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You are here: Home / Four Certainties / Imbalanced Population Growth
In 2020, there will be more of us and at the same time more of us will live in cities. More of us will be older and where there are increasing populations of children, they will largely be in countries least able to support them. The next decade is certainly one that can be characterised by more imbalanced population growth.
Over the next ten years, improvements in health, education and living standards will continue to drive population growth. Longer life expectancy will offset the trend towards having fewer children, which means that by 2020 there will be more of us and more of us will be older. Regional differences in growth rates will result in a larger proportion of people living in Asia. In addition, continued migration from rural areas means that a greater number of us will live in cities than ever before.
This suggests that, as long as there are no disasters on a huge scale – natural or man-made – over the next decade, demographic changes are much more certain than many other long-term predictions. The macro-trends are clear: the human population has grown massively over the past century or so. All things being equal, this growth trend looks set to continue.
It's easy to suggest that there are just too many of us around these days and that this has put unsustainable pressure on the resources available, but this is not strictly true. The questions that matter are not only around general growth but also around balance. Are people in the right places? Do we have the right skills? Can we reduce child mortality in emerging economies? Do we have enough people of working age to support economic growth? As the population ages, are there enough people to support the old? How can we close the gap between the 'haves' and 'have-nots'? These are all important questions that we need to address in order to understand the primary implications for the world in 2020.
To start with, let's take a closer look at the overall population numbers. We crossed the 1 billion mark in the mid-nineteenth century to reach 1.6 billion at the start of the twentieth century. We hit 2.3 billion at the end of the Second World War and from then on the global population has been increasing at around 75 million per annum. By 2008, we totalled 6.7 billion and now, in 2010, we are approaching 7 billion, with China accounting for over 1.3 billion and India for over 1.1 billion. This means that by 2020 there will be around 7.7 billion people living on Earth. Most likely we will be split between around 1.4 billion in each of China and India, 515 million in Europe and 335 million in the US. In the absence of major pandemics, global natural disasters or multi-regional wars, organisations such as the UN and OECD estimate that the world population will reach around 9 billion people in 2050 and peak at around 9.2 billion in 2075. Taken at this level, an extra 750 million of us in the next decade and an extra 2 billion in the next forty years inevitably means a more crowded world with ever more of us competing for the same resources.
On top of this, child mortality rates are declining and more of us are living longer. Today, our average life expectancy across the globe is 68 at birth. Of course this varies from region to region, with North Americans boasting 79 years as opposed to an average of 54 in Africa. But, wherever you are, expect to be here at least ten years longer than your parents. Looking forward, our children can expect to live on average to celebrate 97 years, and from 2030 onwards it will not be surprising if life expectancy reaches 106. What is clear is that if, as predicted, the proportion of the world population aged 65 years or older increases by a third and the average number of people who live for more than a century increases ninefold, the concept of 'old age' will have to be redefined. In many developed economies, 55 is already the new middle age and we can clearly see a future where what used to be the average age of retirement becomes the mid-point of the average adult life.
This has huge social and economic implications and is certainly bad news for those who, having worked for the traditional forty years, were looking forward to a long and happy retirement. Pension providers will have to re-evaluate their business model. In relatively recent times, people who retired at 65 did so, on average, only a few years short of their life expectancy. If the current threshold stays in place, our children can reasonably expect to live in 'retirement' for an additional 32 years. It's a pity that their pension funds are unlikely to be able to pay for this: most pensions have been designed to accommodate an upper quartile life expectancy where retirement age is 'death minus ten'. It looks like there is no alternative – we will all have to work longer than our parents.
On the other side of the coin, an overall increase in the working population could also result in increasing numbers of people finding themselves unable to find a job as the decade progresses, the global recession bites, and economies adapt to changing technologies, resource constraints and different methods of working. This has the potential to lead to a sense of frustration and exclusion amongst those who are unable to find work, which in turn will have significant political and social ramifications, particularly in the more vulnerable economies – probably in Europe and the West.
Overall, while the macro-trend around global population increase is clear, three factors shape the balance of the growth both in terms of scale and location. They each have influence and are shifting future projections. These three factors are:
• changing fertility rates and decreasing child mortality
• people living longer
• migration
We are currently experiencing an extraordinary fertility decline. The fertility rate represents the number of children an average woman is likely to have during her childbearing years (15–49). Taking typical averages into account, the natural replacement rate by which a population stays level is 2.1 children per woman. So, a rate of below 2.1 is the point at which population growth begins to slow or even fall. Globally we will reach that point by around 2020 for the first time. Small wonder, therefore, that fertility has become a primary focus for local political parties and national governments as well as transnational and global agencies.
It's worth remembering that a decline in fertility does not mean a decline in population, which can continue to rise while fertility goes down. For example, high fertility in an earlier generation can lead to an increased number of women of childbearing age all having fewer children but together increasing the overall number of children. This is why the UN and OECD see a peak population accruing around 30 years after we reach the natural replacement rate in 2020
There are several reasons for the decline in overall fertility. There is, for example, clear evidence to suggest that as we get richer we want smaller families. This trend was first noticed in nineteenth-century industrialised Britain and is fairly well established. As poor countries now race to catch up and more of us are becoming richer, the global population looks set for a relatively speedy decline – so much so, in fact, that the transition in fertility rate from five children to two, which took place over 130 years in Britain (1800–1930), happened in just twenty years (1965–85) in South Korea. In Bangladesh the fertility rate dropped from five to three in twenty years (1980–2000) and in Mauritius it took ten (1963–73). Some countries are experiencing an even more dramatic change. Take Iran, for example, where the national fertility rate dropped from 7.0 in 1984 to 1.9 in 2006 and in Tehran it has now dropped to a mere 1.5.
Such declines in fertility at one level have a lot to do with the movement of people from the countryside to the towns and cities: tilling the land is generally labour intensive and an extra pair of hands to help is welcome but it's a different matter altogether in the restricted space of the city where the cost of feeding and housing a larger family is often prohibitive. It's a simple matter of economics and living standards. Generally speaking, fertility starts to drop when the annual income per person is $1,000–2,000 and falls until it reaches the replacement level at $4,000–10,000. Poorer agricultural regions often have higher fertility rates so it's not surprising that although India's average fertility rate in 2010 was 2.68, it's poorest state, Bihar, had a fertility rate of 4.0 while its richest, such as Andhra Pradesh, Goa and Tamil Nadu, have rates of only 1.8.
Fertility is also falling because more women are better educated and are therefore more likely to go out to work and demand contraception and less likely to want large families. The impact of female education on fertility is perhaps most evident in Iran where in 1976 only 10% of rural women aged between 20 and 24 were literate. That share is now 91%. As more women become literate, so their economic roles and societal views change, and the desire for fewer children increases. In addition, the widespread availability and use of contraception has also played a fundamental role in changing fertility trends. Family planning has helped many people reduce the number of children they have – and research even suggests that fertility in some counties would be even lower if family planning services were more widely available. The impact of female education and use of contraception in controlling population growth highlights why both issues are so high on the agendas of the likes of the UN and several major NGOs as well as many national governments.
Over the next ten years we can expect to see further declines in fertility to a point where nearly all major economies are below the replacement level of 2.1 children per woman. German fertility dipped below replacement in 1970 and is still low. In the likes of France, Korea and Russia, a host of incentive programmes are already underway to encourage families to grow. This is driving some change – take France, for example, where the fertility rate is now 1.98 children per woman after having been as low as 1.7 in the mid-1990s. The US seems to have been most successful in encouraging its population to grow – it is the only rich country that, having fallen below the replacement rate, has risen back above it.
In general, it is in many developing countries where the more stable fertility rates will continue to be found over the next decade, and so where the rates of population growth will be highest. Some countries, particularly those with little or no infrastructure because of war or low living standards, will continue to have high fertility rates – think of Malawi, Uganda, Angola, Chad, Mali and Sierra Leone, which are currently running at over 6.0. Associated population growth rates for these countries range from 2.5% to 3.3%. This means that around 250 million people will be added to the African population over the next decade – over twice the rates in Asia and South America. Compare this with projections for Europe, which are largely flat, and North America, where the population growth is expected to be around 8% over the decade. To put it another way, one-third of the net global population growth between today and 2020 will take place in Africa.
The main problem with all of this is that because fertility rates decline as standards of living rise, it would seem clear that the majority of the world's population growth will occur in the nations least able to sustain it. Furthermore, as fertility falls it changes the structure of the population by increasing the size of the workforce relative to the number of children and old people. More women can work and, because there are fewer dependants, they have more money to spend. That said, consider how quickly fertility rates in some high-population developing economies such as India and Indonesia are falling and how low they are going. This could lead to change that will shift the world's long-term population growth in a more sustainable direction.
The flip side of the influence of fertility on population growth is that of infant mortality – which is essentially measured by the number of infant deaths per 1,000 births. With advances in public health and wider availability of medical support, some of the primary causes of infant mortality have been significantly controlled over recent years. During the past half century, average infant mortality has been cut from 116 to 47 and, based on the UN constant fertility scenario, is expected to fall to around 40 by 2020 and 30 by 2050. However, the story varies significantly from region to region.
In Western Europe, infant mortality is already down to four deaths per 1,000, but in Latin America and China it is currently at 22, and in many parts of Central Africa it is not expected to drop much below 100 over the next decade. Essentially this means that a child born in a developing country is over thirteen times more likely to die within the first five years of life than a child born in an industrialised country. Although reducing child mortality by two-thirds from 1990 to 2015 is one of the UN's Millennium Development Goals, it looks highly unlikely that it will be achieved.
On a positive note, there is rising investment from global agencies and philanthropic ventures, like the Gates Foundation, which are working hard to reduce the incidence of the leading causes of childhood deaths, such as measles, malaria or diarrhoea, which are the scourge of the young and vulnerable. However, success is patchy: mortality rates are higher for children from rural and poor families and whose mothers lack a basic education.
By 2020, the overall impact of reducing infant mortality on the global population may not, in isolation, be significant but, combined with the possibility of decreasing fertility rates in the regions of continued high child mortality, such as found in Central Africa, some have argued that we could see a reduction in the rate of local population growth combined with a decrease in child mortality that will help improve the quality of life of millions.
Taken together, declining fertility and infant mortality rates have great potential to slow, if not immediately halt, population growth in some important regions. While getting the world as a whole to below the natural replenishment rate looks probable in the next decade or so, the big challenge is really in the areas where this is taking place slowly if at all. For all the obvious reasons relating to sustainability, food availability and economic growth, Africa is always high on the agenda of many organisations when the topic of imbalanced population growth is discussed, but other countries with high fertility rates, such as Pakistan, should not be ignored.
Of course, reductions in fertility and increases in the life expectancy of children are not going to solve the problem of there being too many people on the planet. It really is a question of balance. Extremes at the other end of the spectrum are already significant cause for concern.
In most major economies of the world, the population is getting older. The percentage of the population over 65 has been rising steadily in all OECD countries and today 7.7% of the world's population is over 65. By 2020, this figure will be 9.4%. At the moment, the developed world is at the forefront of this demographic revolution; by 2050, UN statistics suggest that pensioners in the 'rich world' will comprise one-third of the population and one-tenth will be over 80. But emerging economies are not far behind (take Mexico, for example: in 1980 the average Mexican was 17 years old; today, he is 28). Many governments now have to contemplate the prospect of slowing growth and low productivity, rising public spending – particularly on healthcare – and labour shortages.
From an economic perspective, this mass ageing is already producing significant pressure and, going forward, many see it as a time bomb for healthcare, pensions, taxation and wider social dynamics. The key measure for this is the dependency ratio – the portion of population which is inactive in relation to the total labour force. This is equal to the number of citizens aged below 15 or above 64 divided by the number of individuals aged 15 to 64, and so is expressed as a percentage. The higher the figure, the greater the economic burden on the state and hence the labour force. By 2020, the dependency ratio is expected to be above 50% in Finland, Italy and Japan. So, for every elderly inactive person there will be less than two people in the labour force – they are the people paying the taxes to support the elderly. By 2050, most of the world will have reached this point and, in the likes of Spain, Italy, Japan and Korea, where the dependency ratios will have passed the 90% mark, there will be nearly one pensioner for every worker. Whereas some economies, such as the Nordics, are used to high taxation in order to provide high levels of social support, in most countries where low taxation has been a key political foundation in the past there will need to be significant changes in opinion in order to cope with higher dependency. Today's smaller families will find it harder to care for elderly relatives and public healthcare and pensions will have to adapt. This is bad news when many global economies are still having to cope with financial crises and existing debt.
Living longer is, of course, a cause for much celebration rather than despair, particularly as we are also living better. The active elderly are out and about and doing many of the things that governments would otherwise have to take care of: for instance, voluntary work and family duties such as looking after grandchildren. Such unpaid work is difficult to measure but it certainly makes a positive difference to government finances. In addition, people are staying healthier for longer so the 'compression of morbidity', the period of ill health that precedes death, has got shorter – mainly because we are living more healthily and have access to better healthcare services. However, there is no getting away from the fact that, at some time or other, the elderly do need more looking after than young people, mainly because they tend to suffer from long-term, chronic conditions that are, unfortunately, expensive to treat (eg, diabetes, high blood pressure and heart conditions).
Most pensions currently operate on a pay-as-you-go principle, whereby today's workers pay for today's pensioners. They are based on the understanding that tomorrow's workers will do the same for them when their time comes. However, given the increasing number of pensioners dependent on a decreasing number of workers, the pension pot in many economies is beginning to look rather empty and the possibility of filling it challenging. Unpopular decisions will have to be made regarding the system – including raising the age of retirement and increasing the amount we contribute.
Many agree that getting people to work for a few more years would solve a lot of the problems associated with ageing populations. Given the impacts of the recent global financial crisis, many governments are already planning increases in the retirement age; an average of 70 by 2020 is considered highly likely by many in the EU. By carrying on working either full or part time, people will not only save government expenditure by not drawing a pension but they will also feed the public purse by continuing to pay taxes and social security contributions; so, from a government perspective, those extra years are doubly valuable. Those who today are in their early sixties and getting ready to become pensioners may, of course, not see things the same way.
Add an increasingly ageing (and arguably economically non-productive) population on top of the decreasing number of young people in many countries and it is easy to see why concern about the dependency ratio is such a major concern for many government agendas. Even without overall growth in numbers, the fundamental age imbalance of the population within countries such as Japan, Germany and Italy is already provoking political actions. Looking ahead to 2020, as this imbalance increases, the desire for companies to remain economically competitive is driving further changes in attitudes and priorities for population growth.
The impact of migrant workers on the labour force is beginning to be apparent to all. Despite the current global recession, many countries, especially those in Europe, are heading for a period of labour shortages. As far back as 2007, a study by the Institute for the German Economy in Cologne identified a shortage of about 70,000 engineers, which was 50% up on the previous year. The obvious place to look to fill such gaps is among well-qualified older people, and indeed the Institute found that companies had stepped up their recruitment of engineers over 50.
However, in the absence of sufficient local workers, immigrants have been filling the gaps in numerous countries. Immigration in the developed world is the highest it has ever been, and it is making a useful difference. In many areas of still-fertile America, it currently accounts for about 40% of total population growth.
On the face of it, immigration seems like a good idea that benefits everyone. Many developing countries have lots of young people in need of jobs; many rich countries need workers to boost tax revenues and maintain economic growth. But, over the next few decades, labour forces in developed countries are set to shrink so much that inflows of immigrants would have to increase enormously to compensate – to at least twice their current size in Western Europe's most youthful countries, and three times in the older ones. This has cultural and political implications, with public opinion polls clearly showing that people in most rich countries already think that immigration is too high.
The migration issue does cause a lot of agitation but the truth is not as alarming as some would suggest. Today, there are over 213 million international migrants, which is equivalent to 3.1% of the world population. Of these, 15 million are classified by the UN as refugees, so just under 200 million can be seen as economic migrants. Each year, 2.7 million people are moving from the developing to the developed world: 1.3 million into European countries and 1.2 million into North American countries. Most of this international migration, however, is occurring within regions, albeit from one country to another. Within Europe, the free flow of economic migrants from East to West and back again has been a visible social and political issue for the past decade. In 2010, in Asia, net annual migration out of China was around 346,000, from India 200,000 and from the Philippines around 160,000.
Although a real and tangible challenge for many border authorities in the West and an emotional and political issue for many receiving countries – especially the US – taken as a whole, when compared with natural rising populations, international migration is not a major driver of population growth.
What is globally more significant than cross-border migration is the continued shift from rural to urban environments: 2006 was notably the year when, on average, more of us lived in cities than in rural areas. Over the past decade, the shift of people into China's cities has been cited as the largest peacetime movement of population in history. By 2050, 75% of us will be living in cities.
The speed of urban change can be clearly measured by the number of people added to cities every hour. By 2015, 32 people an hour will be moving into Shanghai, 39 into Kinshasa and Jakarta, 42 into Mumbai and Karachi, 50 into Dhaka and 58 into Lagos. Compare that with 12 into New York, 6 into London and zero into Berlin and it is clear that again the places of major change are to be found in Africa and Asia. By 2020, there will be 27 cities with populations over 10 million – the so-called mega-cities. But there will also be 73 cities with more than 5 million people.
The primary driver of this increasingly urban world is evidently economic migration and this is a global phenomenon. Whether internal migration within India, China and Nigeria or intra-regional migration in Europe, people generally move in search of a better life. As long as they believe that this can be found in cities, they will seek to relocate. In many areas, such as Cairo, Mumbai and New York, this will continue to involve the relocation of the whole family but in others it will be just the workers. So, as has happened in the past decade in places like Nairobi and Mexico City, a good proportion of migrants will be only those seeking work and the family will, initially at least, be left behind.
We can clearly see a world in 2020 where not only are there another 750 million people on the planet but also, more significantly, they have mostly been added into cities and developing economies. Globally, population growth is a definite certainty for the next ten years and probably for the next forty. Although the rate of growth is gradually decreasing as lower fertility rates have an impact, the extra 250 million Africans added over the decade will most likely be an economic burden in the short term. Such a geographic imbalance of population growth is clearly a strain on the impacted regions but it also affects us all.
Given declining fertility rates globally and the increasing life expectancy of the growing older proportion of the population, the major imbalance that we will all experience is that of the demographic shift towards an ageing population and increasing dependency ratios. Without significant increases in the number of children being born – which would only add to the growing population problem anyhow – most countries will find this economic imbalance between the retired and the workers a massive problem.
In addition, while net economic migration from Africa, Asia and Central America into Europe and North America will in some way help to adjust the country-to-country population growth differences, most international migration will be added to the cities, and so merely compound the problem created by internal urban migration.
imbalanced population growth
Article rating: 4.29 / 5 (from 14 votes)
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Anonymous says
"Due to population decline and economic growth challenges, in the EU we need to be 2.5x as productive per capita in 2050 as we are today – and that is just to keep us at the same level as 2010"
3499 days ago
Anonymous says
"Dr. Subir Gokarn - Dept Governor of the Reserve Bank of India sees forthcoming demographic shifts as opportunity for India vs. China: China's population will reach imbalance due to one child policy while India will continue to have lots of young workers to drive economy forward"
3499 days ago
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Despite pleas from nearby residents Tuesday, the Gainesville Planning and Appeals Board recommended approval of a rezoning request that would allow owners of an assisted living facility on Enota Avenue to build several new townhomes on their property.
Ashton Senior Living sits on a more-than 5 acre tract in the corner of Enota Avenue and Yonah Avenue and is currently zoned as Residential and Planned Unit Development. Owners are looking to change that zoning to strictly Planned Unit Development to allow up to 15 cottage-style townhomes.
Curtis Magill represents The 5 MCS, LLC, the company that owns the facility, and said the buildings will serve as alternative options for residents of the facility.
"They will be more like a small house upgraded," Magill said. "What I'm wanting to do is bring something that's really upscale, 10-foot ceilings, full trims, modern house, and yet look more like mountain homes like in this area."
Some residents spoke against the request, saying the additional buildings could bring unwanted traffic onto the neighborhood road.
"Riverside Drive, Yonah, and Enota Avenue are not Thompson Bridge Road and they're not South Enota," Riverside Drive resident Anne Chenault said. "Those are major roads and those assisted living facilities are well located there."
Chenault also expressed concerns with previous rezoning approvals that allowed other developments in the area like the Enota Gardens Apartments.
"All of these properties used to be single-family residences and they were zoned for single-family residences," Chenault said. "So I almost wonder why in the world do we even have zoning if they're constantly changed every time somebody wants to do something different?"
The board recommended the approval by a 5-1 vote. Board member Eddie Martin, Sr. voted against the request, and member Connie Rucker was not in attendance.
The proposal will now be heard by the Gainesville City Council at its November 7 meeting.

