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Options Analysis Software for Excel
|Custom Spread | Chain | Spread Scanner | Streamer | Testimonials | The Competition | Innovation
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|Copyright 2010 Star Research, Inc.
|Neither Star Research, Inc. nor Optionstar software
make trading recommendations. None of the charts
or information contained in these pages should be construed as a solicitation to trade any of these strategies.
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subset: commoncrawl


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Federal Polygraph Act Poster
Every employer subject to the Federal Polygraph (EPPA - 08/16) Act shall post and keep posted on its premises a notice explaining the act, as prescribed by the Secretary of Labor. Such notices must be posted in a prominent and conspicuous place in every establishment of the employer where it can readily be observed by employees and applicants for employment.
Federal Polygraph Act Poster Specifications:
- 11"W x 17"H
- Portrait Style
- Printed in Full Color
- Laminated with High Quality Laminate
Additional Information
11 x 17 in


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- Play:
- Song Name: Episode 10: Best of 2017!
- Artist: Upside Down Shark
- Year: 2017
How do they pack so much in 12 months?
We take a look back at all our favourite things in the world of gaming, movies, music and TV from this year to help you escape from the real world.
Because that's healthy, right?
Thanks for listening and see you in 2018!
Visit http://upsidedownshark.com for hashtag fresh content


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tommaso79/iStock/Getty Images
The name Arrow has come to represent the iconic man's dress shirt, as well as the brand that now includes a stylish line of clothing and accessories for men, women and children. Popular across the world, Arrow has been around for more than 150 years, beginning with an idea credited to one woman in upstate New York.
Detachable Shirt Collar
The idea of man's shirt having a detachable collar was invented in Troy, New York, in 1825. Hannah Lord Montague came up with the idea as a way to keep a shirt looking fresh and crisp without daily laundering. Soon, several companies in the area began manufacturing the collars, including Maullin & Blanchard. Cluett Peabody & Company acquired the company in 1885, and soon Arrow collars and cuffs were being widely distributed.
The Arrow Collar Man
Part of the Arrow collar popularity was the creation of the Arrow Collar Man by artist J.C. Leyendecker. This good-looking man, always dressed in the latest Arrow items, became one of the most recognizable brand icons of the time. President Theodore Roosevelt was among his many fans, and at the height of his popularity, the fictional Arrow Collar Man was getting up to 17,000 fan letters a day -- mostly from young women.
From Collars to Shirts
In the 1920s, men's styles began changing. A more casual look was becoming popular, and the preference for shirts with attached collars was growing. At first, Arrow collars could only be purchased with an Arrow shirt. Eventually, Arrow shirts with attached collars were being exported all over the world. Cluett, Peabody & Company became extremely successful. They continued to rely on the Arrow Collar Man to represent their products until 1930. By that time, the Arrow brand also included men's handkerchiefs, cravats, pajamas and underwear.
Sanforizing Process
One of the biggest problems with clothing up to this time was shrinkage. Clothes would continue to shrink after repeated washings. This particularly affected collars and cuffs. In the 1920s, as soft-collar shirts were rising in popularity, Sanford Cluett, a nephew of the company's founders, began working on a process that would virtually "preshrink" fabric -- a process called Controlled Compressive Shrinking. By 1930, the process was officially registered with the "Sanforized" trademark, and the company ceased all collar production in favor of shirts produced with this process. Soon the process was being licensed to other manufacturers and today, later generations of sanforizing are still being used worldwide for cotton-based fabrics.
Expanding the Line
During WWII, the company produced military uniforms. When the war ended, Cluett & Peabody further expanded the Arrow brand to include men's pants, jackets and swimwear, as well as dress and casual shirts, especially those with the new button-down collar. In 1962, the Arrow Company was created as a division of Cluett & Peabody, with the mission to sell the Arrow line of products worldwide.
The Arrow Brand Today
Today Arrow remains a registered trademark of Cluett, Peabody & Co., Inc., which is a wholly owned subsidiary of the Phillips-Van Heusen Corporation. According to PVH, "Today Arrow is an authentic American lifestyle brand with a broad assortment of men's, women's and children's apparel and apparel-related products. Sold in over 55 countries worldwide."
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Writer Bio
Noreen Braman has been writing professionally since 1987. She has contributed to publications such as "GRIT," "Modern Dad," "DayCare and Early Education," "Women's Harpoon," "Priority Parenting," "New Brunswick Business and Entertainment Journal" and "NJ TechNews," as well as several fiction and poetry anthologies. Braman earned a special publishing certificate from the Institute of Children's Literature and a design certificate from the Sessions School of Design.
Photo Credits
tommaso79/iStock/Getty Images


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American Nurses Foundation and the United Health Foundation Award Carli Zegers the Jeannine Rivet National Leadership Fellowship
SILVER SPRING, MD – Carli A. Zegers, Ph.D., APRN, FNP-BC, is the 2020 recipient of a $10,000 fellowship made possible by the Jeannine Rivet National Leadership Fund. The annual fellowship was established by the American Nurses Foundation through a gift from the United Health Foundation to support emerging nurse leaders to integrate their health expertise into civic and professional opportunities.
The fellowship honors retired Executive Vice President of UnitedHealth Group Jeannine Rivet, RN, MPH, FAAN, for her trailblazing contributions to health care and business. It aims to inspire more nurses to increase their nursing knowledge to help make the health care system work better for everyone.
Dr. Zegers will use this grant to pursue multiple leadership development programs.
"I have learned a lot and have come a long way from where I started as a leader; however, I know more work is needed," said Dr. Zegers. "I appreciate all of my past experiences and believe this award and opportunity are necessary to further develop into a stronger leader and better advocate."
An accomplished and rising nurse leader, Dr. Zegers founded the Nebraska Chapter for the National Association of Hispanic Nurses in 2015. Her work in policy and advocacy has provided her with the opportunity to be an American Academy of Nursing Jonas Policy Scholar. She is motivated to continue to support the advancement of others, promote diversity and fight for equality and inclusion. Dr. Zegers is currently an Assistant Professor at the University of Missouri – Kansas City, School of Nursing and Health Studies, and a nurse practitioner in the Emergency Department at Truman Medical Center.
"Carli represents the future of nursing and its potential to create meaningful change," said American Nurses Foundation Executive Director Kate Judge. "There's still much work to do to increase diversity in the nursing profession and we are all witnessing the nation confront inequalities within health care and society. Carli's work to found the National Association of Hispanic Nurses chapter of Nebraska, to raise critical health policy and social justice issues on Capitol Hill, and to be a servant leader motivates us to roll up our sleeves and do the work."
"We are so pleased with the selection of Dr. Zegers and her ongoing efforts to advance equality and inclusion in the nursing profession," said United Health Foundation President Tracy Malone. "Through the Jeannine Rivet National Leadership Fund, we are honored to support rising nurse leaders who will continue to transform and improve health care."
The Jeannine Rivet National Leadership Fund will provide an annual $10,000 fellowship for 10 years. The Fund further underscores a commitment on behalf of the American Nurses Foundation and the United Health Foundation to help increase nurses' contributions to health care and the organizations and communities in which they lead and serve.
# # #
About the United Health Foundation
UnitedHealth Group (NYSE: UNH) is a diversified health care company dedicated to helping people live healthier lives and helping to make the health system work better for everyone. UnitedHealth Group offers a broad spectrum of products and services through two distinct platforms: UnitedHealthcare, which provides health care coverage and benefits services; and Optum, which provides information and technology-enabled health services. For more information, visit UnitedHealth Group at www.unitedhealthgroup.com or follow @UnitedHealthGrp on Twitter.
About the American Nurses Foundation
The American Nurses Foundation is the charitable and philanthropic arm of the American Nurses Association (ANA), with the mission to transform the nation's health through the power of nursing. The Foundation supports research, education, and scholarships, which improve health, wellness, and patient care. For more information visit www.nursingworld.org/foundation.


