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UPDATE: Body found in Newton County is Higginbotham
A woman's search for her sister ended in tragedy after the body of 41-year-old Tami Diane Higginbotham was discovered in Newton County on Friday, Feb. 15.
The search for Higginbotham was initiated after Orange resident Staci Robinson went to the Orange Police Department (OPD) at about 11:56 a.m. Saturday, Feb. 9, to report her sister Tami Diane Higginbotham had been missing since Feb. 7. OPD Officer Michael T. Roush filed a missing persons report on Higginbotham in response to her sister's request.
After a few days passed and there was no sign of Higginbotham, the OPD issued an alert to the media. On Wednesday, Feb. 13, Orange Police Captain Cliff Hargrave reported Higginbotham was still missing. The news release described Higginbotham as a 41-year-old white female from Vinton, La., approximately 5-foot-2 and 120 pounds. Although the original police report indicated she had been missing since Feb. 7, the news release from Captain Hargrave indicated she was last seen Feb. 8 at approximately 12:30 p.m. and was en route to Orange. Her vehicle was found at Bluebird Fishing Camp on Simmons Drive in Orange.
Later the same day, Hargrave issued another release that revealed police were looking for someone who might be able to shed some light on Higginbotham's disappearance. Officers were searching for 26-year-old Joshua Latham who was wanted for a felony probation violation out of Orange County, according to the report. At the time, police were looking for Latham in a gold colored, 1995 Chevrolet extended cab truck, Louisiana license No. X557246. He was reported to be accompanied by his girlfriend and infant child. The information from police indicated Latham lived in Orange but was originally from the Mauriceville area. He was described by the release as "a person of interest in the disappearance of Tami Higginbotham."
Police caught up with Latham in Maryville, Tenn. where the man reportedly had relatives. OPD officers contacted law enforcement officials in Maryville and Latham was arrested at approximately 8 p.m. on Feb. 14. Orange Police and the Texas Rangers went to Tennessee that very day to interview Latham in regards to Higginbotham's disappearance.
The next day, the worst possible outcome for the friends and family of Higginbotham was realized. On Friday, Feb. 15, at approximately 5:30 p.m., detectives discovered the body of a white female in Newton County. According to the news release from Orange Police, the body was believed to be Tami Higginbotham. The report indicated the body was found north of Mauriceville in a heavily wooded, hunting lease area and was brought to the Jefferson County Morgue for an autopsy. The Newton County Sheriff's Office joined the investigation, which is still ongoing, according to police, and confirmed the body found was that of Higginbotham. No charges have been brought against Latham and there is no word yet as to the nature of his connection with or knowledge of Higginbotham's disappearance.For The Examiner's previous reporting on this developing story, click the link below:


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High Energy Physics (HEP)
Image courtesy of Neil Fazel
The inside of the University of Texas, Austin, vacuum chamber where electrons were accelerated to 2 GeV. The laser pulse comes in from the right, ionizes the gas inside the gas cell (center), and sets up the wakefield that creates a huge electric field that pushes the electron bunch along by riding the crest of the waves.
Powerful petawatt laser pulses at University of Texas, Austin, create low density plasmas wakefields that maximize electron acceleration. Energies to 2 gigaelectronvolts (GeV) have been achieved, a breakthrough in plasma wakefield acceleration.
Particle accelerators, a basic tool of physics research--and one that has found widespread use in medicine and security--have been around for more than 70 years. But traditional accelerators have grown ever bigger and more costly to build. The Office of High Energy Physics supports basic research in a technique known as laser wakefield acceleration, a technique that one day may lead to next generation accelerators able to drive table-top coherent light sources such as x-ray free electron lasers at significantly less cost. Achieving two GeV electrons is a step towards making this technique a practical reality.
Laser plasma wakefield is a powerful acceleration technique that may lead to electron and other charged particles having energies far beyond the reach of current accelerators. The potential applications are enormous and may lead to new physics; compact x-ray sources for biological, chemical and materials research; and more cost effective medical centers that rely on charged particle beams for cancer treatment. But accelerating electrons to energies greater than a GeV has been a challenge both in practice and in the theory of understanding the basic physics of laser, electron bunch, and plasma interactions. This is because relatively low power, terawatt laser pulses are able to produce high density plasma wakefields that inherently limit electron energies to approximately 1 GeV due to dephasing between the accelerating electron bunch and the plasma wake and later by the erosion of the plasma itself. Scientists at the University of Texas at Austin have overcome this problem by increasing the power of the laser--no small feat in itself--so that laser-plasma accelerator can be operated in plasmas of lower densities. By doing so they have kept the electron bunch in phase with the wakefields. The result: 2 GeV electrons! This is a major milestone towards next generation particle accelerators.
Michael Downer
University of Texas, Austin
Basic research: DOE Office of Science High Energy Physics program
Xiaoming Wang et al., Quasi-monoenergetic laser-plasma acceleration of electrons to 2 GeV, Nature Communications 4, Article number 1988, DOI: 10.1038/ncomms2988
UT Austin laser-based tabletop particle accelerator reaches major milestone
Tabletop Device Accelerates Electrons to 2 GeV
The Office of Science (SC) is the single largest supporter of basic research in the physical sciences in the United States.

subset: commoncrawl


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Southern California
Docomomo US/SoCal's mission is to increase awareness of, and celebrate the unique legacy of, Southern California's Modern Movement and its influences, through education, documentation, and advocacy. We partner with other local, regional, and statewide organizations and agencies to enhance understanding and appreciation of the area's diverse Modern resources.
For more information on Docomomo US/SoCal visit their website or their Facebook page for upcoming events and to get involved.
Docomomo US/SoCal has limited quantities of the Modernism for the Masses poster designed by Michael Murphy.
Prints measure 20"L x 16"W including border, unframed, and are giclee printed on Somerset Velvet paper, all signed and numbered. Each print is $75.00, and shipping is flat rate $20.00 if in US, $40 outside US.


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SOURCE: Infobright
January 23, 2008 16:17 ET
Infobright's Brighthouse Provides Enterprise-Ready Analytic Data Warehouse
TORONTO and CUPERTINO, CA--(Marketwire - January 23, 2008) - Infobright Inc., an innovative
analytic data warehouse provider, and MySQL AB, the developer of the
world's most popular open source database, today announced a multi-year
extension of their partnership agreement. Infobright is a MySQL Certified
Storage Engine partner. The combination of Infobright's Brighthouse and
MySQL provides organizations an analytic data warehouse that delivers
unprecedented scalability, performance and ease-of-use.
"Infobright plays a key role in enabling MySQL users to deploy a
leading-edge data warehouse solution," said Mark Burton, MySQL AB's
executive vice president of Sales, Channels and Alliances. "This extension
of the agreement allows our customers to deepen their MySQL relationship
and dramatically improve their ability to reach new levels of performance
for complex and ad-hoc queries -- while significantly reducing TCO."
The MySQL Certified Storage Engine Program enables third-party ISVs and
open source community developers to produce high-quality database engines
for the millions of MySQL database users worldwide. More information on the
program is available at http://solutions.mysql.com/engines.
With its Brighthouse solution, Infobright has radically altered data
warehouse design. Competitors' products require physical partitions and
indexing of data or the purchase of large hardware systems, which
ultimately leads to a less agile solution. Brighthouse patent-pending
Knowledge Grid technology automatically creates layers of "data about data"
for all columns, thereby eliminating the need for indexing or partitioning.
This flexibility enables organizations to resolve complex ad-hoc queries on
vast amounts of data, while allowing their business intelligence (BI)
infrastructures to grow and change along with the evolving needs of the
business world today.
"MySQL is great to work with from both a technical and business
perspective," said Miriam Tuerk, president & CEO of Infobright.
"Brighthouse and MySQL have enabled customers such as BlueLithium and Xerox
to bring a new level of business intelligence to their operations. In
addition, through our joint marketing activities and co-selling
relationship, we are able to take advantage of MySQL's reach into the
enterprise, and we are seeing lots of demand."
About MySQL
MySQL AB develops and supports a family of high-performance, affordable
database products. The company's flagship offering is 'MySQL Enterprise', a
comprehensive set of production-tested software, proactive monitoring
tools, and premium support services.
MySQL is the world's most popular open source database software. Many of
the world's largest and fastest-growing organizations use MySQL to save
time and money powering their high-volume Web sites, business-critical
systems and packaged software -- including industry leaders such as Yahoo!,
Alcatel-Lucent, Google, Nokia, YouTube and Zappos.com.
With headquarters in the United States and Sweden -- and operations around
the world -- MySQL AB supports both open source values and corporate
customers' needs. For more information about MySQL, please visit
About Infobright
Infobright is taking a radical new approach to data warehousing.
Infobright's Brighthouse analytic data warehouse software is designed to
answer some of the most complex, detailed questions involving massive
amounts of information, and answer those questions today, not next week. By
fundamentally reinventing data warehouse architecture, Brighthouse "works
smarter, not harder." Brighthouse achieves breakthrough performance, while
eliminating the need for indices, data partitions, and other physical data
structures, as well as the need to deploy large hardware systems. By
delivering the most powerful and usable analytic data warehouse, Infobright
is enabling companies to bring a whole new level of information
intelligence to business operations. For more information, please visit
"MySQL" and "MySQL Enterprise" are registered trademarks of MySQL AB in the
USA and other countries. Other product or company names mentioned may be
trademarks or tradenames of their respective companies.
Media Contact:Laurie GibsonKickstart Consulting for InfobrightEmail Contact, orEmail Contact+1(650) 969-0764
Steve CurryMySQL ABEmail Contact+1 408 213-6544
See all RSS Newsfeeds


