text:
Post00850 Sharps Injuries + Health $ + Abstracts + News 27 April 2016
1. New Report: Sharps Injuries among Hospital Workers in Massachusetts,
2. World Immunization Week 2016: Close the immunization gap
3. Abstract: Development assistance for health: past trends, associations,
and the future of international financial flows for health
4. Abstract: No-needle, single-visit adult male circumcision with Unicirc:
a multi-centre field trial
5. Abstract: Several issues on the epidemiology of Zika virus disease
6. Abstract: Evidence and recommendations for use of intra-articular
injections for knee osteoarthritis
7. Abstract: Variability in syringe components and its impact on
functionality of delivery systems
8. Abstract: Particulate matter in injectable drug products
9. Abstract: A Biopharmaceutical Industry Perspective on the Control of
Visible Particles in Biotechnology Derived Injectable Drug Products
10. Abstract: Ethanol-based handrubs: Safe for patients and health care
11. No Abstract: Access to needle and syringe programs by people who
inject image and performance enhancing drugs
12. News
– UK: What to do if you discover dirty needles after school run mum found
– Libya: 10 people infected in Hepatitis C outbreak in east Libya
– USA: Child Finds Used Syringe, Family Faces Threat of Disease
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1. New Report: Sharps Injuries among Hospital Workers in Massachusetts,
Laramie, Angela (DPH) <email@example.com>
date: Tue, Apr 26 2016
subject:NEW REPORT: Sharps Injuries among Hospital Workers in
Massachusetts, 2014
Hello to all!
We are pleased to release our most recent data report, "Sharps Injuries
among Hospital Workers in Massachusetts, 2014".
Please feel free to distribute the report as you'd like.
It can also be found on the Occupational Health Surveillance Program
website (www.mass.gov/dph/ohsp) under Needlesticks and other Sharps
Injuries, Data and Statistics.
The direct link is: https://tinyurl.com/zpco5fq
Many thanks to the occupational health and infection control staff who
provided the data that makes this and other reports possible.
Angela K. Laramie, MPH
Sharps Injury Surveillance Project
Occupational Health Surveillance Program
Massachusetts Department of Public Health
250 Washington Street, 4th Floor
Boston, MA 02108
2. World Immunization Week 2016: Close the immunization gap
World Immunization Week 2016: Close the immunization gap
Immunization game-changers should be the norm worldwide
21 April 2016 — Immunization averts 2 to 3 million deaths annually.
However, an additional 1.5 million deaths could be avoided, if global
vaccination coverage improves.
Today, nearly 1 in 5 children worldwide are still missing routine
immunizations for preventable diseases.
During World Immunization Week 2016, WHO highlights recent gains in
immunization coverage, and outlines further steps needed to meet global
vaccination targets by 2020.
Read the press release
Watch the video on immunization week
Read the commentary on vaccines
Global Vaccine Action Plan 2011 – 2020
3. Abstract: Development assistance for health: past trends, associations,
and the future of international financial flows for health
Free Full Text: http://dx.doi.org/10.1016/S0140-6736(16)30168-4
Lancet. 2016 Apr 12. pii: S0140-6736(16)30168-4.
Development assistance for health: past trends, associations, and the
future of international financial flows for health.
Dieleman JL1, Schneider MT2, Haakenstad A3, Singh L2, Sadat N2, Birger M2,
Reynolds A2, Templin T2, Hamavid H2, Chapin A2, Murray CJ2.
1Institute for Health Metrics and Evaluation, Seattle, WA, USA. Electronic
address: email@example.com.
2Institute for Health Metrics and Evaluation, Seattle, WA, USA.
3Harvard TH Chan School of Public Health, Boston, MA, USA.
BACKGROUND: Disbursements of development assistance for health (DAH) have
risen substantially during the past several decades. More recently, the
international community's attention has turned to other international
challenges, introducing uncertainty about the future of disbursements for
METHODS: We collected audited budget statements, annual reports, and
project-level records from the main international agencies that disbursed
DAH from 1990 to the end of 2015. We standardised and combined records to
provide a comprehensive set of annual disbursements. We tracked each
dollar of DAH back to the source and forward to the recipient. We removed
transfers between agencies to avoid double-counting and adjusted for
inflation. We classified assistance into nine primary health focus areas:
HIV/AIDS, tuberculosis, malaria, maternal health, newborn and child
health, other infectious diseases, non-communicable diseases, Ebola, and
sector-wide approaches and health system strengthening. For our
statistical analysis, we grouped these health focus areas into two
categories: MDG-related focus areas (HIV/AIDS, tuberculosis, malaria,
child and newborn health, and maternal health) and non-MDG-related focus
areas (other infectious diseases, non-communicable diseases, sector-wide
approaches, and other). We used linear regression to test for structural
shifts in disbursement patterns at the onset of the Millennium Development
Goals (MDGs; ie, from 2000) and the global financial crisis (impact
estimated to occur in 2010). We built on past trends and associations with
an ensemble model to estimate DAH through the end of 2040.
FINDINGS: In 2015, US$36·4 billion of DAH was disbursed, marking the fifth
consecutive year of little change in the amount of resources provided by
global health development partners. Between 2000 and 2009, DAH increased
at 11·3% per year, whereas between 2010 and 2015, annual growth was just
1·2%. In 2015, 29·7% of DAH was for HIV/AIDS, 17·9% was for child and
newborn health, and 9·8% was for maternal health. Linear regression
identifies three distinct periods of growth in DAH. Between 2000 and 2009,
MDG-related DAH increased by $290·4 million (95% uncertainty interval [UI]
174·3 million to 406·5 million) per year. These increases were
significantly greater than were increases in non-MDG DAH during the same
period (p=0·009), and were also significantly greater than increases in
the previous period (p<0·0001). Between 2000 and 2009, growth in DAH was
highest for HIV/AIDS, malaria, and tuberculosis. Since 2010, DAH for
maternal health and newborn and child health has continued to climb,
although DAH for HIV/AIDS and most other health focus areas has remained
flat or decreased. Our estimates of future DAH based on past trends and
associations present a wide range of potential futures, although our mean
estimate of $64·1 billion (95% UI $30·4 billion to $161·8 billion) shows
an increase between now and 2040, although with a large uncertainty
INTERPRETATION: Our results provide evidence of two substantial shifts in
DAH growth during the past 26 years. DAH disbursements increased faster in
the first decade of the 2000s than in the 1990s, but DAH associated with
the MDGs increased the most out of all focus areas. Since 2010, limited
growth has characterised DAH and we expect this pattern to persist.
Despite the fact that DAH is still growing, albeit minimally, DAH is
shifting among the major health focus areas, with relatively little growth
for HIV/AIDS, malaria, and tuberculosis. These changes in the growth and
focus of DAH will have critical effects on health services in some low-
income countries. Coordination and collaboration between donors and
domestic governments is more important than ever because they have a great
opportunity and responsibility to ensure robust health systems and service
provision for those most in need.
FUNDING: Bill & Melinda Gates Foundation.
Copyright © 2016 Elsevier Ltd. All rights reserved.
4. Abstract: No-needle, single-visit adult male circumcision with Unicirc:
a multi-centre field trial
PLoS One. 2015 Mar 30;10(3):e0121686. Open Access
No-needle, single-visit adult male circumcision with Unicirc: a multi-
centre field trial.
Millard PS1, Goldstuck ND2.
1University of New England, Portland, Maine, United States of America.
2Faculty of Medicine and Health Sciences, Stellenbosch University and
Department of Obstetrics and Gynaecology, Tygerberg Hospital, Cape Town,
South Africa.
BACKGROUND: Voluntary medical male circumcision (VMMC) is a priority HIV
preventive intervention. Current adult circumcision methods need
METHODS: Field trial in 3 primary care centres. Minimally invasive VMMC
using the Unicirc instrument following topical lidocaine/prilocaine
anesthetic. Men were followed up at 1 and 4 weeks.
RESULTS: We circumcised 110 healthy volunteers. Two men complained of
transient burning pain during circumcision, but none required injectable
anaesthesia. Median blood loss was 1ml and median procedure time was 9.0
min. There were 7 (6.3%) moderate complications (5 (4.5%) post-operative
bleeds requiring suture and 2 (1.8%) post-operative infections) affecting
7 men. No men experienced significant wound dehiscence. 90.4% of men were
fully healed at 4 weeks of follow-up and all were highly satisfied.
CONCLUSIONS: Use of topical anaesthesia obviates the need for injectable
anesthetic and makes the Unicirc procedure nearly painless. Unicirc is
rapid, easy to learn, heals by primary intention with excellent cosmetic
results, obviates the need for a return visit for device removal, and is
potentially cheaper and safer than other methods. Use of this method will
greatly facilitate scale-up of mass circumcision programs.
TRIAL REGISTRATION: ClinicalTrials.gov NCT02091726.
Free Open Access Article
5. Abstract: Several issues on the epidemiology of Zika virus disease
Free Full Text in the original Chinese. The Google translation is very
readable http://zhlxbxzz.yiigle.com/CN112338201604/889132.htm?locale=zh_CN
Zhonghua Liu Xing Bing Xue Za Zhi. 2016 Apr 10;37(4):450-4.
[Several issues on the epidemiology of Zika virus disease].
[Article in Chinese]
Lu GY1, Su YY2, Wang N3.
1Department of Intensive Medicine, The First Affiliated Hospital of Xiamen
University, Xiamen 361003, China.
2The State Key Laboratory of Molecular Vaccinology and Molecular
Diagnostics, National Institute of Diagnostics and Vaccine Development in
Infectious Diseases, School of Public Health, Xiamen University, Xiamen
361102, China.
3National Center for AIDS/STD Control and Prevention, Chinese Center for
Disease Control and Prevention, Beijing 102206, China.
Zika virus belongs to Aedes mosquito-borne flavivirus. In response to the
current cluster of congenital malformations (microcephaly) and other
neurological complications (Guillain-Barré Syndrome) that could be linked
to Zika virus infection, WHO declares that Zika virus is of global public
health importance. Data sources were from peer review articles and WHO
documents. The sources of Zika virus infection would include patients,
people with asymptomatic infections and primates.
The infectious period of Zika virus remains unclear. However, according to
the period that RNA of Zika virus can be positively detected in blood,
saliva, urine or semen, we can presume that the communicable period may
last for 2 months or even longer. Zika virus is primarily transmitted to
humans by infected Aedes spp. mosquitoes. Presumptive vertical, blood or
sexual routes of transmission have been reported. More evidence indicated
the existence of a cause-effect relationship between Zika virus infection
and congenital microcephaly/Guillain-Barre syndrome.
Strategies include successful control the amount of mosquitoes and
minimize the contacts between mosquitoes and human beings could
effectively prevent the Zika virus transmission. Other preventive measures
as cutting off vertical, blood or sexual routes of transmission should
also be adopted.
The epidemiology of Zika virus remains uncertain which calls for further
Free Full Text in the original Chinese. The Google translation is very
readable http://zhlxbxzz.yiigle.com/CN112338201604/889132.htm?locale=zh_CN
6. Abstract: Evidence and recommendations for use of intra-articular
injections for knee osteoarthritis
Ann Phys Rehabil Med. 2016 Apr 18. pii: S1877-0657(16)30007-0.
Evidence and recommendations for use of intra-articular injections for
knee osteoarthritis.
Nguyen C1, Lefèvre-Colau MM2, Poiraudeau S2, Rannou F3.
1Université Paris Descartes, PRES Sorbonne Paris Cité, Service de
Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies
du Rachis, Hôpital Cochin, Assistance Publique – Hôpitaux de Paris, Paris,
France; Université Paris Descartes, PRES Sorbonne Paris Cité, Laboratoire
de Pharmacologie, Toxicologie et Signalisation Cellulaire, INSERM UMR-S
1124, UFR Biomédicale des Saints Pères, Paris, France. Electronic address:
2Université Paris Descartes, PRES Sorbonne Paris Cité, Service de
Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies
du Rachis, Hôpital Cochin, Assistance Publique – Hôpitaux de Paris, Paris,
France; Université Paris Descartes, PRES Sorbonne Paris Cité, INSERM UMR-S
1153 et Institut Fédératif de Recherche sur le Handicap, Paris, France.
3Université Paris Descartes, PRES Sorbonne Paris Cité, Service de
Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies
du Rachis, Hôpital Cochin, Assistance Publique – Hôpitaux de Paris, Paris,
France; Université Paris Descartes, PRES Sorbonne Paris Cité, Laboratoire
de Pharmacologie, Toxicologie et Signalisation Cellulaire, INSERM UMR-S
1124, UFR Biomédicale des Saints Pères, Paris, France.
Pharmacological treatments are widely recommended in international
guidelines for management of osteoarthritis (OA). However, the use of
intra-articular (IA) therapies of diverse active drugs remains
We critically reviewed studies of the efficacy and safety of IA injections
of corticosteroids (CS), hyaluronic acid (HA), platelet-rich plasma (PRP),
and botulinum toxin A (BTA) and evidence-based international
recommendations for their use in treating knee OA. The process of article
selection was unsystematic. Articles were selected on the basis of
authors' expertise, self-knowledge, and reflective practice. Only studies
assessing knee OA were included.
IA CS and HA injections were conditionally to fully recommended for
treating knee OA. No recommendations have been formulated for IA PRP or
BTA. The evidence remains inconsistent and controversial for the use of IA
therapies for knee OA.
The characteristics of and selection criteria for the OA population that
would likely benefit from these therapies need to be identified.
Accurately phenotyping and selecting patients is mandatory in future
randomized controlled trials. Therefore, efficacy and safety meta-analyses
should be performed, as should qualitative and sensitivity analyses of
published trial results.
Copyright © 2016 Elsevier Masson SAS. All rights reserved.
KEYWORDS: Botulinum toxin A; Corticosteroids; Evidence-based medicine;
Hyaluronic acid; Intra-articular injections; Osteoarthritis; Platelet-rich
7. Abstract: Variability in syringe components and its impact on
functionality of delivery systems
PDA J Pharm Sci Technol. 2011 Sep-Oct;65(5):468-80.
Variability in syringe components and its impact on functionality of
delivery systems.
Rathore N1, Pranay P, Eu B, Ji W, Walls E.
1Drug Product and Device Development, Amgen, Thousand Oaks, CA.
Prefilled syringes and autoinjectors are becoming increasingly common for
parenteral drug administration primarily due to the convenience they offer
to the patients. Successful commercialization of such delivery systems
requires thorough characterization of individual components. Complete
understanding of various sources of variability and their ranking is
essential for robust device design.
In this work, we studied the impact of variability in various primary
container and device components on the delivery forces associated with
syringe injection.
More specifically, the effects of barrel size, needle size, autoinjector
spring force, and frictional forces have been evaluated. An analytical
model based on underlying physics is developed that can be used to fully
characterize the design space for a product delivery system.
LAY ABSTRACT: Use of prefilled syringes (syringes prefilled with active
drug) is becoming increasingly common for injectable drugs. Compared to
vials, prefilled syringes offer higher dose accuracy and ease of use due
to fewer steps required for dosage.
Convenience to end users can be further enhanced through the use of
prefilled syringes in combination with delivery devices such as
autoinjectors. These devices allow patients to self-administer the drug by
following simple steps such as pressing a button. These autoinjectors are
often spring-loaded and are designed to keep the needle tip shielded prior
to injection. Because the needle is not visible to the user, such
autoinjectors are perceived to be less invasive than syringes and help the
patient overcome the hesitation associated with self-administration.
In order to successfully develop and market such delivery devices, we need
to perform an in-depth analysis of the components that come into play
during the activation of the device and dose delivery. Typically, an
autoinjector is activated by the press of a button that releases a
compressed spring; the spring relaxes and provides the driving force to
push the drug out of the syringe and into the site of administration.
Complete understanding of the spring force, syringe barrel dimensions,
needle size, and drug product properties is essential for robust device
design. It is equally important to estimate the extent of variability that
exists in these components and the resulting impact it could have on the
performance of the device.
In this work, we studied the impact of variability in syringe and device
components on the delivery forces associated with syringe injection. More
specifically, the effect of barrel size, needle size, autoinjector spring
force, and frictional forces has been evaluated.
An analytical model based on underlying physics is developed that can be
used to predict the functionality of the autoinjector.
8. Abstract: Particulate matter in injectable drug products
Full Free Text http://journal.pda.org/content/67/3/186.long
PDA J Pharm Sci Technol. 2013 May-Jun;67(3):186-200.
Particulate matter in injectable drug products.
Langille SE1.
1Office of Pharmaceutical Science Center for Drug Evaluation and Research
Food and Drug Administration 10903 New Hampshire Ave, Bldg. 51, Rm. 4158
Silver Spring, MD 20993.
Clinicians have had concerns about particulate matter contamination of
injectable drug products since the development of the earliest intravenous
therapeutics. All parenteral products contain particulate matter, and
particulate matter contamination still has the potential to cause harm to
With tens of millions of doses of injectable drug products administered in
the United States each year, it is critical to understand the types and
sources of particulate matter that contaminate injectable drug products,
the possible effects of injected particulate matter on patients, and the
current state of regulations and standards related to particulate matter
in injectable drug products.
Today, the goal of manufacturers, regulators, and standards-setting
organizations should be to continue to minimize the risk of particle-
induced sequelae, especially in high-risk patients, without trading
unnecessary manufacturing burden for minimal safety gains.
LAY ABSTRACT: All injectable drug products are contaminated with some
level of solid particulate matter, including, for example, fibers, dust,
rubber, and silicone. These materials enter drug products primarily during
the manufacturing process.
The possible effects on patients of injectable drug products containing
particulate matter depend on a number of factors. However, given the large
number of patients receiving injectable drug products each year in the
United States and the potential for particulate matter to cause harm to
patients, it is critical to continue to minimize particulate matter
contamination in injectable drug products.
Manufacturing standards and regulations have helped improve manufacturing
quality. Nevertheless, manufacturers, regulators, and standards-setting
organizations must continue to work toward improving manufacturing quality
and minimizing the risk of harm from particle contamination, especially in
high-risk patients.
KEYWORDS: Current good manufacturing practice (cGMP); Injectable;
Parenteral; Particulate matter; Pharmaceutical quality
9. Abstract: A Biopharmaceutical Industry Perspective on the Control of
Visible Particles in Biotechnology Derived Injectable Drug Products
PDA J Pharm Sci Technol. 2016 Apr 18. pii: pdajpst.2015.006189.
A Biopharmaceutical Industry Perspective on the Control of Visible
Particles in Biotechnology Derived Injectable Drug Products.
Mathonet S1, Mahler HC2, Esswein ST3, Mazaheri M4, Cash PW4, Wuchner K5,
Kallmeyer G6, Das T7, Finkler C6, Lennard A8.
1Sanofi; firstname.lastname@example.com.
5Janssen R&D;
6La Roche Ltd;
7Bristol Myers Squibb;
The EP and Unite[d] States Pharmacopeial (USP) monographs for Parenteral
Preparations require drug products for parenteral administration to be
"practically free" or "essentially free" of visible particles,
respectively. Both terms can be considered and have been used
interchangeably. These definitions acknowledge the probabilistic nature of
visual particle inspection.
The EP monograph 2031, Monoclonal Antibodies for Human Use', as revised in
2011 set the following expectations and requirements for visible particles
in monoclonal antibody drug products, as noted below in excerpts from
different sections in the monograph: Definition: Examined under suitable
conditions of visibility, they are practically free from particles.
Production: As part of the in-process control each container (vial,
syringe or ampoule) is inspected after filling to eliminate containers
that contain visible particles. During development of the product it must
be demonstrated that either the process will not generate visible
proteinaceous particles in the final lot or such particles are reduced to
a low level as justified and authorised.
Tests-Appearance: They are without visible particles, unless otherwise
justified and authorised. The question remains unresolved for a clear
meaning of the term "without visible particles" that may lead to
differences in understanding between industry and agencies. Is this term
intended to mean "zero particles" or is there any intention to distinguish
between particle type such as: 'zero extraneous visible particles' or
'zero proteinaceous particles'? Furthermore, how can 'zero' particles as a
criterion for release testing be reconciled with "practically free from
particles" as stated in the definition and a low, justified level of
particles after production? PHARMEUROPA Vol. 23, No. 3, July 2011 provided
explanatory notes and summary of changes to the monograph 2031 to be
published in Supplement 7.3. The merit of the 2011 monoclonal antibody
monograph revision was that EP experts acknowledged that protein products
may also contain proteinaceous particles at release or that protein
particles may form during storage. Indeed, industry experience has
demonstrated that therapeutic proteins such as monoclonal antibodies can
exhibit a propensity for self-association leading to the formation of
aggregates that range in size from nanometres (oligomers) to microns
(subvisible and visible particles). As a result, the requirement for Drug
Product appearance for monoclonal antibodies was changed from "Without
Visible Particles" to "Without Visible Particles unless otherwise
authorised or justified". It was stated in the explanatory notes that: –
Without Visible particles was intentionally kept to give clear guidance
that the presence of visible particles is unwanted and the appropriate
formulation studies should be performed during development to find an
optimal formulation. – practically free could not be a pass/fail criteria
in a test and that – visual inspection is not a quality control test, even
though performed at the end of the production. As a result of the
probabilistic nature of detecting particles by visual inspection method,
without (zero) visible particles is an unrealistic requirement for QC
release/shelf life testing of any parenteral product and especially those
of biotechnological origin. Even with significant formulation and
container development, supported by long term stability studies and stress
stability studies (e.g. agitation) the probability of a visible particle
being present cannot be completely eliminated. Interestingly, a
requirement of without (zero) visible particles is not aligned with the
small molecule parenterals which states "essentially/practically free" of
visible particles.
In our view, "ractically free from particles" should be considered a
suitable acceptance criterion for injectable biotech and small-molecule
products, as long as appropriately defined. Furthermore, we argue that
visual inspection is a suitable QC release test and that "practically free
from particles" is a suitable specification when adequately described. The
purpose of this position paper is to review best practices in the industry
in terms of visual inspection process and associated operator training, QC
sampling, testing and setting acceptance criteria corresponding to
"practically free of visible particles" and providing considerations when
visible proteinaceous particles are deemed unavoidable. It also provides a
brief overview of visible particle characterization, and perspectives on
patient safety. This position paper applies to biotechnology derived drug