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A kitchen renovation is an interesting job especially when it comes to home improvement. Sometimes being too excited you can end up forgetting about your plumbing system and focus only on the design, layout and most of all shopping for new appliances. When renovating a kitchen, plumbing is the most important part. Once it fails, your renovation will likely to fail. The good news is when you carefully plan for your renovation especially your plumbing system, everything is possible to achieve.
Below, are common plumbing mistakes you need to avoid when planning for your kitchen renovation.
- Discarding the floor details
Everyone loves to have a prescribed floor detail in their kitchen. You should install it first before putting up your cabinets and other kitchen countertops. This is one of the common details that most of us forget when renovating our kitchen. Often, tiles are installed in most kitchens so, in order to avoid from having a trouble getting out of it, you should install it first.
- Choosing kitchen cabinet first before the kitchen sink
The sink is considered to be the centerpiece of your kitchen area. When you plan to renovate, this is the first thing you must not forget. Often, this is the most common plumbing mistake to everyone. Your sink should be the very first item you have to select before installing your cabinets. This is the countertop of your kitchen area. When you install it first, it's a lot difficult to handle when it comes to hooking up a new sink since it could end up that the piping is too high coming out of the wall.
- Incompatible Pipes
Incompatible pipes can lead to corrosion which is very dangerous and can damage your renovation. When you renovate, you need to make sure that your pipes are matched. If they don't match, it won't fit. You have to obtain the right fittings to make the system functional and your money will not be wasted.
- Forgetting the vent
When installing your kitchen sink, you should not forget the vent. You also need to secure the right one for your drain. This is one of the common plumbing mistakes you need to avoid. Your kitchen renovation for sure will have a complete reno when your plumbing line is in good condition. Forgetting the vent in your drain will expose your kitchen to everything from pests.
- Trying to handle it alone
After all, if you are not highly experienced in plumbing and trying to manage your kitchen renovation alone, it will not guarantee that your renovation project will be successful. You have to push back especially if you are not sure about what you are doing. It's really important to ask help from a professional to ensure that from top to bottom, everything is in place.
Always have in mind to put up first what is necessary to be done. Beforehand, it's always helpful to jot down every detail you need for your renovation in order to avoid any of these mistakes.


