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Story highlights
- Bipolar disorder affects about 2.6% of the U.S. population
- A family history of the disorder makes a person more likely to get it
- There is no known cause of bipolar disorder
- With the right combination of medications, the symptoms can lessen
Before he got sick, my husband, Mike*, was one of the warmest, funniest guys around. He was a great talker who could engage with anyone about anything -- Czech history one minute, 1950s monster movies the next.
The two of us had countless in-jokes, and our conversations always seemed to devolve into laughter.
But in April 1996, 12 years after we had first started dating, Mike said something that wasn't funny at all.
"See that guy over there?" he whispered to me in a voice so low I had to lean closer to hear. "He thinks I'm CIA." Mike and I had arrived a few hours earlier for our vacation in Saigon, exhausted and bleary-eyed after 22 hours of flying from our home in New York City.
We had eaten dinner and were sipping beers in the café at our hotel. I glanced in the direction Mike was staring. All I saw was a 20-something Vietnamese man reading a magazine.
There was no way that this man thought Mike -- a curly-haired, jeans and T-shirt--clad freelance copy editor -- was in the CIA. Then I looked into Mike's eyes. His pupils were completely dilated. I felt unsteady. Mike just peered at me, his eyes wide with fear.
I could see that something was wrong with him, but I didn't know what. I was naive; mental illness didn't even cross my mind. I simply thought that if we could cut our vacation short and get him back to familiar surroundings in New York, everything would be fine.
But Mike calmed down, insisting that he was OK and that he wanted to stay in Vietnam. I complied, as I often did.
In those days, I was painfully passive, certain that it was best for both of us that Mike made the decisions. And for much of the rest of the trip, I was grateful that we hadn't taken drastic action.
Mike was back to his delightful and charming self. We had pho for lunch one day (a noodle soup pronounced "fuh") and made up puns about it.
"I'd fuh-gotten how tasty this is," Mike said to me, and I laughed.
However, I purposely ignored some of his more curious behaviors: checking the hotel locks and windows multiple times; shushing me, even when we were alone in our room. He had never acted like this before; what I didn't realize was that a new paranoia had taken up residence in Mike's mind -- and it was never going away.
Mike and I met in 1983, when we were college students in New Orleans.
Our relationship turned romantic quickly.
We'd sit in the sun in his quad or mine or read books side by side on his futon, snuggled under his childhood tiger-print blanket.
After graduation, we traveled for a year, strapping on backpacks and bumming around various parts of the world.
Then, in 1987, we moved to Manhattan, where we both got jobs and shared an apartment.
We didn't really have separate lives: We'd often meet for lunch just to catch up on the few hours we'd spent apart. Neither of us went out without the other. If Mike was meeting up with his friends, I'd tag along. If I had a girls' night planned, Mike would come, too.
I was terribly insecure.
I didn't feel smart or clever, and I knew that Mike was smart and clever. So I deferred to him whenever I could. Once I wanted to try a yoga class. So I spent hours convincing Mike to come along. It didn't occur to me that I could try a class on my own. We even shared an e-mail account. It was only years later, as Mike grew ill, that I realized that my dependency was unhealthy.
When we returned home to New York after our trip to Saigon, Mike seemed normal.
But a few months later, when Mike was 33, his strange behavior returned.
At first the changes were subtle.
We had a crate where we kept important papers -- tax forms, passports -- and he became obsessed with rummaging through it.
His voice changed, too, in a way that was imperceptible to anyone but me. His tone was deadened. When he joked, he lacked his previous enthusiasm.
I only began to worry in earnest on the night he stayed out until dawn, without warning.
When he finally came back, he kissed me on the forehead like he'd just finished a day at the office.
Furious, I told him how distraught I'd been. In response, all he said was, "It's OK. I was out for a stroll." Then he shot me an eerie, fake smile.
None of this was like Mike.
I suddenly wondered what else he might do: Would he make an offensive comment to a stranger and trigger a fight? Would he wander into traffic? Increasingly concerned, I called his parents, who lived in New Jersey and didn't know anything had been the matter with their son.
An hour later, they pulled up in front of our building, and we drove straight to the family's primary-care doctor.
He suggested a battery of tests and a hospital stay to rule out physiological explanations for Mike's behavior.
But he clearly suspected mental illness and recommended that Mike go to a psychiatric ward. Shocking though it may seem, that's when it first occurred to me that Mike's mind was the problem. I was both relieved (hey, at least it probably wasn't a brain tumor!) and terrified.
Mike was diagnosed with severe depression and was put on an antidepressant.
But he didn't last long in the psych ward. He checked himself out two days after his arrival, insisting he wasn't sick. And after about a month at home, thanks to medication and weekly therapy, Mike again seemed like himself.
I was so optimistic about his recovery, in fact, that about a year later, when he spontaneously asked me to marry him, I said yes. The next day, December 12, 1997, we took our vows at City Hall.
Five months later, I became pregnant.
I was ecstatic at the prospect of starting a family -- convinced that we would be fantastic parents and that Mike's illness was behind us for good.
But my sense of certainty was crushed just a few minutes after our daughter, Lizzie, was born, on February 9, 1999. As I lay in the hospital bed, Mike leaned over and said, "I heard the baby talk to me."
I couldn't believe it: He had gone off his medication without my realizing it.
I begged him to go back on the drugs, and he listened. But he seemed less stable than before, as though he might lose control at any moment.
As in Saigon, he constantly checked our locks and shushed me. He struggled to bond with Lizzie: He held her in a rocking chair and read her books but often had a totally blank expression on his face.
I never felt comfortable leaving Lizzie alone with Mike. His mind always seemed elsewhere.
When Lizzie was about 14 months old, Mike went off his medication yet again and was hospitalized.
This time he received a new diagnosis, the one he still has today: severe bipolar disorder, which is a mental illness characterized by long periods of depression followed by shorter bouts of mania.
The diagnosis scared me. Although about 5.7 million Americans have bipolar disorder, I'd never known someone with it.
Perhaps for that reason, I saw the disease as shameful. I couldn't bear to tell my mom and dad, or my friends, that Mike was no longer just "depressed."
Meanwhile, Mike wasn't getting better.
Instead of nine good months at a time, he'd have five, then two -- largely because he kept refusing to take his Zyprexa pills, swearing that he wasn't ill.
Panicked, I visited countless doctors, read countless books, and visited support groups in an effort to find him (and myself) real help.
Mike didn't want to hear about any of it. He stopped working and spent hours lying on the floor, listening to "Ziggy Stardust" over and over.
Then one weekend, in the spring of 2002, I reached a tipping point.
Mike was driving the two of us to a nearby grocery store. He seemed a bit withdrawn but still communicative. So I was unprepared when, suddenly, he blew through a stop sign.
I shouted for him to brake, but he didn't seem to hear. "STOP!" I screamed again, petrified, after he ran another. When he finally did stop, I got out of the car and walked home, shaken.
I didn't know what to do. The answer became clear the next day, when our family went to the park. Three-year-old Lizzie held out her hands to Mike, shouting, "Daddy, up!" He just walked right by her, and I saw her face fall.
That night, as I tucked her into bed, she said, "I don't like Daddy really much." Her words got to me. What kind of example was I setting by not putting my daughter first? I made a silent vow to take control of my life.
One day later, I stood before a New York City Supreme Court judge and requested to have Mike committed. I told him, voice quavering, that Mike was a danger to himself and others, citing the stop-sign incident and his inconsistency with his medication as evidence.
The order was granted.
Police officers came to our apartment and took Mike to the hospital; he resisted at first, but eventually the officers convinced him to comply. I told Mike that if he stayed there and got help -- and kept going to his psychiatrist after he was released -- I'd be there for him.
If not, I'd leave. I knew what would happen, and it did: He checked himself out of the hospital after 48 hours (which was legal under the terms of the commitment order).
And true to my word, I took Lizzie and left.
Six months later, I filed for legal separation, and two years after that we divorced.
It wasn't easy: I held on to a lot of guilt for ending the marriage.
I felt that I shouldn't have abandoned someone who was ill, someone whom I had loved for so long. I felt it was my duty to make Mike better.
However, I also was relieved -- for me and for Lizzie.
To her, Mike had been so emotionally absent that his physical disappearance seemed like the next logical step.
As for me, I felt like a great weight had been lifted, and I could finally enjoy life again. I remember walking down the street feeling like I could float away.
After the marriage ended, I needed to talk about Mike's mental illness.
It was as if I'd explode if I didn't. I found I was far from alone.
One friend told me about her debilitating postpartum depression. An acquaintance, who was married with two kids, told me she had bipolar disorder.
But she saw a therapist regularly and understood that she needed medication. Her case made me fully understand the severity of Mike's condition and of his denial.
Seventeen years into his illness, Mike still cycles on and off his medications.
When he's off, he tends to fixate on bizarre ideas. (He's prone to announcing via e-mail that he's an heir to an oil fortune or a Mayflower descendant.)
Mike's mother, with whom I remain close, is his legal guardian and helps him function. He still cannot work.
I've moved on. I married a wonderful man, Jeff, who has been a full parent to Lizzie.
Our relationship is truly equal: We make all our decisions together.
Lizzie and I see Mike only about once a year, due to his erratic behavior. And in between visits we don't keep in touch. I hear about Mike periodically through his mother. Lizzie knows that he has bipolar disorder and that there's a genetic component to the illness.
"Will I get it?" she asked me a few years ago, when she was 11. I told her probably not, but that, regardless, it's usually treatable. We talk openly; I never want her to feel mental illness is something that should be hidden, as I once did.
But I also don't want her to believe that an increased chance of mental illness is the only thing she inherited from Mike.
So I tell her about his keen intelligence, our exciting travelsand the relationship we once shared. And when she laughs and jokes, sometimes I catch a glimpse of that man, my first love. It's a bittersweet moment, but one I wouldn't trade for the world.
The basics of bipolar disorder
Affecting about 2.6% of the United States population, bipolar disorder is a chronic mental illness distinguished by severe mood swings and drastic changes in energy level. Sufferers typically endure long periods of clinical depression, followed by short spells of mania, which can be experienced as euphoria or irritability.
"It's also possible for bipolar people to feel manic and depressed at the same time," says Dr. Igor Galynker, the director of the Family Center for Bipolar Disorder at Beth Israel Hospital, in New York.
Mike suffers from the severest form of the disease, type 1, in which the manic episodes can require hospitalization and feature psychosis (like Mike's delusional thoughts). Type 2 sufferers also require medication, but their symptoms are less dramatic.
What causes it?
There is no known cause, but a family history of the disease makes a person more likely to get it.
"A parent with type 1 or type 2 bipolar has about a 10% chance of having a child who suffers from the illness," says Galynker.
Can it be treated?
With the right combination of mood stabilizers, antidepressants and anti-psychotic medications, the symptoms can lessen, allowing bipolar sufferers, types 1 and 2, to lead relatively normal lives.
Unfortunately many of the drugs have marked side effects (including painful rashes, diabetes, and weight gain), which is why some patients struggle to stick with their regimens. Denial of the illness is another reason.
How can I get help?
If you suspect that you or a loved one may have bipolar disorder, talk to your primary-care doctor about how to proceed. To learn more, visit the website of the National Alliance of Mental Illness.