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Assistant Director of the Civil War Institute at Gettysburg College.
Document Type
Blog Post
Publication Date
Department 1
Civil War Institute
Megan Kate Nelson is a writer and historian living in Lincoln, Massachusetts. Her new book, The Three-Cornered War: The Union, the Confederacy, and Native Peoples in the Fight for the West, will be published by Scribner in February 2020. This project was the recipient of a 2017 NEH Public Scholar Award and a Filson Historical Society Fellowship. Nelson is the author of two previous books: Ruin Nation: Destruction and the American Civil War (Georgia, 2012) and Trembling Earth: A Cultural History of the Okefenokee Swamp (2005). She has also written about the Civil War, the U.S. West, and American culture for The New York Times, Washington Post, Smithsonian Magazine, Preservation Magazine, and Civil War Times. Her column on Civil War popular culture, "Stereoscope," appears regularly in the Civil War Monitor. [excerpt]
This blog post originally appeared in The Gettysburg Compiler.
Copyright Note
This is the author's version of the work. This publication appears in Gettysburg College's institutional repository by permission of the copyright owner for personal use, not for redistribution.
Recommended Citation
Luskey, Ashley Whitehead, "Speaker Interview: The Civil War in the West" (2019). The Gettysburg Compiler: On the Front Lines of History. 359.


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The policy change in Volusia was prompted by the case of an 8-year-old Deltona girl being raised as a boy. It follows on the heels of a similar move in Flagler County to protect gay, lesbian, bisexual or transgender (GLBT) students. Both cases were championed by the ACLU.
The Volusia County School Board Tuesday evening unanimously approved adding "gender identity or expression" to the district's policy prohibiting student bullying and harassment.
Click On:
- Bullying of Gay Student at FPC Leads to Teacher's Public Apology and Policy Change
- My Son Is Gay
- Beaven: A Nation of Bullies: Our Children Are Watching. And Waiting.
- Born This Way Blog
The policy was prompted by the case of an 8-year-old Deltona child, biologically a girl, who is being raised as a boy according to what the parents and the boy believe is the child's true sexual identity. The boy's parents granted his wish in 2009, including a boy's name. The child's mother has been pressing the school board for a policy change for almost two years. The school board resisted for months, saying its policy was sufficient to protect all students. Meanwhile, the boy was being harassed about his identity by other students.
The policy move in Volusia follows on the heels of a related issue in Flagler County, where a gay 9th grade student, formerly at Flagler Palm Coast High School, had been bullied by students and insulted by a shop teacher. The ACLU intervened. The teacher was reprimanded and required to make a public apology, though the student never returned to school. He's taking courses through Florida Virtual School. The Flagler County School board also agreed to do what the Volusia board did Tuesday, though Flagler has yet to enact that pledge.
"We are very happy to see this important policy adopted," said George Griffin, President of the Volusia-Flagler Chapter of ACLU of Florida. "We've been working with the board and the community for more than a year to take this step forward to make students and schools safer."
Griffin and the Volusia-Flagler Chapter began working to get explicit protections based on "gender identity or expression" added to the policy after the 34-year-old mother of the student brought concerns about the treatment of her child in a Volusia school to the ACLU's attention.
During the Tuesday board meeting, Griffin read a statement from the mother, who would not appear in person. "I wish I could be the one reading this to you today, but because of the controversy surrounding this subject we must remain anonymous to protect our family," her statement read.
"We have spoken to individuals and organizations across the state and across the country, and we've learned of the relentless torment these kids endure simply because they want to be themselves," Griffin said for the mother. "By adding gender identity and expression to the policy, you are not just protecting my child, but hundreds of others will have one more layer of protection, knowing that they matter to you."
"We were happy to play a role in developing this policy but it would not have been possible without the leadership of elected officials such as Board Member Diane Smith who really took this issue to heart," Griffin said.
After a year of meetings and discussions between local and state ACLU representatives, the parent, and district officials including Smith, the inclusive policy was adopted at a regular Board meeting Tuesday night.
"This was the right thing to do," Smith said. "Our school board is student focused and makes decisions with their best interests in mind. This amendment strengthens our current policy so that we can ensure all students are protected from bullying and harassment."
The success in protecting students in Volusia is part of the ACLU of Florida's longstanding commitment and work through litigation and advocacy to secure and protect the rights of LGBT students — that is, lesbian, gay, bisexual and transgender — to learn in a safe environment that is free of harassment, bullying and discrimination.
"The most common forms of bullying and harassment in Florida schools, and across the country, are based on actual or perceived sexual orientation, gender identity, and physical appearance," said Shelbi Day, ACLU of Florida LGBT Project Attorney. "Although the state anti-bullying law clearly prohibits bullying and harassment of any students, it is imperative that individual school district policies make clear that bullying and harassment of LGBT students is prohibited and will not be tolerated. This is a critical step in making Florida schools truly safe for all students."