text:
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Wednesday, April 20th 2005, 10:26am
Supreme Member
Location: USA
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Location: Metro NYC
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You have options! Read below to see your various options.
Did you know that creditors filed over 940 lawsuits against hardworking people just like you in Justice of the Peace Harris County Precinct 4 Place 2 last year?
These Creditors demanded the most money last year. Maybe one of them demanded money from you?
|Lawsuit Plaintiff xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
|Total Lawsuits Filed xxxxxxxxxxxxxxxxxxxxxxxxxxxxx
|Total Suits in this Court xxxxxxxxxxxxxxxxxxxxxxxxxx
|MSW Capital
If you owe the money and just want to pay it, then it may be best to negotiate a settlement. This is especially true if the dollar amount is very low.
If you are looking to negotiate a lump sum reduced settlement or to set up monthly payment arrangements, then it may be best to obtain the services of an attorney. Many times your attorney can get the creditor's attorney to agree to better settlement terms than you could obtain on your own.
If you think suing you is wrong, then it may be worth fighting the creditor over it. This is true if you know you don't owe the creditor any money or you paid the debt in full. (I don't owe it!) It may be worth it even if you admit you owe the money, but you know the amount is wrong. (I don't owe that much!) Finally, it may be worth fighting if they sued the wrong person (It wasn't me!) or you were not legally capable of being sued (I was only 17!).
If you don't owe the money or if there are circumstances which eliminate or reduce your responsibility, then it may be best for you to obtain the services of a law firm. If you do, make sure that the firm is prepared to take your case to trial. Many attorneys are not willing to invest the time and resources in going to trial, they just prefer you settle. If you believe there are circumstances where you would not owe the money, then you really need the services of lawyers who not only go to court, but aren't afraid to go to trial.
Whether you owe the money or not, if it has been MORE THAN FOUR (4) YEARS since the alleged breach of contract, you may be able to defeat the lawsuit. This is because Texas requires a creditor to sue you within four years of the alleged breach of contract. If the creditor waits too long, you may be able to get the suit dismissed because the creditor waited too long.
If you think that the creditor actually owes YOU money, then you may want to counter sue them. If you think that you have a claim against the creditor (item delivered was wrong, was damaged, services promised were not fully performed, etc) then you may want to make a counter claim against the creditor for the difference in price, costs or expenses.
It is possible to sue the party who sued you (the plaintiff). If it turns out that the plaintiff has broken debt collection laws or is guilty of some wrong act towards you, then you may want to obtain the services of a law firm. You would want to look for a firm who can file a counter suit and try to collect money for you; instead of collect money from you.
Every creditor that files a suit in Justice of the Peace Harris County Precinct 4 Place 2 must ensure that the Defendant was properly served with a copy of the complaint or summons.
If you believe that the creditor did not follow proper procedure, then you may wish to hire a law firm who can file an action asking that the case be dismissed or require the creditor to serve it properly.
Sure, doing nothing IS an option. If you do not get involved in the lawsuit, the creditor likely will get a default judgment against you. The creditor then may try to abstract that judgment against property that you may own. Then the creditor may try to execute that judgment against you and ask that certain property of yours be seized to satisfy the amount of the judgment. As most people know, Texas has certain protections for its citizens that prevents a creditor from taking certain property from you. These are known as exemptions. GENERALLY, this means that your homestead, wages, and your retirement plans are fully protected and your vehicles and household furnishings up to a certain dollar amounts may not be seized from you. Your property that is not protected is known as a non-exempt asset. . Be aware that Texas law does not protect your bank accounts.
If you decide to do nothing, it is important to remember that actions that you do not like may be taken against you or your family's property. It is very important that you meet with an experienced attorney about which assets you own are or are not protected from a judgment creditor. There are many nuances to the exemptions and seizure laws which cannot be discussed in a blog post. Our firm is fully equipped to discuss Texas exemptions with you.
If this lawsuit is just one of several debts you owe, then it is very likely you will be sued by more creditors. Being sued is no fun and having to deal with each and every suit will become overwhelming. Generally we recommend that if you owe a number of creditors and owe over $10,000 in debt, then it may be worth filing for bankruptcy protection.
When you file for bankruptcy protection, you deal with all of y our creditors at once. Generally, the cost of filing the bankruptcy is much less than trying to deal with each creditor individually. Even if you negotiate good settlements of your suits, you generally will find that the cost of the bankruptcy is equal to just ONE case you settle with just ONE of your creditors. Plus, you have a attorney representing you against ALL of your creditors instead of the lawyer representing you against just ONE of your creditors. Not only that, you have ALL the protections of the bankruptcy code and the bankruptcy rules along with a Bankruptcy Judge who is willing to enforce those rules.
In our experience, once you owe a number of creditors and owe enough debt, bankruptcy clearly becomes the easiest and most cost efficient route for dealing with your creditors and your lawsuits.
Justice of the Peace Harris County Precinct 4 Place 2 is presided over by the Honorable Judge Tom Lawrence. The court is located at 7900 Will Clayton Parkway, Humble, TX 77338. The Texas Constitution requires that each county in the State establish between one and eight justice of the peace precincts, depending upon the population of the county. Also, depending on the population of the precinct, either one or two justice of the peace courts are to be established in each precinct. In Harris County there are 16 Justice of the Peace courts. You may find them here. The Justice of the Peace Harris County Precinct 4 Place 2 is located here.
There are approximately 823 justice of the peace courts in Texas for the 254 counties. Judge Tom Lawrence. has jurisdiction of civil matters in which the amount in controversy is not more than $10,000, exclusive of interest. Before September 1, 2007, the jurisdiction of the Judge Tom Lawrence. was limited to claims up to $5,000.00. Judge Tom Lawrence. also has jurisdiction of suits relating to enforcement of a deed restriction of a residential subdivision that does not concern a structural change to a dwelling. Justice of the Peace Harris County Precinct 4 Place 2 Judge Tom Lawrence. also has jurisdiction of Eviction Cases. Rules 523, of the Texas Rules of Civil Procedure govern procedures in the Justice Courts. All rules governing the district and county courts also govern the Justice Courts insofar as they can be applied, except where otherwise specifically provided by law. Rule 523, Texas Rules of Civil Procedure. The Texas Rules of Evidence govern civil proceedings in the Justice Courts. Rule 101, Texas Rules of Evidence. The Precincts in Harris County made be found at: http://www.harriscountytx.gov/CmpDocuments/12/Maps/ConstablePrecinctsJanuary2013.pdf
If you receive a Judgment and do not file a Motion for New Trial within five (5) days, do not file an Appeal within ten days, or do not pay the Judgment within ten (10) days the Plaintiff may seek other remedies to collect your Judgment.
A Plaintiff may obtain an Abstract of Judgment any time after the 11th day from the date of Judgment. The cost of an original Abstract is Five Dollars ($5.00), and you may obtain them from Justice of the Peace Harris County Precinct 4 Place 2 . The Abstract should be filed at 201 Caroline 3rd floor with Harris County Clerk or in any County where the Judgment Debtor may own real property.
The Plaintiff may obtain a Writ of Execution any time after the 30th day from the date of Judgment. A Writ of Execution allows a Sheriff or Constable to try and seize certain non-exempt property from the Defendant. If property is seized, an auction will be held and the proceedings from the sale will satisfy the Judgment.
A Writ of Garnishment is available 7 Days after the date of Judgment. Texas allows bank accounts but not wages to be garnished.
This process requires a Court hearing. This may include turnover of non-exempt property and tax refunds.
If one party to whom a judgment is owed cannot be located, it is possible to pay the judgment into the registry of the court on a showing of good faith attempts by the judgment debtor to locate the prevailing party. Once the court is satisfied that the party cannot be located, the payment can be accepted and the court can issue a release. The money is then held until claimed by the party to whom it is owed, or the money is forfeited to the State of Texas.
Please visit our website for more information about us and the services we offer to people being sued in Justice of the Peace Harris County Precinct 4 Place 2. You may also view our video with Bankruptcy Information.
Call us today at (713) 974-1151 to schedule a no-obligation consultation or feel free to email us at firstname.lastname@example.com.
We provide legal services in the greater Houston metro are including the cities of
Houston , Baytown , Bellaire , Bunker Hill Village , Deer Park , El Lago , Friendswood , Galena Park , Hedwig Village , Hilshire Village , Humble , Hunters Creek Village , Jacinto City , Jersey Village , Katy , La Porte , League City , Missouri City , Morgan's Point , Nassau Bay , Pasadena , Pearland , Piney Point Village , Seabrook, Shoreacres , South Houston , Southside Place , Spring , Spring Valley Village , Stafford , Taylor Lake Village , Tomball , Waller , Webster , West University Place , Aldine , Atascocita , Barrett , Channelview , Cinco Ranch , Cloverleaf , Crosby , Highlands , Mission Bend , Sheldon , Spring , Alief , Airline , Bammel , Barker , Beaumont Place , Bridgeland , Cedar Bayou , Champions Forest , Coady , Cypress , Dyersdale , East Aldine , Fall Creek , Hockley , Hufsmith , Kingwood , Klein , Kleinbrook , Kohrville , Louetta , Lynchburg , Northcliffe Manor , Northcliffe , North Houston , Northgate Forest , Remington Ranch , Rose Hill , Satsuma , Westfield , The Woodlands
We handle bankruptcy cases in all of these counties: Brazoria, Chambers, Galveston, Matagorda, Austin, Brazos, Colorado, Fayette, Fort Bend, Grimes, Harris, Madison, Montgomery, San Jacinto, Walker, Waller, Wharton


