text:
The used car industry has seen a steady growth for the past several years due to its economic benefits of lower purchasing and depreciation. In particular, for young professionals, buying new models require large investments that would most likely depreciate faster than you can drive it. Some dealers and manufacturers even provide certification programs for used cars.
Used auto dealers like Butler Kia of Fishers have an extensive inventory of pre-owned cars and trucks with established knowledge in the industry of used car dealerships in Indianapolis. The pre-owned vehicles of these auto dealers are guaranteed to pass the 60-point stringent inspection for consumer convenience. With their pre-owned program comes providing certified repair and maintenance of different authorized parts and accessories from their car selection.


text:
BBC Radio Interview:
"Outlook" -- January 2000
with Damien Fowler for the British Broadcasting Company and Christopher Langan, Gina LoSasso and Nik Lygeros for the Mega Foundation
BBC: If you ever try to get into a nightclub in New York and one of the security men, or bouncers, denies you entry, think twice before you try to argue your way in...especially if the bouncer's called Chris Langan, because he's been described as "the smartest man in America". His IQ, or intelligence quotient, has been put at a staggering 195. The human average, remember, is 100. University students tend to score about 120. But is having an IQ of nearly 200 a blessing or a curse? More on that shortly. But first, why is Chris Langan working as a nightclub bouncer?
CML: I had to do a lot of fighting when I was in high school. I had to defend my little brothers as well, who were also in for a lot of negative attention. It's not necessarily that I would have gravitated towards fighting a lot, it's just that that was my lot. I was more or less thrown into a mode of existence in which it was either fight or be stomped on...and I chose to fight. I've kind of carried that forward into my current life. I've been a bar bouncer for the last 20, 25 years now. I'd like to get out of it because I'm not by nature a violent person, I don't like to hurt other people. The reason I fought was mainly self-defense and to defend others who I cared about, who I thought were getting the short end of the stick.
There's a great dissonance, a great clash, there. You go to work, and you stand there and you're thinking about what you were thinking about before you came to work, which is, say, some kind of combinatorial mathematics, you're trying to prove in a theorem of some sort or another, and suddenly you come to a noisy place where people are screaming, yelling, drinks are being thrown. Eventually arguments start, there are fights, and you can't really keep your train of thought going in that kind of an environment, and it is painful to have to switch tracks all the time.
Others began getting wise to the fact that I had a higher than average intelligence level when I started talking at a very early age. Actually the first thing that I was drawn to was biology and zoology, but I found it a bit too soft and mushy for my taste, so I gravitated towards mathematics and logic...things of that sort.
I would have welcomed the chance to get out of the bouncing business years ago. But frankly, you know, even 15 years ago I was so sick of it I would have gotten out of it if somebody had offered me a good way to make a living that didn't take too much of my energy and allowed me to work on what I really cared about when I wasn't on the job. If you go to work for corporate America, unfortunately, usually they'll take so much of your time and energy that you have nothing left for writing books or doing any theorizing when you're not on the job. So I couldn't take one of those jobs. On the other hand, I did a lot of menial labor, things like construction, working in factories, being a cowboy, being a firefighter. All of these things take a great deal of your energy, and all you can do when you come home is just crash, just fall down and go to sleep. And if you find a half-hour a day to do any theorizing or any meaningful intellectual work your lucky at that rate. So it's, like I say, the bouncing was the lesser of evils.
There's something about people that you have to realize, something about IQ that you have to realize: a person doesn't have to have a super high IQ to be interesting because they can also have intellectual creativity as well. Often times, I find that even simplest people or people that are regarding as being simple can say things that are entirely surprisingly interesting to me, that have a novelty to them, a newness that actually makes me sit up and take notice. Everybody has a microcosm in his or her head and they may have varying degrees of access to our true intellectual abilities and that may be measured by scores on certain kinds of tests. But, the fact of the matter is, at some point in time even, if I may say, if I may use such a term as, the stupidest man, can come up with something absolutely brilliant in a given context.
BBC: Chris Langan in New York for whom having an ultra-high IQ has not always been easy. So he and a few others have set up The Mega Foundation which came into being at the start of this month.
Joining us from the U.S. State of Connecticut, now, is another founding member of the organization, psychologist, Dr. Gina LoSasso, and from the French City of Lyon, we're joined by another member, Nik Lygeros.
Now, Gina let me start with you. We just heard Chris' story there, have you had similar problems?
GL: Well, it's very difficult growing up, being severely gifted. The reasons are many. You have a very complicated personality style. Gifted individuals, in addition to having a higher IQ, also are extremely empathic, emotionally, very sensitive, usually very creative, and fiercely independent. So we don't really do very well in school systems and occupational settings and so forth. ,Sure, I've had my own share of problems growing up.
BBC: It sounds particularly at the education stage in the younger years. Nik, what about yourself? Did you have, during your educational years, problems fitting in and feeling satisfied?
NL: Yes, very often I had a similar problem, but, in fact, it was rather different because, for me I was gifted always most in mathematics, so for the common people, mathematicians are already strange, so to be severely gifted is another way to be strange also.
BBC: Did you find that caused problems between you and other students, or even between you and the teachers?
NL: More with teachers, in fact.
BBC: Why was that? Did they...is it that they had a problem accepting your above-average, well, above-average abilities?
NL: Yes because they need to teach something to the majority, so if you are very, very different, they have to do their job in a different way. So it's a problem for them.
BBC: And they know that you could possibly challenge them if they get it wrong, that's a problem.
NL: Yes.
BBC: So they have to stay on their toes!
Gina, you used that phrase, "severely gifted." Is that a recognition that seems to be coming in over the last few years? Being gifted, being well above-average intelligence IS tricky because it causes all sorts of problems and we didn't sort of find...we didn't have that awareness before, did we?
GL: Well... I think the severely gifted did, but the general population, probably not. They see people who are intelligent or creative, and they think 'Oh great, they have talents. They don't need any help.' But the fact of the matter is, it's very difficult to negotiate a life that's geared towards, as Nik was pointing out, a school system that's geared towards the average student, and is often held to the pace of the slowest student. It can be just mind-bogglingly frustrating to sit in a classroom and be bored silly every day. So... I mean there's a lot of pluses. At no point would I ever trade my abilities. I really feel empowered, that I can do anything that I set my mind to. But, it is a mixed blessing, it makes social interactions difficult and it makes educational and occupational settings very difficult.
BBC: So then you, in The Mega Foundation, argue that early recognition is crucial?
GL: Early recognition is very important...you see, gifted children--severely gifted children--can have difficulty fitting in with their peer group. They're more like little adults. And they don't fit in with adults either, because they are, after all, children. If we can identify them we can hook them up with each other so they can have a mutual support system with the resources that they need, so they don't have to flounder in the educational system.
BBC: So is that something that The Mega Foundation hopes to do, help link up young children with each other as early as possible?
GL: Oh absolutely. Just as we started the Ultranet, the global Hi-Q network on January 1st, we're starting, next month, the Telenet, which is the Telemach Network for Gifted Youth, which is going to run along the same lines. It's a forum for exchange of ideas, and mutual support, and insight into resources, and so forth. And then directly following that, we will initiate our mentor program.
BBC: But where does ultra high IQ start? What's the benchmark in IQ terms?
GL: Well in IQ terms we generally think of severely gifted as being an IQ of 164 or above but that's not...we don't have a specific cut-off for the people that we're looking to bring together. And the reason is that IQ scores are limited in what they measure and they can be suppressed for a number of reasons, including poverty, abuse, depression. So that what we're looking for is an individual who shows not only intelligence, but also creativity, depth of thinking, original ideas, and so forth.
BBC: Nik, when you bump into people can you tell whether they have a high IQ, an ultra-high IQ?
NL: Quite difficult question, but yes. I think so, because it's a different way to think, so you can make rather quickly the difference.
BBC: Not necessarily something you can measure, just sometimes...something you can perceive.
NL: Yes, more like this. In fact you don't measure at all. I think there's a different character to this aspect, so you perceive this aspect.
BBC: Just one final thought. We were talking about schooling just now. Is it also difficult to find job satisfaction, Nik?
NL: Yes, of course.
BBC: We heard it from Chris Langan. What about in your case?
NL: That's rather strange because I work in the Department of Mathematics, but I have also a similar problem because, you see, when some mathematician, even a professional, takes months to solve something and he didn't manage to solve, in fact, this and he comes and asks you, " Can you help me?" and he sees that in a few days that you finished the problem. So it's very difficult for him to accept, for example, the co-publication with you and sometimes he leaves the article to you!
BBC: Nik Lygeros in Lyon, and Gina LoSasso, thank you both very much indeed for joining us. And just briefly, The Mega Foundation is on the Internet at www.megafoundation.org.

subset: commoncrawl


text:
- Original Article
- Open Access
Emergency department utilization by HIV-positive adults in the HAART era
© Springer-Verlag London Ltd 2008
- Received: 20 June 2008
- Accepted: 9 September 2008
- Published: 18 November 2008
No published study has analyzed emergency department (ED) utilization by human immunodeficiency virus (HIV)-positive adults in the highly active antiretroviral therapy (HAART) era.
