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This item appropriates funds for the Financial Information System for California (FI$Cal). FI$Cal is an information technology (IT) project managed by a partnership of the Department of Finance (DOF), the State Treasurer's Office (STO), the State Controller's Office (SCO), and the Department of General Services (DGS). The purpose of this project is to create and implement a new statewide financial system.
For FI$Cal, the 2008–09 budget proposes 98 positions and $40.1 million ($2.4 million General Fund, and $37.7 million special funds).
The 2008–09 Governor's Budget proposes to proceed with statewide implementation of the Financial Information System for California at a total cost over a multiyear time frame of $1.6 billion, with a 30–day legislative review period after the initial departments are implemented. We recommend an alternative which limits the initial scope of the project, allows for a more extensive legislative review before proceeding with statewide implementation, results in lower initial expenditures, and reduces the project's reliance on borrowing.
Expanding on the New System for DOF. Since 2005, DOF has been working on a project to modernize its existing budget system, known as Budget Information System (BIS). In planning for the development of BIS, DOF came to the conclusion that it made more sense to replace all of the state's financial and accounting systems, rather than just modernize the one system within its department.
Project Description. In the 2007–08 budget, the Governor proposed an IT project, referred to as FI$Cal, that would take eight years to develop and implement a statewide automated financial system in all state departments, with a total cost of $1.3 billion. The new financial system would encompass budgeting, purchasing, accounting, and cash management. The project effort would be managed by a partnership of the four control agencies responsible for California's financial management: DOF for budgeting, DGS for procurement, SCO for accounts payable and receivable, and STO for cash management. Independent project oversight would be provided by a consulting contractor reporting directly to DOF.
Last Year's Analysis: Project Risks Significant. In the Analysis of the 2007–08 Budget Bill, we noted that there are significant risks involved in a project as large as FI$Cal. And, like all such IT projects, these risks must be managed and mitigated. Accordingly, we recommended that increased project oversight be imposed in order to maximize the potential for project success. In addition, we discussed a number of key project components which imposed further project risk including:
During the spring 2007 budget hearings, the Legislature acknowledged that the state's financial systems were aging and in need of replacement. However, the FI$Cal project risks were a concern. In the 2007–08 Budget Act, the Legislature appropriated $6.6 million for FI$Cal and adopted language which required (1) transferring an existing oversight contract to the Bureau of State Audits (BSA) and (2) delivering a series of reports to the Legislature by April 2008 to address various project implementation issues. Key elements of the required reports include:
In November 2007, DOF submitted a revised special project report (SPR) to the Legislative Analyst's Office (LAO)—five months early. This SPR is generally responsive to the requirements of the budget act. For example, an MOU has been entered into among the control agencies and a detailed process to hold the vendor accountable is documented. However, the alternative project plans required by the budget act came up short in some respects. Figure 1 summarizes the alternative FI$Cal plans. One of the alternatives specified by the Legislature to be included in the SPR is a pilot project. The SPR included a proof–of–concept project which on the surface may look like a pilot project, however, as presented in the SPR, this alternative is not viable because it would implement less than 10 percent of the departments for nearly $800 million—one–half of the full FI$Cal cost. Finally, we note that the oversight communication plan, also due in April 2008, has not yet been provided to the Legislature.
Figure 1
Summary of Administration's Alternative Approaches to FI$Cal
Completion Year
Recommended Approach. Statewide implementation of new financial system in waves. After completion of first wave with control agencies and four departments, there would be a 30-day legislative review period while implementation of additional waves was under way.
$1.6 billion
Original FI$Cal Proposal. This would implement a new statewide financial system replacing all existing systems.
$1.3 billion
"Proof of Concept" Pilot Project. This would be the four control agencies plus three program departments. Subsequent statewide rollout would be a separate project.
$784 million
Budget Information System (BIS). This is limited to a new budget system at the Department of Finance (DOF).
$138 million
BIS Plus Accounting. This would implement a new budget system at DOF plus a new statewide accounting system.
$1.2 billion
Do Nothing. This would leave departments to propose projects for replacement of their individual financial systems.
$6.2 billion
The revised SPR proposes the original project scope to modernize the control agencies' processes and then implements the FI$Cal system in all departments over a schedule that has been extended by two years. The costs have been revised from $1.3 billion to $1.6 billion to reflect the extended schedule. Industry best practices that improve the project's opportunity for success continue to be part of the proposal. These include having knowledgeable state financial staff on the project and conducting classroom training prior to putting the system into production. Below we describe the plans for implementation and financing.
Implementation Approach. Under the recommended approach, the first wave of departments will be implemented by 2012. These include the four control agencies (DOF, SCO, DGS, and STO) plus four program departments. The program departments are the Departments of Social Services (DSS), Justice (DOJ), Parks and Recreation (DPR), and the Board of Equalization (BOE). These program departments were selected for their broad representation of different state financial functions. For example, the DSS administers many different federal programs involving block grants and entitlements. The BOE is a revenue–generating department. The DOJ has the same 1970s financial system as BOE. The DPR does capital outlay projects, grant management, and bond financing. Together, these departments will test the system's ability to meet a wide range of public sector financial requirements.
By October 2012, the project would submit a status report to the Legislature for a 30–day review period. At this point, the project will have spent $490 million and the second wave of 11 departments will be 15 months into their 24–month implementation. Assuming legislative approval, the remaining statewide implementation would continue and be completed over the following five years. This proposal assumes statewide implementation in 2017 at a total estimated cost of $1.6 billion.
Financing Approach. The administration proposes to borrow $1.2 billion of the $1.6 billion total project costs, initially through short–term bond anticipation notes (BANS). The BANs will include "capitalized" interest so as to eliminate debt–service costs until permanent financing is issued in the form of Certificates of Participation (COPs). (Capitalized interest is the practice of borrowing expected future interest payments so as to avoid debt service costs in the short term.) Debt service would begin in 2012–13. Ongoing maintenance and operations costs (M&O), including repayment of the borrowing, are to be funded through cost allocation to the departments.
Debt Repayment by Departments. The administration's fiscal estimates reflect M&O costs of $101 million starting in 2017, after statewide implementation is complete. The repayment schedule estimates that total debt–service payments in 2017 will be $99 million, rising to $142 million in 2020. Departments will be allocated their share of these combined amounts. Currently, departments share in the cost of existing financial systems such as CalSTARS. Savings from not having to pay their share of CalSTARS operations will in part offset the departments' new obligations to pay M&O and debt–service costs for FI$Cal. The amount of any such savings will only be determined after each department is implemented and is not likely to be significant. However, there may be management efficiencies in that better information is available from the new system for analysis.
Cost Allocation Plan and Federal Participation. The administration indicates that the federal government will share in about 18 percent of project costs. However, federal participation will not begin until 2012–13, after the system is operational in the control agencies and Wave 1 departments. This is because the federal government does not participate during the development phase of financial projects such as FI$Cal. In addition to the federal 18 percent share, the administration estimates that the General Fund will cover about 31 percent of project costs, with special funds covering the remaining 51 percent.
Figure 2 shows the estimated annual project costs through 2017–18. The first BAN would be issued in June 2009. This BAN would repay a proposed General Fund loan to cover FI$Cal costs during 2008–09 and fund project costs during 2009–10.
Figure 2
FI$Cal: Administration's Recommended Approach Estimated Annual Project Costs
(In Millions)
Below we assess the advantages and limitations of proceeding now with FI$Cal or a FI$Cal–like IT project.
Replacing Old Systems in Danger of Failing. Most of the state's financial infrastructure is comprised of individual department systems which were primarily developed in the 1970s and 1980s. Many of these 'legacy' systems are written in programming languages that have been out of use for more than a decade. These systems must be updated regularly for changes to law, policy, or to add new functions—such as direct deposit. Locating programmers skilled in these outdated languages is becoming increasingly difficult. In addition, these older systems are inefficient and labor intensive. Their limitations inhibit the state's ability to meet growing financial reporting requirements. Many departments struggle to close their accounting books within regulatory time frames each year.
Human Capital Risks of Delay. Over the years, the limitations of the state's out–dated financial systems have led state staff to develop external processes and subsystems to supplement these legacy systems. For the most part, these staff are near or at retirement age. These subsystems and processes are largely undocumented. Tapping this knowledge base before it is lost is seen by the administration as an important reason for proceeding now.
Efficiency Gains From Automated Interfaces. FI$Cal will automate the control agencies' processes, many of which still require receipt of hardcopy information. This should introduce efficiencies that result in savings. In addition, there are several departments that have replaced, or are in the process of replacing, their outdated financial systems. These replacement systems allow automated transmission of data. If the control agencies can receive automated data transmissions from these departments, it will maximize the success and efficiency of these newer systems at departments like the Department of Water Resources (DWR), Department of Technology Services (DTS), California Department of Corrections and Rehabilitation (CDCR), Department of Transportation (Caltrans), and the Administrative Office of the Courts (AOC).
High Risk Nature of Project. FI$Cal would be one of the most complex and most expensive information technology projects undertaken to date by state government. It is designed to integrate the budgeting, purchasing, accounting, and cash management systems of the State of California and thus involves more than 100 different entities. Each department will have to adjust its business processes to accommodate commercial software that is different than is being used today. During each department's implementation period, which is estimated to span a year, state staff will continue to be responsible for accomplishing their ongoing workload using current processes while at the same time transitioning to new business practices. This will create a significant level of organizational stress. At this stage of the project, there is no absolute assurance of project success. Given the project's complexity, time delays and cost overruns can be expected.
Degree of Financing Is Unprecedented for an IT Project. The FI$Cal proposal to finance the majority of project development costs using BANS and COPs is a departure from the way IT projects have been paid for in the past. It is common practice for the state to borrow for the acquisition of tangible capital assets. Equipment purchases by the state data centers are financed to align their cash flow with their cost recovery schedule. Borrowing is also used for large IT development projects to acquire the hardware and software products needed to implement the system. For FI$Cal, these costs are $83 million of the $1.2 billion that will be financed. The balance of the borrowing, however, would cover staff and contractor salaries in addition to leased facilities and payments to the state data center for processing and telecommunications costs. For past IT projects, these types of costs were funded with pay–as–you–go appropriations.
Typically, debt financing is used to acquire tangible assets such as buildings and equipment, which have an economic value. In essence, this plan finances a less tangible asset, something that has value to the state, but could not be valued as collateral because it would have little or no value to an outsider. The proposed borrowing adds $400 million in debt–service costs over the life of the project. Although we believe this financing is feasible, it is not necessarily desirable, especially in the magnitude proposed. Given that this is a less tangible capital asset, it is likely that bond buyers would demand a higher interest rate to compensate for the lack of hard collateral that would typically be available when capital assets such as office buildings are financed. The amount of this risk premium is unknown. Finally, we would note that using bond financing increases the cost of project failure because, even if the project is never completed, the bond buyers would need to be repaid with interest.
Impact on Departments. The future cost of maintaining the FI$Cal system would be paid for by allocating its cost to departments based on their share of use. Adding debt repayment costs to the ongoing maintenance cost would increase costs to departments. Using 2017 as an example, departments would be allocated a total of $200 million; $99 million to repay the debt service plus $101 million for the M&O of the system. Of this amount, the federal government would pay 18 percent, while special funds would pay 51 percent and the General Fund would pay 31 percent. To some extent, this cost would be offset by some unknown savings. In order for departments to maintain their program service levels, the Legislature would most likely be asked to appropriate additional funds to cover these FI$Cal costs.
Borrowing Versus Pay–as–You–Go. Given the state's fiscal condition and the need to update the state's financial systems, a reasonable case can be made to finance the first two or three years of project costs. However, by the third or fourth year, it makes sense to use a more balanced approach between borrowing and "pay–as–you–go" appropriations of special funds and General Fund monies. This would reduce the future debt service burden on the state and its departments.
Proposed Legislative Review Period Unworkable. The project plan requires the administration to submit a report to the Legislature that will discuss the status of the project after implementing the new system in the four control agencies and four program departments. The report would share lessons learned and how these lessons will improve the implementation of the project as it goes forward. However, the report is to be delivered to the Legislature in October, when the Legislature is not in session. Presumably, the Legislature already would have had to make a funding decision regarding the project by July as part of final actions on the state budget.
We believe the proposed 30–day review period is unworkable. First, the Legislature will already have had to make a funding decision as noted above. Second, the review mechanism does not allow adequate time for the Legislature to explore fully the project's challenges and accomplishments and make an informed decision regarding whether to continue with statewide implementation. Moreover, during the proposed review and approval period, the next group of departments will already be more than 60 percent complete in their FI$CAL implementation, thus compromising legislative review of the project.
Although it is a close call, we believe the benefits of proceeding with FI$Cal at this time outweigh the benefits of canceling the project altogether. If the project were canceled, it would take many years before it could begin to be implemented in the first wave departments. In the meantime, departmental systems will continue to be at risk of failure and some may have to be replaced, reducing the benefits of FI$Cal.
Below we present the key features of an alternative which provides for greater legislative oversight and review, lower initial costs, and less reliance on borrowing.
Initial Project Scope. The LAO alternative would go forward with the implementation of "Wave 1" departments. Wave 1 develops the FI$Cal system and installs it in the four control agencies (DOF, SCO, DGS, and STO) plus four program departments (DSS, BOE, DOJ, and DPR). We concur with the administration that these program departments are reasonable choices for the first wave because of their broad representation of state financial functions.
Adjust the Schedule. In order to facilitate legislative review and oversight, the project schedule should be adjusted so that the report on the status of Wave 1 implementation would be presented to the Legislature no later than March 1 after implementation.
Pause for Legislative Approval. Rather than the 30–day review period provided in the administration's plan, we recommend that the Legislature decide whether to proceed with full implementation during the regular budget process or through separate legislation. Unlike the administration's proposal, the project would not proceed with activities to prepare additional departments for system installation until the Legislature has reviewed the report and decided to continue the project. The advantage of this approach is twofold, (1) the Legislature has time to conduct a full inquiry about the project status and, (2) departments that will be implemented in the second phase of the project are not spending project implementation funds until the Legislature has approved the project to continue.
This approach will add a year to the total project schedule because subsequent departments would not begin their one–year preparation until after the Legislature's review. Over the ten–year schedule, this will increase project cost by approximately $67 million, (about $20 million in 2008–09 dollars) compared to the administration's estimates. One might argue that increasing the Legislative review would slow the project down and, therefore, add costs beyond this estimate. We would note that any cost impact could be minimized by (1) adjusting the project schedule to deliver the status report in March instead of October and (2) having the vendor plan for this legislative pause.
Limit Borrowing to $250 Million During the Initial Phase of Development. We estimate the total cost of the first four years of the LAO alternative through Wave 1 implementation to be $461 million. This is $29 million less that the administration's proposal. Given the state's fiscal situation and the need to update the state's financial systems, we recognize a reasonable case can be made to borrow during 2008–09 and 2009–10. However, beginning in 2010–11, we think it makes sense to use a more balanced approach—a combination of additional bond financing and pay–as–you–go appropriations. Bond authority of $250 million represents about 55 percent of estimated Wave 1 project costs. While we see value in replacing the state's aging financial system in the near future, this financing approach will allow adequate time for the administration to set budget priorities that could substantially reduce or even eliminate further borrowing. The Legislature could revisit the issue of additional bond financing, if and when it decides to authorize the remainder of statewide implementation.
Expenditure of Bond Proceeds Subject to Appropriation. In order to increase legislative oversight of funding, we recommend requiring the administration to obtain annual budget act authority to expend bond proceeds.
We recommend that the Legislature adopt the LAO Alternative described above. This alternative would enable the control agencies' processes to be modernized and critical system requirements to be tested fully in four diverse departments by 2012. In contrast to the administration's proposal, this alternative would also ensure the Legislature has time to explore fully the project's status in order to determine if continuing implementation is in the state's best interest. In addition, it results in lower initial expenditures and reduces the reliance on borrowing, thereby avoiding future interest costs.