text:
This month's puzzles mark the
sixth year
of our joint Monthly Interactive & Printable Logic Problems project. To
celebrate, we've posted
an extra, bonus puzzle as our little
anniversary gift for everyone who likes our puzzles and enjoys solving them.
Happy Puzzling Birthday!
Four coworkers are all going on different vacations during the month of February. Each proclaimed that they wanted to go somewhere warm for awhile – they'd seen enough snow for one winter. The rest of their departments watched them come and go with envy. Each coworker had a wonderful time and returned to work with a tan and lots of pictures of their trip. Determine the full name of each vacationer, the city each is traveling to, the means of transportation being used (one was an airplane), and how long each vacationer plans to stay (3 to 6 days).
1. Mr. Cook didn't go to Las Vegas but he was gone longer than the person who used the bus. The person whose last name was Wakefield was gone longer than the person who went to Atlanta.
2. The person who traveled by train spent five days on vacation.
3. Fred rented a car for his vacation. Melinda's last name wasn't Wakefield.
4. Larry went to Orlando. The person whose last name was Surrey didn't travel to Atlanta but was gone for three days.
5. Harriet West didn't travel by bus. The person who visited Atlanta for four days wasn't Fred.
6. Larry's last name wasn't Wakefield. The person who went to Houston was gone for six days.
file size 179 KB
If you enjoyed
this puzzle and want to play another one online, go
here for another online logic problem.
Last Update
February 14, 2008


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Have you said, "I don't have the patience to homeschool!"? If so, then this episode is just for you! These practical tips will help you develop the patience and mindset to successfully homeschool your children.
Helping homeschool moms bring order to the chaos and create a calm, peaceful home atmosphere.
Have you said, "I don't have the patience to homeschool!"? If so, then this episode is just for you! These practical tips will help you develop the patience and mindset to successfully homeschool your children.
Crystal Wagner is a delightful speaker with a relevant and inspiring message for parents. She has an engaging style and offers practical application to the ideas she presents.
Just wanted to share that your website is the only one that I choose to be in my newsfeed. Love your site.
These are great ideas, thank you! I just printed your list to keep them at hand for the next time we are struggling to figure out what to do.
I am enjoying reading what you send, and I regularly read the links you post on fb. Thanks for sharing!
You had so many great tips and ideas I'm going to have to watch this a few times and take notes! I love it, thank you for sharing!!
Your tips have been so helpful. I look forward to implementing them in the coming school year.
I wasn't sure what to expect – would it be too far beyond my reach? It wasn't! Crystal does a good job of making an intentional math lifestyle possible for the average person through examples and her passion for the subject.
Like a rich stock, Crystal takes Charlotte Mason's ideas and simmers them down into an easily digestible form where they are easy to understand and implement. To listen to Crystal speak is to dip from the pot of her hours of research and insight for a very pleasant and practical meal.
Thank you for your insight. I am constantly trying to pull back on this but all things around us say to increase our activity level. It's good to hear encouragement about leaving margin.
There is so much good information on your site, the book lists alone are a treasure for CM Mama!!
I just wanted to say what a joy it was to be in your workshops and learn from your wisdom. You had some refreshing ideas that I plan to implement into my homeschool day.
I have been scanning through your website and I absolutely love the content.
I love your videos! I'm a new homeschool mom so it's great to get realistic ideas. We're an eclectic homeschool family and I'm always looking for ways to incorporate more Charlotte Mason. The resources that you provide are wonderful.
Crystal, thank you for continuing to inspire and lift my efforts to offer a broad feast of ideas to my precious children.
This is really a great resource, thank you SO much!


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Archaeology training program to begin in June
Marion County residents are invited to attend an Archaeological Excavation in Ellis County, Kansas
Volunteers are invited to participate in the 2013 Kansas Archeology Training Program (KATP) Field School June 1-16, at the presumed location of the Billy Dixon trading post (14EL311) south of Hays in Ellis County. Also known as Whisky Ranch, this site presents an opportunity to investigate the history of immediate post-Civil War era Ellis County, and to advance understanding of the buffalo hunter culture.
The annual field school is an opportunity for the public to work alongside professional and vocational archeologists. No experience is necessary, just a desire to learn. Volunteers can participate for a couple of days or the entire 16 days of the project. Participants assist archeologists in surveying for sites, excavating sites, and cleaning/cataloging artifacts in the lab. Archeology technique courses are also offered and can be taken for college credit. Registration fee for the field school is $20 for members of the Kansas Anthropological Association or Kansas Historical Foundation. Nonmember fee is $80. Children must be at least 10 years old and accompanied by a parent or responsible adult. After May 1 the participation fee increases to $30 for members and $90 for nonmembers. Registration is required for access to the excavation site, which is restricted to project participants only.
For more information call Virginia Wulfkuhle at (785) 272-8681, ext. 266. The registration packet and related information is available on the historical society's website at www.kshs.org/14622.
A full schedule of evening programs will be free and open to the public at Fort Hays State University and other venues in Hays; the schedule is posted on the KHS website (scroll down and click on embedded link "About KATP 2013"; then scroll down to "2013 KATP Evening Programs").
The 2013 Field School is sponsored by the Kansas Historical Society, Kansas Anthropological Association, Ellis County Historical Society, and Fort Hays State University Departments of History and Geosciences.


text:
Hermes Narrow Printed Enamel Bracelet Pre Owned
Authentic: Pre Owned
This is an authentic pre owned Hermes Printed Bangle. Featuring Black and red cloisonne enamel over Gold plated.
- Condition: Excellent
- Color: Gold
- Inner Circumference: 8 in.
- Width: 0.4 in.
Product Code: 1931026
All photos are of actual item being sold. © 2007-2018 LuxeDH.
This Hermes® item is guaranteed to be authentic. Hermes is a registered trademark of Hermes. LuxeDH is not affiliated with or represents Hermes in any way or form.
New Arrivals


