American women had far fewer babies after the onset of the Great Recession, which made 2011 the year with the nation?s lowest recorded birth rate. But it is immigrant women, specifically Mexican immigrant women, who had the steepest drop in births, a 23 percent lower birth rate between 2007 and 2010. ?By comparison, the drop during those years for U.S.-born women was 6 percent, ?and among all foreign-born women it was 14 percent.
According to the new Pew Research Center report released today, it was not just foreign-born Latinas who had fewer children. ?The authors,?demographers D?Vera Cohn and Gretchen Livingston, report that ?U.S.-born Hispanic women also had larger birth rate declines in the years between 2007 and 2010 than women of other ethnic or racial groups.
The numbers tell the picture quite clearly. Between 1990 and 2010, for example, the birth rate among U.S.-born Hispanic women dropped from 82.4 percent to 65.4 percent, a 21-point decline. ?Among foreign-born Latinas, there was a 30 percent drop from 1990 to 2010. ? And during the Great Recession years, between 2007 and 2010, births to Mexican women went down from 455,000 births in 2007 to 346,000 ? a 24 percent drop.
While the authors say the report does not address the reasons for the birth declines after 2007, they point out previous Pew Research analysis which finds ?that the recent fertility decline is closely linked to economic distress.? ?The report notes that states with the largest economic declines from 2007 to 2008 were most likely to see fertility declines from 2008 to 2009. ?Hispanics had the largest decline in household wealth ? 66 percent ? during the Great Recession, as well as higher unemployment and poverty rates.
The report?s findings do not surprise Leticia Mederos, vice president of the National Partnership for Women and Families. ?The size of a family is clearly an issue of economic security to so many Latino families, and very connected to pocketbook issues,? she notes.
It is important to note, however, that immigrants and their families are projected to account for 82 percent of the U.S. population by 2050. ?In fact, the 23 percent share of all 2010 births to foreign-born mothers was higher than the 17 percent share of women immigrants ages 15 to 44. ?And of all Hispanic births in 2010, 56 percent were to immigrant mothers.
One interesting finding is the age at which immigrant women have children. More immigrant women over the age of 35 give birth than do U.S.- born women. ?In 2010, 33 percent of births to women aged 35 or older were among immigrant women.? Conversely, very few foreign-born women are teen moms (5 percent) in part because of the age profile of immigration.
ST. LOUIS? (RNS) A federal appeals court on Wednesday (Nov. 28) temporarily blocked the enforcement of the Obama administration's contraception mandate while a Catholic business owner appeals a lower court's ruling that tossed out his suit.
Show Caption |
A federal appeals court on Wednesday (Nov. 28) temporarily blocked the enforcement of the Obama administration's contraception mandate while a Catholic business owner appeals a lower court's ruling that tossed out his suit. Credit: RNS photo courtesy Shutterstock (http://www.shutterstock.com/cat.mhtml?searchterm=contraception&search;_group=&lang=en&search_source=search_form#id=48504880). *Note: This image is not available to download
Opponents of the law said that it was the first time that an appeals court had weighed in on the issue, which has spawned multiple suits across the country, and called it a ?significant victory.?
?The order sends a message that the religious beliefs of employers must be respected by the government,? said Francis Manion, senior counsel of the American Center for Law and Justice, one of the lawyers representing Frank O'Brien.
In a two-sentence order issued Wednesday, a three-judge panel of the St. Louis-based 8th U.S. Circuit Court of Appeals voted 2-1 to grant O'Brien's company a delay while the appeal is heard.
O'Brien Industrial Holdings and O'Brien, a devout Catholic, sued the federal government in March, alleging the contraception mandate that's part of the 2010 health care reform law would force him to choose between his moral and religious beliefs and possibly face stiff fines.
The law requires coverage of prescription birth control pills and implants in all private health insurance policies, starting in 2013.
A lower court ruled in late September that the health care law does ?not impose a 'substantial burden' on either Frank O'Brien" or his company, or violate their rights.
At the time, the law's opponents said the lower court ruling was the first on the law's merits among 30 similar suits.
After O'Brien's suit was tossed out by a lower court, his lawyers asked for an expedited appeal.
O'Brien's company includes several businesses that process ceramic materials, and the charitable St. Nicholas Fund.
(Robert Patrick writes for the St. Louis Post-Dispatch).
Alright, you?ve heard your newborn bundle of joy?s lusty cry; you?ve counted his or her fingers and toes; you may just have learned the baby?s gender. So let?s not waste another minute before sucking the joy from this picture of blissful innocence and answering a key question about his or her health and appearance: Will he or won?t she be fat?
Noting that ?prevention of obesity should start as early as possible after birth,? international researchers have devised a checklist of factors that can be quickly toted up at a mother?s bedside to predict with moderate certainty ? an accuracy of between 71% and 85% ? her newborn?s prospects of becoming obese.
The resulting checklist, published Wednesday in the journal PLoS One, uses just six inputs to determine a newborn?s probability of remaining obese (in the absence of early intervention) throughout childhood and beyond: his or her parents? body-mass indices (BMI), the baby?s birth weight, the mother?s weight gain during pregnancy, the number of members in the baby?s household, the professional category of the baby?s mother, and whether mom smoked during pregnancy.
A child?s prospects of obesity were ?largely driven? by his or her parents? BMI, researchers found: If one or both were obese, the baby?s odds of joining them in that status increased steadily as a function of how obese, and whether one or both were obese. But other factors ? mom?s avoidance of tobacco while pregnant, a larger number of household members, a mother?s status as a professional rather than an unskilled worker ? could powerfully check the bad start that came from having an obese parent (or two).
Least likely to become obese was a baby born into a household of five people who weighed about 6.5 pounds (3 kg) at birth and had a normal-weight father and a professional mother of normal weight who didn?t smoke during pregnancy. This baby?s likelihood of becoming obese in childhood was calculated at 0.13%.
By contrast, a baby born at close to 9 pounds into a household of three, including an obese father and a mother with a BMI of over 35 who smoked during pregnancy and worked as a skilled manual laborer had a probability of childhood obesity of more than 77%.
Importantly, the researchers set out to include genetic variations that would help predict a baby?s prospects of accumulating too much fat. In the end, they found that none of the known genetic variations associated with obesity predicted a baby?s future girth as powerfully as the six factors listed above.
'They were my big brothers and on top of that they made sure I could spit,' Eve tells 'RapFix Live' of relationship with Double R family. By Rob Markman, with reporting by Sway Calloway
Sheek Louch and Eve on "RapFix Live" Photo: MTV News
Addis Ababa, Ethiopia -?For all of you music lovers Selam Festival is just around the corner. The festival which is in its third year will begin on Saturday December 8th, 2012. This annual music bash is one of the few platforms which offer a unique setting for concerts, cultural shows and workshops to promote music and culture.
Artists, spectators, and music industry players converge at Selam?s venue to partake in music and cultural exchange. The aim of the festival is bringing together artists, industry players, and cultural troupes to interact, collaborate and perform to a wide audience.
This year?s festival has an impressive line-up for you with artists like Erik Wainaina from Kenya, Timbuktu from Sweden, Mahmoud Ahmed, Alpha Blondy from Cote D?Ivoire and many more. The event will not only feature singers but also famous cultural dance groups like Ethio Color.
Selam Festival also recognizes the role of the entertainment sector and organizes workshops, capacity building programs, artists? roundtable as well as forums to create dialogue as well as extend support to the performing arts.