products including monoclonal antibodies in late phase development to
licensed products.
Copyright © 2016, Parenteral Drug Association.
KEYWORDS: 100% inspection; Lyophilized; QC sampling; particle
identification; proteinaceous particles; visible particles
10. Abstract: Ethanol-based handrubs: Safe for patients and health care
Am J Infect Control. 2016 Apr 15. pii: S0196-6553(16)00167-X.
Ethanol-based handrubs: Safe for patients and health care workers.
Pires D1, Bellissimo-Rodrigues F2, Pittet D3.
1Infection Control Programme and World Health Organization (WHO)
Collaborating Centre on Patient Safety, Infection Control & Improving
Practices, University of Geneva Hospitals and Faculty of Medicine, Geneva,
Switzerland; Department of Infectious Diseases, Centro Hospitalar Lisboa
Norte and Faculdade de Medicina da Universidade de Lisboa, Lisbon,
2Infection Control Programme and World Health Organization (WHO)
Collaborating Centre on Patient Safety, Infection Control & Improving
Practices, University of Geneva Hospitals and Faculty of Medicine, Geneva,
Switzerland; Social Medicine Department, Ribeirão Preto Medical School,
University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
3Infection Control Programme and World Health Organization (WHO)
Collaborating Centre on Patient Safety, Infection Control & Improving
Practices, University of Geneva Hospitals and Faculty of Medicine, Geneva,
Switzerland. Electronic address: email@example.com.
This issue of the American Journal of Infection Control presents a timely
and interesting article addressing the relative importance of alcohol
absorption by health care workers (HCWs) using ethanol-based handrubs
(EBHRs) for hand hygiene during patient care.1 Importantly, this is the
first study performed in a real-life setting. The objective of the study
was to investigate the kinetics of urinary ethanol and one of its
metabolites during clinical work by HCWs in a teaching hospital in Germany
where EBHR is the mainstay of hand hygiene.
11. No Abstract: Access to needle and syringe programs by people who
inject image and performance enhancing drugs
Int J Drug Policy. 2016 Feb 1. pii: S0955-3959(16)00039-6.
Access to needle and syringe programs by people who inject image and
performance enhancing drugs.
Iversen J1, Hope VD2, McVeigh J3.
1Viral Hepatitis Epidemiology and Prevention Program, The Kirby Institute,
UNSW Australia, Sydney, Australia. Electronic address:
2Public Health England, Colindale Avenue, London, United Kingdom; Centre
for Research on Drugs and Health Behaviour, London School of Hygiene &
Tropical Medicine, United Kingdom.
3Centre for Public Health, Liverpool John Moores University, Liverpool,
United Kingdom.
12. News
– UK: What to do if you discover dirty needles after school run mum found
– Libya: 10 people infected in Hepatitis C outbreak in east Libya
– USA: Child Finds Used Syringe, Family Faces Threat of Disease
Selected news items reprinted under the fair use doctrine of international
copyright law: http://www4.law.cornell.edu/uscode/17/107.html
UK: What to do if you discover dirty needles after school run mum found
By Catherine Phillips, Worcester News, UK (26.04.16)
DIRTY needles should not be touched warn police after several syringes
were discovered by a school run mum.
Instead, Cathedral Safer Neighbourhood Team (SNT) has advised people to
place something on top of the needles such as a traffic cone or box then
contact the city council immediately.
They issued the advice after Michelle Barnes, from Conway, Tolladine,
found several used needles along the path on Midland Road, Worcester.
The horrified mum-of-four was walking her six-year-old daughter Leola to
Stanley Road Primary School when she found the needles which she believes
had fallen from behind a billboard.
The 37-year-old contacted the Worcester News to warn other parents.
She said: "I don't judge anybody but when it comes down to people's safety
it's a different story.
"Children like to be adventurous and some climb up on the mud, they like
investigating but they don't see the risks involved."
A spokesman for the area's safer neighbourhood team said: "[We are]
committed to tackling the issue of drugs in the area and will continue to
work with our partner agencies to do so.
"If you discover any discarded needles or similar items, do not touch them
unless there is an immediate danger to you or other residents.
"If there is something to hand that you can place on top of it to stop
others from getting to it, for example a cone or a box, then please do
They added that discarded needles could be reported to the council at the
Worcestershire Hub on 01905 722233 or online at worcester.gov.uk/report-
Libya: 10 people infected in Hepatitis C outbreak in east Libya
The Libya Observer, Tripoli Libya (20.04.16)
Al-Marj Teaching Hospital in east Libya declared Tuesday a state of
emergency following the outbreak of Hepatitis C virus at the hospital's
Hemodialysis Department, sources say.
The parallel LANA News Agency of the eastern government of Abdullah Al-
Thanni said 10 patients have been infected with Hepatitis C, but the real
reasons of the outbreak are still unclear.
The hospital's administration said the reason was due to lack of resources
and medical staff.
The news agency added that the discovery of the contagious liver disease
was based on rapid blood tests and that samples have been sent to
authorized labs outside the hospital for confirmation.
Al-Marj is a town some 94 km to the east of Benghazi.
USA: Child Finds Used Syringe, Family Faces Threat of Disease
By Michael Kitch, Laconia Daily Sun, New Hampshire USA (15.04.16)
LACONIA — With a child's discovery of a discarded hypodermic needle, a
local family recently found themselves threatened by the scourge of
addiction, which through no doing of their own has cast a shadow over
their lives.
A father, who wished to remain anonymous, said that he his 7-year-old
daughter was playing in the family's fenced backyard where she found a
discarded hypodermic needle in the vegetable garden. The needle had been
tossed over the 7-foot-high fence. The girl, who enjoys collecting things,
took the needle to her clubhouse and played with it for three days before
her parents discovered it.
"We were very concerned," said the father, who was aware that blood from a
used needle may carry disease, especially the AIDS virus, HIV, and viral
hepatitis, particularly hepatitis C, or HCV. The Centers for Disease
Control estimates that about eight of 10 addicts infected with HIV are
also infected with HCV.
The father said that he took his daughter to the emergency department at
Lakes Region General Hospital at once and called the Laconia Police
Department to collect the needle.
"She was very scared," he recalled, "and I probably scared her even more."
He said that the staff at the emergency room drew blood from his daughter
as well as also tested residue in the syringe and the needle.The tests, he
said, indicated "the odds were in her favor and her chances of being
infected were remote." He said that the "the staff at the hospital went
out of their way to make us feel comfortable. They were terrific." The
family also contacted their primary care physician, who after consulting
with a number of other doctors, reached the same conclusion.
The father said that his daughter will undergo regular blood tests over
the course of a year, but for the moment — and hopefully forever — will be
spared intensive treatment on the recommendation of the physicians.
Nevertheless, he said that the incident "has affected our lives greatly
and will continue to do so." There remains, he said, "the possibility she
may have contracted HIV or hepatitis C, and the chance she will need an
intensive, 30-day treatment that will wreak havoc on her body."
The short-term side effects of the medications used to treat HIV include
anemia, diarrhea, dizziness, fatigue, headaches, nausea, vomiting, pain
and rashes. There are also long-term side effects of these medications.
They may cause body fat to be redistributed from the face and limbs to the
abdomen, and abnormal levels of blood sugar that can lead to diabetes.
Cholesterol and triglyceride levels may rise. Likewise, lactate, a waste
product in the body, may increase, causing problems ranging from muscle
aches to liver failure.
The father said that the ordeal "also slams it in our faces that this
problem doesn't just affect those held in the grip of drug abuse. It also
affects a completely innocent 7-year-old and her innocent family."
He urged those injecting drugs not to leave their needles where a child
can find it. "I can't think of anything more selfish, abhorrent or wrong."
At the same time, he asked parents to warn their children against touching
and handling discarded needles.
"Parents need to teach their children," he said. "Bad things can happen."
Police Chief Chris Adams said that anyone who finds a needle should
immediately report it to the police, either by dialing 911 or calling the
station at 524-5257.
"Do not touch it," he stressed.
He explained that officers are equipped and prepared to handle discarded
needles safely and have secure containers where they can be kept before
being disposed of at the hospital. He said that the department is working
with the school to alert children and adolescents of the risks of handling
discarded needles.
"Don't touch them," he repeated. "Call us and let us deal with them."
04-16 needles
This bundle of needles was found on a beach in Laconia recently. One child
in Laconia found a used needle when it was apparently tossed into the
family's back yard over a tall fence. (Courtesy photo/Laconia Police
New WHO Injection Safety Guidelines
WHO is urging countries to transition, by 2020, to the exclusive use of
the new "smart" syringes, except in a few circumstances in which a syringe
that blocks after a single use would interfere with the procedure.
The new guideline is:
WHO Guideline on the use of Safety-Engineered Syringes for Intramuscular,
Intradermal and Subcutaneous Injections in Health Care
It is available for free download or viewing at this link:
PDF Requires Adobe Acrobat Reader [620 KB]
Making all injections safe brochure
This is an illustrated summary brochure for the general public.
pdf, 554kb [6 pages]
SIGN Meeting 2015
The Safe Injection Global Network SIGN meeting was held on 23-24 February
2015 at WHO Headquarters in Geneva Switzerland
The main topic of the meeting was the new injection safety policy
recommendation and developing the appropriate strategies for
implementation in countries worldwide.
A report of the meeting will be posted ASAP
* SAFETY OF INJECTIONS brief yourself at: www.injectionsafety.org
A fact sheet on injection safety is available at:
* Visit the WHO injection safety website and the SIGN Alliance Secretariat
at: http://www.who.int/injection_safety/en/
* Download the WHO Best Practices for Injections and Related Procedures
Toolkit March 2010 [pdf 2.47Mb]:
Use the Toolbox at: http://www.who.int/injection_safety/toolbox/en/
Get SIGN files on the web at: http://signpostonline.info/signfiles-2
get SIGNpost archives at: http://signpostonline.info/archives-by-year
Like on Facebook: http://facebook.com/SIGN.Moderator
The SIGN Secretariat, the Department of Health Systems Policies and
Workforce, WHO, Avenue Appia 20, CH-1211 Geneva 27, Switzerland.
Facsimile: +41 22 791 4836 E- mail: email@example.com
All members of the SIGN Forum are invited to submit messages, comment on
any posting, or to use the forum to request technical information in
relation to injection safety.
The comments made in this forum are the sole responsibility of the writers
and does not in any way mean that they are endorsed by any of the
organizations and agencies to which the authors may belong.
Use of trade names and commercial sources is for identification only and
does not imply endorsement.
The SIGN Forum welcomes new subscribers who are involved in injection
* Subscribe or un-subscribe by email to: email@example.com, or to
The SIGNpost Website is http://SIGNpostOnline.info
The SIGNpost website provides an archive of all SIGNposts, meeting
reports, field reports, documents, images such as photographs, posters,
signs and symbols, and video.
We would like your help in building this archive. Please send your old
reports, studies, articles, photographs, tools, and resources for posting.
Email mailto:email@example.com
The SIGN Internet Forum was established at the initiative of the World
Health Organization's Department of Essential Health Technologies.
The SIGN Secretariat home is the Service Delivery and Safety (SDS)
Health Systems and Innovation (HIS) at WHO HQ, Geneva Switzerland.
The SIGN Forum is moderated by Allan Bass and is hosted on the University
of Queensland computer network. http://www.uq.edu.au