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subset: commoncrawl


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On Sundays, we usually stay in and do house related chores. Today, we went to The Home Depot to buy dirt, seeds and paint; and I happened to come across these adorable Disney paint chips :p.
We've killed all of our plants, except for our succulents, but we're willing to give gardening another try. David bought some tomato seeds and I chose these flowers.
Oh, and I should mention that we used the GPS even though we knew how to get to Home Depot, only because David downloaded a Darth Vader voice and we wanted to listen to his directions, haha.
Our weekends also usually involve family related activities, this Saturday we had a little birthday party and it was a cow themed one!
On Saturday or Friday nights (preferably very late at night), we always go to a 24hs Walmart to do our grocery shopping. I always have my phone camera ready to go, because there's always something worth snapping. Here are some things I'd never seen before.
Weird name for a pizza ...
Cupcake Vineyards, Red Velvet??? Haha!
Religious chocolate, once again!
Right now, we're watching Bob's Burgers, which is back, yay :p. I'm not really into cartoons, but I enjoy this one.
Oh, before I go, here's a very silly stop motion video I made with some Peeps David brought home the other day. I'd seen them online and was willing to know what they're all about. It's super silly and cheesy, you're allowed to laugh, haha.


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For discussion of Electric Universe and Plasma Cosmology. The ideas and opinions expressed on this forum do not necessarily reflect those of T-Bolts Group Inc or The Thunderbolts Project(TM)
When continents break it gets warm on Earth
Rift zones released large amounts of CO2 from depth, which influenced global climate change
The concentration of carbon dioxide (CO2) in the atmosphere determines whether the Earth is in greenhouse or ice age state. Before humans began to have an impact on the amount of CO2 in the air, it depended solely on the interplay of geological and biological processes, the global carbon cycle. A recent study, headed by the GFZ German Research Centre for Geosciences in Potsdam, shows that the break-up of continents – also known as rifting – contributed significantly to higher CO2 concentrations in the atmosphere.
The acronym GLOF is used for glacier floods caused by the drainage of naturally dammed lakes in the glacier, on or at the margin of glaciers.
Glacial lakes form when a glacier retreats, leaving the debris mass at the end of the glacier – the end moraine – exposed.
The moraine wall can act as a natural dam, trapping the meltwater from the glacier and leading to the formation of a lake. The moraine dams are composed of unconsolidated boulders, gravel, sand, and silt. As with landslide dams,
they can eventually break catastrophically, leading to a glacial lake outburst flood or GLOF...
The GLOF event of 4th August 1985 from Dig Tsho glacial lake in Eastern Nepal...
Glacial lake outburst floods can transport enormous masses like this clast in Nepal of about 200 tones
(photo: Richardson/Rey- nolds).
Electric Universe theorists postulate that approximately 10,000 years ago, Earth was engulfed by electric arcs that prehistoric eyewitnesses called "thunderbolts of the gods". Those gigantic lightning bolts dissected the continental geography, forming what consensus science says are eons-old structures, in an instant.
GaryN wrote:I have been looking for photos of rock being transported atop or falling out of glaciers but...
The giant stone was released by ice in a glacier that melted thanks to the fantastic heat produced by the erupting volcano. The melting glacier caused a meltwater flood, which swept the rock down the mountainside with it.
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NEW YORK CITY, N.Y. - The Vancouver Canucks talking about trading a goaltender has become the norm in the past year. But usually it's Roberto Luongo.
This time, general manager Mike Gillis is getting calls about Cory Schneider, and he's at least entertaining the possibility of moving him.
"You have to listen," Gillis said Saturday. "If you're in any business, you have to listen to what the proposals may be and act accordingly. That's what we're doing.
At 27-years-old and a manageable cap hit of US$4 million over the next two seasons, Schneider never seemed to be the logical choice for the Canucks if they were to trade a goalie. Luongo is 34 and is set to count $5.3 million on a deal that pays him $40.57 million over the next nine years.
It has been well-known that the Canucks are trying to trade Luongo, and there's plenty of speculation that he could be a compliance-buyout candidate. Schneider's contract is more attractive to other teams, but that's not why Gillis thinks the younger goalie is drawing interest.
"I think he's a very good, young player and teams are after good, young players all the time," Gillis said. "We get calls all the time about our young players, and he's one of them."
Gillis said he wasn't surprised Schneider was a subject of talks. "Never say never" was his reply when one reporter suggested that Schneider wouldn't be going anywhere.
But Gillis doesn't know if he'll get a deal done for one of his goalies by the end of Sunday's NHL draft.
"We're going to see how it goes," he said. "Obviously we're listening to proposals, and I'm not sure how it's going to turn out, but we're certainly listening."
The Canucks have been listening to offers for Luongo for a while. But the veteran with a no-trade clause isn't being consulted in trade talks at this time.
"It's not until we have some kind of frame that we can go to him and have a discussion," Gillis said.
While the Canucks might be driving the trade market on goalies, it's in flux thanks to the Philadelphia Flyers using a compliance buyout on Ilya Bryzgalov and the Toronto Maple Leafs acquiring Jonathan Bernier from the Los Angeles Kings. Reports have surfaced that the Buffalo Sabres are talking to teams about Ryan Miller, too.
"It's a changing landscape you have to adjust to," Gillis said. "Right now there's a lot of stuff in the air, there's a lot of balls in the air and included in that is compliance buyout situations. You just have to try and stay fluid and react to things as they come your way."
That includes listening to what other teams are willing to give up for Schneider. Asked if a prospect and a first-round pick would be enough, Gillis said, "It all depends on the team and on the pick."
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The Keb' Mo' Bluesmaster Acoustic Guitar has a classic Gibson L-00 body and custom herringbone top trim, recalling the instruments played by some of the first blues artists in the Deep South of the United States. The custom neck shape and wider nut width give the Bluesmaster guitar easy playability. Tonal enhancements are created by a customized th... Click To Read More About This Product
The Keb' Mo' Bluesmaster Acoustic Guitar has a classic Gibson L-00 body and custom herringbone top trim, recalling the instruments played by some of the first blues artists in the Deep South of the United States. The custom neck shape and wider nut width give the Bluesmaster guitar easy playability. Tonal enhancements are created by a customized thinner top made of Adirondack red spruce for singing tone and sustain.
The Keb' Mo' acoustic guitar's carved French heel neck shape means easy finger reaching up the neck for those high notes and vibrato. The 12th fret is joined to the guitar body for a warmer resonant tone and added playing comfort. Gibson gives the Keb' Mo' Bluesmaster guitar a special darker vintage antiquing of its authentic nitro-lacquer finish. Other embellishments include a Keb' Mo' Signature truss cover and L.R. Baggs Element pickup with soundhole volume control. Includes case.
Body Wood
The top of the Keb' Mo' Bluesmaster is made from 2 pieces of solid Adirondack red spruce, a rare and highly prized tonewood that featured in the tops of many instruments from the golden age of the flattop acoustic guitar. The instrument's back and sides are made from solid mahogany.
The Keb' Mo' Bluesmaster is made in the image of Gibson's small-bodied L-series guitars, such as the L-00. Its solid spruce top is sanded to a custom thickness and is supported by an X-brace pattern formed of scalloped spruce braces, all of which optimize its resonance and tonal richness. In the tradition of many small-bodied finger-style guitars, the Keb' Mo' Bluesmaster carries no pickguard, a feature which also further enhances the top's resonance.
Tonal Characteristics
Despite its small body dimensions, the Keb' Mo' Bluesmaster has a deep, rich, multidimensional tone, and a volume that belies its size. Its thin, lightly braced top aids its superb projection, while its solid mahogany back and sides add excellent definition and a velvety high-end shimmer to its tone.
The Keb' Mo' Bluesmaster is available in either antique natural or vintage sunburst.
The Keb' Mo' Signature Bluesmaster is hand-finished in a process that demands several coats and many hours. Unlike many other manufacturers who settle for a polyurethane finish, Gibson opts for a nitrocellulose finish that will encourage the natural vibration of the instrument for a purer tone. In addition, a nitro finish is very porous and actually gets thinner over time. That way your guitar's wood can breathe and age beautifully.
Neck Wood
The neck is made from quartersawn solid mahogany. The quartersawn grain orientation produces superior strength and resonance, and is preferred in the necks of high-end acoustic guitars.
Truss Rod
Gibson's traditional truss rod, found in most all of their guitars, is highly responsive to the individual adjustments you'll want to make to personalize and optimize string action and sustain.
The guitar's neck is carved to a custom Keb' Mo'-designed sculpted V profile.
Headstock Shape and Angle
The headstock is carved in the style of Gibson's Advanced Jumbo with tapered edge, and is pitched at the vintage-correct 17-degree back angle.
The Gibson logo is inlaid in mother of pearl across the top of the Keb' Mo' Bluesmaster's headstock, which also carries the traditional mother-of-pearl crown inlay. The truss rod cover is further engraved with Keb' Mo's signature.
The Keb' Mo' Bluesmaster's glued-in neck is attached with a compound dovetail joint, positioned at the 12th fret. This neck/body joint results in a bridge placement further into the center of the guitar's rounded lower bout, which perfectly hits the top's "sweet spot" for improved resonance and sustain.
Tonal Characteristics
The angled, classical-style peg head and mahogany neck work together to provide exceptional tonal richness and sustain from the neck, while the deeper bridge placement-a result of the 12th fret neck/body joint-increases the guitar's overall sonic depth.
Fingerboard Species
The neck carries a fingerboard of East Indian rosewood. Rosewood is both hard wearing and sonically superlative, adding sweetness and depth to the guitar's overall sound.
The Keb' Mo' Bluesmaster is built to a 25" scale length, and its fingerboard has a 12" radius. Combined with its 1.805" nut width, these dimensions offer plenty of room for popular traditional and contemporary blues styles with a string spacing that finger-style players in particular will appreciate, and no "dead' or "choked" strings during blues bends.
The fingerboard carries 18 narrow, vintage-style frets in total, with 12 frets clear of the body.
The fingerboard is inlaid with vintage-style 1/4" mother-of-pearl dot position markers.
Nut Material
The Keb' Mo' Bluesmaster has a genuine bone nut for optimum resonance and sustain.
The width of the nut is approximately 1.805", the preferred width for flattop blues guitars.
The Keb' Mo' Bluesmaster carries a built-in L.R. Baggs Element pickup with a single volume control mounted inconspicuously in the edge of the sound hole and a standard 1/4" end-pin jack. The Element is an advanced unit from one of the world's leading acoustic-guitar pickup manufacturers, and it offers a broad, natural projection of the guitar's natural tone without interfering with the vibration of the top and bridge when it is played unplugged.
Tuning Keys
The headstock carries vintage-style, open-back nickel tuners with an efficient 14:1 ratio for excellent tuning stability.
The Keb' Mo' Bluesmaster carries a traditional "belly down" bridge made from solid East Indian rosewood with traditional bridge pins and a solid bone bridge for enhanced sustain and resonance.
Check the drop-down menu to the right to select colors and/or other options.
Our product catalog varies by country due to manufacturer restrictions. If you change the Ship-To country, some or all of the items in your cart may not ship to the new destination.