The purpose of this study is to describe the demographic and HIV-specific variables associated with ED utilization by HIV-positive adults and their diagnoses when discharged from the ED or subsequently from the hospital.
We conducted a retrospective cohort study of all HIV-positive adults cared for at a tertiary center HIV clinic and ED (1 January–31 December 2006). Demographic, HIV clinical, and HIV lab variables were abstracted from the clinic database. ED/hospital diagnoses coded by the ICD-9 Diseases/Injuries Tabular Index were abstracted from identified discharge records. We used multivariate logistic regression to compute odds ratios (OR) of ED utilization based on the abstracted variables. We described the cohort and diagnoses using descriptive statistics.
A total of 356 patients met inclusion criteria. Their mean age was 42.7 years, and 77.2% of included patients were male; 52.5% were Caucasian and 47.5% non-Caucasian; 72 patients (20.2%) presented to the ED during the study period [153 visits; 37 (10.4%) required hospitalization (61/153 visits)]. Income level and mean 2006 viral load had a significant association (p < 0.05) with ED utilization. Of 155 ICD-9 ED discharge diagnoses, ill-defined symptoms/signs (25.2%), injury (18.7%), and musculoskeletal disorders (11.6%) were most prevalent. Of 450 ICD-9 hospital discharge diagnoses, endocrine/metabolic (13.3%), psychiatric (12.2%), infectious/parasitic (12%), and circulatory disorders (11.8%) were most prevalent.
In this study of HIV-positive adults, income level and mean 2006 viral load had a significant association with ED utilization. Noninfectious diagnoses were alone most prevalent in ED discharged, but not hospitalized, patients.
- Emergency department
- Highly active antiretroviral therapy
- Utilization
The World Health Organization estimates that as of December 2007, 33.2 million individuals are infected with human immunodeficiency virus (HIV), with 2.5 million individuals becoming newly infected in the previous 12 months [1]. With the advent of highly active antiretroviral therapy (HAART), HIV-infected adults have experienced an increase in life expectancy. One study has quantified the mean increase in life expectancy for a 20-year-old HIV-infected adult as rising from 9.1 years (+2.3 years) in 1993–1995 to 23.6 years (+4.4 years) in 2002–2004 [2]. This increase in life expectancy, largely attributable to HAART [3], has also resulted in a changing spectrum of illness for HIV-positive adults. Recent studies from the HAART era where patients have access to such medications have found that hospitalizations due to opportunistic infections, especially late-stage conditions such as Cryptosporidium and Mycobacterium avium, have decreased while those related to cardiovascular disease, medication side effects, and malignancies have increased [4, 5]. This pattern stands in contrast to the pre-HAART era when opportunistic infections comprised over 23% of hospital discharge diagnoses, with an additional 10.1% due to respiratory ailments, predominantly pneumonia of an uncharacterized nature [6].
To our knowledge, no published study has analyzed what factors are specifically associated with emergency department (ED) utilization by HIV-infected adults in the HAART era. Similarly, while previous studies have focused on the pattern of inpatient discharge diagnoses among HIV-positive adults [5, 7], the nature of ED and hospital discharge diagnoses in HIV-infected adults who present to the ED has not specifically been examined. Previous articles in the emergency medicine literature have emphasized the treatment of opportunistic infections in the HIV-infected population [8–10]. While one previous study based on ED presentation found that HIV-infected patients often were diagnosed with conditions unrelated to their HIV status, their patient population was examined in the pre-HAART era, though published in 1997 [11]. The changing spectrum of illness in HIV patients requires emergency physicians to have a better understanding of the conditions that can bring HIV patients to the ED and require hospitalization [12]. Previous studies have shown that attempts to develop triage instruments for HIV-positive patients have poor sensitivity and specificity for emergent versus nonemergent conditions, supporting the need for a better understanding of why and how HIV-positive patients present for emergency care [13]. It would also be useful to both emergency physicians and infectious disease specialists to determine if preventable factors are associated with ED utilization that can be addressed in the outpatient setting.
Study purpose and hypotheses
The purpose of this study is to describe the demographic and HIV-specific variables currently associated with ED utilization by HIV-positive adults and to describe their diagnoses when discharged from the ED or subsequently from the hospital. We hypothesized that for HIV-positive adults in the HAART era, demographic [age, sex, race, and income level relative to the federal poverty line (FPL)], not HIV-specific clinical (years since diagnosis/on antiretroviral therapy, 2006 use/interruption of HAART) or laboratory (recorded peak and mean 2006 viral load/nadir and mean 2006 CD4 count) factors are significantly associated with ED utilization within this population. We also hypothesized that, with the availability of the improved means to control HIV through HAART, noninfectious ED/hospital discharge diagnoses are most prevalent among HIV-positive adults who present to the ED.
Study design
This was a retrospective, observational cohort study of all HIV-positive adults followed in a federally supported HIV clinic located in an urban, level 1 trauma tertiary care center from 1 January 1 to 31 December 2006. The study was approved by the Institutional Review Board for this center.
The study center is a level 1 trauma tertiary care referral center with an ED that sees approximately 50,000 patients per year. The center is located in a county with an estimated prevalence of acquired immunodeficiency syndrome (AIDS) patients between 50–165/100,000 residents [14]. The dedicated HIV clinic in this center is governmentally supported and is a referral center for the region for HIV-infected adults, with treatment provided to local patients as well as those from adjacent states.
Study population and inclusion/exclusion criteria
All HIV-positive adults followed in this center's HIV clinic between 1 January and 31 December 2006 were included in this study. These individuals were identified from a preexisting database maintained by the clinic for outpatient management. Demographic, clinical history, and laboratory information on these patients is entered into this database by treating physicians and nurses and maintained by a program coordinator for the clinic.
Definition of clinical variables
Age was calculated as that on 1 January 2006. Some included patients did not have viral load or CD4 count testing during the study period, either due to presenting late in 2005 and not having follow-up until early 2007, having been diagnosed in 2006 and not having HIV-related lab testing until early 2007, or only having one clinic visit during the study period and not undergoing serum testing as prescribed. For these study subjects, these variables were treated as unknown. Viral loads (copies/ml) were classified as either <400, 401–1,000, 1,001–100,000, or >100,000. Previous studies have found that increases in viral load from undetectable to higher levels are associated with adverse outcome and that categorization of viral load similar to these cutoffs was associated with increased risk of progression to AIDS in HIV-infected adults [15, 16]. CD4 counts (cells/ml) were classified as <200, 201–350, and >350 based on existing guidelines for initiation of HAART to decrease the risk of developing AIDS and AIDS-defining illnesses [17].
All ED and hospital discharge diagnoses were included for analysis as to the prevalence of particular ICD-9 Diseases/Injuries Tabular Index categories during the study period in ED and hospital discharged HIV-infected adults. The only diagnoses excluded from analysis were those coded under the ICD-9 classification as V or E. These codes are used in the ICD-9 classification to provide context to the more specific diagnosis given. Diagnoses coded V50-V59, indicating encountering of health personnel for specific procedures and aftercare, were included for analysis. Previous studies examining HIV-related hospitalizations have only included the first four coded hospital discharge diagnoses [6]. However, as the abstracting investigators for this part of the study were not the treating physicians for these patient visits, it was felt that selection bias was best avoided by including all coded diagnoses for each ED visit.
Data collection and processing
The investigators created a standardized case report form that was used to abstract the specific demographic and HIV-specific variables described above in included study subjects. The study subjects were identified from the preexisting clinic database described above. The case report form also was used to record whether a subject was seen in the ED, was subsequently admitted to the hospital, and what their ICD-9 coded ED and hospital discharge diagnoses were. Demographic (age on 1 January 2006, sex, race, and income level relative to FPL), HIV clinical (years since HIV diagnosis, years on any antiretroviral therapy, use of HAART during 2006, and interruption of HAART during 2006), and HIV laboratory variables (highest viral load on record to 31 December 2006, mean viral load during 2006, lowest CD4 count on record to 31 December 2006, and mean CD4 count during 2006) were chosen for abstraction based on the theoretical framework outlined above. One investigator and the clinic's program coordinator jointly abstracted this information to the standardized case report form. The investigator and clinic program coordinator were not blinded to the study's purpose.
The center's information services department, which maintains a database of this center's medical and discharge billing records, was queried as to whether the identified HIV-infected patients meeting inclusion criteria had presented to the ED during the study period. The information services department provided a list of ED visit dates, whether the patient was discharged from or admitted to the hospital, and ICD-9 coded ED and hospital discharge diagnoses for each patient who presented to the ED. Two investigators concurrently abstracted this information to the case report form and classified these diagnoses using the ICD-9 Diseases/Injuries Tabular Index, which has been used in previous studies to analyze the characteristics of hospital discharge diagnoses in HIV-infected patients [6, 18]. Data from the case report forms were then entered by the investigators into a Microsoft Excel (Microsoft Office for Windows XP, Redmond, WA, USA) spreadsheet, and range and consistency checks were performed to verify accuracy of data entry.
