecise. Chronic use of alcohol, opiates, and cocaine is the most common factor leading to depressive symptoms. Psychotic disorders have been identified as secondary to a wide variety of addictive substances, including PCP, crack cocaine, hallucinogens, alcohol, and ecstasy. The type of depression seen as secondary to substance abuse is similar to a primary depressive disorder, except the symptoms are likely to be mild to moderate rather than severe (RachBeisel and McDuff, 1995).
Suicide, associated with depression, is a serious concern for individuals with co-occurring disorders: 15 to 25 percent of suicides are committed by individuals who abuse alcohol, and between 5 and 27 percent of all deaths in individuals who abuse alcohol are due to suicide, compared to 1 percent in the general population (Jaffee and Ciraulo, 1986, in RachBeisel and McDuff, 1995). Psychotic episodes, including suicide, may be associated with intoxication or withdrawal from addictive substances, or may be a lasting result of chronic substance abuse. The 2000 National Household Survey on Drug Abuse reported that approximately 3 million youth age 12 to 17 thought seriously about suicide or attempted suicide in 2000. The data show that while 13.7 percent of youths aged 14 to 17 considered suicide in the past year, only 36 percent of those at risk children received mental health treatment or counseling. The data also reveal that youth who used alcohol or illicit drugs in the past year were more likely than other youths to consider taking their own lives. The likelihood of suicide risk was similar among white, black, Hispanic and Asian youth.
A growing body of research has implicated trauma - including past or current physical or sexual abuse - as a risk factor for the development and course of both substance abuse disorders and mental disorders. For example, between 51 and 97 percent of women with serious mental illnesses report some form of physical or sexual abuse during their lifetimes (Goodman, 1997). Among women in treatment for drug or alcohol disorder, 41 percent to 71 percent report being sexually abused as children or adults (Alexander, 1996). A more complete discussion of the role of trauma is presented in Chapter 4 of this report.
Despite strides in the research base over the past two decades, little remains known about the etiology and temporal ordering of co-occurring substance abuse disorders and mental disorders. For this reason, many researchers and clinicians believe that both disorders must be considered as primary and treated as such (Ridgely, Osher & Talbott, 1987; Minkoff, 1991; Drake, McLaughlin et al., 1991; Osher and Kofoed, 1989).
A report on the treatment experiences of youth with co-occurring substance abuse disorders and mental disorders states:
Tragically, youth with co-occurring substance abuse disorders and mental disorders and their families rarely get the kind of help they need at the time they need it. Services and supports are fragmented, isolated, and rigid (Federation of Families, 2000).
The discussion that follows summarizes data that confirm this observation, not just for youth, but for people of all ages who have co-occurring disorders. A history of treatment approaches for co-occurring disorders and barriers to providing appropriate care are highlighted in subsequent sections of this chapter.
Many Individuals Receive No Care or Inadequate Care.
Research has suggested that the vast majority of people with co-occurring substance abuse disorders and mental disorders do not receive care for a broad range of reasons. For example, severe under-funding of the public substance abuse and mental health treatment delivery systems has led to long waiting lists for care. At the same time, private insurance often excludes or severely limits coverage for services for people with either substance abuse disorders or mental disorders, a significant issue since both disorders can be chronic in nature, requiring long-term treatments, not dissimilar to the long-term needs of people experiencing diabetes, heart disease or stroke. Finally, the discrimination and stigma of substance abuse disorders and mental disorders may be isolating, making people with these disorders less likely to seek care in the first place.
The National Comorbidity Survey Replication. A total of 5,000 interviews have already been conducted for the NSC-R, out of a planned total of 10,000. The principal investigator, Ronald C. Kessler, has provided SAMHSA with new estimates based upon these cases, with the important caveat that preliminary results are incompletely weighted and based on the first half of the NCS-R survey.
The data from the NCS-R provide valuable information about service use (see Table 1.1 below). Of those with both substance dependence and serious mental illnesses, only 19 percent receive treatment for both disorders; 29 percent do not receive treatment for either problem. If treatment is received at all, it most often is for the mental disorder alone (49 percent).
