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The basic form of an elevator may be traced back all the way to the Middle Ages, when a basket of some sort was lifted through a pulley system. The modern-day elevator wasn't introduced until the 1800s, when hydraulic or steam plungers worked to lift a platform. Since then, the elevator has transformed into a fast-moving component vital for the swift transport of people in buildings of all sizes. Due to the numerous movable parts within an elevator, elevator technicians are required to ensure the machine operates smoothly and safely. If you are interested in becoming an elevator technician, also known as an elevator constructor, you must undergo specialized training offered at vocational schools throughout the United States.
Enroll in an elevator technician apprenticeship program. This program typically lasts four years and provides you with a combination of classroom lectures and on-the-job training. Throughout most of the apprenticeship program, you will be paired with a licensed elevator technician and will shadow him throughout his daily work. Eventually, you will perform basic duties of an elevator technician while being supervised by a licensed technician. The U.S. Department of Labor states aspiring technicians are typically required to have a high school diploma; however, those with higher education typically advance faster than those with only a high school diploma. Apply for an elevator technician apprenticeship program by contacting your state's Apprenticeship and Training Division or the National Elevator Industry Educational Program, which requires you to pass the Elevator Industry Aptitude Test.
Check your state's licensing board to determine if you must hold an elevator technician license. If your state requires a license, you will be required to pass a written examination, which tests your knowledge of technical limitations, installation procedures and other vital information a technician must know. You may also be required to pay a licensing fee and meet other educational requirements.
Obtain a nationally recognized certification as an elevator technician. The U.S. Department of Labor states that on completing an apprenticeship program, you are awarded a journeyworker certificate, which is recognized throughout the nation; however, you may be required to obtain additional certification. The National Association of Elevator Contractors offers a Certified Elevator Technician, or CET, certificate, which requires completion of two levels of testing. Check with your state to determine if this certification is required for employment as an elevator technician. Once you have gained all necessary certification, you may work in your state as a certified elevator technician.
Tips & Warnings
- Contact the National Association of Elevator Contractors regarding the CET examination to determine if this is best route for you.
- Avoid scams promising a "fast-track" to certification. No matter where you live, you will spend a minimum of four years training for this career.
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Thick Knit Long Scarf With Fringe
$13.49 $27
This simple scarf is warm, soft, and a pleasure to touch. Scarf measures 7 inches wide. Scarf measures 77 inches long, end to end. Scarf fringe trim measures 9 inches long, on each end.
• Made of a very thick acrylic yarn knit.
• Scarf has very long 9" fringe.
• Long enough to be wrapped around your neck, and still have long flowing tails.
• Acrylic
• Imported
Product Code: APS00672/S02046 S02047 S02048

subset: commoncrawl


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Watkinsville Post Office
1090 Experiment Station Rd, Watkinsville, GA 30677
Phone: 706-769-6980
Fax: 706-769-2358
Toll-Free: 1-800-Ask-USPS® (275-8777)
Monday-Friday 9:00am - 3:30pm
Saturday-Sunday Closed
Monday-Friday 8:30am - 5:00pm
Saturday 9:00am - 12:00pm
Sunday Closed
Monday-Sunday 12:01am - 11:59pm
Monday-Sunday 12:01am - 11:59pmLast Collection Times
Monday-Friday 5:00pm
Saturday 3:30pm
Sunday Closed
Monday-Friday 8:30am - 5:00pm
Saturday 9:00am - 12:00pm
Sunday Closed
Monday-Friday 8:30am - 5:00pm
Saturday 9:00am - 12:00pm
Sunday Closed
*This facility does not process US Passports applications or renewals. Check nearby locations below.
- Bulk Mail Acceptance
- Bulk Mail Account Balance
- Bulk Mail New Permit
- Burial Flags
- Business Reply Mail Account Balance
- Business Reply Mail New Permit
- Duck Stamps
- General Delivery
- Global Express Guaranteed®
- Money Orders (Domestic)
- Money Orders (Inquiry)
- Money Orders (International)
- Packaged Stamps
- Pickup Accountable Mail
- Pickup Hold Mail
- PO Box Online
- Priority Mail International®
- Lobby has Copier
- Lot Parking
Visit our Links Page for Change of Address, Hold Mail/Stop Delivery, PO Boxes™ rentals and fees, Rates on Postage Stamps and Freight/Shipping, Holidays, Bulk Mail, Money Orders, and Available Jobs.
*Please call to verify information. Is anything incorrect? Let us know here
Nearby Post Offices:
4861 Macon Hwy
2.2 miles away
Athens Promenade Station New
3654 Atlanta Hwy Ste M
3.2 miles away
1011 Salem Rd
3.6 miles away
115 E Hancock Ave Ste 100
4.0 miles away
Oconee County


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California State Senator Seeks Equal Sentencing For Crack Vs. Cocaine Arrests
For many years, it has been that people who are caught selling or using crack cocaine have received higher sentences and harsher punishment than those who are accused of the same types of crimes, but instead with powder cocaine. Senator Holly Mitchell, a Democrat from Los Angeles, is introducing Senate Bill 1010 which is aimed to equalize the penalties for crack cocaine to the current penalties for powder cocaine.
"Same crime, same punishment is a basic principle of law in our democratic society," said Senator Mitchell, Chair of the Black Caucus and member of the Senate Public Safety Committee. "Yet more Black and Brown people serve longer sentences for trying to sell cocaine because the law unfairly punishes cheap drug traffic more severely than the white-collar version. Well, fair needs to be fair."
Crack Cocaine Vs Powder Cocaine
Crack cocaine and powder cocaine are essentially the same thing. It's just that crack is a "lesser" version in that it is a cut down version of powder due to the way that it is made, but the only real difference is the purity and the name.
There have been studies done that were posted in the Journal of the American Medical Association that prove the effects of both drugs are nearly identical on the body. But in our legal system, it would seem from the outside that they are two completely different drugs, in terms of the way they are treated legally.
Disparate Sentencing Guidelines
"Whatever their intended goal, disparate sentencing guidelines for two forms of the same drug has resulted in a pattern of institutional racism, despite comparable rates of use and sales across racial and ethnic groups," according to Lynne Lyman of the Drug Policy Alliance.
According to intake data from the California Department of Corrections and Rehabilitation, people of color account for over 98% of people sent to California prisons for possession of crack cocaine with intention to sell it. From 2005 to 2010, Blacks accounted for 77.4% of state prison commitments for crack possession with intention to sell, Latinos accounted for 18.1%.
Whites accounted for less than 2 percent of all those sent to California prisons in that period of five years. Blacks make up 6.6% of the population in California; Latinos 38.2%, and whites 39.4%. There is an obvious disparity here that the Senate Bill 1010 is trying to take care of.
Eliminating Disparity
"Eliminating this disparity is a very important step towards fulfilling the promise of equal justice and ending the pattern of racial discrimination and over-incarceration that has targeted Latinos and all communities of color for many years now," Antonio Gonzalez, President, William C. Velasquez Institute (WCVI).
In a show of cooperative bipartisanship in 2010, Republicans and Democrats in the US Congress passed legislation to address the disparity in crack/cocaine sentencing in federal law by reducing the disparity from 100-to-1 down to 18-to-1. There is still a large bias there but this was a huge step forwards.
Smarter Sentencing Act
And on January 30, 2014, the US Senate Judiciary Committee voted 13-5 in favor of the Smarter Sentencing Act to reduce or eliminate mandatory minimums for specified drug offenses, and to allow courts to reduce sentences for persons convicted of crack cocaine offenses committed before the August 2010 sentencing reform. Republican coauthors include Senators Mike Lee (UT), Rand Paul (KY) and Ted Cruz (TX).
