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Sleep Apnea May Contribute to Earlier Onset of Alzheimer's Disease
According to a recent study carried out at New York University, people suffering from sleep apnea are likely to develop cognitive impairment, such as dementia and Alzheimer's disease, nearly 10 years earlier than those without the condition.
The extensive study, which tested 2,470 people between the ages of 55 to 90, discovered a clear link between sleep apnea and early onset of Alzheimer's, and highlights the importance of getting tested as soon as possible if you believe that you may be suffering from disturbed sleep. Read More →
Rob Amity Posted in Uncategorized	alzheimers disease, Sleep Apnea
Decoding the Science of Sleep – Tampa
Zlatko Glusica was the captain of an Air India Express plane carrying 166 passengers from Dubai to Mangalore, a bustling port city on India's southern coast. As his Boeing 737 approached the city, Mr. Glusica woke up from a nap in the cockpit and took over the controls. His co-pilot warned him repeatedly that he was coming in at the wrong angle and that he should pull up and try again. The last sound on the cockpit recorder was the co-pilot screaming that they didn't have any runway left. The plane overshot the landing and burst into flames. Only eight people survived. An investigation found that the captain was suffering from "sleep inertia."
The accident was a fatal reminder of the power of something prosaic that most of us typically don't give much thought: sleep. Yet it's a lesson that is habitually forgotten. Since that 2010 Air India flight, sleepy pilots have been at the center of several near-accidents, including two this year. In April, 16 passengers of an Air Canada flight were injured after the plane's pilot went into a sudden dive after he mistook the planet Venus for an oncoming plane. And in July, a Texas judge found that a JetBlue pilot's bizarre ranting in the cabin was a psychotic breakdown that may have been caused by a lack of sleep.
It isn't just the airline industry. Some 20% of automobile accidents come as the result of drowsy drivers, according to the Centers for Disease Control and Prevention. U.S. military researchers, meanwhile, have concluded that sleeplessness is one of the leading causes of friendly fire.
Sleep wasn't something we were supposed to worry about in the early years of the 21st century. Technology was making the world smaller by the day; the global economy blurred the lines between one day and the next, and things like time and place were supposed to be growing ever less important in the always-on workplace. Most of us never gave sleep much thought—considering it nothing more than an elegant on-off switch, like the ones on our smartphones, that the body flips when it needs to take a break from its overscheduled life. Sure, we'd like to get a bit more of it. But, beyond that, sleep likely hovers somewhere near flossing in most of our lives: something we are supposed to do more—but don't.
Americans, however, are starting to wake up about sleep. Endless ads for dubious energy drinks and an equal number of much slicker ads for prescription sleep aids reveal a culture in 2012 that is wired and tired. Lack of sleep, it seems, has become one of the signature ailments of our modern age.
Nearly a third of working adults in America—roughly 41 million people—get less than six hours of sleep a night, according to a recent CDC report. That number of sleep-deprived people is up about 25% from 1990. About 27% of workers in the financial and insurance industries are sleep-deprived, according to the CDC, while nearly 42% of workers in the mining industry share the same complaint. A 2011 study published in the journal Sleep found that insomnia costs $2,280 per worker in lost productivity, adding up to $63.2 billion nationwide.
This skyrocketing sleeplessness has given rise to a large and growing industry: Americans now spend tens of billions of dollars on prescriptions, at sleep labs, on mattresses and for medical devices in our quest for some simple shuteye, according to Marketdata Enterprises, a market research firm based in Tampa, Fla. "Fatigue management consultants," meanwhile, now work with more than half of the current Fortune 500 companies, law-enforcement groups and even Super Bowl-winning teams on ways to maintain a consistently high-performing workforce and prevent accidents.
So why is sleep, which seems so simple, becoming so problematic? Much of the problem can be traced to the revolutionary device that's probably hanging above your head right now: the light bulb. Before this electrically illuminated age, our ancestors slept in two distinct chunks each night. The so-called first sleep took place not long after the sun went down and lasted until a little after midnight. A person would then wake up for an hour or so before heading back to the so-called second sleep.
Sleep wasn't something we were supposed to worry about in the 21st century—as time and place were set to be erased by technology.