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This is your chance to "bend the rudder" of government. There are many "stakeholders" who wish to alter how you practice medicine through use of the EHR.  Attached (below) is a link to download the document.\r\n
The HIT Policy Committee (HITPC) has developed a preliminary set of recommendations specifically designed to solicit additional public feedback. The goal of sending out this request for comment (RFC) early is threefold.\r\n
The deadline for public commentary for the RFC is February 25, 2011.\r\n
I would encourage you to participate.\r\n
If you are searching for the notice online to submit an electronic comment, use the following website http://www.regulations.gov and the following "Keyword or ID"
Jamie Loehr
Here is my comment - submitted Feb 6, 2011
I have several comments about the proposed Meaningful Use Objectives and Measures for Stages 2 and 3.
First, the eRx requirement of 80% for stage 3 is extraordinarily high. We have used an electronic Rx program for 10 years and transmitted prescriptions using Sure Scripts for over a year and we might not meet this requirement.
For example, I just saw a patient who is not sure of the copay and deductible for his prescription. Instead of sending two antibiotic prescriptions to the pharmacy electronically, I gave him two computer-generated prescriptions on paper. He will take both to the pharmacy and ask about pricing before deciding if the extra cost is worth the extra convenience.
Another example involves ear infections. There is excellent data that 85% of all ear infections clear without antibiotics and recent guidelines recommend waiting two days before starting a prescription. Again, I give a computer-generated prescription on paper to the family with plans to fill the prescription if symptoms persist for more than two days. In both these circumstances, the paper prescriptions are for patient convenience and/or appropriate medical care and yet would not count towards this objective.
Finally, the proposed regulations for electronically transmitting prescriptions for controlled substances are extremely onerous and I suspect few providers will avail themselves of the opportunity. Thus, all controlled substances will be printed on paper.
I suggest a lower threshold for electronically transmitting prescriptions. Alternatively, exempt controlled substance prescriptions from the denominator and allow the provider to flag certain prescriptions as printed for patient convenience or for medical considerations.
With regards to Clinical Summaries, I would prefer that patient access to the information via a web portal be counted as providing a clinical summary. I rarely finish my notes at the time of the visit and only finish 90% of my notes on the same day of the visit. Some of partners finish their notes two or three days after the visit. It would be a significant burden to have to print out the plan for every patient at the time of the visit. And in fact, sometimes my plan changes as I think more about the case at the end of the day and decide to add extra labs or Xrays to the plan. I suggest extending the timing to within 72 hours for access to a given encounterâs information.
The HIE requirement is also quite steep. A bidirectional connection requires a willingness on the part of the HIE to adapt to many different EMRs and some smaller organizations with exotic or home grown EMRs might not be able to meet this requirement. As for having connections with 30% of my referral network, that would be wonderful but requires action that is largely outside my control.
As for the objective that lists âcare team membersâ, I am not sure of your goal. Which members do you want listed and why? Does that include my office staff? Or are we talking about therapists and consultants? A bit of clarity here would be helpful.
The goal for a bidirectional connection between an EMR and an immunization registry is worthy but again, might be difficult for all EMRs. I also hesitate because I have found the data in my stateâs registry is not always accurate. This might be due to the âgarbage in, garbage outâ phenomenon.
For example, when I started submitting data to the state IIS, I had to have my IT person data-mine the EMR to find which vaccines to upload using the required file specifications. We found that we could not necessarily look at the individual vaccine cells to decide if a vaccine was given because the providers would put notes in there to clarify a situation. For example, if the HIB was unavailable due to a national shortage, we wrote that in the cell to explain why the HIB was not given that date. We have since changed our protocols but we had eight years of data to clean up before submitting the vaccines to the IIS.
Finally, as for allowing group reporting, I would strongly be in favor of this option.
James Loehr, MD
Cayuga Family Medicine