Despite the fact that there are still disparities out there for the sentencing of people who are caught with crack cocaine versus powder cocaine, there are large legal steps being taken here in California to stop this bias that exists. Hopefully, this Senate Bill 1010 will have effective results and the rest of the country will notice, and then enact their own types of bills that address the same problem.


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BUILD OUR EST CASE. June 2011 EVIDENCE. American Association for Justice ENLIST THE RIGHT EXPERTS, FIND THE KEY EVIDENCE.
- Kathlyn Kennedy
- 1 years ago
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1 American Association for Justice June 2011 BUILD OUR EVIDENCE Case: Date: EST ENLIST THE RIGHT EXPERTS, FIND THE KEY EVIDENCE New Expert Discovery Rules The Credible Life Care Plan CASE High-tech Forensic Tests
2 The only bank tailored to the needs of attorneys. Esquire Bank was created by lawyers for lawyers. So no bank meets your needs better. Personal attention is only a call or click away. And our Esquire Card Program works harder and smarter for you. Case Cost Financing/Business Lending Deposit Services & Private Banking Qualified Settlement Fund Banking Branded Debit Card Settlement Disbursements Please visit us at the AAJ Conference and go to esquirebank.com Partnership for Justice s Terms and conditions subject to change without notice Member FDIC Equal Housing Lender
3 2011 AAJ AnnuAl ConvenTion Preview new york City is the glittering venue for AAJ s biggest event of the year. In this special section, get a preview of next month s full slate of education programs, networking opportunities, and social events. then make plans to join your colleagues in the Big Apple. Presented By BRIGHT lights, BIG CITY BRIGHT LIGHts, BIG CITY BRIGHT LIGHTS, BIG CIty BRIGHT LIGHTS, BIG CITY Trial June
4 2011 AAJ AnnuAl ConvenTion Preview Presented By Something s Brewing in NYC Next month, the trial lawyers take Manhattan. At AAJ s Annual Convention in New York City, thousands of attendees from around the country will gather for five days of networking, education, and recommitment to the fight for justice. They will hear from authoritative speakers on dozens of litigation topics, meet with colleagues at exciting Manhattan venues, earn CLE credit, and learn about hundreds of practicerelated products and services on display in two exhibit halls. Politically minded attendees will have the opportunity to hear from candidates for office, elected officials, and pundits eager to share their distinctive takes on the current political climate. Renowned civil rights lawyer Morris Dees will address the Membership Luncheon. Also scheduled is a special screening of the upcoming HBO documentary Hot Coffee, which revisits the famous story of Stella Liebeck s much-maligned and misrepresented lawsuit against McDonald s. The convention will be held from Saturday, July 9, to Wednesday, July 13, at the Hilton New York and Sheraton New York in Midtown. Throughout the five days, in business meetings and education programs, at social events, and in impromptu hallway conversations, members will meet and exchange valuable tips and strategies for better representing clients and building a law practice. The networking opportunities alone make it worth attending AAJ conventions, said George McLaughlin of Englewood, Colorado. Highlights of AAJ in NYC: Mingle at MoMA. The opening reception, sponsored by Baron & Budd, P.C., will be held at the Museum of Modern Art on Saturday evening. Attendees can kick off their convention experience and mingle with their colleagues among a collection of modern and contemporary art that inspires creativity. Schedule shift. In a departure from past conventions schedules, the Membership Business Meeting and Elections will be held on Tuesday rather than on Wednesday this year. Wednesday will feature a robust lineup of education programs and business meetings, so attendees should adjust their travel plans accordingly. Talking politics. The AAJ PAC M Club Luncheon on Sunday will feature remarks by Sen. Sherrod Brown (D-Ohio). Democratic strategist and CNN contributor Paul Begala will speak at the AAJ PAC Town Hall Luncheon on Monday. Trial Lawyers Care commemoration. The Membership and Awards Luncheon on Tuesday will include a commemoration of the 10-year anniversary of AAJ s Trial Lawyers Care program. In the aftermath of the 9/11 terrorist attacks, hundreds of AAJ (then ATLA) members donated countless AAJ Members Say don t Miss these nyc Gems If you re Looking for the Best Bagel H & H Bagels, 80th st. and Broadway (Upper West side) or 46th st. and 12th Ave. (Hell s Kitchen) Tal Bagels, 977 1st Ave. (Midtown location) Pastrami on rye Katz s Delicatessen, 205 east Houston st., at Ludlow st. (Lower east side) Gee Whiz Diner, 295 Greenwich st., at Chambers st. (tribeca) new York-Style Pizza Lombardi s Pizza, 32 spring st. (soho) Grimaldi s, 19 Old Fulton st. (Brooklyn location) Nick s Pizza, nd Ave. (between 93rd st. and 94th st.) (Upper east side) Place to Get Away from it All Central Park woodlands The New York Botanical Garden (the Bronx) 46 June 2011 Trial
5 For more information, schedule updates, and easy registration, visit A Year s Worth of CLE in Five days hours of pro bono legal representation to help victims obtain compensation from the September 11th Victim Compensation Fund. Hot Coffee. AAJ members are well acquainted with Stella Liebeck s story and the case she brought against McDonald s after she suffered severe burn injuries from spilled coffee. In Hot Coffee, lawyer-filmmaker Susan Saladoff set out to tell the real story of how big business distorted Liebeck s case to limit people s access to the civil justice system. The film premiered at the Sundance Film Festival earlier this year. Convention attendees can view a special AAJ screening on Monday. Giving back. Every year, the New Lawyers Division (NLD) organizes a public service project for convention attendees who want to give back to the community. In New York, the NLD will work with Habitat for Humanity to build a home. The project will take place Friday, July 8. The Minority Caucus will also host a service project on Friday. To sign up, contact Brandon Grubesky at Wrapping up in style. The convention will wrap up at a black-tie-optional closing party from 9 p.m. to midnight on Wednesday at the Edison Ballroom on 47th Street. At this art deco venue with a long history of hosting famous entertainers from Count Basie to Jon Bon Jovi attendees can dance to the New York City band Kinky Spigots and the Welders and sip martinis and champagne to close out another successful convention. Many AAJ members return to conventions year after year to gain new tools for successful law practice and renewed energy for their mission. As Barry Dyller, a member from Wilkes- Barre, Pennsylvania, put it: When I attend AAJ conventions, it is like I am with family. It reinvigorates me and reminds me why I love being a lawyer. More than 300 speakers including AAJ members, judges, law professors, and other experts will share their expertise with convention attendees next month in new york. AAJ education will present 45 continuing legal education programs over the convention s fi ve days, giving members from across the country and around the world the opportunity to earn more than a year s worth of CLe credits while keeping abreast of the latest developments in their practice areas and polishing their courtroom techniques. the fi ve-day Advocacy Track focuses on trial skills development in several areas, including jury selection, advocacy through technology, storytelling and persuasion, forecasting defense tactics, and damages. Many of AAJ s 18 practice sections, more than 20 litigation groups, and several committees will present programs focused on specifi c legal topics. repeat attendees will notice an important schedule change this year: With the Membership Business Meeting and elections moving from their traditional Wednesday