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Home > Bridal Dress Categories > Alternative Wedding Dresses
ALTERNATIVE WEDDING dresses
A distinctive collection of stunning wedding dresses, each a little different....
View other bridal dress categories
More about Alternative Wedding Dresses
This is a collection of some of Angelina's most distinctive bridal gowns. Drawn together by their unique and different style, these dresses allow you to truly express yourself and make a bold statement whilst still retaining breath taking elegance and glamour. Through the use of colour, dramatic styling and vintage Hollywood glamour, these dresses stand apart and have a character all their own.
Isadora is a bold and iconic dress from Angelina's collection. A sophisticated claret velvet gown that captures all the glamour of the silver screen. The concealed corsetry flatters and supports to give an hour glass silhouette complete with a fish tail train. The deep and delicious claret velvet draped across the body and neckline adds a sensuous touch to a distinctive dress.
A completely different look can be acquired with a two piece, beautifully illustrated by Julienne. With a gentle nod to the decadence of the mid nineteenth century, this bodice is a work of art. Skilfully embellished and embroidered, the crinoline style bodice sits perfectly over the slim line oyster silk crepe satin skirt. The bias cut skirt hugs the figure and reveals a soft train. Unforgettable and bespoke, this duet of textures is an elegant choice for an alternative bride.
A dramatic entrance can be almost guaranteed with Venezia, bringing to life themood and majesty of the Carnevale di Venezia. Contrasting fabrics and textures using silk duchesse satin, metallic silk organza and a crystal beaded neckline create a unique dress for a dramatic entrance.
These are just a few of Angelina's alternative wedding dress designs. We have created many incredible dresses which stand out in their elegance and drama, colour and style.

