text:
BOSTON — A year after the Boston Marathon bombings, the Red Sox had plenty of chances to make a special day even more memorable.
They almost succeeded.
Boston scored one run in each of the last three innings – stranding runners in scoring position in all of them – in a 7-6 loss to the Baltimore Orioles in Monday's traditional Patriot's Day morning game
Not bad, though, considering the Red Sox trailed 6-0 after three innings.
"Our guys battled and fought and did a good job of making a game of it and it came down to the last pitch," David Ross said. "We did a good job of representing Red Sox baseball today. We just want to win, for the fans and the whole situation."'
Boston beat Tampa Bay 3-2 in last year's Patriot's Day game. About 40 minutes after the final out, two bombs went off near the marathon finish line a little over a mile from Fenway Park, killing three spectators.
This year, Monday's game began at 11:09 a.m., 12 hours, 28 minutes after Boston's 6-5 win ended Sunday night.
"Once you show up here, we have a job to do," Baltimore's Adam Jones said. "It doesn't matter what time it is."
The game started about an hour before Meb Keflezighi crossed the finish line as the first American man to win the Marathon since Greg Meyer in 1983. A long, loud cheer went up when the result of the race was shown on the center field video screen.
Boston's Mike Napoli called Monday "a special day."
"Of course, you want to go out there and win," he said.
That seemed unlikely when Baltimore scored six runs off Clay Buchholz in the third inning. The Red Sox, who overcame a 5-0 deficit Sunday, started to come back again.
"It never seems to be enough against these guys," said Baltimore first baseman Chris Davis, who fielded Mike Carp's grounder and stepped on first for the last out. "They claw and battle and continue to score runs and put pressure on us to score more runs."
Boston loaded the bases with one out in the ninth on a single by Brock Holt, a double by Dustin Pedroia and an intentional walk to David Ortiz. One run scored on Napoli's groundout to second before Tommy Hunter escaped with his fifth save.
Nothing special for Hunter.
"It's another inning, another game," he said. "I was actually pretty calm."
Wei-Yin Chen (3-1) and five relievers pitched well enough for Baltimore to gain a split of the four-game series.
Baltimore started the third with consecutive singles by Steve Lombardozzi, David Lough, Nick Markakis, Nelson Cruz and Davis that produced three runs. Jones drove in another on a forceout at second base before a run-scoring double by Steve Clevenger and an RBI single by Jonathan Schoop made it 6-0 and knocked out Buchholz (0-2).
Buchholz had slept over at Fenway Park after Sunday night's game and doesn't regret the decision.
"I'd have had to wake up earlier than I did here to get here this morning," he said, "so that had nothing to do with it."
Boston cut the lead in half with three runs in the fifth on RBI doubles by Jackie Bradley Jr. and Pedroia and a sacrifice fly by Holt.
In the seventh, Boston made it 6-4 on Ross' first homer and then had a chance to go ahead after Holt singled and Pedroia walked. But Ortiz hit an inning-ending groundout.
Deering High graduate Ryan Flaherty had an RBI single in the eighth to make it 7-4 before Napoli's solo homer in the bottom half. Singles by Xander Bogaerts and Daniel Nava put runners at first and second with one out, but pinch-hitter Jonathan Herrera struck out as the runners took off and Bogaerts was tagged between second and third.
"It takes some added energy," Boston manager John Farrell said of the repeated comeback attempts. "We'd certainly like to get the offense going a little bit earlier rather than having to dig out of a hole."
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text:
Israel, Hamas Cease-Fire Deal Announced
Egypt announced on Wednesday that a ceasefire had been reached to end the conflict between Israel and the Palestinians, starting later in the day.
Egyptian Foreign Minister Mohamed Kamel Amr made the announcement in a joint news conference with U.S. Secretary of State Hillary Clinton. The ceasefire would come into effect at
``These efforts ... have resulted in understandings to cease fire and restore calm and halt the bloodshed that the last period has seen,'' Amr said.

subset: commoncrawl


text:
Since the anonymous team behind TrueCrypt has left the building, security aware people were left wondering what's next. I personally keep using TrueCrypt and as long as it works I will keep recommending it.
Recently, Bruce Schneier has raised a few red flags by his strange advice that seems to indicate that he is being paid now for his "services to the community" by parties not so interested in keeping the community secure. One more thing is his advice to switch from TrueCrypt to BitLocker.
The guys that "disappeared" from behind TrueCrypt recommended to switch to BitLocker and that makes BitLocker suspect right away. Moreover, anyone working in security would be right suspecting that BitLocker, coming from Microsoft, would be backdoor-ed. And now Bruce Schneier is coming out and saying that he recommends BitLocker now instead of TrueCrypt? Great. I am not going to trust either.
TrueCrypt for the moment remains the only trustworthy application for disk encryption. There is an effort to make TrueCrypt survive and support newer features of the file systems. I hope it works and we still have some tool to trust in five years from now.
I have also stored the recent versions of TrueCrypt.


text:
Muslims in LaosHidden Beyond the Mekong
In terms of economic and political freedom, Laos still ranks among the most restricted countries in the world. It is all the more surprising, therefore, that the country's Muslims enjoy considerable religious freedom. Yogi Sikand paid a visit to Southeast Asia's smallest Muslim community
Sandwiched between Thailand to the west, China to the north, and Cambodia and Vietnam in the east, and with a population of less than seven million, Laos is one of the smallest countries in South-East Asia. It is also one of the poorest countries in the world. Some sixty per cent of Lao's population belongs to the dominant Lao ethnic group, most of who claim to be Buddhists.
Around a third of Laotians, mainly from the minority Hmong and Khmu communities, are animists, worshipping various forest and ancestor spirits. Muslims form a very small proportion of Lao's population. Community leaders estimate their number of be less than eight hundred, making Laos possibly the country with the lowest number and proportion of Muslims in the whole of Asia.
The first Muslims in Laos are said to have arrived in the early twentieth century, when the country was under French colonial rule. Most of them were Tamil-speaking Labbais and Rawthers from south India, many of them from the French-ruled enclave of Pondicherry along the south-eastern coast of the Bay of Bengal. The majority of them were single men, who worked mainly as guards and labourers in Vientiane, the capital of Laos. They were later joined by Pashtu-speaking Pakhtun Muslims from the North-West Frontier Province in what is now Pakistan. Many of these were earlier employed in the British army and had been stationed in neighbouring Burma during the First World War.
Chaos after independence
In 1953, Laos won freedom from the French after a long and bloody struggle. However, years of chaos followed, plunging Laos into a deadly war between American-backed forces and the communist Pathet Lao, supported by Vietnam and China. In 1973, America was forced to halt its war against Laos, and, two years after, the communists took over the entire country and established the Lao Peoples' Democratic Republic.
In the mid-1960s, the Muslim population in Laos was estimated at around seven thousand. However, the war in the country forced most of them to flee to various other countries. Most of those who remained were the poor, who could not afford to shift elsewhere.
Cambodian Muslims
Today, a little more than a hundred Muslim families remain in Laos. The single-largest ethnic group among them are Muslims of Cambodian origin, numbering sixty-one families. The first Muslims from Cambodia arrived in Laos as workers and small traders some forty years ago, but most of them came after the mid-1980s, when their homeland was taken over by the deadly Khmer Rouge. Today, most of them live by selling traditional medicinal herbs, which they import from Cambodia.
Most of Vientiane's Cambodian Muslims cluster around in a locality not far from the town's Chinese quarter. In the centre of their settlement is a large mosque, established in 1986, the Majid Azhaar – a graceful building topped with numerous gilded domes, which contains two large rooms. One room serves as a prayer-hall, and the other as a maktab, where some fifty Cambodian Muslim children study in two daily shifts that are timed in such a way as to allow them to attend regular school as well.
Migrant Muslims from Pakistan
Pakhtuns from Pakistan's North-West Frontier Province are the largest Muslim ethnic group in Laos after the Cambodian Muslims. In recent years, the community has been considerably depleted with migration to Pakistan and Western countries, and it now numbers less than thirty families.
Almost all of them are Lao citizens, and some twenty Pakhtun men have married Lao women, the women having converted to Islam thereafter. Roughly a dozen Pakhtun men are in government service, including one who is a top-ranking police officer. Most of the rest are fairly prosperous cloth merchants based in Vientiane, and several of them own considerable amounts of agricultural land.