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The Video Bernanke is Watching Right Now
Somewhere in the lavish Eccles Building in Washington D.C., Bernanke is watching this video: thousands clash with Egypt riot police in Cairo.
Bernanke is caught between a rock and a hard place. The stock market bubble began to collapse last summer as soon as the Federal Reserve began unwinding its special "liquidity" and "easing" programs.
So they went back to the "quantitative easing" well, with the hope of getting investors to buy real estate and stocks. Unfortunately for that plan, there are no free lunches.
Money flooded into commodities, which are a much better store of value and a much better play on inflation.
The commodity speculation has caused food prices to rise, which has led to riots. According to the Financial Times, twenty-five per cent of Egypt's budget is already devoted to food and energy subsidies, and it's also the world's biggest importer of wheat. Food riots have the potential to topple governments, sweeping away the system of puppet governments controlled by the U.S.
As Dmitry Orlov puts it, American leaders appear to be following the Soviet playbook for the imperial end-game quite faithfully: cringing behind high walls and locked doors, looting the treasury like there's no tomorrow, and, of course, lying their heads off. There are a few moments each century when status quo suddenly becomes status quo ante. We may be living through just such a moment now.
The bulls are pretty confident that there will be a third quantitative easing program, and a fourth, ad infinitum. But the Egyptian food riots fortell what will happen in other countries if quantitative easing continues.
Also, I explained a couple months ago that inflation is bad, not good for corporate profits and for earnings multiples. Now, we are starting to see the effects in fourth quarter earnings:
- Procter & Gamble experienced a 190-basis-point decline in gross margins, of which 160 basis points came from increased commodity costs.
- 3M says that it will rein in capital spending as it copes with higher commodity prices as well as rising pension expenses and a higher expected tax rate.
- Ford reports commodity costs increased by $1 billion in 2010 and sees even higher costs in 2011, squeezing profit margins.