Outcome measures
The primary outcome measure in this study was whether an HIV-infected adult followed at this center's HIV clinic during the study period utilized the ED. The analytic strategy was designed to identify whether demographic, HIV clinical, or HIV laboratory variables distinguished those who presented to the ED from those who did not. A secondary dependent variable was a descriptive classification of ED and hospital discharge diagnoses in those HIV-infected patients who presented to the ED, as classified by the ICD-9 Diseases/Injuries Tabular Index.
Statistical analysis
Descriptive statistics (percents, means, and standard deviations) were used to characterize the demographic and HIV-specific characteristics of the included subjects. We used SPSS for Windows v. 15.0 (Chicago, IL, USA) to create a multivariable logistic regression model and compute odds ratios (OR) with 95% confidence intervals (95% CI) for the association of the specific demographic, HIV clinical, and HIV laboratory variables abstracted and the likelihood of ED utilization within the cohort from those who did not present to the ED. Given the presence of missing data, we used a χ2 analysis (SPSS for Windows v. 15.0, Chicago, IL, USA) to determine if those patients with missing data were differentially more or less likely to present to the ED.
To analyze the prevalence of ED and hospital discharge diagnostic categories within the ICD-9 Diseases/Injuries Tabular Index for those cohort patients who presented to the ED, we calculated the percentage of each ICD-9 diagnostic category using Microsoft Excel (Microsoft Office for Windows XP, Redmond, WA, USA).
Characteristics of study subjects
Demographic and HIV-specific characteristics of the patient cohort
Demographic or HIV-specific variable
Full sample (N = 356)
No ED visit (N = 284)
ED visit (N = 72)
Mean age (SD)
42.7 (8.5)
42.8 (8.7)
41.9 (7.6)
Gender (% male)
Income level (%)
Below poverty level
1–2× poverty level
2–3× poverty level
>3× poverty level
Not recorded
Race (% non-Caucasian)
Mean years since HIV diagnosis (SD)
8.5 (5.9)
8.2 (5.9)
9.8 (5.8)
Mean years on antiretroviral therapy (SD)
3.5 (3.2)
3.6 (3.3)
2.9 (3.0)
On HAART in 2006 (% yes)
HAART interrupted/discontinued in 2006 (% yes)
Peak viral load on record, copies/ml (%)
Mean viral load in 2006, copies/ml (%)
Lowest CD4 count on record, cells/ml (%)
Mean CD4 count in 2006, cells/ml (%)
Main results
Odds ratios of likelihood of emergency department utilization based on abstracted demographic and HIV-specific variables
Demographic/HIV-specific variable
Referent value (if applicable)
Odds ratio
95% confidence interval
p value
Demographic variable
Income level (1–2× FPL)
Income level (<FPL)
Income level (2–3× FPL)
Income level (>3× FPL)
HIV clinical variable
Years since HIV diagnosis
Years on HAART
On HAART in 2006
HAART Interrupted in 2006
HIV laboratory variable
Highest viral load on record (401–1,000)
Highest viral load on record (<400 copies/ml)
Highest viral load on record (1,001–100,000)
Highest viral load on record (>100,000)
Mean viral load in 2006 (401–1,000)
Mean viral load in 2006 (<400 copies/ml)
Mean viral load in 2006 (1,001–100,000)
Mean viral load in 2006 (>100,000)
Lowest CD4 count on record (0–200)
Lowest CD4 count on record (>350 cells/ml)
Lowest CD4 count on record (201–350)
Mean CD4 count in 2006 (0–200)
Mean CD4 count in 2006 (>350 cells/ml)
Mean CD4 count in 2006 (201–350)
Among the HIV-specific clinical and laboratory variables, higher mean viral load during the study period was associated with increased odds of ED utilization within the study cohort, contrary to our hypothesis that only demographic variables would show a significant association with ED use. Those with a mean viral load of 1,001–100,000 copies/ml during 2006 were 3.49 times more likely to present to the ED when compared to those with low viral loads (p = 0.02, 95% CI: 1.26–9.73). Similarly, those with very high mean viral loads (>100,000 copies/ml) during 2006 were 5.43 times more likely to present to the ED when compared to those with low viral loads (p = 0.02, 95% CI: 1.39–21.21). No other HIV-specific variables were related to ED utilization.
This study's results show that ED utilization among HIV-positive adults in the HAART era was associated with a lower income level and greater mean viral load during the study period and that infectious/parasitic diagnoses continue to be among the most prevalent among hospitalized, though not ED discharged, HIV-infected adults. However, there are a number of limitations that affect the generalizability of these findings. This center resides in a region with a low prevalence of HIV in comparison to other major urban centers, both within the country and worldwide [14]. For centers in higher prevalence areas, the diagnoses distribution and variables associated with ED utilization may be different due to other epidemiological factors, such as lack of knowledge of underlying HIV status and lack of access to clinical resources to manage HIV. Such factors should be addressed in future studies that are larger scale and have the ability to differentiate and follow patients found to be HIV-positive after ED visits suspected to be related to HIV.
In addition, larger epidemiological studies with greater sample sizes may indicate that other demographic and HIV clinical/laboratory variables are associated with ED utilization by this patient population. This study, as such, is preliminary and should be used to guide further evaluation of ED utilization by HIV-positive adults on a multicenter basis.
The retrospective methodology used does not allow the investigators to control for other comorbid conditions that might affect the prevalence of diagnoses in this cohort or as a confounding variable of ED utilization. Similarly, the retrospective methodology does not allow for the ability to determine the accuracy of all ascribed ED and hospital discharge diagnoses in this cohort. Any attempt to do so by the study investigators would introduce significant selection bias into these findings, and, as discussed above, previous studies on this topic have not controlled for these two factors [6].
Finally, the analysis of ED utilization in this cohort (Table 2) is limited to those patients with complete data to allow multivariable logistic regression. Sixty-three patients had missing data, primarily related to CD4 count and viral load during the study period. This often was related to patients who were followed in the center's HIV clinic during the study period, but did not require lab testing per the treating physicians, having been seen late in 2005 and not requiring follow-up until 2007, having been diagnosed with HIV in 2006 and not having lab testing related to that diagnosis until early 2007, or due to patient nonadherence with prescribed lab testing during the study period. This limitation would likely apply to any retrospective study on the subject. However, our analysis of these 63 patients, in comparison to the 293 patients with complete data, did not reveal that they were differentially more or less likely to present to the ED. A prospective study may limit this factor, but would introduce the bias of investigator knowledge of the purpose of the study and potentially result in overly careful monitoring of patients in the outpatient setting and decreased use of the ED beyond what is found in this type of observational study.
This study presents the first attempt to determine what variables are specifically associated with ED utilization by HIV-positive adults during the HAART era as well as an analysis of ED and hospital discharge diagnoses of those who presented to the ED for care. The findings that income level and mean viral load during the study period had a significant association with ED utilization supports previous studies that have found that a combination of demographic considerations and health status are in general associated with frequent ED users [19, 20]. Specifically related to HIV, previous studies evaluating outpatient and inpatient utilization in the HIV-positive adult population have found that demographic and HIV-specific factors are associated with increased requirements of inpatient resources. Fleishman et al. found that black patients, female patients, and those with worsening immunosuppression, as determined by either CD4 count or viral load, were more likely to require inpatient care in the HAART era [21]. Floris-Moore et al. found that female sex and not being on HAART increased the risk of hospitalization among HIV-positive adults [22].
Our study, in contrast, did not find that race or gender had a significant association with ED utilization. That income level was the only demographic variable found to be associated with ED utilization in this study raises the likelihood that either those with higher incomes, due to having better access to outpatient and primary care, had less need for emergency services or that they sought emergency care in other centers unless feeling they would require hospitalization. There is evidence from the pre-HAART era that racial disparities associated with ED utilization by HIV-positive adults in that period were partially explained by the lack of access to outpatient resources such as substance abuse rehabilitation and home health care [23].
The finding that mean viral load during the study period alone was associated with ED utilization among HIV-specific factors suggests that this factor should be further evaluated by infectious disease and emergency physicians as a target for preventing the need for emergency care. Previous studies have come to differing conclusions about the relative importance of viral load versus CD4 count in prognosis of HIV-infected patients. MacArthur et al. found that CD4 count more than viral load had a significant association with progression to AIDS or death [24]. In contrast, Mellors et al. found that increasing viral load was associated with risk of dying of AIDS though the combination of viral load and CD4 count were most predictive of this adverse outcome [16]. The result in our study that increasing mean viral load, and not decreasing CD4 count, was associated with ED utilization may indicate that viral load is a better surrogate marker for acute illness requiring emergency care while CD4 count is a better marker for long-term outcome, such as death or developing AIDS-defining illness. Larger epidemiological studies of known HIV-positive patients should further evaluate this finding.
This investigation did not consider insurance status as a potential variable associated with ED utilization. As this study center is supported by governmental funding, patients treated at the clinic, if not fully covered by private or public insurance, had access to treatment medications through this program. Income level, taken from patient report to the clinic, is an easy financial marker tracked by the clinic database that can be used to determine how socioeconomic status affects the likelihood of ED use. This variable is also more readily considered in practice settings where insurance status is not an issue due to single-payer health systems.
