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The Human Kinetics advertising program is designed to introduce unique, innovative physical activity products to our readers that will help them lead healthier, more active lives. We are here to work with you to introduce your products and services by planning an advertising schedule that fits your marketing needs!
Human Kinetics publishes more than 25 journals for the physical activity field. You'll find journals covering exercise, fitness and health, sports health care, rehabilitation, sport performance, physical activity and aging, special populations, the nutritional aspects of athletic performance, and teacher education for physical education. We have a journal that will reach your target audience.
Expand your advertising to both print and online media to reach both markets and profit from great combo discounts!
For more information, please contact:
Pat Fish Human Kinetics1607 N. Market StreetP.O. Box 5076 Champaign, IL 61825-5076 Phone: 217-351-5076, Ext. 7838Fax: 217-239-1215
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Overseas Consultants in Hyderabad - Go International Careers
Chinese language courses, lessons, and websites
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Overseas Consultants in Hyderabad - Go International Careers
Go International Careers is a one of the fastest developing consultants providing expert visa guidance and professional help to students seeking admissions abroad and our services are tailored to individual circumstances of each student. For more information on overseasconsultantsinhyderabad, overseas consultants in hyderabad visit our website.
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Tactical and Combat Knives
Tactical and combat knives are those knives that are built for military, law enforcement, and anybody that needs a sturdy knife they can rely on when things get rough. Each tactical knife in this category has been hand-picked because it will meet the strenuous demands of tactical situations.
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OVB Outside Vertical Bar
VRCB Volatility Reduced Compression Bar
Brent Crude Oil (December):
- Short Term Trends are bearish.
- Confirmation of a bottom with a range violation on 10/05/12 @ 112.70. Confirmation of a bottom with a close violation on 10/09/12 @ 113.41. Upside Targets = 117.15 – 117.88.
- December Brent Crude Oil dropped lower on Friday as a round of profit taking hit the market after once again stalling just below $115.
- Expect Brent to trade lower initially on Monday before rallying back above $114 where it will have to overcome a critical juncture at $114.45 to continue higher near the contract high.
- Projected Daily Range: 2.32
- Projected Weekly Range: 5.34
- Projected Monthly Range: 12.02
WTI Crude Oil (November):
- Short Term Trends are bearish.
- Confirmation of a bottom with a range violation on 10/09/12 @ 91.85. Confirmation of a bottom with a close violation on 10/09/12 @ 92.39. Upside Targets = 94.56 – 95.72.
- Inside VRCB generated on Thursday. Possible confirmation of a top with a range violation @ 91.01. Possible confirmation of a top with a close violation @ 91.01 or lower.
- November WTI Crude Oil dropped a shade lower on Friday in a very thin trading range as the market failed to log a sustainable rally throughout the session and settled just below the day's mid-range.
- Look for WTI to drop lower on Monday in early trading as this move higher should now go back to retest the $90 threshold to try and find support.
- Projected Daily Range: 1.99
- Projected Weekly Range: 5.11
- Projected Monthly Range: 11.33
Natural Gas (November):
- Short Term Trend is bullish.
- Confirmation of a bottom with a range violation on 10/11/12 @ 3.516. Confirmation of a bottom with a close violation on 09/25/12 @ 3.105. Upside Targets = 3.602 – 3.747.
- VRCB generated on Friday making new highs on current move @ 3.638.
- November Natural Gas generated new 2012 highs on Friday as it struggled to continue on the bullish momentum from Thursday bullish storage report, only managing to settle up seven ticks on the day.
- Natural gas has now spent the past two sessions trading within the lower range of IT resistance zone and a drop below Friday's low could signal a profit taking sell-off that could drop this market from its oversold stature down at least $0.20 cents and possibly more as the overall fundamentals remain slightly bearish.
- Projected Daily Range: .108
- Projected Weekly Range: .349
- Projected Monthly Range: .624


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I am trying to take several serial keys for one program and find the encryption algorithm in order to code a keygen. I am a computer science student and am currently learning C and Java. This is for educational purposes and the serial keys that I have are to programs that I do not need. I am at school right now, so I do not have the product numbers with me. However, they are very similar to the windows 98 product keys. They are in this format (IE: ADSKFJ-23JD34-3JFK8D-I3JFSL).
Finding the algorithm may not be possible, but it seems like it is possible to do. I am not disassembling any executables to find the algorithm, just using arithmetical computation. I just finished printing off about 20 pages on common algorithms such as RSA. I read about block ciphers, asymmetric cryptosystems, and such (http://en.wikipedia.org/wiki/Categor...hic_algorithms). I just started this little project last night, but I am kind of unsure where to start or what type of Algorithm is used for keys such my example. Can anyone give me a clue as to what type of algorithm is most likely used, or give me an idea if this is even possible?


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Your Location: Home >> Coal >> coal processing equipment supplier in shanghai
We have cooperate with Gulin company for three years. Three years ago, when we were looking for a ore processing machine manufacturer. The Gulin company help us.
The 100 ton processing plant that Gulin company have provided for us is very good. Over two years it only have one problem.
Gulin company provide the gold pans, sluice boxes, snuffer bottles, screens, magnets and books of the their products. Gulin gold processing equipment bring me a big profit.


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Ten Big Ideas In Education
Our team at Scholastic developed a list of the top ten education trends over the past decode based on our experience with educators all over the county. We think that these ideas will continue to be influencer in the year's ahead. Here's the list:
Alternate Paths to Teaching—from Teach for America to Troops to Teachers to urban Teaching Fellows programs, schools of education are no longer the only place that teachers begin their careers.
Transformative Technology— From whiteboards to online education, 1-to-1 computing to eReaders, for the first time in the history of American education, classrooms are increasingly plugged in – and so are the students.
Accountability— No matter where you stood in the debate on No Child Left Behind, it's impossible to deny that this decade marked a new era with a shift toward reporting the results for every child in every school.
Data-Driven Instruction—Once we have data on every student, it's easier to reach them quickly and to teach them better. Data is the new currency of 21st Century schools.
Charter Schools—While the jury remains out on their effectiveness, there is no doubt that charter schools are incubators of innovation in education and harbingers of parent involvement in schools.
The Rise of Digital Content—By 2020, 95% of all knowledge will be a search term away—marking a game-changing move from static pages to dynamic, digitized content.
A Focus on Adolescent Literacy— With 65% of American 8th Graders reading below grade level, teaching reading is no longer a job just for elementary school teachers. Our middle and high schools are taking dramatic steps to tackle the job of teaching reading to older, struggling students—ensuring that every child learns to read in an era of global competitiveness.
Books Are the New Black — In the decade that gave us Harry Potter, Twilight and The DaVinci Code, the hottest accessory is definitely the book. And it's impossible to deny the power that a single book can have on children's feelings about reading. According to the 2008 Kids and Family Reading Report, 74% of kids ages 5-17 say, "Reading Harry Potter has made me interested in reading other books."
It Takes A Village—More than ever, education is reaching beyond the walls of our schools to build strong communities that support learning both in and out-of-school. From the Universal Pre-K movement and burgeoning after-school programs, to summer reading initiatives and in-school community centers, we're learning that it takes a combination of home, school and community to prepare kids for their futures.
The American Recovery & Reinvestment Act (ARRA)—Although it is the hallmark of only the last year of the decade, with its more than $100 billion dollar investment in America's schools, ARRA represents an historic moment in American Education. While we cannot predict its impact, we can say with certainty that ARRA will leave an indelible mark on this decade of ideas in education.
For more information, go to http://mediaroom.scholastic.com/node/279
Happy reading!


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1950s RETRO: THE BIG WHITE CRUISE SHIP SAILS AGAIN TO CATALINA ISLAND! from CRUISINGTHEPAST.COM on Vimeo. Push arrow above to play video. A retro look at the SS CATALINA and SS AVALON. They were called the BIG WHITE STEAMERS. These day tourist steamships operated together from 1920 into the early 1950s — except for WW 2. The SS CATALINA continued ... Read More »
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Enrollment in the College of Agriculture broke records for the fourth straight year this fall, hitting 645 majors, up from 549 in 2011. The latest figures represent a growth of nearly 80 percent since 2006. Each of the four majors and options within the College of Agriculture have experienced growth, led by animal science, which has more than doubled in the past six years to 240 majors, and crops, horticulture, and land resource management, which has tripled to 112 majors. Agricultural business is up 43 percent with 201 majors, and the option in agriscience and education has grown 41 percent to 92 majors.
Dean Jennifer Ryder Fox said that enrollment in agriculture programs is growing nationwide, but the growth at Chico State is surpassing national averages. "I believe the overall growth is partly due to society's growing interest in food, how it is grown, and where it comes from. Here at Chico State, we are becoming the college of first choice for a growing number of students."
Fox cites the college's hands-on opportunities, close relationships that students have with faculty, and its emphasis on leadership and civic engagement as the driving forces behind the record growth. "It's a place where students can get a truly practical agriculture education in a welcoming environment and a great community, and prospective students recognize that," she said.
While growth has been a goal of the College of Agriculture for years, Fox said it comes at a difficult time when the college's budget is not adequate to support the increase in student enrollment. "We have not been able to hire new faculty to serve the hundreds of new students. Faculty and staff are working really hard to keep up, but clearly we cannot continue to grow as we have the past several years."