slot to tuesday afternoon, education will continue at full throttle on Wednesday, the last day of the convention. Attendees will want to ensure they don t miss Wednesday s full slate of programs. All convention education programs, as well as AAJ education seminars that occur at other times during the year, are recorded. For members who cannot attend the programs in person, these audio and video recordings provide a convenient way to gain the knowledge needed to better serve clients in the convenience of a lawyer s offi ce, home, or car. selected sessions are now available in VideoPoint format, in which the presenter s PowerPoint presentation is synced with the audio and video recording for a virtual re-creation of the original session, allowing the viewer to toggle between slides and video. to learn more about AAJ s audio and video provider, PlayBack now, or to order recordings from previous programs, visit Kid-Friendly Spot American Museum of Natural History, Central Park West, at 79th st. (Upper West side) The Circle Line Sightseeing Cruises (information and tickets at Any playground in Central Park or Battery Park Central Park Boat Pond, (near east 72nd st. entrance, at 5th Ave.) (Upper east side) FAO Schwartz, 5th Ave. at 58th st. (Midtown east) view of the City The Brooklyn Heights Promenade 230 Fifth Rooftop Garden Bar and Restaurant 230 Fifth Ave. (Chelsea) Hidden Gem The Cloisters Museum and Gardens (Fort tryon Park) nightclub The Boom Boom Room at the Standard Hotel, 848 Washington st. (Meatpacking district) MPD, 76 Gansevoort st. (Meatpacking district) Lavo, 39 e. 58th st. (between Park Ave. and Madison Ave.) (Midtown east) Trial June
6 2011 AAJ AnnuAl ConvenTion Preview Presented By Prime Time for Networking, Practice Building Attendees arrive at AAJ conventions looking to connect with colleagues and restock their practice tools. In New York, they ll find plenty of resources specific to dozens of practice areas. Sections and litigation groups. Eighteen sections and more than 70 litigation groups will meet at the Annual Convention to discuss important legislative developments, case strategies, and proven trial techniques. Attendees who participate in these groups can network with peers and learn the most up-to-date information in their practice areas. Several newly certified litigation groups, including Acetaminophen Injury, Cell Phone Radiation, Spinal Cord Injury, DePuy Metal on Metal Hip Implants, Darvon/Darvocet, Crestor, Topamax, and Zimmer Knee will hold meetings in New York. Several new groups will be considered for certification at the convention. This year, litigation group business meetings will take place Saturday through Wednesday rather than concluding on Tuesday, as at past conventions so attendees should plan their travel accordingly. A detailed schedule is available at Several groups including the Aviation Law Section, the Class Action Litigation Group, and the Railroad Law Section will hold receptions for their members to meet and mingle after a full day of meetings and education programs. All section members are invited to the annual Section Connection Reception on Sunday, July 10. Litigation packets. The AAJ Exchange is continuously publishing new and updated litigation packets containing valuable court documents, including discovery materials and defense expert depositions. Developed with input from leading AAJ members, the packets also include statutes, case law, and AAJ Education speaker papers related to specific litigation areas ranging from birth injury to motor vehicle accidents to insurance bad faith. AAJ staff will be on site in New York at the Practice Resource Center with litigation packet samples and online search demonstrations. Document libraries. The Exchange also hosts document libraries collections of depositions, briefs, and other case materials available for section and litigation group members to download quickly and securely for free. All 18 sections and most litigation groups have developed document libraries. Hundreds of new documents for various practice Schedule at a Glance Visit for a detailed schedule, including times for AAJ education programs and section and litigation group business meetings. Friday, July 8 Saturday, July 9 Sunday, July 10 registration: 2 p.m. 6 p.m. 9 a.m. 4 p.m. new Lawyers division Public service Program 5 p.m. 7 p.m. Women trial Lawyers Caucus reception 7 p.m. 9 p.m. Minority Caucus event registration: 8 a.m. 6 p.m. exhibit Hall: 8 a.m. 12 p.m. and 3 p.m. 6 p.m. 4 p.m. 5 p.m. First-timers reception 4:30 p.m. 6 p.m. exhibit Hall reception 5 p.m. 6:30 p.m. AAJ PAC eagles event 7:30 p.m. 9:30 p.m. Opening reception at MoMA registration: 8 a.m. 6 p.m. exhibit Hall: 8 a.m. 12 p.m. and 3 p.m. 6 p.m. 8 a.m. 9:30 a.m. Leadership Breakfast 10 a.m. 12 p.m. Women trial Lawyers Caucus Brunch 11:45 a.m. 12:30 p.m. Platinum M Club Meet & Greet 12:30 p.m. 2 p.m. AAJ PAC M Club Luncheon 4:30 p.m. 6 p.m. exhibit Hall reception 5:30 p.m. 6:30 p.m. section Connection reception 6 p.m. 7:30 p.m. Minority Caucus reception 9 p.m. 12 a.m. new Lawyers division Party 48 June 2011 Trial
7 For more information, schedule updates, and easy registration, visit areas including class action, employment rights, and products liability are added monthly. AAJ supports 18 sections and more than 100 litigation groups. For more information, call (202) , ext. 8700, or visit For immediate access to AAJ Exchange resources, visit and click on Search the Exchange, Litigation Packets, or Document Libraries. AAJ to Honor Excellence and Service AAJ members who have made outstanding contributions to the association, their communities, and the legal profession will receive special recognition at the convention. Among the awards to be bestowed in New York City: The Distinguished Service Award is given each year by AAJ s outgoing president to members of the Board of Governors who provided exceptional support and assistance throughout his or her term. In giving the F. Scott Baldwin Award, the New Lawyers Division (NLD) honors a member who has made a significant contribution to the NLD and who has attained one or more outstanding trial verdicts. The Harry Philo, David Shrager, and Howard Twiggs Awards are presented to trial lawyers who have made outstanding contributions to the safety and protection of American consumers and our civil justice system. The Johnnie L. Cochran Jr. Soaring Eagles Award, presented by the Minority Caucus, goes to an attorney of color who, despite the challenges of his or her own journey, pursues excellence and has made outstanding efforts and contributions to the legal profession in paving the way for others. The Civil Rights Section presents the Leonard E. Weinglass In Defense of Civil Liberties Award to an individual usually, but not necessarily, an attorney who has made a notable contribution to the defense of civil liberties by bringing, trying, or resolving a suit, or by otherwise protecting or advancing civil liberties, in a way that has had a significant impact in the past year or over the course of the recipient s career. The Leonard M. Ring Champion of Justice Award honors a member who demonstrates this former ATLA president s devotion to human and civil rights. The Lifetime Achievement Award recognizes an AAJ member who has devoted significant time and effort to meeting AAJ s ideals by working to ensure that victims of negligence can hold responsible parties accountable and by demonstrating a commitment to strengthening the civil justice system. The Women Trial Lawyers Caucus presents the Marie Lambert Award to an AAJ woman attorney member who demonstrates exemplary leadership to her profession, to her community, to AAJ, and to the caucus. These awards and others will be presented at several luncheons and receptions throughout the week. Monday, July 11 Tuesday, July 12 wednesday, July 13 Thursday, July 14 registration: 8 a.m. 6 p.m. exhibit Hall: 8 a.m. 12 p.m. and 3 p.m. 6 p.m. 12 p.m. 1:30 p.m. AAJ PAC town Hall Luncheon 4:30 p.m. 6 p.m. exhibit Hall reception 7 p.m. 8:30 p.m. Leaders Forum/endowment reception 8 p.m. 12 a.m. Putting on the ritz at Cipriani A reception Honoring Incoming President Gary Paul registration: 8 a.m. 6 p.m. exhibit Hall: 8 a.m. 1 p.m. 8 a.m. 9:30 a.m. Civil Justice Foundation Breakfast 12 p.m. 2 p.m. Membership & Awards Luncheon 3 p.m. 5 p.m. Membership Meeting and elections 8:30 p.m. 10:30 p.m. International relations dessert reception registration: 8 a.m. 1 p.m. 9 p.m. 12 a.m. Closing event at the edison Ballroom 7:30 a.m. 8:30 a.m. Board of Governors Orientation 9 a.m. 1 p.m. Board of Governors Meeting Schedule is current as of May 9, 2011, and is subject to change. Trial June