subset: commoncrawl


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Saturday, March 30, 2013
Happy Easter!
Wake up! Resurrection Sunday is almost here! The God who created you has provided a way for you to spend an eternity in His presence. He has even prepared a place just for you. "...I go to prepare a place for you. And if I go and prepare a place for you, I will come again and receive you to Myself; that where I am, there you may be also." (John 14:2) There is only one way to receive the gift of eternal life and spend eternity in that place that God has prepared for you. "...I am the way, the truth, and the life. No one comes to the Father except through Me." (John 14:6) That's pretty straightforward.
Here's how it works.
Everyone of us has sinned to the point that we are not worthy to enter into heaven on our own. No amount of good works, charitable contributions, or loving our neighbor will buy our way in to heaven. "For all have sinned and fall short of the glory of God". (Romans 3:23) There is not a soul on earth worthy of entering heaven on their own merit.
"The wages of sin is death." (Romans6:23) The price that must be paid for our sinful behavior is death. Not just physical death, the spiritual death, which is the eternal separation from God. So how do we establish a right relationship with God?
"...that if you confess with your mouth the Lord Jesus and believe in your heart that God has raised Him from the dead, you will be saved. For with the heart one believes unto righteousness, and with the mouth confession is made unto salvation." (Romans 10:9-10) We must admit that we have led a sinful life and that we are in need of a savior. We are required to believe that Jesus Christ is the Son of God and that He has, in fact, risen from the dead. Call on the name of the Lord.
"...that those who live should live no longer for themselves, but for Him who died for them and rose again." (2 Corinthians 5:15) This is NOT a fire insurance policy. Accepting Christ as your savior requires that you and I turn away from our sinful lifestyle and pursue those things that please God. A change in our heart should change our life. Accepting Christ can take place anywhere, any time.
"Behold, I stand at the door and knock. If anyone hears my voice and opens the door, I will come in to him and dine with him and he with Me." (Revelation 3:20) The invitation is open 24/7. You don't have to be in a church, you don't have to be in front of a minister, you only have to open the door to your heart and invite Christ into your life. So, the questions are:
1. Are you a sinner?
2. Do you want forgiveness for your sins?
3. Do you believe Jesus died on the cross for you and rose again?
4. Are you willing to surrender your life to Christ?
5. Are you ready to invite Jesus into your life and into your heart?
I ask you again...
1. Are you a sinner?
2. Do you want forgiveness for your sins?
3. Do you believe Jesus died on the cross for you and rose again?
4. Are you willing to surrender your life to Christ?
5. Are you ready to invite Jesus into your life and into your heart?
Are you sure?
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VINTAR, Ilocos Norte, Jan. 6, 2021– A 15-year-old driver perished in a motorcycle crash at Brgy. Parut, this town, a PNP report said.
P/Major Arnel Tabaog, the town police chief, reported that the fatality and his back rider, 14, were going to a piggery farm when the motorcycle they boarded allegedly hit a big stone on the road leading to the accidental crash.
Due to the impact, the two riders were thrown into the ditch.
The 15 years old was declared dead on arrival at the hospital due to head injuries while the 14 years old survived with bruises, Major Tabaog said.
Investigators said that under the law, parents have liability if they allow their minor children to drive any motor vehicles, worst if they figure in a road accident. (tri-media report)


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Browse by author
Lookup NU author(s): Professor Eileen KanerORCiD, Professor Brian McAvoy, Catherine Lock, Dr Eilish Gilvarry
Full text for this publication is not currently held within this repository. Alternative links are provided below where available.
General practitioners' (GPs') recognition of, attitudes towards, and intervention for. excessive drinking and alcohol problems among their patients were assessed in a postal questionnaire survey. Levels of recognition of, and intervention for, excessive drinking by GPs were low. GPs did not routinely enquire about alcohol and had managed only small numbers of patients specifically for excessive drinking or alcohol problems in the previous year. Enquiry about alcohol issues was elicited mainly by physical symptoms or by new patient registrations. Although 83% of GPs felt prepared to-counsel excessive drinkers, only 21% felt effective in helping patients reduce consumption. Over the past 10 years, there appears to have been an increase in numbers of GPs who feel that they should be working with alcohol issues, but fewer GPs perceive themselves as being effective in this work. The main barriers to brief alcohol intervention were given as insufficient time and training, and lack of help from government policy; the main incentives related to availability of appropriate support services and proven efficacy of brief interventions.
Author(s): Lock CA; Kaner EFS; Gilvarry E; McAvoy BR; Heather N
Publication type: Article
Publication status: Published
Journal: Alcohol and Alcoholism
Year: 1999
Volume: 34
Issue: 4
Pages: 559-566
Print publication date: 01/07/1999
ISSN (print): 0735-0414
ISSN (electronic): 1464-3502
Publisher: Oxford University Press
URL: http://dx.doi.org/10.1093/alcalc/34.4.559
DOI: 10.1093/alcalc/34.4.559
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A message from Myles:
Hello, My name is Myles and I am working on my master's project at Buffalo State. I have created a survey/quiz for students in middle or high school technology classes to participate in. I am researching to see how much knowledge of basic hand tools students have entering the class. It is completely anonymous and should take about 10 minutes to complete through the link provided. I have also included a pdf file of the survey that can be used as a pre assessment test or review for educators to use in technology classes. Once I have the data compiled, I will send the results out for anyone interested. I am looking to gather data only in the Western New York area and have surveys completed by March 26. Survey: https://forms.gle/gcDL8kk6xTpx45GS8
Thank you for your time and participation, Myles Marshall
Any questions for Myles please reach out to us for his email address! Good luck on your master's project!


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R&R In The FASTLANE 180
Welcome to the 180th edition of Research and Reviews in the Fastlane. R&R in the Fastlane is a free resource that harnesses the power of social media to allow some of the best and brightest emergency medicine and critical care clinicians from all over the world tell us what they think is worth reading from the published literature.
This edition contains 5 recommended reads. The R&R Editorial Team includes Jeremy Fried, Nudrat Rashid, Soren Rudolph, Anand Swaminathan and, of course, Chris Nickson. Find more R&R in the Fastlane reviews in the : Overview; Archives and Contributors
This Edition's R&R Hall of Famer
Anderson DJ, et al. Enhanced terminal room disinfection and acquisition and infection caused by multidrug-resistant organisms and Clostridium difficile (the Benefits of Enhanced Terminal Room Disinfection study): a cluster-randomised, multicentre, crossover study. Lancet 2017. PMID: 28104287
- This cluster randomised control trial looked at terminal cleaning of rooms from which a patient with infection or colonisation with a target organism was discharged. 4 different cleaning strategies were tried: reference group (quartenary ammonium disinfectant), UV group, bleach group and UV +bleach group. Patients admitted to rooms previously occupied by patients harbouring a multi-resistant organism or C Difficile were 10-30% less likely to acquire the same organism if the room was disinfected using an enhanced strategy. The most effective of these strategies was when disinfecting ultraviolet was added to a standard disinfectant strategy.
- Recommended by: Nudrat Rashid
Donkor J,et al. Analysis of Gastric Lavage Reported to a Statewide Poison Control System. J Emerg Med 2016. PMID: 27595368
- Gastric lavage used to be frequently and inappropriately used but, better understanding of it's utility as well as the development of other treatment modalities (including antidotes) has led to decreased use. This article reviews lavage cases called in to a state poison center and finds that while numbers are down, many of the ones performed were inappropriate. Bottom line, better education needs to be done to stress when and where it's useful. Ingestions within 60 minutes of presentation of enough drug to have a serious toxic effect and where there's no available antidote should prompt consideration for lavage in conjunction with a toxicologist when possible.
- Recommended by: Anand Swaminathan
Talan DA, et al. Antibiotics-First Versus Surgery for Appendicitis: A US Pilot Randomized Controlled Trial Allowing Outpatient Antibiotic Management. Ann Emerg Med 2016. PMID: 27974169
- Even though the results are very promising for using an antibiotic first strategy in acute uncomplicated appendicitis, a much larger trial would need to be performed before generalizability. Even so, this trial did show that outpatient ED management of uncomplicated appendicitis is feasible.
- Recommended by: Salim R. Rezaie
Hobbs WR, et al. Online social integration is associated with reduced mortality risk. Proc Natl Acad Sci U S A. 2016;113(46):12980-4. PMID: 27799553
- This is a fun little study. They looked at the activity of 12 million facebook accounts in California and compared that to state health records. Having more friends on facebook was associated with decreased risk of mortality. However, you can't just have friends – they have to request you. If you send out more friend requests, you are actually more likely to die. Being tagged in photos means you will live longer whereas posting more status updates means you will die sooner. (They guess that this might correlate with real life social interactions: being tagged in a photo means you were probably with someone else, whereas constantly adding more status updates means you are probably are currently alone, and might stay that way forever.) So, get more friends on facebook, but make sure they add you and not vice versa, and go tag yourself in some photos. (Do I really need to comment on association not being causation?)
- Recommended by: Justin Morgenstern
Nelson CJ et al. Morbidity and mortality associated with medications used in the treatment of depression: an analysis of cases reported to US poison control centers 2010-2014. Am J Psychiatry 2017. PMID: 28135844
- Use of TCAs and MAOIs for treatment of depression has largely given way to the more popular and safer SSRIs. Overdose of SSRIs are comparatively well tolerated and managed relatively easily with good supportive care. With the emergence of the newer antidepressants, particularly the DNRIs (bupropion) and SNRIs (venlafaxine, duloxitine), more serious and even fatal toxicities are not uncommon. Though causality cannot be inferred due to limitations in poison center data, this article highlights the increased attention and caution EM providers should give to overdoses of newer antidepressant medications.
- Recommended by: Meghan Spyres
Intensivist and Donation Medical Specialist, Australia | @NudratRashid |


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Poly-lined 23" grout bag designed for easy flow of material creating a consistent application. It is ready to use with a 3/8" tip molded into the end. The size of the tip can be increased by cutting a small amount off with scissors. Holds 1-1/4 gallons of material to minimize refills. Great for grouting masonry or tile joints for a professional finish. Proudly made in the USA.
- Poly-lined for easy flow for material
- Molded 3/8" tip, which can easily be enlarged
- Holds 1.25 gallons of material.
- Ideal for use in grouting masonry or tile joints
Additional information
Weight | 1 lbs |
Dimensions | 5 × 5 × 3 in |