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What is Creatine?
When we told our friends that we were writing a book on creatine, some of
them had quizzical responses. "You're writing on creating? Creating what?"
"Is it an herb?"
Creatine is a nutrient that is naturally found in our bodies. It is made
from a combination of the three amino acids arginine, glycine and
methionine. Creatine helps provide the energy our muscles need to move,
particularly movements which are quick and explosive in nature. This
includes the types of motion involved in most sports. Approximately 95
percent of the body's creatine supply is found in the skeletal muscles. The
remaining five percent is scattered throughout the rest of the body, with
the highest concentrations in the heart, brain and testes. (Sperm is
chock-full of creatine!)
The human body gets most of the creatine it needs from food or dietary
supplements. Creatine is easily absorbed from the intestinal tract into the
bloodstream. When dietary consumption is inadequate to meet the body's
needs, a limited supply can be synthesized from the amino acids arginine,
glycine and methionine. This creatine production occurs in the liver,
pancreas and kidneys.
How Does Creatine Work?
Creatine is an essential player in one of the three primary energy systems
used for muscle contraction. It exists in two different forms within the
muscle fiber: as free (chemically-unbound) creatine and as creatine
phosphate. This latter form of creatine makes up two-thirds of the total
creatine supply. When your muscles contract, the initial fuel for this
movement is a compound called ATP (adenosine triphosphate). ATP provides
its energy by releasing one of its phosphate molecules. It then becomes a
different compound called ADP (adenosine diphosphate). Unfortunately, there
is only enough ATP to provide energy for about ten seconds, so for this
energy system to continue, more ATP must be produced. Creatine phosphate
comes to the rescue by giving up its phosphate molecule to ADP, recreating
ATP. This ATP can then be "burned" again as fuel for more muscle
contraction. (We'll discuss all this in greater detail in Chapter Six.)
The bottom line is that your ability to regenerate ATP depends on your
supply of creatine. The more creatine you have in your muscles, the more
ATP you can remake. This allows you to train your muscles to their maximum
potential. It's that simple. This greater ATP resynthesis also keeps your
body from relying on another energy system called glycolysis, which has
lactic acid as a byproduct. This lactic acid creates the burning sensation
you feel during intense exercise. If the amount of acid becomes too great,
muscle movement stops. But if you keep on regenerating ATP because of all
the creatine you have, you can minimize the amount of lactic acid produced
and actually exercise longer and harder. This helps you gain strength,
power and muscle size; and you won't get fatigued as easily.
Creatine has also been shown to enhance your body's ability to make
proteins within the muscle fibers. Two of these proteins, actin and myosin,
are essential to all muscle contraction. So when you build up your supply
of these contractile proteins, you actually increase your muscle's ability
to perform physical work. And the more work you do (whether it's lifting
weights or running 100-meter dashes), the stronger you become over time.


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You will learn
You will learn where to find the resources to get started with Swift development using Xcode. This includes information on how to get enrolled in the Apple Developer Enterprise Program, where to get Xcode and information about the Swift programming language. This tutorial will also familiarize you with Xcode and will show how to build your first application.


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In 2012, Diego "Dieguito Li" Quiroga, suffered a sports-related injury that sidelined him in accomplishing his work duties. His boss wasn't pleased with the situation, therefore causing tension between the two. This lead the Argentinian-designer to his decision to quit.
A New Opportunity
Diego's search for a new job led him to Freelancer. "I decided to give online freelancing a shot, thinking that it was really hard to succeed," shared Diego.
The first project Diego was awarded with was a simple character sketch to be used for the employer's website. After a whole day of working on the design, he completed it and sent it over to his employer.
In a matter of hours, Diego received some feedback. The employer was very happy with the design he received and was certain that if he needed a design project done again, he would hire Diego.
Working on a couple of projects helped Diego build his credibility and portfolio on the site. Reviews and ratings from previous employers play vital roles in landing projects. Diego makes it a point to exhibit utmost professionalism by providing his employers with only his best works and good working relationships.
Reaching New Milestones
After a couple of years freelancing, he has learned to love the setup. Having the opportunity to work at home was a pleasing experience for Diego, since he was able to spend more time on activities he enjoyed such as football, tennis and running.
According to Diego, that wasn't the best part of being a freelancer. "Working as a freelancer let me be present in every moment of my newborn baby's life. He's growing up so fast, and he learns something new everyday," enthused Diego.
Away From Keyboard
Spending time away from his laptop and being with his baby, Dante, is nothing new to Diego. He's able to work on the go using the Freelancer mobile app which made searching and bidding for projects very convenient.
Projects kept coming in and Diego worked extra hard to get his projects completed. He recalls a project wherein he was hired to design a series of books to be used in teaching English to Taiwanese kindergarten students.
"Knowing my work was making a difference in the lives of others makes me feel so proud of the hard work I put in," mentioned Diego. The six-month long project was the longest and most memorable project Diego worked on.
The earnings Diego received from the project were added to his savings. He wants to save enough money for another family vacation, but this time with baby Dante.
Living the Dream
Working as a freelancer has brought Diego a step closer to achieving his dream -- to travel the globe. A year into freelancing, Diego and his wife visited Japan for a vacation. It was their dream destination and it left them in awe. The month-long stay was a fantastic experience for the Quiroga duo.
Diego was also able to upgrade his design equipment. He purchased a new computer and a top notch design tablet, which were much better than his old notebook and Wacom tablet.
"Now I know that talent is important but not as much as a lot of hard work and constancy," said Diego. With the commitment he's put into his freelance design work, he's bound to travel the world alongside his wife and son.
Get your design projects done by Diego. Click here to hire him.


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I just got a Admin Job at my New School,its a new school they have like 2 years , 2 weeks ago we setup the whole network, and the teachers told me that when they had the old network the students used to do all kinds of stuff to Fuc% the computers. they decided that only the admin username should be used to logging to the computers and inside the admin account changeing identidies , but because the principal and i were the only ones with the password, and i had to wake up early every day to go and get the network online, because they don't whant the network to stay up 24/7, but i recieved an email a few hours ago, that i could put 2 user accounts at the Welcome Screen, but i was testing in my own computer, and i created the accounts, and they didn't show up at the Welcome Screen, what do you think i did wrong? ? ?
any other suggestions that could help secure the school network
by the way im using Win XP pro on all the computers at my school.
any programs or security messurements that any of you recomend i would apreciate.
thanks in advanced