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Seemingly trivial, though in today's climate with the COVID-19 pandemic claiming over 213,000 deaths, the act of proper hand-washing is more important than ever! With proper hand-washing habits and techniques, you could potentially prevent the further spread of the COVID-19 virus and save lives.
https://cmedjupiter.com/wp-content/uploads/2020/10/pexels-karolina-grabowska-4498605-scaled-1.jpg 2560 1707 Concierge Medicine of Jupiter https://cmedjupiter.com/wp-content/uploads/2021/05/concierge-medicine-300px.jpg Concierge Medicine of Jupiter2020-10-14 12:58:122020-12-10 23:37:18The Best Method to Washing Your Hands
Concierge Medicine of Jupiter
2151 S. Alternate A1A, Suite 950
Jupiter, FL 33477
Phone: 561.743.2239
Fax: 561.768.9700
Office Hours
Monday-Thursday 9:00am–5:00pm
Friday 9:00am–1:30pm


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Daniela Ulloa
Athlete of the Week Mar 2, 2020
Daniela Ulloa
Daniela played a key role as a defensive specialist and secondary ball handler to help guide the Bulldogs to their first Regional Championship in 9 years. Daniela also advanced to the Sectional round of the 3 point competition by finishing in the top 4 at the Regional level. Congratulations to Daniela on a great week and fantastic season.


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Our certified mechanics come to you · Backed by our 12-month, 12,000-mile warranty · Get a fair and transparent estimate upfront
The heater control valve is located near the firewall in your vehicle. It controls the flow of coolant through the heater core, which is used to heat the inside of your vehicle. It is vacuum-controlled to open and close based on the driver's input on the heater controls inside the cabin.
The entire heater control valve temperature control assembly works by means of the radiator, which disperses engine heat. When you turn on your car, the engine immediately begins generating heat from the friction in its various components and the engine cooling system activates. Heat has to move away from the engine in order to prevent the components from being damaged. The coolant absorbs that heat and moves it through the radiator, where it disperses into the air. The heater control valve simply diverts some of this heat into your car, and controls how much heat is delivered. When the heater control valve is set to high, you get more hot air.
If you turn your heater control knob and nothing happens, there is a risk of too much heat building up in your engine compartment. This can be devastating to sensitive engine components. You should have the problem checked out by one of our expert mechanics so that your engine cooling system will continue to work properly. It could be the heater control valve assembly, or something else in the cooling system.
Never neglect a problem with the cooling system. If you do, your engine could overheat and key components could become badly or irreparably damaged. You could end up needing your engine rebuilt or even replaced. If you are not getting heat to the passenger cabin or you notice that your car is running hot, you should immediately have one of our expert mechanics diagnose the problem and determine if the valve assembly needs to be replaced.
Our service team is available 7 days a week, Monday - Friday from 6 AM to 5 PM PST, Saturday - Sunday 7 AM - 4 PM PST.


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Four Canadore College Culinary Management students have their summer jobs lined up. They will be operating Brewside Eats, the food truck on-site at New Ontario Brewing Company in North Bay. It will officially open to the public on Thursday, June 17, 2021.
"I'm looking forward to putting my skills to the test and seeing how fast I can be when it comes to prepping the food and getting it out there," said student Logan MacRae.
Student Spencer Stringer believes he and his classmates will develop those skills quickly.
"The more people come, the more word will spread," said Stringer. "And, as the hot weather comes, the more people are going to come to the patio for beer so we can expect more customers."
Student Yuzhe "Leon" Ding is from China where there are no food trucks. He is looking forward to honing his time management skills leading the food prep and making sure it gets to the truck on time.
"I need to organize the time and the food – organize the day. I'm excited," said Ding.
Student Daulton Smith, who has been working the curbside service on-campus at 100 Elements, is excited to lead the customer service for Brewside Eats to ensure patrons have the best experience.
The Brewside Eats menu includes southern fried chicken, corn-dusted perch, and grilled halloumi among its offerings.
"The menu was inspired by my years living in the southern US, and a mutual desire by the New Ontario Brewing Company to offer a unique product for brewery patrons to enjoy on their patio," said Lou-Anne Robinson, Culinary Technologist.
"We decided if we were going to do a truck, especially with the skillset that comes with 100 Elements, we would do something that doesn't compete with the rest of the food trucks in town and that pairs well with the beer we make here."
Brewside Eats will be open Thursday through to Sunday, from noon to 7p.m, all summer long at New Ontario Brewing Company, 1401 Seymour Street, North Bay.
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What's new in CareKit
Written by Federico Zanetello
Description: Build feature-rich research and care apps with CareKit: Learn about the latest advancements to our health framework, including new views for its modular architecture, improvements to the data store, and tighter integration with other frameworks on iOS. And discover how the open-source community continues to leverage CareKit to allow developers to push the boundaries of digital health — all while preserving privacy.
How to get started
What is CareKit?
CareKit is an open-source framework that helps you build beautiful care apps.
Three components:
- CareKitUI: provides static views that are perfect for displaying that data.
- CareKitStore: provides health flavored data models and a core data layer for persistence.
- CareKit: ties the UI and store layers together by providing synchronization between the two
What's new
- CareKitUI:
- Some UIKit views now also have a SwiftUI variant
- New SwiftUI-exclusive views
- CareKit:
- Synchronized SwiftUI views
- WatchOS support (via SwiftUI)
- CareKitStore:
- You can now use data in HealthKit alongside CareKit data to create HealthKit-driven tasks
- FHIR compatibility via the new
- New CareKit Remote synchronization APIs


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Help Me
One of the best ways to support me is to buy my books on Amazon using my affiliate link. If you use my affiliate link, more of your dollars go directly to me (Phil Williams), and less go to Jeff Bezos, billionaire owner of Amazon. You do NOT pay one single cent more either way. Full disclosure: Amazon affiliate links are active for 24 hours, so if you enter my Amazon book page, using my link, then purchase something else, I would also receive affiliate income on the purchase. Again, this will NOT cost you a single cent more. Your support is massively appreciated!
The above link is a Genius link, that will route you to the appropriate Amazon store regardless of your location around the globe, and it contains my Amazon affiliate info, so your support goes to me and not Jeff Bezos.
I'm a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for me to earn fees by linking to Amazon.com and affiliated sites.