Selam is an independent non-profit music organization that is registered in Sweden and Ethiopia, but also takes part in co-operational projects in the Gambia, Kenya, Mali, Mozambique, Namibia, Senegal, Tanzania, Uganda, and Zambia.
ScienceDaily (Nov. 29, 2012) ? Breakthrough drugs have made it possible for people to live with HIV longer than ever before, but more work must be done to actually cure the disease. One of the challenges researchers face involves fully eradicating the virus when it is latent in the body. A new report appearing in the December 2012 issue of the Journal of Leukocyte Biology suggests that a cancer drug, called JQ1, may be useful in purging latent HIV infection by activating the virus in the presence of potent therapy -- essentially a dead end for the virus.
"This drug may be useful as adjunctive therapy in efforts to purge latent HIV reservoirs to eradicate infection," said Monty A. Montano, Ph.D., principal investigator from the Section of Infectious Diseases at Boston University Medical Campus, in Boston, Mass. "This drug functions synergistically with other HIV purging agents."
To make this discovery, scientists used cell lines that contained latent HIV, as well as cells from patients who were on potent antiretroviral therapy with no detectable virus in their blood. Researchers then added JQ1 to latently infected cells, at physiologic concentrations, and observed potent reactivation of latent HIV. The researchers also observed potent suppression of inflammatory genes in genome-wide expression studies using the same cells. JQ1 reactivation of latent HIV may make it vulnerable to current therapies.
"One thing that's been made clear by the decades of HIV research is that there is no magic bullet for curing this disease," said John Wherry, Ph.D., Deputy Editor of the Journal of Leukocyte Biology. "Rather, the progress that's been made has been a series of incremental steps that often build on other previously developed therapies. The hope is that the ability of JQ1 to make latent HIV 'visible' to other HIV drugs described in this report will be another cog in the gearwheel of an HIV cure."
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Journal Reference:
C. Banerjee, N. Archin, D. Michaels, A. C. Belkina, G. V. Denis, J. Bradner, P. Sebastiani, D. M. Margolis, M. Montano. BET bromodomain inhibition as a novel strategy for reactivation of HIV-1. Journal of Leukocyte Biology, 2012; DOI: 10.1189/jlb.0312165
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Hey all. Really getting tired of mystery product and paying for packaging, so I found myself a cheap beat up cabinet and made a bunch of trips to the home improvement stores. I also made a trip to a local hydroponics gardening store (got coco and Botanicare nutes).
The cabinet is 2 feet deep, 3 feet wide, and 4 feet tall on the outside. Inside is around 21"x32"x41" once I cut out the base for the drawers at the top (as shown in the upside down picture.) The cabinet has an adjustable shelf - you can see the support rails along the sides.
cabinet.jpgcabinet_sans_drawers.jpg
At first, I was going to leave a strip of wood and cut out a hole, then mount the drawer fronts back in place. I decided to take a more clever approach to make full-height doors but in retrospect, I should have went with plan A. I would change a bunch of things next time. Oh well - I think this will work. I forgot to take pics step by step so I'll just jump to the finished cabinet:
cabinet_done.jpgcabinet_open.jpg
I was going to make a custom light (CFL) support that could be raised, but because of the cramped space and limited height, I attached bulb sockets directly to the top. The ventilation system is a basic 4" vent fan and some ducting, exiting out the back. I have some holes in the floor and front base with light baffling for passive intake of fresh air. There is a constant hum from the box, but the house heater (you can see a vent on the floor) makes more noise when it kicks on. If you look real close at one corner of the door, you can see a tiny speck of light. The power strip is up there, so I may re-do that. However, even in the dark room at night, you have to look real close to see that bit of light.
Since I can't adjust the height of the lights, I kept the adjustable shelf. I'll cut holes to suspend my pots, and have a drain tray (hand water and runoff whatever the acronym for that is) on the cabinet floor. I know it will be a pain to adjust the shelf when the plants are growing, but I'll just have to deal. Ultimately, I want to build a bigger second cabinet, and keep this one for stage one, or even use the shelf to split it into two sections.
cabinet_lights_on.jpgcabinet_lights_off.jpg
The shiny stuff goes most way down the sides. The large bulb is a 68W (300W eq). If I use four of those during flower, that should be plenty. With those lights on and the fan off, the cabinet got up to 96F. With the vent fan on, the cabinet stays at 71-73F. There is no filtration as of yet. I designed the vent system (poorly) to be able to retrofit something later on. If this winds up as a cloning cabinet, I might not need anything.
I germinated two different fem nirvana seeds in paper towels - they only took a day. They were just moved to cups of coco in the photo. I plan on attempting SCROG or LST - I can tie down to the adjustable shelf the cups are sitting on and the pots will sit in.
U.S. Congressman-Elect Doug LaMalfa and local leaders will join Ameresco executives for a ribbon-cutting ceremony to recognize the completion of construction on the 2.2 megawatt (MW) landfill gas-to-energy project at Butte County?s Neal Road landfill. The only one-of-its- kind north of Sacramento, the facility will collect methane gas produced by decaying organic materials and process it to generate power, with a portion of the revenues from the sale of that power returned to the County for the duration of the 20-year contract. Projected to expand to 4.3 MW, Ameresco designed, built, owns, operates and maintains the facility, which generates enough clean energy to power over 1,300 homes.
WHO:
?
?
?
Speakers and Invited Guests include:
U.S. Congressman-Elect Doug LaMalfa
Steve Lambert, Chair for the Board of Supervisors, Butte County
Butte County Officials
Ameresco Executives
WHEN:
?
Wednesday, December 5, 2012
10:00 a.m.
?
WHERE:
Neal Road Recycling and Waste Facility
1023 Neal Road, Paradise, CA 95969
About Ameresco, Inc.
Founded in 2000, Ameresco, Inc. (NYSE:AMRC) is a leading independent provider of comprehensive services, energy efficiency, infrastructure upgrades, asset sustainability and renewable energy solutions for facilities throughout North America. Ameresco?s services include upgrades to a facility?s energy infrastructure and the development, construction and operation of renewable energy plants. Ameresco has successfully completed energy saving, environmentally responsible projects with federal, state and local governments, healthcare and educational institutions, housing authorities, and commercial and industrial customers. With its corporate headquarters in Framingham, MA, Ameresco provides local expertise through its 63 offices in 34 states and five Canadian provinces. Ameresco has more than 900 employees. For more information, visit www.ameresco.com.
A meeting of like minds at the Combined Logistics Networks annual meeting in Bangkok from May 25-30, 2010, aims to be a good start to rebounding quickly from the impacts of the Global Financial Crisis.
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BEIRUT (Reuters) - Syrian war planes attacked towns in the country's north and east and killed at least five civilians in a strike on an olive oil press as fighting raged in the capital Damascus on Tuesday, opposition activists said.
The latest fighting follows recent battlefield gains by the rebels in their struggle to topple President Bashar al-Assad, but it is far from clear if a strategic breakthrough is likely.
More than 90 people were killed on Tuesday, according to the Syrian Observatory for Human Rights, a Britain-based group.
Rebels trying to make inroads into the capital battled government forces in the suburb of Kfar Souseh on the edge of the centre of the capital, activists said.
In Aleppo province in the north, rebels shot down a military helicopter, according to video footage posted on YouTube that showed what appeared to be a missile hitting the aircraft.
Security sources and activists have reported a small but growing number of heat-seeking anti-aircraft missiles entering Syria, weapons the rebels would need to stand any chance of overcoming Assad's increasing reliance on air power.