Table 1.1
Rates of Treatment by Type (Mental Health, Substance Abuse) and
by Severity Level of the Disorder (NCS-R)
Level of Substance Abuse Disorder
Type of Treatment
Level of Mental Disorder
12-month serious mental illness
12-month other
mental illness
12-month substance dependence
Neither MH nor SA
MH only
SA only
Both MH and SA
12-month substance abuse
Neither MH nor SA
MH only
SA only
Both MH and SA
For people with less severe but still diagnosable mental illnesses and either substance dependence or substance abuse, the pattern is similar. Most receive no treatment (71 percent and 78 percent, respectively), and only a very few receive treatment for both disorders (4 percent and 3 percent, respectively). Once again, the most frequent treatment is for the mental disorder alone. As stated in the table and elsewhere in the report, there is a clear need and challenge to strengthen the training and resources in mental health treatment systems to use appropriate alcohol and drug testing tools in the diagnosis and treatment of patients with co-occurring disorders.
The Healthcare for Communities Survey. Data from the Healthcare for Communities Survey, conducted by UCLA and RAND®, support the NCS-R findings. Among people with co-occurring disorders, this study found that 72 percent did not receive any mental health or substance abuse treatment over the previous year (Watkins et al., 2001). Fewer than 25 percent of individuals with co-occurring disorders received appropriate mental health services, and only 9 percent received supplemental substance abuse services.
Both the NCS-R and Healthcare for Communities Survey also found that individuals with a substance abuse disorder are more likely to receive treatment if they have a co-occurring mental disorder, suggesting that substance abuse disorders are left untreated more often than mental disorders. This is a matter of special concern because individuals with substance abuse disorders tend not to get better unless they receive treatment, and because the severity of the co-occurring mental disorder is predictive of substance abuse treatment outcomes among individuals with co-occurring disorders (McLellan et al., 1983; Drake et al., 1996).
Insurance Claims Data. Under SAMHSA sponsorship, a multi-organizational team of investigators analyzed rates of treatment of individuals with substance abuse disorders and/or mental disorders as represented in fee-for-service, health insurance claims data (Finkelstein et al., 2002a). They employed files from public insurance programs (Medicare and Medicaid in Michigan, New Jersey, Pennsylvania, and Washington) and from a sample of claims representing private insurance companies from the mid-1990s. The investigators found that between 7 and 9 percent of all enrollees had evidence of either a substance abuse disorder or a mental disorder or both. In contrast, rates of treatment among adults for both disorders are less than one percent, ranging from 0.2 to 0.9 percent.
The question arises as to whether these rates are higher, lower or about what would be expected. The actual prevalence rates for these disorders in these particular insurance programs are not known. However, it is known, for example, that the prevalence rate of co-occurring disorders in the general adult population is estimated to be 4.8 percent (Kessler et al., 1996). The rate in the Medicaid population, given the fact that people living in poverty are at increased risk for developing co-occurring disorders, is likely to be even higher. Thus, finding treatment rates of 0.2 to 0.9 percent for both disorders suggests that there are many fewer people in treatment than those who need it.
Veterans Affairs Data. Unlike other systems, the health care system operated by the Department of Veterans Affairs has high rates of identification of co-occurring disorders. Rosenheck and Greenberg (2002) reported that 44 percent of 72,252 inpatients treated during fiscal year 2001 had co-occurring substance abuse disorders and mental disorders. Among veterans receiving specialized treatment for post traumatic stress disorder, 41 percent had a co-occurring substance abuse disorder (Fontana et. al., 2002).
Individuals Who Receive Care in the Mental Health or Substance Abuse System
Individuals with co-occurring disorders who receive care are likely to be treated in the system to which they present themselves. Mental health service programs have assumed responsibility for comprehensive care, including substance abuse treatment, for individuals with serious mental illnesses (Drake, Essock et al., 2001). Substance abuse treatment programs care for large numbers of individuals who have co-occurring substance abuse disorders and mental disorders.
An analysis of State Alcohol and Drug Abuse Profile (SADAP) data reveals that in fiscal year 1999, 142,164 individuals were admitted to State-funded alcohol and drug abuse programs specifically for treatment of substance abuse disorder with a co-occurring mental disorder (NASADAD, 2002; emphasis original). SAMHSA's 1999 Uniform Facility Data Set (UFDS) indicates that in 1999, nearly half of all public and private facilities that provide substance abuse treatment offered services to individuals with co-occurring mental disorders. Thirty-eight percent of programs that focus primarily on substance abuse disorders reported offering services to people with co-occurring disorders. This survey does not reveal the specific types of services offered or the manner in which they were delivered (SAMHSA, 2002d). Services for co-occurring disorders were most likely to be offered by facilities operated by the U.S. Department of Veterans Affairs (73 percent), and by programs that provide treatment for both substance abuse disorders and mental disorders (67 percent).