Tamil Muslims
The third, and smallest, Muslim ethnic group in Laos are Tamil-speakers from southern India, who number around seventy. Most of them are engaged in the cosmetics trade, importing their goods from China, Vietnam and Thailand.
The Jamia Masjid mosque in the heart of Vientiane serves mainly Pakhtuns and Tamil Muslims. The Imam of the mosque, Maulvi Qamruddin, is a Tamil, and addresses the Friday congregations in both Urdu and Tamil, alternately using one of the languages every week. The mosque has a small maktab attached to it, where children are taught Arabic and about Islam, and the medium of instruction is Lao.
Laos' Tamil Muslims, along with Pakhtun and Cambodian Muslims living in the country, recently joined together to set up the Muslim Association of Laos to oversee Muslim community affairs and also to liaison with the government. Says Haji Muhammad Rafiq, alias Sofi Sengsone, President of the Association, "Our relations with the Lao government have always been very good and we face no problems at all in our religious affairs. The Lao people, in general, are very gentle and affectionate," he adds, "and we think it is our good fortune to be living here."
Yogi Sikand
© Qantara.de 2008
A Meeting with Nik Aziz
"Look at the Prophet ans How He Lived"
Nik Aziz, state chief minister of Kelantan and spiritual leader of the Islamic PAS party, is also a charismatic personality. Mike Millard visits him in his ministerial offices and talks with him about how Islam may be tolerant and yet retain its principles
Southeast Asia
Moderate Muslims and the Iraq War
Moderate Muslim cultures of Southeast Asia are reacting to the US-led "War on Terror" and the military invasion of Iraq. For 250 Million Malay-speaking Muslims, this has meant readjusting their view of the World – and a change of domestic power balances. By Amri Baharuddin Shamsul
Southeast Asia
Islamism Has Taken the Place of Communism as Divisive Force
The religiously and ethnically influenced separatist movements currently thriving in Southeast Asia show just how far the region has to go before nations based on consensus can be formed. Islamism has taken the place of communism as divisive force. By Manfred Rist


text:
OBJECTIVE—To investigate prospectively whether intake of total or type of sugar is associated with the risk of developing type 2 diabetes. The contribution of sugar intake to the pathogenesis of type 2 diabetes has not been settled in the context of primary prevention because of limited prospective data.
RESEARCH DESIGN AND METHODS—The Women's Health Study is a randomized controlled trial of aspirin and vitamin E in the prevention of cardiovascular disease and cancer. A validated semiquantitative food frequency questionnaire was completed by 39,345 women aged 45 years and older. The main outcome was the incidence of type 2 diabetes. The predictor was sugar intake, including sucrose, glucose, fructose, and lactose. Using Cox proportional hazard models, multivariate RRs of type 2 diabetes for increasing quintiles of sugar intake compared with the lowest quintile were estimated.
RESULTS—Compared with the lowest quintile of sugar intake, the RRs and 95% CIs for the highest quintiles were 0.84 (0.67–1.04) for sucrose, 0.96 (0.78–1.19) for fructose, 1.04 (0.85–1.28) for glucose, and 0.99 (0.80–1.22) for lactose, after adjustment for known risk factors for type 2 diabetes. Similar findings of no association were obtained in subgroup analyses stratified by BMI.
CONCLUSIONS—Intake of sugars does not appear to play a deleterious role in primary prevention of type 2 diabetes. These prospective data support the recent American Diabetes Association's guideline that a moderate amount of sugar can be incorporated in a healthy diet.
Prevailing beliefs over the past 20 years regarding sugars and diabetes admonished that added sugar, primarily sucrose, should be avoided and that naturally occurring sugars should be restricted in the diabetic diet (1,2). Support for these beliefs was based largely on results from animal and human studies suggesting that simple sugars would confer a higher postprandial glycemia than starch (3). Consequently, diets for diabetic patients have been sugar restricted for fear of stimulating hyperglycemia (1), exaggerating insulin response to carbohydrates (4,5), and causing possible cardiomyocyte dysfunction (6) and/or accelerated loss of β-cells (7).
However, several metabolic studies have reported that inclusion of a moderate amount of dietary sucrose within a balanced diabetic diet did not elicit subsequent deleterious effects on glycemic control (2,8–12). Different types of sugars may have variable metabolic effects on glycemia or lipemia (13–15). After fructose ingestion, several researchers observed blood glucose levels that were reduced compared with levels after starch or sucrose ingestion in diabetic patients (10,15–18). Additionally, studies conducted in healthy subjects noted that different amounts of fructose intake did not change HbA1c levels (19), yet they significantly elevated plasma triglycerides (20).
The risks and benefits of sugar ingestion in metabolic studies of diabetes have been controversial, and the data on primary prevention, namely, on long-term effects of sugar intake on risk of type 2 diabetes in healthy individuals, are sparse. The need for scientific bases on primary prevention have been addressed by several researchers (2,21). The Women's Health Study (WHS) prospective cohort offered an opportunity to investigate the relation of sugar consumption and subsequent development of type 2 diabetes in a group of initially healthy women with homogeneous demography.
Ethical and human research considerations
The study protocol was approved by the Brigham and Women's Hospital institutional review board, and the protocol adhered to the guidelines put forth in the Helsinki declaration and Belmont Accord for the duration of the study.
WHS is a randomized, double-blind, placebo-controlled trial designed to evaluate the balance of benefits and risks of low-dose aspirin and vitamin E in the primary prevention of cardiovascular disease and cancer (22). A total of 39,876 female health professionals aged ≥45 years who were free of self-reported coronary heart disease, stroke, and cancer (other than nonmelanoma skin cancer) were randomized. Of these subjects, 39,345 (98%) provided detailed information about their diet, completing a 131-item semiquantitative food frequency questionnaire (SFFQ). We excluded those who left >70 spaces blank in their SFFQ or reported unreasonable energy intakes of <600 kcal (2,514 kJ) or >3,500 kcal (14,665 kJ), and we excluded prevalent diabetes cases at baseline. As a result, the final sample for analyses consisted of 38,480 women.
Assessment of sugar and other dietary intake
For each food, a commonly used unit or portion size (e.g., one slice of bread, half a cup of broccoli) was specified on the SFFQ, and each participant was asked how often she had consumed that amount, on average, during the previous year. Nine possible responses ranging from "never" to "six or more times a day" were recorded. Nutrient scores were computed by multiplying the frequency of consumption of each unit of food from the SFFQ by the nutrient content of the specified portion size according to food-composition tables from the U.S. Department of Agriculture (23), the Harvard Food Composition Database, and other sources. The validity and reproducibility of the SFFQ in a similar cohort of male health professionals were reported elsewhere (24). The correlation coefficient for energy-adjusted carbohydrate intake between the SFFQ and diet record ranged from 0.59 to 0.73 in women (25). An additional validity study conducted in the Nurses' Health Study reported that the correlation coefficient of the SFFQ with two 1-week diet records for various foods ranged from 0.56 (for noncarbonated fruit drinks) to 0.84 (for orange or grapefruit juice) (26). The correlation coefficient of sucrose intake estimated by SFFQ with the average of four diet records ranged from 0.52 to 0.60 (25). Intakes of sucrose, fructose, glucose, and lactose for each participant were calculated and categorized in quintiles.
Ascertainment of outcome
The status of type 2 diabetes was evaluated at baseline, and women with a history of diagnosed diabetes were excluded. Thereafter, all of the participants were asked annually whether and when they had been diagnosed with type 2 diabetes since completing the previous questionnaire. To confirm self-reported diagnoses, we mailed a supplemental questionnaire inquiring about the onset of disease, symptoms, diagnostic tests, and hypoglycemic treatment to all respondents reporting a diagnosis of type 2 diabetes. From the supplemental questionnaire, type 2 diabetes was confirmed according to the guidelines proposed by the American Diabetes Association (27). If a participant was receiving treatment with hypoglycemic medications (insulin or oral hypoglycemic agents), a confirmed diagnosis was presumed.
We have conducted a validation study documenting the validity of our diagnostic algorithm for type 2 diabetes from the most recent cycle of data-gathering (1999–2000) in the WHS. The validity was excellent, with 97.5% (78 of 80) of self-reported cases confirmed by medical records. Because all of the participants in this cohort are >45 years of age, and the cases reported at baseline were excluded from the analysis, the self-reported incident cases thereafter were considered type 2 diabetes.