The video could be one of the first clear indications that such weapons are in use. The Local Coordinating Committee opposition group said the Free Syrian Army had downed the helicopter near the Sheikh Suleiman army base, 30 km (20 miles) northwest of the contested city of Aleppo.
More than 40,000 people have been killed in the uprising, activists said. What began as a series of peaceful protests against four decades of Assad family rule in March last year grew into a bitter civil war with sectarian overtones.
U.N. Special Coordinator for the Middle East Peace Process, Robert Serry, told the U.N. Security Council on Tuesday that around 450,000 are now believed to have fled Syria, with even more displaced inside the country.
"Destruction, death and suffering have become part of daily life across Syria," Serry said. "The humanitarian crisis is becoming more acute with the winter upon us and the number of those in need growing, potentially reaching 4 million inside Syria by the end of 2012."
International Syria mediator Lakhdar Brahimi is due to brief the 15-member council on Thursday and the U.N. General Assembly on Friday. There is diplomatic deadlock between Western powers, who broadly support the opposition and Assad's supporters Russia and China which have blocked Security Council action.
CAR BLASTS AND BARREL BOMBS
Syrian state television said that two people were killed and four wounded in a "terrorist suicide car bomb" in Artouz, near Damascus. The Observatory said the explosion was caused by a car bomb next to a military police checkpoint.
Near the Old City in Damascus, a car bomb killed one person and blew the legs off another man, according to opposition activist Samir al-Shami. He said it was unclear if the car, a white Toyota, was rigged by Assad loyalists or rebels.
In northern Idlib province, a government jet dropped barrel bombs - cylinders packed with explosives and petrol - at the Abu Hilal olive oil press, 2 km (1.2 miles) west of Idlib city, activist Tareq Abdelhaq said.
At least five people were killed and five wounded in the attack, according to the Observatory. Abdelhaq placed the number much higher, citing locals saying that at least 20 were killed and 50 wounded.
Activists said the victims were civilians waiting to press their olives for oil, but they said opposition fighters were in the area. It was unclear if there were any rebel targets nearby.
Combat also took place in the Baba Amr district of Homs city, an area that was overrun by government troops in February, as well as in Aleppo, Deir al-Zor, Deraa, Idlib province and Hama province, the Observatory said.
AIR STRIKES
Rebels have captured at least five army and air force installations in the past 10 days, putting pressure on Assad's forces in Aleppo and Idlib and the eastern oil region of Deir al-Zor.
The opposition are calling for international military aid, particularly against air attacks, but Western powers who support the uprising are wary of radical Islamist units among the rebels. However, some anti-aircraft equipment has been seized from captured army bases.
The government also launched air strikes on Deir al-Zor city and on the strategic town of Maraat al-Numan in Idlib province on Tuesday.
The rebel takeover of Maarat al-Numan last month effectively cut the main north-south highway, a route for Assad to move troops from the Damascus to Aleppo, Syria's largest city where rebels have taken a foothold.
Most foreign powers have condemned Assad, and Britain, France and Gulf countries have recognized an umbrella opposition group, the Syrian National Coalition, as the sole representative of the Syrian people.
But Assad has been able to rely on his allies, especially regional powerhouse Iran, which is believed to be bankrolling him and supplying military support despite U.S. and European sanctions. Russia, its main arms supplier, says it has only sent weapons already agreed to in previous deals.
Nonprofit news website ProPublica reported on Monday that Russia sent 240 metric tons of bank notes to Damascus this summer. U.S. and European sanctions include a ban on minting Syrian banknotes.
(Reuters) - Want to quit that depressing job? Buy a bigger house? Or how about a whole tropical island of your own? Maybe start a foundation?
Dreams of vast riches from a record Powerball lottery jackpot of more than half-a-billion dollars prompted a frenzy of ticket-buying across the United States ahead of Wednesday's draw, and continued heavy sales were nudging the payout even higher.
Powerball has not had a winner for two months, and the pot has already grown by about $225 million following brisk ticket sales after no one won the top prize in Saturday's drawing. By early afternoon on Wednesday, the jackpot stood at $550 million.
The drawing takes place at 10:59 p.m. ET/0315 GMT, and ticket sales cease from one to two hours earlier, depending on the state.
In a western suburb of Chicago, Illinois, Joe Cooke, 29, fantasized that if he won he could quit his job fielding customer service calls for a financial institution, which he described as listening to "rich, mean people" complain all day.
And how exactly would he quit?
"I was thinking, maybe I should hire a marching band to help me," he said after buying $50 worth of Powerball tickets Wednesday morning. "Or maybe I'll just walk right into office and moon him."
The draw on Wednesday night would dish out more than $360.2 million if paid as a lump sum. Alternatively, the total of $550 million can be paid out in an annuity over three decades.
In the Idaho mountain town of Salmon, lottery vendors reported record numbers of people lining up on the last day to buy tickets.
"We sold 800 tickets yesterday and we're expecting even more today. People are really excited,' said Laurie Barrett, clerk at the Salmon Chevron.
Retired construction worker Bob Powell said it was his first time to play Powerball.
"I never buy tickets. My money comes too hard," he said.
Asked why he made an exception, Powell joked, "A deep voice came to me in my sleep last night. It said, ?Buy a lottery ticket.'"
"But I didn't buy a ticket," Powell said. "I bought the ticket."
Powerball is sold in 42 states, Washington, D.C., and the U.S. Virgin Islands. There have been nearly 300 jackpot winners over the past 20 years, taking home payouts of over $11.6 billion.
The previous Powerball top prize of $365 million was won in 2006 by ConAgra slaughterhouse workers in Nebraska. The largest-ever U.S. lottery jackpot, the $656 million Mega Millions drawing, was shared by three winning tickets last March.
Among dreamers lining up at an Arizona grocery store in Tucson for a shot at Wednesday's prize was metal shop worker Errol Simmons, 54, entrusted with a list of lucky numbers by a dozen or so co-workers.
WHAT TO DO WITH THE WINNINGS?
"I've got to get this right," he said as he checked through the list. "I don't want to be the guy who lost us half a billion dollars because I couldn't count.
"If we win, I'll buy a new truck," he said. "For each day of the week."
The chances of winning the jackpot are about one in 175 million, compared to about one in 280,000 for being struck by lightning.
Mary Neubauer, a spokeswoman for the Iowa Lottery, where Powerball is based, said lottery officials had received calls and emails from people around the world asking if they can buy a ticket. They cannot.
"Sales across the country are just through the roof. It means lots of people are having fun with this, but it makes it difficult to keep up with the (jackpot) estimate," she said.
At a convenience store in Philadelphia, store supervisor Usman Malik said some people were spending $100 at a time on Wednesday to scoop up tickets. "It's like a frenzy," he said. "Everybody thinks they are going to win."
(Reporting by Laura Zuckerman in Idaho, Teresa Carson in Oregon,; Keith Coffman in Colorado,; Paul Ingram in Tucson, Jonathan Kaminsky in Washington state, Dave Warner in Philadelphia and Nick Carey in Illinois; Writing by Peter Rudegeair and Tim Gaynor; Editing by Paul Thomasch, David Storey and Jackie Frank)
Apple announced an upcoming?update to its popular iMac desktop computer line in October, but on Tuesday the Cupertino-based company finally confirmed that the 21.5-inch version of the?new, ultra-thin desktop will be available on Nov. 30.?