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Rutgers alumnus: University becoming more politically correct (Listen)
Rutgers is home to some of the highest paid state employees in New Jersey, and you're footing the bill, whether or not you like what's coming from it.
Attorney and Save New Jersey blogger Matt Rooney is a Rutgers grad and one of the disappointed taxpayers who doesn't think the school's leadership has been acting wisely.
"I think the mismanagement up there goes pretty deep," said Rooney about the Rutgers administration. "A simple Google search will reveal quite a bit of it." According to him, the college has become very politically correct under President Robert Barchi's leadership.
The latest illustration of this, Rooney said, is an email that was sent out by Executive Vice President and Chancellor Richard Edwards for the school's 250th birthday anniversary. Rather than use the opportunity to celebrate the university's positive achievements, Edwards wrote that RU would form a committee to investigate the school's history of displacing groups like the Leni Lenape Indians who may have been negatively affected by the school's establishment.
"What they would tell you they're doing is trying to paint a more accurate picture of history," said Rooney, regarding acts like Edwards' apologetic message. "But really, what they're doing is imposing their ideology on a new generation by only focusing on the negative things."
Rooney also pointed to the "safe zone" trend that is spreading throughout American universities as an example of what's wrong with Rutgers. These politically correct bastions occur when students define a region on campus where no one is allowed to challenge their view points (least they be accused of hate speech, that is).
Ultimately, it's actions like this that stifle free speech and learning. Rooney and I agree that you have to call people out when they try to restrict personal liberties like this.
What do you think about Rutgers' leadership? Has it gone off the deep end, or are people like Rooney overreacting?
Let me know whether you agree or disagree by commenting or tweeting at @nj1015 and @BillSpadea.
Bill Spadea is host of the Chasing News TV program. He periodically fills in for NJ 101.5 show hosts, and you can daily hear his opinion about all things New Jersey here, or by tweeting @BillSpadea.


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College senior Jay Garrick has studied the gasses emnating from "hard water" for three years, and is about to embark on a new experiment to seperate the elements.
He's found unconscious in the lab the next morning, having breathed in the new gas created by the accident all night. What effect will it have on our young hero?
And you know what that means...
Not only does The Flash owe his super-speed to cigarettes, be it indirectly or directly (Did the cigarette smoke combine with the fumes to form that new gas? Did the amount of nicotine in Jay's blookdstream contribute to his becoming a freak of nature?), but he's one of the most active ninety-somethings on the planet, despite having smoked cigarettes in his youth.
If we assume he graduated college in just four years, he would have been 22 in 1939; that would make him 90 today, and he's still running around fighting super-crime with the Justice Society of America.
(All above panels taken from Flash #1 , 1939. Art by Harry Lampert...I'm pretty sure)
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Unlike other recent films about Jesus (yes, I've seen The Young Messiah and God's Not Dead 2), Last Days in the Desert is hardly aimed at the evangelical community. There's partial nudity, and a Jesus (Ewan McGregor) who frequently kisses people on the mouth and seems confused as to what his powers are and when he should use them. And if that makes things sound more exciting than the average sermon, please hold your enthusiasm. A middling compromise between Terrence Malick-style meditation and Last Temptation of Christ-like spiritual probing, this tale of the Christ from director Rodrigo GarcÃa (Six Feet Under, Carnivale) coasts by on atmosphere while offering little in the way of enlightenment.
Initially identified only as "the holy man," McGregor's Jesus is the lone figure in a vast, open desert, isolated from all worldly temptations. He walks. He drinks water. He sits next to a thorn bush and laughs ironically as he finds thorns in his hair, presumably understanding the foreshadowing. He comes across an old woman and shares his water. Then he comes across himself. And while it's natural to talk to yourself after a long period in isolation, it's not often that the self you're talking to has a whole other body. That's right: Ewan McGregor is both Jesus and Satan in this story, or as the film insists on calling them, "Yeshua" and "the demon." He's fine in both roles, as you get a sense he has a much better idea of what the story is about than you do.
Restaging the familiar temptations from the Gospelsâyou know, turning stones to bread, ruling a kingdom, jumping off a cliff to be caught by angelsâwould be too pedestrian for a director aspiring to capital-A art like GarcÃa, so instead we have Yeshua come upon a family of three, none of whom have names, because Allegory! The father (Ciaran Hinds) likes the desert, and wants to keep farming here and building a house from stone. The son (Tye Sheridan) wants to go to the big city and see the world. The mother (Ayelet Zurer) is dying, and once she is dead and buried the father will insist that the son can now really, really never leave because it would be disrespectful to leave her grave behind.
The demon makes Yeshua a deal: he will leave him alone if the savior can figure out a way to resolve the family's differences without using force. And if you're thinking he could just go up to them and say, "I'm Jesus Christ, son of God, and I can heal your sick wife"…well, no. At first, a spiritualist might be inclined to think that this is the Jesus of Mark's Gospel, who was only clear on his divinity following the baptism by John. But no…a shot of him levitating, and numerous knowing references made by the demon about his father make it clear that this Messiah does indeed know who he is. The only reason not to heal the mother, as far as we can tell, is that Satan thinks he should, because that would be a temptation to use his power. But if that is, then wouldn't every instance of healing be a similar temptation? Is it that he has to learn he can't heal everybody with miracles, but soothe them with words? Because he doesn't do a whole lot of talking either, and his attempt to get father and son to bond over shared interests falls literally flat.
I'd hate to spoil an ending that actually contains plot points, so I'll say only that the resolution to the family's problems feels neither particularly Christian nor much of a solution. And the final scenes, featuring flash-forwards, serve only to obscure the story's point further rather than enhancing it. Is GarcÃa's point that there will always be suffering? That endings parallel each other? That Jesus is coming back? I'd love to think he means to provoke these kinds of questions, but it honestly feels like he just couldn't commit to a satisfying resolution. And if the story of a man who gives his life for his beliefs so that you'll take him and them seriously isn't about satisfying resolutions, that's probably news to most people.
Two and a half burritos for Last Days in the Desert, which gives good ambiance but comes up short on spirituality.
[UPDATE: The original version of this review mentioned full-frontal nudity. Subsequent to publication, we were informed by Broadgreen Pictures that those scenes have been removed and do not reflect the current theatrical version of the film.]
Images: Broadgreen Pictures


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Red-light-running cameras, or, red light cameras, are devices set up by law enforcement at specific traffic intersections in some locations. Law enforcement agencies use these cameras for issuing red light camera tickets to drivers who enter intersections after a light has turned red.
These devices are widely used in many countries and large cities around the world. However, people debate their usefulness, and research studies continue probing their safety and effectiveness in preventing accidents.
Looking at a red light camera map for areas where you drive, and driving safely, can help you avoid a costly ticket and potential damage to your driving record from a red light camera citation.
Red Light Camera History and Controversy
Countries around the world began installing red light cameras in the late 1960s. Countries widely using red light cameras include the United States, Canada, Israel, Netherlands, Norway, the UK, Singapore, Australia, and New Zealand.
Promoters of this method of law enforcement claim they prevent traffic accidents, and those opposed believe the installations are primarily for generating income for local municipalities through traffic tickets.
Studies investigating the effectiveness of red light cameras report they may cause drivers to stop more suddenly, resulting in more rear-end collisions. However, most studies also find these cameras reduce side collisions.
Some jurisdictions have removed red light camera systems due to high levels of public complaints. The city of St. Louis recently had their program voided by a judge, the city council in Cary, North Carolina, voted to end their program in 2012, and a San Diego mayor had red light cameras removed as part of a campaign promise in 2012.
How a Red Light Camera Works
Red light cameras operate using a loop of wire set into or on the pavement which measures the timing and speed of a car entering an intersection. A camera located in a nearby protective box is connected to the stop light and takes photos and video whenever a vehicle enters the intersection after the light turns red.
Red light video cameras are usually located overhead, and still-photo cameras are situated where they can capture the car license plate number. A red light camera flash is sometimes seen by the driver when the still camera takes a photo.
Once photos are recorded, the data is sent to a law enforcement official for review, and a citation is mailed to the vehicle's owner if this person determines a violation has occurred. Drives can then challenge the ticket.
Where Red Light Cameras are Used
Red light cameras are currently installed in 26 states and Washington D.C. Some jurisdictions only allow cameras in specific communities, such as in New York State where they are only permissible in cities with populations over one million.
Florida law allows any municipality to install red light cameras on any state-owned road. State laws often specify the fines charged for a red light camera ticket.
The states of Arkansas, Nevada, West Virginia, Michigan, Mississippi, Montana, New Hampshire, and Maine have all banned the use of red light cameras.