Ascertainment of confounding factors
Potential confounding factors for diabetes included age and BMI as continuous variables (kg/m2), frequency of vigorous exercise in four levels (rarely/never, <1/week, 1–3 times/week, and ≥4 times/week), cigarette smoking status in three categories (current, past, and never), history of hypertension (yes/no), history of elevated cholesterol level (yes/no), alcohol consumption in four categories (rarely/never, 1–3 drinks/month, 1–6 drinks/week, ≥1 drinks/day), and parental history of type 2 diabetes (yes/no). Women were considered to have a history of hypertension if they reported a previous diagnosis or blood pressure ≥140/90 mmHg. Women were classified as having an elevated cholesterol level if they reported this diagnosis or cholesterol levels ≥240 mg/dl.
Statistical analyses
Using SAS statistical software, we tested for normality and calculated the means and standard deviations of all continuous variables. If normality could not be assumed, data were transformed into categorical variables. Sugar intake was categorized by quintiles, and the incidence rates of type 2 diabetes were calculated in each quintile of sugar consumption by dividing the number of cases by the number of person-years. After testing the proportional hazards assumption, the RR of developing type 2 diabetes for each quintile of sugar intake, compared with the lowest quintile, was estimated via Cox proportional hazards modeling.
The initial models were adjusted for age and smoking, and the models were then adjusted for multiple covariates including age, smoking, BMI, vigorous exercise, alcohol use, history of hypertension, history of high cholesterol, postmenopausal hormone use, vitamin use, and family history of type 2 diabetes as defined above.
Because participants with a history of hypertension or with elevated cholesterol levels might have changed their dietary intake, we carried out similar analyses excluding these women with history at baseline. In addition, because the effect of sucrose on the risk of type 2 diabetes, if any, may be mediated via cumulative effects of overweight and obesity, we examined the sugar intake-diabetes relation stratified by BMI status (BMI <25 and ≥25 kg/m2 based on World Health Organization criteria). We also performed additional analyses excluding cases of type 2 diabetes that occurred in the first 4 years of follow-up. Because individual sugars often coexist with other sugars in diets, we examined whether total sugars, including sucrose, fructose, glucose, and lactose, would confer stronger effects related to the risk of type 2 diabetes. We also examined the independent role of starch, excluding sugars, in the incidence of type 2 diabetes.
The distribution of baseline risk factors across the quintiles of sugar intake is presented in Table 1. Most risk factors were distributed similarly across quintiles of sugar intake. At baseline in 1993, women who consumed more sugars were slightly older, smoked less, were thinner, and drank less, although these differences were not statistically significant. Low consumers of sugar in our cohort ingested slightly higher levels of total fat and cholesterol, both of which have been postulated to contribute to insulin resistance (28,29). High consumers of sugar in this cohort appeared to consume less protein and more carbohydrates, and exercised more.
A total of 918 incident cases of type 2 diabetes occurred during 222,521 person-years of follow-up. The RRs of type 2 diabetes with increasing quintiles compared with the lowest quintile of total sugar intake were 1.0, 0.94, 0.88, 0.92, and 0.86 (P value for linear trend = 0.17), and with sucrose they were 1.0, 0.98, 1.00, and 0.84 (P for trend <0.16), adjusting for all pertinent confounding variables. In this cohort, as expected, sucrose comprised ∼75% of total sugar intake, similar to what was reported in an Iowa women's study. A similar absence of significant trend was observed for fructose, glucose, and lactose. Several initial models adjusted for age and smoking indicated a strong inverse linear trend of association between sugar intake and the risk of type 2 diabetes (P = 0.0007 for total sugar, 0.006 for sucrose, 0.002 for fructose, 0.04 for glucose, and 0.02 for lactose). When a full set of covariates were included in the model, none of the RRs was statistically significant. The multivariate-adjusted RRs for the highest category of sugar intake compared with the lowest were 0.86 (95% CI 0.69–1.06) for total sugar, 0.84 (0.67–1.04) for sucrose, 0.96 (0.78–1.19) for fructose, 1.04 (0.85–1.28) for glucose, and 0.99 (0.80–1.22) for lactose (Table 2).
In a subcohort excluding subjects with hypertension or elevated cholesterol level at baseline (271 incident cases of type 2 diabetes and 131,025 person-years of follow-up), sucrose and lactose appeared to suggest an inverse association with type 2 diabetes in initial models, with RRs for increasing quintiles of intake at 1.0, 0.83, 0.84. 0.78, and 0.60 (P for trend = 0.03) for sucrose and 1.0, 0.69, 1.03, 0.94, and 0.76 (P for trend <0.06) for lactose, but only sucrose intake remained inversely associated after full adjustment for other risk factors. Corresponding RRs for ascending quintiles of sucrose in the multivariate model were 1.0, 0.84, 0.85, 0.73, and 0.59 (P value for linear trend = 0.05) (see Table 3). In neither stratified analyses by BMI <25 and BMI ≥25 kg/m2 (Table 4) nor analyses excluding cases of type 2 diabetes that occurred in the first 4 years of follow-up (Table 3) did sugar intake exhibit any consistent trend in relation to the incidence of type 2 diabetes. There was only a weak positive relationship between glucose intake and the incidence of type 2 diabetes in the subgroup excluding cases of type 2 diabetes that occurred in the first 4 years of follow-up. The RRs were 1.0, 1.03, 1.03, 1.15, and 1.34 for increasing quintiles in a fully adjusted model, a trend that was not significant (P = 0.09) (data not shown). Finally, the intake of starch, excluding total sugar, was not associated with increased risk type 2 diabetes, and the adjustment for glycemic index (GI) did not change the relation between sugar intake and risk of type 2 diabetes.
In our large cohort of 38,480 initially healthy postmenopausal women followed for an average of 6 years, we accrued 918 incident cases of type 2 diabetes and found no definitive influence of sugar intake on the risk of developing type 2 diabetes. In the subcohort excluding subjects with hypertension and elevated cholesterol level at baseline, sucrose intake was inversely associated with the risk of type 2 diabetes with marginal significance (P = 0.05), whereas fructose, glucose, and lactose did not appear to be significantly associated with the risk of type 2 diabetes. It is possible that those who were diagnosed with hypertension and high cholesterol at baseline might have changed their dietary intakes from their long-term dietary pattern. Excluding those who might have changed their dietary intake because of hypertension and high cholesterol elicited a less-biased association. Although our results concur with the results from several randomized metabolic trials (8–10,12,30) investigating the acute responses to sugar intake among diabetic patients, our prospective study further extends these findings to the risk of developing type 2 diabetes in a cohort of initially healthy women, offering scientific bases for primary prevention.
Since the introduction of the GI paradigm by Jenkins et al. in 1981 (31), the rationale that the contribution of carbohydrates to postprandial glycemia depends on their glucogenic ability, not on the size of carbohydrate molecules, has been gaining acceptance in the context of pathogenesis of diabetes (32,33). The glucogenic ability, measured as GI, of carbohydrates has been implicated in the development of atherosclerotic processes considered "the common base" for type 2 diabetes and coronary heart disease (34–36).
Meyer et al. (37) observed no association between GI/load and type 2 diabetes, but they found significant inverse association between sugar intake and type 2 diabetes in their study. In contrast, we observed no quantifiable association with either GI or sugar intake and risk of type 2 diabetes. GI, in the present analyses, was positively associated with type 2 diabetes in a model adjusted for age, randomization, and smoking (RR 1.46, 95% CI 1.10–1.79, P for trend <0.001). However, this relationship was attenuated in a multivariate-adjusted model (1.10, 0.87–1.38, P for trend = 0.22). Our reports are consistent with the rationale that the contribution of sucrose and other sugars to blood glucose level depends on which carbohydrate they replace (38,39). Because sucrose by itself has a glycemic response similar to or less than that of starchy foods such as bread, rice, and potatoes, sugars that replaced starch of equal GI value would not raise the glucogenicity of the meal. However, if sugars substitute for low-GI food such as legumes, then the blood glucose level would be elevated (40).