"Isn't it amazing how something new makes the previous generation instantly look old?" asked?Apple's senior vice president of worldwide marketing, Phil Schiller, when he first?unveiled what a press release calls "the most advanced desktop Apple has ever made."?The new iMac looks quite similar to the previous generation from the front, but from the side, it is incredibly clear that the desktop has undergone a significant redesign: It has an edge that's a mere 5 millimeters thin.?There is, of course, a bit of a bulge in the middle of the computer's back, for the sake of some internal components, but it still has about 40 percent less internal volume than its older siblings and weighs about eight pounds less, as NBC News' contributor Joel Johnson pointed out when we first heard about the new iMac.
The new iMac is offered in 21.5-inch and 27-inch versions, which start at $1,300 and $1,800, respectively. The new desktops have displays with 75 percent less reflection than the prior generation and a Fusion Drive option (which combines a standard hard drive and a flash-based one to offer up to 60 percent faster performance).
While the 21.5-inch version of the new iMac will begin arriving in customers' homes on Nov. 30, its?27-inch counterpart won't begin shipping until December, according to a press release issued by Apple.
Want more tech news?or interesting?links? You'll get plenty of both if you keep up with Rosa Golijan, the writer of this post, by following her on?Twitter, subscribing to her?Facebook?posts,?or circling her?on?Google+.
If you were a fly on the wall of my studio of late, you would find a half-crazed woman with glue on her hands, half-buried alive in boxes full of beads with a trail behind her of camera set-ups and half-made jewelry pieces.? Not to mention the pile of items by the computer yet to be described and added to Etsy.? Perhaps you can identify.? Indeed, it is the holiday season in the land of Etsy shop owners everywhere.
That?s why it?s serendipitous that the next principle in Jack Canfield?s self-improvement book, Success Principles, is Chunk It Down.? As busy Etsy shop owners in the midst of holiday madness, knowing how to take our goals and break them down into manageable tasks could prove helpful.? At the very least, re-reading this chapter may very well have saved my sanity.
In this chapter, Canfield discusses making overwhelming goals more attainable by breaking them down into a series of tasks from beginning to end.? He suggests a?couple of?different ways to do this.? One way is to work backwards from successful completion and identify each step along the way.? Another way is to create a mind map.? A mind map is pretty much a to-do list that is set up in a visual way.? Start off by writing your goal in the center of a big piece of paper and circling it.? You can also do this on post-it notes on your wall or on a magnetic board.? I prefer post-its because it?s dynamic (and because I?m completely addicted to them).? Divide your goal into major categories of tasks.? Underneath each of these subcategories you can write your spokes or task items.? You can break it down as far as you need to until you get to individual tasks or steps.? I took my insane and unfocused attempt at my goal and turned it into a mind map that has structure to it (see below).? My major goal is to make a certain amount in sales by the end of the year.? That is written on the orange post-it note in the center of the map below.? Next, I identified my sub-categories (in pink).? In this case, I wrote the vehicles for my profits:? repeat customers, local shop sales, Etsy sales, and craft fair sales.? Lastly, I broke down into steps the things I need to do in order to generate more sales within each of these subcategories.? These tasks are written on small blue post-it notes.? I may break this down even further.
Once you have your mind map, you can use it to create daily to-do lists.? Ideally, you would create your next day?s to-do list the night before so that you are ready to go in the morning.
How do you chunk it down?? I?m interested in how you all organize your busy lives so that you can be efficient and focused when you do have time to devote to your business and your shop.? How are your holiday preparations going?? Please share!
ge the student Reference-and-Education Red Ribbon Week Time to Celebrate Freedom 20th September 2007 So many times when we celebrate Red Ribbon Week we only think about not taking drugs. Students get tired of the no, don't do that message. They want to hear something else. Well, if you think about it this should be a week to celebrate
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WASHINGTON (AP) ? For decades, conservative lobbyist Grover Norquist vowed to drive Republicans out of office if they didn't pledge to oppose tax increases. Many lawmakers signed on.
But now, several senior Republicans are breaking ranks, willing to consider raising more money through taxes as part of a deal with Democrats to avoid a catastrophic budget meltdown.
Tennessee Sen. Bob Corker says the only pledge he will keep is his oath of office. House Majority Leader Eric Cantor says no one in his home state of Virginia is talking about what leaders in Washington refer to simply as "The Pledge," a Norquist invention that dates to 1986. Georgia Sen. Saxby Chambliss says he cares more about his country than sticking to Norquist's pledge.
It's quite an about-face for senior members of a party that long has stood firmly against almost any notion of tax increases. And while GOP leaders insist they still don't want to see taxes go up, the reality of a nation in a debt crisis is forcing some to moderate their opposition to any movement on how much Americans pay to fund their government. Republican legislators and Democratic President Barack Obama's White House are haggling vigorously as they look for ways to reach agreement on detailed tax adjustments and spending cuts before automatic, blunt-force changes occur at the new year.
"Oh, I signed it," Sen. Jeff Sessions said on Fox News about Norquist's pledge. "But we've got to deal with the crisis we face. We've got to deal with the political reality of the president's victory."
The naysaying about the pledge is raising the question of whether Norquist ? a little-known Republican outside of Washington ? is losing his position of power within the GOP. It's a notion that he calls ridiculous.
"Nobody's turning on me," Norquist said Monday.
But he indicated he would turn on lawmakers who defy him, starting with Corker, who Monday published an opinion piece in The Washington Post outlining an alternative to the budget breakdown that includes more revenue.
"Corker was elected to the Senate because he took the pledge," Norquist said on Fox News. "He would not be a senator today if he hadn't made that commitment. If he breaks it, he's going to have to have a conversation with the people of Tennessee about his keeping his word. And the same thing with other people who are elected because they made that written commitment to the people of their state."
At the White House, spokesman Jay Carney said Monday that the shifting away from Norquist signaled an opportunity for Republicans to work with President Obama.
"They represent what we hope is a difference in tone and approach to these problems and a recognition that a balanced approach to deficit reduction is the right approach," Carney said.
Norquist, the head of the conservative Americans for Tax Reform, opposes tax increases of any kind, whether eliminating deductions, a position some GOP lawmakers say they're open to, or raising rates. He has insisted on hardline positions from lawmakers and, for years, has held outsized sway in the party for someone who does not hold public office. His pledge doesn't allow any change to the tax code that adds a dollar to revenues.
House Speaker John Boehner has called that notion unrealistic and has dismissed Norquist as "some random person."
Nevertheless, Norquist has maintained a certain level of clout for years.
Heading into the 2012 elections, 279 lawmakers had signed Norquist's' pledge, according to Americans for Tax Reform.
But some who have signed the pledge are having second thoughts. And when the new House is seated next year, no more than 212 of them consider themselves bound by the promise.
"I'm not obligated on the pledge," Corker told CBS News. "I was just elected. The only thing I'm honoring is the oath I take when I serve when I'm sworn in this January."
He's not alone in his stance on the pledge.
"When I go to the constituents that have re-elected me, it is not about that pledge," Cantor said on MSNBC. "It really is about trying to solve problems."
Chambliss, a veteran senator from Georgia, said he signed the pledge during an earlier campaign when the country's debt was nowhere near its current $16 trillion level.
"Times have changed significantly, and I care more about my country than I do about a 20-year-old pledge," Chambliss told his local television station. "If we do it (Norquist's) way, then we'll continue in debt."
"I'm frankly not concerned about the Norquist pledge," Chambliss added.
Raising taxes, whether by closing loopholes or raising tax rates, is seldom a vote-winning strategy.
President George H.W. Bush broke his campaign promise to not raise taxes; he ended up losing re-election 1992.