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4 Hours
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We all know human trafficking is a problem in Florida. Just this year, after a nine-month investigation, over 100 people were arrested for their involvement in a possible human trafficking ring occurring within several licensed massage establishments in Florida. Often, human trafficking is hidden (or not so hidden) in licensed and unlicensed massage establishments.
Detectives in the above case said "It was clear that multiple women were working and living inside the spas. They were cooking on the back steps of the business. They were sleeping in the massage parlor on the massage tables."
Human trafficking is a modern form of slavery. Most victims have temporary work visas and are indebted to the brokers who helped them get to the United States with the promise of jobs that do not exist. Once they are here, they are then trapped and coerced into sexual servitude. Their passports may be taken, they often have a language barrier, and do know where to turn for help.
Human trafficking is a difficult subject. However, massage professionals are in a unique position to spot human trafficking, report it, and help victims. This course will help massage therapists do just that: recognize and report human trafficking.
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After this course, participants will be able to do the following:
- Define human trafficking, sex trafficking, and labor trafficking
- Differentiate between human smuggling and human trafficking
- List four myths and misconceptions about human trafficking
- List five indicators or warning signs of human trafficking
- List two places to report suspected cases of human trafficking
- List two resources to help human trafficking victims
*This course is an elective course. It does not meet the recent 1-hour human trafficking course requirement at this time.
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885 Forest Ave Hamilton OH
Sold for $78,000
Great location in Lindenwald Nice starter home with a 24x24 garage with 10Ft ceiling, newer windows,Furnace,water heater.
Directions to 885 Forest Ave Hamilton OH 45015: Rt 4 to Laurel Ave to right on Van Hook to left on Forest. Pleasant Ave to east on Forest Ave
Sold on 05-15-2020
More info about this property
Send me information
No spam. Ever.
Bowling & Kugler Realty
Donald Davis
Donald Davis
Office: 513-844-8405
Phone: 513-678-4604
Phone: 513-678-4604
The data relating to the real estate for sale on this web site comes in part from the Broker Reciprocity program of the MLS of Greater Cincinnati, Inc. Real estate listings held by brokerage firms other than Comey & Shepherd Realtors are marked with the Broker Reciprocity logo or Broker Reciprocity house icon. The properties displayed may not be all the properties available through Broker Reciprocity.


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DSLR Planetary Astrophotography by Jerry Lodriguss
The extreme crescent of Venus is seen here about 39 hours after inferior conjunction. This image was taken just after noon in the daytime when Venus shone at magnitude -3.8 and subtended an apparent size of 57.69 arc seconds. Venus was just 2.5 degrees from the Sun at the time.
The crescent extends some 285 degrees, with hints of a full circle. This is much more than the expected 180 degrees. This "Ring of Venus" is caused by sunlight scattering in the highest cloud deck in the atmosphere of Venus. This is a different phenomenon than the Aureole of Venus, which is caused more by refraction of light through the atmosphere of Venus.
This image was taken on June 7, 2012 at 16:07 UT. Venus was at inferior conjunction at 01:09 UT on June 6. Inferior conjunction occurred as Venus was transiting the Sun.
Both the Ring and the Aureole of Venus are popularly called "twilight" phenomenon because they take place on the border between day and night on the planet.
The sky is black in this image because it was taken in hydrogen-alpha light. The filter darkens the blue sky. Because the image was exposed for brilliant Venus, the sky went black from the combination of exposure and filtration.
I have more about the story of how I took the image on my blog.
If you like the information you have read here, I have several books that you may find of interest.
If you think there is a lot of information here on these web pages, just wait until you see how much more there is in these books!
This book on CD-ROM for beginning astrophotographers explains how to take beautiful images with your digital single lens reflex (DSLR) camera using simple step-by-step techniques that anyone can learn.
You will see how easy it is to take great pictures with very modest equipment and basic methods that are within everyone's ability.
With this book you will learn how to take amazing images of the night sky with your DSLR camera.
Get Started in DSLR Astrophotography Today!
This book written in HTML5 is a digital download. It is for beginning astrophotographers and explains in step-by-step detail how to stack your images in DeepSkyStacker and then process them in Photoshop.
You will learn how to improve the brightness, contrast and color of your deep-sky images to produce beautiful results.
The book also includes 25 video tutorials on each step of image processing.
Get started in Astronomical image processing today!
This book on CD-ROM is for more advanced imagers. It explains how digital cameras work in more technical detail and gives step-by-step directions for more advanced imaging techniques.
It also tells you on how to process your images in Photoshop, with step-by-step directions that will produce beautiful results.
The CD-ROM also includes more than 100 minutes of video tutorials on image processing.
Take your astrophotography to the next level!
This book on CD-ROM will show you how to take planetary images with your Live-View equipped DSLR. It explains the basics of high-resolution planetary imaging and gives step-by-step directions on how to shoot exciting pictures the Sun and Moon and fascinating planets like Jupiter, Saturn and Mars.
It also tells you on how to process your images in programs like RegiStax and AutoStakkert!, with step-by-step directions that will produce beautiful results.
The CD-ROM also includes more than 100 minutes of video tutorials on image processing.
Get started with planetary photography with your DSLR today!
This book on CD-ROM is will help you answer the question "what should I shoot tonight?"
It will provide you with detailed information and examples of the many beautiful objects in the deep sky that you can photograph with your own equipment.
A master list of objects includes 500 of the best and most photogenic galaxies, nebulae, supernovae remnants, stars, star clusters and constellations. This list can be sorted by object name, object type, catalog number, constellation, right ascension and focal length.
Images of more than 275 select objects visible from the northern hemisphere are displayed on individual pages with photographic information and details about these objects.
All-sky constellation charts are clickable with links to individual constellation images. These, in turn, have objects plotted on them that link to object pages.
A local sidereal time calculator will tell you when objects are on the meridian where they are highest in the sky and best placed for photography.
Discover the many fantastic targets in the deep sky!
This HTML book is a guide to basic digital correction and advanced enhancement techniques for astrophotos in Adobe Photoshop image-processing software.
Whether you are a beginning amateur astrophotographer, or a seasoned veteran, you will learn new and exciting techniques.
Use Photoshop to produce visually stunning images!
These books will help you to avoid those bad practices that lead to poor images. I made just about every mistake you could make when I was first starting out and did not know what I was doing. You don't have to make these same mistakes. You too can learn the secrets of deep-sky astrophotography!
Don't waste your long and hard efforts at astrophotography - find out how thousands of others just like you have gotten excellent results by using these books.
You can do it too! What are you waiting for?


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Party Crash has also been updated with an "ultimate" Hedlok and new Bonus Periods.
Posted By Ravi Sinha | On 01st, Feb. 2018 Under News
Nintendo's ARMS, a bizarre arena fighter involving combatants with slinky arms, has received a new update. Version 5.1 of the game brings a new Gallery feature that lets you unlock different illustrations by either spending in-game currency or achieving different objectives.
The full patch notes (courtesy of Zachbasa on ResetEra) also note that new badges have been added. You can also earn badges when certain fighters pair up and fight together over an extensive series. There are also badges to earn for continued usage of each ARM. Party Crash has also seen some updates with the "ultimate version" of Hedlok, the game's big boss, appearing here. New Bonus Periods will also appear.
Finally, if that wasn't enough, there's Tournament Mode to look forward to. While you can't receive badges or in-game currency from playing this, all ARMS will be unlocked when participating. ARMS launched back in June 2017 so it's good to see Nintendo continuing to support it with new features.
Version 5.1
New additions to Party Crash.
Added "Tournament Mode."
A mode made for tournaments with all ARMS unlocked. When in Tournament Mode you will be unable to play other modes such as Grand Prix or Ranked Match, and you won't receive badges or in-game currency. Records will also not be recorded. You can switch between Normal Mode and Tournament Mode on the Top Menu by holding in the R Stick and pressing L and R.
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Better Together
Teens and seniors will engage in a sharing of perspectives, experiences, opinions and wisdom on a different social justice topic each month. They will utilize a curriculum created by renowned educator and former executive of Avoda Arts, Deb Krivoy. Seniors and teens will also collaborate on a culminating final project to be presented at our annual congregational meeting in June. Dinner is included. RSNS gratefully acknowledges Legacy Heritage for inviting our synagogue to participate in its Better Together program. Dates: Student orientation at RSNS, 9/24 from 6:30 – 7:30PM (10th grade only) Students and Adult Seniors: Sundays, 5:00 – 7:00PM at North Shore Towers, 10/27, 11/24, 1/5, 2/2, 3/1, 4/5, 5/3