We also observed parallel findings between our results and the results by Meyer et al. (37), whose RR of type 2 diabetes for the highest versus the lowest quintile of sucrose intake was 0.81, compared with our RR of 0.84. Moreover, sucrose intake from our subgroup analyses excluding the participants with hypertension and elevated cholesterol was inversely associated with type 2 diabetes, with marginal significance (P < 0.05) (data not shown), an observation consistent with the report by Meyer et al. (37). Our RR for glucose intake suggests a nonsignificant positive association with the incidence of diabetes (P for trend <0.09) (data not shown), consistent with the notion that among sugars, glucose best predicted the insulin response (41). According to our data, sugar intake does not appear to increase significantly the risk of developing type 2 diabetes. The homogeneity of our cohort may provide a more precise estimate of the association between sugar intake and risk of type 2 diabetes, although generalizability of our results is limited.
The finding that higher sugar consumption corresponds to higher total carbohydrate intake in our cohort is in agreement with reports showing that individuals who consume high amounts of added sugars eat more total carbohydrate than those who consume lesser amounts of sugars (42–44). Wolever and Miller (40) reported that the glycemic response of sugar followed a logarithmic curve dependent on concomitant carbohydrate ingestion, and said curve leveled off at ∼100 g of carbohydrate. Thus, the impact of sugar ingestion is greatly attenuated when individuals consume >100 g of carbohydrates. Our findings are consistent with this report by Wolever and Miller (40) because our recorded mean intake of carbohydrates was 194.1 g in the lowest quintile and 247.5 g in the highest, and the impact of sugars on plasma glucose levels may be insignificant in the context of such high carbohydrate intake.
We have adjusted for all known covariates, but it is possible that some residual confounding covariates may remain. Additionally, the number of diabetes events (918) might not have provided sufficient statistical power to detect the observed moderate RRs. The median follow-up time of 6 years might not have been long enough to detect a very subtle relationship between sugar intake and incidence of type 2 diabetes. It is also possible that measurement errors associated with dietary assessment might have attenuated an otherwise inverse or positive association between sugar intake and risk of type 2 diabetes.
A more definitive answer to this question of whether sugars contribute to the pathogenesis of type 2 diabetes may emerge with further research efforts that include long-term metabolic trials and other large prospective studies.
In summary, the intake of sugars does not play a detrimental role in primary prevention of type 2 diabetes. However, the results from this study should not be interpreted as an endorsement for unlimited sugar intake. Rather, it should be emphasized that only moderate sugar intake should be incorporated within the boundaries of acceptable energy intake in a well-balanced diet. This moderate sugar allowance may promote better compliance with the diet regimen among diabetic patients (12).
Article Information
The work reported in this article was supported by grants PHS NO-CA47988, HL43851, HL34595, HL58755, and DK02767 From the National Institutes of Health.
The authors are deeply indebted to the 39,876 dedicated participants of the WHS for their dedication and commitment. The authors acknowledge the crucial contributions of the entire WHS staff, under the leadership of David Gordon, as well as Susan Burt, Mary Breen, Marilyn Chown, Lisa Fields-Johnson, Georgina Friedenberg, Inge Judge, Jean MacFadyen, Geneva McNair, David Potter, Claire Ridge, and Harriet Samuelson. We extend our appreciation to Lynda Rose and Eduardo Pereira for their expertise and contribution to this study and Jaylyn Olivio for editorial service.
Address correspondence and reprint requests to Simin Liu, Division of Preventive Medicine, Brigham and Women's Hospital, 900 Commonwealth Ave. East, Boston, MA 02215. E-mail: email@example.com.
Received for publication 18 November 2002 and accepted in revised form 2 January 2003.
A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.


text:
Open Data
This is the keynote presentation I gave at the Accessibility 2.0 conference held in London in April 2008.
- Listen to an audio recording of this talk.
We have come here to listen to a veritable pantheon of Web accessibility experts give us advice that is practical and relevant to working on the Web today. I'd like to offer something of an alternative. By that I don't mean that I'm going to give you advice that is irrelevant and impractical. I mean that I'd like to take a step backwards and try to look at the bigger picture. There won't be any code. There won't be any hints and tips that will help you in working on the Web today. Let's leave today behind and delve back into the past.
Let's start with the Norman conquest of England in 1066. This was the watershed moment that split history into the Dark Ages of everything pre-Hastings and the Middle Ages of everything afterwards. Twenty years after the invasion, William the Conquerer commissioned the Domesday Book, a remarkably thorough snapshot of life in 11th Century England. This document still exists today. It rests in a glass case in the National Archives in this very city.
In the run-up to the 900th anniversary of the Domesday Book's completion, the BBC began the Domesday Project, an ambitious attempt to create a multimedia version of the document. The medium they chose? Laserdiscs. The medium was out of date before the project was even finished. Vellum, while not the most popular storage medium these days, has proven to be far more durable.
The debacle of the Domesday Project is often cited in hand-wringing discussions around the problems of digital preservation. The laserdisc format was not durable. I don't mean that the physical medium stopped storing its ones and zeros. I mean those ones and zeros don't make any sense to a modern computer. To put it another way, laserdiscs are inaccessible.
Let's go back even further to examine a medium that is even more durable than vellum. Egyptian hieroglyphic writing was often carved into stone. Symbols dating back as far as 3200 years BC have survived to this day. But for most of the past two millennia, this writing was completely inaccessible. The ones and zeros had been preserved but the key to interpreting them had not. It was only thanks to the Rosetta Stone (also on display in this very city) and the valiant efforts of Champollion that we can read and understand hieroglyphics today.
By the way — and this is a complete tangent — do you know what the great-grandson of Chamopollion does for a living? I only know this because my wife is a translator: he writes software for translators. Well, I say software …he's actually created a plugin for Word. So his legacy might not be quite as enduring as his ancestor's.
Word suffers from the same problem as laserdiscs. It is not a good format for digital preservation. Given time, it will become an inaccessible format.
It is my contention that what is good for digital preservation is good for accessibility.
Here's a tired old cliché: let's compare digital documents to buildings. This conceptual metaphor is as old as the Web itself. We talk about web "sites": an accurate description of places that so often feel as if they are under construction.
I'd like to compare the digital and the concrete in a slightly different way. In his book How Buildings Learn, Stewart Brand explains the concept of shearing layers, a term first coined by the architect Frank Duffy and explained thusly:
"Our basic argument is that there isn't any such thing as a building. A building properly conceived is several layers of longevity of built components."
Those layers are:
- the site
- the structure,
- the skin (which is the exterior surface),
- the services (like wiring and pipes),
- the space plan and
- the stuff (like chairs, tables, carpets and pictures).
Each one of these shearing layers is dependent on the layer before. The stuff depends on the space plan, the skin depends on the structure, the structure depends on the site, and so on.
Already you might be seeing parallels with Web development, especially Web development carried out according to the principle of progressive enhancement. But let's not get ahead of ourselves here. What I'd like to point out is the different pace at which each one of these shearing layers changes.
It's easy to rearrange furniture. It's more troublesome to change the wiring or pipes. Making changes to the fundamental structure of a building is a real pain in the ass. The site of a building is unlikely to change at all, discounting any unforeseen tectonic activity.
If we want to preserve information, we should aim to bury it in the deepest shearing layer available. Vellum and stone have worked out well because they are the informational equivalent of a reasonably deep shearing layer. But they don't scale very well, they aren't easily searchable and it's extremely time-consuming to make non-destructive copies. That's where digital storage excels.
So how can we ensure that we choose the right formats in which to store our information? How can we tell whether a storage medium is a deep shearing layer? How can we avoid reinventing the laserdisc?
We have a few rules of thumb to help us answer those questions.
Open formats are better than closed formats. I don't mean they are necessarily qualitatively better but from the viewpoint of digital preservation (and therefore, accessibility), over a long enough timescale they are always better.
The terms "open" and "closed" are fairly nebulous. Rather than define them too rigidly, I'd like to point to the qualities that can be described as either open or closed. The truth is that most formats contain a mixture of open and closed qualities.
First of all, there's the development process of creating a format in the first place. On the face of it, a closed process might seem preferable. It allows greater control of how a format develops. But it turns out that this isn't always desirable. The open-source model of development, for all its chaotic flaws, has one huge advantage: evolution. Time and time again, the open-source community has produced efficient, well-honed gems instead of the Towers of Babel that would be logically expected. That's because Darwinian selection, be it natural or otherwise, will always produce the best adaptations for any environment. It doesn't matter if we're talking about ones and zeros instead of strands of DNA; the Theory of Evolution is borne out in either case. Microsoft aren't getting their ass kicked by the Linux penguin or the burning fox of fire; Microsoft are getting their ass kicked by Charles Darwin.