Other Republicans, however, now are willing to put additional tax revenues on the table as a bargaining chip for a deal with Democrats to get changes in Social Security and Medicare and pare down federal deficits.
"I agree with Grover, we shouldn't raise rates. But I think Grover is wrong when it comes to we can't cap deductions and buy down debt," Sen. Lindsey Graham of South Carolina said Sunday on ABC's "This Week."
"I will violate the pledge ? long story short ? for the good of the country, only if Democrats will do entitlement reform," he added.
Rep. Peter King of New York told Sunday's "Meet the Press" on NBC that the pledge is good for a two-year term only.
"A pledge you signed 20 years ago, 18 years ago, is for that Congress," King said. "For instance, if I were in Congress in 1941, I would have signed a support of declaration of war against Japan. I'm not going to attack Japan today. The world has changed, and the economic situation is different."
And Sen. John McCain, his party's presidential nominee in 2008, said the pledge is losing its clout.
"Fewer and fewer people are signing this, quote, pledge," he told an audience recently.
LONDON (Reuters) - A man from Northern Ireland was arrested in Britain on Monday in connection with the death of Northern Ireland policeman Ronan Kerr, who was killed in April last year when a bomb exploded under his car, the Police Service of Northern Ireland said.
The 22-year-old man, from Omagh in County Tyrone, was detained in Milton Keynes, England, as police widened their investigation to northwest England. Police said they were conducting searches in Northern Ireland and northwest England.
Kerr, 25, was the first policeman killed in the British-controlled province for two years. A Catholic, Kerr was a new recruit and a symbol of Northern Ireland's new police service, which before the peace deal was predominantly made up of Protestants and viewed with scepticism by many Catholics.
The arrest of the suspect, who was not named, was made by the North West Counter Terrorism Unit at the request of PSNI Serious Crime Branch detectives, according to the PSNI.
A prison officer, David Black, was shot and killed in his car earlier this month, and a group of militant Irish nationalists claimed responsibility.
International monitors confirmed in 2005 that the Provisional Irish Republican Army had given up all its weapons, but dissidents disenchanted with the peace process, which largely ended three decades of violence in which over 3,600 people died, have increased violent activity in recent years.
Earlier this year, militant nationalist groups in Northern Ireland united under the banner of the so-called New IRA.
(Reporting by Stephen Mangan; Editing by Jackie Frank)
College-level acceptance who are non-native English speakers about consistently appearance bookish autograph in accurate and English autograph in accepted as arresting tasks. For non-native English speakers, speaking in English is arduous abundant and autograph is generally beheld as a burden. The addiction to appearance it as a accountability arises with the mindset that speaking is the abandoned all-important accomplishment in adjustment to get by central an EFL classroom. In addition, acceptance are acceptable to advance a abhorrence for autograph if the English accent curriculum/program provided is inept in emphasizing a accomplished accent access to the abstraction of the ambition language.
For countries wherein acquirements the English accent is an arising trend, the development of accomplishment in speaking and chat abilities a allotment of the humans are apparent as key civic goals and are even indicators of all-around competitiveness. English accent programs focus on students' adeptness to allege and backpack a chat in English as against to the added acceptable grammar-translation method. The accurate botheration that has emerged from emphasizing candid adequacy is the askew development in the basal accent abilities (speaking, listening, reading, and writing) of acceptance accustomed the accent of the curriculum/program on a accurate accent accomplishment alone. Ideally, all basal accent abilities should be developed appropriately through a accomplished accent approach.
How do we accomplish college-level acceptance who are non-native English speakers like autograph then? This is apparently traveling to be an acclivous action accustomed the students' conditioned abhorrence for writing. There are no quick and absolute solutions but nevertheless, alteration the mindset of the acceptance is necessary. A chat of attention though, agents should be able to acknowledge with affinity and backbone against the actual achievability of acerbity a allotment of students.
Tip#1
Positive change and innovation, in adjustment for them to be acknowledged should appear from the top and be implemented downwards. The administration in an bookish administration or assemblage has the accurate claiming to advance the vision, goals, policies, and strategies for a accomplished accent access against English accent learning. Agents who acquaint change after the abounding abetment of the arrangement are acceptable to feel balked with the abridgement of abutment from the administration or assemblage leadership.
Tip#2
EFL acceptance charge to accept that English speaking and chat abilities are no best advised as appropriate skills. Perhaps, there was a time if beneath humans could allege in English and it was a appropriate activity to be one of them. Nowadays, globalization and Internet accept created an English accent explosion. All over the world, there are added humans who can allege English and the English accent is now advised as a lingua franca. Hence, accomplishment in speaking and chat abilities abandoned are absolutely not abundant to be acknowledged in your career.
Tip#3
Although there is annihilation atypical about English autograph abilities per se, even so, not all EFL acceptance accept in actuality baffled English writing. In fact, there are abounding EFL acceptance who do not like autograph and accordingly do not accept the backbone to advance their autograph skills, which happens to be an befalling for you. Since English autograph for EFL acceptance is not easy, this aswell agency that by advance added accomplishment into developing your autograph abilities it in actuality gives you an bend compared to added EFL students.
Tip#4
Think of approaching assisting applications if you are able to advance your English autograph skills. Autograph is an capital allotment of any business or industry. From the advertisements and websites to forms and letters, all of them are some anatomy of writing. Acceptance absence the point if they anticipate that they are abandoned training themselves to address for a chic requirement.
Tip#5
Nowadays, amusing networks like Facebook, Twitter, WordPress and added blogging casework accept revolutionized the way we accumulate in blow with friends. Also, people's autograph habits accept been decidedly impacted and changed. Humans all over the apple are autograph added than ever. Self-expression is a accepted need. EFL acceptance can account from application Internet technology to convenance and adore writing. What needs to be done is for acceptance to just advance the addiction of cogent their thoughts.
At the end of the day, befitting acceptance motivated to address in English depends on how able-bodied they accept the approaching implications of developing their basal English accent abilities in adjustment to attain success in their careers. The action should appear from aural and application grades abandoned and added alien rewards ability plan on a abbreviate appellation base but acceptance who can actuate themselves absolute of their agents are added acceptable to be successful. To do this, acceptance charge to authorize a claimed acceptation for traveling through all the agitation in developing their English autograph abilities alongside the added basal skills, as well.
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If you still have some Thanksgiving leftovers lurking about your fridge, it's time to get creative and use them up. If cranberry sauce is among those leftovers, the folks at CHOW have a creative use for it: use it in a tasty cocktail you can sip while you figure out what to do with the rest of the leftovers.
The video above walks you through the recipe. It's pretty straight forward, and while the cranberry sauce CHOW uses is clearly of the canned, gelatinous variety, we imagine you can do the same with any cranberry sauce, even homemade, as long as it's smooth enough to mix easily. If it's chunky leftover cranberry sauce you're trying to get rid up, a quick hit with an immersion blender (or even a regular blender) should smooth it out enough to give this a whirl.
How to Transform Leftover Cranberry Sauce into a Cocktail | CHOW
Posted by Mary on Nov 25, 2012 in Civil Law | Comments Off
Real Estate Property Crimes can take many forms. ?Most often these crimes involve grand theft and forgery. ???Common ?fraudulent real estate investment schemes have typically involved the sale of trust deeds, ?the use of forged escrow instructions to steal escrow deposits, purchasing homes with straw buyers for those with poor?credit and?forgery of grant deeds or other recorded documents. ?Other fraudulent schemes can involve trusts. ?This happens when vulnerable ?owners are told to deed their property to a trust. ?They are told the trust ?will make the mortgage payments until the owner recovers financially. These kind of ?scammers steal the equity and get loans with even larger payments so the original homeowner never stands a chance to get his or her property back.