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● Wireless is more free, it is a good helper for cleaning
Wireless handheld, dirty and easy to clean, free from wire constraints, more flexible, more convenient to clean, not only for everyday homes but also for office and car.
● Bordeaux bottle design
60% of the size of similar products, placed in the car, home not to occupy the land.
● Lightweight and small body, low noise and large suction
The white version of the vacuum cleaner uses the Japanese technology carbon brush and the German technology SCHUNK carbon brush. The black Pro version is a brushless motor that uses Japanese technology wave gaskets, which can drive up to 60,000 rpm/min, with a maximum suction force of 12000Pa, which instantly absorbs food residue, soot, hair, etc., while reducing noise.
● High performance power lithium battery
Type-C convenient fast charge brings longer battery life with 3 high-performance power lithium batteries, which will bring longer battery life and stronger and lasting power. Type-C is easy to charge and can be fully charged in about 2.5 hours.
● Hidden High-brightness LED Lighting
● Patented air guiding system greatly enhances the experience, Guarantee long lasting battery
Brand: Shunzao
Charging Method: Type-C
Noise: Black: High Speed is 78dBA; Low Speed is 70dBA
White: 78dBA
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CLINICAL CASE STUDY article
Sec. Neurodegeneration
Volume 5 - 2014 | https://doi.org/10.3389/fpsyt.2014.00059
A case of chronic Wernicke's encephalopathy: a neuropsychological study
- 1Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, Netherlands
- 2Slingedael Korsakoff Center, Rotterdam, Netherlands
- 3Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, Netherlands
- 4Brain Center Rudolf Magnus, Center of Excellence for Rehabilitation Medicine, De Hoogstraat Rehabilitation, University Medical Center Utrecht, Utrecht, Netherlands
A 54-year-old woman was referred to our Korsakoff Center because of extensive cognitive problems following acute Wernicke's encephalopathy (WE). She had a relatively short history of alcohol abuse and was found lying on the floor in her home by her son. After 5 days without treatment, she was diagnosed with WE in a general hospital. During the course of the disease, minimal change to the acute situation occurred, with chronic confusion, attention deficits, and incoherent behavior symptoms most notable unlike classical Korsakoff's syndrome. Neuropsychological assessment after 4 and 16 months after admission to the hospital revealed global cognitive decline, with striking impairments in attentional, executive, and memory functions. The present case study suggests that the state of confusion and the neuropsychological symptoms in WE can become chronic in case of very late treatment. We therefore recommend that confused alcoholics should receive appropriate parenteral thiamine according to the current clinical standards.
Wernicke's encephalopathy (WE) is an acute neuropsychiatric syndrome resulting from vitamin B1 (thiamine) deficiency (1). The syndrome is characterized by confusion, attentional disorders, incoherence, eye-movement disorders, and ataxia, although frequently only one or two characteristics are present (2–4). In the industrialized world, most patients with WE have a background of chronic alcoholism and self-neglect (5). WE requires immediate treatment with intravenous or intramuscular thiamine. When patients with WE are promptly treated with parenteral thiamine replacement therapy, this is a life-saving measure that also may prevent the development of chronic brain damage (6). When WE is left untreated or is inappropriately treated with either low doses of thiamine or oral thiamine replacement therapy, this may result in a life-threatening situation with mortality rates up to 20% of the patients (4). In the patients who survive with this lack of treatment, varying degrees of brain damage develop, although the exact course of illness is not well-understood (7). Progression into a well-known form of chronic amnesia, Korsakoff's syndrome (KS), is not uncommon [Ref. (8), see Figure 1]. Usually, KS follows WE when acute confusion improves within one to a couple of weeks. Primary characteristics of this improvement include the ability to concentrate for a longer time, less incoherence in behavior, and clear consciousness over the course of the day despite severe amnesia (8–10).
Figure 1. Evolution of Wernicke's encephalopathy as proposed by Harper et al. (3) and Day et al. (11). See Kopelman et al. (8) for a review.
Descriptions of cases of WE where the symptoms do not improve rapidly are scarce and often restricted to the acute situation. Examples of such cases have been described in the course of World War II following starvation in prisoners of war (12). Descriptions of the cognitive sequelae in the course of prolonged confusion following WE are currently not available in the literature. Such neuropsychiatric descriptions of severe cases of WE are crucial, however, as it will give insight in the severity of the syndrome. Despite the current standards of emergency care in the industrialized world, a vast majority of patients with WE are inadequately managed, resulting in patients who show confusion for a prolonged time (13–15). Here, we present a case study that illustrates the cognitive and behavioral characteristics, including signs of confusion, of a patient who was admitted to our clinic with untreated WE. Neuropsychological assessment revealed striking cognitive impairments unlike KS. Importantly, the initial cognitive and neuropsychiatric problems did not resolve in time, providing an example of a patient with acute WE that became chronic.
Case Report
Biographical History
According to members of the family, the patient functioned independently prior to the neurological problems. The son of the patient visited her several times a week. In her house she was able to manage the household, despite her alcohol abuse. The amount of alcohol she consumed varied between one and three bottles of wine each day. She divorced 12 months prior to diagnosis with WE. Up until 6 months before admission, the patient worked in a reel kitchen in a hospital. The last month, she had not been eating well and consumed alcohol throughout the day. He told that the patient did not feel like eating, but still spoke about things she wanted to undertake to manage her alcoholism. The day before she was found, she had a telephone call with her son. The son reported that the telephone call included a regular exchange of information without any striking exchange of information.
Medical History
Our patient is a 54-year-old woman with a 7-year history of alcohol abuse. The patient did not have a psychiatric history. She was found in her house on the floor of the living room. According to reports of her son who found her, she was unable to move her legs, showed odd eye movements, had visual hallucinations of food lying around her, talked nonsense, and was incontinent of urine. After a visit of a general practitioner to her house, her son was told to give his mother rest. After 5 days and no apparent change to her situation, a visiting psychiatrist referred her to the hospital where she was diagnosed with WE and underwent a therapy of oral thiamine treatment. Subsequently, the patient was admitted to a department of an addiction center where she stayed for almost 8 months. Here, her behavior was described as incoherent and confused. She showed a compulsion to visit the toilet regularly and to frequently ask the nursing staff for cigarettes. After her stay in the addiction center, she was referred to our clinic for patients with KS.
Four months after she was found, a neuropsychological evaluation was performed (T1) in the addiction center. Sixteen months after the first evaluation, the cognitive functions were re-evaluated (T2). Results of the first and second neuropsychological evaluation are displayed in Table 1. A chronic KS reference group is displayed in the last column. The results for the reference group were adopted from group studies on chronic KS patients as displayed in Table 1. The first neuropsychological evaluation consisted of the Wechsler Adult Intelligence Scale-III (16), the Raven Standard Progressive Matrices (17), Word-Fluency Animals and Professions (18), Digit Span Forward and Backward (16), Rey's Complex Figure Task (19), Wechsler Memory Scale-R, Hooper Visual Integration (20), Stroop (21), Trail Making Task (22), and the Behavioral Assessment of Dysexecutive Syndrome Key Search Task. The second neuropsychological assessment consisted of the Mini Mental State Examination, the Cognitive Screening Task (23), Word-Fluency Animals, Digit Span Forward and Backward, Trail Making Task, the Visual Association Test (24), Rey's Complex Figure Task and the Frontotemporal Dementia Rating Scale (25). The patient was informed by the first author and asked whether she was willing to participate. Written informed consent was obtained from the legal representative. The procedure was performed in accordance with the guidelines of the Declaration of Helsinki and guidelines for recruitment of incompetent patients [cf. Ref. (26)].