Open-source development is the most obvious open quality that a format can have. Another open quality is standardization. Again, at first glance, this might seem counter-intuitive. After all, the standardization process is all about defining boundaries and setting limits as to what is and isn't permitted. But this deliberate reigning in of the possibility space is what gives a format longevity. This will come as no surprise to the designers amongst you who are well aware that constraints breed creativity. As Douglas Adams said,
we demand rigidly-defined areas of doubt and uncertainty.
As a card-carrying member of The Web Standards Project, it will probably come as no surprise that I'm rather fond of standards. But my fondness for standards extends beyond the Web. When visiting Paris with my good friend and fellow geek Brian Suda, we tried calling up the International Bureau of Weights and Measures which has its headquarters there. We wanted to see the meter. But we were rebuffed in brusque French fashion. "Zis is not a museum!"
Harrumph! Who needs the French anyway? The true father of standards is a British man, a member of The Royal Society which was based, yes, right here in this city. His name was Joseph Whitworth and he was an engineer. A developer in other words. He standardized screw threads. Before Whitworth, screws were made on a case-by-case basis, each one different from the next. That didn't scale well for the ambitious project that Whitworth was working on. He was the chief engineer on Charles Babbage's difference engine which, although it can't boast a direct lineage to this computer, bears an uncanny resemblance in its internal design. I love the idea that there's a connection between the screws that were created for the difference engine and the standards that we use to build the Web.
Standardization doesn't necessarily lead to qualitatively better formats. Quite the opposite in fact. The standardization process, by its very nature, involves compromise. But I would rather use a compromised standardized format than a perfect proprietary one.
The Flash format, for example, while it has some open qualities remains mostly closed as long as the Flash player remains under lock and key. I've discussed this with my fellow Brightonian Aral Balkan who knows a thing or two about Flash. He sympathises with Adobe's position, claiming that if anybody were able to build a Flash player, then developers would have to support buggy players. Aral recently made a foray into building a site using CSS for layout. Now that he's experienced the pain of cross-browser, cross-platform development, the last thing he wants is to port that pain over to the Flash environment. I see his point but personally I'm willing to pay the price for working with standardized formats… even if I sometimes do find myself tearing my hair out over some browser's inconsistent rendering of some CSS rule.
The standardization of HTML, CSS and ECMAScript means that, in theory, anyone can make a Web browser. While I hope that remains just a theory (I don't want any more browsers, thank you very much) that bodes very well for the longevity of data written in those formats.
Of that trio of formats, the one that's most directly relevant to information storage and accessibility is HTML. It's also a vital component in another trio of technologies: HTTP, URLs and HTML. If I had any slides, I'd probably be showing you a Venn diagram right now with HTML as the common component bridging the infrastructure and the content of the World Wide Web.
I've had the great pleasure of meeting some of the people who worked with Tim Berners-Lee at CERN 'round about the time that he created the Hypertext Markup Language, the World Wide Web and the first Web browser. One of those people, the lovely Håkon Wium Lie was so enamoured with HTML he placed a bet that the language would be around for at least 50 years. That's a good start. That's in a different shearing layer to most of the file formats that our computers read today.
The Web was not the first distributed network of documents. Tim Berners-Lee stood on the shoulders of giants like Vannevar Bush and Doug Engelbart. HTML is far from the best possible hypertext system. Other systems envisioned two-way linkage and Ted Nelson's idea of transclusion would be a welcome addition to the World Wide Web.
The strength of HTML is its simplicity. Simplicity beats complexity for many of the same reasons that open beats closed. Simple formats are more likely to have a longer lifespan. Yes, it can sometimes feel limiting to work with a relatively small number of HTML elements but on balance, I don't mind paying that price. Remember what I said about constraints breeding creativity? Just look at the amazing multi-faceted Web that we've managed to construct with this simple technology.
The same simplicity that informs HTML extends right down the stack into the infrastructure of the Hypertext Transfer Protocol. It's not just simple, it's downright dumb. By design. In retrospect, given the simple, open nature of HTTP plus URLs plus HTML, the rise of the stupid network looks inevitable.
As you can probably tell, I'm a big fan of HTML. Not only do I believe it to be a relatively durable format, I believe its simplicity lends itself well to accessibility. The most obvious example of this is the way that HTML can be interpreted by a screen reader. But that's just one example of information stored in markup being transformed into another format (in this case, speech). Another example would be transforming information from markup onto a piece of paper by printing out a web page.
The glib answer is to surrender control and embrace flexibility. Instead of battling against the anarchic nature of the Web, go with it.
I'm sure that piece of advice is old news to you but I think you can take it further. Embrace flexibility in your attitude towards accessibility.
We nerds tend to be a logical bunch. We like looking at the world as a binary system where there's a right way and a wrong way to do something. But accessibility isn't that simple. It's not black and white — it's a big messy shade of grey. Reducing accessibility down to a Boolean value is harmful.
Who was at @media last year? Remember when Joe Clark gave a nuanced and well-argued presentation entitled When Web Accessibility Is Not Your Problem? Before he had even left the stage, people were already claiming that Joe Clark was saying "Web accessibility is not your problem."
This Reductio ad Absurdum has got to stop. It even creeps into our thinking about users. We start thinking about disability as a permanent state, either one or zero. It isn't that simple. If I'm suffering from a dearth of sleep or a surfeit of alcohol, I am cognitively disabled. If I'm trying to use the trackpad on my laptop while I'm squashed into a seat on the train from Brighton to London, I am motor-impaired.
Also, let's stop talking about making websites accessible. Instead, let's talk about keeping websites accessible. I'm not saying that HTML is a magic bullet but as long as you are using the most semantically appropriate elements to mark up your content, you are creating something is, by default, accessible. It's only afterwards, when we start adding the bells and whistles, that the problems can begin.
Don't get me wrong: I'm not saying that we should censor ourselves and stifle our innovative ideas. I'm just talking about having a good baseline of solid structure. For a start, don't fuck with links and forms.
If you ask me what technology I think every web designer should know, I'm not going to answer with CSS or Ajax or any programming language. No, I think that every web designer should know the difference between
GET and
POST. Know when to use a link and when to use a form. This is basic stuff that was built into the infrastructure of the Web from day one.
GET and
POST aren't the only methods that were created at the birth of the Web. Tim Berners-Lee also gave us the lesser-known
PUT and
DELETE. From the start, the World Web Wide was conceived as a read/write environment. It just didn't turn out that way …until now.
Speaking for myself, I've found that I'm increasingly using the Web to publish information as well as consume it. I've got a bookmarks folder called "my other head" which contains links to the services I use daily: Flickr, Twitter, Pownce, Magnolia. They aren't just websites, they are publishing tools. On today's Web, I read and write in equal measure.
Accessibility guidelines that deal with Web content just don't cut it any more. Guidelines intended for authoring tools are more applicable (if I had my way, the number one guideline would be "don't fuck with links and forms").
Accessibility doesn't just mean that everyone should be able to consume what's on the Web, it also means that everyone should be able to publish on the Web.
On the face of it, the current situation does not look good. Most social media sites have dreadful markup, obtrusive JavaScript and inflexible designs. But at the same time, they have a pervasive sense of openness that I find very encouraging indeed. The shared ethos is that this is your data so you should have access to it.
These services provide the ability to read and write information not just through an HTML page rendered in a browser. They offer the same access in a multiplicity of ways from the simplicity of microformats through to RSS and right up to fully-fledged APIs. The most successful social media websites are the ones where you don't have to visit the site at all.
Time for another tired old cliché: information wants to be free. As trite as this sounds, I think that on the Web it's fundamentally true. Lack of access to data is damage. People will find a way to route around it.
Matthew Somerville excels at routing around the damage of inaccessibility. He's the guy who built the accessible version of the Odeon cinema listings. He also built traintimes.org.uk, a more accessible way of getting train timetable information. He had to scrape the original websites to build these. That's hard work. APIs provide an easier way for us to create alternate, accessible versions of valuable services.
If APIs are an accessibility feature, then we need to change how we judge websites accordingly. Suppose we're looking at a web page with a list of stories. If the document doesn't make good use of headers —
h2, etc. — then that's a minus point. But if there's link to an RSS equivalent, then that's a plus point.
The more and varied the formats in which you can access data, the more accessible that data is. I realise that this flies in the face of the programming principle of DRY: Don't Repeat Yourself. But really, you can never have too much data.