8 2011 AAJ AnnuAl ConvenTion Preview Presented By For more information, schedule updates, and easy registration, visit Meet the Exhibitors At the convention s two exhibit halls, attendees will meet face to face with exhibitors to discuss winning strategies, try out the latest advances in legal technology, and find solutions to enhance their practice. AAJ Extras providers are shown in boldface. Answering Services Legal Intake Professionals Case/Practice Management Client Profiles needles, Inc. trialworks Case Management software/lawex Consumer Products British Custom tailors & shirt Makers shanghai Custom tailors Court reporting Services Fink & Carney reporting and Video/ny Videoconference Center rosenberg & Associates/ infocus Litigation support Day-in-the-life videos Advocate Films Demonstrative evidence Artery studios Cerescan, Inc. dk Global, Inc. High Impact, Inc. Medical Visions, Inc. MediVisuals, Inc. engineering Consulting & Analysis ArCCA, Inc. Auto Claims experts, Inc. Ced Investigative technologies, Inc. Fischer Forensic services Global engineering scientific solutions Knott Laboratory, LLC ruhl Forensic ryan Forensics expert witness Services Alcohol solutions, LLC American Medical Forensic specialists Comprehensive Medical Case Management Cts Group d&a Consultants, Inc. FdAble Greenfield Advisors Hospital experts Keys Claims Consultants, Inc. Marex Medical Advisors, Inc. MedMal Consulting medquest Occupational Assessment services, Inc. rgk Consultants, LLC robert W. Johnson & Associates robson Forensic the tasa Group, Inc. tinari economics Group Vocational economics, Inc. Financial Services 360 Financial Planning, LLC ABA retirement Funds Program Advocate Capital, Inc. American Asset Finance, LLC Appellate Advance Associates Bentzen Financial Brook-Hollow Financial Counsel Financial Covered Bridge Capital empire settlement Funding esquire Bank LawCash nationwide Litigation Funding Oasis Legal Finance Peachtree Pre-settlement Funding PenChecks, Inc. Plaintiff support services Ps Finance strategic Capital Corp. structure Adjust, Inc. UBs-the settlement solutions Group Wells Fargo special needs trust Group insurance Services Jamison risk services Marsh Consumer MetLife Jury/Trial Consultants schlesinger trial and Jury Consulting, LLC legal nurse Consultants Alliance Medical Legal Mindy Cohen & Associates Phoenix LnC & Associates legal Publishing American Bar Association Images of Justice national Institute for trial Advocacy trial Guides legal research Services Lexisnexis West, a thomson reuters business lien resolution Services Garretson resolution Group Lien negotiation Counsel Lien resolution Group Lien resolution services, LLC litigation Support A.B. data, Ltd. Attorney Consultant, Inc. Bisnar Chase Crivella West davis, saperstein & salomon, P.C. express Medical records the Garden City Group, Inc. Magna Legal services Med View services MediConnect Global Merrill Corp. Marketing Services American Association of Motorcycle Injury Lawyers, Inc. Attorneys On Call Attorneys Online, Inc. dotco Law Marketing, LLC Gulf Media solutions Intake Advantage Lawyers Group Lawyersandsettlements.com L Z Productions, Inc. MCM services Group yodle Membership organizations American Association for Justice national Board of Legal specialty Certification national Crime Victim Bar Association office Services/Supplies ups Public interest Groups Center for Justice & democracy Public Justice Foundation Structured Settlement Services Creative Capital, Inc. Forge Consulting the Halpern Group the James street Group Lesti structured settlements web Site Design ejustice FindLaw, a thomson reuters business Obu Interactive Page 1 solutions Current as of May 9, June 2011 Trial
9 The new approach to settlement disbursements everyone will want to swipe. It s time to think forward. Instead of cutting ties with your client right after you cut them that settlement check, give them their cash on our Esquire Card instead. They ll appreciate having their settlement instantly available in a no fee interest-bearing account, with a debit card they can use to get cash and make immediate purchases. Plus, since your firm s name is printed right on the front, it acts as a minibillboard reminder every time they choose to use their card. So take advantage of this innovation that benefits you both. The power to make a very positive change is in your hands. Please visit us at the AAJ Conference and go to esquirebank.com Partnership for Justice s Terms and conditions subject to change without notice Member FDIC Equal Housing Lender
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By Gary Mihoces, USA TODAY
NEW ORLEANS Nine Super Bowls have been played here. Each time, fans from someplace else have celebrated victories by dancing on Bourbon Street and whooping from its balconies.
This time, New Orleans isn't hosting the game; it's in it. Never mind that Super Bowl XLIV will be in Miami. If the New Orleans Saints beat the Indianapolis Colts, the biggest party will be right here, Louisiana style. Let the good times roll.
PHOTOS: Best of the NFL playoffs
The Saints began play in 1967 and didn't have a winning record until 1987. This region has endured the suffering and devastation of Hurricane Katrina in 2005. Now, amid the recovery, the Saints have delivered hope, pride and euphoria. The sidewalks of Bourbon Street are paved with red bricks, but this city is walking on air.
"My mom's 80 years old, in a nursing home. I had to go buy her a Super Bowl jersey," Les Cooper, 42, of Picayune, Miss., said at a Bourbon Street bar.
His mom, Pauline Cooper, also has delayed hip surgery. "She told the doctor, 'I'm not going to have this surgery until after the Super Bowl because I'm going to be in good health to watch this game,' " Cooper said.
As cab driver Dennis Oliver, 31, drove into the city, the Louisiana Superdome came into view. "See where it's all painted white on top. They had a lot of pieces that were torn off (post-Katrina). They put it back together real nice," he said.
After Katrina, he had about a foot of water in his house. "I didn't have too much damage. … It wasn't the total destruction it was in some parts of the city," Oliver said.
But he and his wife and four children had to spend a year in Dallas. "The infrastructure around my neighborhood wasn't together, like stores and grocery stores. You couldn't do simple things you used to," he said. "I lived with my sister (in Dallas) for a few months and then I got an apartment."
In 2005, the Saints went 3-13 while playing "home" games in San Antonio and at LSU's stadium in Baton Rouge. They returned to the Superdome in 2006.
"I knew they were coming back," Oliver said. "That was one thing the city needed. That was the one thing we had. That was our team."
Stephanie Dockery, 22, a hostess as a Bourbon Street club, had 6 feet of water in her uptown house after Katrina.
"We stayed in a FEMA camper," she said. "They parked a FEMA camper in the front yard. We stayed in that for two years. Me and my little brother and my little sister and my dad and my cousin all stayed in a little, bitty FEMA camper."
On the day of the NFC title game, she was part of the massive Bourbon Street celebration.
"After Katrina, we didn't think we'd have a football team," she said. "That year (2006) when they almost made it to the Super Bowl was awesome. … This year, by far, is the best."