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Views: 1923
Well said
It truly fills me with pity to see so many religious people committing what is intellectual suicide. religious dogma murders the philosopher in all of us, it teaches people to accept things without evidence, the accept an authority without question and worst of all tells people not to ever ask questions. If only the could see the the beauty of the world when looked at in a scientific way is far more beautiful then any description in their holy books.
I take my view with Socrates "The un-examined life is not worth living"
I'm a bit surprised to discover this post and disappointed that I hadn't seen it much sooner. I hope I needn't tell you that I am in utter, absolute, 100% agreement with it! Brilliantly said, Terry!
Thank you Loren. That's a big compliment coming from an atheist who writes so much, so well, and so eloquently on Atheist Nexus.
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Beefy hardware makes for a fast phone
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Lots of great apps
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The exchange of kidnapped Israeli soldier Gilad Shalit for more than one thousand Palestinian prisoners, many of them convicted terrorists, may indicate a shift in Hamas' position, says former U.S. ambassador to Israel Martin S. Indyk. Hamas' leadership has been based in Syria and heavily influenced by Iran, both of which pushed back against any deal with Israel, says Indyk. But the Syrian regime's recent crackdown on the Muslim Brotherhood drove Hamas' external leadership to look for a new headquarters, namely Cairo. To allow this relocation, Egypt insisted that Hamas make concessions to end the Shalit stalemate. Indyk notes that while the deal isn't likely to produce any short-term breakthrough, it could augur "a long-term trend on Hamas' path toward greater pragmatism and flexibility and willingness to do a deal with Israel."
What is the overall significance of the prisoner exchange?
The deal's human dimension can't be dismissed, because it was what drove the deal. And Israel's desire to save one soldier's life is what led to this lopsidedness. The broader political implications aren't positive. Hamas has long argued that its approach--violence, terrorism, kidnapping, hostage-taking--is the most effective way of retaining Palestinian rights, whether that's getting prisoners released, getting settlements evacuated, or getting territory liberated. That narrative has been vindicated by this deal.
Palestinian Authority President Mahmoud Abbas (Abu Mazen), who is Hamas' political opponent, was unable to achieve a major prisoner swap like this, which included the release of many terrorists with a good deal of blood on their hands. Abu Mazen has been unable to achieve through negotiations the evacuation of Jewish settlements from the West Bank or the liberation of Palestinian prisoners. So those who reject compromise and peacemaking with Israel and talk violence and terrorism are the ones who have been strengthened.
Do the Israelis see this as a setback?
You sure wouldn't know it from the way that the Israel public is welcoming Gilad Shalit. This shows that they value the return of a soldier more than they care or are concerned about the threat of terrorism. That's because Israel is a small country with universal conscription. And with every family having a child or grandchild in the army or going into the army, they want to know that their leaders are going to do everything possible to bring them back from the battlefield if they are captured--or indeed, if they are killed, that their remains will be returned. This is creating an inversion of values, so that rather than the army protecting civilians, it's the civilians who have to protect the soldier. In recent times that has led to a restraint on the use of force in wars with Hezbollah and, to a lesser extent, with Hamas. This inversion of values could be problematic for the next conflict, but at the moment the context is one in which there is very little terrorism, very little violence.
The so-called Middle East Quartet--the United States, Russia, the EU and the UN--is due to come to Jerusalem later this month to try to jump-start talks between the Palestinian Authority and Israel. Does the prisoner exchange make talks more relaxed or does it make it tougher?
It makes it tougher. First of all, those talks [weren't] going anywhere anyway. President Abbas decided some time ago that there was no point in negotiating with the current government in Israel, that the gap between his minimum requirements for a Palestinian state and the maximum concessions demanded by the current Israeli government under Prime Minister Benjamin (Bibi) Netanyahu would not allow him to risk what was left of his credibility. So he chose this unilateral route of appealing to the United Nations for membership and the establishment of a Palestinian state. I don't see any indication that he's changed his course. If anything, he found something that made him more popular among Palestinians. Netanyahu, even though what he has done is popular in Israel, will not want to be seen as making concessions on substantive issues to the Palestinians, having made such a very big concession on the issue of terrorism.
Were you surprised that Netanyahu agreed to this swap, given that he's such a strong opponent to dealing with terrorists?
No. Bibi is a politician. He's a good politician, and he saw in the last two years the way in which the Shalit family had managed very effectively to make the issue of their son's freedom a popular issue among the Israeli public. It became overwhelmingly apparent in mid-summer, with major demonstrations in support of freeing Shalit, that there was a strong majority of the population that supported it. That was manifested in the cabinet vote, in which twenty-six out of twenty-nine ministers voted for this prisoner swap. Netanyahu could give up his principle without fear of political retribution because of the shift in public mood. But the critical element in this shift, and it's another irony in the situation, is that terrorism had been dramatically reduced by cooperation between Abbas's Palestinian Security Forces in the West Bank and the Israeli army. Yet Abbas, who helped reduce the terrorism and violence against Israelis, is the one who's going to suffer politically as a result of this deal.
What does the deal say about the new Egyptian government, which mediated with the German government? Is this something the Mubarak regime could have negotiated as well?
Hamas has long argued that its approach--violence, terrorism, kidnapping, hostage-taking--is the most effective way of retaining Palestinian rights. That narrative has been vindicated by this deal.
The negotiations were conducted by the same Egyptian intelligence services that conducted negotiations in Mubarak's time, so there has really been no change in that regard. What's changed is that Hamas was more willing to do the deal and make concessions this summer than they were previously. The key to understanding why they became more flexible lies not in the Egyptian revolution but in the Syrian revolt.
Hamas' external leadership has been based in Damascus, where they are under the direct influence of Iran and Syria. The Iranians have had no interest in any deal that would lower the flames of Arab-Israeli conflict, because it is that conflict which enables them to spread their influence into the Arab hotbed, right up to the borders of Israel. Therefore, in the past they pressed Khaled Meshaal, the leader of the external Hamas based in Damascus, not to do the prisoner deal with Israel. Much to the frustration of Egyptian and German mediators, they were unable to pull this deal off at critical junctures because of Iran telling Meshaal not to do the deal.
But that was not the only reason. Domestic politics in Israel made it difficult to do the deal; the security chiefs in Israel had previously opposed it. Still, what made this particular deal possible more than anything else was the fact that Khaled Meshaal was in a very awkward potion in Damascus. The Syrian regime was killing Sunnis, many of whom were part of the Muslim Brotherhood, and Hamas is part of the Muslim Brotherhood. And Iran was pressing Meshaal to come out in support of the Assad regime, and rather than do that, he started to talk to the Egyptians about shifting his headquarters out of Damascus to somewhere else in the Arab world, such as Cairo. The Egyptians said to him: You can come, but there are two things that you have to do. One: Agree to the reconciliation with Fatah, and that happened in May of this year. Two: You have to be more flexible on the prisoners deal. That happened in July, when the Egyptians were able to convey to the Israelis a more reasonable offer from Hamas, which produced the deal that was consummated October 18.
What does this deal foretell for the future?
While in the short term, this is unlikely to produce any kind of breakthrough to reconciliation with Israel, it does signal a long-term trend on Hamas' path toward greater pragmatism and flexibility and willingness to do a deal with Israel. It may in the end produce reconciliation between Israel and the Palestinians, but I wouldn't hold your breath.
The United States is just an onlooker in this whole thing?
Well, the United States was certainly interested in trying to free Gilad Shalit, but it didn't have any role to play because of course it has no relationship with Hamas.
Should the United States change its policy on Hamas or is that politically impossible?
The United States has clear and sensible requirements in terms of dealing with Hamas. It is a terrorist organization; it preaches terrorism and violence. The United States as the custodian of the peace process has to maintain certain principles, and you can't promote a peace process with a party that wants to turn it into a war process. But there are various things that the United States can do to encourage what I believe is a long-term trend in Hamas' greater pragmatism. Eventually, that could produce a greater moderation.
The heart of that process is the fact that Hamas is no longer just a terrorism organization. The fact that it controls the Gaza Strip puts it in a daily dilemma between feeding the people in Gaza or fighting Israel. They cannot have it both ways, so most of the time they choose to feed the people rather than fight Israel. The external Hamas leadership shifting out of the Iranian-Syrian camp, the rejectionist camp, into the more moderate Arab camp that supports brokering peace with Israel can reinforce that tendency. Khaled Meshaal opposed the Gaza Hamas people taking control of Hamas, precisely because he knew they would be put in that dilemma. But history has moved on, and he is in much less of a position to oppose them. What we are also seeing here a shift from the influence of the external Hamas to the greater influence of internal Hamas.