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Suffolk, ss. Division of Administrative Law Appeals
Paul Balboni,
v. Docket No. CR-06-831
Plymouth Retirement Board,
Appearance for Petitioner:
Robert Deubel, Esq.
Law Offices of Deborah G. Kohl
191 Bedford Street
Fall River, MA 02720
Appearance for Respondent:
Michael Sacco, Esq.
285 College Highway
P.O. Box 479
Southampton, MA 01073-0479
Administrative Magistrate:
Sarah H. Luick, Esq.
Pursuant to G.L. c. 32, §16(4), the Petitioner, Paul Balboni, is appealing the November 1, 2006 decision of the Respondent, Plymouth Retirement Board, denying his request for accidental disability retirement benefits. (Ex. 2) The appeal was timely filed. (Ex. 1) A hearing was held November 28, 2007, at the offices of the Division of Administrative Law Appeals (DALA), 98 North Washington Street, 4th Floor, Boston, MA 02114, pursuant to G.L. c. 7, §4H.
Various documents are in evidence. (Exs. 1 - 26) The parties entered into some stipulations of fact. ("A") Two tapes were used. The Petitioner testified. Both parties made arguments on the record which closed December 12, 2008.
1. Paul Balboni, d.o.b. 1/21/52, worked for the Town of Duxbury from September 1992 - November 2003. Thereafter, he began work in November 2003 for the Town of Plymouth within the Department of Public Works as the Operations or Highway Superintendent. ("A". Exs. 3 & 4. Testimony)
2. The Operations or Highway Superintendent position performs administrative and supervisory work of planning, directing, and managing work for the Highway Department. The position works under the direction of the Director of Public Works. The job involves high level responsible functioning with "access to department-related confidential information." Expected is an ability to "exercise of considerable independent judgment in planning and inspecting the construction of highway projects and in determining the scope and scheduling of maintenance projects." When Mr. Balboni performed the job he supervised about 32 full time employees. He had to work outdoors, and had "frequent exposure to hazards associated with heavy equipment construction sites." He had to drive to various job sites. He used a computer and other standard office equipment when in the office. He had "constant contact with the general public and … frequent contact with other town officials, as well as utilities and private contractors." He had in person, telephone, or written discussions regarding "complex information." He had to resolve "difficult customer service requests." The work covered "three districts." He had to supervise personnel engaged in highway emergency and snow removal operations. He supervised the cleaning of streets, catch basins, culverts, drains, outfalls, and manholes. He supervised the construction and repair of bridges. He had to plan, schedule and supervise pavement markings, installation of traffic signs, and he had to supervise trash pick-up operations. He worked on highway budgetary issues. He had to do project coordination work. He had to be able to engage in moderate physical efforts such as pushing, pulling, carrying and lifting on occasion, "objects weighing up to 30 pounds." He had to sometimes "lift heavy objects and … occasionally perform some strenuous work under varying weather conditions." He had to be able "to walk and stand for long periods of time." This work also involved being on call twenty-four hours a day for emergencies. (Exs. 3, 5 & 26. Testimony)
3. In July 1995, Mr. Balboni was hospitalized to rule out a stroke. He had suffered a "TIA, a PFO and hyperlipidemia." He had no further TIAs. In or around 1998, he underwent a splenectomy. He was hospitalized in August 2002 "for a penetrating wound of the plantar aspect of his foot." He was treated "with IV antibiotics," and had a "surgical debreavement." He did well after that. He has been diagnosed with hypertension, high cholesterol, high triglycerides, and gout. He takes Coumadin medication which prevents taking some anti-inflammatory drugs. During the fall 2004, he was complaining to his primary care physician, Dr. David Z. Grace, of stress at work and of left shoulder discomfort. (Exs. 3, 12, 16, 18, 19, 20, 21 & 22)
4. On December 21, 2004, Mr. Balboni was at work to address ongoing snow storm and plowing/sanding roadway matters. He had been working without time off from the prior day. He was going to various Town locations such as important traffic intersections, schools, certain hilly roads, the police and fire stations, and the downtown roads. At about 10:00 AM, he was in the parking lot at his office standing near his car. He was on his way to his office after doing some site visits because he wanted to learn if new calls had come in for him to visit more sites. He then saw one of the sander truck drivers he needed to talk to about roadway issues. He began to signal and walk toward the moving truck to flag down the driver, when he slipped and fell to the ground, hitting his left side. He got up and then immediately slipped again and fell again onto the ground. He likely hit his head and landed on his back. He may have temporarily lost consciousness. He felt disoriented. He called out for help and began crawling on his hands and knees to the office. At the doorway, he rose to his feet and entered. ("A". Exs. 3, 5 & 8. Testimony)
5. Mr. Balboni told his secretary he had fallen. His back side was covered in snow. Because he had a crew at a job site waiting for him, he decided to go there first before being checked out at the hospital emergency room. While in the office he put his left arm behind his neck to relieve pain he had. His whole back, neck, and extremities felt sore. Mr. Balboni did not leave his car as he usually would have once he reached the crew. After that meeting, he drove to the Jordan Hospital Emergency Room. A notice of injury report was filed with his employer. (Exs. 3, 5 & 8. Testimony)
6. At the hospital, Mr. Balboni reported he fell on ice and may have lost consciousness for awhile. He reported "some pain in his left shoulder, neck and hip." He reported some left knee tenderness. He had x-rays done on the pelvis, lumbosacral spine, left knee, and left shoulder. He had lab work done. He was admitted for observation. He had a head CT scan that was normal. He was evaluated by Dr. Joseph F. Zabilski, an orthopedist, for left shoulder pain. By x-ray, he had no "fracture or bony abnormalities." Dr. Zabilski opined he had "rotator cuff tendonitis," and was prescribed a sling and Vicodin medication for pain. Dr. Zabilski could not rule out an occult fracture. (Exs. 9, 12 & 17. Testimony)
7. Mr. Balboni stayed out from work. He was followed by Dr. Grace. Mr. Balboni had more testing done. He had a lumbar spine MRI on January 12, 2005 that was normal but for "a minor facet arthropathy." He had a left shoulder MRI on January 22, 2005,
showing a linear area of high T2 signal within the superior aspect of the rotator cuff which may represent a partial intrasubstance tear … [no] definite evidence of full thickness tear … otherwise essentially unremarkable …. (Ex. 13)
Mr. Balboni had a thoracic spine MRI on January 28, 2005 revealing, "degenerative findings … [and] a tiny central bulge or contained herniation at T7-8 without evidence of neural impingement." He had a cervical spine MRI on February 26, 2005 showing; "No evidence of disc protrusion or herniation." Another head CT scan on March 7, 2005 was normal. (Exs. 3, 5, 13 & 16. Testimony)
8. Mr. Balboni was prescribed physical therapy with conservative measures for his pain complaints. He had this between January 25 and February 14, 2005. His spine at T6-8 was found to be "hypersensitive" to light pressure. His left shoulder had clinical symptoms consistent with a rotator cuff condition. The treatments ended because Mr. Balboni had not experienced much symptom relief. (Ex. 14. Testimony)
9. Dr. Alan R. Murphy, a neurosurgeon, evaluated Mr. Balboni on February 28, 2005. He opined Mr. Balboni had, "cervicalgia with right hemi-hypalgesia without cear-cut compression of the spinal cord or exiting nerve roots or cauda equine." He also found a left rotator cuff tear and a lumbar strain. He recommended "a directed rehabilitation program." (Ex. 18)
10. Mr. Balboni was evaluated on March 4, 2005 by Dr. DeWitt Brown, an orthopedic surgeon. Dr. Brown had the MRI results and found a left shoulder rotator cuff tear. He found the MRIs of the neck, thoracic spine, and lumbar spine to all be "within normal limits." By physical examination he detected most of Mr. Balboni's "discomfort" was "about the left side of his low interscapular area." (Ex. 19)
11. Dr. Zabilski saw Mr. Balboni for follow-ups on January 7 and March 9, 2006. He diagnosed a "traumatic left shoulder rotator cuff tendonitis, and inter-scapular right shoulder and back pain." He found the films of the thoracic spine revealed, "mild degenerative scoliosis of the upper thoracic spine with the apex in the region of the interscapular back pain." He found Mr. Balboni's examination to be "consistent with inter-scapular back pain as well as traumatic rotator cuff tendonitis." He recommended a cortisone injection for the shoulder condition. By an April 6, 2005 evaluation, Dr. Zabilski opined Mr. Balboni was doing well and could "return to full, non-restricted work activities." By his April 4, 2005 visit, Mr. Balboni's right paraspinal pain had diminished to permit a return to work. (Exs. 17 & 20)
12. As late as March 25, 2005, Dr. Grace found Mr. Balboni unable to return to work. He then changed his mind to find him able to return to work part-time starting April 4, 2005. He cleared him to gradually reach full-time work after April 18, 2005. (Ex. 16)
13. Mr. Balboni had been out from work receiving workers' compensation. He returned to perform his same job duties. By the start of May 2005, he was working full-time. He experienced recurring pain symptoms in his back, neck and right leg, triggered by no particular activity, and occurring even when sitting at his desk or when driving. He was still taking Vicodin for pain. (Exs. 3, 5, 7 & 8. Testimony)
14. On April 20, 2005, Mr. Balboni's employer gave him and discussed with him, "a ninety day work plan as Highway Manager … [which] provided a continuing series of dates by which … to complete specified tasks." Now full-time, on May 9, 2005, Mr. Balboni met with his employer to evaluate how he was readjusting to a return to work. There were some "deficiencies" found in his reports, and he was given a new deadline to improve them. At the meeting, Mr. Balboni did not assert and did not provide to his employer information showing an inability to work. (Exs. 3, 5 & 7. Testimony)
15. Mr. Balboni was evaluated on May 10, 2005 by Dr. Grace. He reported stress at work due to his secretary being out from work. He was sleeping poorly and was concerned he might have another stroke. Dr. Grace found his spine to be tender. He concluded the back pain was now chronic. Mr. Balboni told Dr. Grace he wanted to stop working because it was hard to sit at work without pain symptoms. Thereafter, Dr. Grace produced a short note for Mr. Balboni's employer simply stating Mr. Balboni was "unable to work due to back pain and stress." (Ex. 16. Testimony)
16. When Mr. Balboni's employer saw the May 10, 2005 note from Dr. Grace, a concern was raised that there was "no additional information concerning diagnosis, prognosis, treatment plans, medication, therapy, etc." By now, his workers' compensation had stopped and Mr. Balboni told his employer he "might need an indefinite leave of absence." This request was refused. He was placed on medical leave. His employer informed him about being "skeptical about your current claim of total, indefinite, incapacity." There was a concern he was magnifying his symptoms. The employer was relying on the report of Dr. Brown of March 4, 2005. (Exs. 7 & 19. Testimony)
17. Mr. Balboni stopped working on May 11, 2005, but on May 14, 2005, he wrote his acceptance of the job of Highway Manager his employer was offering him. A job description for this position was created. Mr. Balboni felt it was just a new title on the job he had been performing. (Exs. 5, 6, 7 & 8. Testimony)
18. The Highway Manager performs:
Administrative and supervisory work in planning, directing and managing the operations of the Highway Department … under the administrative direction of the Director of Public Works …. Performs highly responsible functions requiring the exercise of considerable independent judgment in planning and inspecting the construction and maintenance of highway projects and in determining the scope and scheduling of maintenance projects …. Supervises a department of 32 full-time employees. (Ex. 5)
The job description calls for use of a car, a computer and standard office equipment, and requires being on-call 24 hours a day, seven days a week for emergencies. The work contemplates "constant contact with the general public and … frequent contact with other town officials, … utilities and private contractors." The work includes making contact "in person, by phone, or in writing" to discuss "complex information" and to resolve "difficult customer service requests." There is "access to department-related confidential information." The job description sets forth the "Essential Functions" as follows:
Plans, assigns, schedules, supervises and reviews the work of subordinates with regard to the construction and maintenance of streets, roads, sidewalks, traffic lights, bridges, drains, storm-control structures, and related facilities; supervises the installation of signs.
Specific tasks encompass the following: supervising all highway workers and private contractors involved with emergencies and snow removal; securing the cleaning of streets, catch basins, culverts, drains, outfalls and manholes, and sweeping relating to the construction and repair of bridges; ordering materials needed; planning, scheduling and supervising the pavement markings and installing of traffic signs; inspecting work "for compliance with standards or instructions or for contract compliance;" supervising three districts as to the maintenance of secondary roads along with coordinating the work of the districts; doing the preparation, submission and administration of the Highway Division budget; taking responsibility "for trash pick-up at various streets and buildings;" planning the use of manpower and equipment for highway projects and programs as well as directing the work of field crews and assigning tasks to laborers, operators, and foremen, and ensuring that safety procedures are followed; and, coordinating field operations. The job description calls for an ability to expend:
Moderate physical effort … Occasionally … to move (push, pull, lift or carry) objects weighing up to 30 pounds … to lift heavy objects and to occasionally perform some strenuous work under varying weather conditions … to work and stand for long periods of time …. (Ex. 5)
19. On May 16, 2005, Mr. Balboni was evaluated by Dr. Adriana Carillo. He complained of "severe thoracic pain, especially on the right side … pain goes back and forth from his shoulder blades and irradiates to the right buttocks and/or right hamstring muscles." He reported feeling "severely stressed at work … [and that] he stopped working … taking Vicodin … at night for pain." Dr. Carillo found "myofascial pain of the right thoracic region," and opined that "usually the myofascial pain would increase with stress … apparently what's happening." She recommended physical therapy and use of Vicodin. (Ex. 20)
20. By letter of May 18, 2005 to Mr. Balboni, he was informed that he would be evaluated by a Town appointed physician, Dr. Anthony Caprio, on May 24, 2005. He was asked to bring along his medical records. By this letter, Mr. Balboni was warned that the Town was not finding credible his claim of being disabled from work. (Ex. 7. Testimony)
21. Mr. Balboni was evaluated by Dr. Caprio on May 24, 2005. Dr. Caprio learned about Mr. Balboni's medical history. He understood Mr. Balboni's principal complaint was "burning electrical pain that sometimes shoots down his back in between the shoulder blades around T6-T7 sometimes causing pain in his right shoulder … no specific low back discomfort per se." Dr. Caprio learned about the December 21, 2004 injury at work of a slip and fall on ice which caused him "left shoulder, low back , and mid-thoracic spine" symptoms. He understood Mr. Balboni was out from work until about April 11, 2005. Dr. Caprio understood he worked only about three weeks before experiencing "mid-thoracic discomfort … again." Dr. Caprio was aware that Mr. Balboni was a public works superintendent with a varied job involving both office work and in the field work that could be "quite strenuous at times." Dr. Caprio was aware that Mr. Balboni had a left shoulder rotator cuff tear with no surgery done on it, an "unremarkable" cervical spine MRI, a dorsal spine MRI showing "degenerative changes predominantly at T2-T3, T3-T4 and T7-T8," with the "maximum tenderness … in the T7-T8 area." He was aware Mr. Balboni had physical therapy treatments. He had the results of Dr. Brown's evaluation. Dr. Caprio gave a physical examination. He diagnosed a left shoulder injury involving the rotator cuff that had resolved, a neck strain that resolved, intrascapular thoracic pain with left parascapular pain having an unknown etiology, and a lumbar spine strain that resolved. He opined these diagnoses were related to the fall at work other than the intrascapular thoracic pain that "may or may not be on a degenerative basis." He recommended an evaluation with a thoracic spine specialist. He did not feel a medical end point had been reached. (Ex. 21) He concluded Mr. Balboni could not, handle all of the duties outlined [in the job description he received] such as strenuous work, but certainly he can do sedentary light work … can lift up to 25 pounds but should restrict his overhead work and repetitive bending … can work on a full time basis. (Ex. 21)
22. Mr. Balboni underwent further physical therapy treatments that started in early June 2005. He had only slow progress in improving his symptoms. (Ex. 15) He was evaluated by Dr. Carillo on June 13, 2005, and found to have "right myofascial pain" over his paraspinal muscles in the right thoracic region. (Ex. 20)
23. Mr. Balboni was evaluated on July 8, 2005 by chiropractor Ian C. Paskowski, D.C., for his pain in the upper right and middle right back. Dr. Paskowski had a history on Mr. Balboni that included the test results and the details about the fall at work on December 21, 2004. He gave a physical examination. He opined the "thoracic MRI does not indicate significant disc pathology … primary complaint seems to be residual myofascial pain and spasm at the inferior angle of the right scapula." Dr. Paskowski recommended "instrumented and manual myofascial release technique, scapular stabilization exercises and graded spinal manipulation." (Ex. 22)
24. On July 14, 2005, Mr. Balboni was evaluated again by Dr. Brown. He understood Mr. Balboni was not working due to "increasing discomfort involving his right shoulder." He knew that Mr. Balboni was having "some ongoing pain associated with his posterior right scapular area." By now Mr. Balboni had begun treatments with Dr. Paskowski. Dr. Brown gave a physical examination, and diagnosed right scapular discomfort. Dr. Brown found no causal connection between these symptoms and the December 21, 2004 fall. He did not connect the current right shoulder pain to this fall. Dr. Brown concluded Mr. Balboni "has no objective findings … does have some signs that are not physiologic … has reached a medical end result with respect to … the December 21, 2004 incident," and "no ongoing disability related to the December 21, 2004 injury." (Ex. 19)
25. The Town had Mr. Balboni evaluated on July 21, 2004 by Dr. Douglas G. Bentley. Dr. Bentley understood he hurt his neck and left shoulder during the December 21, 2004 fall. He understood he returned to work in April 2005 for only about one month, stopping again "because of continued symptoms." Dr. Bentley was aware of the left shoulder rotator cuff tear by MRI, the dorsal spine MRI showing "a small herniated disc at T7-T8," and he was told by Mr. Balboni that recent dorsal spine x-rays showed "wedge compression fractures." Dr. Bentley learned he had done left shoulder physical therapy treatments and was having ongoing physical therapy for the neck and upper back. Dr. Bentley gave a physical examination. He diagnosed an acute contusion, shoulder strain, and partial rotator cuff tear in the left shoulder that had "essentially resolved." He diagnosed an acute cervical and dorsal spine strain, a herniated disc at T7-T8, and a possible herniated cervical disc at C6-C7 on the right. He opined these conditions were due to the December 21, 2004 injury. He opined that EMG and nerve conduction studies to the upper extremities might determine if there is any nerve injury, and that there should be a cervical MRI to determine if there is a herniated disc. Dr. Bentley found Mr. Balboni "capable of light sedentary work with no repetitive bending or squatting and no lifting over 15 pounds." Dr. Bentley could not determine a time when Mr. Balboni might return to his full duties. (Ex. 23)
26. Dr. Grace evaluated Mr. Balboni on July 29, 2005. Dr. Grace reported to Mr. Balboni's employer that Mr. Balboni was "undergoing a work up and treatment for back pain … remains unable to return to work." (Ex. 16)
27. On July 11, 2005, Mr. Balboni had a chest x-ray that revealed a possible "nondisplaced right posterior/posterolateral rib fracture." That day he also had thoracic spine x-rays showing: "Likely chronic minimal anterior wedge deformities in the mid and lower thoracic spine," and cervicothoracic scoliosis. On July 26, 2005 he had a scoliosis x-ray series showing; "Shallow scoliosis of the lumbar spine convex to the right …." On August 11, 2005 he had a bone scan that was normal. (Ex. 13)
28. On August 5, 2005, Mr. Balboni's employer wrote to him concerning a return to work. The Town found him able to perform all of the supervisory functions in the job description of Highway Manager on a full time basis with the "only limitations … [being] strenuous work." (Ex. 5) The Town explained it was willing to modify and/or waive (as appropriate), those requirements as an accommodation … not be 'required to move (push, pull, lift or carry) objects weighing up to 30 pounds' … not be required to lift heavy objects or perform strenuous work or stand for long periods of time … accommodations … for a period of ninety (90) days at which time you will be reevaluated to determine if an extension of the accommodations may be required. (Ex. 5)
A response was sought by August 15, 2005. (Ex. 5)
29. This letter resulted in a meeting on August 16, 2005 where the job performance issues were discussed. Mr. Balboni refused to return to work full-time even with the offered accommodations. He informed the Town that he could provide further medical opinion evidence to support why he could not do this offered work. The Town refused the offer to work part-time. The Town responded that it would be willing to consider further job accommodations if supported by medical documentation, but would need Mr. Balboni "to perform all of the normal duties and responsibilities." He was warned to return to work by September 12, 2005 with the accommodations offered or with further negotiated accommodations, or he would risk losing the job. (Ex. 5. Testimony)
30. Mr. Balboni was evaluated on September 1, 2005 by Dr. Paskowski. He complained of continuing discomfort symptoms that had not improved. (Ex. 22) Dr. Paskowski opined,
the initial injuries including left shoulder strain and cervical and thoracic sprain injuries are resolved/resolving. The remaining complaint's etiology remains unidentified. (Ex. 22)
Dr. Paskowski felt a medical end point had not been reached with a need to explore cervical intervertebral disc pathology and the disc herniation at T7-T8. (Ex. 22) He found Mr. Balboni able to do, light duty (sedentary) responsibilities … return to work …
should be gradual … environment should allow for frequent change of position … responsibilities should not include repetitive forward bending, reaching or lifting. Objects that he moves should not exceed 15 pounds. (Ex. 22)
31. Mr. Balboni had a cervical MRI on September 14, 2005 that revealed:
Minimal degenerative disease of the uncovertebral facet joints primarily on the right side of the neck … no evidence of a focal disc herniation or evidence of cord impingement … only mild neural foraminal narrowing … (Ex. 13)
32. Mr. Balboni had workers' compensation payments resumed in August 2005. (Ex. 8)
33. Mr. Balboni did not try to return to work and instead filed for accidental disability retirement benefits at the end of September 2005. Dr. Grace supported his claim of a disability based on the December 21, 2004 fall. ("A". Exs. 3 & 4)
34. On October 5, 2005, Mr. Balboni was admitted to the Jordan Hospital for a consultation by Dr. David P. Gannon, Jr., concerning the mid-scapular pain, right arm pain, low back pain, and right leg pain. Pain complaints were of "aching, sharp stabbing pain between the shoulder blades with paresthesias and dysesthesias running down the right upper extremity." Dr. Gannon gave a physical examination. He reviewed the test results such as the cervical and thoracic spine MRIs showing minimal degenerative changes. (Ex. 13) Dr. Gannon opined Mr. Balboni had:
Long thoracic nerve injury as a result of either C7-8 radiculitis or C7-8 irritation … scapular winging … strongly suggestive of long thoracic nerve weakness or palsy resulting in seratus anterior dysfunction … obtain neurologic consultation and obtain electrodiagnostic studies in an attempt to map out the extent of the patient's
deficit. (Ex. 13)
Dr. Gannon concluded that Mr. Balboni cannot lift or do physical activity involving his upper extremities. (Ex. 13)
35. Mr. Balboni was evaluated by Dr. Douglas Childress, a neurologist, in the fall 2005. He found "lower cervical and upper thoracic cord injury." He prescribed Cymbalta. He also found EMG and Nerve Conduction Studies on the right arm and leg were normal, so that Dr. Childress opined Mr. Balboni had had "some type of regional pain syndrome post trauma." He switched him to Neurontin. By January 2006, Dr. Childress noted Mr. Balboni "had cortalgia of the upper limb … and … would explore injection and medication management of pain." (Exs. 13 & 16)
36. Dr. Grace examined Mr. Balboni on February 14, 2006. Mr. Balboni complained of persisting pain in the back, right leg and right arm. He reported intermittent shoulder pain. He did not secure relief from the medications Dr. Childress prescribed. He felt a "coldness in his right leg, numbness with decreased sensation from the knee to his toes." He noted "stabbing pain in his right buttocks." By examination Dr. Grace found "tenderness of the right scapular to palpation." His neck showed a "decreased range of motion to the left … unable to abduct his right shoulder without pain." Dr. Grace concluded that Mr. Balboni had chronic pain due to the December 21, 2004 injury. (Ex. 16)
37. At a February 22, 2006 evaluation, Dr. Gannon found Mr. Balboni to likely be "suffering from either suprascapular neuralgia and/or long thoracic nerve neuritis and neuralgia." He recommended injection treatments which Mr. Balboni had. On March 29, 2006 Dr. Gannon opined that Mr. Balboni was still showing "signs of long thoracic nerve injury, and/or irritation … parascapular pain may very well be a result of lower cervical and upper thoracic uncovertebral or facet irritation with subsequent radiation of the pain to his parascapular area." He again recommended injections for pain relief. Dr. Gannon could not determine its causation. (Ex. 13)
38. Mr. Balboni was evaluated by Single Physician Medical Panels in August 2006. The Plymouth Retirement Board provided to the three physicians records from the Jordan Hospital, Braintree HealthSouth physical therapy, Jordan Hospital physical therapy, and records from Dr. Grace, Dr. Paskowski, Dr. Eric Johnson, and Dr. Zabilski. In addition, the Panel physicians were sent the application documents which included job description information for Highway Manager, and Dr. Grace's statement in support of the accidental disability claim. Dr. John Groves, one of the Panel physicians, sought the job description for Highway Superintendent which was sent to him. (Exs. 9, 10, 11, 24, 25 & 26)
39. Panel physician Dr. David G. Heller, an orthopedist, evaluated Mr. Balboni on August 9, 2006. He answered his certificate in the affirmative. He understood Mr. Balboni's job was "overseeing operation of the highway [department], solid waste vehicle maintenance, as well as other functions." Dr. Heller understood Mr. Balboni fell on ice in the parking lot on December 21, 2004, suffering a "very severe" fall that involved injury to the shoulders with loss of consciousness. Dr. Heller understood Mr. Balboni was seen at the Jordan Hospital Emergency Room and was admitted overnight for observation. Dr. Heller was aware that Mr. Balboni did not return to work due to symptoms in his shoulders, upper back, and numbness in the right arm and leg. He understood Mr. Balboni "has not been able to resume any activities that were at all strenuous … daily activities are very limited." Dr. Heller was aware that the treatments Mr. Balboni has undergone have been conservative including physical therapy and Vicodin for pain relief. Dr. Heller was aware of Mr. Balboni's "cardiac problems with valvular and septal defects … on long-term Coumadin." Dr. Heller gave a physical examination. He also evaluated the various test results such as the shoulder and upper back MRI showing the rotator cuff tear and the "ruptured thoracic disk at T7-8, compression fracture of the upper thoracic spine … reference to a possible right tenth rib fracture." Dr. Heller diagnosed an impingement syndrome including partial tear of the right shoulder rotator cuff as per history and examination, a compression fracture of the thoracic spine by history, and undiagnosed nerve damage that may be cervical in origin that involves the right arm and right leg by history. Dr. Heller found Mr. Balboni unable to do his job duties. He found that this disability is permanent and might be the natural and proximate result of the December 21, 2004 injury. There was no further discussion on causation. (Ex. 9)
40. Panel physician Dr. Lawrence H. Luppi, an orthopedist, evaluated Mr. Balboni on August 16, 2006. He answered his certificate in the negative. He understood Mr. Balboni's job was Operating Superintendent within the Public Works Department. He understood he slipped and fell on ice on December 21, 2004 and may have suffered a loss of consciousness. He understood he was evaluated at the Jordan Hospital, given a head CT scan, as well as x-rays of the left shoulder, lumbosacral spine and pelvis, which were all normal. He understood he was followed by Dr. Grace. He understood Mr. Balboni has had "varying degrees of neck, diffuse spinal, right arm, right leg, and bilateral scapular pain which prevents regular employment … attempted to return to work in April of 2005." Dr. Luppi was aware that Mr. Balboni had been evaluated by Dr. Zabilski, Dr. Murphy, Dr. Carillo, Dr. Paskowski, Dr. Childress, and Dr. Gannon. He was aware of the diagnostic studies Mr. Balboni has undergone including the lumbosacral spine MRI showing minimal degenerative changes, the left shoulder MRI, the thoracic spine MRI showing minimal degenerative findings, the cervical spine MRIs showing minimal degenerative findings, the head MRI that was normal, the head CT scan that was normal, and the upper and lower electrodiagnostic tests done with Dr. Childress that were within normal limits. Dr. Luppi was aware of the various physical therapy and medical treatments Mr. Balboni has undergone. He understood that Mr. Balboni was taking Vicodin for pain. He understood his symptoms were of neck, right shoulder and diffuse dorsal and lumbosacral pain, and right leg pain that starts in the low back. He understood that Mr. Balboni had a medical history that includes gout, an anxiety disorder, a history of colonic ulcers, "mitral valve prolapse, and transient ischemic attack secondary to patent foramen ovale." Dr. Luppi was aware that Mr. Balboni takes a number of medications including Coumadin. Dr. Luppi gave a physical examination. He diagnosed Mr. Balboni with chronic pain by history, and found no "ongoing significant orthopedic/anatomical diagnosis to account for his pain, and … unable to establish a disability as related to any employment." (Ex. 10)
41. Panel physician Dr. John Groves, an orthopedist, evaluated Mr. Balboni on August 24, 2006. He answered his certificate in the affirmative. Dr. Groves was aware of the fall at work on December 21, 2004 of slipping on ice and landing hard onto the left shoulder, including sustaining "a fractured right rib." Dr. Groves noted Mr. Balboni was unconscious for awhile as a result of the fall. He noted he fell onto his back and also injured his right arm. He was aware Mr. Balboni was seen at the Jordan Hospital, and that he was since evaluated by a number of physicians including Dr. Zabilski of the Jordan Hospital Pain Clinic. Dr. Groves was aware that he tried to return to work in April 2005 but was not able to last more than four weeks with no work since and with continuing symptoms from the December 21, 2004 fall. Dr. Groves understood Mr. Balboni has pain in his right scapular region, has weakness in his right arm, and radiating pains into his right leg and foot. He understood he has trouble bending and stooping. He understood he has left shoulder pain that improved. He understood he has trouble due to numbness in the right hand with typing and writing, and that he cannot engage in strenuous activities because of the right arm and right shoulder. Dr. Groves was aware of his diagnosis of "a patent foramen ovale and … significant TIA some twelve years ago for which he is being treated with Coumadin." He had knowledge of the 2002 foot injury and the splenectomy. He understood Mr. Balboni has been treated for gout, hypercholesterolemia, and hypertension. Dr. Groves gave a physical examination. He also saw the various test results such as the x-rays and MRIs. He found they revealed: minimal degenerative disease without herniation or impingement in the cervical and lumbar spines; "chronic minimal anterior weight deformities in the lower thoracic spine with cervical thoracic scoliosis," and degenerative findings; and, the left shoulder rotator cuff partial tear. He also reviewed the reports of Dr. Grace, Dr. Carillo, Dr. Paskowski, Dr. Murphy, and Dr. Zabilski. He reviewed the job description for Highway Superintendent. (Ex. 11) He diagnosed:
1. Paralysis thoracic anterior muscle right shoulder blade;
2. Mild adhesive capsulitis right shoulder related to diagnosis
number one;
3. Degenerative arthritis thoracic spine;
4. Facet arthropathy lumbar spine;
5. Foot drop right lower extremity with absent ankle reflex;
6. Fractured right tenth rib, resolved. (Ex. 11)
Dr. Groves opined that Mr. Balboni could not perform his essential duties on a permanent basis and that this disability might be the natural and proximate result of the December 21, 2004 injury. He found "objective physical findings of paralysis of the anterior serratus muscle of the right shoulder blade area due to inactivity of the long thoracic nerve." He opined Mr. Balboni has reached a medical end result. (Ex. 11)
42. The Plymouth Retirement Board voted to deny Mr. Balboni's application for accidental disability retirement. Mr. Balboni filed a timely appeal. ("A". Exs. 1 & 2)
Mr. Balboni's claim involves a complicated set of medical conditions. At the very least, the Plymouth Retirement Board has shown that it provided to the three Medical Panel physicians, all the pertinent medical information that existed at the time of filing for accidental disability retirement. It is unclear from the record if all the Panel physicians had information on the treatments Mr. Balboni had after filing for retirement, by Dr. Childress and Dr. Gannon. Dr. Luppi notes his knowledge of their evaluations, but the reports of Dr. Heller and Dr. Groves do not. Mr. Balboni should have provided the evaluations of these two physicians to the Respondent Board for forwarding to the Panel physicians. The record shows that all three physicians gave Mr. Balboni a physical examination, and understood that he had fallen on ice on December 24, 2004.
The Panel physicians were able to review the details of the many medical tests and evaluations done following that fall. They also had a past medical history on Mr. Balboni. In terms of the job description information, the Panel physicians had the job description for Highway Manager, and Dr. Groves also had the job description for Highway Superintendent. I agree with Mr. Balboni, that absent some accommodations made to avoid the exertional work set forth in both job descriptions, both descriptions read largely the same including as to the essential duties.
The Medical Panel physicians are to address the medical evidence that is beyond the expertise of a lay person to adequately assess. They must also have before them the pertinent non-medical information such as proper job description information and a proper understanding of the claimed injury at work. Malden Retirement Board v. Contributory Retirement Appeal Board (CRAB), 1 Mass. App. Ct. 420 ( 1973) The Medical Panel take into consideration the job's essential duties and determine if these tasks can be performed on a sustained basis. G.L.c.32, §7(1) See, Brookline Retirement Board v. CRAB, 33 Mass. App. Ct. 478 (1992) (The Police Officer is disabled even if can perform light duty and at least some of the regular required duties.); Quincy Retirement Board v. CRAB, 340 Mass. 56 (1960) (There is a disability when there is an inability to carry out regular required duties on a sustained basis.). The Panel physicians had to determine if any total disability found is permanent, or if it is a condition that may be improved with reasonable treatments, or will improve within a reasonable period of time. Retirement Board of Revere v. CRAB (DiDonato), 36 Mass. App. Ct. 99 (1994) (Police Officer refused arthroscopic knee treatments likely to have improved his condition at reasonable risk to him.) See also, Yoffa v. Metropolitan Life Insurance Company, 304 Mass. 110 (1939); Hovhanesian v. New York Life Insurance Company, 310 Mass. 625 (1942) (Improvement to the point of no further disability at some unforeseeable time does not prevent finding the disability to be permanent.). The Panel had to determine whether any total and permanent disability found might be the natural and proximate result of the December 21, 2004 incident. This means finding this incident was more than a contributing cause among a number of causes for why Mr. Balboni cannot work at the job any longer. Campbell v. CRAB, 17 Mass. App. Ct. 1018 (1984) This also involves considering whether what happened on December 21, 2004 might be the primary cause for aggravating a pre-existing condition into a total and permanent disability. Zavaglia v. CRAB, 345 Mass. 483 (1963); Baruffaldi v. CRAB, 337 Mass. 495 (1958)
The findings made show that Mr. Balboni had pre-existing health issues including a 2002 foot surgery, and a stroke/cardiac incident that resulted in being placed on Coumadin ever since. He was also being treated for high cholesterol, hypertension, and for an anxiety disorder. He was complaining of left shoulder discomfort in the fall just prior to the December 2004 injury. The left shoulder condition was one of the complaints Mr. Balboni had following the fall. He also experienced stress at work upon his return in April 2005. It is not clear from the medical evidence just how significant a role any of these conditions played in why Mr. Balboni stopped working. None of these pre-existing conditions was set forth by the majority of the Medical Panel physicians as playing a factor in why Mr. Balboni is disabled.
From the December 21, 2004 time period through the time of the Medical Panel evaluations in August 2006, the kinds of pain complaints Mr. Balboni experienced, changed in ways that appear to be significant. He was given lumbar spine, pelvis, left shoulder, and left knee x-rays as well as a head CT scan as a result of his emergency room visit after the accident. Nothing emerged at that time concerning right shoulder issues or right arm, hand and leg symptoms, or interscapular thoracic discomfort. He fell onto his left side and back during the fall. The opinion of Dr. Brown was that Mr. Balboni was not disabled, and the etiology of the thoracic spine discomfort was not due to the December 2004 fall. The opinion of Dr. Caprio was that the thoracic spine condition was not due to the December 2004 fall, and that Mr. Balboni was able to do his job's non-exertional tasks on a full-time basis. Dr. Bentley found Mr. Balboni able to do sedentary work. Dr. Gannon could not determine the etiology of the thoracic spine condition. Dr. Paskowski found Mr. Balboni could do sedentary work, and he could not determine the etiology of the thoracic spine condition.
These are conditions that existed at the time of the Panel evaluations. Dr. Heller notes in his report that the fall produced "injury to his shoulders and loss of consciousness," and that subsequently, he felt unable to work "because of ongoing problems in multiple areas, including both shoulders, upper back, and decreased sensation with feeling of numbness of the right arm and right leg." Dr. Heller found he had by MRIs, a "partial tear of the right rotator cuff, ruptured thoracic disk at T7-8, compression fracture of the upper thoracic spine, with the exact level not identified … a reference to a possible right tenth rib fracture." He goes on to diagnose an impingement syndrome in the right shoulder, a compression fracture in the thoracic spine, and an undiagnosed nerve damage involving the right arm and leg. He does not provide any detailed explanation about how the August 2006 disabling conditions are tied to the December 2004 fall. (Ex. 9)
Dr. Luppi notes in his report that Mr. Balboni landed "on his back with questionable loss of consciousness …[had] head CAT scan and x-rays of the left shoulder, lumbosacral spine, and pelvis … reported to be within normal limits." He understood after this Mr. Balboni had complaints of "varying degrees of neck, diffuse spinal, right arm, right leg, and bilateral scapular pain." He simply found by his August 2006 evaluation, no "ongoing significant orthopedic/anatomical diagnosis to account for his pain." (Ex. 10)
Dr. Groves notes in his report that Mr. Balboni "fell heavily" on the ice on December 21, 2004, "landing on his left shoulder and he sustained a fractured right rib." He also found he landed on his back, and "injured his right arm." He notes complaints in August 2006 in the "upper back, right shoulder, right scapular region, low back and right leg." He further notes an August 2006 complaint of right hand numbness and right arm limitations. He notes that now Mr. Balboni has "paralysis of the anterior serratus muscle of the right shoulder blade area due to inactivity of the long thoracic nerve." He finds there is a "right foot drop and signs of right leg radiculopathy." Dr. Groves does not provide any detailed information to support his affirmative certificate response as to causation. (Ex. 11) I read the majority Panel physicians reports as finding it medically possible all the disabling conditions they found are due to the December 21, 2004 fall.
There is no discussion in any of the Panel reports that address the job accommodations Mr. Balboni was offered by his employer which he rejected. He testified that even with accommodations, he could not work full time due to back pain. The accommodations allowed him for 90 day time periods at a time to avoid any heavy lifting or strenuous tasks. This information reflects the actual job standard that the Panel physicians should have considered of the Highway Manager with the job accommodations, and not just the job as it was written. There is some indication in the Employers Statement concerning the accommodation, and it may be that the Panel physicians were provided with the letters from the employer discussing the ability to work with an avoidance of strenuous tasks. But, either they did not consider these job accommodations or they did not realize there were such accommodations. Either way, this is a significant piece of factual information that taints the propriety of the Panel evaluations as to the existence of a disability. Kelley v. CRAB, 341 Mass. 611 (1961)
Dr. Luppi found no disability even employing the full job description which includes the occasional need to do strenuous tasks, so appreciating he could avoid such tasks due to the job accommodations would not have altered his certificate answers.
Based on this failure to give consideration to the pertinent job accommodation/ modification of duties issue, the case is remanded to the same Medical Panel physicians for reconsideration of their certificate responses in light of Mr. Balboni's ability to avoid strenuous tasks in working as Highway Manager, although he still had to work full-time. In addition, the Panel physicians need to be provided with the evaluations done by Dr. Childress and Dr. Gannon. (Exs. 5, 6, 7 and 13) If it is not practicable for the same Panel physicians to reconvene about this issue, then a new Medical Panel is to be convened.
Sarah H. Luick, Esq.
Administrative Magistrate
DATED: March 12, 2008
This information is provided by the Division of Administrative Law Appeals .