The investigators also did not consider methods of HIV transmission as a variable affecting ED utilization. We had no logical construct as to how transmission status—whether sexual, intravenous drug use, or blood transfusion/professional exposure—would relate to presentation in the ED setting. Fleishman et al. found that adults infected with HIV through intravenous drug use were more likely to require inpatient, though not outpatient, resource use, but could not distinguish whether this was due to ongoing substance abuse [21]. The result in our investigation that psychiatric diagnoses, specifically those related to substance abuse, are the second most prevalent hospital discharge diagnoses suggests that ongoing drug use, as opposed to means of transmission, is more important as a risk factor for ED presentation and inpatient care.
This investigation represents the first study, to our knowledge, that has specifically analyzed the character of ED diagnoses in HIV-infected adults during the HAART era who are discharged after care in the ED. The finding that ill-defined signs and symptoms (Fig. 1) are most prevalent may represent a bias among treating emergency physicians to rule out life-threatening diagnoses and characterize discharged patients in the broadest sense (chest pain or abdominal pain NOS, for example). At the same time, given the association of increased viral load with ED utilization, it is also likely that these ill-defined symptoms/signs represent patient complaints that are potentially related to poor control of their underlying systemic infection or side effects from complex medication regimens. Other studies have found that hospitalizations specifically related to medication side effects have increased in the HAART era [4, 5]. The use of ICD-9 coding and classification would not easily allow examination of whether particular diagnoses were related to HAART regimens or not. The finding that injury and musculoskeletal ailments were also most prevalent suggests that minor trauma is common in the HAART era among HIV-positive patients as it was in the pre-HAART era [11].
This study found that endocrine/metabolic, psychiatric, infectious/parasitic, and circulatory disorders are most prevalent among hospital discharge diagnoses in this cohort of HIV-infected adults. The finding that psychiatric and circulatory disorders in the inpatient setting have become more prevalent in the HAART era supports previous research that has addressed the nature of inpatient diagnoses in the HIV-infected population [5, 7]. However, the finding of high prevalence of infectious/parasitic disorders in the inpatient setting does differ from some of the most recent studies on the subject. Pulivirenti et al. found that admissions for late-stage AIDS-defining illnesses such as Cryptosporidium and Mycobacterium avium have declined in their single-center analysis [5]. Our investigation, by using the ICD-9 Diseases/Injuries Tabular Index, more comprehensively analyzed the nature of all hospital discharge diagnoses. While treatment of thrush, for example, may not have been the primary reason for inpatient care, the fact that such treatment was required during the inpatient stay suggests that conditions relating to poor immune function remain an important diagnostic consideration for emergency physicians. The spectrum of illness in the HIV-infected patient population that requires emergency care and hospitalization has grown from just classic AIDS-defining illnesses to other major systemic diseases, such as cardiovascular, neurologic, and orthopedic ailments [12]. Our study confirms that emergency physicians seeing HIV-infected patients must consider both noninfectious and infectious diagnoses in their assessment, even if noninfectious illnesses have become more common.
Future studies on the subject of ED utilization by HIV-infected adults should be conducted in a multicenter fashion to allow capture of patients both in high and low prevalence settings. A larger sample size would also allow analysis of what specific variables are associated with hospitalization, as opposed to ED utilization, which this study was not powered to do. In addition, a prospective methodology will allow a more focused analysis on what are the specific primary ED and hospital discharge diagnoses that require the most health care resources in the HAART era and what factors are associated with their occurrence. However, such a study would require separation of investigators from treating physicians to prevent a Hawthorne effect by increased scrutiny and follow-up care in the outpatient setting than what might normally occur.
In this study of HIV-positive adults in the HAART era, income level and mean viral load during the study period had a significant association with ED utilization. Noninfectious diagnoses were alone most prevalent in ED discharged, but not hospitalized, patients.
The study authors would like to thank Mary Gallagher for her assistance with data abstraction.
Conflict of interest
The authors declare that they have no conflict of interest or disclosures.
No funding or grant support was used for this study.
Authors' Affiliations
- UNAIDS, World Health Organization (2007) AIDS epidemic update, December 2007 edn. United Nations, GenevaGoogle Scholar
- Lima V, Hogg R, Harrigan P et al (2007) Continued improvement in survival among HIV-infected individuals with newer forms of highly active antiretroviral therapy. AIDS 21(6):685–692PubMedView ArticleGoogle Scholar
- Palella F Jr, Delaney K, Moorman A et al (1998) Declining morbidity and mortality among patients with advanced HIV infection. HIV Outpatient Study Investigators. N Engl J Med 338(13):853–860PubMedView ArticleGoogle Scholar
- Pulvirenti J (2005) Inpatient care of the HIV infected patient in the highly active antiretroviral therapy (HAART) era. Curr HIV Res 3(2):133–145PubMedView ArticleGoogle Scholar
- Pulivrenti J, Muppidi U, Glowacki R et al (2007) Changes in HIV-related hospitalizations during the HAART era in an inner-city hospital. AIDS Read 17(8):390–394, 397–401Google Scholar
- Kozak L, McCarthy E, Moien M (1993) Patterns of hospital use by patients with diagnoses related to HIV infection. Public Health Rep 108(5):571–581PubMedPubMed CentralGoogle Scholar
- Betz M, Gebo K, Barber E et al (2005) Patterns of diagnoses in hospital admissions in a multistate cohort of HIV-positive adults in 2001. Med Care 43(9 Suppl):III3–III14PubMedGoogle Scholar
- Talan D, Kennedy C (1991) The management of HIV-related illness in the emergency department. Ann Emerg Med 20(12):1355–1365PubMedView ArticleGoogle Scholar
- Guss D (1994) The acquired immune deficiency syndrome: an overview for the emergency physician, Part 1. J Emerg Med 12(3):375–384PubMedView ArticleGoogle Scholar
- Guss D (1994) The acquired immune deficiency syndrome: an overview for the emergency physician, Part 2. J Emerg Med 12(4):491–497PubMedView ArticleGoogle Scholar
- Hafner JJ, Brillman J (1997) Symptomatology of HIV-related illness and community-acquired illness in an HIV-infected emergency department population. Ann Emerg Med 29(1):151–157PubMedView ArticleGoogle Scholar
- Venkat A, Piontkowsky DM, Cooney RR et al (2008) Care of the HIV-positive patient in the emergency department in the era of highly active antiretroviral therapy. Ann Emerg Med 52(3):274–285PubMedView ArticleGoogle Scholar
- Haukoos J, Witt M, Zeumer C et al (2002) Emergency department triage of patients infected with HIV. Acad Emerg Med 9(9):880–888PubMedView ArticleGoogle Scholar
- Pennsylvania Department of Health (2004) Integrated epidemiologic profile of HIV/AIDS in Pennsylvania. HarrisburgGoogle Scholar
- Smith C, Stein G (2002) Viral load as a surrogate end point in HIV disease. Ann Pharmacother 36:280–287PubMedView ArticleGoogle Scholar
- Mellors J, Munoz A, Georgi J et al (1997) Plasma viral load and CD4+ lymphocytes as prognostic markers of HIV-1 infection. Ann Intern Med 126(12):946–954PubMedView ArticleGoogle Scholar
- Panel on Antiretroviral Guidelines for Adults and Adolescents (2007) Guidelines for the use of antiretroviral agents in HIV-infected adults and adolescents. Department of Health and Human Services (http://www.aidsinfo.nih.gov). December 1, pp 1–136
- Kozak L, DeFrances C, Hall M (2006) National hospital discharge survey: 2004 annual summary with detailed diagnosis and procedure data. Vital Health Stat 13 162:1–209PubMedGoogle Scholar
- Hunt K, Weber E, Showstack J et al (2006) Characteristics of frequent users of emergency departments. Ann Emerg Med 48(1):1–8PubMedView ArticleGoogle Scholar
- Zuckerman S, Shen Y (2004) Characteristics of occasional and frequent emergency department users: do insurance coverage and access to care matter? Med Care 42(2):176–182PubMedView ArticleGoogle Scholar
- Fleishman J, Gebo K, Reilly E et al (2005) Hospital and outpatient health services utilization among HIV-infected adults in care 2000–2002. Med Care 43(9 Suppl):III40–III52PubMedGoogle Scholar
- Floris-Moore M, Lo Y, Klein R et al (2003) Gender and hospitalization patterns among HIV-infected drug users before and after the availability of highly active antiretroviral therapy. J Acquir Immune Defic Syndr 34(3):331–337PubMedView ArticleGoogle Scholar
- Menke T, Giordano T, Rabaneck L (2003) Utilization of health care resources by HIV-infected white, African-American and Hispanic men in the era before highly active antiretroviral therapy. J Natl Med Assoc 95(9):853–861PubMedPubMed CentralGoogle Scholar
- MacArthur R, Perez G, Walmsley S et al (2005) Comparison of prognostic importance of latest CD4+ cell count and HIV RNA levels in patients with advanced HIV infection on highly active antiretroviral therapy. HIV Clin Trials 6(3):127–135PubMedView ArticleGoogle Scholar


text:
Social Responsibility of Sports Conference
Conference Information
Date: Monday, March 14, 2016
Location: NYU Kimmel Center
Eisner & Lubin Auditorium
60 Washington Square South, 4th Floor, New York, NY
Just as public companies are accountable to shareholders, professional sports leagues and teams are being held more accountable than ever by fans, stakeholders, and the media as to how they address issues of social responsibility. To explore this emerging field, the NYU School of Professional Studies Preston Robert Tisch Institute for Global Sport brought together sports industry professionals for its first Social Responsibility of Sports Conference.Panel discussions provided a forum during which top leaders from major sports leagues and entities discussed unprecedented research on social responsibility in sports. They engaged in an open dialogue about the ways in which they can develop lasting programs that are relevant to business and that lead to societal change, in addition to the importance of doing so. Along with the extraordinary inside-out discussions, the Tisch Institute presented exclusive findings and groundbreaking insights gained through a comprehensive academic research project.