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Steven M. Studebaker, The Trinitarian Vision of Jonathan Edwards and David Coffey (Amherst, NY: Cambria Press, 2011).
Steven Studebaker, a Trinity grad who teaches at McMaster Divinity College in Ontario, has published more than anyone on Edwards and the Trinity–including three books in the past four years. This book, however, is the most revealing and personal of his writings on the subject. It compares Edwards with Studebaker's mentor, David Coffey, an Australian Roman Catholic who taught for a time at Marquette University in Milwaukee when Steve was a doctoral student there.
Edwards, Coffey, and Studebaker share a strong affinity for the Augustinian mutual love model of the Trinity. And in Studebaker's telling, this has yielded in all three of them "a way of thinking about salvation that is primarily relational and transformational" (i.e. more than forensic and then moral) and "a theological basis for an optimistic attitude that the grace of Christ can touch those people who participate in a non-Christian religion and have never heard the Gospel of Jesus Christ" (p. 2).
Historians of theology will recognize that Studebaker is working in the train of Coffey's teacher Karl Rahner as he explicates Augustine and especially the notion of anonymous Christianity. Edwards scholars will recognize that Steve builds on the scholarship of Anri Morimoto and Gerald R. McDermott when it comes to Edwards' understanding of spiritual rebirth and the possibility that non-Christian seekers might experience it.
The book has six chapters, all remarkably erudite. Chapter one lays out the Augustinian mutual love tradition. Chapter two places Edwards and Coffey within that grand tradition. Chapters three and four treat the Spirit-Christology and pneumatological concept of grace found in both Edwards and Coffey, which fill out their Trinitarian understanding of salvation and prepare the way for Studebaker's constructive contribution. Chapter five maps out what Studebaker calls "A Trinitarian and Evangelical Vision of Redemption." Chapter six develops "A Trinitarian and Evangelical Theology of Religions."
This volume is an exercise in ecumenical thinking by an up-and-coming scholar with an evangelical pedigree and sympathy for Roman Catholic history and theology. Studebaker employs Edwards and Coffey in an effort to promote doctrinal convergence among the people he knows best (evangelicals and Catholics) on the issues at the center of their longstanding division (soteriological issues). Conservatives on both sides may dislike his argument. But Edwards scholars will find here a window onto Studebaker's soul and its passion to promote renewed reflection on the Trinitarian vision of Jonathan Edwards.
–By Douglas Sweeney, Director of the JEC at TEDS