Table 1. Test results of neuropsychological assessment after 4 and 16 months after admission to the hospital in our case and a KS reference group.
Observations and Neuropsychological Assessment on T1
Qualitative observations on T1 showed a consistent pattern of striking impairments. Mental confusion was reported, with a preference to keep asking for cigarettes, high distractibility, and disorganization of behavior. The patient would frequently walk away during a conversation. Her behavior appeared severely disorganized. While she was sitting behind a computer performing Solitaire, she would move her legs up and down vigorously, possibly as a symptom of late-stage WE (4). Moreover, she would walk into her room, undress, lay in her bed for just a couple of minutes. Hereafter she would dress herself, ask the nursing staff for cigarettes, smoke and walk into her room to undress and lay in her bed for just a couple of minutes, and dress again. During lunch and dinner time, she walked into the room and would just eat one bite and leave the room instantly. During the nights, she would ask the staff for food. According to nursing staff reports, she did not show evidence of positive nor negative emotions during the day.
The left column of Table 1 depicts the test scores on neuropsychological assessment after 4 months after admission to the hospital. Initially (T1), her performance on the neuropsychological assessment was consistent with a profile of cognitive deterioration, showing impaired performance on tests for attention, orientation, intelligence, word-fluency, working memory, long-term memory, construction, and executive functioning, compared to healthy participants. Importantly, the cognitive profile was severely affected by the attentional disorders, consistent with an acute WE. Neuropsychological performance ranged from moderate to severe impairment, with the exception of perceptual abilities. The reference groups of KS patients had an impaired performance on orientation, long-term memory, and executive functioning. On tasks intended to index orientation, word-fluency, working memory, visuoconstruction, and intelligence, the performance of the patient was more than 1 SD below the average score in the KS reference groups. This suggests that both the nature and extent of cognitive disorders in the case study were remarkably serious.
Observations and Neuropsychological Assessment on T2
Qualitative observations of confused behavior lasted during her stay in our Korsakoff clinic without showing any signs of improvement or deterioration over time. The patient appeared as highly distractible if the team members were able to motivate her. She would frequently undress and redress herself in her room.
The right column of Table 1 depicts the test scores on neuropsychological assessment after 16 months after admission to the hospital. The pattern of cognitive functioning was consistent to the pattern of observed cognitive dysfunction at T1. The patient showed similar performance on the cognitive tasks: impaired performance on tests for orientation, intelligence, word-fluency, working memory, long-term memory, construction, attention, and executive functioning compared to healthy participants. Attentional problems were as striking as at T1. The cognitive pattern was stable compared to T1, whereas improvement in case of KS is to be expected based on the available literature (see Figure 1).
The patient in the present case report showed a distinctive chronic pattern of cognitive and neuropsychiatric impairments in the course of severe WE. Signs of confusion and incoherent behavior were evident and did not resolve in time. Cognitive disorders in attention, long-term memory, working memory, visuoconstruction, and word-fluency became apparent both after 4 and 16 months after admission to the hospital. Importantly, the attentional deficits severely affected the cognitive profile on both neuropsychological evaluations. Compared to a KS reference group, the patient showed a broader range of severe cognitive impairments. The patient was able to function independently up to the point that she developed WE. The cognitive and neuropsychiatric problems were in accordance to the acute symptoms of WE and did not improve over the course of her stay in the clinic, suggesting that her WE became chronic.
Wernicke's encephalopathy is a life-threatening condition following acute thiamine deficiency (5). Whereas a large deal of research on WE has been devoted to successful treatment of WE in the acute phase, descriptions of cases where confusion does not improve rapidly are currently lacking. This is striking given that in clinical practice, WE is undertreated and patients are still admitted to general or psychiatric hospitals with prolonged states of confusion (13–15). Moreover, WE is potentially fatal in about 20% of the patients (8). The present case study suggests that WE can not only result in a life-threatening acute situation, but also in a chronic form of WE, incorporating a chronic state of confusion and disorganized behavior. The severity of the neuropsychiatric symptoms makes a patient in need of lifelong care.
A possible explanation for why the patient in the current case study developed a severe chronic pattern of cognitive problems could be the late hospital admission and inadequate treatment with thiamine replacement therapy. Although the patient was found lying on the floor with abundant symptoms of neurological disease (e.g., odd eye movements, visual hallucinations, incontinence), she was not admitted to the hospital in the first 5 days and received no treatment during this period. Since severe cognitive disorders are the consequence of untreated or under-treated thiamine deficiency, the patient should have received thiamine replacement therapy instantly (7). In the present case, WE was eventually diagnosed in the hospital, after which oral thiamine supplementation started. This time point of thiamine supplementation is regarded as a very late compensation for thiamine deficiency (13). Moreover, oral replacement therapy is less effective than parenteral replacement therapy (4).
Given that the prognosis of WE is known to depend on the speed of compensating the deficiency in thiamine (14) and the severe chronic cognitive disturbance associated with chronic WE observed in the present study, our results indicate that an active treatment policy is needed to avoid severe chronic neuropsychiatric symptoms. Current treatment standards suggest that parenteral (intravenous or intramuscular thiamine should be given 200 up to 500 mg three times daily until symptoms of acute WE resolute (32). In order to prevent severe and chronic cognitive disorders, physicians should have a high index of suspicion for WE and dose parenteral thiamine accordingly (7).
Although the patient in our case study had a history of alcohol abuse, the neurocognitive symptoms had an acute onset as reported in WE, which makes alcohol dementia an implausible explanation for the severe acute cognitive problems (33). Moreover, the cognitive problems remained stable over a period of 16 months, unlike progressive dementia. Dissimilar to KS, the patient had chronic problems in her attentional function, working memory, visuoconstruction, and word-fluency functions.
In conclusion, the current case study illustrates the cognitive and behavioral characteristics of a patient who was admitted to our clinic with untreated WE. Our description provides the first report on a patient with prolonged states of confusion following WE, suggesting that WE can become chronic in case of late thiamine replacement therapy.
Conflict of Interest Statement
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
We thank the patient and her family for their willingness to participate. Tanja C. W. Nijboer was supported by NWO Grant #451-10-013.
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Keywords: Wernicke's encephalopathy, Korsakoff's syndrome, confusion, delirium, dementia, amnestic, cognitive disorders, thiamine
Citation: Oudman E, Van der Stigchel S, Postma A, Wijnia JW and Nijboer TCW (2014) A case of chronic Wernicke's encephalopathy: a neuropsychological study. Front. Psychiatry 5:59. doi: 10.3389/fpsyt.2014.00059
Received: 13 February 2014; Paper pending published: 21 April 2014;
Accepted: 12 May 2014; Published online: 27 May 2014.
Edited by:Raymond Scott Turner, Georgetown University, USA
Reviewed by:Greger Lindberg, Karolinska University Hospital, Sweden
Vijay Delaffon, Kent and Medway NHS Trust, UK
Copyright: © 2014 Oudman, Van der Stigchel, Postma, Wijnia and Nijboer. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Erik Oudman, Experimental Psychology, Helmholtz Research Institute, Utrecht University, Heidelberglaan 1, Utrecht 3584 CS, Netherlands e-mail: firstname.lastname@example.com