subset: commoncrawl


text:
19 March 2008
2 comments:
- Tim Hussin March 19, 2008 at 4:10 PM
I'm so majestic.
- Anonymous March 20, 2008 at 8:23 AM
Hello. This post is likeable, and your blog is very interesting, congratulations :-). I will add in my blogroll =). If possible gives a last there on my blog, it is about the TV de Plasma, I hope you enjoy. The address is http://tv-de-plasma.blogspot.com. A hug.
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When Joakim Noah was ejected during Game 2 of the Heat series in Miami, he was greeted by the middle finger of a now-infamous Heat fan, a woman identified as Filomena Tobias, whose colorful back story was widely circulated afterward. However, few people commented on the statement given by Tobias' daughter Victoria Racanati, who told the Sun-Sentinel in Fort Lauderdale that her mother is a Heat season ticket holder who attends every game.
A crazy Heat fan who flips off players? That won't surprise Bulls fan and seven-year Miami resident Robbie Karver, 29, who gave RedEye the breakdown on the three kinds of Heat fans.


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The RRCS is a signature advocacy initiative by the Malaysian AIDS Council that aims to increase our appeal to wider audience through celebrity endorsement. The programme was conceived in 2009 to complement our previous National Strategic Plan, whereby we plan to advocate for the creation of supportive environment to address the issue on AIDS-related stigma and discrimination.
Representing the diverse ethnic backgrounds that reflects the spirit of unity of this country, these celebrities are also considered leaders by their peers in their respective fields of music, film & television and other alternative media.
Their involvement is purely on voluntary basis and they have pledged to give their full commitment to the cause in their free time.
Coming soon! 20 April 2012 - Official Launch of 2012/2013 Red Ribbon Celebrity Support Programme (RRCS)


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Capri Blue- 9oz Circle Candle
Capri Blue- 9oz Circle Candle
We absolutely love these Capri Blue candles made from our sweet friends in Mississippi. The mercury base with wooden top are perfection. We have 2 scents available: Blue Jean and Volcano. 8 oz. Size 4 X 3.25. Burn time 40 hours.
Add To Cart


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The importance of business credit continues to increase as more and more banks are using business credit scores to determine the creditworthiness of business owners. For the last 30+ years, the Fair Isaac Corporation has been developing a business credit scoring model called the "Liquid Credit Small Business Credit Scores." This model is currently being used to determine the creditworthiness of business owners applying for SBA loans under $350,000.
The SBA loan program has dispersed over $30 billion in loans each year to small business owners over the last 3 years. That amount alone should serve as an example of how many applicants will be impacted by the new scoring model. If you plan on applying for an SBA loan under $350,000, it would be wise to have a clear understanding of how to build business credit and how it will affect your ability to get approved.
Understanding How to Build Business Credit – Try Vendor Trade Lines
Your business credit is just as important as your personal credit when it comes to being eligible for an SBA loan under $350,000. This is because with the new scoring model, your personal and business credit scores will be combined to come up with your "Liquid Credit Small Business Credit Score." You will need a score of at least 140 to qualify for SBA loans under $350,000. Since the SBA is using a scoring model that combines your business credit with your personal to come up with a cumulative score, it is imperative that you fully understand how to build business credit.
In my experience, the best way to start building business credit is to establish vendor trade lines that report to Dun & Bradstreet and obtain unsecured business lines of credit that report to Experian Business. Vendor trade lines are lines of credit issued to business owners by companies like Best Buy, Office Depot and Quill. These companies issue trade lines to business owners who may need to purchase office supplies and equipment for their business.
Verify that Vendors Report Your Usage
The vendor providing you with the trade line typically reports your trade line usage to the business credit bureau, Dun & Bradstreet. However, it's always important to ask a vendor if they will report your trade line usage to at least one of the business credit bureaus (FYI: there are three business credit bureaus– Experian Business, Equifax Commercial and Dun & Bradstreet). Vendors who do not report your trade line usage to any of the business credit bureaus will not help you build a business credit history (this is why it's important to ask the vendor).
Unsecured Business Lines of Credit May Help You Build Business Credit
Unsecured business lines of credit are "cash" lines of credit that can be used anywhere for any business purpose. You are not limited in where you use them since they are not issued by a specific vendor (like Office Depot), rather a bank like Bank of America or Chase. Not many lenders report your unsecured business line of credit usage to the business credit bureaus however there are some that do.
The banks that do typically report unsecured business line of credit usage, use Experian Business only. Therefore if you plan on applying for an unsecured business line of credit, you should definitely ask the lender if your usage will be reported to the business credit bureaus. Lenders like Capital One typically report your unsecured business line of credit usage to your personal credit history (not all lenders do this), so asking beforehand is critical if you want to build a business credit history and score.
Start Building Business Credit Today – LenCred Can Help!
If you are convinced that building business credit can be beneficial to you in your ability to secure small business financing, I suggest you contact the Funding Advisors at LenCred to learn more. Not only can they help you obtain unsecured business lines of credit, they can also help you obtain vendor trade lines, both critical components in building a credit history that will help you qualify for SBA loans under $350,000.


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LJ Cat jpeg ratio value invalid!
p>The dog welcomes me home from work and tells me about her busy day…/p> p>a href="http://presence.irev.net/gallery/daily/aav">img src="http://presence.irev.net/albums/daily/aav.thumb.jpg">/a> /p> p>This is my dog's poker face./p>
One Response to "LJ Cat jpeg ratio value invalid!"
Yea, that is some poker face. If you can, send us a picture of this. John wants to submit it to the Register for their best dog contest.