It was a fact of life that was once as common as breakfast—and one which might have remained forgotten had it not been for the research of a Virginia Tech history professor named A. Roger Ekirch, who spent nearly 20 years in the 1980s and '90s investigating the history of the night. As Prof. Ekirch leafed through documents ranging from property records to primers on how to spot a ghost, he kept noticing strange references to sleep. In "The Canterbury Tales," for instance, one of the characters in "The Squire's Tale" wakes up in the early morning following her "first sleep" and then goes back to bed. A 15th-century medical book, meanwhile, advised readers to spend their "first sleep" on the right side and after that to lie on their left. A cleric in England wrote that the time between the first and second sleep was the best time for serious study.
The time between the two bouts of sleep was a natural and expected part of the night, and depending on your needs, was spent praying, reading, contemplating your dreams or having sex. The last one was perhaps the most popular. A noted 16th-century French physician named Laurent Joubert concluded that plowmen, artisans and others who worked with their hands were able to conceive more children because they waited until after their first sleep, when their energy was replenished, to make love.
Studies show that this type of sleep is so ingrained in our nature that it will reappear if given a chance. Experimental subjects sequestered from artificial lights have tended to ease into this rhythm. What's more, cultures without artificial light still sleep this way. In the 1960s, anthropologists studying the Tiv culture in central Nigeria found that group members not only practiced segmented sleep, but also used roughly the same terms to describe it.
That natural cycle was forever changed by Thomas Edison (whose contributions to our sleepless nights also extend to his work on the phonograph and the motion picture). Soon, sunset no longer meant the end of your social life, but the beginning of it. Night became the time when all the good stuff happens. And, for businesses, it meant that darkness no longer got in the way of production. Factories soon began running all night long. By the 1920s, the idea of a first and second sleep had entirely disappeared from our daily rhythms, completing a process that had begun 200 years earlier with the introduction of the first gas lamps and the surge in the number of coffee houses in Northern Europe. Now we have so much artificial light that after a 1994 earthquake knocked out power, some concerned residents of Los Angeles called the police to report a "giant, silvery cloud" in the sky above them. It was the Milky Way. They had never seen it before.
None of us wants to go back to a time before electric lights, of course. Yet our attempts at blending our natural sleep rhythms with the modern world look to be failing—especially as the electric light has migrated from the ceiling to the palms of our hands, where smartphones and other devices now rarely leave our side.
Caffeine may work in the short-term, but it isn't a long-term solution for the average person because the body begins to build up a tolerance to it.
Our attempts at blending our natural sleep rhythms with the modern world look to be failing—especially as the electric light has migrated from the ceiling to the palms of our hands.
The consequences of this change in lifestyle are far more dire than a simple loss of connection to the natural world. Researchers are increasingly finding that lack of sleep is terrible for our health. Sleeplessness has been linked to increased rates of heart disease, obesity, stroke and even certain cancers. The exact reasons for these effects are still largely unknown, but give support to the theory that sleep is the time when our bodies naturally repair themselves on a cellular level.
Recently, researchers have also found how important these overlooked hours are to our mental performance. Sleep, or the lack of it, is now thought to be a complex process that underpins everything from our ability to learn a new skill to how likely we are to find a novel solution to a problem. It is also considered a vital part of happiness and one of the best forms of preventative medicine.
Many of us try to mitigate our lack of sleep with coffee and sleeping pills, but it just doesn't work. Caffeine may work in the short-term, but it isn't a long-term solution for the average person because the body begins to build up a tolerance to it. Soon, higher and higher doses are required to get the same effect. Strong doses of caffeine tend to make the body jittery and, once the caffeine wears off, lead to crashing in exhaustion.
And no amount of caffeine can alleviate the need for sleep. When that time comes, many adults turn to sleeping pills for help. About 60 million prescriptions for sleeping pills were filled in the U.S. last year, according to IMS Health, a data and analytics firm in Parsippany, N.J. That number is up from 48 million in 2006. Yet a number of studies have shown that drugs like Ambien and Lunesta offer no significant improvements in the quality of users' sleep.