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I took this bottle to York with me, where we had a lovely weekend with my parents. Mom cooked 'Biochemist's Lamb' and we spent the evening drinking and chatting. Pop had several helpings from this bottle so I think he enjoyed it. Rightly so! It is a light, fruity red with a touch of fizz.
On Sunday I went to the Unitarian Chapel with Mom & Pop and quite enjoyed it. I have little spirituality, though, and had to suppress that. The best element was the music: there was a terrific pianist who played Piazolla, Janacek and Lionel Bart!
Taken on 15th January |


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Degree | Wheeler | Charubel | Borelli | Kozminsky |
0-1 | An Indian chief claims power from the assembled tribe. | A man standing on a rocky eminence with arms folded, in a contemplative mood. | A boy and girl standing with arms entwined. | A man, armed, rising out of the earth. |
1-2 | Three rose windows in a gothic church, one damaged by war. | A lofty building, with nave and massive pillars on each hand. | A vane of which the arrow is pointing North. | A revolving disc of light, red center surrounded by a black rim. The colors are pure and distinct. |
2-3 | A human soul, in its eagerness for new experiences, seeks embodiment. | A gigantic dragon tree (known to botanists as Dracoena Draco) belonging to the Canary Islands. | A serpent coiled around an uplifted beacon. | An old man seated on a throne in the clouds with his right foot on a sword. A large bright star is above his head and two pillars of light are on either side. |
3-4 | A group of people outfitting a large canoe at the start of a journey by water. | The planet Venus. | A vestal lamp burning brightly. | Persephone rising gracefully from the under to the upper world. The sun is shining, and the surrounding country is rich in fields of corn, fruits, birds, and flowers, whilst butterflies are sporting round her head. |
4-5 | Indians on the warpath. While some men row a well-filled canoe, others in it perform a war dance. | A very small unpretentious window in the wall of a massive tower. | A small cottage with wide open door. | A winged urn from which water is pouring on to the parched earth. Where the water falls vegetation springs forth luxuriantly. |
5-6 | Ten logs lie under an archway leading to darker woods. | A butcher clothed in his working dress conducting a sheep into the slaughter house. | A heart surmounted by an aureole. | A traveler walking up a long forest rise, the path surrounded by dense gnarled trees. It is approaching evening, and the way is long and gloomy, but at the top can be seen a star within a wreath of fine clouds illuminating a beautiful blue sky. |
6-7 | A veiled prophet speaks, seized by the power of a god. | A maze. | A heart pierced by a nail. | A harp with broken strings, a scowling face above it. |
7-8 | In a sunlit home domesticated birds sing joyously. | A man desponding, standing on a barren plain with leaden colored clouds overhead. | An eagle carrying its prey in mid air. | A woman looking on an empty cradle in an attitude of deep grief, the figure of a child near her, surrounded by a bright light, striving to pierce the gloom of her atmosphere. |
8-9 | An angel carrying a harp. | A man climbing a steep hill, a road consisting of steps; an angel form at the top giving words of cheer with a golden crown awaiting him. | A cross and a broken key. | A man lying half asleep in a field, a veiled figure behind him with upraised hand. |
9-10 | An albatross feeding from the hand of a sailor. | A large encampment consisting of women, little children, old people and invalids; a man at the gate keeping guard. | An owl sitting in the moon light. | A glimmering light stealing into an old armory, on the wall of which hang polished implements of war. |
10-11 | A large group of pheasants on a private estate. | A man inspecting horses. | A roll of parchment, sealed and lying across a scepter. | An armed man riding on a lion, below him a scarabaus; above, a mailed hand grasping an iron rod. |
11-12 | An illustrated lecture on natural science reveals little-known aspects of life. | A spacious park with a baronial mansion in the background. | A fox running apace in the moonlight. | A man in full armor, visor up, holding his two hands on the hilt of his sword, the point of which pierces the ground. |
12-13 | A fire worshipper meditates on the ultimate realities of existence. | An Eastern town (Constantinople). | A tripod with flames of fire issuing from a brazier. | A sublime spirit of female form holding by the hand a poorly attired child coming from the darkness into the mists and ascending from the mists into the light. |
13-14 | An ancient bas-relief carved in granite remains a witness to a long-forgotten culture. | A vista extending to a great distance; on either hand are majestic trees covered with a profusion of foliage. | A barrow standing on an open field. | A woman in a drapery establishment, the table crowded with articles of dress, none of which please her. |
14-15 | In a hospital, the children's ward is filled with toys. | A lonely traveler in a solitary way, with a heavy burden on his back; he is assaulted by ruffians. | A soft cloudy cumulus upon a bright horizon. | A hand extended, on which is resting a triangle, from which rays of light are issuing. |
15-16 | School grounds filled with boys and girls in gymnasium suits. | A man of stout make, good proportions round rosy features, looking very merry, dancing grotesquely. | A man riding at high speed upn a well-conditioned horse. | A number of books floating near a coast land rich in vegetation and floral charm, with beautiful grottos rising from the blue sea. |
16-17 | A repressed woman finds a psychological release in nudism. | A man with a large pair of scales in the act of weighing. | A lyre lying upon a wreath of flowers. | A flood of deep blue light which, gradually becoming more and more refined, fades away altogether. |
17-18 | The union jack flag files from a British warship. | A racecourse, the racers at full speed. | Two men in fierce strife. | A silver-hued garment lying in the mud. Overhead are the dark clouds of an approaching storm. |
18-19 | A five-year-old child carrying a bag filled with groceries. | A coal pit, the machinery at a stand still, the whole of the plane in a dilapidated condition. | A rocky eminence in the midst of a turbulent sea. | A large crab with its claws embedded in a seal. |
19-20 | A hidden choir is singing during a religious service. | A person ascending a spiral staircase with sunshine at top, within a dark enclosure. | An ape seated before a mirror. | A girl carrying a bowl of water into which are reflected the rays of the setting sun. All around is darkness. |
20-21 | A relay race. | A ferry boat in the act of taking people across a wide deep stream. | An ancient hieroglyphic manuscript with a retort and crucible upon it. | The head of a goat with the solar disc between its horns. |
21-22 | By accepting defeat gracefully, a general reveals nobility of character. | A spacious hall, like a museum, the walls of which are covered with symbols and hieroglyphics. | A plough. | A hawk standing on a square black rock bathed in the rays of the rising sun. |
22-23 | A soldier receiving two awards for bravery in combat. | The sun shining brightly in a cloudless sky. | A wineglass overturned. | A dog, holding a bird in his mouth, running across a field of daisies. |
23-24 | A woman entering a convent. | A man struggling in a lake; only the head out; sometimes the head appears to sink under, but it rises again and again until at last a lifebuoy is thrown to him by a person witnessing his position; finally he is saved. | A tankard set upon a table. | Three quivering arrows speeding towards a kneeling maiden, but before they reach her they crumble to atoms against a mighty hand which suddenly descends from the heavens. |
24-25 | A store filled with precious oriental rugs. | A field of ripe corn; the reapers are at work beneath the beams of the Sun. | A series of bubbles floating in the air. | A man, gaudily attired, opening a document in the center of which is a dagger. |
25-26 | A nature sprit dancing in the iridescent mist of a waterfall. | Too revolting to be given. | A wide, open seascape on which are distant sailing boats. | A woman lifting from the ground an injured child. |
26-27 | Pilgrims climbing the steep steps leading to a mountain shrine. | Two men running a race. | A stretch of broken country with a fringe of woodland. | A woman, neatly dressed, seated on an old fashioned chair, looking out of a cottage window on to a pretty little garden. Her face expresses pleasant contemplation. |
27-28 | A large aviary. | An indescribable scene; chaos, confusion, dissolving views. | A sextant and compass. | An athlete throwing a large iron quoit and disregarding a wild, ill-conditioned dog who is barking at him. |
28-29 | A woman reading tea leaves. | A man walking beside a cow, with his hand on her back, and bringing her home from the pasture at eventide. | A dark and lonely pool overhung by wooded banks. | A dismantled fortress in ruins; near-by, an old man sitting on the ground, his back resting against a rock, with a sacred book beside him. His face expresses great sadness. |
29-30 | A secret meeting of men responsible for executive decisions in world affairs. | A shepherd on the mountain top with crook in hand, looking out for the locality of his sheep. | An arrow in flight. | A meteorite falling on a mountain-top. |