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Running Time: 136 minutes
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It was during the Dust Bowl era that the technology used to detect high-pressure drought-causing systems was developed.
Many researchers and journalists are calling the high-pressure system causing California's historic drought the "Ridiculously Resilient Ridge," a weather phenomenon identified using technology developed in the 1930s.
For the past 12 months, California has been drier than a sandbox in the Sahara thanks to a stubborn high-pressure system perched over the Gulf of Alaska since December of 2012. This system has kept rainfall in the Golden State at historic lows, with precipitation 10 inches lower than average in most places across the state.
California Gov. Jerry Brown has described it as a "mega-drought," while California's Catholic bishops have asked the public to pray for rain. The state has even attempted cloud seeding, where the clouds are sprayed with silver iodide in an attempt to squeeze out every last drop.
But for meteorologists, the solution is simple: that high pressure system over the Gulf of Alaska needs to weaken so precipitation from the Pacific Ocean can make its way to California.
The problem is that system has stayed strong for the past 13 months.
"Given the remarkable persistence and distinct structure of this high-impact feature of recent atmospheric circulation, I would argue that it's now worthy of a proper name," wrote Daniel Swain, a Ph.D. hopeful in the Environmental Earth System Science Department at Stanford University, about the high-pressure system.
"With this in mind," Swain continued, "here's a visual reminder of the spatial and temporal character of the Ridiculously Resilient Ridge of 2013."
That phrase proved to be just catchy enough for weather experts and the journalists that cover them. "Ridiculously Resilient Ridge" has now become the accepted name of that high pressure system, which is more than 4 miles high and 2,000 miles wide.
"I first heard about the name a few days ago," said the National Weather Service's (NWS) Dr. Warren Blier. "It's alliterative, it's relatively accurate, but it's not the term I would use. It doesn't sound particularly scientific."
Of course, weather events are often named for the benefit of informing the public. For example "Dust Bowl" may not have sounded scientific either back in the 1930s, but it accurately explained the widespread drought conditions that crippled the country.
And it was during the Dust Bowl era that the technology used to detect the so-called Ridiculously Resilient Ridge was developed.
"The [NWS] uses radiosondes technology to get a large-scale picture of atmospheric conditions, just as they did in the 1930s," Blier said. "Radiosondes attached to weather balloons helped us identify this persistent warm front."
Radiosondes evolved from temperature and pressure gauges hung from kites and balloons in the 19th century. Since the 1950s, radiosonde technology has been relatively stagnant.
"It's not complicated stuff," Blier added. "The radiosonde package is more sophisticated, but the idea is still the same as when they were first invented."
When released, the Radiosondes use electronic signals to relay information back to researchers and meteorologists around the world to measure pressure, precipitation and temperature. Radiosondes helped identify a high-pressure system in 1976-77 that caused similar drought conditions in California.
While the radiosondes are important, Blier was quick to note there have been significant technological advances since then that have greatly improved the accuracy of NWS forecasts in the short-term.
For example, commercial airliners have been equipped with data-gathering instruments so researchers at the National Oceanic and Atmospheric Administration have a constant stream of information used to forecast. Blier credited that system, known as AMDAR, along with improvements in radar and satellite technology, with helping save lives before tornadoes and other quick-forming weather phenomenon.
"We can predict five to six days out now, where as back in the 1970s, we could only predict two to three days out," Blier said. "We didn't have a way to issue a tornado warning until someone saw a tornado touch down."
Technology that detects rapid changes is also very important to California water monitors. David Rizzardo heads the new snow survey section of the California Department of Water Resources. He said a vast network of monitors and sensors surround lakes, reservoirs and other watersheds throughout the state. These monitors use microwave and satellite signals to dispatch real-time information to water monitors in Sacramento.
"It is our first line of defense for emergency response if there's a flood," Rizzardo said. "It's vitally important because it's a dam safety issue, and we can make real-time adjustments based on the data."
Yet, like the NWS, Rizzardo said for big-picture data gathering, old techniques and technologies are often deployed. For example, the Department of Water Resources still uses manual water surveys, where people measure samples with buckets.
"It's the best climate record we have," Rizzardo said. "It's been used to measure snow levels in the Sierra Nevada since 1909."
In fact, researchers know that this current drought is historic, in-part, because of those bucket measurements.
"Older technology can be incredibly useful for the big picture," said the NWS' Blier.


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December 2, 2010 | Comments Off on iPad Trainz
It is done! Trainz is now arriving to an iPad at the App Store on December 4th. You will be able to build a layout and drive trains on the iPad while sitting on a couch.
To the fat guy in the red suit, could you send an iPad my way?
Developing a route without a mouse might seems tough but as the following video shows, using your finger and other controls it looks just the same.
Route Creation in Ipad:


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On July 6, during the day shift in Unit 2100 at Christus-St. Vincent Regional Medical Center, a nurse cared for two patients labeled high acuity—medical parlance for seriously ill.
The nurse deemed one patient, who'd just undergone foot surgery, as "non-compliant." Another patient for whom the nurse cared "was an IV drug user."
The drug user, reported the nurse, had "made arrangements to meet someone at the hospital to bring him drugs."
The drug user's escape from the unit went unnoticed. His nurse was on a rapid response call for one patient while trying to monitor a separate patient's "continuous bladder irrigation emergency."
"After both previous emergencies were under control," the nurse later wrote, "I went to the front entrance of the hospital and found the IV drug user patient almost outside. I needed to call security as the patient would not return to his room."
On May 11, during the day shift, seven nurses, two nursing assistants and a secretary watched over 34 patients in Unit 2100.
That's four beds short of the unit's capacity.
Four call lights had been left on for 30 minutes without a response from hospital employees.
Meanwhile, a surgeon instructed that a postoperative patient should get out of bed three times a day. But the patient's nurse left a note for the surgeon saying that task was impossible. The patient "required coaxing" and moderate assistance to get out of bed, "which took 20 minutes."
"Because of short staffing, no one had time to get this patient out of bed more than once," wrote a nurse on the unit, "and once to the bedside commode."
Another patient in Unit 2100, on June 4, could have only wished for a bedside commode.
The patient "had a 'fecal accident' because no one was available to take the patient to the bathroom," a nurse reported later.
These are just a few stories told in anonymous nurse reports provided to SFR by District 1199NM of the National Union of Hospital and Health Care Employees, the union that represents nurses and other employees at Christus St. Vincent, along with hospitals across the state.
Tension between management and the union has been simmering since the two parties entered into a collective bargaining agreement in August, 2011. The agreement abated a strike by nurses over alleged staffing shortages at Santa Fe's largest hospital. Having too few staff, nurses say, seriously compromises patient care. It can lead to harder hospital stays and even preventable death.
Yet two years later, nurses say the staffing problem persists. And as the expiration date on the collective bargaining agreement approaches—July 31, 2014—union nurses have been alleging that Christus St. Vincent has been violating its own staffing standards etched into the contact. The hospital disagrees.
Hard data about staffing levels is sorely absent from the contentious debate.
But union leaders say hospital memos obtained by SFR indicate the benchmark for staffing levels at Christus St. Vincent are below staffing levels of 60 percent of peer hospitals.
A hospital document states its benchmark for the amount of hours nurses spend with patients daily is at the 40th percentile of that of peer hospitals, meaning that 60 percent of comparable hospitals are more robustly staffed with nurses and other auxiliary unit employees.
Previously, Christus St. Vincent pegged its hours-per-patient day benchmark at the 50th percentile, according to hospital documents and nurses.
But the hospital appears to have lowered the bar for the current fiscal year.
The hospital refused to grant SFR an interview with any top managers for this story, then declined to respond directly to a series of written questions. Instead, spokesman Arturo Delgado issued a general statement. The hospital's nurse staffing levels "are based on patient acuity" and "national benchmarking standards," he writes in an email Monday.
"When benchmarking," Delgado writes, "we look at hospitals of similar size and scope at our hospital."
Delgado would not provide SFR with a nurse-to-patient ratio at the hospital, but he writes that hours of care per patient day, the hospital's projected census, the skill of the staff and severity of patient conditions all factor into deciding staffing levels.
"At Christus St. Vincent Regional Medical Center," he writes, "we are proud of the hard work and dedication demonstrated by our nurses, and staff, on a daily basis. Patient safety and patient satisfaction are always our first priority."
He adds that it is "unfortunate that union leadership would choose to disparage the hospital and the wonderful care our staff provides each patient, every day."
On June 10, the union took the unusual step of lodging a complaint with the state Department of Health, which has regulatory authority over New Mexico hospitals.
The union asked the department's Health Facility Licensing and Certification Bureau to investigate whether the alleged staffing shortages represented a danger to the "health, safety, or welfare" of the patients and staff at the hospital.
Like many states, New Mexico doesn't mandate a nurse-to-patient ratio for hospitals.
State regulations say that an "adequate number" of professional registered nurses "shall be on duty at all times to meet the nursing care needs of the patients."
The number of "nursing personnel for all patient care services of the hospital," the regulations say, "shall be consistent with the nursing care needs of the hospital's patients."
"The ratio of licensed nursing personnel to patients," reads another section of the administrative code, "shall be determined by the acuity of patients, the patient census, and the complexity of care the must be provided." (A patient census is the number of patients in the hospital).
In response to the union complaint, DOH conducted a site visit of Christus St. Vincent on July 11 and concluded the hospital was in compliance with "applicable regulations." However, it noted several deficiencies in patient care.
Among them: the hospital "failed to ensure that medical records were accurately written and that documentation was completed promptly following patient falls" that occurred between June 1 through July 1. DOH surveyors also found that the hospital "failed to ensure" that medical records of three active inpatients who required turning or repositioning every two hours were kept.
According to DOH documents, there was no immediate documentation of a patient fall on June 23, other than "a retroactive charting or a late entry nursing note in the medical record," logged the next day. The "late-entry" note by the nurse, states DOH documents, said the patient had been transferred to a new room in the evening "to be more visible" from the nursing station.
"[B]ut at the time of the fall," states the DOH document, "there was nobody at the nursing station, due to staff being busy with other patients."
Christus St. Vincent said in plans of correction that it will begin auditing charts and "re-educating" nurses.
"The complaint was unsubstantiated," the DOH investigative report says of the union's allegations. "There are no federal or state specific ratios identified for staff/patient ratios at present time," writes DOH spokesman Kenny Vigil in an email to SFR.
Delgado writes that the department review was not based on the July visit alone, but that investigators "reviewed 6 months of hospital staffing and outcome data and determined that union leadership claims of compromised patient safety were unsubstantiated."
The hospital called DOH's visit "unannounced." (Vigil says DOH "does not let a facility know beforehand about a site survey.") But the union alleges Christus St. Vincent staffed up for DOH's visit. It filed the complaint on June 10 and the investigation occurred roughly a month later.
The union's "staffing insufficiency reports" from that time period show nurses expressing surprise that units were overstaffed.
"Overstaffed!" reads one report filed by a nurse on the Behavioral Health Unit on July 8. "Why—DOH?" The unit, according to the report, had a nursing assistant when the required staffing grid didn't call for a nursing assistant.
"Staffed up 1 [registered nurse] and 1 Unit Secretary," reads a report filed July 10 from Unit 2100. "DOH at CSV." The nurse listed one extra registered nurse working on the unit, along with one extra secretary.
"[F]ull compliance of staff," reads another July 11 report from the Rehab Unit. The unit had eight employees, according to the report, caring for 18 patients.
Days later, on July 12, five hospital employees—three nurses and two nursing assistants—cared for the same number of patients. "Short 1 RN," reads a union report. "Short 1 Unit Secretary as Unit Secretary made to sit for 12 hours. Unit secretary states it was obvious they staffed up for DOH. DOH never came to Rehab to visit with staff."
The union has been collecting the staffing insufficiency reports since at least January. The reports, however, are difficult to independently verify.
They don't reveal any names of patients or of nurses making them, and they're meant to further the union's goal to "present statistical and other relevant data to lawmakers to help them pass legislation that mandates safe staffing levels," according to the union's website.
Union officials say they believe the reports are coming from a small number of nurses, but they declined to say how many of Christus St. Vincent's nurses are dues-paying union members. Meanwhile, the hospital won't say how many people it employs or address specific allegations in the reports, including the target time for staff to respond to a patient call light.
Yet the reports detail dates of incidents, the required staff working at the time of the incidents, the actual staff working during the incidents, the number of patients during the shift, the units where incidents occurred and the effect that alleged insufficient staffing had on patients.
The anonymous reports still provide a rare glimpse into the operations of a hospital that has tried to stifle nurses from publicly talking about their experience inside the units.
The hospital filed a grievance with the National Labor Relations Board accusing the union of violating contractual clauses in the collective bargaining agreement that prevent nurses from entering into a strike or a lockout.
An attorney for Christus St. Vincent accused the union, in a letter, of undertaking an "illegal corporate campaign" in violation of contractual language that states the union shall not engage in "concerted action where the purpose or effect is to interrupt, interfere with, impair, impede or obstruct any phase of CSVRMC's operations or business."
The letter further alleged the union violated a clause that the parties "agree to cooperate with one another" in the furtherance of their mutual interests.
The hospital's evidence?
Nurses were bypassing the work of a contract-sanctioned staffing committee by communicating with "constituencies outside of the medical center concerning the establishment of mandatory staffing ratios at CSVRMC," including lawmakers, the media and the public.
The letter followed a vote-of-no-confidence petition against hospital executives circulated by the union. Dozens of hospital employees signed the petition and some gave interviews to local media alleging staffing shortages.
"...[T]he Union and its agents have published, caused to be published, or distributed a multitude of false and defamatory statements in petitions, flyers, newspaper interviews, website postings, and various other media," reads the letter, "attacking CSVRMC as engaged in and promoting practices that endanger the lives and safety of patients."
Fonda Osborn, president of the union, replied in her own letter to the hospital's attorney that she was "disappointed, but not surprised, that your client had chosen to use oppressive tactics to silence lawful activities" such as the right to seek redress of grievances from one's government.
"We understand and share the hospital's desire to keep certain matters internal; that ethic has its place in any institutional setting," Osborn wrote. "But, in this instance, the hospital's insistence on secrecy must be sublimated to patient care."
A labor board arbitrator concluded early this year that union employees had not violated the anti-strike clause in their agreement nor had they engaged in illegal or defamatory speech.
"Testimony indicated that the right to speak out against practices potentially affecting patient care is an ethical obligation of the nursing profession," an NLRB arbitrator wrote in January. The hospital's grievance was dismissed "as lacking demonstrated merit."
Around the same time, the union and hospital management entered into a settlement in which the hospital agreed to provide the union with data showing the number of patients and nurses at the hospital, allowing the union to evaluate whether the hospital is properly staffed.
The August 2011 collective bargaining agreement established the nurse staffing committee to "develop, implement, and maintain a written nurse staffing plan." The staffing committee is composed of 10 members—half management, half union nurses. Management breaks any tie votes. It composes new staffing plans partly based on algorithms that determine how many hours nurses spend caring for patients per day. The hospital has been arguing that the algorithms show it has been using more staff than necessary.
A November 2011 hospital document, for instance, shows that, based on the hospital's algorithms, only two out of 18 units were understaffed. The document showed the hospital benchmarked staffing levels at the 50th percentile.
But hospital reports from June and August show the hospital lowered its 2014 benchmark to the 40th percentile, and that three units in the hospital —critical care, maternity and nursery—didn't even meet that benchmark.
On Monday, Aug. 26, Diane Spencer, a clinical nurse with 16 years under her belt at St. Vincent, met with the nurse staffing committee.
"Our goal was to be an average hospital," she says of the 50th percentile staffing benchmark. "[B]ut wouldn't you want to be one of the best hospitals in the state?"
Spencer tells SFR that management didn't inform the staffing committee of its plans to drop the benchmark staffing levels to the 40th percentile.
Delgado, the hospital spokesman, refused to respond to specific questions about why the benchmark was dropped.
He writes in a prepared statement that the hospital has "seen significant increases in the quality of care and in out patient satisfaction scores."
"[A]nd we will continue to work hard to ensure our scores and quality outcomes continue to improve," he writes.
A state legislator last year introduced a measure to address the issue, but other lawmakers stalled the proposed Safe Staffing Act, carried by Rep. Christine Trujillo, D-Bernalillo. It would have required hospitals to establish a nurse staffing committee, composed of six nurses, a nurse manager and "any other qualified person as determined by the hospital." The bill would have charged committees with establishing staffing plans for hospital units. The union lobbied for the bill while the hospital opposed it.
"A hospital shall formulate and adopt an algorithm for maintaining nursing staffing levels determined by the committee," the proposed legislation reads, "which may require the hiring of additional nurses."
It would have also required hospitals to report data on staffing and patient levels to the Department of Health—which would then post that data on its website for public inspection.
There's also no federally mandated nurse-to-patient ratio.
"We don't have nurse-to-patient ratios in our standards," says Elizabeth Zhani, media correspondent for The Joint Commission, a hospital accreditation agency.
Trujillo's state proposal was similar to federal legislation Sen. Barbara Boxer, D-California, introduced last spring. The law would penalize hospitals that fail to maintain a minimum nurse-to-patient ratio, and prescribes minimum ratios for acute-care units.
Peer-reviewed research doesn't definitively link higher staffing levels to better patient outcomes. But patient outcomes are difficult to measure because of the diversity of circumstances under which they occur.
Barbara Mark, a registered nurse and professor at the University of North Carolina at Chapel Hill's School of Nursing, led a 2012 study of the impacts of a California state law that increased nurse-to-patient ratios in certain hospitals. The study found that after the California legislation was implemented, some hospitals experienced a decrease in rates of failure to rescue—patients dying after complications—and that infections due to medical care increased "significantly" in certain hospitals. That could be because having more nurses leads to better detection, not because of an actual increase in infection.
Her research also indicated that mandating nurse-to-patient ratios also negatively impacted the bottom line of hospitals, where financial performance and charity care decreased after the legislation went into effect.
Mark tells SFR that research still hasn't shown what a good nurse-to-patient ratio looks like, because other factors in the hospital—not just the number of nurses—impact quality of care.
Too many nurses working a unit can be problematic as well, she says, because a nurse might assume another nurse is covering a task. Mark concludes there's a "sweet spot" at the top of a bell-curve that would mark the ideal number of nurses. But that "sweet spot" is still unknown to researchers.
"It's really difficult to parse out clean and clear relationships," she says. "But as I said, there does seem to be some fairly convincing evidence on the whole that better nurse staffing is associated with decreased mortality and decreased failure to rescue."
It's been roughly five years since Texas-based Christus Health purchased St. Vincent Regional Medical Center—the state's first hospital—which had been sinking in debt. Christus says it owns more than 40 hospitals and health facilities in seven US states and six states in Mexico. In 2010, the latest year for which its tax information was available, Christus reported that it pulled in $498 million in revenue and ended the year on a positive financial note—a $2.9 million profit. The previous year, Christus Health was operating at a $20 million loss.
Its mission, according to its website, is "to extend the healing ministry of Jesus Christ."
Observers note Christus is eyeing to expand that mission. This year, Alex Valdez, formally the CEO of the hospital, moved to Christus Health's newly created position: president of international advocacy.
In Santa Fe, Christus has already expanded, snapping up the Physicians Medical Center on Rodeo Drive in 2011. A local nonprofit corporation affiliated with Christus St. Vincent, SVHsupport, paid $14.8 million for the purchase.
As a 2013 Health Status Profile conducted by Santa Fe County and Christus St. Vincent shows the hospital, with 268 beds, is "the largest hospital facility north of Albuquerque and the region's only Level III trauma center." The second largest county hospital is the 19-bed Physicians Medical Center that Christus St. Vincent purchased. The only other hospital in the county is Santa Fe Indian Health Service Hospital, with four beds.
When the union began collecting insufficiency reports, they began mostly as dry notes of how many employees worked on a unit. Nurses writing them mostly commented that their unit was short-staffed and logged the staffing levels.
But as time passed, the reports have grown richer in detail. Union president Osborn tells SFR that the reports are intended to "notify management" of staffing insufficiencies.
"They could always say they didn't know," she says, "but then we could say 'Well, you did know because we sent you these documents."
"We have people that fall," wrote an employee about the June 27 day shift in unit 3200, "…because one person…cannot properly care for 15 patients."
"Vital signs are vital," wrote the nurse, "and we can't even get those because it takes 2 hours to get all 15 patients' vital signs."
When the nurse complained to the manager, the manager advised the nurse to skip patient baths "because vitals are more important."
"So is skin, I thought," the nurse wrote. "There's too much wrong on our floor. It's to the point where I and my coworkers dread work."
"Daughter of a patient observed that the RN was moving quickly from one patient room to another to fulfill patient needs," reads a June 18 report from the day shift of Unit 2100, the medical-surgical unit. "Daughter stated: who can I talk to that you need more staff?"
A nurse from the same unit detailed a "positive note" from the day shift on May 26, saying that because of "appropriate staffing" the nurse was able to: provide holistic care for a patient with a new diagnosis of HIV; get a patient out of bed three times who "had no motivation to participate in his care"; get "my morbidly obese patient out of bed" three times to a chair and bedside commode; to provide therapeutic spiritual care by having time to talk with patient regarding his goals for the hospitalization and how to achieve them; and take care of a "confused patient who kept trying to get out of bed independently because he was restless and anxious."
But most of the reports don't focus on the positive.
"This place has become an unsafe environment for patients and staff," wrote one nurse in June. "Nurses are at constant risk of losing their licenses. I would not bring anyone in my family here because I know there is not enough staff to take good care of my loved ones. :(. Patients are not safe here anymore."
Mark, the researcher, argues that whatever the staffing levels of a hospital, it's important that "patients have some information about what the staffing level ratios are in the hospitals where they're being treated" and that "nurses themselves be actively involved in creating those ratios."
Unfortunately, she says, information sources like the Medicare compare website—which allows consumers to compare hospitals—does not have data on nurse-to-patient ratios.
"So patients are going to have to be active advocates," she says, "for their own health and safety in the hospitals where they receive treatment."