New Orleans will host another Super Bowl in 2013, but Saints fans hope the best is yet to come on Super Sunday.
Among them is Ayman Bahar, 31, from Jerusalem. He is working on a master's in computer engineering at the University of New Orleans and also drives a cab part time.
"I wasn't a football fan. But I used to work with a guy, and when we watched the game he went crazy every time the Saints scored," Bahar said. "After he explained the game, I loved it. And I love to watch the Saints win, big time."
Pittsburgh Steelers fans have partied here in black and gold. This time, the Saints will take those colors to the Super Bowl.
"It's big for the city and for all of us who work on Bourbon," said bartender Chris Stoddard, 21. "It's going to generate a lot of business. It has the entire season. The Saints are doing their thing this year. We're all proud of them."
Guidelines: You share in the USA TODAY community, so please keep your comments smart and civil. Don't attack other readers personally, and keep your language decent. Use the "Report Abuse" button to make a difference. Read more.


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Resources & Forms
On this page you will find the following information:
- Classroom Supply Lists (3rd-8th)
- Before & After Care
- Year-At-A-Glance (PDF)
- School-Wide Calendar
- Free/Reduced Lunch Application
- School Consent Forms
- Handbook & Policies
- ISL Uniform Policy & Suppliers
Classroom Supply Lists
- 3rd Grade Supply List
- 4th Grade Supply List
- 5th Grade Supply List
- 6th Grade Supply List
- 7th Grade Supply List
- 8th Grade Supply List (Revised)
Before and After Care Programs
- Before and After Care is offered at all ISL campuses. For more information on the Early Bird and Prime Time programs including late pick up policy and registration, please click here.
- Community Works LA After School Enrichment: Community Works LA will be hosting it's after school programming with ISL again this year. Community Works LA offers visual arts, music, theater, sports, writing, chess, and much more.
- The cost of this program is based on a sliding scale monthly fee based on your student's lunch status (Free, Reduced, or Regular).
- Dinner is provided.
- Transportation is NOT provided.
- Pick up time for Community Works LA is 5:30 p.m. everyday.
- Registrations start on August 8th. To register for Community Works LA, apply here online. Please note participants are selected for this program on first come first served basis. Spaces are limited.
School Consent Forms
- Emergency Consent
- Update Contact Form
- Medication Order
- Attendance & Truancy Policy
- Authorization of Written Material
- Records Request
- Declaration of Domicile
- Universal Field Trip Permission Form
- Louisiana Residency Form
- Withdrawal Form
Handbook and Policies
The Student Code of Conduct & Family-Student Handbook are in place to help students gain the greatest possible benefit from their educational opportunities at the International School of Louisiana. The school uniform policy can be found in the Family-Student Handbook.
- ISL Pupil Progression Plan
- HomeworkLouisiana offers FREE online tutoring and academic resources from Tutor.com for Louisiana residents from kindergarten students through adult learners. Get help in math, science, social studies or English from a live tutor. The services can be accessed from a Louisiana public library, from your home computer or from your mobile device. Visit HomeworkLA.org for more information.


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Are you short on money this month? Are you trying to think of the way that you can get a few thousand dollars that you can use to pay your bills? If you are, there are payday loan companies that are available all over the web, businesses that are willing to provide unsecured loans to people that are in desperate need of cash. Once you have found several of them, you can apply, and see what they have to offer. Some of them will only lend you a few hundred dollars, and all of them are not concerned about your credit rating, making this very easy for most people to get this type of loan.
How To Find Payday Loans Online
The search that you do should contain the words cash loans or payday loans, allowing you to quickly find businesses that are ranking for these particular keyword terms. There will always be several that will be easy to obtain money from, although the amount of money that they charge for interest may very. It is also possible that you may only get 1000 dollars, which may not be enough to pay off the payments that you have coming up. However, you always want to stay below the amount of money that you have coming in from your paycheck, helping you to pay off the loan when it comes to without having to deal with penalties or extra interest.
Choosing The Best Company For Your Situation
It's simple enough to fill out the application for the loan that you need to take out. After you have submitted online, it will go to an approval team that will overlook your information. They are primarily looking for proof that you are going to have a paycheck coming in that will be able to cover the amount that you are requesting to borrow. If this is the case, you should have no problem getting approval within a few hours, and you should get a deposit into your account not too much later, allowing you to start making your payments on the bills that are coming due.


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Shipshewana Dining Collection
This Amish handcrafted Round Barrel Bistro Table has a clean, contemporary look. The dark finish shown is a brown maple wood with an espresso stain and a 36" solid top, with a 36" high pedestal top and a Mission edge. Customize the look by selecting a variety of options like wood type, finish, table size, table height, table edge and extensions. You will love the look of your new custom bistro table!
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Check out our matching Amish Barrel Stools!
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Be Intentional with Your Kids. God is not only a God of intent, He has the power to make whatever He intends become reality. We are also intentional beings. That is one of the great gifts God has given us when He made us in his image. But unlike God, we do not have the power to always make our intention become perfect reality. Sometimes we don't even manage to make our intention reality at all, and sometimes we get a reality that we didn't intend. As it pertains to our kids, we can be intentional about investing into their walk with God. While you may have already done that today, you can share your intentions and show others how they can invest into their kids spiritually when you visit my Facebook page.
Ryan Daniel has emerged from a 12-step program. What was he quitting? Affirmation. Validation from people other than God. Co-dependency. He wrote about it in 'Completely' by Among the Thirsty, and in this chat with Dan Young from SOS Radio, he shares the first step in walking away from co-dependency.
David Crowder talks about crazy live action Disney movies, staying sane on a long flights and how he almost took over an insurance agency instead of doing music professionally. We talk about finding your sweet spot.
Shauna Niequist shares wisdom on how to savor life when it feels busy. She also talks about how we can avoid burnout when life just keeps coming at us! Her new book Savor: Living Abundantly Where You Are, As You Are.
"My God my God why have you forsaken me?" Read Psalm 22 if you're wondering what Jesus really meant. It's a Psalm of David written hundreds of years before Jesus was born. David was a songwriter & poet. He was wrestling with the challenges in his life and he penned this Psalm in his pain. It's so deep it actually includes some prophecy of the coming Messiah - a different kind of king in David's lineage.
"My God, my God, why have you forsaken me? Why are you so far from saving me, from the words of my groaning? O my God, I cry by day, but you do not answer, and by night, but I find no rest.
Annie Lobert was a high end escort in Las Vegas, but she broke free and God changed her life. This is a raw story of redemption. We talk about what human trafficking really looks like in our region, we talk about the other side of pornography and how pimps have power over both woman and men in the sex industry. Annie Lobert is author off the book: Fallen - Out of the sex industry and into the arms of the Savior. (This discussion is PG-13)
Kathi Lipp & Carol Boley talk about how to have success in blending families. Their new book is called, "But I'm NOT A Wicked Stepmother" is out now. We talked about how it takes years to blend a family. We talk about strategy, oneness, discipline and priorities.
Individual Shepherds Pie:
By Chef Phillip Dell of SinCityChefs.com
Fox News Sunday Anchor Chris Wallace & Lorraine Wallace talk about blended families, the importance of regular family dinners together and their new book Mr & Mrs Sunday's Suppers.
We all want to see breakthroughs in our life. We all want God to break the strongholds that have been holding us back. We want to see our faith and family grow, and we need consider real accountability to get there.