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Game On! Sports Schedule for February 20, 2013
The New York Knicks continue their quest to remain within shouting distance of the Miami Heat in the Eastern Conference race, while the Indiana Pacers want to remind the league they have designs on a deep playoff run.
The Knicks and the Pacers tussle tonight in Indiana. The Pacers are breathing down the Knicks' neck for the second seed in the East and a win tonight will only tighten things up.
Here's a look at the entire sports schedule this evening. All times Easterm:
Memphis at Toronto 7 p.m.
Detroit at Charlotte 7 p.m.
New York at Indiana 7 p.m.
New Orleans at Cleveland 8 p.m. (ESPN)
Miami at Atlanta 8 p.m.
Brooklyn at Milwaukee 8 p.m.
Oklahoma City at Houston 8 p.m.
Philadelphia at Minnesota 8 p.m.
Orlando at Dallas 8:30 p.m.
Boston at Los Angeles Lakers 10:30 p.m. (ESPN)
Phoenix at Golden State 10:30 p.m.
NCAA Men's Basketball Top 25
Santa Clara at (3) Gonzaga 11 p.m. (ESPNU)
Providence at (8) Syracuse 7 p.m. (ESPN2)
(9) Kansas at (14) Oklahoma State 9 p.m. (ESPN2)
DePaul at (11) Georgetown 7 p.m.
Washington at (12) Arizona 11 p.m. (ESPN2)
Minnesota at (18) Ohio State 7 p.m.
(19) Wisconsin at Northwestern 9 p.m.
Houston at (21) Memphis 9 p.m.
(22) Colorado State at UNLV 10:15 p.m. (CBS Sports Network)
Philadelphia at Pittsburgh 7:30 p.m. (NBC Sports Network)
St. Louis at Colorado 10 p.m. (NBC Sports Network)
Los Angeles at Calgary 10 p.m.