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The journey toward a major lapse in ethics starts with small steps but takes the shape of a steep hill over time. Employees' small lies may seem nominal when isolated, but they add up and will prove explosive if not addressed.
There's a lot on the line when business leaders don't create and maintain an ethical culture. Aside from a tarnished reputation — depending on the fallout — when companies sweep bad behavior under the carpet, they open themselves up to the possibility of higher turnover, lower productivity and diminished profitability, wrote Dori Meinert in a 2014 HR Magazine article.
Learning leaders play a key role in building the right culture — by developing standards of conduct and delivering regular ethics training. But David Shulman, CEO and founder of the hiring assessment tool company Veris Benchmarks, said it would be better to get ahead of ethical issues by scrutinizing people before they even enter the workplace.
Measures like background checks don't take into account many indiscretions, he explained, and companies would benefit from getting clued in early to people who have behaviors and beliefs that may put the company at risk.
Shulman spoke with Chief Learning Officer about the cost of ignoring employee misconduct and what organizations can do to promote a culture of ethics.
Chief Learning Officer: Is there a dollar amount we can associate with employee misconduct?
Shulman: Reputation is hard to quantify. I guess the way we look at it is that companies pay more for people working at jobs where their performance has the biggest impact on the firm's financial success. Harvard Business Review found that toxic talent — people who are talented but selfish or even destructive — have 10 times the impact on annual performance value.
So even after a two-year basis a bartender who could make an average of $20,000 a year, has now [cost the company] $40,000. For an investment fund manager with an eight-year tenure, making about $100,000, it's about $800,000. So, a toxic bartender can lead to a $400,000 performance dollar cost, and an investment fund manager could lead to an $8 million investment loss. It's time to get serious about reducing the incidence of toxic talent with more than a hope and a promise and a lot of opinions.
CLO: How do you see companies handling workplace ethics issues currently?
Shulman: Companies are all over the place. They either do a background check and a drug check. Rarely are they doing, on a uniform basis, assessments, and [they're] really holding themselves open to all kinds of risks in that capacity. Through discussions with major institutions across the financial services field and in other industries as well, I've found the companies that are the most progressive are really embracing data. The more data they have in analyzing their prospective employees, the more powerful they become in terms of being able to make more objective, not subjective, knowledge decisions.
CLO: How susceptible are companies to being impacted by employee misconduct now in comparison with the past?
Shulman: It's the same risk, but the result is much more magnified and scaled today because of technology. There are countervailing factors at play here. Today there are more ways to electronically monitor previously private transactions. So, you would think you could reduce the risk and the length of time that violations of rules or polices or strategies or laws go unchecked because you have technology and surveillance mechanics to keep those items in check. However, on the flip side — in an era of constant and instant connectivity — technology allows abuse to get out and go viral over the internet leading to much larger financial implications than were possible previously.
CLO: If organizations take a more strategic approach to identifying high-risk employees, what are some areas they should pay attention to in the screening and interview process?
Shulman: Managers need to pay attention and observe certain behavior patterns. We test for items like understanding people, sincerity, accountability, tolerance, work ethic, integrity, risk taking, learning, decision-making to be able to better understand how those individuals answer questions. You can really go on both sides of the coin. On one side, when we talk about learning: Some people learn very slowly with some difficulty, and think and learn at a very shallow level; they become confused or overwhelmed with information. Some people are very close-minded in their thinking; they ignore new information and opportunities, and that is definitely the negative side on the learning curve. On the other side, you've got people who can learn quickly, understand difficult material quickly. They can think clearly under pressure, solve problems logically and rationally. They understand subtleties and fine points.
CLO: How can learning leaders promote an ethical culture?
Shulman: A company that has good people draws more good people. Know your people. Put onus on the management structure to be intimate with the work behaviors in their divisions, their people. They can scale that down through their organization through their management style. There is no substitute for knowing your people.
Bravetta Hassell is a Chief Learning Officer associate editor. Comment below or email email@example.com.


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Don't let us catch you eating what we don't think is a meal.
Bar owners have had a particularly tough go of it during the pandemic, with the governor completely shutting them down following a brief reopening early this summer, but they are getting creative as the lockdown continues. According to the state board of alcoholic beverage control, bars can open if — and only if — they offer "bona fide meals" in conjunction with their wine, beer and cocktails.
If they do, they essentially function as restaurants and must follow the rules imposed on dining establishments, and as long as Monterey County remains in the most restrictive shutdown category, that means take-out and outdoor dining only.
The ABC's standards for what constitutes bona fide meals are fairly strict. They can't be pre-packaged sandwiches and salads, or appetizers and side dishes like fries and chicken wings.
Snacks such as bagged pretzels or popcorn aren't meals,and neither are reheated refrigerated or frozen entrées. Just offering dessert won't cut it, either.
"In short, the primary focus of the licensed premises should be on meal service, with the service of alcoholic beverages only as a secondary service in support of that primary focus," according to the state.
Inspectors tasked with determining whether a bar's food service suffices generally consider "the various menu offerings, availability during typical meal hours, and whether the food offered is served in a reasonable quantity and what a reasonable person might consider to be a meal consumed at breakfast, lunch or dinner."
This is from Mary Schley, "Bars strive to become restaurants in the social distancing era," Carmel Pine Cone, September 18, 2020.
Bar owners are trying to figure out ways to survive and the state government is making it harder. The issue is not whether patrons socially distance. Those rules are enforced. It's not about whether people are allowed to eat and drink indoors. In Monterey County, where I live, they aren't. The issue is that the California state government wants to enforce its view of what constitutes a meal. It's almost as if the government officials don't care about bar owners and patrons.


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Rights and Accountability 24 March 2021
President Joe Biden has made clear his administration's staunch support for Israel.
He's so far failed to roll back the Trump administration's most damaging attacks on Palestinian rights.
Even before the election, Antony Blinken, now secretary of state, reassured the Israel lobby that under Biden, US funding for Israel's military would remain unconditional.
Since the election, top Biden officials, including Blinken, have reaffirmed their hostility to BDS – the nonviolent boycott, divestment and sanctions movement for Palestinian rights.
A new Gallup poll indicates just how out of step these hardline anti-Palestinian positions are with the Democratic Party base – further confirmation of longtime trends.
On its face, the poll may appear reassuring for the Israel lobby. Overall, 75 percent of Americans view Israel favorably while 30 percent see the Palestinian Authority – as distinct from the Palestinian people – more favorably.
Similarly, 58 percent of Americans sympathize more with the Israelis – though that is down from 64 percent in 2018.
Meanwhile, the number whose sympathies lie more with the Palestinians has edged up from 19 percent in 2018 to 25 percent today.
But that hides what Israel lobbyists will consider an alarming shift: More than half of Democrats now want the US to put more pressure on Israel than on the Palestinians.
Pressure on Israel
After hitting 50 percent in 2018, the percentage of Americans wanting more pressure placed on the Palestinians has fallen to 44 percent now. Meanwhile, the proportion of Americans wanting more pressure on Israel has increased from 27 percent to 34 percent, Gallup states.
That's a positive trend for Palestinians. But it may not be the most significant result of the poll.
Most of the increase since 2018 in Americans wanting the US to pressure Israel more comes from Democrats, "the majority of whom now take this position," Gallup states.
The 53 percent of Democrats opting for more pressure on the Israelis is up from 43 percent in 2018, and no more than 38 percent in the decade before that.
This marks "a substantive change in Democrats' perspective on US policy," according to Gallup.
Only 29 percent of Democrats now think the US should put more pressure on Palestinians than on the Israelis.
This will horrify lobby groups that have long lamented the steady erosion of support for Israel in the Democratic Party's base.
The lobby has tried to fight back.
One such effort is Democratic Majority for Israel, a group that attacked progressive standard bearer Senator Bernie Sanders during the 2020 primaries.
Sanders had proposed making US aid to Israel conditional on Israel's treatment of Palestinians.
Partisan divide
According to the Gallup poll, a narrow majority of Americans – 52 percent – favors Palestinian statehood, while 37 percent oppose it.
Unfortunately, Gallup did not ask about alternatives, like a single democratic state with equal rights, nor did it inquire about views on BDS.
The poll also confirms a sharp partisan divide: 80 percent of Republicans sympathize more with the Israelis, compared with just 10 percent whose sympathies are more with Palestinians.
Yet among Democrats the split is much more even: 43 percent sympathize more with Israel, against 38 percent who sympathize more with Palestinians.
Among Americans identifying as "liberal," a larger number (44 percent) now sympathizes more with the Palestinians than with Israel (36 percent).
There are also some notable demographic contrasts.
For example, 48 percent of whites think there should be more US pressure on the Palestinians to make compromises, while one-third thinks there should be more pressure on Israel.
But among non-whites, according to Gallup, the number who think US pressure should focus on the Palestinians drops to 38 percent, while 37 percent want to see more pressure on Israel.
Meanwhile, almost half of those aged 55 and up want to see more pressure on the Palestinians, while 34 percent want to see more pressure on Israel.
For those aged 18-34 there is a more even split: 40 percent want more pressure on Palestinians, while 38 percent want Israel to feel more pressure.
All of this means that the battle lines between staunchly pro-Israel Democratic Party elites and a base much more oriented towards justice are going to remain sharp – and that advocacy for Palestinian rights appears to be having an impact.
Permalink Frank Dallas replied on
What is remarkable is that shift in opinion has taken place while US media are seriously biased towards Israel. Imagine what the figures would be if there was even-handed comment, and further, if the facts were consistently placed before the US public. It would be interesting to know how many Americans are aware of the attack on the USS Liberty, and among those who are, what is their view of Israel? How many Americans know how many dollars are granted to Israel annually? How many know what weapons and training America provides? How many know what the population of Jews is compared to that of Palestinians in Israel/Palestine? How many know what Sykes-Picot was? How many know the the Herzelites compared Britain to the Nazis during the Mandate? It would be interesting to know because without being informed, and the historical facts are uncontroversial, making a reasonable judgement is difficult. Informing people is easy. You don't need to read Pappe in detail to get the gist of the ethnic cleansing of 1948 or the nature of Gaza as a prison. Modern communication technology is extraordinary. It's easy to inform people. Yet what is put before them by the media falls in, by and large, with the Israel view of things. That the propaganda machine works night and day and still people see through it and make up their own minds, even if, as yet, a minority, is testament to the propagandists' failure to understand the discrepancy between what is offered and how it's received. There is enough scepticism and independent thinking for Big Brother not to be able to infest every corner of every mind. And, of course, there are the valiant few who continue to seek the facts and to base their perspective on the evidence. In the long run, the propagandists are bound to fail because their distorted view is an insult to the human mind. We are moral by nature and in the end we insist on fairness.
Critical mass?
Permalink Carl Zaisser replied on
So what? Does anyone really think that AIPAC, and all the organs of the deep state in Washington care one iota about what the majority of Democratic party voters want? The days back in 1947 when the Department of Defense and the Department of State were OPPOSED to the UNGA resolution to partition Palestine are now a distant memory. And this doesn't mention what level of pressure it would take for Israel to do anything REAL anyway. It's all smoke and mirrors, windowdressing, and patent B.S. Palestinians need to 'stick to their guns', fight, and wait for the day when the one-state reality becomes a single state in Israel and Palestine, and that is NOT going to happen with Israeli consent.