Recently, Identify Theft ?has become more common in real estate fraud. ???Identity Theft is a newer criminal activity aided by computer hackers ?and is becoming more widespread and dangerous to all consumers.
? California Penal Code (CPC) section 530.5 defines Using Personal Information of Another:
CPC 530.5. ?(a) Every person who willfully obtains personal identifying information, as defined in subdivision (b) of Section 530.55, of another person, and uses that information for any unlawful purpose, including to obtain, or attempt to obtain, credit, goods, services, real property, or medical information without the consent of that person, is guilty of a public offense, and upon conviction therefor, shall be punished by a fine, by imprisonment in a county jail not to exceed one year, or by both a fine and imprisonment, or by imprisonment pursuant to subdivision (h) of Section 1170.
By assuming the identity of the true owner, or claiming to represent the true owner, the thief fraudulently obtains title to a property. This kind of scammer may ?then borrow against the property, or sell the property, stealing the equity. The typical target of such a scheme is a property with a large amount of equity, most likely an elderly owner. Protect your identity by?securing?your personal information as much as possible on and off line. ?Especially on the computer, make sure any information you give out is?guaranteed?to be secure.
The housing market continues to be in a very unstable market, and ?criminals are taking advantage of struggling homeowners by committing fraud. Many appear to be legitimate brokers or ?consultants, but their activities and?illegal? schemes are aimed at stealing your money or property. If you believe that you have ?been a victim of real estate fraud, call ?the Law?Office?of Peter S. Cameron ?at 877-603-8473 or submit your ?questions online with our?guaranteed?secure case review form. ?We are here to help you explore the legal solutions available to this kind of consumer fraud.
This?article?is for educational and?marketing?purposes only. ?It does not?create?an attorney-client relationship.
New readers? pets are posted every Monday.? Send your pet?s picture (jpg or gif) along with your pet?s name to webmaster@evanovich.com.? (Please don?t use photo sharing websites as most galleries expire before we can get to your picture.)
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There?s a saying in the neuroscience field, ?Neurons that fire together, wire together.? The idea is that what we see and hear and feel makes a lasting impression on us that determines how we experience things. It?s used to explain everything from love to post traumatic stress disorder and why medical students sometimes manifest the symptoms of the disease they are studying. It is used by marketing groups trying to sell us things and by psychologists who hope to help patients form new, healthier thought habits.
Click Here for your FREE 30 DAYS of The Christian Science Monitor Weekly Digital Edition
If the mental organization of our perceptions is causative, it would seem a no-brainer to learn how to manage the process to encourage what is best and to avoid what is not.
Scientific theory that begins with the concept of the brain as the physical generator and preserver of what we experience has not worked out why the firing, wiring neurons of one person are different from another?s. Why, say, Harry in a lions? den has a different experience than Daniel.
Having spent time in prayer ? consciously stepping away from reacting to mental images in order to remember and cherish the primacy and power of Spirit ? I can say that what we actively recognize as most real and meaningful is key to determining how we live our lives. You can talk about adapting the brain, but only God has the authority to truly transform, reform, and heal. God is spiritual, divine good ? what remains when partial, temporal understanding fails. God is the ever-present Love that bases what is best in humanity and overcomes the fears that thwart and sicken us.
Because divine good trumps lesser claims of mere belief, turning to God not only provides relief from mental stress, but also uncovers the underlying, overriding Truth that we live in relation to. Such profound encounters with the spiritual foundation of our lives are indeed transformative. Even small experiences of this kind are life-changers.
Some years ago I was going through a rough patch. Little things piled up. Our elderly dog needed to be walked about every 45 minutes, including through the night. Our neighbor would work on his motorcycle below our bedroom window at 2 a.m. Everyone was tired and cranky, and this led to more stress.
One night, I lay awake wondering how I was going to cope with the next day?s demands. My thoughts ranged from one problem to another; and there were many, erupting with annoyance and despair as I considered the neighbor?s rudeness, the dog?s condition, and my own limitations.
Then a thought arrived that was not part of the despondent train I?d been caught up with: ?Nothing is either good nor bad, but thinking makes it so.?
I recognized the words; Hamlet says them to Rosencrantz and Guildenstern in Shakespeare?s play. But they had greater resonance for me as an epigraph in ?Science and Health with Key to the Scriptures,? by Mary Baker Eddy, who discovered Christian Science. And they reminded me that the things I had been mentally adding up were not, in themselves, capable of making me angry or sad or even tired.
That was a light-bulb moment, because I realized that those thoughts were all trumped by a larger, more fundamental Truth: the presence and power of divine Love. This brought great relief, and I began to relax into sleep.
And then the baby started to cry.
I headed to her room, half smiling. I was no longer taken in by the notion that the good in my life was at the mercy of circumstances. Rather, God?s good was always with me. My daughter had a fever, and I walked the room with her in my arms. I felt we were together in the light of God?s love. I sang softly to her, ?O gentle presence, peace and joy and power; / O Life divine, that owns each waiting hour...? (Mary Baker Eddy, ?Christian Science Hymnal,? No. 207).
The baby soon fell asleep and was no longer feverish. I tucked her back in bed and returned to my room. With only an hour left until dawn, I had a brief, but peaceful, sleep.
The next day went smoothly. More than smoothly. It was as if, having become the witness of the innate goodness of all life, my own life kept turning up examples of God?s control. Contacts were made, work got done, appointments were made and kept, the family?s needs were met, all in an effortless procession of order and harmony. I hadn?t created it, but by acknowledging the real source of good, I was able to see more of it.
That night I felt like a new person. My daughter was well, the dog no longer needed hourly walks, but more than anything else, I knew I wanted to keep living in relation to the pervasive fact of Truth and Love. It makes all the difference.
Gastric bypass surgery helps diabetes but doesn't cure itPublic release date: 26-Nov-2012 [ | E-mail | Share ]
Contact: Rebecca Hughes hughes.r@ghc.org 206-287-2055 Group Health Research Institute
People with earlier, less severe diabetes benefit more in HMO Research Network study
SEATTLEAfter gastric bypass surgery, diabetes goes away for some peopleoften even before they lose much weight. So does that mean gastric surgery "cures" diabetes? Not necessarily, according to the largest community-based study of long-term diabetes outcomes after bariatric surgery. For most people in the study, e-published in advance of print in Obesity Surgery, diabetes either never remitted after gastric surgery or relapsed within five years.
Among the two thirds of the study's patients whose diabetes at first went away, more than a third re-developed diabetes again within five years after gastric surgery. After adding in the one quarter of patients whose diabetes never remitted after surgery, most (56 percent) of the study's patients had no long-lasting remission of their diabetes following gastric surgery. However, when diabetes did go away, the research team extrapolated, it stayed away for a median of eight years.
Which kinds of obese people with type 2 diabetes are likely to get the most benefit from gastric surgery? "Our results suggest that, after gastric surgery, diabetes stays away for longer in those people whose diabetes was less severe and at an earlier stage at the time of surgery," said principal investigator David E. Arterburn, MD, MPH, a general internist and associate investigator at Group Health Research Institute. "Gastric surgery isn't for everyone," he said. "But this evidence suggests that, once you have diabetes and are severely obese, you should strongly consider it, even though it doesn't seem to be a cure for most patients."