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If you missed the Heroes, Villains, and Monsters gallery, now's your chance to get the prints that are left!
Heroes, Villains, and Monsters gallery prints are 16x24 metallic art prints mounted on 1/8th foamcore board ready for framing.
Each print is one of a kind and there is only one available.
Some prints were damaged while hanging at the gallery which is reflected in the photos and prices of the prints as well as below
(not damaged)


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Many Ways To Skin A Cat - Modernising Bookmaster / Script
MartinPacker 11000094DH Visits (9515)
With apologies to cat keepers everywhere (of whom I'm one). Most of my reporting - when not graphical using GDDM - is created using Bookmaster. This looks in many ways like HTML and is another declarative markup language for text. It used to be what most IBM publications (including Redbooks) are written in. And customers bought Bookmaster (and DCF / Script/VS), embedding it into the... [More]
Java's Not The Only JVM-Based Language
MartinPacker 11000094DH Comments (9) Visits (20465)
JVM-based languages have an interesting property for z/OS programmers: They are zAAP-eligible. As we all know zAAP Eligibility brings a number of benefits - including the licence charge benefits and the ability to run on a full-speed processor even when your general-purpose processors are subcapacity ones. (I'll briefly mention zAAP-on-zIIP here for completeness, and then move on.) You... [More]


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TD Bank | Personal Banking, Small Business Banking, Mortgages and Loans, Investments
Banking made easy
What's happening in your life?
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Our Mobile Banking App offers flexibility, convenience, and security.
Our Mobile Banking App allows you to navigate with ease by using our intuitive dashboard. From the dashboard you can use quick links to navigate and a slide out menu to access features.
Our Mobile Banking App offers convenience on the go while you are out and about. You can check your account balances, view and perform transactions, and view your check images. Our funds transfer feature allows you to move funds immediately between your accounts or schedule future transfers. Our bill pay feature is easy to use and you can pay almost any company or person.
Our Mobile Banking App offers check deposit right from your phone, anywhere, anytime. It is so simple to deposit a check from your phone; the camera auto takes the picture for you.
We have many other great features in our mobile app, such as TouchID login from Apple. You can send and receive secure messages in your app inbox. You can view months' worth of online statements. You can update your personal settings, such as contact information, and change your password. Finding a branch location is fast and easy with our branch locator tool
Download our app today at the Apple and Google Play app stores by searching on TD Mobile App.
Banking Essentials
Your financial health
Making more informed everyday financial decisions can help you reach your long-term goals – like buying a car, saving for retirement or home renovations.
Financial tools and tips | Money management articles
Find the best checking account for you
Mobile App - secure banking from anywhere
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Finances for a growing family
Resources and tips for new couples and parents to plan, save, budget and talk about your money.
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To be eligible for the 0.125% discount, a TD Bank personal checking account is required to be open and in good standing within 14 calendar days of loan application. Offer subject to change.
*This is an example only. Savings example is based on a rate for a 30-year-fixed rate loan and assumes the purpose of the loan is to purchase a property, an existing single family home to be used as a primary residence with an estimated property value of $250,000, a 20% downpayment and loan value of $200,000. The property is located in Framingham, MA and is within Middlesex county. The rate reflects a 60 day rate lock period.
The rate shown is not guaranteed and is subject to change without notice. This is not a credit decision or a commitment to lend. The information provided assumes excellent credit score rating of 740. An escrow (impound) account is required. Your actual rate will depend on various factors including but not limited to loan type, credit profile, property type, appraised value, occupancy, subordinate financing and loan size.Close window and return to home page
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Provocative Voices: Profiles in Blogging
Inspired. That's how I felt after reading Profiles in Blogging, a new report published by the Center for International Media Assistance that examines how bloggers around the world practice their craft. Christopher Connell, an independent writer, editor, and photographer who was also former bureau chief for the Associated Press in Washington, provides a window into the experience of eight bloggers from Nepal, Saudi Arabia, Cambodia, Ghana, Yemen, Philippines, China, and Cuba. He provides an interesting narrative about each blogger, noting their important role in filling information gaps and their evolution into influential bloggers. He also examines how these bloggers find their audiences, the obstacles they face in practicing their craft, and, most inspiring (as least in my view), what motivates them.


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Richmond Theatre
Thompson Street and Wright Street,
Staten Island,
No one has favorited this theater yet
Located in the Stapleton district of Staten Island, the Richmond Theatre opened in 1906. It was located on Thompson Street at Brook Street (today Wright Street). It was closed in 1948.
Recent comments (view all 3 comments)
The theatre closed in 1928. A photo and more info can be found at http://oldstatenisland.tripod.com/
This theatre was still open after 1928. I was looking through the April 14, 1931 edition of the local newspaper (the Staten Island Advance) today, and the Richmond is listed as showing the film Ex-Flame, with Neil Hamilton and Marion Nixon.
Seats – 800 Opened – September 17, 1906 Closed – 1948 Owners – Moses & Johnson then Rosenblatt & Welt
The original structure was a small brewery operated by George Seltz, the founder of Constanz Brewery.
In 1896 the building was acquired by a German-American gymnastic group known as The Turners, thus the name "Turn Hall"
On September 17, 1906 the Richmond became the first legitimate theater on Staten Island.
It seated 800 patrons in its orchestra, balcony and box seats. It actually rivaled many a Manhattan stage. The first show was called "The Christian". From 1906 to 1912 it hosted performances by stock companies. The best seats in the house could be had for just a dollar. This was such a hit that the Richmond Light and Railroad Company ran extra trolleys just to handle the overflow crowds.
For years the dramas in this theater thrived only to be replaced by the comic operas with works by many of the works of Gilbert and Sullivan being performed before the audience. In 1916, the firm of Moses and Johnson took over the operations of the theater and started showing the latest rage, "The Motion Picture" Later owners, Rosenblatt and Welt attracted children with the showing of many western movies. In the mid 1930 the Richmond was shut down for a while for renovations, then in the1940s was closed forever. The insides of the building was scraped for the war efforts and then in 1948 a huge three alarm fire ended the life of that building for good.
Well selected plays that draw a full house at every performance, of which there were six nights a week and a matinée each Wednesday, Friday and Saturday. The theater was tastefully decorated and well ventilated. There was a new play each week. for photos of this and many more Staten Island Theaters go to my website http://www.statenislandhistory.com/staten-island-theaters.html
Just login to your account and subscribe to this theater