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More Beauty Skin Care & Gorgeous Smiles Articles
Holiday Beauty At Any Age Four Keys To Find the Right Doctor
This year, men and women are increasingly choosing non-surgical methods to improve their appearance and look more youthful, rather than going under the surgical knife, and with good reason. Today's non-invasive technology helps rejuvenate you dramatically, yet subtly. It's also more economical. You can look completely natural, without scarring and be able to return to normal activities, while others will be unaware that you've had anything done, unless you choose to tell them.
Here are four keys to help you choose the right doctor for your holiday makeover.
1. Credentials The American Board of Medical Specialties certify doctors in specialties and can provide guidance on what credentials mean. Dermatology, plastic surgery, facial plastic surgery and oculoplastic surgery, are the four recognized core specialties in the area of cosmetic surgery, and board certification in one of these specialties may help you feel confident and comfortable with your doctor.
2. Select an Expert The most expert cosmetic surgeons are very involved in the field and have a lot of experience and training. You might also notice them steering physician training programs, or serving as FDA study investigators or advisors for new cosmetic surgery technologies. Their offices usually will be well equipped with the latest equipment, with well-trained staff. A search of the medical literature will usually find them quoted, or referenced, in several places.
3. Look For Choices Cosmetic surgeons offer many different treatment options, so that your action plan can be customized to address your own unique pattern of aging.
Depending on your needs, your cosmetic surgeon should be able to offer you a wide range of possible plans and solutions, including Botox, Dysport and Xeomin, Restylane, Juvederm, Belotero, Radiesse, Scupltra and other fillers, state-of-the-art lasers for wrinkles, hair removal, sun spot and veins, and also advanced procedures such as Ulthera nonsurgical face lifting, Accent skin tightening, LipoLite nonsurgical laser fat removal, Fraxel and CO2RE laser resurfacing, Asclera for leg veins, and permanent make-up.
Even if you don't choose all these, the fact that your surgeon offers them can indicate a real commitment to cosmetic surgery, and the more choices you have, the better.
4. Look For the Latest Technology and Techniques Ulthera, one of the hottest new lasers for 2012, is the only laser that is FDA approved for nonsurgical face lifting. It is a quick and completely noninvasive way to recontour your jawline, tighten your neck and lift sagging cheeks and brows.
The other hottest laser is the CO2RE resurfacing laser, which uses radiofrequency to make your treatment more precise and effective with less down time. You can see dramatic improvement in wrinkles, pigmentation, scars, pores and other blemishes and your skin will regain its youthful, healthy glow.
Syneron eMatrix and Triniti laser systems rejuvenate all three layers of your skin simultaneously with little or no down time by removing wrinkles, discolorations, scars and broken blood vessels, and tightening your skin and pores.
The newest Fraxel laser, the Fraxel Repair, also can dramatically rejuvenate your face, neck, chest, hands or other body areas. The new Alma Accent and Harmony lasers tighten skin non-surgically and also treat sunspots, broken blood vessels and unwanted hair.
Nonsurgical volumizing with the natural fillers, Radiesse, Perlane and Restylane, removes under-eye hollows, bags, and jowls, and restores youthful fullness to your lips and cheeks, taking years, even decades, off your appearance. Other fillers such as Juvederm and Sculptra can be added.
New Botox, Dysport and Xeomin techniques safely smooth out worry lines, frown lines, crow's feet, and wrinkles around your mouth and on your neck, while preserving your natural facial expressions. The latest fat-busting breakthrough is the LipoLite, which safely, comfortably and precisely melts away unwanted fat from areas such as your abdomen, thighs, arms and chin and also dramatically tightens your skin, with little or no recovery time. LipoLite can be combined with Velashape to also improve cellulite and stretch marks.
If you follow these four keys, you can balance how you look with how you feel, and start the holidays projecting youth, energy and vitality.
Other Articles You May Find of Interest...
- Avoiding Opioids After Surgery: A Plastic's Surgeon's Secrets
- Cosmetic Dentistry
- Acupuncture and Meditation
- Sculpting a Healthier You: Understanding EmSculpt for Targeting Problem Areas
- Botox Myths and Facts
- Preventing Ingrown Hairs After Laser Hair Removal: Tips from Experts
- Cold Winter Air and Skin Health: A Plastic Surgeon's Perspective


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From a media release:
- Canada's late-night talk show to broadcast live from Vancouver this April
Alright, Vancouver, by now it's tradition: GEORGE STROUMBOULOPOULOS TONIGHT is heading to the west coast, to tape a series of episodes you don't want to miss. So come be a part of the show from Tuesday, April 3 to Thursday, April 5 2012. For more information on how to get tickets, and to check out the exciting guests, who will be announced soon, visit www.cbc.ca/strombo.
While in Vancouver, GEORGE STROUMBOULOPOULOS TONIGHT will be taped at the CBC Vancouver Broadcast Centre (700 Hamilton Street) at 4 p.m. PT from Tuesday, April 3 to Thursday, April 5. Tickets are free, and are available on a first come first served basis at www.cbc.ca/strombo.
Host Stroumboulopoulos was recently named a Young Global Leader by the World Economic Forum, and will join a select group of outstanding young leaders from around the world for their professional accomplishments and commitment to society. Young Global Leaders engage in initiatives that address specific challenges of public interest with the objective of shaping a better future. For a complete list of 2012's YGLs, and further information visit: www.younggloballeaders.org.
GEORGE STROUMBOULOPOULOS TONIGHT airs Monday through Friday at 11:05 p.m. on CBC Television and is taped daily in front of a live studio audience. Follow George's week on the West coast on Twitter @Strombo.


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By the good people of Arlington, TN. Wow. The 'war on Jesus/Christmas/America/Whatever' continues.....
In the opinion of Arlington Mayor Russell Wiseman, President Barack Obama's speech on Tuesday night on the war in Afghanistan was deliberately timed to block the Christian message of the "Peanuts" television Christmas special.
Wiseman made the statements on his Facebook page, where he declared Obama to be a Muslim. Only people on Wiseman's "friend's list" had access to the post. He has more than 1,600 friends on Facebook.
"Ok, so, this is total crap, we sit the kids down to watch 'The Charlie Brown Christmas Special' and our muslim president is there, what a load.....try to convince me that wasn't done on purpose. Ask the man if he believes that Jesus Christ is the Son of God and he will give you a 10 minute disertation (sic) about it....w...hen the answer should simply be 'yes'...."
"A Charlie Brown Christmas," which first aired in 1965, has become an endearing program for many because of its emphasis on the "real meaning of Christmas," including Linus' memorable reading from the Gospel of Luke of Jesus' birth.
In Wiseman's extensive thread that attacked the president, his supporters and Muslims, he stated "...you obama people need to move to a muslim country...oh wait, that's America....pitiful."
At another point he said, "you know, our forefathers had it written in the original Constitution that ONLY property owners could vote, if that has stayed in there, things would be different........"