When I was 17 I was hired at a mainstream pop radio station in Detroit, Michigan. I was a Christian and I saw a lot of temptations in front of me at that job. I asked my past youth pastor Kevin if he would meet with me every 2 weeks and ask me a series of questions to help hold me accountabile. Over the next 5 years we developed a really deep relationship that actually held each other accountable. He asked me the tough questions, but he also answered those questions openly to me. It was a HUGE breakthrough in my faith journey. HUGE.


text: Making a 15-square-foot impression, the Inipi B sauna designed by EOOS for Duravit allows designers to create a luxe spa in indoor environments that are tight on space. The freestanding system only requires an electrical outlet. The jury wrote that the sauna, which can fit one or two people, offers "attractive and intelligent detail solutions in addition to minimal demand in space and energy [to] provide a maximum sense of spaciousness."


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China, IL
Season 3
A Gentleman's Bet
Frank and Steve compete over their annual "Gentleman's Bet"; The Dean & The Mayor solicit Pony & Baby Cakes' help for a Think Tank.
Season 1
Baby Boom
After a giant baby is born in the Super Science lab, obliterating the campus, the faculty is split between whether they should raise the monstrous infant or destroy it.
Coming out of the Casket
Student registration for the History Department sinks to an all-time low after the death of Harold, one of the faculty's best professors. Steve must come up with a plan to save their jobs while Frank becomes convinced that he's getting unsolicited attention from a paranormal being.
Prom Face/Off
Baby Cakes brings a date to the University's "Faculty Prom," which is held at the old, abandoned schoolhouse full of surprisingly vicious inhabitants.


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Monsters, Inc. 3D (G). First released in 2001, this film is still funny, but in 3-D, it's more for children 7 and older. The film takes the idea of kids' nighttime fears about monsters and runs with it. The monsters are real creatures with serpent hair or extra eyeballs. They can be lizardlike or giants with green and purple fur. They live in Monstropolis and work at Monsters, Inc., walking through magical doors and into little kids' closets to scare them. The monsters are taught to be scared of kids, too. So when a toddler winds up on the factory side of her closet door, due to the evil tricks of a chameleon-like monster, all the monsters freak out. Sulley and Mike risk their lives to protect her.
An Oscar-winning animated Pixar short, "For the Birds," precedes it and is, if you'll pardon, a hoot. A flock of small birds settles onto a telephone wire and tries to keep a big, gangly bird from joining them. He gets great comic revenge.
THE BOTTOM LINE: The scary bits are defused by laughter in "Monsters, Inc." But some of the monsters and the chase scenes will seem more intense to kids younger than 7. It's just different when it looks like a monster is in the room with you.
Parental Guidance (PG). "Parental Guidance" is perfectly okay for kids 8 and older. In this weak new comedy, Billy Crystal's rat-a-tat shtick will more likely appeal to older adults and leave kids wondering what the fuss is about. Artie and wife Diane fly to Atlanta at the request of their daughter Alice to babysit her and husband Phil's three kids for a week. Diane is determined she and Artie will bond with the grandkids this time. Both grandparents quickly see that Alice's idea of parenting is very different from theirs.
THE BOTTOM LINE: Too many of the gags involve verbal, visual and aural toilet humor. The script also contains mild sexual innuendo and subtle homophobic humor. Grown-ups tell anecdotes about getting drunk. Crystal's character gets slammed in the crotch with a baseball bat and then projectile vomits onto the child perpetrator. Grandson Turner gets bullied at school and comes home with a black eye.
Les Miserables. The tragedy, suffering and grand emotions in this operatic tale make it perhaps too much movie for some middle-schoolers and definitely for preteens. The fact that even the dialogue is sung may also put them off. Many other teens, though, will be swept up by the epic grandiosity. Filled with themes about forgiveness and love, "Les Misérables" recounts how Jean Valjean, released from a chain gang after serving almost 20 years for petty thievery, lets go of his bitterness and starts a new life, thereby breaking his parole. When his ward, Cosette, falls in love with Marius, Valjean vows he'll protect Marius for her. All the while, prison guard turned policeman Javert is on Valjean's trail.
THE BOTTOM LINE: The strongest element that earns the PG-13 rating is the sense of squalor and suffering. The violent clashes between students and the army muskets are not graphic but have a fierceness. Prostitutes in low-cut rags troll the streets in one chapter, singing crass, suggestive lyrics. A key character jumps off a bridge and we see his body hit.
Django Unchained. Absolutely not for anyone younger than 17, this bloody and profane new film by Quentin Tarantino nevertheless has much to say. This is a tale about an unlikely duo who wage their own mini war against slavery in 1850s America. A German-born bounty hunter named King Schultz buys the freedom of the slave Django because Django can identify three wanted men Schultz is after. Schultz always kills the men he's hunting, hauls their bodies to the nearest U.S. marshal, then collects his bounty. Django tells Schultz that his beloved wife, Broomhilda, was sold to punish him. Schultz offers to help Django find her, as long as Django teams with him to help kill his list of wanted men.
THE BOTTOM LINE: Several scenes show slaves being whipped, and one shows a man set upon by dogs. Male slaves are forced to fight each other to the death. The ultra-violence includes explosive, deafening gun battles, great amounts of spattered blood and bodies ripped open by bullets. There is frequent use of the N-word and other racial slurs. A horse is killed in a gunfight. There are strong intimations of rape, and we briefly see a female character naked.
Promised Land. Other than occasional strong language, it is perfectly okay for high-schoolers 15 and older. However the movie is just too fact-filled and serious to entertain teens over the holidays, unless they happen to be deeply committed environmentalists. Steve Butler is a rising executive with a large natural gas drilling company. He and co-worker Sue Thomason arrive in a rural community to persuade farmers and other landowners to sell them drilling rights. He and Sue are taken aback when they encounter resistance in the form of a genial science teacher and a slick out-of-town environmentalist.
The bottom line: The script includes fairly frequent strong profanity. A photo of a contaminated farm with dead cows in a pasture appears several times.
Horwitz is a freelance writer.


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Anthony Ciasulli is a senior counsel in Morgan Lewis's Real Estate Practice. Mr. Ciasulli represents both developers and lenders in connection with commercial, residential, industrial and resort real estate.
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By John M. Brion, PhD, RN, CHES, Julie Barroso, PhD, ANP, APRN, BC, FAAN, Elizabeth P. Flint, PhD, Elizabeth Manly, RN, BSN, and Meghan Worley, RN, BSN
Cigarette smoking is more common in people infected with HIV (40% to 70%) than in the general U.S. population (19.8%),1-3 and it is an important modifiable risk factor for cardiovascular and pulmonary disease.4 Until the advent of antiretroviral therapy (ART), HIV-infected smokers did not expect to live long enough to develop these conditions.5 Advances in treatment have increased life expectancy for people living with HIV, making smoking cessation an important priority.
HIV-infected smokers are at greater risk for chronic diseases associated with tobacco use (Table 1).1,3,8,10-14 Cardiovascular disease (CVD) risk is particularly high for HIV-infected smokers on ART, because both antiretroviral medication and smoking elevate this risk.1,3 Smoking also undercuts the effects of ART, reducing viral suppression and immunologic response.2,6,7 People with HIV who smoke significantly increase their risk for AIDS-defining opportunistic infections and HIV-associated malignancies - even if they take highly active antiretroviral therapy (HAART)7,8 Finally, smoking is an independent risk factor for poor ART adherence.7,9
Smoking also increases mortality in people with HIV. In a study of women taking HAART, those who smoked within the previous 6 months had 50% higher mortality than nonsmokers.7 Other studies found that middle-aged Americans with HIV15 and aging HIV-infected veterans11 experienced mortality that was more than twice as high as that in current smokers who were not HIV positive.