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At this point, the Diabetes Control and Complications Trial's (DCCT) finding that intensive insulin treatment reduces the number of long-term diabetes complications is, hopefully, only news to the recently diagnosed. What is less commonly known is that the same tight BG control that reduces the risk of complications has a darker side. The intensive insulin therapy (IIT) described by the DCCT presents a three fold risk of severe hypoglycemia – sometimes with dire consequences.
The DCCT Research Group published this finding in their original report and in a subsequent report in 1995. Now doctors and researchers are developing a greater respect for the potential dangers of hypoglycemia.
What is Hypoglycemia?
Hypoglycemia is the term used to describe a low blood glucose level (BG). All people with diabetes, regardless of type or their method of treatment, suffer from hyperglycemia (high BGs) when left untreated.
In type I diabetes, BGs run high because the pancreas is unable to produce insulin to process sugars for energy. In type II diabetes, the body has become resistant to insulin over time. The body can, in most cases, still process sugar, but not very efficiently. As a result, the sugars awaiting processing cause BGs to run high.
Chronic high BG levels result in a number of diabetic complications from retinopathy to kidney disease. As a result, a number of therapies have been created to keep hyperglycemia in check. It is some of these therapies that cause hypoglycemia, not the disease itself.
The DCCT
1993 saw the publication of the Diabetes Control and Complications Trial (DCCT). The trial revolutionized the treatment of type I diabetes, causing doctors the world over to aim for lower BGs for their patients.
Patrick Boyle, MD, associate professor at the University of New Mexico, was one of the DCCT researchers. He claims, "This [severe hypoglycemia] is an enormous problem and it is becoming more common across the world as people push harder to control their diabetes." As a result of aiming for lower BGs, "we saw a lot of seizures, comas and spouses trying to wake up their partners at night," he continues.
In 1995 the DCCT Study Group released the report, "Adverse Events and Their Association With Treatment Regimens in the DCCT." In this report, and the original study write-up, the authors noted that the intensive therapy that provides such powerful protection against the microvascular complications of diabetes also results in a "threefold increase in the risk of severe hypoglycemia with potentially serious [consequences]." Severe hypoglycemia was defined as seizure, coma or any disorientation or confusion requiring the assistance of another person.
Consequences of Hypoglycemia
A severe hypoglycemic event has a number of consequences. Some are well understood, others are surrounded by controversy. Hypoglycemia can result in accident and injury. Other times it can result in hypoglycemia so severe it can be fatal. Repeated episodes of hypoglycemia appear to affect a person's ability to recognize the warning signs of approaching attacks in the future. Some researchers have even claimed to have found evidence that hypoglycemia may affect brain function.
The easiest to imagine consequence of severe hypoglycemia is an accident caused by confusion or possible unconsciousness.
On August 29, 1996, the Wall Street Journal, in an article entitled "Patients Who Carefully Manage Diabetes May Face Hidden Risks to Their Health," reported the story of a pregnant woman with diabetes who drove into a tree at 73 miles per hour. According to the article there were no skid marks. "She evidently just passed out, and her foot hit the accelerator," said the victim's grieving father.
In May of 1997, an Ann Landers column featured a similar story. A woman was killed, and her fianc_ received permanent brain damage in a car accident caused by a man with diabetes who had gone unconscious at the wheel.
Stories like this are becoming more common and are a cause for great anxiety for people with diabetes on IIT. These tragic stories lead to the question, How common is this?
Opinions vary.
Even though the IIT patients had three times as many hypoglycemic reactions, the DCCT Study Group found no significant difference between the accident rates of the IIT and standard therapy groups.
The DCCT report points out that the similar accident rates of the two groups, despite their strikingly different rates of hypoglycemia, might be attributable to "the particular emphasis clinical staff placed on avoidance of hypoglycemia during driving."
The report continues, "Early in the study all of the clinics developed individual educational programs aimed at preventing hypoglycemia while operating a motor vehicle." These programs instructed patients to always check their blood sugars before driving, immediately stop driving at any signs of hypoglycemia, have a carbohydrate in the car at all times, and to test BGs frequently on long trips. Many type Is on IIT may get these same warnings at sometime or another, but whether or not they are presented as often or in as powerful a way is unknown.
Some research estimates that between four and 13 percent of the deaths of people with type I diabetes are the result of hypoglycemic events. "What's worrisome about these deaths is that they are due to the treatment," says Philip Cryer, MD, FACP president of the American Diabetes Association (ADA).
One especially frightening possibility for people on insulin that may be the result of severe hypoglycemia is what the journal Diabetic Medicine referred to in 1991 as "dead in bed syndrome." Victims of the syndrome are found dead in an undisturbed bed, observed to have been in good health the day before and are free from evidence of late diabetes complications.
As is the case with accidents, it is very hard to determine if these deaths are the result of hypoglycemia. Researchers in the U.K. note, however, that the timings of the deaths and other circumstantial evidence suggests that hypoglycemia or a hypoglycemic event is responsible.
There are major problems with diagnosing hypoglycemia after death (see page 18). Cryer explains that testing the blood sugar of someone found dead after an accident or mysterious death that appears to be the result of hypoglycemia "is of zero value." He explains that the body will continue to process glucose for some time after death. As a result, the BG of a person after death will most likely not be an accurate reflection of their BG prior to death.
Hypoglycemia and Cognitive Function
Of all the possible effects of hypoglycemia the most hotly debated is its effect on brain function. Some researchers and doctors claim that hypoglycemia has no detrimental effect on cognitive function. Others claim to have found evidence to the contrary.
The DCCT Study Group found that, "Despite their increased frequency of severe hypoglycemia, … intensive treatment group subjects showed no trend toward worsening neuropsychological or cognitive functioning over time."
A clinical study, published in 1994 in the Journal of Neurology, Neurosurgery and Psychiatry, found no difference in brain function between patients with a history of more than 10 hypoglycemic comas and those without such events. The authors claim that their data suggest that IIT, "although increasing the frequency of hypoglycemic coma, may not always be harmful for the brain." They offer the possible explanation that this may be due to the limited duration of hypoglycemic coma.
Howard McEwen, MD, FRCP(C), FACP, a recently retired clinical professor of medicine at the University of Calgary has over 40 years of experience with insulin and type I diabetes. He claims to have noticed "no chronic damage to the brain" in his patients after the adoption of IIT.
Despite these findings, other researchers claim that their work shows that severe and recurrent hypoglycemia can cause mild deterioration of cognitive function. In addition, there is strong evidence that recurrent hypoglycemia leads to more hypoglycemic unawareness, a serious risk for people on insulin therapy.
A 1996 study published in Diabetes Care found a significant correlation between IQ discrepancy (before and after hypoglycemic events) and the reported frequency of severe hypoglycemic events. They note that their findings should be interpreted with caution and that "it was not always clear whether the cognitive impairment is an effect of severe hypoglycemia or a cause."
Authors of a 1997 study in the Journal of Clinical Endocrinology and Metabolism claim their work supports the theory that hypoglycemia impairs brain stem function.
Some of the strongest recent evidence in support of adverse effects of hypoglycemia on the brain comes from an article in the June 1997 issue of Diabetes Care. Using magnetic resonance imaging (MRI) researchers found that cortical (brain) atrophy was present in 45 percent of type I test subjects with a history of recurrent severe hypoglycemia. Cortical atrophy was nonexistent in type I subjects without such a history.
The authors of the study claim that "in contrast to the reassuring DCCT results" the association supports the hypothesis that hypoglycemia is detrimental to the brain. These "degenerative structural changes of the brain … may, in a few individuals, promote cognitive dysfunction," they say.
Regardless of the association between hypoglycemia and brain function, the researchers also found that these abnormal MRIs were far more prevalent in type Is than in the nondiabetic population of comparable age (35 to 52 years old). The abnormalities discovered are normally associated with aging and are extremely rare in subjects of this age. The data suggest that they may "be a feature of diabetes and may represent accelerated brain aging associated with the metabolic disorder," they claim.
Why the Disagreement?
A review article in Diabetic Medicine, the journal of the British Diabetic Association, suggests that the inconsistencies may be the result of different researchers using different measurements.
Researchers investigating this issue use a wide range of methods for measuring cognitive function and inducing hypoglycemia, the authors note. They believe that "progress could be made if all groups agreed on a limited range of cognitive function tests and used them in a standardized manner."
Cryer explains that the primary debate surrounding the current research on hypoglycemia and brain function may be the result of technological short comings. The evidence is conclusive that people on IIT with HbA1cs closer to the non-diabetic range "require lower BG levels than non-diabetics and the poorly controlled to experience the symptoms of hypoglycemia," says Cryer. He also mentions that effectively controlled IIT patients require lower BG levels to trigger the counter-regulatory response of hormones like epinephrine.
The controversy, says Cryer, is whether or not these well controlled patients require lower BG levels to experience impaired cognitive function. He concedes that the answer may have to wait until more precise tools are available to measure these aspects of hypoglycemia.
The authors of the Diabetic Medicine article agree. They concede that definitive studies of hypoglycemia's effect on cognitive function "may have to await the development of advanced technology such as high resolution MRI or PET scanning."
It should be noted that very little is known about the consequences of hypoglycemia on children. Boyle points out that no subjects of the DCCT were under 14-years-old. Many researchers agree that the consequences of hypoglycemia could be much worse for children, however, because their brains are still developing.
Hypoglycemic Unawareness
A major disadvantage of repeated hypoglycemia is its effect on hypoglycemic awareness. A study from the journal Diabetes found that the enhanced rates of cerebral blood flow found at the onset of hypoglycemia are associated with a diminished perception of low blood glucose levels and weakening of the hormonal counter-regulatory response.
Generally, more severe hypoglycemic events equal more hypoglycemic unawareness. This can be remedied however.
According to Cryer, three separate studies have shown that hypoglycemic unawareness is "largely, if not entirely, the result of multiple hypoglycemic reactions." Two of these three studies also showed that as little as two to three weeks of "scrupulous avoidance of hypoglycemia will reverse hypoglycemic unawareness," says Cryer.
Some believe that hypoglycemic unawareness is made more extreme when people are switched over from animal to human insulin. In fact, the package inserts of the two companies marketing insulin in the U.S. have warnings about human insulin. "A few patients have reported that after being transferred to human insulin, the early warning symptoms of hypoglycemia were less pronounced than they had been with animal-source insulin," reads the warning from one of these companies. (The warning for the other company's human insulin is almost identical.)
Some people who use insulin (and the doctors that care for them) believe that they are better controlled on animal insulin rather than human insulin.
The Bellagio Report, published in 1996 by the Insulin Dependent Diabetes Trust (IDDT) in the U.K., recommends that those "who are at increased risk of hypoglycemia such as children, the elderly and those reporting frequent hypoglycemia should be prescribed natural animal insulins which are absorbed more slowly and have a slower onset of action."
Others believe that the apparent effects of human insulin on hypoglycemia and hypoglycemic unawareness may not be directly attributable to the insulin.
Cindy Onuffer, RN, MA, CDE, views reports of human insulins leading to more cases of hypoglycemic unawareness with caution. She says that, in her experience, those who originally start on human insulin don't seem to have more hypos than those on animal. In addition, she notes that when patients are switched from animal to human the switch may be accompanied by other changes in their treatment plan, like a switch from standard to intensive insulin therapy, instructions to change injection sites, or more frequent BG monitoring. "When more than one variable is changed [in an insulin treatment regimen] one has to be very careful about attributing reactions to just one of those variables," says Onuffer.
In addition, John Walsh, PA, CDE, points out that human and animal insulins have different times of action that may require modification of doses. He claims that many of the problems attributed to human insulin may be the result of neglecting to take these differing times of action into account.
Others agree with this caution but feel from experience that animal insulin provides better control for many patients. McEwen notes that he has had "plenty of patients who kept exactly the same treatment measures [after switching from animal to human] and have refused to stay on human" after experiencing more frequent hypoglycemia and hypoglycemic unawareness.
What Can be Done?
A study by Bruce Bode, MD, published in 1996 in Diabetes Care suggests that pump therapy can greatly reduce the incidence of severe hypoglycemia. The study documents a more than six-fold decline in the incidence of severe hypoglycemia during the first year of pump therapy. The rate remained significantly lower in the three year follow up as well.
DCCT researcher Patrick Boyle, MD, mentions that two clinical studies have also shown that severe hypoglycemia can be reduced by more frequent BG testing. In these studies, the participants received a great deal of attention and support from the researchers. They were called on the telephone up to three times each day and reminded to test their blood
ugars. The research team also provided detailed and repeated instruction on how to time insulin injections in relation to food and activity. Boyle points out that this relationship is something that people on insulin can't learn enough about if they want to effectively prevent hypoglycemic reactions.
While Boyle realizes that this level of patient support is unrealistic for the everyday management of the 800,000 type Is in the U.S., he believes that an important lesson can be learned. It illustrates to patients and healthcare professionals that more testing and greater knowledge of how different factors affect insulin action equals more protection against severe hypoglycemia.
There are no easy answers on how to deliver this level of education and support for those working to achieve tight BG control. But Cryer sums up the current situation best in a review article published in Diabetes Care.
"To achieve and safely maintain near normoglycemia in most people with [type I diabetes] we must learn to deliver insulin in a much more physiological fashion, or learn to prevent, correct or compensate for [hypoglycemic unawareness]," he says.
"Pending such advances, application of the principles of current insulin therapy, including patient education, self-monitoring of blood glucose, and professional support, must be coupled with prudent glycemic goals to minimize the frequency of severe hypoglycemia without completely compromising metabolic control," adds Cryer.
Hypoglycemia is a multifaceted aspect of diabetes. It is affected by a great number of factors, and a great deal is yet to be learned. What is known is that hypos are the result of certain diabetes treatment regimens, and repeated episodes make hypoglycemic unawareness more pronounced.
Unfortunately, there is a lack of definitive clinical evidence documenting the consequences. But, as long as those at risk are aware of the causes of severe hypoglycemia and the potential risks involved, they can discuss these with their healthcare professionals and make their own decisions regarding their treatment regimens.
The intention of bringing up the potential risks of IIT is not to scare people away from the benefits of achieving tight control. The DCCT's findings definitively show that tight BG control drastically reduces the incidence of eye, kidney and nerve damage caused by diabetes.
Instead, the information should illustrate the importance of avoiding severe hypoglycemia, while still trying to maintain tight BG control. Each contributor to this article expressed the opinion that avoidance of hypoglycemia should not come at the expense of good control. They claim that, in light of the current clinical evidence, the benefits of tight control still outweigh the potential risks of severe hypoglycemia in most cases.
Their advice is to test more often and come to a better understanding of how BG levels are influenced by meals, physical activity, stress and the number of other factors that affect blood sugars.
"The majority of hypoglycemic events observed in the DCCT occurred at night. For that reason, patients should check their BG levels before bed and not go to sleep unless their BGs are in a good, safe range," adds Linda "Freddi" Fredrickson, MA, CDE, RN.