text:
SAN FRANCISCO (AP) — Waterlogged Northern California was slated to get a brief reprieve on Monday after a stormy weekend, but more rain is forecast on Christmas Day.
SAN FRANCISCO (AP) — Waterlogged Northern California was slated to get a brief reprieve on Monday after a stormy weekend, but more rain is forecast on Christmas Day.
The National Weather Service was forecasting a mostly sunny Monday, but Tuesday will likely see a return to soggy conditions.
The National Weather Service has issued a winter weather advisory for the northern Sierra on the afternoon of Christmas Day.
Other areas are under a winter storm watch.
Northern Californians slogged through two days of wet and windy weather this weekend as two storms moved through the region, causing headaches for people driving on freeways and delays for air travelers.
After a bit of a break in the weather Saturday evening, more heavy rain and strong winds hit the region on Sunday as a slow-moving but more powerful weather system moved through the region, said National Weather Service forecaster Diana Henderson.
"It (Saturday's storm) didn't hold as much water," Henderson said. "It came, it dumped its rain and it ran," she said. "This one is a little moister and a little slower, so it's taking its time meandering through the Bay Area."
But with the ground already saturated from the previous rain, flood warnings were issued for Sonoma and Napa Counties, particularly for small creeks, streams and roads, Henderson said.
A flood watch issued by the National Weather Service for the Russian River at Guernville in Sonoma County remained in effect Monday morning.
Other rivers were at flood monitoring stage.
For holiday travelers, the storm caused delays at the airports and accidents on the freeways through late Sunday.
"We've definitely had our share of crashes but not a significant amount," said California Highway Patrol Sgt. Diana McDermott.
A nine-car pileup in Oakland and fatal crashes in Sonoma and Marin counties were among the traffic accidents caused by speeding drivers on slippery highways, McDermott said.