HIV-infected smokers can reduce some morbidity and mortality risks by quitting. Former smokers are significantly less likely than current smokers to develop CVD, bacterial pneumonia and cancers unrelated to AIDS.8,10,12 Several longitudinal studies of people with HIV documented significantly lower mortality in former vs. current smokers.8,11,15
Barriers to Cessation
Next to the initiation of appropriate ART regimens, smoking cessation may be the single most important intervention for improving long-term survival and quality of life in people infected by HIV.16 But healthcare providers have not consistently addressed cessation as a high-priority concern.2 In one U.S. survey, 97% of HIV medical care providers agreed it was important for HIV-infected smokers to quit, but fewer than half routinely provided self-help smoking cessation materials, recommended quitlines or prescribed pharmacologic cessation aids.17 In a study of New York City healthcare professionals, 95% agreed that addressing nicotine addiction in HIV-infected patients was important, but fewer than 70% consistently assessed current or previous tobacco use in these patients, and just more than half offered individual cessation counseling or provided nicotine replacement therapy (NRT).18
Providers in these studies identified many system barriers, including: competition from health issues perceived as more urgent; overloaded appointment schedules; cost and reimbursement issues impeding access to therapy; limited provider knowledge of smoking cessation treatments; doubts about treatment efficacy; and low provider confidence in the ability to deliver treatment successfully.2,17,18 Despite evidence that many HIV-infected smokers are interested in quitting and have tried to quit,1,18,19 many providers also perceived HIV-infected smokers as uninterested in or resistant to smoking cessation.18
Clinical factors strongly linked to tobacco use in the general population (especially depression and co-occurring alcohol and/or illicit drug abuse) present additional barriers to quitting for HIV-infected people.2,3,5 Psychiatric comorbidity and substance abuse are so prevalent among people with HIV that cessation interventions that do not address these issues are unsuitable for this population.19 Other factors that reinforce tobacco use (low socioeconomic status, high stress, low self-efficacy and social networks comprised primarily of smokers) are disproportionately common in people with HIV.2,3
Helping HIV-Infected Smokers Quit
Provider-initiated cessation counseling improves smoker quit rates, and even brief counseling sessions are effective if repeated.4 HIV-infected patients visit healthcare settings often, so clinicians who care for smokers with HIV are well-positioned to help them quit.2. However, even under the best of circumstances, success rates are rather low. Multiple quit attempts and relapses are typical.4 How, then, can NPs and PAs help patients with HIV stop smoking?
The "5 A's" (Ask, Advise, Assess, Assist, Arrange), a tool recommended by the U.S. clinical practice guidelines for tobacco cessation,4 provides a starting point.6 Within this framework, healthcare providers can incorporate brief counseling sessions, pharmacotherapy and referral to more intensive cessation programs (such as state quitlines).4 The guidelines recommend the 5 A's as a standardized approach for promoting smoking cessation in all populations.4 But few HIV specialists use this framework when discussing smoking with their patients.17
Because the guidelines present the 5 A's in a context that focuses on smoking as a single health issue, clinicians may perceive this approach as having limited applicability to patients with multiple complex health issues. However, training HIV clinic staff in this model can improve quit rates.20 For best results, the framework should be tailored to HIV-infected smokers by including systematic assessment of highly prevalent comorbidities that are recognized barriers to successful smoking cessation (psychiatric conditions; drug and alcohol abuse)5 and addressing these comorbidities with individualized cessation strategies.9
Adapting the 5 A's
Ask. Smoking status can be determined while reviewing medical history or obtaining vital signs.4,6 Ask if patients currently smoke or used to smoke, ask former smokers when and how they quit, and ask current and former smokers how long they smoked and how many packs per day. Document responses,20 flagging those of current and former smokers with chart reminders to check smoking status at subsequent visits.21 Conclude this step for nonsmokers and former smokers by congratulating them on their healthy choice. With current smokers, proceed to the "Advise" step.
National guidelines advise providers to review smoking status for every patient at each visit.4 However, generic repetition of this procedure may not be in the best interest of HIV-infected patients seeking urgent treatment for other medical issues. It also could alienate lifelong nonsmokers who might interpret repeated queries as evidence that the clinician disregarded their initial response. Implementing each step in the 5 A's requires sensitivity to each patient's unique circumstances and complex health concerns.
Advise. Using clear, strong, specific, personalized language, advise HIV-infected smokers to quit.4,6 Remind them that smoking puts them at high risk for poor health outcomes. Use statements such as, "Smoking makes your antiretroviral medication less effective" or "Continuing to smoke increases your risk for AIDS-defining infections like recurrent pneumonia." Next, assess desire and ability to quit.
Assess. Evaluate the HIV-infected smoker's nicotine dependence, tobacco use patterns and motivation to quit.20 Then, screen for comorbid depression and alcohol or illicit drug abuse,5 which are common in this population and strongly associated with continued smoking, inability to quit and post-cessation relapse.2,9 Evaluate other potential barriers to quitting,21 such as inadequate access to and coverage for cessation treatment, weak social support, patient beliefs that reinforce smoking behavior, and reliance on smoking to cope with stressful circumstances or self-manage pain 2,5 If patients are interested in quitting and willing to try, proceed to the "Assist" step. For patients unwilling to stop smoking, the "5 R's" (discussing Relevant reasons to quit, Risks of smoking, Rewards of quitting, Roadblocks to quitting, and Repeating these messages during subsequent visits) may help build motivation to quit.4
Assist. All smoking cessation plans should include pharmacotherapy (unless medically contraindicated) and behavioral interventions.4 Work with the patient to tailor an individualized quit plan that provides both access to appropriate medication and counseling to address previously identified barriers to cessation.2 Counseling should include education and encouragement as well as behavioral training to help patients identify situations that trigger smoking and develop effective coping strategies.4 The "Assist" step concludes with patient and provider setting a quit date.4
Arrange. With the quit plan in place, arrange to provide continued support through clinical appointments or phone contact: within a week, within a month and additionally as needed.4 At each follow-up, congratulate patients who have not smoked since the previous contact, and help those who have been less successful develop strategies to overcome ongoing challenges and barriers.6
Pharmacologic interventions
First-line medications for smoking cessation include five NRT modalities and two non-nicotine medications.4 Consult Belcon's recent review in ADVANCE for NPs & PAs21 for information about dosage, duration, cost and common adverse effects for each treatment.
NRT provides small doses of nicotine to replace the nicotine that a patient previously received by smoking; it is available over the counter as chewing gum, lozenges and transdermal patches, and by prescription in nicotine inhalers and nicotine nasal sprays.4,6,21 Bupropion SR (Zyban) and varenicline (Chantix) pills are available by prescription only. In small clinical trials with HIV-infected smokers, both bupropion (n = 21)22 and varenicline (n = 36)16 showed promise as cessation aids. Bupropion is indicated for smoking cessation and the treatment of depression. It can be combined with NRT and may be helpful for some depressed HIV-infected smokers.6,9 Some antiretrovirals inhibit bupropion metabolism in vitro, but no clinically significant interactions have been reported in HIV-infected patients taking bupropion while on ART.1,22 Varenicline appears to be more effective for cessation than NRT or bupropion; medication interactions have not been reported in patients on ART,1 and in one trial it improved CD4 counts in HIV-infected smokers.16 However, varenicline must be used with caution if kidney function is impaired,6 and its use increases the risk of adverse cardiovascular events.16
Both varenicline and bupropion carry "black box" warnings that psychiatric adverse events may occur when they are used for smoking cessation.23 Comparing adverse-event reports of self-injury, suicidal behavior and serious depression for both medications and NRT, Moore and colleagues found somewhat higher risk with bupropion and much higher risk with varenicline. They concluded that varenicline could no longer be considered suitable for first-line use.23 Because psychiatric comorbidity is common in HIV-infected smokers, psychiatric symptoms must be carefully monitored when using bupropion to promote cessation, and varenicline should be avoided altogether.