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Where We Lived Before Birth
|Premortal Existence
Before we were born we lived as spirits in a place called the Premortal Existence (or heaven) with our Heavenly Father, who is God. God presented to us his Plan of Salvation, a Savior was chosen, and Satan rebelled.
Additional Plan of Salvation Resources
Definition of Plan of Salvation
A definition of the term Plan of Salvation including alternate names for God's plan.
|Poll: Do you believe we lived before birth?
What do you believe? Share your thoughts with us in this poll!
|God's Plan of Salvation Visual Map
At any time during this course you can visit the Plan of Salvation map to see a visual display of each part of God's plan. There are two different charts that might help you better understand the visual layout of God's Plan. You can also visit this page if you would like to read any of the lessons in advance.
|God's Plan of Salvation or Redemption
When you're finished reading these articles you might also like to visit this site to read several scriptures about each aspect of God's plan.
I'm a gal that lives in Chandler Arizona, just transplanted from South Portland Maine. I love to share funny things that I find. I also enjoy writing some "Personal Stores".
Monday, March 14, 2011
God's Plan of Salvation:: Lesson 1: Premortal Existence 3/14/11
Posted by Shonii Mitchell at Monday, March 14, 2011
Labels: About Latter-day Saints, Rachel Bruner
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New Shades of Bare Escentuals Ready Eyeshadow 2.0 and Bare Escentuals Ready Eyeshadow 4.0 for Spring/Summer 2012
Are you ready for more? More Bare Escentuals Ready Eyeshadow 2.0 and Bare Escentuals Ready Eyeshadow 4.0 launch again this Spring/Summer 2012 with new exciting shades to choose from.
So I ask again, ready for more?
More variety, more color, more to get excited about.
Coming this may there will be seven new shades of Bare Escentuals Ready Eyeshadow 2.0 Duos and two Bare Escentuals Ready Eyeshadow 4.0 Quads.
Some of these shades may be familiar to the QVC junkies out there as they have been released in auto delivery sets but are will now be available nation wide this May.
Bare Escentuals 2.0 Eyeshadow
New Shades:
- The Phenomenon (Golden Iris + Azure Iris)
- The Cliff Hanger (Suspense + Awe)
- The 15 Minutes (Page Six + Most Requested)
- The Alter Ego (Wicked + Daring)
- The Last Call (On the Rocks + Shaken Not Stirred)
- The Hidden Agenda (Stealth + Undercover)
- The Winner Is…. (Chart Topper + Hit Single)
(The Alter Ego)
(The Hidden Agenda)
(The 15 Minutes)
(The Phenomenon)
(The Cliff Hanger)
(The Last Call)
Bare Minerals Ready Eyeshadow 4.0
New Shades:
- The A List (Ice Breaker, Fashionably Late, Swanky, Black Tie Optional)
- The Soundtrack (Rhythm, Remix, Louder, Speaker Box)
(The Soundtrack)
So whats your pleasure?
Any shades you are in love with?
Gotta admit 15 Minutes has my heart.
Dontcha appreciate the fact that Bare Escentuals names the palettes as well as each shade inside? So thoughtful!
I'll have swatches of these and a mini review shortly.
Keep your eyes on www.bareescentuals.com and they'll be launching soon!
P.S. What's on your book list at the moment? I had to stop reading Fifty Shades, it was emotionally draining after I completed Book 2. I needed a break, perhaps a vacation, maybe a hot shower to wash away all that dirty ha…Phew!
I decided to sit down to Beautiful Disaster last night. I really like Jamie's stuff. You might remember a post I did about Providence last year which she also wrote. I fear I went from the frier into the frying pan though as Beautiful Disaster is almost as draining as Fifty's insanity. What is it with these crazy emo heroes?
Note to self, stop reading these trippendicular YA novels.
In other news….
Game of Thrones went graphic, which kinda has me on the meh side of the fence. Not sure I want to get involved with the story in a graphic novel format. It's already draining enough to read the series as is.
Do share your current reads.
P.S. No GoT spoilers, I didn't watch Season 2's first eppy yet. I'm still trying to finish up Spartacus before starting GoT. Cut me a break if Joffrey aka McSmirk got bitch slapped in the first eppy, I don't want the element of surprise ruined, dig?


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CareMore Health System
January 11, 2018
At long last, the Office of the National Coordinator for Health IT has named a new chief privacy officer. The post has been vacant since Deven McGraw left the acting chief privacy officer post in October, and some in the industry speculated the Trump administration would not fill the post at all. Instead, Kathryn Marchesini, the agency's Senior Advisor and Deputy Director for Privacy, is being...
August 17, 2016
IBM Watson Health announced that its Watson for Oncology program, trained at Memorial Sloan Kettering Hospital, will be rolled out to 21 hospitals throughout China. The initial 21-hospital introduction is the beginning of a multi-year partnership through which IBM's Chinese partner Hangzhou CognitiveCare will introduce Watson for Oncology to hospitals across China. More. CareMore Health System ...
April 11, 2016
Anthem's CareMore Health System announced that its president, Leeba Lessin, will retire this week after working at CareMore since 2006. CareMore Chief Medical Officer and Chief Operating Officer Sachin Jain will take over as the new CEO. "With Dr. Jain in place, I know we have leadership and energy to lead us into the next era," Lessin said in a statement. "Given CareMore's focus on clinical...
Editor's Pick
March 18, 2016
February 26, 2016
February 26, 2016
February 23, 2016
March 18, 2016
March 08, 2016


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Bridgehead IT uses a stepwise process to help your organization realize the long-term gains of I.T. Service Management. We don't just prescribe products and services. Our collaborative advisors, from the tacticians to the technicians, continually evaluate your business environment and progress to ensure the best possible path is taken with consideration to your timeline and budget. The result is a transformation experience that is low risk, high reward and devoid of confusion, exhaustion, and false starts.
Contact Us


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San Francisco Day of Evangelism 2007
Click on links for photos.
Rob Wertheim, leader of our San Francisco branch, planned the outreach for All Star Week, which included the headquarters Day of Evangelism.
Susan Perlman: bright colors and a big smile helped get the message across
A couple from Texas ask how they can witness to Jewish friends.
Michael Chadwick, part of the new Liberated Wailing Wall in training, responds to a cab driver's request for a broadside.
This bicyclist stopped to take a tract
Dave Garrett, one of our most avid baseball fans bringing the good news of Jesus right across the street from the stadium.
Sara Herr and Matt Friedman broadsiding along the parade route one month before their wedding!
Baseball hero Barry Bonds and his family were part of the parade.
This guy is not part of our staff but some of us wondered if people would take tracts from a walking hot dog for Jesus.


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I would have loved to have been the "fly on the wall" the day some product marketing geniuses burst through the conference room (or lab) door and exclaimed that they had discovered the next best thing and it's called cloud computing!
Now a new name has become popular – consumerization of IT. This will soon be shortened to simply "consumerization", much like cloud computing became just "cloud" . Consumerization is currently being defined by the marketing departments and at the various conference circuits i.e. Interop and is reaching critical hype mass.
For CIOs and any member of the IT department or function: think broadly — this is less about giving corporate e-mail access to iPhone users or enabling social media through the firewall than it is about federating a governance model within your organizations.
What is IT governance? The question should simply be what is governance? We need to drop the IT out, as if there is or should be (or ever was) a difference from organizational policy and decision making. While you are at it, put less think time into "controls" directed at the users. Instead, the view needs to be the very system and data models in place and how users, excuse me – "consumers", are exposed to them.
Because your employees have arms and legs, your company's data walks into and out of the building every day and has for decades on laptops, cell phones, thumb drives, USB drives or through the VPN to home machines. While you were controlling things by clamping down on BlackBerrys and auto deleting corporate e-mail when the mail box limits were reached, users were forwarding messages to MobileMe, Google, Dropbox, Hotmail.
Look for a lot of articles, posts, conferences, Gartner and Forrester research, etc. on consumerization. Look for vendor hype to include scare tactics that your data is melting right before your eyes! Of course, new products are on the way.
For CIOs: Don't panic, no knee-jerk is required. Think beyond iPads, iPhones, Android as devices. That gives you the feeling that you can control. Instead, think about the way your business needs to do its business, fundamentally, and work with the business to come up with practical strategies for their consumers.
Bottom line: get to a point where you deeply understand the issues. My bet is that many of you are not there yet. While you are at it, start to become aware of the term "frictionless".