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48th annual Geoscience Conference – Virtual.
"Geoscience favorites will be available virtually and compatible on iOS and Android devices via a dedicated event mobile and web browser application or "app". Delegates will have access to interactive sessions, trade show and poster and core session, in advance of, during the event and for months to come. We encourage delegates from their offices or homes, to engage in real-time with speakers, exhibitors, sponsors and event partners through chat rooms, direct messaging, or as part of the interactive session question and answer periods." – Ed Peart, President


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"Paul at 7MS helped us quickly detect and remove an outside hack on a client's website. His expertise saved a lot of time and enabled us to enhance the security and support."
Paul Gully, Elevated Online
Fill out this short form and we'll be in touch very soon to discuss your requirements.
Rest assured, your personal details are never passed on to any 3rd parties.


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And we've got a done deal! Remember how we said that it seems unlikely that Faouzi Ghoulam would sign for Napoli without Aurelio De Laurentiis tweeting about it? Well, he's tweeted about it.
Benvenuto Faouzi! Sono certo che darai un grande contributo in una squadra che è già molto forte #ADL
— AurelioDeLaurentiis (@ADeLaurentiis) January 31, 2014
Then the news became official on the Napoli website. A photo of Ghoulam signing a contract, along with the news that he'll remain at Napoli until 2018. It's thought the fee is around €5m.
By now, y'all should probably know the rough details of Ghoulam. Aged 22, he's spent his entire senior career (and much of his youth) at Saint-Étienne. While capped at the U-21 level for France, he started for Algeria in a World Cup qualifying match, earning his first cap for the country. Oh, and he turns 23 tomorrow - what a lovely birthday present.
But enough of the boring stuff. Let's celebrate. Napoli bought a left back.
And we will not need to watch Pablo Armero in a Napoli kit again this season.


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Printed In Germany! Pure Analogue Recording & Cutting!
This item not eligible for any further discount offers!
"Salvatore Accardo is an outstanding Italian violin virtuoso, best known as a master of the works of Niccolò Paganini, but equally accomplished across a wide variety of repertory for the instrument. His playing is characterized by a taut, visceral tone and a disciplined musical approach that avoids self-indulgence. Having also established himself as a successful conductor, chamber musician, and teacher, Accardo may be considered one of the most accomplished and influential musicians of his generation." - AllMusic.com
"Astor Piazzolla is the single most important figure in the history of tango, a towering giant whose shadow looms large over everything that preceded and followed him. Piazzolla's place in Argentina's greatest cultural export is roughly equivalent to that of Duke Ellington in jazz the genius composer who took an earthy, sensual, even disreputable folk music and elevated it into a sophisticated form of high art. But even more than Ellington, Piazzolla was also a virtuosic performer with a near-unparalleled
mastery of his chosen instrument, the bandoneon, a large button accordion noted for its unwieldy size and difficult fingering system. In Piazzolla's hands, tango was no longer strictly a dance music; his compositions borrowed from jazz and classical forms, creating a whole new harmonic and rhythmic vocabulary made for the concert hall
more than the ballroom (which was dubbed "nuevo tango")." - RippleTunes.com
180g Virgin Vinyl
Limited Edition
Pure Analogue Recording & Cutting
Cutting Machine wired by Signoricci
Heavy Quality Sleeves
33 rpm
Printed In Germany
Produced in only 496 copies
Side 1
1. Adios Nonino
2. Verano Prteno
Side 2
1. Tanti Anni Prima
2. Tres Piezas Para Orcuestra De Camera
3. Preludio
4. Fuga
5. Divertimento


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$ 10.99
When you are snorkeling or diving, the last thing you want is a foggy dive mask. A quick application of Sea Drops by cleans lenses and provides anti-fog protection for a crystal clear view of the underwater world.
When you're snorkeling or diving, a foggy dive mask can be problematic. A quick application of Sea Drops anti-fog and cleaner clears up dirty and foggy lenses – giving you a crystal-clear view underwater. It's easy to use waterside. Just squeeze, rub, rinse and wear. The gentle formula will not harm surrounding silicone or rubber support frames. So, toss a bottle of Sea Drops Anti-Fog and Cleaner in your dive kit and see what you've been missing.
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|Non-toxic, biodegradable and alcohol-free
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|Also great for eye glasses, face masks, binoculars and telescopes


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The McKnight Ranch is one you have to see to believe. This ranch consists of 6,210+/- deeded acres. You will not find a better ranch when it comes to pasture and farm ground. Nothing has been missed when it comes to owning and operating a cattle ranch, from the excellent fences, the cattle barns...7,075 Acres : $16,000,000
McKnight Ranch
Bison : Perkins County : SD
Hayden Outdoors


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Students will draw upon a range of texts as reading stimulus and engage with creative as well as real and relevant contexts.
Students will have opportunities to develop higher-order reading and critical thinking skills that encourage genuine enquiry into different topics and themes.
This specification will ensure that students can read fluently and write effectively. Students will be able to demonstrate a confident control of Standard English and write grammatically correct sentences, deploying figurative language and analysing texts.
Our state-of-the-art facilities have everything you need to #GetTheEdge
Download the latest Ron Dearing UTC prospectus here


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Tag: exercise
My Story 13: Icey Tria
I was always the fat/chubby child. Growing up was hard, being bullied by some random children just because I was heavy. It was very, very traumatic for a child. Worse came when I hit puberty, the mockery and ridicule was sky-high.
CONQUER Mt. Pulag – January 30-31, 2010
How about starting the year right by climbing the second highest mountain in the Philippines? Travel Factor is hosting a Climb of Mount Pulag on January 30-31, 2010.
Do you need a Personal Trainer?
A personal trainer is not for everyone, but having one do have its benefits.
Craving for some Pasta?
Pomodoro Pasta by: Pamcy Yu Here's a healthy treat for the pasta lover. Ingredients: 250 g Angel Hair Pasta, undercook by about 1-2 minutes ¼ cup Extra-virgin Olive...