And they only give you the tiniest bit more in the quantity department. In one meta-analysis of sleeping pill studies sponsored by the National Institutes of Health and published in 2007, patients taking popular prescription sleeping pills fell asleep just 13 minutes faster than those given a sugar pill. They slept for a grand total of 11 minutes longer. People seem to overestimate the effectiveness of sleeping pills, partly because of the placebo effect, and partly because some of these pills cause short-term memory loss that leaves people believing they got better sleep than they actually did—they just don't remember all their tossing and turning.
So why don't we put more effort into dealing with our sleep problems? While we'll spend thousands on lavish vacations to unwind, grind away hours exercising and pay exorbitant amounts for organic food, sleep remains ingrained in our cultural ethos as something that can be put off, dosed or ignored. We can't look at sleep as an investment in our health because—after all—it's just sleep. It is hard to feel like you're taking an active step to improve your life with your head on a pillow.
Nonetheless, there are steps we can take to adapt the way we approach sleep to be more effective for modern life. In a new branch of sleep medicine, scientists have identified how to get a good night's sleep naturally. Most of the suggestions come down to changing your behavior. One thing you can do is go to bed at the same time every night. Also, studies have shown that people should avoid the bluish light from computer screens, TVs and smartphones—which our brains interpret as sunlight—for at least an hour before bed. And, by doing yoga or other relaxation techniques that put the mind at ease, subjects in studies have dramatically improved both their sleep quality and quantity.
Poor sleep habits can also be a data problem. With nothing more than hazy memories of the night to go on, most of us have only rough estimates of when, exactly, we fell asleep—and whether we spent the night tossing and turning. New consumer devices, like headbands that measure brain waves during the night and pedometer-like devices that measure movement, can give the home user data rivaling what they might get in a sleep lab. Such data can allow people to pinpoint the real effects of each day's choices on their night's sleep.
Such tracking and behavioral adjustment isn't that far removed from the work that fatigue-management consultants do. Their work often consists of combing accident reports and comparing them with work schedules to find out how long employees on duty had been awake. By charting the outcomes, fatigue-management consultants are often able to prove that a greater respect for sleep can lead to better results at the office, whether that office is a multinational corporation or a local fire department.
The secret to a good night's sleep may very well be acknowledging that it takes work. And that the work is worth it. Health, mental sharpness, sex, relationships, creativity, memories—all of these things that make us who we are depend on the hours we spend each night with our eyes closed.
As Heraclitus wrote 2,500 years ago: "Even a soul submerged in sleep is hard at work and helps make something of the world."
Randall is a senior reporter at Reuters and the author of "Dreamland: Adventures in the Strange Science of Sleep," to be published Aug. 13 by W.W. Norton.
V Tipnes Posted in Uncategorized	Blackstone Medical Services, CPAP, Sleep Apnea
Pro Athletes: Sleep Helps Them Stay in the Game – Tampa
The athletes who rise to the level of professional sports in the United States are an elite bunch, some of the most physically gifted players on the planet. As difficult as it is to reach this level of sport, once they've been drafted into the pro leagues, their work is still just beginning. Maintaining a career in professional sports is intensely competitive and difficult, requiring serious dedication to developing and maintaining their skills.
Along with speed and agility, scoring prowess and defensive might, should an athlete's sleep ability be a factor in determining his or her value as a player?
According to two recent studies, this may just be a pretty good strategy. Sleep researchers at Virginia's Martha Jefferson Hospital Sleep Medicine Center have established a connection between career longevity and stability and levels of daytime sleepiness among athletes in two professional sports — football and baseball.
Both studies, which were presented at SLEEP 2012, an annual meeting of the Association of Professional Sleep Societies, investigated links between sleep and the staying power of careers for athletes in the National Football League and Major League Baseball. Researchers found that athletes in both leagues who reported experiencing high levels of daytime sleepiness were more likely to have shorter careers — and less likely to stay with the teams that originally drafted them — than players who were better rested, and reported feeling less tired during the day.