I'm not suggesting that any inaccessible website that provides an API automatically receives a "get out of a jail free" card. But I do think that the API offers more potential solutions to fixing the accessibility issues. Instead of bitching and moaning about bad markup and crappy Ajax, we could more constructively use our time hacking on the API to provide a more accessible alternative.
The idea that information must reside on one specific website is dying. I hope that outdated marketing terms like "eyeballs" and "stickiness" die along with it.
As with any great change, there's plenty of fear. If you have a business model that is based on the premise that some data is centralised, scarce and closed, you are backing a losing horse. The inaccessibility of that model dooms it.
There is a spirit of openness and collaboration that has spread inexorably through the Web since its creation. That spirit extends beyond data formats and technology. Our concepts of ownership and property are also changing. Try to ignore any whiff of socialism you might detect — this process is much more natural and inevitable.
So we come to the most important and the most contentious quality of openness: the right to information.
In this country, we suffer many affronts to our right to information. We have to pay to access ordnance survey data that was gathered using our tax money. Open Street Map and Free The Postcode are the natural responses to these most egregious of insults. People are beginning to ask for other data too. The Guardian is spearheading a campaign called Free Our Data to do exactly what it says on the tin.
Data that comes laden with restrictive licensing is crippled. When those restrictions are encoded into the format itself, the data is doomed. I'm talking about what is so euphemistically referred to as Digital Rights Management.
Here's one last tired old cliché, this one from the sphere of anthropology. If a visitor from another planet came to Earth, what would they make of our society?
This is the very situation that Iain M. Banks describes in his short story State Of The Art. A visitor from a post-singularity culture, called simply The Culture, looks down from her ship above Earth and reflects on her recent sojourn there:
I stroked one of Tagm's hands, gazed again at the slowly revolving planet, my gaze flicking in one glance from pole to equator. 'You know, when I was in Paris, seeing Linter for the first time, I was standing at the top of some steps in the courtyard where Linter's place was, and I looked across it and there was a little notice on the wall saying it was forbidden to take photographs of the courtyard without the man's permission.' I turned to Tagm. 'They want to own the light!'
They want to own the light. They really do. They call it plugging the analogue hole. Even DRMd images and video must eventually be converted into photons. Even DRMd audio must eventually be converted into vibrations in the air. That's the analogue hole. They don't just want to own the light, they want to own our very culture.
Every day we write words, we record videos, we take photographs. We also read, we watch movies, we listen to music, we look at works of art. We are contributing to a digital record that is an order of magnitude greater than the Domesday Book. This is more than just data. This is who we are. It must be preserved. It must be accessible.
It's time to take sides. It would be hyperbole to describe it as a battle between good and evil but it's no exaggeration to say it's a battle between good and bad.
We can either spend our time and effort locking data up into closed formats with restrictive licensing. Or we can make a concerted effort to act in the spirit of the Web: standards, simplicity, sharing… these are the qualities of openness that will help us preserve our culture. If we want to be remembered for a culture of accessibility, we must make a commitment to open data.
This presentation is licenced under a Creative Commons attribution licence. You are free to:
- Share
- Copy, distribute and transmit this presentation.
- Remix
- Adapt the presentation.
Under the following conditions:
- Attribution
- You must attribute the presentation to Jeremy Keith.


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5 Tips for Visiting People in the Hospital
In Matthew 25, we read Jesus' teaching, "I was sick and you took care of me… I tell you the truth, just as you did it for one of the least of these brothers or sisters of mine, you did it for me" (vs.36-39).
Despite this exhortation, many Christians are hesitant to visit people who are in the hospital and care for them. Why? It could be because of a previous negative experience. Or maybe they just aren't sure what to do when they get there. Indeed, feeling unprepared seems to be one of the major reasons that believers hesitate to visit even their loved ones who are in the hospital.
Practical Advice for Hospital Visitation
On an episode of the Table Podcast, Dr. Darrell Bock sat down with Chaplain Eva Bleeker and Stronghold Ministry Director Joe Fornear and talked about becoming prepared to minister to patients. Out of this conversation came some good, practical advice that you can use today.
Here are just five tips to help you prepare for visiting someone in the hospital.
1. Be there for them
Just showing up and being there for your friend in the hospital is a big deal. It's OK to be brutally honest when you show up and tell them, "I'm not really sure what to say, but I just wanted to be here for you." Your mere presence by their side could be a very big deal to them.
2. Let them lead
Some people worry about saying something at the wrong time, even if it's something positive. But remember that this visit isn't about you. You're actually off the hook when it comes to having to say something profound or being in the spotlight. This is all about the patient. So let them lead and direct what happens during your visit. Ask them what they would like your time to look like.
3. Be a good listener
Rather than feeling pressured to give advice or "make it all better," come in as a listener. Ask open ended questions. Fornear, a former cancer patient, suggests something like, "I know this is horrible. How are you handling this? How are you coping?" or even just, "What it is this like for you?" Listen carefully and openly to their answers. You might find this tells you a lot about their plans, what they're putting their trust in, and where they are at with God.
4. Respect their pain
Respecting the pain your friend or relative is going through means not saying something like, "I can really relate to you and what you are going through," if you haven't actually experienced the same thing. Fornear discovered that, even though he had been a cancer patient, he needed to be more sensitive to the specific types of issues he encountered during hospital visits. He explains:
I once had an experience with a female patient. She was really hurting. She was describing something about the procedure that she had, but it was female-related. And I had lot of really painful things (happen to me). I was just trying to say, "I've been there. I've had a lot of pain."
I could tell I really offended her because she was saying, "You haven't had what I just had," because it was a female-related procedure she had. Even though I had horrible pains and horrible things they were doing to me, I think it's wise not to say, "Oh, I can really relate to what you're experiencing."
5. Be ready to pray and read scripture
Be ready to read from the Scriptures. Pick out a few verses just in case, but always be sure to ask the person you're visiting, "Could I read you some Scripture verses that came to mind while I was thinking about you?"
Be ready to pray for them. But, again, be sure to ask. "Can I pray with you? What's your biggest prayer request right now?" Beyond physical healing, the patient might have a specific request in regards to their care, the medical staff, their family, or something else that is weighing on them.
Get Equipped
Although many Christians feel unprepared to visit and care for their friends and relatives who are in the hospital, there are simple things you can do to put yourself in their shoes and be equipped to serve. These five tips are just the beginning of an entire episode on practical advice to help you feel more prepared to visit someone in the hospital.
Watch the entire Episode Practical Advice for Ministering to Patients
About the Contributors
Mikel Del Rosario
Mikel Del Rosario (ThM, 2016; PhD, 2022) is a Professor of Bible and Theology at Moody Bible Institute. While at DTS, he served as project manager for cultural engagement at the Hendricks Center, producing and hosting The Table podcast. You can find him online at ApologeticsGuy.com, the Apologetics Guy YouTube channel, and The Apologetics Guy Show podcast.


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Romain Voulet
Romain Voulet was born in Valence in 1989. He has a sensitive approach to design and a passion for materials and manufacturing processes. Having graduated in 'technologie spécialisé dans la mécanique et la productique' (specialised technology for mechanics and manufacturing), he went on to study at the EID de Toulon, from which he was to graduate with a Masters in Industrial Design. After working for Lafuma he moved on to studio ID's. He currently works for Youmeus Design in London, designing for numerous companies such as Panasonic, Kenwood and Joseph Joseph. He also works as a freelance designer, designing and producing his own creations.


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FORT LAUDERDALE, Fla. (AP) _ Federal health officials gave Florida the green light to enroll tens of thousands of older, long-term care patients into a statewide Medicaid privatization program.
But Gov. Rick Scott noted Monday he is awaiting a final signoff from the feds to privatize the program statewide for most of the state's nearly 3 million Medicaid recipients.
Florida lawmakers have been waiting for nearly two years to learn whether the feds will allow them to expand a program that allows for-profit providers to determine the health care of millions of the state's poor.
The goal of the sweeping privatization bills passed in 2011 was to save the state money while improving services, though little solid data exists on whether the approach works.
Lawmakers warned that Medicaid's roughly $21 billion annual costs were consuming the state budget.
But critics worry for-profit providers are scrimping on patient care and denying medical services to increase profits.
U.S. Health and Human Services Secretary Kathleen Sebelius approved the long-term care portion of the request late Friday.
During a meeting in Washington last month, Scott asked her to act quickly on the statewide request so that Florida lawmakers can figure out how it will affect their plans to implement The Affordable Care Act.