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Shown here are the oil seals for the MERCEDES LS4 steering rack and power steering pump.You can select the required oil seal according to its installation location . The high-resolution photos show the seals of the real manufacturer in four angles and the place of installation in the steering mechanism. Sale of oil seals from constant availability in our warehouse, You can buy the steering rack oil seal for MERCEDES LS4 now.
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The A-WL56M2C CabCAM WiRELESS System. The camera system comes with one 7" wide-angle color LCD monitor and two wireless 1/3" color CCD cameras. The 2.4 Ghz wireless system has a 200 yard barrier-free transmission range. The WL56M2C wireless system supports 12V automotive battery power allowing for easy installation. The WL56M2C wireless system can also be expanded to four camera capability.
200 yd barrier-free transmission range. 5.6 TFT LCD Wide-Angle Color Camera: High Resolution monitor with antenna. Four camera capability 2.4GHz wireless receiver with four channels. The monitor includes: power indicator, remote receiving window, POWER button, MENU button, SEL button, channel selection, loudspeaker, support attaching slot and power supply terminal. (2) 1/3 CCD Weatherproof Color Camera: One Channel 3 and one Channel 4 camera.
Infrared Illuminators allow up to 32 feet of night visibility, image mirroring function, made to withstand off-road conditions, audio capabilities. Each camera has an antenna and a power supply jack. Cameras require 12V power source.
Accessories: Base-Mounted Remote Antenna with 9.75' cord, Ball Swivel Mounting Bracket with Mounting Pad, U-Support Mounting Bracket with Thumb Screws, 6 Pin Power Wire Harness with Jack for AC/Cigarette Lighter/DC Adaptor, AC Power Adaptor. Cigarette Lighter Power Adapter, (3) 3.25' DC Adapters, Sunshield, RCA Cable, Full-Featured Remote Control. This system can be expanded to support up to four cameras. The item "CabCAM VIDEO SYSTEM WIRELESS MONITOR 2 CAMERAS WL56MC2" is in sale since Monday, October 24, 2011.
This item is in the category "Business & Industrial\Heavy Equipment, Parts & Attachments\Heavy Equipment Parts & Accessories\Heavy Equipment Accessories\Cameras". The seller is "tractorpartsbarn" and is located in Greer, South Carolina. This item can be shipped to United States.


text: Asher Roth is an interesting artist. Initially thought to be the next Great White Hype, his debut was solid but left a bit to be desired in my opinion. Since then, his star has been eclipsed by the uber-talented Yelawolf. But this record is a step in the right direction. It has that hip-pop crossover sound that the kids are diggin' these days but, as a duepayer, I was more drawn to the message than anything. Like I always say, rather than force feed edutainment to the masses you gotta put that pepto bismol in a bottle of YooHoo. Make it fun to listen while serving up some good food for thought. But what really brought it home for me was the visuals. Again, I was drawn to the authenticity of the imagery. Just like NY, LA is definitely a "feast or famine" type of town. You're either doin' it way big or hustlin' to get by. This video does a great job of depicting the Hollyhood side of LA. Not mad at this at all.