When studying NFL athletes, researchers included 55 players from around the league, all of whom went from college-level football through the draft process to professional teams. Players completed a questionnaire that enabled researchers to evaluate the athletes' levels of daytime tiredness. They found that athletes who scored higher for excessive daytime tiredness — those who were more tired during the day — were less likely to stay with the original team that drafted them than players who scored at lower levels for excessive daytime tiredness. Among players who reported high levels of daytime sleepiness, 38 percent stayed with their drafting team, compared to 56 percent of better-rested players.
To study baseball players, researchers presented these athletes with the same questionnaire on sleep and daytime tiredness. They included 40 pro baseball players from MLB teams. Researchers discovered that those players who reported the highest levels of daytime sleepiness had significantly higher dropout rates from the league. Ballplayers who reported feeling more tired during the day had dropout rates in the range of 57-86 percent, compared to average MLB drop out rates, which are in the range of 30-35 percent.
This is important information for team organizations, players, and coaches: Protecting and encouraging sleep among these pro athletes may be one way to enhance and even prolong players' career-long levels of performance.
This isn't the first time we've seen evidence that sleep can have a powerful effect on athletes' performance. We know from athletes' own discussions of their training regimens that a successful training schedule often includes early bedtimes and careful attention to rest and recovery. And this 2011 study of college basketball players found that additional sleep resulted in significant improvements to speed and shooting skills, as well as diminished feelings of daytime tiredness and improvements in players' moods and sense of well-being related to their sport.
It's worth noting that in this college basketball study, researchers found many of the athletes suffering from chronic sleep deprivation at the study's outset. I'd be willing to guess that with their demanding practice and game schedules, combined with near-constant traveling, many professional athletes are in a similarly sleep-deprived state. This latest study gives us reason to wonder: How much better, longer — and healthier — could our pro athletes play if that made sleep a regular part of their training regimen?
We study the health and performance of our professional athletes for many reasons. Pro sports are both big business and an important part of our culture. Leagues have a lot of incentive to push their players to play at their best — they also have a responsibility to their players' health, and to ensure that their athletes are playing as safely as possible. In addition, what we learn from people who push their bodies to extremes can deliver lessons and insights for the broader population — those of us who don't tackle and block against 300-pound guys for a living, or chase down 100-mph fastballs with speed and lightning-quick footwork.
Making sleep a priority — getting your seven to eight hours of sleep per night, every night, and addressing sleep problems before they become chronic or serious — can help you protect your health and your longevity on your field of play, whatever that may be. You don't have to have a career lived out on AstroTurf or in a stadium to want to work — and live — well for a good, long time. Remember that sleep is one of your most powerful tools for helping you stay at the top of your game.
Sweet Dreams,
Michael J. Breus, PhD
Study: OSA Can Be Managed Successfully in Primary Care Setting
Patients with moderate-to-severe obstructive sleep apnea (OSA) can be successfully managed in a primary care setting by appropriately trained primary care physicians (PCPs) and community-based nurses, according to Australian researchers.
"With the rise in demand and growing waiting lists for sleep physician consultation and laboratory-based sleep services, there has been increasing interest in development of ambulatory strategies for the diagnosis and management of OSA involving home sleep monitoring and auto-titrating continuous positive airway pressure (CPAP)," said lead author Ching Li Chai-Coetzer, MBBS, of the Adelaide Institute for Sleep Health at Repatriation General Hospital in Australia. "While previous studies have demonstrated that ambulatory models of care for OSA in specialist settings can produce patient outcomes which are comparable to laboratory-based management, this is the first randomised controlled study to be conducted in primary care."
The results were presented at the ATS 2012 International Conference in San Francisco.
"We randomized 155 patients to either primary care-based management or usual care in a specialist sleep center," said Chai-Coetzer. "At 6 months, mean change in Epworth sleepiness scale (ESS) scores, the primary outcome measure of the study, was similar in the two groups (4.9 in the primary care group vs 5.1 in the specialist group)."
PCPs identified patients with symptomatic, moderate-to-severe OSA using a four-item screening tool, the ESS, and home oximetry. Primary care-based management was led by the patient's PCP and a community-based nurse and involved use of home auto-titrating continuous positive airway pressure. Usual care in a specialist sleep center involved management by a sleep physician and laboratory-based testing.