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STOCKTON - Diego Sanchez got to know Tahoe Flash the first two times he rode the colt, and was confident they would eventually get into the winner's circle together.
STOCKTON - Diego Sanchez got to know Tahoe Flash the first two times he rode the colt, and was confident they would eventually get into the winner's circle together.
His prediction was realized Saturday in the 11th Dick Kranz Memorial Race at the San Joaquin County Fair.
Tahoe Flash held off a late charge to win the six-furlongs race dedicated to Kranz, a longtime sportswriter and assistant sports editor of The Record and horse racing enthusiast who died in 2002. Sanchez, who missed most of the first week of the fair because of illness, posed with several members of the Kranz family after his victory .
"This is the third time I've been on this horse, and he just gets better and better each time," said Sanchez, who won his 33rd race of the year and first of the fair. "I'm not surprised he came out ahead."
Virginia Kranz, Dick's wife, made a small wager on Tornado Red because of jockey Ronald Richard, whose surname is the same as her husband's full first name. Tornado Red was third, but she wasn't troubled. She sat in the box area on "Derby Hat Day," and got into the spirit of the event with a bright purple hat.
"Oh, no, I don't worry about winning," she said. "It's such a nice day and remembrance of Dick, and it's nice it has kept going all these years."
Dick Kranz came to Stockton in 1961 to work at The Record, and soon became involved with horse racing at the fair. His son, Dave Kranz, said some years his father would plan his vacation time around the fair so he could help out, and sometimes he covered it for the paper. It meant a lot to him, and the race in his honor means as much to his family.
"For us, it's like a family reunion," Dave Kranz said. "It's on the calendar, along with Christmas, Easter, Thanksgiving and the Super Bowl."
Veteran jockey Russell Baze had another big day, winning three times on Toss the Dice (fourth race), Voltarra (sixth) and Bespoke Suit (eighth). He has 15 wins at the fair this year and a record 11,489 victories in his career.
"This is one of the better fairs that I've had in a while," Baze said. "It's just gone very well."
The derby hat event drew many women in colorful hats, and some new horse racing fans. Among the fans were members of the Sacramento chapter of the Red Hat Society, a group dedicated to social interaction and bonding among women over the age of 50.
"We proudly wear our hats in public, and heard about this Derby Hat Day and decided we would come," said 60-year-old Jackie Bush of Sacramento. "I had never seen horse racing, but it was wonderful. There's a lot of nice hats here, the grounds are beautiful and the fair is nice."
Contact reporter Scott Linesburgh at (209) 546-8281 or firstname.lastname@example.com.