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Tel: +86 21 33655589Fax: +86 21 33655581Email: firstname.lastname@example.com
Home / Posts tagged 'journal bearing material'
As a famous China journal bearing material Manufacturers and journal bearing material factory,Shanghai Bhs Journal Bearing Co.,ltd located in FengXian District of Shanghai, the company's brand "BHS",Our company is specialized in supplying and maintaining a variety types of sliding bearing,bearing bushes and journal bearing material, which are widely used in high-speed pump, compressor, turbine, high-speed gear box, aerator, etc.The accuracy of our processing machine tools reaches grade 5 (highest accuracy: 0.006),which can be use to machining high precision bearings like tilting-pad bearing, dislocation tile bearing, multioil leaf bearing,journal bearing material wholesale and multioil gapbearing. Our bearing alloys are purchased form Yunan Tin Co., Ltd., which are provided with complete reports of chemical composition and mechanical properties.If the bearing alloy has special requirements, we can also purchase import
Millions kilowatt of nuclear power bearings, Babbit alloy casting localization test was successful. The project is successful, not only symbols the company already has capacity to produce millions of nuclear power bearing in domestic,but also further reduce the manufacturing cost of nuclear steam turbine, can save a lot of money for purchasing companies and users.
Fan-shaped thrust pad,Round thrust pad,Guiding tiles.
BHS stocking some models that most popular and frequent be used bearings in warehouse,which save time and money for end user.
Non self-balance tilting pad thrust journal bearing be used for Middle,high speed and middle,heavy load machines,such as compressors,gearboxes,turbines and pumps,centrifugal machine .etc.
High speed motor tilting pad bearings
Water lubrication bearings


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Over The Atlantic gigs
Next week we play at two Over The Atlantic gigs on their album release tour. The first is in Hamilton at Flow Bar (with Dynamo Go) on Friday the 28th of November, and the second is in Auckland at Kings Arms (with Mean Street) on Saturday the 29th of November.
If you haven't heard of Over The Atlantic yet you should check them out online: http://www.vimeo.com/221742828th Sep 2008
ASPA Awards
On Friday night we performed at the Aotearoa Student Press Association awards. This was our first performance since I (Nick) returned from overseas. Photos from the event can be found on our images page.17th Aug 2008
Live recordings of covers of our songs by other Hamilton bands....
The Gills - See The World
One Fat Man - Half-time Double-team
Dot Eyes - Salty
Our fourth single "Rain" is now available for download on our music page. It will be heading out to New Zealand radio stations over the next few weeks, so keep an eye (or an ear) out for it.
This single has come from the recording sessions in Te Pahu during 2007. A live performance of the song can be viewed at Vimeo.11th Dec 2007
Images from the weekend....
We've added some photos from the weekend to the images page.
The gig went surprisingly well. Thanks to all that came along. Thanks also to Adam Fulton who spent the night mixing our background visuals.
You can view our performance of the unreleased track "Rain" below. We'll upload some more footage soon.2nd Oct 2007
Half-time Double-team music video....
It's finished, so check it out....
As always, you can check out the making of the video on our blog and download a copy of the video from our video page.
We hope you like it!3rd Sep 2007
Working on another video....
We've started work on a third music video. This time for the song Half-time Double-team. We'll be shooting most of the footage over the weekend at The Yellow Submarine. If you'd like to follow the progress of the video, check out our blog.
We'll also be shooting some footage at our gig on Friday (7th of September) at The Yellow Submarine. Come along if you'd like to be in the crowd for the video. Also performing will be Phony Bone, The Wicks and MC Stormtroopa.13th Aug 2007
Thanks Little Pictures
We'd like to say thanks to Little Pictures for inviting us down to play in Wellington. And thanks to everyone who came along to the show. We really enjoyed playing and look forward to returning (hopefully soon).
While we were in Wellington we also dropped in to Radio Active 89FM for a few interviews. One of them should be appearing over the next few weeks on the weekly Uncharted show on bnet and a few Australian radio stations.
This weekend we play a show at The Yellow Submarine with Grey Power, The Stomps and Sora Shima. Don't miss it.


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Davis's Drug Guide for Nurses App + Web from F.A. Davis and Unbound Medicine covers 5000+ trade name and generic drugs. Includes App for iPhone, iPad, and Android smartphone + tablet. Handbook covers dosage, side effects, interactions, uses. Davis Drug Guide PDF. Explore these free sample topics:
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**Off Market Drug**
This medication is no longer available in the United States. Information provided here is for reference purposes only.
Trade Name(s)
- Agenerase
Ther. Class.
Pharm. Class.
protease inhibitors
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A lecture based on a new book, "Introduction to American Deaf Culture"
Thomas Holcomb, Professor of Deaf Studies at Ohlone College, brings his experience as a deaf person in a deaf family to his presentation on his new book, Introduction to American Deaf Culture, published by Oxford University Press.
Introduction to American Deaf Culture takes a cultural look at the deaf community and looks at various ways deaf people live in a world dominated by hearing people.
This lecture will be presented in American Sign Language, with voice interpretation. The Main Library is wheelchair accessible. To request other accommodations, call (415) 557-4557 or contact email@example.com. Requesting accommodations at least 72 hours in advance will help ensure availability.
Sponsored by Deaf Services Center


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E3: Ubisoft announces eight new titles for Nintendo Wii U
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Today at the E3 conference, video game producer Ubisoft announced the release of eight games by the first half of 2013 for the Nintendo Wii U.
It was also announced today the Nintendo Wii U would be released sometime before the upcoming holiday season.
The titles include: Assassin's Creed III, Just Dance 4, Marvel Avengers, Rabbids Land, Rayman Legends, Sports Connection, Your Shape Fitness Evolved 2013 and ZombiU.
For more information on each title, visit their website.


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Your Rights
A patient's doctor is in charge of medical care and will visit the patient to check on progress and to direct treatment. Registered nurses (RNs), licensed practical nurses (LPNs), clinical nursing assistants (CNAs) and other health care professionals will work with the doctor to care for a patient. A Statement of Patient Rights and Responsibilities is available in English and Spanish:
Advance Directives
In South Carolina, patients legally can let their families and health care professionals know their intentions if they are unable to speak for themselves by using advance directives called living wills and health care powers of attorney.
All patients are encouraged to complete an advance directive prior to entering the hospital, and bring a copy of this document with them to be placed on the medical record. The living will and health care power of attorney forms are available in both English and Spanish, free of charge, from the South Carolina Hospital Association, below as a PDF download, or by calling 864-449-1334. Our Patient Relations staff is available to assist you if you would like to execute this document.
- Download Healthcare Power of Attorney Document(English)
- Download Healthcare Power of Attorney Document (Spanish)
- Download Living Will (English)
- Download Living Will (Spanish)
Patient Satisfaction
At St. Francis, customer feedback is very important in our effort to constantly meet the expectations of patients. If you, or someone you know, has been a patient recently, please share any suggestions that might improve our quality of care by calling 864-255-1093. Please indicate if you would like a response.
Spiritual Care
St. Francis strives to provide holistic care by recognizing that a patient's spiritual and emotional well being is just as important as medical needs. Our staff of professionally trained spiritual caregivers makes themselves available to patients, families, and staff daily. People of all faiths are welcome in the chapels at St. Francis. Chapels are located on the ground levels of both hospital facilities. Services are held weekly in the downtown chapel. Televised music and inspirational programming also are available on Channel 2 in patient rooms at St. Francis Downtown.
Interpreters are available for hearing impaired patients and for those for whom English is a second language. A TDD phone will be provided upon request for the Hearing Impaired. Language line phones are also available for non-English speaking patients. To request an Interpreter, call 864-449-7993 to reach the Patient Relations interpreter on call.
Social Work/Case Management
A medical social worker is available to all patients and their families, and offers free information and assistance with:
- coping with illness and hospitalization
- locating resources available in the community (St. Francis HomeCare, at-home meal delivery,at-home medical equipment)
- coordinating post-hospital care (nursing home placement, rehabilitation, assisted living)