In addition to similar changes in ESS scores at 6 months, mean change in Functional Outcomes of Sleep Questionnaire (FOSQ) score was similar in the two groups (2.3 in the primary care group vs 2.7 in the specialist group), as was compliance with CPAP. Mean daily use of CPAP was 4.8 (±2.1) hours in the primary care group and 5.4 (±1.8) hours in the specialist group.
Furthermore, within-study costs for primary care management were lower than those for specialist care, with significant savings of AUD$2,157 (95% CI: $1,293 to $3,114) per patient.
"Our results show that using a simplified, ambulatory approach for the treatment of OSA in primary care is not clinically inferior to management of these patients in a specialist sleep center," concluded Chai-Coetzer. "This approach also offers a lower cost alternative to usual care. In addition, waiting lists for specialist sleep centers are long, and home care may be preferred by patients."
In your opinion, can OSA be successfully managed in a primary care setting? Why or why not? How do studies like this impact the sleep profession? Join the discussion on Sleep Review's LinkedIn page.
One-Third Of U.S. Workers Aren't Getting Enough Sleep: Study, Tampa
Despite the recommendation that adults get between seven and nine hours of sleep a night, a new study shows that about a third of us aren't hitting those goals.
Researchers from the Centers for Disease Control and Prevention looked at data from the 2010 National Health Interview Survey on sleep habits of U.S. workers. They found that 30 percent of people in the study — which calculates to about 40.6 million workers in the U.S. — get fewer than six hours of sleep a night. Their research was published in this week's Morbidity and Mortality Weekly Report.
The study of 15,214 people also shed light on what kinds of jobs are linked with less sleep. The researchers found that people who work in manufacturing get less sleep than other workers, with 34.1 percent of them reporting getting less than six hours of sleep a night.
In addition, people who work the night shift were more likely to report getting inadequate sleep (44 percent), compared with those working during the day (28.8 percent).
Among people who worked the night shift, certain industries had high prevalences of inadequate sleep, including 69.7 percent of warehouse and transportation workers and 52.3 percent of health-care and social assistance workers, according to the report.
The researchers also found that people between ages 30 and 64 were more likely to report not getting enough sleep, compared with workers between ages 18 and 29 and workers age 65 and older.
People who work more than one job are also more likely to not get enough sleep during the night, compared with people who just have one job — 37 percent versus 29.4 percent. People who work more than 40 hours a week are also less likely to get enough sleep per night, compared with those who work a 40-or-under week.
Sleep deprivation is dangerous because it raises the risk of a whole host of health problems. Studies have linked inadequate rest with depression, a decreased immune system and memory issues, WebMD reported. Sleep deprivation has also been linked to obesity, high blood pressure and daytime fatigue, which could present safety issues on the job, Harvard Medical School reported.
Is There A Link Between Sleep Problems And Fibromyalgia Pain? Tampa
People with fibromyalgia often report problems with sleeping, but a new study in the Journal of Pain shows that troubled sleep doesn't actually predict fibromyalgia pain.
University of Florida researchers hypothesized that because past research has shown a link between troubled sleep and other kinds of pain, as well as a link between sleep deprivation and pain in people who don't have fibromyalgia, there might be a link between less sleep and pain from fibromyalgia.
But in their study, they found that lack of sleep was not able to predict the pain the study participants felt. Their study was based on 74 people with fibromyalgia, whose sleep and pain information was taken for 14 days.
"This study suggests that measures of sleep duration and nightly wake time do not predict fibromyalgia pain at the group level," the researchers wrote in the study. Rather, they said that being inactive or having fatigue may better predict pain than the amount of sleep obtained in a night.
However, this research isn't to say there's no link between sleep and fibromyalgia. A recent study in the journal Arthritis & Rheumatism showed that trouble sleeping can increase a woman's risk of developing fibromyalgia by more than three times, compared to people who get better rest, Health.com reported.
But still, the researchers of that study cautioned that the research doesn't show that sleep problems cause fibromyalgia, Health.com reported:
"Sleep problems are just one factor that may contribute to the development of fibromyalgia," says Paul J. Mork, Ph.D., a study coauthor and a researcher at the Norwegian University of Science and Technology, in Trondheim. "Fibromyalgia is a complex pain syndrome and there are numerous other factors that may contribute to the development of this illness."