Hotel and Travel Information
Hotel Information
New York University has worked with HHM to provide attendees with a diverse array of hotel options within Manhattan and Brooklyn, as well as discounted room rates.
Travel Information
New York University is located in NYC and has sites in Manhattan's historic Greenwich Village neighborhood and throughout the City.
Contact firstname.lastname@example.com for additional conference information. Follow us @nyutischsports.
Sponsorship Opportunities
For inquiries about sponsorship opportunities, please contact Sonal Pande at firstname.lastname@example.com or call 212-998-6961.
Contributions from sponsor organizations will provide student scholarships and will support the academic programs of the NYUSPS Preston Robert Tisch Institute for Global Sport.


text:
Here are a couple of videos from the developers of the concept:Daily Mail wrote:'Every day, more than 100 diesel truck journeys are needed to transport products from YARA's Porsgrunn plant to ports in Brevik and Larvik where we ship products to customers around the world,' said Svein Tore Holsether, President and CEO of YARA.
'With this new autonomous battery-driven container vessel we move transport from road to sea and thereby reduce noise and dust emissions, improve the safety of local roads, and reduce NOx and CO2 emissions.'
Frankly, I find the schedule to be extremely optimistic for such a challenging project. I doubt this ship will be on the water next year and I also doubt that it will be autonomous by 2020. Still, this looks like a very interesting idea.


text:
Humari Sanskritihttp://www.netleondev.com/humarisanskriti/
Project Overview
We are an British Columbia based non profit organization involved in promotion of South Asian Culture by way of arranging Indian Festivals, events, seminars, conferences. This effort is done by the people who believe in our traditional very rich culture. We are planning to arrange a South Asian Festival Called Jhalakh, Jhankar, Jalwa in the form of multi-disciplinary South Asian Arts festival.
This prodigious multi-generational presentation would be connecting today's world with the wonders of 5000 years of civilization, its ancient traditions and modern influences. This strong & vibrant presentation will open the doors to all of us to come closer & will know each other, to understand better in this today's complex & stressful environment. It will give insight, create awareness & will remove all those self created barriers by individuals, because of non reciprocity & relationship.
- Technologies WordPress, CSS3, HTML5
How we helped
- Requirement Analysis
- User Interface Design
- Database Management
- Back end Panel
- Payment Gateways
- Web Strategies
- Mobile Solutions
- Search Engine Optimization
- Social Media Marketing
© Copyright 2014. Netleon Technologies Private Limited, All Rights Reserved


text:
A day which began with incredible promise ended with my hands against the wall of a building while being accosted and intimidated by an aggressive, out-of-control, Port Authority Police Officer - in spite of having committed absolutely no crime.
This is my story:
Allow me first to begin by talking about why I was in New York.
I was in NYC that night to attend the annual Fellows Dinner for The Moving Picture Institute. For those who don't know, MPI is an incredible organization dedicated to developing the careers of talented, aspiring filmmakers who are interested in promoting freedom through entertainment media, with financial support and mentoring opportunities.
I became a fellow of their Rising Filmmaker Program in 2010, when I was awarded a grant to produce two films on the history and philosophy of the Bill of Rights. While no one would look back on those two short films as anything special, MPI's support at that time enabled me to change the trajectory of my career in entertainment and achieve my goal of becoming a full-time multimedia producer for libertarian causes.
Without The MPI's support, I would not be where I am today.
Their annual fellows dinner is an opportunity to connect with donors and other filmmakers - many of whom are good friends from NYC or Los Angeles that I don't get to see very often. A lot of these folks - myself included - are documentarians, journalists, and narrative filmmakers; and we're all freedom fighters. Here's a list of some of the projects MPI has supported over the years: http://www.thempi.org/mpi_films/
MPI itself was co-founded by Thor Halvorssen, a Venezuelan freedom advocate who also created the Human Rights Foundation and the Foundation for Individual Rights in Education; and who has presented on human rights abuses at venues around the world, including the United Nations. Thor is a bold and courageous man.
WATCH him take on the Venezuelan representatives at the UN when they absurdly tried to gain a seat on the UN's human rights council.
I ate dinner at Thor's table during the event, in fact.
My point in sharing all of this is not just to show how proud I am to be associated with The MPI (extremely) or to explain to everyone what kind of an event I was at (ie. intimate fancy gala, not frat party); but also to fully contextualize what happened after my friend and I left Tribeca Grill to return to our hotel.
This setup is so everyone can clearly understand precisely how ironic (or at least poetic) our interaction with the police state that is New York City really was that night.
So, here's what happened.
By about 11:00 PM, dinner was over, and guests were mingling and enjoying connecting with each other. At this point, the staff started nudging us out the door so they could clean up and go home themselves. Since MPI had put most of the out-of-town folks (including myself) up at the SoHo Grand hotel about a half a mile away, many of us decided to go back there and continue our conversations at the hotel bar.
I ended up walking back with a DC friend, Matthew Szewczyk, who moved to Los Angeles a couple years ago to work as a commercial director.
As you can see on the map below, the Tribeca Grill and the hotel aren't too far away from each other, but the streets are disrupted by some parks and the Canal Street entrance to the Holland Tunnel, so the easiest way to get there is a little circuitous.
And therein lies our mistake.
Instead of heading directly East from the Tribeca Film Center, Matt and I walked uptown along Hudson Street.
We were engaged in conversation, and although I used to work and go to grad school in this area, I wasn't really paying attention to the fact that we'd gone too far. We'd walked a ways up before I realized that we'd have a painful time getting across Canal, and suggested that we just cut across over to West Broadway from wherever we were if we could.
So we turned down Vestry Street and headed to the end of the block, hoping to get across that way instead. Alas, there was a low fence at the end of Vestry, which at the time, we assumed was just there to stop cars from going the wrong way onto the street marked on the map as I-76.
At that point, Matt suggests that we just hop the low fence and keep going. Not ideal, but it seemed fine to me, so we tossed our program booklets and DVD from the dinner over the fence and my friend started to jump over.
As he got about halfway over the fence, we heard a man on a bullhorn from across the street shouting at us not to go that way.
Of course, our books and such were already on the other side, and Matt was halfway over already so he shouted back that he would just get his books and we'd go back the way we came... Which is exactly what happened. He landed on the other side, grabbed the booklets and DVD, handed them to me and climbed right back over to the acceptable side.
No harm, no foul... Or so we thought.
A few seconds later, as we began walking back out the way we came, a couple of goons wearing coveralls that had some kind of Port Authority markings on them showed up and told us to stop while they and the guard-stand guy across the street with the bullhorn figured out "what to do with us." They didn't ask us if we would stick around for a few minutes, they simply demanded that we don't go anywhere.
These men were not police. They did not present any identification. They did not have any authority of any kind to detain us. And they were not being polite.
Keep in mind also that this is taking place at the end of a dark, unpopulated dead-end street in New York City, in the middle of the night.
It was extremely creepy.
As my friend and I continued to walk up the street, the goons said that cops were already on their way to talk to us. We heard the sirens. They weren't lying.
At this point, we knew that we'd be interacting with police officers.
Now... Note that Matt and I are both people who spend a lot of time working in an issue space as filmmakers who take human rights, liberty, and the growing American police state extremely seriously. Way back in 2010, I produced a short piece on police abuses in America being more worrisome than international terrorism and small-government political activism.
Since then, I've produced and contributed to films that deal with police abuses ranging from my documentary, "No Vans Land", which (among other things) touches on intimidation and violence against immigrant entrepreneurs competing with taxis and city buses, to work with the Institute for Justice exposing the practice of police profiting from taking people's property without so much as a conviction via civil asset forfeiture, which was recently brought to the national spotlight by John Oliver's "Last Week, Tonight".
Matt is currently working on a film about drone surveillance called "The Right Hand of God".