Typically, individuals with co-occurring disorders who receive services through either the mental health or substance abuse treatment systems receive sequential treatment (treatment first from one provider, then another) or parallel treatment (treatment from two separate providers at the same time). Neither system has the capacity to provide both mental health and substance abuse treatment within a single program. Despite evidence in support of integrated treatment for substance abuse disorders and mental disorders, only 4 percent of individuals in the Healthcare for Communities Survey reported receiving sequential care (Watkins, et al., 2001). Another 4 percent reported receiving parallel treatment.
Fragmented and uncoordinated services create a service gap for persons with co-occurring disorders. This service gap led to a call by many clinicians, researchers, and consumers for the provision of treatment for people with co-occurring disorders in an integrated program where both the mental health services and substance abuse treatment could be provided by the same clinician or group of clinicians (e.g., Drake et al., 1995; Mueser et al., 1997), identified as integrated treatment. There is no need to create a separate system of care for people who have co-occurring substance abuse disorders and mental disorders (The National Council and SAAS, 2002; AACP, 2000; Osher, 1996; Ridgely et al., 1987).
Individuals Who Receive Care Outside of the Mental Health or Substance Abuse System
Recognizing that stigma is associated with substance abuse disorders and mental disorders, many individuals with co-occurring disorders seek treatment in primary care settings. However, when the mental health, substance abuse, or primary care setting does not meet the needs of an individual, that person risks becoming homeless
Primary Health Care. Individuals with co-occurring substance abuse disorders and mental disorders have high rates of other health problems and often present for care in the primary health care system. In fact, many individuals with mental disorders seek and receive care exclusively through the primary health care system (Gournay et al., 1997; Shapiro et al., 1984). There is little evidence that these disorders are identified or treated, or that the primary health and behavioral health care systems collaborate to deliver care effectively (Ridgely and Johnson, 2001). Data from the Medical Outcomes Study found evidence that primary care physicians often do not detect the presence of substance abuse disorders and mental disorders (Ford, 1994; Wells et al., 1989). This is especially true for older adults.
Homeless Services. Approximately 39 percent of people who are homeless have a mental disorder, and an estimated 50 percent of adults with serious mental illnesses who are homeless have a co-occurring substance abuse disorder (U.S. DHHS, 1999b; Lehman and Cordray, 1993; Ridgely & Dixon, 1993; Fisher and Breakey, 1991). Because individuals who are homeless are far less likely to use the traditional systems for receiving care (Burt et al., 1999), a broad range of community programs has emerged to address their substance abuse, mental health, housing and social support needs. Many of these programs are supported by Federal initiatives, such as the SAMHSA Projects for Assistance in Transition from Homelessness (PATH) program, the Health Resources and Services Administration (HRSA) Health Care for the Homeless Program, and the U.S. Department of Housing and Urban Development (HUD) Continuum of Care program.
Though these programs provide important, high quality and sometimes lifesaving services, they alone are not sufficient to provide fully adequate care for individuals who are homeless, including those with co-occurring disorders who are without a home, and who struggle with all of the conditions associated with a life of poverty (Osher and Dixon, 1995).
The Criminal Justice System. Epidemiological studies show the use of drugs or alcohol by people with untreated serious mental illnesses increases their potential for violent behaviors (IOM, 1999). One analysis suggests that substance abuse, psychotic symptoms, lack of contact with specialized community mental health services, and poor adherence to medication are all associated with greater risk of adult life-time violence (Swartz et al., 1998).
The criminal justice system, as a whole, has experienced substantial growth over the past decade with a 76 percent increase in the number of individuals incarcerated since 1990. Estimated rates of severe mental and substance abuse disorders in jail and prison populations range from 3 percent to 16 percent (Peters and Hill, 1993; Teplin, 1990; Steadman et al., 1987). Among detainees with mental disorders, 72 percent also have a co-occurring substance abuse disorder. In the juvenile justice system, preliminary data suggest that two-thirds of the 1 million youth who have formal contact with the justice system, or more than 670,000 youth, have one or more substance abuse disorders and mental disorders (OJJDP, 2001).