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Interview with David Gerber and The Oregon Vagabond on BlogTalkRadio by The RAYYTuesday, September 27th, 2011
View Jed Reay's interview with David Gerber at September 21, 2011 The Success Curve Show with Guest Host Editor in Chief of "The Oregon Vagabond" Newspaper David Gerber from Jed A. Reay on Vimeo.
David Gerber is the Editor in Chief of "The Oregon Vagabond" newspaper. This newpaper is dedicated to stories, news and feature articles about the life of the homeless. The plight of the homeless is growing and growing daily.
Join the conversation on September 21, 2011 and find out how David's passion to bring the stories of the street to the main stage. Join David and I as wee discuss this dificult situations.
So please join us Wednesday September 21, 2011 for some powerful, thought provoking conversation, at 7:00pm PT 10:00pm ET for another episode of "The Success Curve" on… Comcast channel 29 in Eugene and Springfield, OR.
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To say that I have been distracted is an understatement. Our Seattle Seahawks have been unbelievable and every moment since the New Year has been filled with anticipation of the big game. Yes, the SUPERBOWL....I can't believe it really happened. Our team went to the big game. I know we were there 8 years ago...but it was so different. It was a fluke...everyone was so surprised and no one felt like we should have been there. But, this time, we were good.....really good all year. With every win, we started to believe. We were THAT good. Super Bowl good.
Sure enough....and then the doubters started. The Broncos had Peyton Manning and that alone made the Seahawks the underdog. The Seahawks never faltered --- all they had to do was play their game. Ignore the chatter and all the hype. And they did that and so much more.
They smoked them...the Broncos looked like a practice team. Peyton was harmless.
Okay....now back to reality. I have some fun designs to share with you!
First off.....some fun Valentine's made with the Heart Healthy Red Bean Soup line from Jillibean Soup and some Hampton Arts products!
The best part of the Heart Healthy Red Bean Soup is that it can be used for more than just Valentine's Day! Here are a couple layouts too!
Guess what? I have more Jillibean Soup goodness for you!
This next layout and card were created with the brand new Spicy Social Soup line!
and the new Birthday Bisque Collection:


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Barth Anderson was among an early wave of new food entrepreneurs in the Seaport District when he opened Barrington Coffee Roasting Company last year, gambling that as the economy slowly improved the nascent neighborhood would eventually turn into a full-blown community with an active social scene.
But even he's surprised at the speed with which the Seaport is filling in. In the next few months, another wave of restaurants and entertainment options is scheduled to open in the Seaport District, seemingly racing the developers who are rushing to fill in the area's empty lots with office buildings and residential towers.
"In an otherwise relatively tame world of development, this area feels like it's on fire," Anderson said. "It's forging ahead against all norms."
The latest influx involves some of the biggest names in Boston's food scene, from celebrity chef Ming Tsai to veteran restaurateurs Seth Greenberg and Tom Kershaw, with options that range from neighborhood tavern, to French bistro, to gourmet grocer.
"I'm very bullish on the whole area," said Greenberg, the owner of Mistral who plans to open a French eatery in a former textile factory on Melcher Street next spring. "It has huge potential for cool restaurants, retail, and loft apartments."
After several fitful starts, building activity in the Seaport District is taking off, with blocks of office towers and hundreds of residential units under construction, or soon to be. Many of the existing eateries in the neighborhood are among the most popular in the city, with Temazcal and the other restaurants at the new Liberty Wharf complex, in particular, regularly jammed.
Next door, Kershaw, owner of Cheers, 75 Chestnut, and the Hampshire House, just opened 75 on Liberty Wharf in a 1,500-square-foot glass kiosk on Boston Harbor, where diners can sip cosmopolitans and feast on pumpkin ravioli as boats bob in the distance.
Far from a business risk, Kershaw said opening the new restaurant "seemed like a slam dunk, and I think it probably will be."
Kershaw noted that business at his Beacon Hill and Faneuil Hall restaurants is "still very flat," while activity across the Seaport is running "counter to the economy."
Developer Young Park envisioned this kind of boom back in 2004, when his company, Berkeley Investments Inc., began buying up buildings in the Fort Point area. Among his first projects was a complex on Congress Street where he developed the FP3 condos.
Park then convinced two Boston food celebrities, Barbara Lynch and Joanne Chang, to be among the first to venture new eateries in the burgeoning area.
In 2008, Lynch opened Sportello and craft cocktail bar Drink at a time when Congress Street was a lonely strip at night. Two years later she followed with deluxe French restaurant Menton. Opening with pricey plates during a slow economy was "crazy, crazy, crazy," she recalled.
Having survived that time, Lynch said she is pleased to welcome high-wattage company to the neighborhood.
"Bring it on. We need it," said Lynch.
Park, meanwhile, had held off leasing several of his other choice retail locations, turning down offers from national chains, until he found food entrepreneurs that he felt fit the tone of the emerging Seaport.
In the storefront next to Chang's Flour Bakery, Jason Owens, former co-owner of The Biltmore in Newton and Local 149 in Southie, will open a gourmet grocery next month. The Bee's Knees Supply Company will have a fishmonger, butcher, and chocolate cafe.
And at 381 Congress St., Park is preparing a 6,000-square-foot space on the ground floor of a 44-unit boutique apartment building that he promises will be "spectacular."
Park said the restaurant, set to open next fall, will be run by a celebrity chef whom he declined to identify. And around the corner at 343 Congress St., Park said, another chef is interested in a space being vacated by a lighting shop.
"We had a vision for the street. The vision is being realized. It's very satisfying," said Park.
A few blocks away from Park's building, Tsai is planning to open Blue Dragon, an Asian gastro pub, this winter in a former deli on A Street.
"I am so psyched to be coming to the neighborhood," said Tsai, who made his mark with the celebrated Blue Ginger in Wellesley.
Another addition to that area of the Seaport will be Tavern Road, a rustic-style restaurant where all the dishes will be made from scratch. Scheduled to open in the spot vacated by the Blue Wave on Congress Street, it is the first venture by Louis Dibiccari, a Boston-based chef who runs a popular "Iron Chef"-like event called Chef Louie Night.
"I feel really excited to be part of something that's new and not a stagnant neighborhood oversaturated with restaurants already," said Dibiccari.