"We need HHS's immediate action to determine what flexibility we will have within our current Medicaid program and its impacts on the cost, quality and access to healthcare.
Our state is facing unprecedented decisions that demand unprecedented attention from federal health officials," Scott said in a statement.
The waiver approved on Friday is somewhat of an incremental step in the process and does not signal that federal health officials will approve the expansion of the statewide program.
The waiver requires tens of thousands of older Medicaid recipients to get long-term care through managed care organizations, including home and community-based services to keep them out of nursing homes.
AARP Florida Director Jeff Johnson warned managed care organizations to adhere to strict compliance of the laws, saying the wellbeing of the "frailest of the frail is at stake." `
`AARP Florida and its members will be watchdogs for this reform and will seek to hold state officials accountable for how these plans are implemented, for the transparency of the state's actions, and for the quality of care and consumer protections provided by managed-care plans that are funded by state and federal dollars under this experiment," Johnson said in a statement.
The decision comes as the GOP-controlled Legislature is playing a catch-up of sorts on implementing the federal health overhaul.
Florida led the way in challenging the constitutionality of the Affordable Care Act.
Some Democrats are now accusing state agencies of not having a Plan B in case the law was upheld, leading lawmakers to make crucial decisions on tight deadlines.
For now, it appears Florida will allow federal health officials to run an online state exchange, where consumers can shop for health insurance.
Florida must also decide whether to expand Medicaid under the federal health overhaul and offer health insurance to an additional roughly 900,000 residents.
Meanwhile, the state is waiting on the feds to sign off on the statewide privatization request.
Federal health officials have been cautious all along about Florida's statewide privatization request to continue with an overhaul that expands on a five-county pilot program.
HHS officials have said they want to make sure the state addresses concerns about access to health care in the program raised by some residents.
In 2011, federal health officials allowed the state to continue running the five-county pilot program, but insisted on new protections, more accountability, and quality reporting.
Some doctors have dropped out of the pilot program, complaining of red tape and that the insurers deny the tests and medicine they prescribe.
Patients have complained they struggled to get doctor's appointments. Supporters of the overhaul say new accountability measures will address those concerns.
Several health plans also dropped out of the pilot program saying they couldn't make enough money.
Patients complained they were bounced from plan to plan with lapses in care.
Federal health officials have also noted concern about those disruptions during the nearly two-year negotiations.
Nearly half of the 200,000 patients enrolled in the pilot have been dropped from at least one plan, federal health officials previously said.
The state has been running the program in Broward County, Duval County and three of its neighbors since 2006.
Lawmakers say they have fixed the pilot program's shortcomings, with provisions including increased oversight and more stringent penalties, including fining providers up to $500,000 if they drop out. The measures also increase doctors' reimbursement rates and limits malpractice lawsuits for Medicaid patients in hopes of increasing doctor participation in the program.


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I preached this sermon on Sunday, October 20, 2013 as part of our church's "BUILD: An Extreme Makeover" series at Grace United Methodist Church. The scripture is Genesis 7:1-5. Here's the audio: Stories capture what happened in the past in a compressed format. Because stories are compressed, they leave certain details out. There's some obviously […]
Posts Tagged 'house build'
Obedience Without InstructionsPosted: October 21, 2013 by Todd in Sermons
Tags: adaptive challenges, animals, ark, flood, house build, Noah, obedience, technical challenges, USMP


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The Best of The Physics Teacher 2013-2014
Most downloaded articles:
A Guided Inquiry on Hubble Plots and the Big Bang
Electrostatic Deformation of Liquid Surfaces by a Charged Rod and a Van de Graaff Generator
Is there a maximum size of water drops in nature?
Laboratory Investigation of Noise-Canceling headphones utilizing "Mr. Blockhead"
Light-Emitting Diodes: A Hidden Treasure
Physics Almost Saved the President! Induction and the Assassination of James Garfield: A Teaching Opportunity in Introductory Physics
Physics Exams that Promote Collaborative Learning
Tarzan's Dilemma: A Challenging Problem for Introductory Physics Students
Using the Wii Balance board in Elevator Physics
Additional Good Reads
A Carbon Nanotube Cable for a Space Elevator
Analyzing Forces on Amusement Park Rides with Mobile Devices
Average Annual Rainfall Over the Globe
Boomwhackers and End-Pipe Corrections
Bringing the Digital Camera to the Physics Lab
Car Stopping Distance on a Tabletop
Circuits in the sun: solar panel physics
Developing Early Undergraduate Research at a Two-Year College
Moments of Inertia of Discs and Spheres Without Integration
More than "Cool Science": Science Fiction and Fact in the Classroom
Removing Coins from a Dice Tower: No Magic — Just Physics
Vacuum energy and inflation: 1. A liter of vacuum energy


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Fortunately not a question we get to ask everyday. But unfortunately, alleged images of his robocop are making the rounds. Happy Halloween?
A couple of weeks ago, Radar reported that some enterprising ladies were shopping around salacious pics of Yeezy, which, according to a source, he had apparently sent to "many girls on MySpace." (MySpace: where nothing good ever happens.) Now these photos have wormed their way onto the web, originally appearing on Media Takeout just long enough for other blogs to grab them and spread the cringe. There are two pictures: the inoffensive one above, and the second shot, in which we see the lower half of his torso and then some. (Obviously INCREDIBLY NSFW, but here you go.) Put the two together and you've got a full pinup shot. If that's your thing.
I'm not going to bother with a verdict on whether or not the penis in question is indeed Kanye's, or if the image is even real — you can decide that for yourself if you choose to click the link. But my heart sank a little bit when I looked at the picture (as I am editorially obligated to do). It wasn't because I was disappointed in what I saw (I didn't look long enough to form an opinion), and it's not because I feel sorry for the noted douchebag. Nor did I even feel remotely offended or shocked by the image. And that's what's so depressing here: whether you'd heard rumors about it or not, Kanye's cell-phone cock shot is so…expected, isn't it? It's just another instance of unpleasantness from an artist whose Crazy tends to steal the spotlight from his considerable talent. And after a certain point, naughty celebrity pictures are blasé, particularly in an era of Lohan and syringes. Yeah, I'm jaded as all hell, but even if I weren't, I doubt this would do much more than half-raise an eyebrow. After all, it's not like Kanye's ever presented himself as a wholesome fellow like Wrangler-wearing Brett Favre.
The fact of these images — or the circumstances under which they were taken, sent out, and eventually sold off — being so unremarkable is perhaps what made it so easy for Kanye to share them with his ladies of choice. And we have no idea whether or not these images were solicited or welcomed on the part of the recipients; there's as good of a chance that they were as there is that they weren't. And that's fine if they were. I'm just making a guess here, but I suspect Kanye didn't think twice before snapping the pics and sending them out. If anything is remarkable here, it's that he perhaps thought that they wouldn't get leaked.
I'm not going to assault your eyes with this against your will. But if you need to indulge your fascination with the macabre, you can see the VERY NSFW picture here.
Now, what's that we were saying about free birth control? Indeed.


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An Amazing Sampling Of LA Beer Week Events
Los Angeles, CA – Unless you've been under a rock and/or ignoring our stellar press releases/blog posts, you should be more than aware that the 4th Annual LA Beer Week is nigh, taking place from September 20-30, 2012. And you've undoubtedly read about Unity (the official beer of LA Beer Week), and all the other prickly pear beers being made by local breweries, right? OK, good. Just checking.
Now, we'd like to draw your attention to some of the stellar events happening throughout this glorious 11-day period, which—as you of course know—culminates with the signature LA Beer Week Festival at Union Station. Here's a rundown of some of the killer events taking place. To see all of them, simply click on each date to go to our calendar for that respective day. (How convenient, no?)