Studies have found that approximately one-third of adult male detainees and one-quarter of female detainees who needed services for severe mental disorders reported receiving treatment in jail. Fewer than 10 percent of Federal inmates who are addicted to drugs or alcohol have treatment available to them, despite the growing evidence demonstrating that intensive treatment in prison can reduce recidivism by one-half after release (CSAT, 1996).
1 For the purposes of this report "mental disorders" represent the continuum of psychiatric severity from less to more severe.
2 For purposes of estimating the annual prevalence rates of co-occurring disorders, epidemiologists typically assume that diagnostic criteria for specific disorders as defined by American Psychiatric Association's Diagnostic and Statistical Manual (DSM) must be met, and that the two disorders must occur within a 12-month time period.
3 Serious mental illness is defined as having a mental disorder that resulted in functional impairment within the past 12 months.
4 Risk factors, as described in detail in the "Prevention" chapter of this report, are factors such as low socioeconomic status or relationship loss and bereavement that increase an individual's, a group's, or a community's vulnerability to mental illness or substance abuse.


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A North Carolina businessman and his now-defunct credit counseling agency must pay a summary judgment amount of more than $126,000 for unlawful upfront fees and excess charges of monthly service fees.
West Virginia Attorney General Patrick Morrisey filed the action in Kanawha County Circuit Court against James R. Armstrong and Family Credit Counseling along with several for-profit companies that solicited consumers to enroll in debt management plans administered by a nonprofit corporation Armstrong owned.
In a recently-filed order, Kanawha County Circuit Judge James C. Stucky granted summary judgment against Armstrong and Family Credit Counseling Corporation in the amount of $126,085.22— $95,737 for unlawful upfront fees and $30,348.22 in excess charges of monthly service fees.
Stucky also granted a permanent injunction, prohibiting Armstrong and the counseling corporation from doing business of debt pooling or any other debt relief service in West Virginia without obtaining a certificate of authority from the West Virginia Secretary of State.
Court documents state Armstrong and the credit counseling corporation administered debt management plans— which is a plan to repay credit card debt typically negotiated by nonprofit credit counseling agencies — in several states.
Morrisey said these plans are regulated by the state's debt pooling statute, which prohibits upfront fees and limits monthly service fees for non-profit agencies to 7 percent of the monthly payment amount.
Morrisey additionally said this credit counseling corporation overcharged 250 customers in West Virginia in upfront fees and monthly service fees.
"The type of service offered by debt-relief and credit counseling agencies typically is very beneficial to consumers who want to pay off their credit cards but may need a little more time to do so," Morrisey said in his office's news release. "However, in this case, many West Virginia residents did not receive the services as promised. We will take firm action against businesses that take advantage of residents trying to do the right thing."


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|For Release:
|September 4, 1997
|June Gates, 216/579-2048
In a recent Economic Commentary, Federal Reserve Bank of Cleveland Economist Ben Craig says that between 1988 and 1996, the number of workers who moved out of banking each year was huge -- between a fifth and a quarter of the entire industry workforce. Yet almost all of the outflow was offset by new hires.
According to Craig, a large majority of workers who leave banking find employment in other industries, while a smaller number leave the labor force entirely, and a much smaller number become unemployed. However, many of those who do become unemployed are out of work for a long time.
Another major change in banking's workforce in the last decade has been a near doubling in the share of banking jobs that are professional, and a dramatic increase in the educational level of bankers. These compositional changes, necessitated by expanded use of technology and changes in the mix of banking products and customers, were also accommodated by America's competitive labor market.
While net banking employment has fallen gradually, about 1 percent per year since 1988, some analysts predict an additional 20 percent decline by the end of the next decade. Since some of the bankers who lose their jobs experience extended periods of unemployment, policymakers might seek ways to avoid those hardships. But Craig concludes by cautioning against actions that might erode the extraordinary flexibility of America's labor market.