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Information letter
Dear colleagues!
We invite you to take part in the work
III all-Russian scientific and practical conference
"Modern aspects of Spa treatment and medical rehabilitation of children and adults", dedicated to the 90th anniversary of the DS. N. To. Krupskaya FGBU SKINKS FMBA of Russia
Venue: , Federal scientific clinical center of FMBA of Russia in Essentuki |
Date: May 14 – 17, 2019 |
The purpose of the conference: to improve the professional level of specialists in various fields in the field of Spa treatment and medical rehabilitation, familiarization with the best practices of introduction of innovative medical technologies at the stages of medical care to various groups of children and adults.
In the conference program:
- Plenary meeting;
- Lectures by leading scientists and specialists;
- Breakout session;
- Master classes;
- Exhibition of medical equipment.
Main scientific directions of the conference:
- State policy in the field of public health of the Russian Federation.
- Topical issues of resort medicine and medical rehabilitation of children and adults.
- Problems of legal regulation of medical rehabilitation and Spa treatment.
- Features of integration of medical and prophylactic institutions and scientific and clinical centers into the system of compulsory medical insurance.
- Features of medical rehabilitation in the resort.
- Topical issues of resort Pediatrics.
- Prospects of introduction of new technologies of medical rehabilitation, sanatorium treatment in practice of health care.
- Topical issues of medical and biological support of athletes.
- Principles and methods of medical rehabilitation of athletes in the resort.
- Functional, psychological and psychophysiological diagnostics of athletes and persons engaged in physical culture, in the process of medical support and rehabilitation.
- New programs using modern methods of physical and rehabilitation medicine for health improvement, medical rehabilitation, Spa treatment of children and adults.
- SPA-technologies, methods of traditional medicine, pharmaceuticals, biologically active additives in restorative and sports medicine.
Form of participation:
- Full-time lecture, report.
- Full-time (listener).
- Correspondence (publication of articles).
- Participation in the exhibition of medical equipment.
To participate in the conference are invited:
Heads of scientific, educational, medical and sanatorium institutions, doctors of various profiles, biologists, experts in the field of sports and physical culture, scientists, graduate students, applicants, representatives of companies producing medical products.
The participants of the conference will receive credit points in the system of continuing medical education.
Applications for participation should be sent to the addresses of the organizing Committee. Organizing Committee contact details:
Surname |
Name |
Patronymic |
The name of the organization postal address (in full) |
Post |
Academic degree, title |
Contact phone / Fax (area code) |
Form of participation in the conference (underline) |
Full-time report |
Full-time without report (listener) |
Correspondence participation (publication of abstracts report's) |
The focus of the conference |
Form of report (plenary, sectional report) |
Title of the report / article |
Necessary demonstration equipment |
Need to book accommodation |
Date of arrival |
Departure date |
The conference materials will be published in the electronic network scientific and educational journal "Modern issues of Biomedicine". The journal is included in the scientific citation databases of RSCI and Google scholar.
Requirements for publication of articles in the journal:
- Review articles and original research are accepted for publication. Published materials should be relevant, have scientific novelty, theoretical and practical significance.
- Articles sent earlier for publication in other publications are not allowed to be printed.
- The article must be fully specified surname, name, patronymic, full name of the institution in which the author works, phone and e-mail of the person responsible for the correspondence.
- The article should be prepared in the Word editor, printed in TimesNewRoman font, size-14, line spacing-1.5, indent of the first line-1.25 cm.
- The original article should contain the results of their own research. The volume of the original article is 6-10 pages. In the review of literature and lectures possible volume of 12 pages.
- Article structure original research should be the following: introduction including the relevance of the topic, the purpose of the study; methods and organization studies, research results and their discussion, conclusions, references, illustrative material.
- For all articles necessarily summary with keywords. The summary includes the purpose of the study and its results. The volume of the summary – 10-12 lines.
- Summary, keywords, names and initials of the authors, the full name of the institution are translated into English.
- The article allows the use of common abbreviations (units of measurement, physical, chemical and mathematical quantities and terms) and abbreviations. All letters entered by the author must be deciphered in the text of the article at their first mention. When you enter an abbreviation, it should be written in parentheses after the decryption, then use only the abbreviation.
- The list of references should be arranged alphabetically according to GOST 7.1-2003. Also, the list of literature should be submitted in English according to the Russian version.
- References in the text are given in square brackets in accordance with the numbers of the list of references. All authors of the article, the indication", etc. (etal.) – - is not allowed, because the reduction of the author's team to 2-3 names entails the loss of citations of unnamed co-authors. The literature should be indicated with the title of the articles. References to unpublished works are not allowed.
- Articles accepted for publication undergo scientific review and editing. The editorial Board reserves the right to shorten and correct articles.
- Drawings with signatures should be laid out in the place of the article where they should be located. Separately sent a file in the format of a picture with the extension tiff or jpg, the size is not less than 800 Kb.
- Tables should be laid out in the place where they should be located. On the top right you need to indicate the number of the table, below is its name. Abbreviations of words in tables are not allowed. All figures in the tables must correspond to the figures in the text and must be processed statistically.
- If the figure or table is the same, the number is not assigned. Each figure or table should have a uniform title and a transcript of all abbreviations. The captions to the figures indicate the designations on the axes of abscissa and ordinate and units of measurement.
Cost of publication: free.
Final submission date: may 1, 2019
Arrival and registration of the conference participants-may 14, 2019, the conference may 15-16, 2019, departure of the participants-may 17, 2019


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$ 8.95
| /
Ceratostigma willmottiana (blue)
Positive qualities: Trusting one's inner knowing, intuition; self-confidence, certainty
Patterns of imbalance: Uncertainty or doubt of one's inner wisdom and truth; invalidating what one knows, over-dependent on advice from others
Brandy, water, infusions (1:6000) of cerato flowers (Ceratostigma willmottiana)
As a dietary supplement Four drops in mouth, repeat as needed. Or as directed by your healthcare professional.
*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.


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A comprehensive overview of the Esoteric Testing market is recently added by UnivDatos Market Insights to its humongous database. The Esoteric Testing market report has been aggregated by collecting informative data of various dynamics such as market drivers, restraints, and opportunities. This innovative report makes use of several analyses to get a closer outlook on the Esoteric Testing market. The Esoteric Testing market report offers a detailed analysis of the latest industry developments and trending factors in the market that are influencing the market growth. Furthermore, this statistical market research repository examines and estimates the Esoteric Testing market at the global and regional levels. The Global Esoteric Testing Market is expected to grow Higher by 2027.
Market Overview
The Global Esoteric Testing Market is experiencing significant growth on account of chronic conditions including cancer, diabetes, cardiovascular disorders worldwide, etc. The rising prevalence of chronic illnesses is due to an increase in the consumption of diets, as well as lifestyle choices such as alco-hol drinking and to-bacco smoking. According to the WHO's 2018 report, cancer was the second biggest cause of death worldwide in 2018, with 9.6 million deaths estimated. Furthermore, increasing R&D spending for Esoteric Testing developments and boosting healthcare access in places with unmet medical requirements would boost revenue.
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Moreover, over the forecast period, the market will be driven by an increase in the frequency of rare and complex diseases, as well as increased awareness about early disease detection and treatment. According to the European Commission, rare diseases affect nearly 27 to 36 million individuals throughout Europe. The rapidly growing healthcare sector in developing countries, as well as an increase in the number of sophisticated laboratories providing advanced services, will help the industry flourish.
COVID-19 Impact
The COVID19 has resulted in a profound re-evaluation of the advantages and costs of cancer care. The pandemic has been a devastating disease worldwide. Although an important number of young healthy people have been affected, elderly, comorbid and immunosuppressed patients have been especially compromised. For instance, the largest report up until September 30, 2020, came from the COVID-19 and Cancer Consortium (CCC19), that reported 30-day all-cause mortality for 928 patients from the United States, Canada, and Spain with laboratory confirmed SARS-CoV-2 and a diagnosis of invasive or hematologic malignancy between March 17, and April 16, 2020.
However, at the early phase of COVID-19 pandemic, there was no availability of specific diagnostic tests to detect the disease in patients. Alternative diagnostic tests were used initially but were not much effective. This unavailability of specific COVID-19 diagnostic tests presented lucrative opportunities for diagnostic manufacturers to introduce their COVID-19 diagnostic kits. Many leading players as well as some start-ups from various countries utilized this opportunity and introduced COVID-19 diagnostics kits into local as well as global market. For instance, LabCorp launched self-collection kit for COVID-19 test with delivery and collection facility.
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Global Esoteric Testing Market report is studied thoroughly with several aspects that would help stakeholders in making their decisions more curated.
By Type , the market is primarily bifurcated into
Infectious Diseases Testing segment dominated the by type of the global Esoteric Testing market and will row at X% CAGR to reach US$ X billion by the year 2027.
By Technology, the market is primarily segmented into
Amongst technology, Chemiluminescence Immunoassay accounted for the largest share in 2020 and is expected to grow at X% CAGR during the forecast period 2021-2027.
By End-User, the market is primarily segmented into
Amongst end-user, Independent & Reference Laboratoriesaccounted for the largest share in 2020 and is expected to grow at X% CAGR during the forecast period 2021-2027.
Esoteric Testing Market Geographical Segmentation Includes:
Based on the estimation, the North America region dominated the Esoteric Testing market with almost US$ X billion revenue in 2020 on account of the increasing population and chronic disease prevalence.
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The major players targeting the market includes
Competitive Landscape
The degree of competition among prominent global companies has been elaborated by analyzing several leading key players operating worldwide. The specialist team of research analysts sheds light on various traits such as global market competition, market share, most recent industry advancements, innovative product launches, partnerships, mergers, or acquisitions by leading companies in the Esoteric Testing market. The major players have been analyzed by using research methodologies for getting insight views on global competition.
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Key questions resolved through this analytical market research report include:
• What are the latest trends, new patterns, and technological advancements in the Esoteric Testing market?
• Which factors are influencing the Esoteric Testing market over the forecast period?
• What are the global challenges, threats, and risks in the Esoteric Testing market?
• Which factors are propelling and restraining the Esoteric Testing market?
• What are the demanding global regions of the Esoteric Testing market?
• What will be the global market size in the upcoming years?
• What are the crucial market acquisition strategies and policies applied by global companies?
We understand the requirement of different businesses, regions, and countries, we offer customized reports as per your requirements of business nature and geography. Please let us know If you have any custom needs.
- Concrete Admixtures market was stood around $15 billion in 2020 and is expected to grow at a CAGR of around 8% between 2021-2027


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Low yields in the second pension pillar
U.S. and Asian stock markets produced over 20% yields last year, and European stock markets returned 6-12%. The second pension pillar's index funds, though, only earned their clients 5-8% yields in 2017. Despite this, they were the best performing among all funds in the second pillar. Only 10% of clients use them, though. As many as 75% of clients are in the bond funds, where yields were just 0.4-3.7%. Some 1.4m Slovaks save in the second pension pillar.


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XX1 Eagle AXS Upgrade Kit
- Regular
- $1,055.00
- Sale
- $1,055.00
- Regular
Sold Out
- Unit Price
- per
XC spec and ready for the trail. XX1 Eagle AXS utilizes the proven backbone of SRAM 1x.
With the lightest weight materials and a 520-percent gear range.
More secure and longer wearing X-SYNC 2 chainring. The pinnacle of performance, paired with the connected components of Eagle AXS.
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*SRAM Products are available for U.S. Customers Only
**5DEV Discount codes can not be used with any SRAM product.