- Stone Total Town Takeover: Pasadena | Stone Brewing Co. previews its soon-to-open Stone Company Store – Pasadena location. Co-Founders Steve Wagner & Greg Koch will be on hand, sharing special beers and nibbles from Stone Catering, with live music. Tickets are $25; all proceeds will benefit a local charity. (7-9:30p) Other events with the Stone Brewing Co. team will also be taking place in Pasadena throughout the day. (Details)
- Fried Chicken, Craft Draft | Eva Restaurant offers Chef Mark Gold's all-you-can-eat fried chicken and all-you-can-drink Beachwood BBQ & Brewing Foam Top Cream Ale for $39. RSVP via (323) 634-0700. (6-10p)
- Dogfish Head Craft Brewery Invades Little Tokyo | Far Bar will be pouring 12 of this famed Delaware brewery's beers, including some very rare and hard-to-get selections. In addition, an extra special treat will be running through the "organoleptic hop transducer module"… better known to Dogfish Head fans as Randall the Enamel Animal. (6p)
- Poutine Paradise | No, it's not a recipe or song from Cookin' with Coolio… it's five courses of gourmet poutines will be paired with five Schneider-Weisse beers, along with a special dessert pairing at P'tit Soleil Westwood. (Two seatings: 6:30p & 8:30p)
- Walker's Wild Ride | David Walker of Firestone Walker Brewing Co. will be hauling several rare sour beers around town in a vintage '55 Land Rover, with stops at Golden Road Brewing, Verdugo Bar, 38 Degrees Alehouse & Grill, Far Bar, and Blue Palms Brewhouse. (12:30p-??)
- Better Weather Fest | Golden Road Brewing will be celebrating their first year and their new brewery/restaurant expansions. Festival goers will be able to enjoy craft beers from a number of breweries, tour the new facilities, order eats from food trucks (Mandoline Grill, Crispy Waffle & Frite), all while relaxing to musical beats. (12-4p)
- Schneider Beer Brunch | Wurstküche hosts a tasty 5 course sausage and Schneider beer pairing, presented by a special guest from the brewery. Includes an Aventinus ice cream dessert course paired with Vintage 2008 Aventinus. (11a)
- OC Fest of Ales | The inaugural OC Fest of Ales kicks off in Anaheim with over 100 beers, VIP food pairings, music and a Beer Run 5K.
- Brewer's Brunch | Eagle Rock Brewery be opening up for brunch to chat with the owners and brewers. Resident Chef Jerry Su will be serving up some amazing brunch options as well. Entry is $15; includes two beers, food, and you get to keep the pint glass. (10a-1p)
- Berliner Brunch | Beachwood BBQ & Brewing (Long Beach) offers a special brunch menu along with several different varieties of Berliner Weisse on tap, served with or without house-made syrups. (11a-4p)
- Craft for Crap | Beer Belly wants you to educate your friend who somehow still drinks crap beers, despite the bounty of good we're now surrounded with. Bring that friend, and one of the crap beers from their fridge and trade it up for a craft beer, at the low, low price of one cent.
- Beauty of the Barrel | The Victorian has partnered with Brew Something LA to help you enjoy both barrel-aged spirits and barrel-aged beers in one place at one time. Tickets are $40, and net proceeds go to benefit The Virginia Avenue Project. (4-8p)
- Ancient Ales Dinner | The Little Bear's Chef Andre Guerrero has created a five-course meal to be paired with Dogfish Head Craft Brewery's five "Ancient Ales." The menu is insane. Tickets are $75; reservations can be made via (213) 622-8100. (7p)
- So You Want to Open a Brewery in LA…A Brewers Panel | Join moderator Tomm Carroll (from The Celebrator Beer News) at Rock & Brews as he talks with those brave few who have recently started brewing professionally in Los Angeles — or have plans to do so in the near future. They'll discuss their experiences with starting a brewery and share their war stories. (7p)
- Musical Beer Crawl | Local beer darling/social media pro Cambria Griffith hosts the 2nd Annual LA Beer Week Musical Beer Crawl. This event unites the numerous extra-fantastic beer, music and food venues all along Echo Park's W. Sunset Blvd. for a night of real beer, live music, discounts, surprises and giveaways. Printable "passports" will be available for download at MusicalBeerCrawl.com beginning Tuesday, Sept 18.
- Beer University: Farmhouse Ales | Steingarten LA hosts homebrew guru Drew Beechum, who will give an amazing talk on saisons and other farmhouse ales, selecting some of his favorite examples of the style to drink, with specially tailored food and beer pairings. Five courses. RSVP via (310) 441-0441. (7p)
- Brewmaster's Dinner | Kinetic Brewing Company hosts an epic eight-course beer pairing dinner at their brewery in Lancaster. Tickets are $65. (6p)
- Suckling Pig Roast | King's Row Gastropub roasts a whole hog that's been marinated in Firestone Walker beer. 8+ Firestone Walker beers on tap. (6p)
- Big Crawl in Little Tokyo | Special beers and glassware giveaways at some of Little Tokyo's best beer bars: Far Bar, The Escondite, The Lazy Ox Canteen, Spitz, Izakaya Fu-ga, Weiland Brewery, and Xlixe Pizzeria. (6p)
- Lucky Baldwins Exclusive Pub Tour | Shuttle buses take patrons around the Pasadena environs all night, looping between all three Lucky Baldwins locations. Tickets are $45. (6:30p-12a)
- Port Brewing / The Lost Abbey night | Join the crew from this famed North County San Diego brewery along with over 20 of their beers at The Surly Goat. (6p)
- The Oinkster 6th Anniversary | Six burger specials from the past six years, with a tap takeover featuring Eagle Rock Brewery.
- FoodGPS LA Beer Float Showdown | FoodGPS.com's Josh Lurie has assembled five teams of top L.A. chefs and local breweries to collaborate on creating the ultimate beer float at Golden Road Brewing. Come taste and vote for your favorite. Tickets are $35; VIP $45. A portion of the proceeds will benefit The Pablove Foundation. (2-5p)
- Boneyard Bistro Brunch | Six-course brunch menu, with beer cocktail and special release beer pairings from Deschutes Brewery, Firestone Walker Brewing Co., and Lagunitas Brewing Company. Tickets are $45. (2p)
- LA Beer Week Festival | The signature closing festivities for LA Beer Week. Over 70 breweries will be in attendance at Union Station, pouring unlimited samples of their goodies alongside food trucks and local artisans on-site peddling their wares. Tickets are $50; net proceeds benefit The Spero Foundation, The LA Brewers Guild, and the Glassell Park Recreation Center. (12-4p)
There are also some special events taking place over the entirety of LA Beer Week (9/20-9/30), including:
- Savory Malibu will create a special three-course beer pairing menu featuring Smog City Brewing. RSVP via (310) 589-8997.
- City Tavern will be featuring a different barrel-aged beer pairing each day.
- Bar | Kitchen (at The O Hotel) will be making special craft beer cocktails.
- Lucky Baldwins 16th Anniversary Celebration will feature rare and vintage beers from Stone Brewing Co.
And even more taking place over the course of several days, including:
- Beachwood BBQ (Seal Beach) Farmhouse Ale Festival (9/20-9/23)
- Homebrewing demonstrations at Wurstküche Venice (9/20, 9/23, and 9/27)
- Sadie (Hollywood) will be creating special menu pairings and cocktails with beers from Lost Coast Brewery. RSVP via (323) 467-0200. (9/20-9/22 & 9/25-9/29)
- Tony's Darts Away IPA Festival in Burbank (9/23-9/28)
Also super cool: LACraftBeerTours.com is offering shuttle bus service between breweries to help celebrate LA Beer Week. Email [email protected] to RSVP or for more info.
- Saturday, Sept 22
- Sunday, Sept 23 (11am. Free.)
- LA to OC: Golden Road/Noble Ale Works/Old Orange/The Bruery
- Thursday, Sept 27 (5pm. Free.)
- South Bay: El Segundo/Strand/Monkish/Select Beer Store
- Sunday, Sept 29 (1pm. Free.)
- OC: Old Orange/Noble Ale Works/Bootlegger's/The Bruery
LA Beer Week is an annual celebration of local beer culture, taking place throughout Los Angeles & Orange Counties (and their respective environs) from September 20-30. Enlightened bars, restaurants, bottle shops, and breweries will come together to present a large number of events all around town, with focused tastings, educational seminars, and beer pairing dinners to please craft beer aficionados and neophytes alike. These resplendent activities culminate with the signature LA Beer Week Festival on September 30, from 12-4pm at the historic Union Station. $50 pre-sale tickets for the flagship festival are available now, which entitle attendees to unlimited 4oz. tasters of beer from over 70 of the world's most respected craft and artisan breweries.
Proceeds from the LA Beer Week Festival will be benefiting The Spero Foundation, the Los Angeles Brewers Guild, and the Glassell Park Recreation Center.
LA Beer Week on Facebook – @LABeerWeek on Twitter, official hashtag: #LABW