Strategies for HIV-Infected Smokers
Interventions combining NRT with education and behavioral training have helped HIV-infected smokers quit (Table 2).1,24,25 A particularly promising approach supplemented NRT-based standard treatment by providing prepaid cell phones and delivering ongoing counseling through regularly scheduled phone calls. Smokers receiving supplemental cell phone counseling were 3.6 times more likely to quit, had 20% higher biochemically verified abstinence after three months, and experienced less depression and anxiety than those on standard treatment.
HIV-infected patients have a high prevalence of smoking and are particularly vulnerable to its adverse health outcomes. In this population, the number and magnitude of barriers to cessation are challenging. NPs and PAs can help HIV-infected smokers quit by combining counseling and pharmacotherapy in a patient-centered approach tailored to each person's unique circumstances.
1. Nahvi S, Cooperman NA. The need for smoking cessation among HIV-positive smokers. AIDS Educ Prev. 2009;21(3 Suppl):14-27.
2. Reynolds NR. Cigarette smoking and HIV: more evidence for action. AIDS Educ Prev. 2009;21(3 Suppl):106-121.
3. Vidrine DJ. Cigarette smoking and HIV/AIDS: health implications, smoker characteristics and cessation strategies. AIDS Educ Prev. 2009;21(3 Suppl):3-13.
4. Fiore MC, et al. Treating tobacco use and dependence: 2008 update. Clinical Practice Guideline. Rockville, MD: Agency for Healthcare Research and Quality (AHRQ); 2008. http://www.ahrq.gov/clinic/tobacco/treating_tobacco_use08.pdf
5. Burkhalter JE, et al. Tobacco use and readiness to quit smoking in low-income HIV-infected persons. Nicotine Tob Res. 2005;7(4):511-522.
6. Bouchard-Miller K, et al. Smoking cessation for persons living with HIV: a review of currently available interventions. J Assoc Nurses AIDS Care. 2010;21(1):3-10.
7. Feldman JG, et al. Association of cigarette smoking with HIV prognosis among women in the HAART era: a report from the Women's Interagency HIV study. Am J Public Health. 2006;96(6):1060-1065.
8. Lifson AR, et al. Smoking-related health risks among persons with HIV in the Strategies for Management of Antiretroviral Therapy clinical trial. Am J Public Health. 2010;100(10):1896-1903.
9. Webb MS, et al. Medication adherence in HIV-infected smokers: the mediating role of depressive symptoms. AIDS Educ Prev. 2009;21(3 Suppl):94-105.
10. Petoumenos K, et al. Rates of cardiovascular disease following smoking cessation in patients with HIV infection: results from the D:A:D study. HIV Med. 2011;12(7):412-421.
11. Crothers K, et al. Impact of cigarette smoking on mortality in HIV-positive and HIV-negative veterans. AIDS Educ Prev. 2009;21(3 Suppl):40-53.
12. Bénard A, et al. Bacterial pneumonia among HIV-infected patients: decreased risk after tobacco smoking cessation. ANRS CO3 Aquitaine Cohort, 2000-2007. PLoS One. 2010;5(1):e8896.
13. Vidrine DJ, et al. A randomized trial of a proactive cellular telephone intervention for smokers living with HIV/AIDS. AIDS. 2006;20(2):253-260.
14. Míguez-Burbano MJ, et al. Ignoring the obvious missing piece of chronic kidney disease in HIV: cigarette smoking. J Assoc Nurses AIDS Care. 2010;21(1):16-24.
15. Cockerham L, et al. Association of HIV infection, demographic and cardiovascular risk factors with all-cause mortality in the recent HAART era. J Acquir Immune Defic Syndr. 2010;53(1):102-106.
16. Cui Q, et al. Safety and tolerability of varenicline tartrate (Champix®/Chantix®) for smoking cessation in HIV-infected subjects: A pilot open-label study. AIDS Patient Care STDs. 2012;26(1):2-19.
17. Shuter J, et al. Provider beliefs and practices relating to tobacco use in patients living with HIV/AIDS: a national survey. AIDS Behav. 2011;16(2):288-294.
18. Tesoriero JM, et al. Smoking among HIV positive New Yorkers: prevalence, frequency, and opportunities for cessation. AIDS Behav. 2010;14(4):824-835.
19. Bénard A, et al. Tobacco addiction and HIV infection: toward the implementation of cessation programs. ANRS CO3 Aquitaine Cohort. AIDS Patient Care STDs. 2007;21(7):458-468.
20. Zwiebel MA, et al. Smoking cessation efforts in one New York City HIV clinic. J Assoc Nurses AIDS Care. 2010;21(1):11-15.
21. Belcon AL. Smoking cessation pharmacotherapy: a concise overview. Adv NPs PAs. 2011;2(4):33-34.
22. Pedrol-Clotet E, et al. [Bupropion use for smoking cessation in HIV-infected patients receiving antiretroviral therapy] (in Spanish). Enferm Infecc Microbiol Clin. 2006;24(8):509-511.
23. Moore TJ, et al. Suicidal behavior and depression in smoking cessation treatments. PLoS One. 2011;6(11):e27016.
24. Ingersoll KS, et al. A test of motivational plus nicotine replacement interventions for HIV positive smokers. AIDS Behav. 2009;13(3):545-554.
25. Lloyd-Richardson EE, et al. Motivation and patch treatment for HIV+ smokers: a randomized controlled trial. Addiction. 2009;104(11):1891-900.
John M. Brion is an associate professor at The Ohio State University. Julie Barroso is an adult nurse practitioner who is a professor at Duke University School of Nursing. Elizabeth P. Flint is a research analyst at Duke University School of Nursing. Elizabeth Manly is a nurse at Durham Regional Hospital in Durham. Meghan Worley is a nurse at the University of North Carolina Hospital in Chapel Hill. The authors have completed disclosure statements and report no relationships related to this article.
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Для получения актуальных цен по гостинице Bauernhof Landhaus Taurer, пожалуйста, укажите интересующие вас даты и выполните поиск.
Landhaus Taurer is a country home situated at the end of the Kalser valley, on an altitude of 1,500 meters.This biological farm is located in a sunny and quiet spot neat the Taurerwirt National Park Hotel.For those of you wishing to leave the car at home for once, there is a bus which stops close to our house.In summer, various hiking trails start right at our doorstep (Dorfertal - Dorfersee route, Teischnitztal - Gro?glockner route...). The manager of the house, Hans, is also a professional mountain and ski guide, and will gladly assist you with any questions you might have.Image below: Blauspitz via ferrata
Animals/Products: Cows, Pigs, Cats, Calves
Номеров: 7


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Made to Order.
Delivery time usually 1-2 weeks.
This colourful mat offers a lovely place for babies to rest, with secure sewn in horseshoe cushions so they can sit up with support.
Fitted with a zip each cushion has a fully removable cover. Mat and covers can be washed at 30°C.