But even if we weren't particularly attuned to this stuff, we've all recently seen horrendous abuses in New York City, with an NYPD officer choking Eric Garner to death; who, by all accounts a sweet man whose heinous crime was selling untaxed cigarettes on a street corner in Staten Island. Not to mention the recent shooting of Michael Brown in Ferguson, Missouri, which sparked massive riots and exposed tremendous corruption throughout the St. Louis area police force.
We both intellectually know the risks of dealing with police very well, and we were prepared for what was likely coming our way.
The first thing Matt did was ask was if I had any drugs on my person. As someone who has never smoked a cigarette, let alone been high or had the slightest interest in drugs of any kind, the answer was - of course - no. The second thing he did was suggest that we should both get out our phones and begin recording video of what was about to happen.
Matt pulled out his phone and began recording just as a squad car with lights flashing and sirens blaring rolled up to the curb next to us. I did not get my phone out in time, not that it would have mattered, given what happened next.
|Officer Pasquale Carpentiere
Matt still had his phone in his hand, with the camera pointed toward the officer.
And wouldn't you know it... The very first thing the officer did was jam his knee into my friend's back, shoving him against the wall and attempt to confiscate his phone. At this point, my friend protested and tried to hang onto his phone, but the officer got extremely aggressive, violently taking the phone from his hands while shouting at both of us telling us to comply and stop resisting. In no way had either of us "resisted" anything, though once the officer took my friend's phone, we both clearly told him that he had absolutely no authority to do that and that he was in violation of the law.
For those who don't know, It is 100% legal (and extremely important!) to record police officers on duty.
Officer Carpentiere did not acknowledge this point or return the phone. Instead, he claimed that we were being non-compliant with his requests (completely false), and that my friend's phone "might have been a taser".
Utter. Nonsense.
My friend's phone was out and visible from the very beginning, his hands were up and held against a wall, and neither of us made any motion whatsoever toward the officer. From the moment Officer Carpentiere arrived, we complied with each of his demands. There is absolutely no way he could have possibly mistaken the phone for a taser.
Even if he did briefly believe it to have been dangerous, within a few seconds of holding it he would have known that it was not. Yet, once he confiscated it, the officer did not return the phone to my friend immediately upon inspection.
Again, we registered our protests against this action.
Matt reminded the officer that it was unconstitutional to take private property without cause, and that in no way was it acceptable. The officer's response? Something very close to: "Are you a lawyer? No? Well then, shut your mouth."
It was clear that the phone would not be returned any time soon, so my friend suggested that I take out my phone from my pocket and begin recording the rest of our interactions. A great idea, except that the minute I began to do so, Officer Carpentiere shoved me against the wall and grabbed my wrist while aggressively telling me that either I could keep my phone in my pocket where it was, or he would take it as well.
I opted to keep it in my pocket. Who knows what the officer would have done with it.
Ever since this encounter I have wondered if I should have had my phone out from the beginning so that I could have captured a second camera angle and kept a more tangible record of what happened to us. Upon reflection, I don't think it would have mattered.
After the initial round of intimidation and displays of force, Officer Carpentiere took my friend's phone and both of our IDs back to his squad car with him as he sat down to "write a summons".
The whole time the officer was sitting in the car, Matt was asking to have his phone back, and for a "white shirt" (supervising officer) to be called to the scene. At one point, Carpentiere told us that he would give the phone back when he was done, and because of my friend's "belligerence", he would take as long as he felt like.
When Officer Carpentiere finally returned with the summons and the phone, easily over 15 minutes later, it was clear why he held onto it. The recording Matt had made of the officer's aggressive behavior was gone. Deleted by the officer. I know Matt will do his best to recover the data, but that may not be possible.
Had I immediately filmed these events, it seems most likely that I'd have had my recordings deleted as well.
The officer's behavior was unethical, disgusting, and - again - ENTIRELY ILLEGAL.
By this point, a second officer - Officer Miller - had arrived to support his compatriot. Miller seemed to be a different type of cop compared to Carpentiere. Our interactions with him were not immediately hostile, he did not raise his voice or treat us violently.
I wonder very much whether or not, had he been the first responder, things would have gone the way they did. Who knows.
Ultimately, Matt was given a summons to appear in NYC court for "trespassing". I wasn't. We were told that this was because the officer had reviewed security camera footage (or talked to someone who had), and that I wasn't on tape going over the fence. I suspect it may have also had something to do with the difference in my demeanor vs. my friend's. As you might imagine, once his phone was taken and he took a knee to the back, Matt wasn't exactly happy.
I tend to be pretty even-keeled in stressful situations, and spent most of the time trying to make sure that we didn't get shot or arrested for no damn reason. Freedom-fighter or not, I'm not particularly interested in dying at the hands of a stupid cop power-tripping on his own aggressive machismo.
And make no mistake... There were several points where I believed this to be a legitimately possible outcome, given the way Officer Carpentiere behaved towards us from the beginning.
45 minutes or so into our nightmare, the supervisor arrived. I did capture that entire interaction on camera.
See below:
There are a couple things I'd point out about this. For one thing, I'd note that the very first thing the supervisor did when he arrived on the scene was have a private conversation with Officer Carpentiere outside of our listening or recording range. I don't know what was said, but it made it fairly clear from the outset how the conversation would go.
I'd note also that the supervising officer says a lot of stuff that would make sense if events had unfolded the way he assumed.
For those who don't watch the video, the supervisor assumes that Matt made some quick movements toward his pocket that set-off the negative interaction with Officer Carpentiere. Based on that assumption, most of what he says is understandable - if I were a police officer, I too would be wary of someone in a dark alley reaching for something I couldn't see. I might even react "with prejudice."
But... That's not what happened.
Matt's phone was already out and in plain view when the officer arrived! And as he could see literally everything we were doing at all times and we had complied with each one of his requests immediately (not to mention the fact that the call he would have received could only have referred to us possibly being in a place we weren't supposed to be, with nothing actually criminal, violent, or in any way threatening having taken place), there was never any question of danger to the officer except to the extent that the mere act of recording his actions itself posed a threat.
I've since pondered some other curious aspects of the experience that make the notion that Officer Carpentiere was reasonably acting out of concern for his safety absolutely ridiculous.
Consider that not once did he pat either of us down. Matt's question about drugs turned out to be pointless... Even if we did have drugs on us, Carpentiere didn't even look for them. He didn't ask us if we were carrying any weapons. If he had patted me down, he might have even noted something odd or questionable in my pockets that night. Apart from my wallet, keys, and cellphone; I was carrying about a dozen USB flash drives (preloaded with my two most recent documentaries, to share with attendees of the dinner), which would have probably seemed strange had he bothered to check my blazer.
And that's the thing... He didn't care about any of that. He didn't even ask us why we were there or what we were doing. It was quite clear that the officer did not believe we were a danger to him in any way.
The only thing he cared about seemed to be the phone and the fact that we were recording him.
In the end, waiting for the supervisor was kind of a waste of time. Predictably, his sole purpose was to back up Officer Carpentiere. He gave Matt an opportunity to file a formal complaint, but the likelihood that that will go anywhere seems slim to none.
Eventually we concluded our conversation and left. By the time we made it back to the hotel, many of our peers were wondering where we had been, and we had quite the story to tell.
Final thoughts...
Remember... This whole ordeal occurred for no other reason than because two guys took a wrong turn while walking back to a hotel from a gala dinner for people who make films about human freedom. That's it. And yet, the best thing I can say for this entire experience is that we didn't get killed.
So what have I learned, if anything?
For one thing, I'm now a lot more acutely attuned to the visceral reality of dealing with police. It's one thing to empathize and report other people's experiences as a documentarian. It's quite another to live one of your own.
I'm also not so convinced that recording police encounters is necessarily a viable option in most cases. If having your phone out immediately turns a bad situation into a dangerous one as it did for us, and the only record of police abuse is deleted by the officer while you are required to press your hands against a wall or lie on the ground, then it really doesn't do anybody a whole lot of good. There are a bunch of apps that purport to help people with these kinds of things, but as far as I can tell, they're mostly based on automatic/real-time uploading of video files to the internet.
But what if you don't have strong enough signal for that to work, or what if it doesn't go through in time?
A better app, in my view, would be one where you could start a video recording and have it continue to run until you enter a password, or your phone dies. Had my friend or I had something like that the other night, it's likely that we'd have proper proof of this officer's abuses - including his attempts to stop or delete the recording.
That said, I am much more likely now to record (from a safe distance) any encounter I see someone else having with police. I would encourage absolutely everyone to do the same.
Do not assume that because police have stopped or are detaining or arresting someone, that the person has done something wrong. While my friend and I were up against the wall for a half an hour, numerous people walked by. I don't know what they thought of us, but at one point, my friend shouted "No drugs! Just books!"
At this point, I honestly think it's safer to assume that police are just as likely to be shaking someone down for no reason as they are to be "protecting and serving" in any meaningful way.
Lastly, I would like to take a moment and acknowledge that if my friend and I were not well-spoken, educated, white guys, the whole situation would likely have played out extremely differently. I do my best to treat all police as individuals, just like I do everyone in life, but the statistics are what they are. Police violence and "officer-involved shootings" are far more likely to happen in cases where the victim is non-white.