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- Special Tomato EIO/Jogger Raincover
- Keep your child shielded from bad weather with Special Tomato EIO and Jogger Rain Covers. The ideal accessory for children's mobility equipment, the Special Tomato EIO and Jogger Rain Covers attach to the frame with hook and loop straps to stay securely fastened. The Special Tomato EIO and Jogger Rain Covers are made from clear plastic so your child can see easily when fitted and have ventilation holes to allow air circulation. Stylish and highly suitable, the Special Tomato EIO and Jogger Rain Covers are the perfect complement to both thw Special Tomato EIO and Jogger Pushchairs.
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From youth to the WBC: Netherlands teammates best of friends
TOKYO -- Years ago, Andruw Jones started a baseball tournament back on his home island of Curacao. Jones was the island's first big Major League star, and he wanted to do something for the baseball-playing kids trying to follow him.There was a chance to play, but there was also a
TOKYO -- Years ago, Andruw Jones started a baseball tournament back on his home island of Curacao. Jones was the island's first big Major League star, and he wanted to do something for the baseball-playing kids trying to follow him.
There was a chance to play, but there was also a reward. The winning team would get a trip to Atlanta, courtesy of Jones, and a chance to watch him play in person for the Braves.
The first year he did it,
:: 2017 World Baseball Classic ::
"That was the best," said Schoop, who was about 10 years old at the time.
That was good, but this is the best: Simmons, Gregorius and Schoop playing together on the same Netherlands team, playing in another tournament where the reward is a trip to a Major League ballpark.
The tournament is the World Baseball Classic, and the reward the Dutch team seeks in the second round that begins Sunday is a trip to Dodger Stadium for the semifinals. The Netherlands will open the second round at 6 a.m. ET with a game against host Japan, after Cuba plays Israel (Saturday night, 10 p.m. ET).
Other teams play in the World Baseball Classic for national pride, and other teams have players who are close. But no team can match the Netherlands, where a team workout can feel like a grade school reunion.
"You want to be a fly on the wall when they're talking," manager Hensley Meulens said.
They could be talking about anything, and the group could also include
They've all known each other since they were five or six years old. Profar, who just turned 24, is the youngest. Gregorius, who just turned 27, is the oldest.
They faced each other in Little League, and played together on island All-Star teams. Profar and Schoop played on the Curacao team that won the 2004 Little League World Series. Simmons and Gregorius played on the same youth basketball team.
"I was better at basketball," Gregorius said. "But he was better at soccer."
And baseball?
"We're all good," Gregorius said.
They all are good, and they've all played shortstop. The Angels' Simmons started at short in the Netherlands' first two first-round games, with Meulens explaining, "I don't think there's a better shortstop in the world than this guy."
Schoop plays second base, as he does for the Orioles. Bogaerts, the starting shortstop for the Red Sox, plays third base for the Netherlands. Gregorius, the starting shortstop for the Yankees, was the designated hitter for the first two games and played shortstop in the other game.
Profar plays center field, as he often will for the Rangers.
Offensively, they occupy five of the first six spots in Meulens' lineup (joined by
They didn't dream of this as kids, because when they first met the World Baseball Classic hadn't been played yet. They did dream of playing in the Major Leagues, and now all of them do. Bogaerts, Gregorius and Schoop see each other regularly in the American League East.
They all see each other regularly in the winter, where they maintain offseason residences back in the islands.
"Me and Profar live five minutes apart," Schoop said. "Didi is 15 minutes away. Simmons is five minutes away. Even Bogaerts is just a 30-minute flight."
They work out together almost daily when they're home, and if they're not playing baseball they're getting together to play dominos or video games. They do the same things now, halfway around the world, getting ready to play for a chance to rule the world.
Curacao and Aruba are both what the Dutch call constituent countries of the Kingdom of the Netherlands, and they compete together with players from the home nation in international play. The Netherlands team was a surprise semifinalist in the 2013 World Baseball Classic, with Bogaerts, Schoop and Simmons playing for the team and Profar joining up for the semifinal.
Back then, none of them had yet played a full season in the Majors. Now they return with the experience of that tournament, and they come back as big league stars fully believing they can win.
And why not?
The Curacao kids have played together for years, and they've won together for years. They remind Bogaerts that they always beat Aruba, and they remind each other of every past victory or defeat.
They even talk about those January tournaments, the ones Jones sponsored for more than a decade.
"I won it," Schoop said.
"Jonathan may have won it the second year," Simmons said. "But me and Didi won it the first year."
They remember everything. They'll kid each other about anything. But they'll come together on the Tokyo Dome field as brothers, kids from the neighborhood going out and looking to rule the world.
They might just do it.
The World Baseball Classic runs through March 22. In the U.S., games air live exclusively in English on MLB Network and on an authenticated basis via MLBNetwork.com/watch, while ESPN Deportes and WatchESPN provide the exclusive Spanish-language coverage. MLB.TV Premium subscribers in the U.S. have access to watch every tournament game live on any of the streaming service's 400-plus supported devices. The tournament is being distributed internationally across all forms of television, internet, mobile and radio in territories excluding the U.S., Puerto Rico and Japan. Get tickets for games at Marlins Park, Tokyo Dome, Estadio Charros de Jalisco in Mexico, Petco Park, as well as the Championship Round at Dodger Stadium, while complete coverage -- including schedules, video, stats and gear -- is available at WorldBaseballClassic.com.
Danny Knobler is a contributor to MLB.com.


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Legal talk is often complex, and to the untrained ear it can sound like a completely different language. Luckily for you, the attorneys at Stewart Law Offices are here to provide simple, easy-to-understand definitions for some of the most common legal terms which you might have heard.
- Acquittal: A verdict from a judge or jury that a criminal defendant is not guilty, or the evidence is insufficient to support a conviction.
- Admissible: Evidence is considered "admissible" if it meets all of the standards required to present it in a court of law.
- Affidavit: A statement (written or printed) made under oath.
- Alternative Dispute Resolution (ADR): A way to settle a dispute outside of the courtroom. Most ADRs involve the help of a neutral third party, such as a mediator or arbitrator.
- Appeal: A request made after a trial by the losing party to have the case reviewed by a higher court.
- Bench Trial: A trial where the judge acts as the decision-maker instead of a jury.
- Class Action Lawsuit: A lawsuit in which an individual or small group sues an entity on the behalf of a much larger group. i.e.: Thousands of customers suing a company for damages caused by a faulty product.
- Community Service: A verdict in which the court requires an individual to work without pay for a nonprofit organization.
- Conviction: A guilty verdict against a criminal defendant.
- Defendant: The individual or business against whom a lawsuit is filed.
- Evidence: Facts or items presented in the court of law with the intention to persuade the judge or jury.
- Felony: A serious crime, usually punishable by a minimum of one year in prison.
- Hearsay: Information presented by a witness who did not see the incident in question, but rather heard about it from someone else.
- Judge: An official of the United States Judicial branch with the authority to decide lawsuits brought before a court.
- Jury: A group of people selected to hear the evidence in a trial and make a verdict.
- Litigation: Another word for a court case, or lawsuit.
- Misdemeanor: A less-serious crime, punishable by a maximum of one year imprisonment.
- Mistrial: An invalid trial which leads to the restarting of the same case with a new jury.
- Plaintiff: A person or business who files the lawsuit with a court.
- Plea Bargain: An agreement made between the plaintiff and defendant where the defendant agrees to plead guilty in order to receive a lesser punishment. Also known as a plea deal.
- Settlement: Parties resolve their dispute without trial. This usually involves the payment of the defendant to at least the partial satisfaction of the plaintiff.
- Testimony: Evidence presented orally by witnesses during trials.
- Verdict: The determination of guilt or innocence made by the judge or jury.
- Witness: A person called upon during a trial to give a testimony before the court.
To learn more about the most common legal terms and their definitions, check out this expanded glossary from the United States Court System that covers many common law terms you should know.
The personal injury attorneys at Stewart Law Offices are well-versed in the court of law and are prepared to defend you at your next trial. If you live in North Carolina or South Carolina, and have been injured as the result of someone else's negligence, don't wait. Pick up the phone and call us for a free consultation at (866) 783-9278.