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"Amid many other Census concerns – including the non-arrival of requested paper forms – question 19 in Tuesday night's Census has caused particular community angst," FamilyVoice research officer Ros Phillips said today.
"Until now there has been little controversy. But this year, the religion question (19) – and its implications for the funding of school chaplains and faith-based charities, as well as tax-exempt status for churches – has been the focus of an atheist campaign to manipulate responses."
The religion question is the only one that is not compulsory. It lists six Christian denominations and three non-Christian religions, with spaces for "other". But this year for the first time since "No religion" became an option in 1991, it has been listed at the top – the result of a quiet campaign by the Atheist Foundation of Australia in 2012-13.
"Putting 'no religion' first does not make logical sense," Ros Phillips said. "In questions with multiple choices, the 'none of the above' option is always listed last.
"But the atheists appear to hope that by putting 'No religion' ahead of any other option, they will win the 'donkey vote' – and ultimately force governments to end any subsidy or recognition for the huge amount of public good done by faith-based community organisations.
"They have also mounted an advertising campaign in supermarket car parks and elsewhere, urging people to mark the 'No religion' box.
"The problem is compounded by the fact that many non-denominational Christians mark 'No religion' because they have faith in Christ, but don't belong to a particular denomination. To them, 'religion' means 'denomination'," she said.
Ros Phillips is encouraging Australians with some kind of religious faith or belief to make sure they answer the religion question – by marking one of the six boxes for Christian denominations, or writing "Christian" or their denomination or belief in the spaces provided for the "other" option.
- Christianity and culture
- Government and society
View next article - Preston verdict 'a threat to democratic freedoms'


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As a result of vocation and experience, I spend a great deal of time bridging generations and striving to support leadership and professional development for those just reaching the executive suite and for those just starting out on their career journeys.
It's a fascinating contrast in perspectives.
The more youthful of the two groups stare at today's world of volatility unblinking. It's what they know and what they've grown up with in their short lives. Change, speed, technology, globalization, events that shock the entire economic system .it's familiar ground.
Those with experience still deal with the notion that "this feels really different." In my own case, the global world of business looks nothing like the world I encountered when I was fresh out of college. It does indeed feel different just about every day.
Regardless of perspective there are some critical core skills required to lead successfully in this environment. Leaders and professionals of all ages and experience levels, take heed and invest in cultivating these nine skills required for success in this era:
Nine Key Professional Capabilities Demanded By Our Times:
1. Acting and Leading Authentically. It's more critical than ever to be able to build trust on teams, trust across cultures and trust as a leader, and the best starting point is to be yourself, let people see your strengths and weaknesses and work hard to get to connect with and get to know those you work with and for.
2. Learning to Adjust Your Altitude. Helping your organization successfully navigate through today's minefield of change requires the ability to connect the big picture i.e. the macro forces and emerging patterns in markets and industries to the details of execution inside our organizations. You need to see the forest and the trees.
3. Learning to Leverage Extreme Ambiguity. Unfortunately, ambiguity combines with fear to paralyze teams and individuals and exacerbate problems. Today's leaders must embrace ambiguity as an opportunity to create, not a requirement to hunker down and wait until the smoke clears. It never does.
4. Recognizing the Need to Adapt. It's nice to be the one promoting change and guiding teams into new frontiers. However, change will impact you as well, and your ability to adapt versus retreat is critical for survival and success. Ask anyone who has ever survived and then succeeded following a merger and they will quickly highlight their acceptance of the situation and their focus on adapting to the new role, culture and mission as critical to their success.
5. Paying Attention to Building High Performance Teams. Most of our work takes place on teams and in projects. Your ability to enable and support successful team development is mission critical in this world. There are common conditions surrounding high performance teams, and most of them don't spontaneously generate. As a team leader, you own forming and framing the environment, promoting values, teaching teams to talk, argue and decide. You own feedback, coaching and ensuring proper organizational support. As a team member, you need to approach every assignment as an opportunity to strengthen your network, gain new skills, support your team members and showcase what you can do to help the group achieve.
6. Growing Your Cultural Intelligence (CI). There's a nearly perfect probability that your business will become increasingly intertwined with global suppliers, customers, partners, competitors and team members. Developing CI is an organizational initiative, and one that must be pursued in the planning or early phases of your global outreach. If you are increasingly involved in leading teams with contributors from around the globe, you are absolutely on the spot for advancing your Cultural Intelligence. Your results depend upon it.
7. Learning to Switch Gears from Leading to Following. Strengthening your skills as a follower is as important as strengthening your skills as a leader. As functional and national boundaries dissolve or at least shrink, your ability to move seamlessly from leader of one initiative to committed follower for another is critical to your success. And your efforts here set an outstanding example for those around you.
8. Recognizing the Need to Grow Your Power. Those with power are the ones who get things done inside organizations. The best way to cultivate power is to volunteer for it. Grab the initiatives that need ownership and draw others into those initiatives and suddenly, you are deciding what gets done and who does it. Welcome to power. No need to over-throw the boss or stick knives in backs. Just solve some problems.
9. Cultivating an Innovation Mentality. Gone are the days when innovation was just for engineers. It's an innovation-driven world, and the most compelling innovations are occurring in how we work, communicate, market and make money. If you're leading others, one of your Key Performance Indicators is how innovative your team is. Their innovation is a reflection of your leadership. If you're working as an individual contributor, every team and every project needs great ideas. Learn to take risks and learn to sell hard and then prove your ideas. Build a reputation as an innovative thinker and doer, and the world is yours!
The Bottom-Line for Now:
I've just offered a long list of really difficult things for you to do. Awareness is the first step. Audit yourself against the nine critical skills above and then take action to strengthen the already strong and improve the weak. Seek external feedback from those you trust to provide you the unvarnished truth about yourself. Find a coach. Approach each opportunity with a "Beginner's Mind," and seek to learn through more education or via your own self-education. And most importantly, don't delegate your development and growth to your firm or your boss. Take control. While others choose you for success via promotions and new challenges, you own making their choice an easy one.
Originally published at artpetty.com. Published with permission.
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The Instigator
Pro (for)
0 Points
The Contender
Con (against)
0 Points
You are stupid.
Post Voting Period
The voting period for this debate has ended.
after 0 votes the winner is...
It's a Tie!
|Voting Style:
|Point System:
|7 Point
|2 years ago
|Post Voting Period
|566 times
|Debate No:
Debate Rounds (5)
Comments (9)
Votes (0)
I know this may be the silliest Debate there has ever been on DDO, but I've been very frustrated lately and I can't seem to grasp what you are- A Troll, Autistic, just plain stupid, or a Child. Either of those results would obviously conclude you are a stupid person. And don't come at me with "okay.me=stupid-not.you=stupid-yes" Because that's impossible to understand and has no supporting evidence or logical arguments that prove it. Accept and tell me why you're not an idiot.
my shoe's=black and white
the castle i see=larger then the house besides it
my stupidity is my teacher, and my intelligence is me as the educated student of stupid
I just told you not to do that BS... It's impossible to understand. Why do you make a key for the symbols instead of just writing out the word?
"my stupidity is my teacher" So you admit you're stupid?
Stop using metaphors and quotes. It's not making you look wise- It's making you look like a complete idiot.
That's like me saying, "God is real because he isn't real, and reality is a mistake, so God is real". It makes absolutely no sense. Have you ever tried actually making a good argument, instead of just farting on the keyboard until words come out?
As a human, you're still an idiot. Your intelligence is weaker than the average human's, meaning you are stupid.
Grammar and overall unprofessional behavior says otherwise. I have concluded that you cannot be a Child, since not even them would be this stupid- And if they were, they'd be too young and careless to go on DDO. You can't be an Autistic Man/Child, since they would never care about DDO, and no one can be just plain idiotic to the point of not being able to write out a single Grammatically correct sentence, So I have concluded that you can be none other than a Master Troll. In this case, for someone to be bored and incapable of finding a game online, some video on YouTube, or any other kind of entertainment except being a Troll is stupid, due to the incapability of finding another form of entertainment.
In other words, You are stupid. Genuinely stupid.
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Posted by GoOrDin 2 years ago
he forfeited.
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Walking wounded have seat reserved on the bench
The Warriors are expected to do some serious soul-searching during the All-Star break, and team management has already decided to initiate one noticeable change when things tip off again next week.
Injured players will be expected to be in the arena cheering for their teammates on game nights, coach Don Nelson said.
"It's a team policy that we just changed," Nelson said during a question-and-answer session with listeners on the "Warriors Weekly" radio show. "Unless it's a serious injury that calls them to be off of their legs, I think they should be at the games and should want to be at games."
The Warriors have had players miss 294 games because of injury, illness or personal matters this season. Many have not been with the team during their rehabilitations, including Raja Bell, who has been in Miami since his Dec. 3 wrist surgery. Bell is expected to rejoin the team Tuesday.
When Corey Maggette, who is out with a dislocated finger, showed up for Monday's game, one healthy player looked shocked and said, "What are you doing here?"
The tipping point for Nelson came when he heard stories about Anthony Randolph, who is out with multiple ankle injuries. Nelson was told that Randolph left one game after the first quarter and was at a nightclub during another game.
"There is no excuse for that, and those players will be fined from now on," Nelson said.
Kelenna Azubuike, who had season-ending knee surgery, will have excused absences until he can bend his knee comfortably enough to sit on the bench, Nelson said.
Opening tip: Warriors coach Don Nelson swears the swell in belief that he is not having fun and has become detached from the team isn't getting to him. "They've been talking about me for 30 years, and that is just part of it. I don't listen to it, so how could it have an effect on me?"