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text: Nanny Contracts New York First State to Regulate Nanny Relationship by babysugar 6/04/10 1 Reactions 0 Shares Print 0 0 0 0 0 Uncle Sam may soon be regulating your relationship with your nanny! In a bill that was passed this week, New York will be the first state that requires employers to guarantee paid days off, overtime wages and 14 days termination notice for all domestic workers. California and Colorado are also working on similar legislation. Eight-five percent of LilSugar readers said that parents should have a written contract with their nanny outlining such details before the relationship ever begins, but 53 percent don't pay their caregivers' taxes. Should the government be regulating terms of employment for childcare givers? Source: Thinkstock Read More ContractsTell MommyChildcareNannies Get a Personalized Newsletter! susieparker1972 2 years The question's a bit off as the government already regulates employment for childcare givers. Nannies, for example, are treated as non-exempt employees. That means they're subject to wage and work hour laws. It's good to see that 85% figure about written nanny contracts -- parents looking for a good one might want to check out http://www.mynannycontract.com/nanny-contract or ask their attorney or placement agency. Link Love Mom forced to stop feeding baby homemade formula — BabyCenter Blog The easiest ways to save on organic food — The Stir A look inside Fergie's second baby shower — Celebrity Baby Scoop Danielle Jonas debuts her baby bump — People Moms & Babies 7 light and fresh recipes to take you through Summer — FitPregnancy Does where you live affect your risk for PPD? — The Bump Where to find the best deals on school supplies — Real Simple Now this is how you announce a pregnancy! — HuffPost Parents


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Still Strong by RT from NJ on 06/02/2010. Trim: 2005 Nissan Frontier SE Crew Cab 4WD, Owned 5 years.
Pros: I have owned this truck for 5 years. I have over 140,000 miles and it is going as strong as when new. It is large enough to haul what I need, but small enough for city driving and parking. It tows my camper (4000#) with ease with its strong engine and torque. Very comfortable driving position, plenty of storage inside/outside, love the factory bed liner and clete system. Overall fit and finish are durable and with regular maintenence has been steady as a rock.
Cons: The cloth seats show some wear and tear along the edges even early on, paint on the body scratches very easily, both lock assemblies on the front driver/passenger doors had to be replaced 2x each (doors wouldn't close and drained battery a number of times)
Overall review: Overall, I highly reccomend this vehicle. Strong, sturdy and reliable. And very good looking in my opinion. I have the Red Alert and still smile at it in my driveway every morning.
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English / Bahasa
Bahasa Indonesia
Suite #06-17 Gleneagles Medical Centre 6 Napier Road
Singapore 258499 Tel:
(65) 6475 2282
Head and Senior Consultant, Department of Ear Nose Throat Surgery, at Singapore General Hospital – 1992 to 1995
Head & Senior Consultant
Singapore General Hospital
Dr Stanley as Head of Department with ENT Surgeons in the ENT department, SGH
Spearheaded development of Head & Neck Surgery and Rhinology (Endoscopic Sinus Surgery) in the department.
Encouraged the development of sub-specialties in Oto-Neurology, Paediatric ENT and Laryngology amongst junior surgeons.
Set up an Endoscopic Sinus Surgery Laboratory for training of younger surgeons in the department.
Instrumental in initiating and coordinating a comprehensive Voice Laboratory and Clinic.
Successfully set up the Post-Laryngectomy Voice Restoration Programme in Singapore General Hospital.
Organised Medical Student's training programme for the NUS Medical School. Undergraduate medical student lecturer.
Specialty Training – in Singapore and the United Kingdom
Training in Edinburgh
with Prof AGD Maran
Prof AGD Maran visit to
Singapore General Hospital
Graduated from the University of Singapore with an MBBS degree in 1978.
Post-graduate training in Edinburgh on a Singapore Government scholarship in 1981 / 82.
Awarded Fellowship of the Royal College of Surgeons of Edinburgh (FRCS) in 1982 in Ear, Nose & Throat Surgery.
Advanced training in Head & Neck Surgery in Guys Hospital and Royal National Throat, Nose & Ear Hospital, London
1987 / 88.
The Royal College of Surgeons of Edinburgh, UK
The Royal College of Surgeons of Edinburgh, UK (building)
Royal Marsden Hospital London
with International Fellow from India
Post-graduate sub-specialty training in Head & Neck Surgery at Guys Hospital, Royal Marsden Hospital, Royal National Ear Nose and Throat Hospital, University College London, UK.
Other areas of sub-specialty interest include Endoscopic Sinus Surgery, Allergy-Related ENT diseases, Snoring and Sleep Apnea Management.