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Significance issue bw delta & theta
Mplus Discussion
Confirmatory Factor Analysis
Dorothee Durpoix
posted on Thursday, March 19, 2009 - 6:56 pm
First, sorry, i wrongly put part of this thread by mistake in the SEM topic. I'll try again..
I was wondering what one should do when one or several estimates are significant with Delta parameterization but not significant with Theta parameterization?
I run the same CFA in delta and theta parameterization. While the model fits are good, and the delta model provides significant estimates, the theta model does not.
One of my outcome variable is very highly related to its common latent factor (corr = 0.994 in delta and 0.996 in theta!).
I think it's probably where the problem comes from in theta. But why isn't it a problem in delta modelisation?
Any input would be greatly appreciated!
Bengt O. Muthen
posted on Friday, March 20, 2009 - 11:40 am
The delta method is sometimes preferable to Theta - see Mplus Web Note #4 on our web site.
Dorothee Durpoix
posted on Saturday, March 21, 2009 - 8:19 pm
Hello again,
I was asking about this issue because ultimately I'd like to conduct measurement invariance bw 2 groups, and if possible, examining the residual variances (theta).
I find quite worrying that the two parameterizations can lead me to two different conclusions.
I have read the Mplus Web Note #4, but I have to admit why such a disparity could happen eludes me (statistics are not my strong point, i'm afraid!..).
Bengt O. Muthen
posted on Sunday, March 22, 2009 - 9:42 am
Typically, the two approaches do not give different significance results. But it is possible for this to happen in any given sample due to parameters following different sampling distributions in the two cases. It is also possible that you are not setting up the model in comparable ways in the two approaches - if you want that to be checked you can send your inputs and outputs for the two runs with data and your license number to
Dorothee Durpoix
posted on Sunday, March 22, 2009 - 10:46 pm
Hello Bengt,
Would you mind elaborating a bit more on parameters following different sampling distribution? What could trigger this to happen?
Regarding setting up the model in the two approaches, I thought that the only thing to change was adding in the 'Analysis', PARAMETERIZATION = THETA;
Am i wrong?
Thanks again for your explanations!
Bengt O. Muthen
posted on Monday, March 23, 2009 - 8:25 am
Your first paragraph questions go back to general statistical inference. For instance, the sample mean and sample variance have different sampling distributions (normal and chi-square) - approaching significance happens at different sample sizes for those parameters.
Regarding your second paragraph, the answer depends on the model; how you specify the residual variances versus the scale factors. We would have to see your run to say - so this is a support question.
Eric Teman
posted on Friday, May 25, 2012 - 6:23 pm
When WLSMV is used with theta parameterization for a three-factor CFA, for instance, it won't actually output residual variances, right? It isn't for me, anyway.
Linda K. Muthen
posted on Friday, May 25, 2012 - 6:54 pm
You can estimate residual variances only in multiple group or multiple time points models not cross-sectional models.
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Photoshop is the world's most popular photo-editing program. Artists, photographers, designers, and hobbyists all rely on Adobe Photoshop for image creation and editing. Discover the fastest and most effective ways to use Photoshop from an expert and former columnist for Photoshop User magazine (who has twice been nominated for the Photoshop Hall of Fame).
You'll learn how to use Photoshop while accessing it from the Creative Cloud (CC). The course provides detailed, step-by-step instructions that you'll have no trouble following—even if you've never used a computer graphics program before! And you'll have a lot of fun doing it.
Photoshop CC has a host of impressive new features for photographers, and you'll encounter a number of them. We'll begin with an introduction to the Photoshop environment. Next, you'll learn how to create simple digital paintings (including some brushes that let you create the look of an oil painting from a photo).
Then you'll be editing your own photographs to get rid of dust and scratches, fix the color, and correct image exposure. You'll master techniques for switching the backgrounds on images and removing wrinkles and blemishes from photos, just like they do in magazines. You'll also learn about the content-aware Move tools in CC that, like magic, let you move something on an image and intelligently replace the "hole" left behind at the same time.
By the time you finish this fun, hands-on, project-oriented course, you'll be well on your way to expressing yourself with the most exciting graphics program ever developed.
Sherry London is a noted Photoshop and Illustrator expert, an artist, a writer, and a teacher. Her fiber art has been featured in magazines and exhibitions. Her published works include Photoshop CS2 Gone Wild, Photoshop Magic, Photoshop Effects Magic, Photoshop In Depth, Photoshop Textures Magic, and Illustrator f/x and Design. She wrote the Tips and Tricks column for Photoshop User magazine for many years and is a two-time nominee to the Photoshop Hall of Fame. She has taught for the prestigious Thunder Lizard Photoshop Conference and the Professional Photographers of America seminars, as well as for Drexel University, Moore College of Art, and Gloucester County College. Sherry holds a Master's Degree in Information Systems and has taken doctoral-level courses in curriculum design.
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Vaccinations and HIV
May 23, 2014
What Are Vaccinations?
Vaccinations, or immunizations, are treatments that build up your body's defenses against certain infections. It can take a few weeks for your immune system to respond after a vaccination. Vaccines are usually very safe.
Most vaccines are used to prevent infections. However, others help your body fight an infection that you already have. These are called "therapeutic vaccines." See Fact Sheet 480 for more information on therapeutic vaccines and HIV.
"Live" vaccines use a weakened form of the germ. "Inactivated" vaccines don't use a living germ.
Vaccines can have side effects. With live vaccines, you might get a mild case of the disease. With inactivated vaccines, you could have pain, redness, and swelling where you got the shot. You might also briefly feel weakness, fatigue, or nausea.
What's Different for People With HIV?
If HIV has damaged the immune system, it might not respond as well to a vaccine, or for the same length of time. If you will soon start antiretroviral therapy (see Fact Sheet 403) you may respond better if you wait until your CD4 count (see Fact Sheet 124) increases.
There has not been much research on vaccines and people with HIV, especially since people started using combinations of antiretroviral drugs (ARVs). However, there are a few key guidelines for people with HIV:
Which Vaccinations Are Recommended?
HIV-Positive Travelers
Travelers with HIV should consider vaccination against hepatitis A and B.
Countries have different vaccination requirements for entry. In general, inactivated vaccines should not be a problem for travelers with HIV. However, they should avoid live vaccines, including yellow fever (see above) and smallpox. If polio or typhoid vaccines are required, they should be the inactivated versions, not the live versions.
Instead of getting a live vaccine, people with HIV should get a health care provider's letter explaining that they have a medical reason not to be vaccinated. This is accepted by most countries.
This article was provided by AIDS InfoNet. Visit AIDS InfoNet's website to find out more about their activities and publications.