This experience makes me even more empathetic to this problem.
I wasn't drunk. I don't do drugs. I'm not a violent or aggressive person in any way. I'm practically a pacifist, and mostly a teetotaler. I don't own any guns, and although I would love to carry a multi-tool or a knife on me most of the time, even that has been beaten out of me by years of interactions with security guards at airports and State/Federal buildings. I was wearing nice clothes, and spoke calmly to every person I dealt with that night.
The worst thing either Matt or I had been accused of - and the reason for which police were called to the scene in the first place - was hopping a fence, picking up a couple books, and hopping right back over when we were told not to.
Yet... We spent our night with our hands up and our heads down, getting yelled at and threatened with jail and the confiscation of our property by police like we had just robbed a liquor store.
If it can happen to us, it can absolutely happen to anyone.
And now, with that... I'm happy to take any and all questions. I will also try to edit this post to include more links and additional video if we can recover the important stuff.


text:
The modern farmer and busy bee
Abbott, Emerson Taylor, Editor
The modern farmer and busy bee
Vol. 16, No. 5
St. Joseph, MissouriMay, 1905
URL to cite for this work: http://digital.library.wisc.edu/1711.dl/EcoNatRes.MFBBv16n5
[Cover] The modern farmer and busy bee: Vol. XVI, No. 5: May 1905, p. [1]
[Advertisements], p. [2]
[Masthead] The modern farmer and busy bee, p. [3]
[Articles and opinions pertaining to farming and beekeeping], pp. [3]-18
Based on date of publication, this material is presumed to be in the public domain.| For information on re-use see: http://digital.library.wisc.edu/1711.dl/Copyright


text:
Mickey Mouse
Jerry's Discount Store
Ulysses S. Grant Trivia
Empire State Building
Trivia facts
Johnstown Flood
kola bear
Mickey Mouse Club
gunfight at the OK corral
Johnny Cash
Gun Smoke Trivia
Doc Holliday Trivia
MASH Trivia
Sơn Đong Cave
Carlsbad Caverns
wagon Train Trivia
The Twilight Zone
Al Capone
1923 - The Hollywood sign
1929 - Filming the MGM Lion.
Pearl Hart
Sgt. John Basilone,
Alfred Hitchcock
Trivia Facks
The Hollywood sign
Calamity Jane
A league of there own
The first World Series Game
Transatlantic Slave Trade
The Pony Express
Stephen King
Pat Garrett
The Wright Brothers
Isoroku Yamamoto
Mount Fuji in Japan
The Lincoln Memorial
Henry Ford
Grace Kelly
Benjamin Franklin
President Eisenhower
Sitting Bull
Apollo 11
The Civil War
Margaret Thatcher
Oprah Winfrey
William Shakespeare
Osama bin Laden
The American Revolution
John Paul Jones
Bernard Montgomery
The Capitol, the 1860s.
General William Sherman
Hoover Dam
Tower of Pisa
Sphinx at Giza
Vietnam War
September 11, 2001
The Capitol
Manhattan Project
Amazing Conspiracy Theories
The Roaring 20's
Niagara Falls
Stock market crash of 1929
Davy Crocket
Erwin Rommel
Adolf Hitler
George Custer
Forbidden City in Beijing
National Anthem
Trivia Facts 2
Kilimanjaro in Tanzania
Auschwitz in Poland
Loch Ness in Scotland
Battle of Lincoln 1878
Battle of Normandy
Taj Mahal
Great Wall of China
Christ Redeemer
Pyramid at Chichn Itz
Petra of Jordan
Machu Picchu
Grand Canyon
Top 10 Deaths
Greatest Invention ever Made
10 Favorite Fast Food Chains
Top 10 Amusement Parks in the US
Top 10 Shortest-Lived Presidents
The Little Rascals
Bolivian salt flats
The 10 Oldest Items In The Known World
the oldest human in the world
The Eastside Kids
The Trojan War Horse
Waco Texas massacre
Click Here For Next Page Of Trivia
Page 1
Bob Hope
Top 6 Public Health Scares
Asteroid Impact Sites on Earth
Old Dodge City Kansas
Paraments of Egypt
Elizabeth Taylor
Top Excuses For Being Late to Work
Most Dangerous Animals in the World
Martin Luther King
Popcorn Day
Americans who smoke
All in the Family
Marilyn Monroe
Area 51
Overpriced Gifts
the Concorde
Ronald Reagan
Lyndon Johnson
6 Best Intelligence Agencies in the World
Six famous WW1 flying aces
Most Unusual Town Names
Will Smith Actor
Jim Carrey Actor
Flightless Birds
W W 1 Airplanes
Johnny Carson
Strangest Creatures on the Planet
Cars of the future
Sam Cooke
Top 6 Royal Dynasties
Western Cow Boys
Fort Smith Arkansas
Alexander Graham Bell
Winston Churchill
Behind closed White House doors.
The 54th Regiment
Trivia 2
The iPad
the Challenger shuttle disaster
Mahatma Gandhi
Edgar Allan Poe
Eating in the fifties
The Strangest 50 State Laws
The James Buchanan scandal.
Janet Jackson
Roosevelt FDR
5 Most Beautiful Lakes
James Stewart
General Dwight D. Eisenhower
Hearst Castle
HMS Bounty
Groundhog Day
The Day the Music Died
Ritchie Valens
The Big Bopper
Buddy Holly
Ricky Nelson
10 Amazing Facebook Facts
Redwood National Park
Laurel and Hardy
Page 4
Phoenix, Arizona
Mickey Rooney
The Mickey Mouse Club
Page 2
12 Super Bowl facts
The British Monarchy
Chinese New Year
The Beatles
The 25th Amendment
Betsy Ross
Clint Eastwood
Whitney Houston
Kilroy was here
Abraham Lincoln
World War II: Capture of U-505
Was JFK shot by a secret service man
Valentine's Day
New Mexico
North Dakota
South Dakota
Outrageously Funny 911 Calls
Strange facts about American presidents
Joan Crawford
Battle of Guadalcanal
Humphrey Bogart
Henry Fonda
Weird Facts About Money
The History Of Chess
Coca-Cola Facts
Weird Facts
Trivia one liners
John Glenn
The Hindenburg
weird facts about World War II
Loretta Young
Malcolm X
California Gold Rush
The History Of Mississippi
World War II: The Great Escape
Mount St. Helens
interesting facts about Mexico
Helen Keller
Florence Nightingale
Interesting Facts Baseball
George Harrison
Battle of Iwo Jima
Tom Cruise
Woman Suffrage
Mel Gibson
General Omar Bradley
Peace Corps Service
Donald Trump
Cellular phones
Puerto Rico
Feudal Shang Dynasty
First Moon Landing
Box Jellyfish
Wright Brothers
Walter Cronkite
South Carolina
North Carolina
West Virginia
Facts About Telephones
Battle of the Ironclads
Amazon River
Bora Bora
Ulysses S. Grant
Charlie Chaplin
New York
Financial Scandals of All-Time
Rhode Island
New Jersey
New Hampshire
Washington, D.C.
Banqiao Dam Collapse
Bela Lugosi
The Godfather
A tribute to Facebook
Bizarre Celebrity Suicides
Moon Landing Hoax
History Trivia
St. Patrick
Jimmy Hoffa
The 335 Year War
Facts From History
Page 3When Watching TV Alone
Patrick Henry
Napoleons rabbits
Top 6 Strange Holes
George Washington
Elvis Presley
John Adams
Thomas Jefferson
James Madison
James Monroe
John Quincy Adams
Three Mile Island
Andrew Jackson
Martin Van Buren
William Henry Harrison
John Tyler
Geronimo's Missing Skull
Vending Machines
Fort Apache
James K. Polk
Zachary Taylor
Millard Fillmore
Franklin Pierce
James Buchanan
16 th Abraham Lincoln
Andrew Johnson
pres. Ulysses S. Grant
Rutherford B. Hayes
James A. Garfield
April Fools Day
Chester A. Arthur
Grover Cleveland
Benjamin Harrison
William McKinley
John Gotti
Natalie Wood
Theodore Roosevelt
William Howard Taft
Woodrow Wilson
Warren G. Harding
Calvin Coolidge
Howard Hughes
Killer Whale
Steven Spielberg
Jesse James
Herbert Hoover
Franklin D. Roosevelt
Harry S. Truman
Dwight D. Eisenhower
John F. Kennedy
Lyndon B. Johnson
Richard Nixon
Gerald Ford
Jimmy Carter
prist Ronald Reagan
George H. W. Bush
Bill Clinton
George W. Bush
Barack Obama
The American Flag
Annette Funicello
Website Title
Twenty Interesting Things About…April Fools' Day
I grew up in a family of pranksters; I'm not kidding. In the summer, we stayed for weeks with my grandparents and my Grandma was not your typical grandma.
It was never a surprise to have firecrackers attached to the toilet seat and get the shock of your life when you lifted the lid. She also put frogs in our drawers and surprises in our food.