The Royal Marsden Hospital, London, UK
The Royal Marsden Hospital, London, UK (building)
Visiting Professor at Stanford University Medical Centre, Palo Alto, California, USA
Dr Stanley with teaching faculty
at Stanford University
Ward rounds with Staff & Residents at Stanford University
Invited to be Visiting Professor at Stanford University's Department of Otolaryngology / Head & Neck Surgery in 1993.
Dr Stanley delivered lectures and engaged Residents and Faculty members in clinical discussions and ward rounds.
Live Surgery and Course Director in Endoscopic Sinus Surgery in Vietnam
Live Surgery in Ho Chi Minh City
Plenary Lecture in Recent Advance
in Sinusitis Treatment
Demonstrated 'LIVE' Endoscopic Sinus Surgery and gave keynote lectures to ENT specialists, doctors and students at the Ho Chi Minh City University of Medicine and Pharmacy.
Organised and directed an Endoscopic Sinus Surgery Course for ENT surgeons in Ho Chi Minh City.
Course Director in Endoscopic
Sinus Surgery
Ho Chi Minh City ENT Centre
Endoscopic Sinus Surgery Course Ho Chi Minh City, Vietnam
International Lectures & Patient Consultation in Canada, Myanmar, Brunei, Australia
International Guest Speaker at the Otolaryngology-Head & Neck Surgery Update organised by the Canadian Society of Otorhinolaryngology in Whistler, British Columbia, Canada.
Guest lecturer in Myanmar, Brunei and Western Australia.
Continues to lecture at numerous CME programmes in Singapore and ASEAN region.
Bandung Lecture and
Consultation 2011
Lecture tour in Bandung, Indonesia in 2011 including patient consultation.
Patient Consultation in
Myanmar 2011
2011 Lecture / Consultation Tour in Myanmar
Patient Consultation in Myanmar 2011
TV Interview in Yangon
Speaker on Snoring in Myanmar
Clinical Ward Rounds in Mandalay
Hospital Visit in Mandalay
Medical Conference in Yangon
Dr Stanley with patients from Myanmar whom he has treated
Lecture in Perth, Australia
Lecture presentation to General Practitioners in Perth, Western Australia.
Member of International ENT Societies
Fellow of American Academy of Otorhinolaryngology – Head & Surgery.
Member of American Rhinologic Society.
Member of the American Society for Head & Neck Surgery.
Authored & Co-Authored Local and International Journals
Authored several international papers on Acute Epiglottitis, Recurrent Parotid Tumours, Foreign Bodies in the Throat, Laryngotracheal Stenosis.
Co-authored chapter in the book "Nasopharyngeal Carcinoma" edited by VHF Chong & S Y Tsao.
Keeping Abreast of Global Developments in ENT
Learning Electronic Medical Records
New Sinus Surgery Instrumentation
American Academy of Otolaryngology, Head & Neck Surgery Annual Meeting, Boston, USA 2010.
Robotic head and neck surgery.
Electronic medical records.
Cutting edge technology in sinus surgery instrumentation.
Robotic Surgery in Head & Neck Surgery, 2010
AAO-H&N Meeting in Boston, 2010
Dr Stanley keeps himself up to date with cutting edge technologies in ENT including 'Robotic Surgery' as seen here at the American Academy of Otolaryngology – Head & Neck Annual Meeting in Boston, USA, 2010.
Attend Annual ENT Meetings in the USA
AAO-HNS Meeting 2011
– San Francisco, USA
American Academy of Otolaryngology – Head & Neck Surgery (AAO-HNS) annual meeting is the world's largest gathering of otolaryngologists. It is a premier event in the ENT world, and draws more than 6,000 medical experts and professionals from around the world.
Dr Stanley makes a point to attend the AAO-HNS meetings regularly. He was at the Boston conference in 2010 and the San Francisco conference in 2011, where he attended instruction courses, mini-seminars and networked with some of the world's leading names in this specialty to exchange ideas and experiences.
An exhibition of the latest cutting edge technology in the ENT world is held in conjunction with the Conference.
AAO-HNSF Annual Meeting
& OTO Expo
Premium & Comprehensive Service in Private Practice
Dr Stanley & Clinic Manager,
Ms Irene Lim
Set up Stanley Ear Nose Throat & Sinus Centre at Gleneagles Medical Centre in 1995 as
Senior ENT / Head & Neck Surgeon and Director
Services include the
comprehensive management
of the entire spectrum of ENT-related conditions, including sinusitis, allergy management, snoring and sleep apnea treatment for adults & children, head & neck & thyroid surgery, hearing / dizziness evaluation and treatment and Paediatric ENT.