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To discover why members quit your gym, you must first find out what keeps them coming back to your health club week after week. Often, people don't leave because of anything to do with your club but because they are not seeing results or are not psychologically prepared to commit to new habits.
"If people make behavioral changes without changing their internal values, beliefs and attitudes, the new behaviors are less likely to stick when the external supports disappear," says Dr. Lawrence W. Green, University of Texas Health Science Center.
To get results, people need to exercise regularly, and that means they need to form an exercise habit. Habits are truly our driving force in all areas of our life, and creating a habit is what keeps someone who is seeing results coming back to your club.
To ensure that your members form the habit of coming to your club regularly, address some key areas with them that will help them succeed.
Preparation. How prepared are they to start the habit of exercising? Do they have easy access to your club? Do they have workout gear they are comfortable wearing? Do they have child care if they need it, so they can come regularly to your club?
Goals. What are their short-term goals for the next 90 days or so? Do they have a motivating goal that acts as their purpose for coming to your club? Are these goals measured and realistic? Are they written down and assessable so they will stay top of mind?
Accountability/support. Do they have someone pushing them to go to the gym regularly? Who's monitoring them if they skip a few workouts? Do they have the support of friends and family as they work toward their goals?
Plan of action and repetition. Do they have a clear plan of action that ties with their goals? Are the steps broken into manageable actions so they can form a habit around them? Are the actions easy or complicated? How can they successfully repeat the habit many times early on?
Plan ahead. What obstacles could pop up that could hinder their progress (such as personal or family illness, work stress)? What is the backup plan for when these obstacles appear? What measures need to be in place to ensure regular workouts in spite of these obstacles?
Control environment. Does their home environment support their goals? Do their food cupboards need a good cleaning out? Do they need to shop for healthier foods? Do they have a gym bag ready to grab so they can get to the health club regularly? Do they have friends who might inadvertently try to sabotage their progress?
Small steps/early wins. What steps can they start with to get the ball rolling? What is the earliest measurable "win" they could achieve by going to the gym regularly? By focusing on this small win, they can build momentum and motivation.
Keep going. What happens after they lose weight? What are their new goals to keep them motivated? What's the new plan of action so they don't get bored or complacent and stop coming to the gym?
Rewards. What small rewards can they use as motivation to reach certain milestones? Using rewards will help them push through the hard patches.
This list of questions may seem mammoth, but you need to help your members address these so they can form the right habits. If they get results by coming to your facility and forming the habit of exercise, then you win by creating a loyal member.
If you implement some new systems and strategies in your club to address these issues, you will get great feedback from members as they form the important habit of working out regularly at your club and getting fantastic results, which they will be happy to rave about to others.
Nalisha Patel is an industry specialist in psychology and persuasion strategies designed to increase member retention rates and boost profits for clubs. Test drive an online member retention system (which addresses the questions above) by downloading the free white paper, "Seven Wickedly Effective Ways to Get and Keep Members."


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Agilent Technologies Inc. announced that Universal Scientific Industrial Co. Ltd. (USI) will use Agilent's WiMAX™ manufacturing networking test set for its Mobile WiMAX test needs. The company chose Agilent because of its ability to deliver fast measurement time for USI's Mobile WiMAX module test plan requirements. USI is a leader in the design and manufacturing services (DMS) industry that focuses on product development and capability enhancement.
"We chose Agilent equipment because it delivers greater accuracy, repeatability and the faster test speeds required for our Mobile WiMAX test needs," said Albert Liu, USI vice president and general manager of Wireless Product Business Unit. "Additionally, we experienced great support and quick response to our business requirements."
The Agilent N8300A WiMAX manufacturing networking test set leverages Agilent's experience and success in the WiMAX and WLAN manufacturing market. Manufacturing engineers are constantly faced with time-to-market pressures, while protecting profit potential and ensuring the shortest possible test times. Testing high volumes of Mobile WiMAX devices requires a standard-compliant 802.16e-2005 physical layer test tool. Agilent's N8300A one-box parametric WiMAX test set addresses these challenges.
USI also purchased the Agilent N4010A, a versatile multiformat wireless connectivity test solution that can configure Bluetooth®, ZigBee, WLAN 802.11a,b,g and 802.11n MIMO applications in R&D, integration and verification, or manufacturing. The N4010A offers the flexibility to measure the latest emerging wireless standards and increase test efficiency.
"Agilent's leadership in Mobile WiMAX manufacturing test solutions is demonstrated in this significant success with USI," said C.J. Meurell, European operations general manager for Agilent's Mobile Broadband Division's WiMAX /WLAN portfolio. "We are committed to meeting USI's critical performance needs, that's why we are continually updating our products and support to keep pace with the demanding manufacturing requirements for the deployment of WiMAX."


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Our Dedicated Servers are configured exactly like the DV or DV Developer, except each one hosts only one customer. Each Dedicated Server is a single-tenant box with 128GB of RAM, and all resources on the box are allocated to you. If you need a high performance server with total resource allocation, Dedicated is the solution.
All three are single-tenant services hosted on identical powerful, reliable, high-performance hardware. There are three essential differences: Operating systems, control panels, and CloudTech server administration.
Customers using a DV Dedicated or DV Developer Dedicated solution should have an overall competency in IT and server administration, or have someone to handle this internally.
For customers who want the resources of a Dedicated Server but don't want to handle server administration internally, we now offer Fully Managed Dedicated. It has all the same features as the DV Dedicated server, and also includes our award-winning CloudTech server administration services .
(mt) Media Temple will provide customers with a 7-day money back guarantee on a Dedicated Server.
Our Sales Team can explain the differences and help you decide which solution is best for your needs.
If you are currently on a Media Temple VPS server (either DV or DV Developer), then you can easily scale up to dedicated server via the Account Center. It's easy and completely automated. Likewise, if you need to scale down for awhile, you can make that happen instantly via the Account Center.
Yes. They are available by default, just like on our older DV servers.
Yes, you are more than welcome to migrate to a DV Developer server. However, we currently do not offer migration tools. You will be responsible for migrating your content, including email and databases.
For information on how to change your OS, please see the Community.
Yes, that would be our Developer Dedicated plan. It gives you the additional flexibility of choosing an operating system: Ubuntu, Debian, Fedora, or CentOS. If you are not sure which plan will work best for you, our Sales Team can help you decide.
The Dedicated Server is a 64-bit environment.
Yes. You can use iptables on the container, or use the Power Panel to configure iptables. If you have DV Dedicated, you can also use the Firewall module in Plesk or Security Policies in cPanel®
Absolutely. Although (mt) Media Temple cannot assist in the installation of third-party applications, you are free to install and use whatever software you wish.
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Currently, the lowest wage earned by some city of Meridian employees is $7.25 an hour, which is also the federal minimum wage. Mayor Percy Bland is calling for that to change. As part of his budget proposal, Bland says that he will request a $9 an hour minimum salary for all city employees.
"We can't talk about recruiting and retaining quality people if we don't properly pay them. Of course, I'm not going throughout every department saying that everyone is getting a pay increase. That's not what we're doing. We have got to start somewhere."
Bland calls his $9 an hour minimum salary for all city employees a 'livable wage,' that will be funded by money that's saved from cuts that are made.
"We have a lot of contracts on the books that I think that we can save some money for, and I also think that we've had some contracts in the past that we may not need that we can handle in house. We have a lot of fat in city government in places that I think that we don't need it, and we're going to find the money to do right by those city employees."
To pay for the livable wage Mayor Bland says some vacant city jobs will also likely not be filled. If approved by the city council, he says the $9 an hour minimum salary for city workers will take affect when the new fiscal year starts October 1st.
There are currently 611 city employees in Meridian. Of those, 456 are full-time and 155 are part-time. That number changes regularly according to seasonal demands.


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Costco Joins Parade of Pre-Fiscal Cliff Special Dividends
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This just in: companies are issuing lots of special dividends ahead of the possible tax hikes accompanying the year-end fiscal cliff, in an effort to maximize the value they're returning to shareholders.
Well, this isn't exactly completely new, but it's getting a lot of attention this week. The Wall Street Journal wrote a story about this trend on Monday, and the Financial Times follows with its own front-page story today about how such dividends have hit record levels (and this blog foretold this trend in September and flagged likely issuers three weeks ago). This morning, Costco Wholesale (COST) announced a $7.00 per share special cash dividend, payable Dec. 18 to shareholders as of Dec. 10, which adds up to an aggregate $3.0 billion payout.
"Today's announcement of a $7.00 special dividend, to be paid before the end of the calendar year, is our latest effort in returning capital to our shareholders while maintaining our conservative capital structure," said Richard Galanti, Costco CFO, in a statement.
But if you scratch the surface, there's something beyond simple corporate beneficence at work here. These dividends are likeliest when management also owns a big chunk of company stock. Such was the case when casino operator Las Vegas Sands (LVS) issued a special dividend on Monday and retailer Dillards Inc. (DDS) did the same. Dana Mattioli explores the issue on wsj.com's Corporate Intelligence blog:
Executives are making a big deal about being generous to shareholders when paying special dividends ahead of the year-end fiscal cliff. But in many cases they're also being generous to themselves.
Companies run by big shareholders are more likely to pay special dividends aimed at avoiding tax hikes, market data provider Markit concludes. The firm developed the theory after reviewing dividend payouts in 2010 (ahead of expected tax increases that never came). It helds true in the spate of special dividend announcements this year. Markit found that the average insider holding of the companies that have announced such dividends was 28%.
This is happening with regular dividends too. Last week Wal-Mart (WMT) declared an early dividend, and here's how Nathaniel Popper described it in the New York Times:
The Walton family, which founded Wal-Mart, could save as much as $180 million in federal income taxes after the huge retailer announced Monday that it would pay out its quarterly dividend on Dec. 27 instead of Jan. 2, as was scheduled.
The change will allow the family and other Wal-Mart shareholders to record the income this year, when the federal tax rate on dividends tops out at 15 percent. Next year, if the Obama administration and Republicans are unable to reach a compromise, that rate is set to jump sharply to 39.6 percent. High earners will have to pay an additional 3.8 percent on most investment income to help pay for the newfederal health care law, bringing the total possible tax bite to 43.4 percent.