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As the Slow Train Coming tour rolled on Dylan's audience was furious, and reviewers were savage. Dylan remained undaunted, however, and the unrecorded songs featured in his live show became the core of his next album, Saved.
Tag Archives: Jesus
Album Art: An artist's look at 'Slow Train Coming'
Bob Dylan gets religion in the "gospel years" part 3
The release of Slow Train Coming came as a shock to Bob Dylan's secular audience. As Dylan prepared to hit the road again in November 1979, presumably to introduce his audience to his new way of life, the question on a lot of people's minds was whether the faith reflected in the album would remain as easy to summon up.


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01.18.12Scott Copeland has joined RPM International Inc. as director-corporate development. His work will be focused on RPM's acquisition program.
Prior to joining RPM, Copeland was director, transaction services with PricewaterhouseCoopers LLP (PWC). While at PWC, he worked on a wide variety of acquisitions and divestitures, both domestic and international, including more than 30 transactions for RPM. Before working for PWC, he was an auditor at KPMG in Cleveland, Ohio.
Copeland earned a bachelor's degree in economics and accounting from Miami University in Oxford, Ohio. He sits on the board of the Rocky River Recreation Foundation, is a former member of the Big Brothers Big Sisters Charity Golf Foundation Committee and holds a CPA license in the state of Ohio. He is a resident of Rocky River, Ohio.


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Jessica Stroup Brunette Updo
Jessica Stroup's chic updo works perfectly on straight, layered hair with long, sideswept bangs. Steal her style: 1. If your hair is already straight, great. If not, just blow dry it straight with a paddle brush (use straightening balm if necessary).2. Gather hair into a bun, either straight back or to the side, leaving your bangs and a few side pieces out. Secure with an elastic and bobby pins.3. Make a deep side part with leftover pieces and flatiron them until they are super sleek.4. Mist with shine spray if you want an extra glossy finish. Then set the entire look with hairspray.