Endoscopy - Flexible
Endoscopy - Rigid
Diagnostic Endoscopy of the upper aero-digestive tract is performed in the clinic.
Endoscopic Sinus Surgery
Allergy Management -
Skin Prick Test (Aero-Allergens)
Pure Tone Audiometry
In-house Allergy Management.
In-house Audiological Services.
Pure tone audiometry and tympanometry.
A comprehensive snoring/ sleep apnea service is available from clinical diagnosis, complete sleep study, nasal CPAP Therapy and definitive surgery of obstruction Sleep Apnea problems.
A complete sleep study (Polysomnograph) can be performed at patient's home or hotel or as an inpatient.
Therapeutic management of Halitosis (Bad Breath) is available after thorough examination.
Diverse Community Service Engagements
President Rotary Club of
Jurong Town, Singapore
2000 / 2001
Community service as Rotary Club president
Rotarian and Past President of the Rotary Club of Jurong Town (2000 – 2001).
Member of Fund Raising Committee, Eurasian Association, Singapore.
Member of Transplant Ethics Committee, Parkway Healthcare.
With junior college-level Rotary Interactors
Member Compass 1998 – 2000
Ministry of Education
Medical Expert in Subordinate Courts' Mediation Panel (Medical Arbitration).
Member of COMPASS Committee (COMmunity and PArents in Support of Schools) in Ministry of Education from 1998 to 2000.
Mentoring a Singapore
American School student
SAS student joined Dr Stanley in the operating theatre for a
first-hand look
Dr Stanley was "Mentor for a Day" to a student from the Singapore American School (SAS) in its pilot programme in 2009.
SAS' Mentor for Day programme was designed to provide a hands-on opportunity to students interested in different career fields. Dr Stanley volunteered his time to participate in this worthy programme.
Dr Stanley's mentee for the day wrote an account of her day with Dr Stanley in the school's newsletter
Passionate Appreciation of the Finer Things in Life
Watch Collector
Watch enthusiast with an interest in classic designs and complicated watches.
Collector of fine writing instruments crafted by some of the world's top brands.
Collector of antique medical illustrations that capture the minutiae of the human anatomy.
Amateur photographer – people photography.
Watch collector
Watch Collector
Antique Medical Illustration
Foodie at Heart
Banana leaf curry, wine, local dessert and roti prata are some of the many pleasures Dr Stanley enjoys!
Foodie at heart – loves everything from simple kopi-O see and kaya toast to durians and a good steak!
Durians are another great passion for Dr Stanley, including enjoying local Cambodian coffee in Siem Reap!
Family Man and Doting Father
Active parenting through engaging dinner conversations and shared activities with both daughter and son.
About Doctor Stanley
Clinical Services
International Experience
Contact Us
STANLEY EAR NOSE THROAT AND SINUS CENTRE Suite #06-17 Gleneagles Medical Centre 6 Napier Road Singapore 258499 Tel:
(65) 6475 2282


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A while back, yours truly released an article entitled "The Church Can Turn The Tide." Looking back, it becomes very apparent that it is GOD who turns the tide, and that as HIS Bride through Jesus our Lord and the Holy Spirit's leadings, we are used in this process. At any rate, the tide is turning. There are several news articles of date, including the buzz regarding Alice Walker's daughter, Bishop Eddie Long and so many other things that let us know that people are coming forth with issues that have heretofore been "hidden." The time now is more for prayer, crying out to GOD that as in the book of Jude, many will be rescued. Let us pray that as the sins of this nation are exposed, we will all obey the mandate in the book of Chronicles, and humble ourselves and pray and turn from our wicked ways, and really be GOD's people, so that GOD will truly heal our land! GOD bless you today dear friends!
The Tide is Turning
One Response to "The Tide is Turning"
[...] my article The Church Can Turn The Tide, we can see that our major responsibility remains in the prayer realm, not the political realm. [...]


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Trivia Buff @ Liam Maguire's
When: Wed Feb 13th
8:00 pm - 12:00 am
Where: Liam Maguire's Irish Pub and Restaurant, 273 Main Street, Falmouth
Show off your smarts at Liam Maguire's ab fab Trivia Buff night! Winner takes home prizes~!
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