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Well Comic-Con has produced the usual almost overwhelming amount of news, hints, rumors and trailers. There's a lot to look at, think on, and speculate about. Here, I'm looking at the Justice League trailer. There's a lot in that almost two and a half minutes.
Batman is putting a team together. He seems to already have Wonder Woman after the events of Dawn of Justice. They apparently have a relaxed, bantering relationship. Interestingly, considering the reception of both that movie and Man of Steel, Superman doesn't appear at all. Makes you wonder, doesn't it?
Cyborg gets almost no screen time. We see him both as a normal looking person and in the full metallic look. I'm not sure how that works, unless we're getting his origin. Part of the tragedy of Cyborg is that he always looks like the high-tech Cyborg version. We don't see a lot of him, but we saw looks decent enough. It is a better look than Cyborg's only other live-action appearance, back on Smallville. He's being played by Ray Fisher.
Jason Momoa is playing Aquaman. This is clearly not the nice, neat, Superfriends version, but more the 90's, scruffy, almost feral incarnation. There is some cool footage of him. His interview with Batman, or more accurately Bruce Wayne, doesn't exactly go smoothly. Momoa looks great in the role, and I get a sense of his power from his screen time.
The Flash will be the Barry Allen version. Despite the success and fan acclaim for Grant Gustin's take on the character in the CW-verse shows, he will cinematically be played by Ezra Miller. Nothing here looked right to me. Ezra's black hair is really jarring for the blond Barry Allen. And that costume is hideous. Gustin's on the Flash is much better looking. Hell, John Wesley Shipp's from the live-action 90's Flash looked better. This looks like a weird vinyl/armor hybrid. The lightning effects around him were decent at least.
It appears that Batman is bringing the heroes together to fight some un-named enemy that we learn nothing about. It's an odd version of the League. Several big names and/or traditionally founding members are missing, like Green Lantern, Martian Manhunter, or, in some versions, Black Canary. I guess they left out GL after his disastrous movie a few years ago.
The movie looks more appealing than Dawn of Justice to me. I'm a life-long comic book/hero fan, and I skipped Dawn of Justice for various reasons. The League movie at least looks like it might have some good moments in it. It will be interesting to see how they put this together.


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A teenage boy is dead following a game of Russian roulette early New Year's Day.
According to CBS affiliated station KOIN 6, the victim arrived at a mobile home in Sherwood, Ore., with a gun in tow.
After speaking with several witnesses, police were able to confirm that the teen died while playing a game of Russian roulette alone.
Police and paramedics arrived at the Carriage Park Estates home just before 4 a.m., but were too late. The victim was pronounced dead at the scene.
Authorities were initially called to the mobile home community on reports that someone had committed suicide with a weapon, emergency officials told KOIN 6.
As officers made their way toward the scene, the details of what actually occurred began to unravel.
During a press briefing, Sherwood Police Captain Ty Hanlon said there was at least one "click" of the gun chamber before the teen was shot.
"It appears that he brought a handgun with him and from witnesses account that he was playing a game known as Russian roulette," Hanlon told KOIN 6. "We believe that he showed up and initiated this all on his own."
He's believed to have been using a .357 revolver which was not fully loaded.
It's unclear how he obtained the weapon or what connection he had to the people in the home in which he died.
Ken McPherson, who lives nearby, told KOIN 6 there are often young people hanging out at the dwelling.
"It's usually kids younger than 20 that I see down there," he said.
Another neighbor, Ashley Burgdorf, told the publication her husband was leaving for work when he saw emergency response workers outside the home. She later saw the people who live in the home and decided to reach out.
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"I asked them if everything is OK, anything we can do, and he seemed really shook up," she recalled.
"He said that the boy just came out and shot himself, from what I understand. And he was trying to help him and he was really flustered, like he was really shook up about it."
Burgdorf also said she has two children in her house and is thankful they weren't hurt in the shooting.
"As far as I know, the shooting was, like, right there, like 50 feet away. So, you know, something could have easily happened," she said.
Police are still investigating the shooting.


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The Loudon Food Pantry i san independeent nonprofit organization which strives to feed those who find it financially difficult to feed those who find it financially difficult to feed themselves. Anyone that qualifies and lives in the towns of Belmont, Canterbury, Chichester, Loudon, and Epsom can utilize the pantry. Each week, the Loudon Food Pantry supplies enough food for 80-100 households. Patrons are allowed to come in weekly to get food and the food provided is enough for 3 meals for 3 days per person in each household. Food stamps and commodities are used to support the remainder of their food needs.
To learn more, visit their website at www.loudonfoodpantry.org.
© Copyright 2020 NHHEAF Network Organizations. All Right Reserved.
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Alrighty music fans, here we go, below is the latest Susan Boyle video from the UK television show Britain's Got Talent. The woman dubbed as the, "The Woman Who Shut Up Simon Cowell" returned last night to perform "Memory" from Cats (originally sung in the West End by her idol Elaine Paige.)
It's been awhile since her stints on Oprah, ABC News (and every other major television show) and after the infamous makeover, it is possible that the same audiences that fell in love with her would have grown tired of her.
Even Mr. Cowell warned against it. He made it clear that she did not win as the show is not over. But that doesn't seem to have stopped the Susan Express…just yet.
Round 2: "Memory" from Cats
 But if that performance isn't enough and the Adam Lambert predictions for American Idol taught us nothing — the internet buzz and the emergence of social media behind you, doesn't always predict who will really win.
Internet sites like YouTube, Twitter, MySpace and Facebook all were influential in promoting Susan's rise to fame. It's probably safe to say, YouTube was the biggest facilitator in the set with her videos hitting over two million views within the first 72-hours — within a week over 60 million views.
Round 1:
"I dream a dream" from Les Misérables
Regardless, rumor has it, Simon Cowell is setting up a record deal for her with Syco Records, a subsidiary of Sony Music, whether or not she does win.
Piers Morgan did say Susan "was the biggest wake up call ever."
Is Susan Boyle the next Adam Lambert? Is all the internet buzz, just that? A lot of buzz.
What do you think?
Sasha Muradali runs the 'Little Pink Book' .
Copyright © 2009 Sasha H. Muradali. All Rights Reserved.


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This is a music center in Chongqing city. The school uses the combination of music and English to improve the children's English ability. Apart from teaching English, they pay more attention to cultivating children's confidence, innovation and cooperation ability.
Job Number: T012
Location: Chongqing
Teaching Position: English Teacher
Level of Institution: Training school
Students: 3-12 years old
Start Date: ASAP
Salary: 10,000-15,000RMB/month
Visa: Z
Compensation & Benefits:
Qualifications & Requirements:
About the city:
Chongqing is identified as a "mountain city" and a "city on rivers", built on mountains and embraced by the Yangtze and Jialing rivers. Chongqing, a tier-one city, is the only transportation hub in west China that integrates water, land, and air transportation. Known as hot pot and snack kingdom, it attracts people from all over the world.
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text: Build your dream home or hunting lodge on this 606 acre parcel adjoining National Forest with year round access, that enjoy great views. Excellent hunting property, deer, elk, Bear, Turkey which call this place home. This parcel is about 15 minutes from Blue Mesa Reservoir located on the upper reaches of the Gunnison River in Gunnison County, Colorado boasting great fishing, boating, and sailing. Hunting licenses for this area are not difficult to come by. Multiple decreed springs. The property is covered by oak brush, aspen, service berry bushes.


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What is the medical term for what is happening to me?
Hello. Weird things have been happening to my body past 2 days and was wondering if anyone knows what could be going on. Thank you.
Last night:
- During dinner, my hand suddenly tremor for a good 20 seconds. It was completely random.
- During sex, my legs suddenly felt weak, and burned (burned like how it burns when you're working out at the gym). This usually never happens.
- Woke up from a nap to a headache. Felt heavy pulses when I put my head up.
- Had minor nose bleed a bit after - nothing heavy or long.
Now I feel nauseous, dizzy and weak and not to be dramatic, feels like I'm dying.
Appetite is normal and been using the restroom normally as well. I am a 25 y/o male who does smoke and social drinks. Thank you.
3 Answers
- PatriciaLv 710 months ago
If you're concerned, talk to a doctor. We are not doctors and no doctors come to YA. Unless they are quacks.
- Anonymous10 months ago
you need to go see a neurologist as soon
as possible
who should order a CT scan of the brain
- Anonymous10 months ago
It sounds like a possible neurological problem. You should see a neurologist at the earliest possible time. It may be minor or it could be the beginnings of something very serious. I'm not going to speculate on the possibilities because I don't want to alarm you.