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Pondering Person's Guide To Autism
We help academics and students experience cultures, navigate new languages, and discover historic sights, all while developing the worldwide perspective wanted for success in at present's interconnected world. By no means go for a faculty, college, or a college with out getting related details about them. One of the best ways to acquire data is through speaking with people who have already studied there. Earlier than you commit, get the inside scoop. Ask anyone on the workplace of admissions to introduce you to some alumni in case you do not know anybody at that exact college. Try to clear all of your doubts with the alumni then. The best recommendation is to try to be very cautious when choosing a school or a university as it may be the turning level in your profession. This put up conveys that non-revenue schools are a better choice when compared with their for-revenue counterparts.
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At present, I need to speak more about sharing recommendation with students. This may be a bit more controversial. I never take class time … Read More


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In John 8:25, the religious leaders asked Jesus, "Who are you?"
Jesus was asked the same question of identity that we often are…and often the same question of identity that we ask our selves.
I sat with a young man at our church a few nights ago that had one question on his mind, "What am I?" The young man's response to his own question was direct and rather brutal, "I am gay. That is all that I am or will ever be. It doesn't matter that I am occasionally attracted to women. I need to learn how to fit into a gay identity." It was as if there were a few identities to choose from and he had to choose one.
Last night, I spoke on the phone with a 70-year-old female friend who was in a relationship with a woman for over 40 years that tragically ended with the death of the woman. After a few months, the recently widowed woman to the surprise of nearly everyone around her started dating a man about her age. I asked her if she considered herself to be bisexual or still a lesbian. Her response was priceless,
"Why do I need a label? At my age, it's all just love."
This morning, I was contacted by a friend of mine who has always been attracted to women, but has now found himself at 40 years of age falling for a man. "Am I supposed to assume a gay identity or a bisexual identity? This is the only person I am attracted to right now, but I don't want to discount my past relationships. This guy is the only one that I want. Am I gay or am I bi Jeff?" My friend felt like he had to assume an identity immediately on the phone.
We are a people who push identities both on our self and on others. We need to know what box we are going to check. We need to know where you are going to fit. We need to know what we are and what you are.
The problem with such simplistic thinking is that we are living in a beautifully complex world made up of beautifully complex people where labels and identities always fail to describe the totality of who a person is.
When people ask me, "Who am I?"
I always respond, "You are a queer child of God made in the image of a God who is queer."
The beauty of this statement is that it opens the space for everyone to be the totally unique non-normative child of God that they were created to be by a God that is totally unique and non-normative.
The problem with identities is that they force us to fit into new normativities, often without allowing us to be the unique person that we are. People should be able to love who they love, whether it fits into their assigned or assumed identity or not. To question their love based on the identity they have assumed or we have assigned them, is to not love.
Returning to John 8:25, Jesus responded to the question of the religious leaders, "I am who I told you I was from the beginning."
Perhaps we should start going by who we are…a unique child of God made for unique purposes, who fight for the rights of all people to love who they want to love…for we never know when our assigned or assumed identities might fail us too.


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Month: April 2011
Poilâne and Ladurée
Paris and Pierre Hermé
There were many destinations that I was overeager to see in a day. This is vacation after all, so let's do some planned stuff and then.. let's just get lost.
First on the day's agenda was a trip to the almighty Louvre. You can't go to Paris and not see this place. An added bonus- the Tuileries was right there too. Taking a leisurely stroll and decompressing from all the art overload was nice.
We kept walking, crossed a bridge, and found Notre Dame Cathedral. Just like that. How great is it to just pick a direction and see what you see?
I'm sure you know what the cathedral looks like and there are tons of books that have beautiful photos. So, there won't be any shots here. Instead, I've chosen to focus on the devil in the details.
After being big tourists and seeing some sights, it was time for a snack. We searched out Pierre Hermé and I was determined to get my hands on his famous Ispahan and 2000 Feuille.
Ta-da! Thanks to one of us who has the great map skills and sense of direction (not me), we arrived. Just look at this beauty. I have to say, PH is the greatest! The flavors of lychee, rose, and raspberry come together so effortlessly. This combination is genius. Loved the texture of chewy, slight crunch, ripe fruit and silky cream.
I had to wait until we got back to the hotel to tear into this one. Balancing my treasured bag of PH treats was difficult enough on a park bench in the wind and rain. Again, I was not disappointed. I love both mille feuille and praline so I was certain I would be pleased with the 2000 Feuille. Pleased was an understatement. The. Best. Ever. Had I known, I would have bought two or three.
Do I even need to tell you about the macarons? Insane.
Now that we had a major sugar rush going and infinite smiles, it was time to go for another walk and see what we see…
Space Invaders and Lenôtre
Marché de la Bastille
Paris: La Maison du Chocolat
Bonjour! So we made it to Paris after an all day train ride. After checking into our hotel, we decided to find someplace to grab a quick bite to eat. No problem, we'll just find a cozy neighborhood bistro to have lunch, right? It wasn't nearly that easy. The few places close by to the hotel were not anything to get excited about. So we continued on. We did find a FNAC and cha-ching! Maison du Chocolat! Oh wow. This place was on my list of patisseries to hunt down the next day, but here it was right before me.
I was astounded to see the selection all laid out before me, perfect and calling my name loudly. What to try? I wanted to get one of everything. We ended up leaving with a chocolate tart which I can never pass up and a chocolate eclair. I need to tell you about the packaging. Each item is individually packaged in its own protective box and bagged up in a sturdy bag. Impressive. It happened to be raining that day. We got lost on the way back to the hotel, jostled our way through the FNAC to pick up a Michelin Guide, and dodged the crowds on the street.
When we finally got up to the room, I couldn't wait to break out the dessert. Remember what I told you about the packaging? That was important because everything was intact and just as flawless as it was sitting in the shop case. If you're wondering how these tasted, you should know they were both very good. The chocolate tart had the creamiest texture with perfectly smooth ganache and the chocolate filling in the eclair was melt in your mouth delicious. But, to be honest, we both agreed that Bigot from this previous post was the hands down winner as far as best all around chocolate tart and eclair. I still dream of Bigot.
Goodbye to San Sebastián
Trash Talking
Guggenheim Bilbao and More Tapas
We spent a nice day driving to Bilbao and browsing the Guggenheim. It is indeed a spectacular modern architectural spectacle. The exhibits were as modern as the building itself, but Richard Serra's interactive maze of metal spirals, ellipses, circles, and curves are something to be experienced. Just don't eat right before taking a walk inside this installation.
After returning to our hotel, we were ready for more txacoli and some relaxation. So, we headed down to the restaurant and had a drink and indulged in more tapas.
The hotel's restaurant was always lively and buzzing with people. It was time we checked it out. It's a good thing we did because I would have missed out more tasty tidbits. This tapa had soft, shredded beef inside the phyllo purse and sat atop mashed potatoes with cheese.
A satisfying ending to a fun-filled day.


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First, this is not a bash Patch post. I have friends who work for Patch. I think they're doing some good things. If time proves me wrong about the advantage of local news site ownership, a Patch victory would be better than the alternative (which is the death of local news, or a win by a soulless aggregator).
Here's a few of things I like about Patch:
- They have a strong grasp of what the cost structure needs to be to win at this stage of local online news development. (By this stage, I mean, the current need to minimize costs won't always be that way.)
- Related, Patch leadership gets that you can do a lot more coverage with a smaller staff when you're strictly online.
- Patch is putting the coverage emphasis on local original content rather than aggregation (though they do aggregation). They hire people to live and work in the communities they cover. This is smart.
- Giving away business directory listing to local businesses is a smart way to start building relationships with local business owners.


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A year ago, Tayron Guerrero was a curiosity at Marlins spring training more for an unusual backstory than as a 6-foot-8 pitcher with a 100 mph fastball.
The right-hander is from Isla Tierra Bomba, an island off the coast of Colombia that has no baseball fields. He had to take a boat each day to Cartagena for baseball practice while developing that stunning fastball.
Often he had to return on a different boat that dropped him off at another part of the island, and he recounted how he had to walk more than two hours through snake-infested jungle to get to his remote village.
It made for a compelling story. Unfortunately for Guerrero, his fastball remained as untamed as...


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It's Valentines day, but you forgot to pick up a gift for your loved one. Don't worry! Travis Freese from Leviathyn has a list of easy last-minute gifts to pick up for your gamer loved one.
N4G is a community of gamers posting and discussing the latest game news. It's part of NewsBoiler, a network of social news sites covering today's pop culture.