The multi-site study tracked 4,434 adults at Kaiser Permanente Northern California, Kaiser Permanente Southern California, and HealthPartners for 14 years: from 1995 to 2008. The research arms of all three of these integrated health care delivery systemsand Group Health Research Institute, where the study's results were analyzedbelong to the HMO Research Network. The patients had type 2 diabetes that was either controlled with medication or else uncontrolled, and they were also obese enough to be candidates for gastric bypass surgery.
"Diabetes is an increasingly common disease that tends to keep getting worse relentlessly," Dr. Arterburn said. More than 25 million American adults have diabetesand as populations age and keep gaining weight, 50 million are predicted to have it by 2050. Already, diabetes accounts for 5 percent of all U.S. health care spending. And it raises the risk of blindness, kidney disease, heart attacks, strokes, and deaths.
"Prevention is by far the best medicine for diabetes," Dr. Arterburn said. "Once you have diabetes, it's really hard to get rid of. Attempts to treat it with intensive lifestyle changes and medical management have been disappointing." For instance, the National Institutes of Health recently halted the Look AHEAD study of intensive lifestyle changes for people with diabetes. Despite improvements in risk factors like body weight, fitness, and blood pressure, sugar, and lipids, that study showed lifestyle changes did not lower the outcomes that matter most: heart attacks, strokes, and deaths.
"No wonder so many were excited to learn that diabetes can remit after gastric surgeryeven, in some cases, before any significant weight lossand many were hoping that gastric surgery might be a 'cure' for diabetes," Dr. Arterburn said. "Our study is the first major evidence that diabetes often recurs after gastric bypass surgery." Still, he added, even after diabetes comes back, having had a long period of post-surgery remission is likely to have many positive effects, such as fewer complications of diabetes: less damage to eyes and kidneys, and fewer heart attacks, strokes, and deaths. The researchers are now funded by the National Institutes of Health to study that possibility in this same population. Dr. Arterburn is also leading a randomized controlled pilot trial of intensive behavioral treatment vs. gastric surgery at Group Health with colleagues from the University of Washington.
It's still not clear whether diabetes relapse happens because of gaining weight back or because of underlying the progression of diabetes. But patients' weightbefore and after surgerywas not strongly correlated with remission or relapse of diabetes in this population.
###
As part of the Developing Evidence to Inform Decisions about Effectiveness (DEcIDE) program, the Agency for Healthcare Research and Quality (AHRQ) of the U.S. Department of Health and Human Services funded this project under contract HHSA290-2005-0033-I-TO10-WA1, led by Dr. Arterburn.
Drs. Arterburn's co-authors were: Andy Bogart, MS, and Mary Kay Theis, MA, MS, of Group Health Research Institute; David McCulloch, MD, of Group Health Cooperative; Nancy E. Sherwood, PhD, and Patrick J. O'Connor, MD, MPH, of HealthPartners Institute for Education and Research; Stephen Sidney, MD, MPH, of the Kaiser Permanente Northern California Division of Research, in Oakland; Karen J. Coleman, PhD, of Kaiser Permanente Southern California, in Pasadena; Guilherme M. Campos, MD, of the University of Wisconsin, in Madison; Sebastien Haneuse, PhD, of Harvard School of Public Health, in Boston; and Joe Selby, MD, MPH, of the Patient-Centered Outcomes Research Institute (PCORI), in Washington, DC. Dr. Arterburn is also an affiliate associate professor of medicine and Dr. McCulloch is a clinical professor of medicine at the University of Washington School of Medicine
Agency for Healthcare Research and Quality
The Agency for Healthcare Research and Quality (AHRQ) is the health services research arm of the U.S. Department of Health and Human Services (HHS), complementing the biomedical research mission of its sister agency, the National Institutes of Health. AHRQ is a home to research centers that specialize in major areas of health care research such as quality improvement and patient safety, outcomes and effectiveness of care, clinical practice and technology assessment, and health care organization and delivery systems. It is also a major source of funding and technical assistance for health services research and research training at leading U.S. universities and other institutions, as well as a science partner, working with the public and private sectors to build the knowledge base for what worksand does not workin health and health care and to translate this knowledge into everyday practice and policymaking.
HMO Research Network
The HMO Research Network includes 19 research centers, each associated with a health care delivery system. Researchers at the centers collaborate on multi-site studies in real-world health care settings across the United States and in Israel. With access to information on more than 16 million ethnically and geographically diverse patients, these researchers are finding solutions for common and rare health problems. Since 1994, the Network has been answering pressing questions about keeping people healthy and delivering effective care.
About the Kaiser Permanente Division of Research
The Kaiser Permanente Division of Research conducts, publishes and disseminates epidemiologic and health services research to improve the health and medical care of Kaiser Permanente members and the society at large. It seeks to understand the determinants of illness and well-being and to improve the quality and cost-effectiveness of health care. Located in Oakland, Calif., the Division of Research employs over 600 staff working on more than 250 epidemiological and health services research projects. For more information, visit www.dor.kaiser.org.
About the Kaiser Permanente Department of Research and Evaluation
The Department of Research and Evaluation (R&E) conducts high quality, innovative research into disease etiology, prevention, treatment and care delivery. Investigators conduct epidemiology, health sciences, and behavioral research as well as clinical trials. Located in Pasadena, Calif., the department focuses on translating research to practice quickly to benefit the health and lives of Kaiser Permanente Southern California members and the general population. Visit www.kp.org/research.
HealthPartners Institute for Education and Research
HealthPartners Institute for Education and Research is dedicated to improving health through discovery, the translation of research, and health professional education. Our researchers are dedicated to conducting high-quality, public-domain health research, proposed and led by multidisciplinary teams of independent PhD- and MD-level investigators rigorously trained in statistics, economics, epidemiology, and other fields. The Institute is part of a larger organization consisting of HealthPartners, Regions Hospital, and clinics.
Group Health Research Institute
Group Health Research Institute is the research arm of Seattle-based Group Health Cooperative, a consumer-governed, nonprofit health care system. Founded in 1947, Group Health Cooperative coordinates health care and coverage. Group Health Research Institute changed its name from Group Health Center for Health Studies in 2009. Since 1983, the Institute has conducted nonproprietary public-interest research on preventing, diagnosing, and treating major health problems. Government and private research grants provide its main funding.
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Gastric bypass surgery helps diabetes but doesn't cure itPublic release date: 26-Nov-2012 [ | E-mail | Share ]
Contact: Rebecca Hughes hughes.r@ghc.org 206-287-2055 Group Health Research Institute
People with earlier, less severe diabetes benefit more in HMO Research Network study
SEATTLEAfter gastric bypass surgery, diabetes goes away for some peopleoften even before they lose much weight. So does that mean gastric surgery "cures" diabetes? Not necessarily, according to the largest community-based study of long-term diabetes outcomes after bariatric surgery. For most people in the study, e-published in advance of print in Obesity Surgery, diabetes either never remitted after gastric surgery or relapsed within five years.
Among the two thirds of the study's patients whose diabetes at first went away, more than a third re-developed diabetes again within five years after gastric surgery. After adding in the one quarter of patients whose diabetes never remitted after surgery, most (56 percent) of the study's patients had no long-lasting remission of their diabetes following gastric surgery. However, when diabetes did go away, the research team extrapolated, it stayed away for a median of eight years.