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They feel like the media and the public are hostile towards them, but now are finally receiving their cross-sectorial medal of honor. A joint Ynet-Yesodot poll revealed that a majority of the public – including 51% of the seculars – believe that the settlers are "the Hasmonean counterpart" of our times.
The poll, conducted in honor of Chanukah, also asked who Israelis see as the modern-day Hellenists and what the Maccabees would think about Israel today.
The poll was conducted by Panels Institute on a sample representative of the adult Jewish population in Israel of 498 respondents. The maximum sampling error is 4.4%±.
To the question "Who are the Maccabees of our day?", 55% responded "the settlers," 20% chose the social activists, 13% chose IDF officers, 6% chose members of Knesset, and 6% chose environmental activists. In an analysis of those who chose the settler response according to religious affiliation, shows 50% of charedim, 51% of the seculars, 58% of the traditionalists, and 69% of the religious believe that the settlers are the modern-day Maccabees.
And who are the Hellenists of the 21st Century? Thirty percent believe "those who insert words from foreign languages into Hebrew or those who name their children Latin names." Some 28% said that those who want to make money at any price are the modern-day Hellenists, while 26% said people who are brand-conscious. Another 16% responded that people who watch a lot of television are manifestations of modern-day Hellenism.
Breaking down the results according to shows that seculars were most likely to indicate the desire to be famous (31%). Traditionalists were most noted the use of Latin names and words (32%). The religious public emphasized chasing after brands (31%), and charedim indicated watching television (44%) and the source of Hellenism in today's society.
A clear majority of the respondents (59%) said they would participate in legal protests such as demonstrations and media spokesmanship when faced with State laws and orders antithetical to their beliefs and values.
On the other hand, 18% said they would not do anything "because it wouldn't have an effect." Some 8% said they would involve international bodies in order to revoke the laws, while 4% said they would partake in illegal and violent protest. Some 11% said they do not know how they would react.
Most of the religious affiliations preferred legal protest as their prime path of action: 66% of religious, 59% of traditionalists, 58% of seculars, and 39% of charedim.
In conclusion, the respondents were asked to estimate "what would the Hasmoneans think of the State of Israel as a Jewish and democratic state?" Some 33% responded that the Hasmoneans would think this type of country is ideal. Some 25% said the state would be considered a symbol of Hellenism in the eyes of the Hasmoneans because its laws are not based on halacha. Some 21% said the Hasmoneans would accept the State having no other choice. Another 21% did not respond.
The charedim and the religious believe the State of Israel would be seen by the Hasmoneans as a symbol of Hellenism (67% and 42% respectively). Traditionalists believe they would come to terms with the State having no other choice (31%), and the seculars said the Hasmoneans would see the State as ideal.
{Ynet/Yair Alpert-Matzav.com Israel}


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Loneliness Is An Invisible Epidemic Affecting Physical And Mental Health
Caught up in daily routine, some people enter autopilot mode and fail to even realize they are experiencing a lack of connection in their lives. Loneliness has garnered the reputation of a modern, invisible epidemic across the world.
Aligned with the increasing popularity of smartphones and social media, much debate has ensued over how far digital connections can fight against or aggravate loneliness. Nevertheless, the problem is far from being a contemporary phenomenon, though it has changed in terms of meaning over time. It has been known to affect all kinds of people regardless of gender, race, or socio-economic status.
Former U.S. surgeon general Dr. Vivek Murthy explained that human isolation is, indeed, a growing threat and a public health problem. "It turns out that loneliness is associated with a reduction in your lifespan that is as severe as the lifespan you see with smoking 15 cigarettes a day," he said.
During his tenure, Dr. Murthy described meeting numerous middle-aged and elderly patients who were not only suffering from declining health but were also longing for human connection. "I found that loneliness was often in the background of clinical illness, contributing to disease and making it harder for patients to cope and heal."
Furthermore, the problem is not just limited to older adults. Findings from a recent study also suggested that loneliness in young adults was linked to an increased susceptibility to smoking, being less physically active, compulsive use of digital technology, and mental health problems. Such people were likely to have experienced bullying and social isolation when they were younger.
Unlike certain health disorders, loneliness can often be transient, not permanent. But problems arise when people adopt unhealthy coping mechanisms to deal with long-term, unresolved loneliness.
"Hence the term comfort food, which is better expressed as comforting food. We eat foods that make us feel good, and when we're lonely, we have foods that distract us from feeling lonely." said relationship expert April Masini. In addition to poor nutrition, people may also feel inclined to stay indoors and not get physical activity or fresh air.
As a result, inflammation and stress can steadily increase, harming both physical and mental health. Hormonal changes (such as the increased production of the stress hormone cortisol) can put chronically lonely people at risk of heart disease, high blood pressure, suppressed immunity, insomnia, weight gain etc.
The lack of social interaction, conversation or challenges can also result in a cognitive decline over time. Feeling isolated and disconnected, studies suggest, is often a factor in the increased risk of depression, Alzheimer's disease, and personality disorders.
Loneliness affects different people in different ways, making it difficult for experts to recommend one-size-fits-all tips to fight it. But psychologist Dr. Leslie Becker-Phelps explained that the first step for everyone is to acknowledge their problem and bring awareness to their own struggle instead of feeling shame.
To solve loneliness, it is important to take risks and even learn to enjoy solitude to some degree. One may consider activities like reaching out to old friends, talking to a therapist, going outside more often, volunteering or joining clubs, limiting sedentary behavior (such as long hours of internet use), adopting a pet, or more.


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|This article is a stub. You can help The Elder Scrolls VI Wiki by expanding it.
The Nords are one of the races in The Elder Scrolls VI. The Nords are also skilled warriors and behave as soldiers and mercenaries all over Tamriel. The Nords are always eager to put their combat skills to the test outside the traditional methods of Skyrim, and are proficient at all kinds of Combat and Warfare. Nords thrive within the cold areas of Skyrim, relative of their special abilities to withstand all manners of Cold and Frost, they are also seen as militant people by their neighbours. They are also Captains and Crew of the merchant fleets across many regions and may be found along most of Tamriel's coastlines, their role within the trades has benefited the Nords since the early days during which they have taken part in even the earliest trades and migrations across the sea from Atmora.
Merethic Era
Nords translates to North, which is euphonious as the Nords come from the North of Skyrim. As a race, the Nords originated in the most northern place within the known world of Nirn, from a place that is commonly known by outsiders only as Atmora. Very little is known about the Nords, but what is known comes from old Elvish records which are known to refer to Atmora, and that it is likely that Atmora is a human corruption of this world.
Atmora had been extremely cold even since ancient times, it is thought that the continent is either warmer, or of a similar temperature to what it was like back in ancient times as the Nords whom live there are extremely well suited to living within the freezing climate. It is said that during the time of the migration, a protracted and bloody civil war had gripped Atmora, and as the story goes, a man named Ysgramor rallied those people from all sides who desired to live in peace, after which, he set sail to Skyrim to the south and to the extreme northern tip of the continent of Tamriel, at a place which is commonly known as Hsaarik Head. The new land Mereth was renamed in a tribute to the Aldmeri elves whom used to populate the continent. Most stories about the continent give erroneous credit to Ysgramor, however his colonists and himself were the latest of a long line of emigrants from Atmora. Humans and Elves lived in peace and harmony for a very long time, however racial tensions soon erupted between the two species and it wasn't long before there was an eruption of conflict between the two.
The Elves soon figured that the race would surpass their culture if the Nords were left un-checked upon. Ysgramor and two of Saarthal's sons escaped to Atmora whilst Saarthal was burned. After this happened Ysgramor returned to Skyrim to exact his vengeance, bringing with him five hundred of his companions and followers. Upon their return to Tamriel, Ysgramor and his companions slaughtered the Elves who were living there and began the process through which the Elven population of Tamriel would be destroyed.
First Era
In 1E240, the process of expansion which is now known as the Skyrim Conquest was started by King Vrage the Gifted and began within the First Empire of the Nords. Over the course of approximately 50 years, northern Tamriel, Morrowind and most of High Rock were over-run and ruled by Skyrim. A few of the more ambitious leaders of the Nords had discussed attacking Northern Cyrodiil, however it was later concluded that the Jerall Mountains proved to be too big of a barrier, and the region was not worth the effort that it would take to infiltrate. In the centuries that followed, Skyrim expanded and contracted as battles were won and lost.
In 1E369, the last member of the Ysgramors, King Borgas was killed during the Wild Hunt whilst attempting to start the War of Succession within the region of Hammerfell and High Rock. Not only was King Borgas the last of the Ysgramor line, but this also saw the beginning of the decline of the Nordic Empire. The ruling council and Moot attempted to choose another king of Skyrim which should have been Jarl Hanse of Winterhold, however they were unable to do so, and the ensuing Civil War destroyed the Empire. The war came to an abrupt end in 1E420, and the Pact of Chieftains and the Empire lost all of their holdings within High Rock and Morrowind, and from then onwards, Skyrim was divided into several independent kingdoms. Finally, during the second era, and the Second Empire of Man under the Reman dynasty, one man begun to rule Skyrim.
Second Era
Skyrim fit peacefully into the Empire of Tiber Septim, and the scars of the Battle of Sancre Tor and other battles and clashes were non-visible. Many Nords found employment in the Imperial Legion, as Tiber generally nurtured relations with the north.
Third Era
Shortly after the founding of Skyrim by the Empire, the region was drawn into a series of conflicts for quite some time. One of these was the War of the Red Diamond when Skyrim sided with Queen Potema against the Empire. This started a Civil war which lasted seventeen years, until Potema was finally defeated. There continued to be a strong underground group called the Hörme which believed that Potema and her son of Uriel Septim III were the last of Tiber Septim's true blood and led raids against imperial forces from within the province. Over the years, Skyrim started many wars to expand its territory taking land considered to be "Skyrim ground", and therefore allowing the Nordic counts to occupy large portions of Eastern High Rock and Hammerfell.
Fourth Era
The Fourth Era is the era in which The Elder Scrolls V: Skyrim is set.
Society and Religion
There is a strong spiritual relationship between the Nords and the breath which is associated with the Sky Goddess known as Kyne and is extremely important. As Children of the Sky puts it:
The religions of Skyrim are focused on the Aedra and their ancient ally, Lorkhan. This is similar for all of the races of Tamriel, with the exception of the Dunmer. The Nordic Akatosh is Alduin, a terrible, ravenous dragon who presides over the cycle of existence and devours the universe at intervals. The coming of Alduin is highly feared by all pious Nords. He is also worshipped as a God by the Altmer. More recently, it was shown that the traditional idea of Alduin could co-exist with the less adversarial Cyrodiilic interpretation of Akatosh, the Time Dragon. Followers of Kyne and Kynareth are very different in the sense that followers of Kyne are notably more aggressive and war-like than followers of Kynareth, who are nature lovers. Kyne is the true mother of the Nords even though Mara has assumed the role of the Mother Goddess. Kyne is also credited with sending her sons, Morihaus and perhaps Pelinal to the aid of the Cyro-Nordic slaves during their uprising. The most highly regarded Nord in Skyrim is the leader of the Pantheon, Lorkhan. Shor is widely regarded by the Nords as the King of the Gods, and champion of men in their battle against the Elves. It's said that he was brutally slain by "Elven Devils" but continues to bestow favor on his people by providing them with immortal Champions such as Ysmir, who is also a member of the Nordic Pantheon. Ysmir is the name which by which the Nords know the divinity of Talos.
Certain Daedra, such as the Hermaeus Mora can be found also within the Nordic Pantheon, and so is also noteworthy.
The isolated tribe commonly known as the Skaal tend to follow a very different kind of faith compared to their brothers on the mainland. Instead of regular religious worship, they venerate nature. The Skaal believe that the different parts of nature were created by different beings, for example; the Winds, the Trees and the Sun were created by the All-Maker, or so they were led to believe. For this reason, wolves and bears are especially sacred to the small tribe. It is vital to the Skall that all aspects of nature be in constant harmony, as they believe this is what imbues their people with their Shamanic powers, which are believed to have been given to them by the All-Maker, a benevolent, unknown being. As the Skaal delved further into their oral tradition, they discovered that the All-Maker was their version of the god Alduin. The Skaal were also famous for their legends about the Adversary, who was the enemy of mankind itself, and one of his aspects, the Greedy Man. As other tales show, the Greedy Man was none other than another incarnation of Lorkhan, but cast as a demon in these tales. The adversary of Lorkhan was Padomay, which, in Elven tales, had given birth to Lorkhan. In this regard, the religion of the Skaal was nearly the exact opposite of the pantheon of Skyrim. The Skaal were also well aware of the existence of the Daedric princes, however they did not worship them.