We would return the favor by setting all the clocks and her watch back so we could leave for town earlier, coloring on the bottom of her feet with markers while she slept, and hiding under the pier pretending we were still holding our breath while she counted.
I know, I know, we were all very mature.
Now that I'm older, I'm less into practical jokes. I'm not sure why, but April Fools' Day just doesn't call my name anymore, but my kids LOVE practical jokes, which means SOMETHING will happen in our household on that day. Hopefully, NOT this, though; that was gross.
Here are 20 interesting things you may, or may not know, about April Fools' Day.
1. The earliest recorded reference to April Fools' Day was in Geoffrey Chaucer's Canterbury Tales in 1392.
2. Although historians believe April Fools' began in France, no one is entirely certain. One belief is that it began with a calendar change in the 16th century when Pope Gregory XIII adopted the Gregorian calendar, and New Year's Day was moved from April 1 to January 1.
3. The ancient Romans had a day of jokes called Festival of Hilaria (a.k.a. Roman Laughing Day). In ancient Rome, the festival of Hilaria was held to celebrate the vernal equinox and honor the Anatolian Earth Goddess.
4. Boese of the Museum of Hoaxes points out that April Fools' is a day where social inequalities could be confronted; for example, in the 1800s street urchins played tricks on the London gentlemen.
5. As an April Fools' Day prank in 1998, Burger King published a full-page advertisement in USA TODAY introducing the newest menu item: a "Left-Handed Whopper."
6. In Scotland, April Fools' Day used to be called "Hunt the Gowk Day." "Gowk" is an old Scottish word for a foolish person. A traditional prank involved sending the "gowk" to deliver a sealed message. The message instructed the recipient, "Dinna laugh, dinna smile. Hunt the gowk another mile." The recipient would then send the victim onward to another person, bearing an identical sealed message. The joke went on until either the "gowk" got wise to what was going on, or someone took pity on him.
7. The French call April 1 Poisson d'Avril, or "April Fish." French children sometimes tape a picture of a fish on the back of their schoolmates, crying "Poisson d'Avril" when the prank is discovered.
8. In Spain, December 28th is the equivalent of the U.S.'s April Fools' Day. Dia de Los Santos Inocentes ("Day of the Holly Innocents"), a religious holiday named in honor of young children slaughtered by order of King Herod around the time of Jesus' birth, has largely lost its religious aspect. Now, "pranks that became popular during the Middle Ages have been combined with winter festivities of pagan origin."
9. On 1 April 1976, BBC radio astronomer Patrick Moore stated to radio listeners that an astronomical event (the conjunction of Jupiter and Pluto) would take place at 9:47 a.m. that day, which would noticeably decrease gravity on Earth. If listeners were to jump into the air at that exact moment, they would find they felt a floating sensation.
10. Twenty years earlier, the BBC fooled the nation with a spoof documentary broadcast about spaghetti crops in Switzerland. The documentary "featured a family in Switzerland carrying out their annual spaghetti harvest…carefully plucking strands of spaghetti from a tree and laying them in the sun to dry." Apparently, millions were duped–calling in to ask how they could grow their spaghetti trees.
11. On April Fools' Day in 1996, Taco Bell took out a full-page advertisement in seven leading U.S. newspapers announcing their purchase of the Liberty Bell, which they purportedly renamed the "Taco Liberty Bell." At noon on the same day, it was revealed that the story was a hoax.
12. In 2001, another successful April Fools' marketing ploy was set-up in Denmark involving a car from Copenhagen's new subway. It appeared as though one of the subway cars accidentally pushed through the ground in the square directly in front of town hall.
13. Google outdoes itself each year with April Fools' jokes. In 2013, they introduced the Google Wallet Mobile ATM which advertised that it could attach to most smartphones and "dispense money instantly and effortlessly," including rare $2 and $50 bills. No more searching for an ATM or the bank! "If your mobile ATM is running low on funds, a self-driving, armored, hybrid vehicle will be alerted and dispatched to your location–arriving within minutes to quickly and safely refill [your] ATM."
14. Funnily enough, because of their chronic hoaxes through the years, when Google launched its Gmail service on April 1, 2004, everyone assumed it was another joke. Of course, that was the plan because Google knew it would offer additional free publicity when everyone realized the service was real.
15. A Flemish April Fools' tradition has children locking their parents or teachers from their homes/rooms, only letting them back in when they promise a treat.
16. In England, depending on where you live, instead of being called "fool" on April Fools' Day, you could be called a "noodle," "noddy," "gobby" or "gob."
17. Even Mark Twain had something to say about April Fools' Day: "This is the day upon which we are reminded of what we are on the other three-hundred and sixty-four." (Muddlehead Wilson, 1894)
18. Twitter jumped in on the April Fools' Day bandwagon in 2013 to announce that they were shifting to a two-tiered service. Those who wanted to use their services for free could use Twitter, where they could tweet ONLY consonants. Those who paid $5/monthly could use consonants AND vowels.
19. According to a 2010 national study, 68% of advertising and marketing executives consider April Fools' pranks unsuitable; only 3% found pranks "very appropriate."
20. Based on its readers' feedback and ongoing research over at The Museum of Hoaxes, there is an entertaining and in- depth list of the Top 100 April Fools' Day Hoaxes of All Time.


text:
400 Beach and Parkshore Plaza
January 12th, 2012 categories: 400 Beach, Downtown Condos, Downtown St Petersburg, Parkshore Plaza
400 Beach and Parkshore Plaza were both developed by Opus South, a year apart. The two luxury condominiums a block apart on Beach Drive have many similarities, but each has a different flavor. The common areas at Parkshore have a more traditional decor; 400 Beach is more New York contemporary. The pool at Parkshore is surrounded by the building; at 400 Beach it has a view of the water. Parkshore has a more central location and 400 Beach is built and angled a bit more to the east so has better views of the Skyway. The floor plans of the majority of the tower, 4 per floor, are similar yet have differences. Both are worth looking at if you're in the market for a luxury condo in downtown St Petersburg.
Discussion: No Comments »|
Parkshore Plaza Market Update 4-21-09 Luxury condominiums downtown St Petersburg Florida
April 21st, 2009 categories: Downtown St Petersburg, Market Updates, Parkshore Plaza
Parkshore Plaza currently has 19 condos in the Multiple Listing System of Pinellas County actively for sale, ranging from $435,000 for a 1,421 sq ft townhouse facing 1st St to $1,850,000 for a double unit with 5,465 sq ft. This is approximately 16% of the total units. All of the developer units have been sold.
4 units in Parkshore Plaza have contracts pending, with list prices from $448,500 to $1,295,000.
So far this year there have been 3 sales, ranging from $500,000 to $999,000.
5 units are currently offered for rent in Parkshore Plaza through the MLS, ranging from $3,500/month to $5,250/month. So far this year 5 have been rented, from $3,000/mo to $4,200/month, according to the MLS. There are a total of 17 units that have been rented, and two of the five available for rent do not show a prior rental – indicating that about 15% of the units at Parkshore Plaza are leased.
Discussion: No Comments »|


text:
Tag: Sales Talent
Why is There a Sales Talent Shortage
Posted on June 14th, by Henry Goldbeck in Recruitment, Sales & Marketing. Comments Off on Why is There a Sales Talent Shortage
If you are a company that relies on your sales team, whether you are a start-up or an established firm, you have probably realized how hard it is to hire and maintain talented sales personnel.
A recent Globe and Mail article, Companies Struggle with Shortage of Sales Talent, discusses how sales is in the top … Read More »


text:
Tag: marlene
Marlene Bertrand On HubPages
Emerging developments in mobility expertise, such because the rise of ridehailing and carsharing providers, have led many business analysts to supply their views on how these trends will have an effect on the automotive trade in the United States. The studies stemming from these efforts have resulted in extremely conflicting visions of the longer term, starting from a dramatic decline in vehicle gross sales to a windfall in revenue and income. FRANKLIN, Tenn. (March sixteen, 2009) – March may be the month identified for madness, lions and lambs, however at Nissan North America, Inc. (NNA), the biggest roar is coming from the early introduction of the new 2010 Nissan GT-R supercar, including quite a lot of necessary enhancements. Particularly, 5 further horsepower, a revised suspension, up to date wheel finishes and commonplace entrance seat- and roof-mounted curtain facet-affect supplemental air luggage.
I discovered one thing too,however do not know what to do about it.I like all this innovations in regards to the galaxy..I am not encouraged to admit my own invention to others anymore as a result of it appears to be dangerous,nonetheless bought a save haven until am i going to do about this in the long term now i am sick due to it more or lessPretty excessive actually.still secure,i'm worid..do you know what to do?this not a hoax.
This work can embrace oil changes, lubrications, and tire rotations, as well as transmission or coolant fluid flushes. Car upkeep can range from fast and easy to involved and time-consuming, however it is all the time an important aspect of the job. NAC accepts many students from overseas. NAC presents the best degree of engineering methods in automotive training, as evidenced by the big variety of NAC graduates/ alumni who are very energetic of their businesses, each in Japan … Read More ...