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Top articles
Beer market of Kazakhstan acquired both traits of East European countries and South Eastern Asia taking a transitional position between them by many criteria and consumption style. Yet there is a positive trend in beer production which differs Kazakhstan from most of the neighboring countries. The market has remained consolidated in the hands of two international players because of its small size. However, it faces dynamic processes such as fast growth of draft beer sales, up and downs of regional companies and Carlsberg Group's ultimate expansion. Excessive mainstream segment has declined over the recent years, yet, Zhigulevskoe and national brands with regional links have yielded their positions to a range of new products. In our review special attention was paid to regional analysis of the markets. In 14 regions of Kazakhstan we compared the companies' positions, the market price segmentation and DIOT channel development. Besides we have compared the beer market of Kazakhstan to neighboring countries. ...
Beer market of Russia 2018
- General market picture
- Foreign trade setting records
- Import
- Export
- Demography as challenge to branding
- Aged consumer
- Declining of youth brands
- Nostalgia on trend
- DIOT feels at home
- 5.0 Original is the new face of import
- Positions of Market Leaders
- Carlsberg Group
- AB InBev Efes
- Efes
- AB InBev
- Heineken
Ukrainian beer market 2018
- Better than yesterday
- Performance by value
- Positions of Ukrainian brewers
The beer market dynamics in Russia is approaching zero, yet major brewers are divided into those who developed considerably in 2017 and those who considerably reduced their volumes. For instance, company Efes has managed to substantially extend their sales due to restrained pricing policy and activity in the modern trade. Heineken has also demonstrated an excellent performance promoted by significant increase of advertisement budgets launching a non-alcohol sort of the title brand and unusual activity in the economy market segment. Carlsberg and AB InBev have been focusing on margins and lost a market share of their inexpensive brands. Serious dependence on PET package and mass enthusiasm about Zhigulevskoe have negatively impacted the most of big regional brewers, that have been for the first time pressed by the leaders in the key sales channels, especially in Volga and Central regions. In the small business there has been a noticeable slowdown in appearing of new restaurant breweries, yet the number of craft breweries has been growing rapidly. In 2018, the beer market is likely to grow a little, while the share of AB InBev Efes may decrease due to the integration. ...
SABMiller expands in Nigeria to take on Heineken
Africa's biggest brewer said on Tuesday it will build its new brewery on a greenfield site at Onitsha in southeast Nigeria, to expand its presence in the country after buying small beermaker Pabod Breweries Ltd in 2009.
Nigeria's annual beer market of around 18 million hectolitres is second only to South Africa on the continent and is dominated by Heineken, with around a 70 percent market share, and Diageo's Guinness business with over 20 percent, leaving SABMiller a share of less than 5 percent.
The fast-growing Nigerian beer market has grown at an annual rate of 9 percent in the last 10 years and Heineken acquired controlling interests in five breweries in January to expand its capacity there by nearly a third .
The SABMiller new brewery will produce local brands Grand Lager and Eagle and also Castle Milk Stout and will have an annual capacity of around 500,000 hectolitre of beer and malt beverages, and be able to bottle water and other beverages.
SABMiller Africa - which is 62 percent owned by SABMiller and the rest by privately owned drinks group Castel - will own 80 percent of the new business with the Anambra state government and other Nigerian investors holding up to 20 percent.
2 Мар. 2011


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The Practicing Mind:
Developing Focus and Discipline in Your Life
Thomas Sterner
Creating the Habits We Desire*
Excerpt from The Practicing Mind
now, you should notice -- or, shall we say, you should be
of -- several themes running through this book. One of these themes is awareness
itself. You cannot change what you are unaware of. This truth is nowhere more
important than in the world of self-improvement. We need to be more aware of
what we are doing, what we are thinking, and what we are intending to accomplish
in order to gain control of what we experience in life.
in fact, for most of us, this is a problem because we are so disconnected from
our thoughts. We just
them. The horses are running, and we don't have the reins. We need to become an
observer of our thoughts and actions, like an instructor watching a student
performing a task. The instructor is not judgmental or emotional. The instructor
knows just what he or she wants the student to produce. The teacher observes the
student's actions, and when the student does something that is moving in the
wrong direction, the instructor gently brings it to the student's attention and
pulls the student back onto the proper path. A good instructor does not get
emotional in response to the student moving off the path. That kind of negative
emotion comes from expectations, and that is not the perspective we want to have
if we are to be our own instructor. Expectations are tied to a result or
product, to the thought that "things should be
way right now, and until then I won't be happy." When you experience these kinds
of emotions, they are indicators that you've fallen out of the process, or out
of the present moment.
when we were throwing tennis balls into a trash can, we should observe what
happens, process the information without emotion, and then move on. This is how
we should deal with ourselves as we work at learning something new, or when
we're changing something about ourselves that we don't like. This includes
working on something more abstract, too, such as becoming more
or conscious of what we are thinking, becoming more of an observer of ourselves.
This disconnection from our thoughts and actions is a way of thinking that we
have learned during our lives, and one that takes away all our real power. We
must unlearn this approach to life. What we are really talking about here is a
habit. Everything we do is a habit, in one form or another. How we think, how we
talk, how we react to criticism, which type of snack we instinctively reach for:
all are habits. Even when faced with a circumstance for the first time, we
respond to it from habit. Whether we observe our thoughts or they just happen in
our minds is determined by habits we have learned. We may consider some habits
good, others not so good, but all habits can be replaced at will, if you
understand how they are formed.
Habits and practice are very interrelated. What we practice will become a habit.
This is a very important point because it underscores the value of being in
control of our practicing minds. Our minds are going to practice certain
behaviors whether or not we are aware of them, and whatever we practice is going
to become habit. Knowing this can work in our favor. If we understand how we
form habits, and if we become aware of which habits we are forming, we can begin
to free ourselves by intentionally creating the habits we want instead of
becoming victims of the habits we unknowingly allow to become a part of our
behavior. We can gain control of who we are and what we become in life. But what
are the mechanics that create a habit? Knowing this would be quite valuable.
Fortunately for us, we don't have to figure this out, because others have
already done it for us.
The formation of habits has been studied extensively by behavioral scientists
and sports psychologists alike. Understanding how desirable habits are created
and undesirable habits are replaced is invaluable, particularly in
repetitive-motion sports such as golf or diving. In fact, you often see golfers
practicing certain parts of their swings over and over again, or divers standing
poolside, going through the motions of complex dives they are about to execute.
They are practicing and habitualizing their particular moves. What does that
mean? To me, when we say that something is a habit, it means that it is the
natural way we do something. We do it intuitively, without having to think about
it. The martial arts student practices the moves over and over again,
habitualizing responses until they become effortless, intuitive, and lightning
fast. There is no intellectual process that has to occur in a time of crisis
where the brain is saying, "My opponent is doing this, so I must do that." The
responses just happen because they are a natural part of the student's behavior.
That is what we are after. We want something like being more aware of our
thoughts to be just a natural behavior, not something that requires a lot of
Getting to this point is not complicated. It does take some effort, but the
effort is minimal once we understand the process. What is required is that you
are aware of what you want to achieve, that you know the motions you must
intentionally repeat to accomplish the goal, and that you execute your actions
without emotions or judgments; just stay on course. You should do this in the
comfort of knowing that intentionally repeating something over a short course of
time will create a new habit or replace an old one.
*Excerpted from the book The Practicing
Mind: Developing Focus and Discipline in Your Life
Copyright C 2012 by Thomas Sterner. Printed with permission from New
World Library.
order The Practicing Mind from Amazon.com, click here!
Thomas M. Sterner
is the author of Practicing Mind:
Developing Focus and Discipline in Your Life. He's also a trained jazz
pianist and an avid pilot, student of archery, and golfer. He teaches his
techniques to businesspeople, at sports clinics, and to learners of all kinds.
He lives in Wilmington, Delaware. Visit him online at


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