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Creating an enabling business environment and building suitable indigenous technological capability in technology recipient countries, and creating the enabling environment for stimulating technology outflows are basic to transport technology transfer. Hence, these are briefly commented on in the following two paragraphs before continuing with a description of specific technology transfer policies and measures.
Building the necessary human resource for technology transfer and development is important to the transfer process, and this may involve programmes and policies for an adequate S&T human resource base, promotion of general S&T literacy, ensuring active participation of the indigenous S&T community and utilising local materials and other resources. A modern computerised system for information storage, retrieval and use with linkages to relevant national and global systems is very important. Equally important is a well-organised and co-ordinated institutional framework performing functions ranging from regulating, skill development, information development and dissemination, and to financial management. Suitable legislation for technology imports (choice, selection, evaluation and monitoring), foreign investments, and project assessment, approval and monitoring are needed, as well as institutions for law enforcement and arbitration (Davidson, 1998).
Creating a favourable business environment is important in addition to a stable macro-economy for technology flows. This includes having clear and well-defined operating guidelines for business operations, organised financial institutions, market information development and dissemination, and support training programmes and associated technologies. These capacities will not only enhance the absorption of technologies being transferred, but create the capacity for generating new technologies and so offer new transfer opportunities. As an example, these capacities were crucial in the transfer of technologies to the Asian countries, which have enjoyed significant economic progress recently (World Bank, 1996).
Stimulating technology flows from technology supplier countries is needed for the transfer of transport technologies. This will require instituting certain measures such as informing local companies about potential markets, financial support for joint ventures with companies in recipient countries, grants for investments with transfer-of-transport options, preferential treatment to firms that transfer and sponsor expertise to live and work with recipients. In addition, supplier countries should ensure that options for transfer have been adequately tested domestically to build the confidence and respect of the recipient (UNCTAD, 1999).
An important specific policy for technology transfer is the will and commitment of governments involved in the transfer and development of transport technology. This was the most single important factor for the success of technology transfer of the automobile industry in South Korea as shown in Table 8.6 (Pacudan, 1998). This commitment can be from the highest possible authority and be demonstrated by long-term strategic plans of technology growth, while linking it to other development policies and programmes.
|Table 8.6 Transfer of vehicle technology: a case study of South Korea
|Passenger Cars (Hyundai and Daewoo)
Another specific policy is the promotion of R&D in the transport sector. Globally, industrial R&D in the transport sector have undergone major changes in the last two decades. First, there has been a substantial increase in R&D funds by vehicle manufacturers in industrialised countries, especially in the US, Europe and Japan; second, a change in direction and scope of R&D funding; and third, a change in the management and organisation (Gerybadze, 1994). R&D management has changed from centralisation with no explicit strategies in the 1970s, to project planning, strategic management and decentralisation in the 1980s, and now to integration of R&D strategy to corporate strategy, balancing between basic and applied research programmes within networks. Governments can institute new policies and programmes to exploit these changes, because despite production still being concentrated in a few companies, opportunities exist for technology recipients with vehicle assembly plants to encourage joint R&D activities with the main firms. The case of increased imports of cars produced in Mexico by the U.S. automobile manufacturers illustrates this point. During the devaluation of the Mexican peso, U.S. companies easily imported high quality produced cars from Mexico back to the U.S. for distribution because they were cheaper. It shows the importance of building capabilities in recipient countries. Another aspect of R&D programmes is to enhance local R&D through promotion of contract R&D programmes between public and private sectors within and between countries. This can promote relevance and stimulate interest in local R&D, as has been the case of Malaysia where companies have been able to receive a 200% tax exemption for R&D expenditure (Idrus, 1988). Setting up a revolving fund for R&D promotion and commercialisation of results as being done in countries such as South Korea and Japan can help to promote R&D. Due to the rapidity in innovations, and the expensive and skill demanding nature of modern R&D globally, countries need to participate in international and regional R&D networks. Joint R&D will allow technology recipient countries access to very expensive equipment, laboratories, and high quality skills, which are normally absent in many technology recipient countries.
In general, technology co-operative agreements among firms can form a very good basis for the transfer of transport technologies. Joint ventures in equity and no-equity firms offer opportunities for technology transfer. In equity form, the recipient will be fully involved in decision-making in the capitalisation of technology, royalty fees and organisational arrangements, and depending on the capability of the recipient, significant technical skills such as procurement of equipment, R&D, quality control and marketing skills can be transferred through joint programmes. Joint R&D programmes could be an efficient means of transferring knowledge and stimulating activities especially among resource-constrained countries. Financial, marketing and management cooperation agreements can be used to access technology through non-equity joint ventures. The use of joint agreements in other forms can be used effectively to promote information access and exchange. However, in joint agreements, partners need to be prepared to share the risks and costs of programmes. These agreements could be used to stimulate the transfer of smaller and fuel-efficient cars between parent and subsidiary firms, hence encouraging transfer between countries.
Bilateral co-operative agreements between countries which could lead to twining or linking of cities can provide opportunities for cities with successful urban planning systems that had yielded GHG benefits to transfer such experiences to other cities. Exchange of personnel, targeted visits, joint implementation of programmes are some of activities which could result in the transfer of skills and knowledge (Figueroa et al, 1998). "Integrated transport planning" which involves a set of policies that matches the environmental and transport agendas using experiences worldwide can improve the local and global environment of many cities. This can include the harmonisation of a wide range of policy objectives such as wider use of public transport, new road infrastructures, pricing policies, and environmental quality monitoring (IIEC, 1996).
Technical assistance programmes can offer technology recipient countries opportunity
to access specific skills such as technical advice on operation, maintenance,
and quality control, but not proprietary technical information. Consultancy
services can be used to transfer specific technical skills. Management contracts
could be used to acquire selected skills such as organisational and technology-sourcing
skills, but problems could arise from different perceptions of project objectives
between the two parties, unnecessary extension of contracts, and level of involvement
of indigenous employees.
Promotion of standards and regulations can significantly be used to control emissions, especially from road vehicles as was demonstrated in the USA with the 'Clean Air Act'. Nearly all countries have standards for vehicle emissions, but many technology recipient countries have weak enforcement mechanisms, hence compliance is generally weak. Applying standards depends on several factors such as the manufacturing base of the country, capacity to enforce the standards and facilities to comply with the standards. Using similar standards in countries with assembly plants as those of the parent companies will ensure that updated technology will be transferred between both countries. Countries without manufacturing capacities can institute strict standards, but they need to have the capacity to enforce them such as testing and inspection facilities. Strict standards can also be used to control second-hand imports.
Policies that can promote local technology development if the basic technical capacities are present include discouraging imports of completely built up units, providing incentives to local assemblers to increase local content in production (tax reduction, subsidies), and regulations to ensure local content in varying percentages. These policies, which were instituted in the development of automobile manufacture in South Korea, can provide significant lessons for technology recipient countries in the acquisition of many GHG reduction options in the transport sector (see Table 8.6). Some countries have embarked on national programmes for transport technology development, though most of them are for automobile promotion as was the case of South Korea and India. More recently, some African countries are doing the same. Nigeria and Kenya are examples of such moves. In the case of Nigeria the prototype has been demonstrated, while in the case of Kenya the prototype is yet to be adequately tested.
Policies and measures to promote non-motorised systems mainly involve the construction of the associated infrastructure such as dedicated lanes with the supporting signalling systems, and parking facilities for cycles. Creating local manufacturing facilities for bicycles to increase public access will be useful to improve their use by poorer members of the society. On the whole, these policies and measures should be integrated into the overall transport policy, as has been done in some European cities.
Multilateral agencies can be useful in facilitating the transfer of transport technologies through provision of specific information, support for local information networks, provision of technical advice and providing training programmes. Also, these organisations can be used to provide unbiased information regarding technology products and services. The Global Environment Facility (GEF) that is concerned with providing funds for abating GHG emissions will hopefully approve a transport programme soon that is aimed at funding non-motorised transport, modal shifts, electric and hybrid vehicles, and biomass transport fuel. GEF is expected to be restructured to include support for technology transfer activities (GEF, 1999).
Other reports in this collection


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WHAT: ARM will be presenting two papers at this year's Microprocessor Forum providing attendees with the first opportunity to hear the technical details of two new product innovations.
WHO: John Goodacre, Program Manager, Multiprocessing, ARM, will be presenting "ARMv7 Architecture Receives Multi-processor Extensions" which will be the first disclosure of new extensions to the ARMv7 architecture that form the basis for future ARM multi-processors. This presentation will also explore the fundamental requirements of multi-processor systems and reviews existing hardware and software implementations.
Ian Devereux, Director of Technology, Processor Division, ARM will also present a paper entitled "A New ARM Processor for Synthesis on FPGA", providing an overview of the technology applied to enable the creation of an ARM processor designed for synthesis on FPGA.
WHERE/WHEN: Microprocessor Forum will take place 22 – 23 May, 2007 at the Doubletree Hotel, in San Jose, California. Both ARM papers will be presented in the afternoon on Wednesday 23 May.
WHO: ARM designs the technology that lies at the heart of advanced digital products, from mobile, home and enterprise solutions to embedded and emerging applications. ARM's comprehensive product offering includes 16/32-bit RISC microprocessors, data engines, graphics processors, digital libraries, embedded memories, peripherals, software and development tools, as well as analog functions and high-speed connectivity products. Combined with the company's broad Partner community, they provide a total system solution that offers a fast, reliable path to market for leading electronics companies. More information on ARM is available at http://www.arm.com.
About Microprocessor Forum
Microprocessor Forum is configured to both educate engineers and showcase the latest product announcements. Every presentation made at Microprocessor Forum describes challenges encountered by chip designers and outlines the real world solutions that were implemented to overcome those challenges. Every session is developed to address the primary concerns of OEM and SoC designers today. Presentations are solicited and hand picked by In-Stat's analysts to provide marketing-free, quantitative technical information geared toward both educating engineers and showcasing the latest product announcements. In its 18th year, Microprocessor forum delivers on technical content, unprecedented networking and real world solutions to the challenges that face today's design engineers.
In-Stat is proud to present Fall Microprocessor Forum 2006 – check it out online at:
ARM is a registered trademark of ARM Limited. All other brands or product names are the property of their respective holders. "ARM" is used to represent ARM Holdings plc; its operating company ARM Limited; and the regional subsidiaries ARM INC.; ARM KK; ARM Korea Ltd.; ARM Taiwan Ltd; ARM France SAS; ARM Consulting (Shanghai) Co. Ltd.; ARM Belgium N.V.; AXYS Design Automation Inc.; ARM Germany GmbH; ARM Embedded Solutions Pvt. Ltd.; ARM Physical IP, Inc.; and ARM Norway, AS.
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