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Despite the constant climate change rhetoric and opposition to fossil fuels, one of the cleanest burning fuels is natural gas, including liquefied natural gas (LNG). In fact, LNG has proven to be better than any other fossil fuel for the environment, as it generates 30% less carbon dioxide than fuel oil and 45% less than coal. While LNG still does have an environmental footprint, it contributes to far fewer carbon emissions.
With many across Wall Street expecting a cold winter, the demand for natural gas, which has already driven prices sky-high, could continue to stay elevated. We screened our 24/7 Wall St. database and found five large-cap stocks that are ideal for growth stock investors looking to capitalize on the solid pricing and demand environment.
It is important to remember that no single analyst report should be used as a sole basis for any buying or selling decision.
Baker Hughes
This stock makes sense for investors looking for energy exposure via services. Baker Hughes Co. (NYSE: BKR) is an international industrial service company and one of the world's largest oilfield services and equipment companies. It provides the oil and gas industry with products and services for oil drilling, formation evaluation, completion, production and reservoir consulting.
The company prides itself on being a self-described energy technology company that provides solutions to energy and industrial customers worldwide. Built on a century of experience and with operations in over 120 countries, the firm's innovative technologies and services are taking energy forward.
Shareholders receive a 2.83% dividend. BofA Securities has a Buy rating on Baker Hughes stock, and its $33 price target compares with a $28.97 consensus target and Monday's closing price of $25.45 a share.
Cheniere Energy
This top LNG play has made a nice move off the October 2020 lows. Cheniere Energy Inc. (NYSEAMERICAN: LNG) is an energy company primarily engaged in LNG-related businesses. The company operates through two segments.
Cheniere's LNG terminal segment consists of the Sabine Pass and Corpus Christi LNG terminals. Its LNG and natural gas marketing segment consists of LNG and natural gas marketing activities by Cheniere Marketing.
Cheniere Marketing is developing a portfolio of long- and medium-term SPAs with professional staff based in the United States, the United Kingdom, Singapore, and Chile. The company conducts its business through its subsidiaries, including the development, construction, and operation of its LNG terminal business and the development and operation of its LNG and natural gas marketing business.
Shareholders receive a 1.30% dividend. Evercore ISI's Outperform rating on Cheniere Energy stock comes with a $130 price target. The consensus target is $107.73, and shares closed on Monday at $101.63.
This company is expected to have a stunning percentage of its production come in as natural gas. EQT Corp. (NYSE: EQT) operates as a natural gas production company in the United States. It also produces natural gas liquids (NGLs) and crude oil. As of December 31, 2020, it had 19.8 trillion cubic feet of proved natural gas, NGLs and crude oil reserves across approximately 1.8 million gross acres.
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Blame America
The United States tried to build a stable state in Iraq. We should've known better.
What is happening in Iraq right now is both a cautionary tale and an unfolding tragedy. The lesson is not about leaving Iraq too early, nor is it about having a Status of Force Agreement that would have kept us there. It's not about firing the current national security team and appointing another one. It's not about the effectiveness of air power in halting the advance of an insurgency.
What is happening in Iraq right now is both a cautionary tale and an unfolding tragedy. The lesson is not about leaving Iraq too early, nor is it about having a Status of Force Agreement that would have kept us there. It's not about firing the current national security team and appointing another one. It's not about the effectiveness of air power in halting the advance of an insurgency.
The caution is about the blithe American assumption that the United States is omnipotent, that with enough money, good will, expertise, equipment, and training Americans can build foreign forces and bring security to troubled areas around the world. The tragedy is that what the U.S. does and has done leads down the road to failure. And more often than not, America bears the costs of its mistakes.
Iraqi security has always depended on the quality of Iraqi security forces and the capabilities of the government in Baghdad that commands them. Since 2003, the United States has spent more than $25 billion training and equipping the Iraqi military. Supporting the government that commands them cost the American taxpayer more than a trillion dollars, more than 50,000 dead and wounded Americans (not to speak of the trillion we will spend mopping up the mental and physical damage the war did to our own soldiers). Somewhere between 500,000 and a million Iraqis, so far, have paid for that temporary sense of security with their lives.
Now that the Iraqi military is folding like a cheap umbrella in a thunderstorm, reshaping the surrounding region, from Syria to Kurdistan and potentially far beyond, the Obama administration is left with a pitifully ugly set of options about what to do next.
The lesson is a telling one, and not one the administration or Congress (or much of the public) has learned: We cannot remake other countries, build their militaries, make them behave, and guarantee their security, either through occupation or by training and equipping their militaries.
The story of Iraq is a microcosm of American experience intruding in the security affairs of other countries and being humbled. It started more than 100 years ago, when we invaded the Philippines, spent years there, and left behind a country that remains insecure to this day. In the 1930s and beyond, we provided security and armed and trained a Nicaraguan military that became a dictatorship and remains troubled to this day. From early in the last century to the 1990s, U.S. forces imposed order in Haiti, which remains a basket case.
The biggest and most disastrous case, of course, may be Vietnam, where we supported a corrupt regime with little popular support. That war cost more than $750 billion (in constant dollars), took the lives of 58,000 U.S. military personnel, and left more than 150,000 wounded. And it ended in a loss with security guaranteed by the Viet Cong and the armies of North Vietnam.
Why do we repeatedly do so badly when trying to bring security to troubled countries? Because our military doesn't do it very well. Because we don't have the military or civilian capacity — nor the wisdom — to build other countries' forces. And that is because it is almost impossible to do. The very attempt to provide security and build stability in another country is tragic in the most pure, Greek sense: We head toward a doomed fate, doing what we believe to be right, only to have our efforts undone by the effort itself, since occupation always creates resistance and opposition.
Aside from that, easy to do.
The Iraq tale is important. First, the Bush administration invaded the country and threw out its existing government. Bad mistake. Good or evil, it was their government, and an ugly form of order prevailed. The Coalition Provisional Authority, Bush's steward for Iraq, compounded the error by disbanding the Iraqi military without a proper demobilization and cantonment of their arms. And then the CPA disbanded a substantial portion of the government, chasing the Baathists out of their bureaucratic posts. Then the insurgency and the Sunni-Shiite sectarian war — two prospects no one in the administration seemed to have anticipated — took over and gave the Americans a run for their money.
The Bush administration had not anticipated the need for an assistance program — either for security, the economy, or the Iraqi government. So we didn't have one in place. We ran around for several years stitching one together. Initially, it had a lot of economic, infrastructure, or social development components, but as the insurgency grew, we re-jiggered the program to focus on security. And because we were "at war," we gave the lion's share of the assistance money and responsibility to the U.S. military.
The U.S. military worked the security issue hard. They spent those $25 billion, and doubtless more, training, exercising, and equipping an Iraqi military we had to rebuild virtually from scratch. That was clearly not a success: Despite their expensive training, four divisions disappeared from northern Iraq in the face of, at the most, a couple of thousand insurgents. Kind of like the South Vietnamese military we had heavily trained, exercised, and equipped. Now the Islamic State of Iraq and al-Sham (ISIS) is ending up with the ammo, Humvees, trucks, front-end loaders, and guns that we so generously — and expensively — left behind.
What wasn't left behind was the kind of regime that could reverse this failure. This is the hard part. What really matters in security is not the strength of the troops, but political leadership and effective governance. A corrupt, inefficient, ineffective, divisive, unresponsive regime cannot credibly provide security, except by cruel dictatorship, as Saddam Hussein showed.
But we lack the wisdom and capacity to build a different kind of regime. And we certainly blew it in Iraq by leaving Nouri al-Maliki, a would-be sectarian strongman, in charge. We bought some quietus by paying off Sunnis in the "surge," but once Maliki was in charge, that subsidy stopped, as could have been predicted, opening up the door to renewed insurgency.
It is optimistic to say that building a government in someone else's country is hard work. It may be more realistic to say that it is impossible. Either way, it is a task at which the United States failed. The government in Baghdad that we handed power to lacks wisdom and good judgment, is plagued by corruption and has generally failed at providing security or stability. After buying off the Sunnis, U.S. officials handed power to sectarian Shiites intent on getting what they see as their due. A course was set for sectarian tensions.
And here's the tragic piece. Oedipus thought he had escaped the curse, but he killed his father and married his mother, pursuing what he thought was the best road away from the curse. The American invasion of Iraq was a tragic mistake. For a nano-second, many Iraqis welcomed the U.S. military. But the insurgency started almost at once, and grew, as did re
sentment of the American occupation and the actions of the U.S. military, who were doing what they thought was best to restore order. The harder they tried, the greater the resentment. And the presence of the U.S. military in the heart of the Arab world stirred concern on a regional basis.
Today, putting U.S. forces on the ground in any number is not an option. The American public has no appetite for more boots on the ground in foreign lands. The regional players do not want them there. The only party that would welcome American troops in Iraq is ISIS, who know that further American intervention would only bolster their appeal.
Again and again, we imagine we can bring security to the rest of the world. President Obama announced in a speech at West Point last month that he wants to create a new $5 billion Counterterrorism Partnership Fund to "train, build capacity, and facilitate partner countries on the front lines." He was vague about this fund's details. In fact, as I wrote two weeks ago, the proposal had almost no content at all, which meant its contents could be nearly anything. Some of the $5 billion might be used to equip and train the Syrian rebels. Some might even be used to pay for air strikes against ISIS this coming week.
We have spent well north of $200 billion training and equipping the armies and security forces of more than 100 countries over the past couple of decades. These operations continue today in Mali, Nigeria, Pakistan, Yemen, and more than 80 other countries. We may hope we are doing good, but the reality may well be that we are only training the next corrupt set of militaries who will either support the next generation of dictators or inspire the next generation of insurgents.
More from Foreign Policy
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America Prepares for a Pacific War With China It Doesn't Want
Embedded with U.S. forces in the Pacific, I saw the dilemmas of deterrence firsthand.
The Endless Frustration of Chinese Diplomacy
Beijing's representatives are always scared they could be the next to vanish.
The End of America's Middle East
The region's four major countries have all forfeited Washington's trust.


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