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Traditional Christmas desserts from around the world
Apple pie and sugar cookies will always have a seat at the American holiday table. But maybe there's a place for something a little different, or perhaps even continental. Whether you are trying to broaden your culinary horizons or just looking to sweeten your menu, here are several traditional Christmas desserts and sweets of other cultures worth a taste.
Inspired? Create and share by tagging @hallmarkstores.
Mincemeat tarts
As far back as my British husband can remember, his mum and gran would cook for days to prepare for all the family and friends that would come for Christmas supper and tea. A main staple was mince pies. He was given the grand task of helping roll the dough. We inherited this recipe—the best gift!
— Cindy Moody
When I was growing up, my family always made this Norwegian Christmas treat. They're very sweet wafers cooked on a special iron on the stove and then quickly rolled into cylinders. My fingers were always red from rolling the very hot krumkakes!
— Janette Housman
Coconut rice (Arroz con Coco)
This particular recipe is from the northern region of Colombia, which is where my family is from. We make coconut rice and eat it as a side dish for holidays as well as for family reunions.
— Carolina Fernandez
As a child, I was afraid of "the Lep Cookie" as we called it. But I ended up loving these Lebukuchen after I baked them myself. German immigrants brought the recipe to Boonville, Missouri, my family's hometown, in the 1800s. The cookies sit in sealed containers to "ripen" for a month before being consumed at Christmas. They were prepared around nut harvesting time in November and eaten at Christmas. They are kind of like a granola bar or a fruitcake without fruit.
— Stephanie Young
Nut stollen
This Polish and Czechoslovakian recipe has been handed down for generations in my family and was given to me by my great aunt Lillian. The recipe makes three stollens—one to eat, one to freeze and one to give away.
— Frank Hogg
Swedish pepparkakor
Mom Johnson, my husband's grandmother, always made these tiny spicy cookies, which are as addictive as potato chips. One year, we made thousands of these little guys as a church fundraiser. We didn't have time to do much else that season, but our house constantly smelled of ginger and spice, and no one seemed to mind!
— Denise Johnson
Lefse is a Scandinavian Christmas treat my grandma made all day prior to Christmas. It basically looks like a tortilla, but it is made with potatoes and served rolled up with butter and sugar.
— Jen Hedberg-Jones
Because my wife is from the Philippines and spent most of her life there, I wanted to start a tradition during Christmas of having a wonderful dessert that would remind her of home. She decided that bibingka, a Philippine rice flour cake traditionally eaten during the holiday season, would be the perfect Christmas dessert tradition.
— Jake Johnson
Rosca de reyes
For me, waking up on January 6 meant that a fun day was ahead as the holiday season came to an end with a bang. And, as if the brand-new toys and gifts weren't enough, the aroma of hot chocolate and the sweetness of the traditional Mexican rosca de reyes was sure to remind us all that this once-a-year party was really happening! But don't bite down hard on this special bread or you might loosen a tooth if your piece contains a hidden muñequito, or little doll. Don't misunderstand—finding one of the tiny plastic baby dolls in your piece of bread is a good thing, for it means that you get to be the host of another fun party on Candlemas Day (Día de la Candelaria) in February!
— Elias Cuevas
Buche de noel
I adopted this holiday dessert tradition after living in France my senior year in college. My French host "mother" presented it at the table for Christmas dinner, and I have been wowed ever since. Its stunning presentation is boosted by a relatively easy effort in the kitchen.
— Shelley Knapp
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Case Study: India's Film Production Industry
This content was COPIED from BrainMass.com - View the original, and get the already-completed solution here!
Summarize the key facts of the case.
1. Using the Internet, research "Bollywood," India's film production industry. What are the key characteristics of Bollywood?
2. Does Slumdog's success reflect the Americanization of India or the reverse? Explain. Is the success of Slumdog a fad or a fashion? Explain why?
3. Assume that you are an Indian Bollywood movie producer. You want to extend the appeal of your films to the US. How would you approach this project? Who would the formal and informal gatekeepers be and how would you appeal to them?
The book: Solomon, M., R. (2011). Consumer Behavior: Buying, Having, and Being. 9th edition. Prentice Hall.© BrainMass Inc. brainmass.com June 4, 2020, 4:02 am ad1c9bdddf
Solution Preview
Hope you are well.
The international film industry is one of pristine opportunities to showcasing a different way in expressing visual messages and culture to a variety large audience. In deciphering the film industry, especially, in the India marketplace the movie view is exposed to types of cultural behaviors and politics within a compelling story. Let's take a look at some core elements related to the international film industry, such as, in India with Bollywood:
1. Using the Internet, research "Bollywood," India's file production industry. What are the key characteristics of Bollywood?
Bollywood is one of the largest film producers in Mumbai Bombay producing a variety of genres for the targeted populace movie viewer (Torrin, 2012). In assessing the key characteristics of Bollywood, the understanding knows that India film industry is in certain parts of reflection to the types of funded theatrical works, thereby, Bollywood is one of the largest centers of film production of a cultural theme. Thus, try and identifying the core identifiers within certain characteristic based on the multiple expressions to communicating, such as, in different languages that will further tap into additional demographics. And, the observation that Bollywood is of a descriptor of the India Film industry that a designated location of reference to ...
Solution Summary
India's film production industry case study is examined.