Which kinds of obese people with type 2 diabetes are likely to get the most benefit from gastric surgery? "Our results suggest that, after gastric surgery, diabetes stays away for longer in those people whose diabetes was less severe and at an earlier stage at the time of surgery," said principal investigator David E. Arterburn, MD, MPH, a general internist and associate investigator at Group Health Research Institute. "Gastric surgery isn't for everyone," he said. "But this evidence suggests that, once you have diabetes and are severely obese, you should strongly consider it, even though it doesn't seem to be a cure for most patients."
The multi-site study tracked 4,434 adults at Kaiser Permanente Northern California, Kaiser Permanente Southern California, and HealthPartners for 14 years: from 1995 to 2008. The research arms of all three of these integrated health care delivery systemsand Group Health Research Institute, where the study's results were analyzedbelong to the HMO Research Network. The patients had type 2 diabetes that was either controlled with medication or else uncontrolled, and they were also obese enough to be candidates for gastric bypass surgery.
"Diabetes is an increasingly common disease that tends to keep getting worse relentlessly," Dr. Arterburn said. More than 25 million American adults have diabetesand as populations age and keep gaining weight, 50 million are predicted to have it by 2050. Already, diabetes accounts for 5 percent of all U.S. health care spending. And it raises the risk of blindness, kidney disease, heart attacks, strokes, and deaths.
"Prevention is by far the best medicine for diabetes," Dr. Arterburn said. "Once you have diabetes, it's really hard to get rid of. Attempts to treat it with intensive lifestyle changes and medical management have been disappointing." For instance, the National Institutes of Health recently halted the Look AHEAD study of intensive lifestyle changes for people with diabetes. Despite improvements in risk factors like body weight, fitness, and blood pressure, sugar, and lipids, that study showed lifestyle changes did not lower the outcomes that matter most: heart attacks, strokes, and deaths.
"No wonder so many were excited to learn that diabetes can remit after gastric surgeryeven, in some cases, before any significant weight lossand many were hoping that gastric surgery might be a 'cure' for diabetes," Dr. Arterburn said. "Our study is the first major evidence that diabetes often recurs after gastric bypass surgery." Still, he added, even after diabetes comes back, having had a long period of post-surgery remission is likely to have many positive effects, such as fewer complications of diabetes: less damage to eyes and kidneys, and fewer heart attacks, strokes, and deaths. The researchers are now funded by the National Institutes of Health to study that possibility in this same population. Dr. Arterburn is also leading a randomized controlled pilot trial of intensive behavioral treatment vs. gastric surgery at Group Health with colleagues from the University of Washington.
It's still not clear whether diabetes relapse happens because of gaining weight back or because of underlying the progression of diabetes. But patients' weightbefore and after surgerywas not strongly correlated with remission or relapse of diabetes in this population.
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As part of the Developing Evidence to Inform Decisions about Effectiveness (DEcIDE) program, the Agency for Healthcare Research and Quality (AHRQ) of the U.S. Department of Health and Human Services funded this project under contract HHSA290-2005-0033-I-TO10-WA1, led by Dr. Arterburn.
Drs. Arterburn's co-authors were: Andy Bogart, MS, and Mary Kay Theis, MA, MS, of Group Health Research Institute; David McCulloch, MD, of Group Health Cooperative; Nancy E. Sherwood, PhD, and Patrick J. O'Connor, MD, MPH, of HealthPartners Institute for Education and Research; Stephen Sidney, MD, MPH, of the Kaiser Permanente Northern California Division of Research, in Oakland; Karen J. Coleman, PhD, of Kaiser Permanente Southern California, in Pasadena; Guilherme M. Campos, MD, of the University of Wisconsin, in Madison; Sebastien Haneuse, PhD, of Harvard School of Public Health, in Boston; and Joe Selby, MD, MPH, of the Patient-Centered Outcomes Research Institute (PCORI), in Washington, DC. Dr. Arterburn is also an affiliate associate professor of medicine and Dr. McCulloch is a clinical professor of medicine at the University of Washington School of Medicine
Agency for Healthcare Research and Quality
The Agency for Healthcare Research and Quality (AHRQ) is the health services research arm of the U.S. Department of Health and Human Services (HHS), complementing the biomedical research mission of its sister agency, the National Institutes of Health. AHRQ is a home to research centers that specialize in major areas of health care research such as quality improvement and patient safety, outcomes and effectiveness of care, clinical practice and technology assessment, and health care organization and delivery systems. It is also a major source of funding and technical assistance for health services research and research training at leading U.S. universities and other institutions, as well as a science partner, working with the public and private sectors to build the knowledge base for what worksand does not workin health and health care and to translate this knowledge into everyday practice and policymaking.
HMO Research Network
The HMO Research Network includes 19 research centers, each associated with a health care delivery system. Researchers at the centers collaborate on multi-site studies in real-world health care settings across the United States and in Israel. With access to information on more than 16 million ethnically and geographically diverse patients, these researchers are finding solutions for common and rare health problems. Since 1994, the Network has been answering pressing questions about keeping people healthy and delivering effective care.
About the Kaiser Permanente Division of Research
The Kaiser Permanente Division of Research conducts, publishes and disseminates epidemiologic and health services research to improve the health and medical care of Kaiser Permanente members and the society at large. It seeks to understand the determinants of illness and well-being and to improve the quality and cost-effectiveness of health care. Located in Oakland, Calif., the Division of Research employs over 600 staff working on more than 250 epidemiological and health services research projects. For more information, visit www.dor.kaiser.org.
About the Kaiser Permanente Department of Research and Evaluation
The Department of Research and Evaluation (R&E) conducts high quality, innovative research into disease etiology, prevention, treatment and care delivery. Investigators conduct epidemiology, health sciences, and behavioral research as well as clinical trials. Located in Pasadena, Calif., the department focuses on translating research to practice quickly to benefit the health and lives of Kaiser Permanente Southern California members and the general population. Visit www.kp.org/research.
HealthPartners Institute for Education and Research
HealthPartners Institute for Education and Research is dedicated to improving health through discovery, the translation of research, and health professional education. Our researchers are dedicated to conducting high-quality, public-domain health research, proposed and led by multidisciplinary teams of independent PhD- and MD-level investigators rigorously trained in statistics, economics, epidemiology, and other fields. The Institute is part of a larger organization consisting of HealthPartners, Regions Hospital, and clinics.
Group Health Research Institute
Group Health Research Institute is the research arm of Seattle-based Group Health Cooperative, a consumer-governed, nonprofit health care system. Founded in 1947, Group Health Cooperative coordinates health care and coverage. Group Health Research Institute changed its name from Group Health Center for Health Studies in 2009. Since 1983, the Institute has conducted nonproprietary public-interest research on preventing, diagnosing, and treating major health problems. Government and private research grants provide its main funding.
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Addis Ababa, Ethiopia -?For all of you music lovers Selam Festival is just around the corner. The festival which is in its third year will begin on Saturday December 8th, 2012. This annual music bash is one of the few platforms which offer a unique setting for concerts, cultural shows and workshops to promote music and culture.
If you still have some Thanksgiving leftovers lurking about your fridge, it's time to get creative and use them up. If cranberry sauce is among those leftovers, the folks at CHOW have a creative use for it: use it in a tasty cocktail you can sip while you figure out what to do with the rest of the leftovers. ![[ Back to EurekAlert! ]](https://lh3.googleusercontent.com/blogger_img_proxy/AEn0k_v2ZiilwcVZOoOO-rXg1PA49XH1nS8vWpwYnpMgIRb50wFwIRTlPHZQlLlqZPgu74KdHHAcvxcAzW2GLF6_5oSQUxYODTmcrYaTEW1lkWI=s0-d){kind=small}
Public release date: 26-Nov-2012
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