Depression linked with sleep breathing problems, study finds- Tampa
Experiencing breathing problems during sleep may raise your risk of depression, a new study suggests.
Women with sleep apnea, in which breathing becomes shallow or pauses briefly during sleep, were 5.2 times as likely to have depression compared with women without the condition. Men with sleep apnea were 2.4 times as likely to have depression as men without the condition, according to the study from researchers at the Centers for Disease Control and Prevention (CDC).
Participants in the study who had other breathing problems during sleep also had an increased risk of depression. However, the researchers found no increased likelihood of depression among people who snore.
"Snorting, gasping or stopping breathing while asleep was associated with nearly all depression symptoms, including feeling hopeless and feeling like a failure," said study researcher Anne Wheaton, an epidemiologist with the CDC. "We expected persons with sleep-disordered breathing to report trouble sleeping or sleeping too much, or feeling tired and having little energy, but not the other symptoms."
Both depression and breathing problems during sleep are common, and both are underdiagnosed, the researchers wrote. Screening people who have for one disorder for the other could lead to better diagnosis and treatments, they said.
The researchers took into account other factors that might influence the results, such as age, sex and weight. The results are in line with those of the other studies, the researchers said.
The study found an association, not a cause-and-effect link. However, the researchers wrote that evidence from other research suggests that breathing problems during sleep may contribute to the development of depression. For example, one previous study found a link between the severity of breathing problems during sleep and the odds of later developing depression. And other studies have shown that people who received treatment for sleep apnea showed improvement in their depression.
"Mental health professionals often ask about certain sleep problems, such as unrefreshing sleep and insomnia, but likely do not realize that [breathing problems during sleep] may have an impact on their patients' mental health," the researchers wrote in their conclusion.
Although exactly how the link might work is unclear, it could partly be explained by the fact that people with breathing problems experience sleep that is fragmented, or may have low levels of oxygen in the blood during sleep.
The researchers used data collected from 9,714 adults who participated in the National Health and Nutrition Examination Survey, which is an ongoing study conducted by the CDC.
Participants were considered to have depression based on their answers to a questionnaire asking about how often they experienced symptoms of depression.
Six percent of men and 3 percent of women in the study reported having physician-diagnosed sleep apnea.
The study was limited in that participants' depression and sleep problems were measured at only one point in time, and in that it relied on self-reported symptoms. People may not be aware they have breathing problems during sleep, and there was no information about whether participants were being treated for depression.
The study is published in the April issue of the journal Sleep.
Read more: http://www.foxnews.com/health/2012/03/30/depression-linked-with-sleep-breathing-problems-study-finds/#ixzz1rjdng6yg
Mild Sleep Apnea May Raise Heart Risk – Tampa
Even Sleep Apnea Patients Who Don't Feel Drowsy in Daytime Are at Risk for Heart Disease – By Caroline Wilbert, WebMD Health News
Sleep apnea — even if it is so mild that people have no daytime drowsiness — may increase the risk of cardiovascular disease, a study shows.
The study, published in the American Journal of Respiratory and Critical Care Medicine, compared patients with mild sleep apnea to a comparison group that didn't have sleep apnea. There were 64 participants with mild sleep apnea and 15 participants without sleep apnea.
To compare the risk for heart disease, researchers tested endothelial function, which is how well the cells in the lining of the blood vessels work, and artery stiffness. Endothelial dysfunction and arterial stiffness are involved in developing atherosclerosis, or hardening of the arteries. Moderate to severe sleep apnea has already been linked to increased artery stiffness, endothelial dysfunction, and high blood pressure.
Malcolm Kohler, MD, from the Oxford Centre for Respiratory Medicine in England, and colleagues found that patients with mild sleep apnea had worse endothelial function and greater arterial stiffness than the comparison group without sleep apnea.
Researchers also tested blood pressure, another way to gauge cardiovascular disease risk. The groups tested similarly on blood pressure.
The researchers write that "although this was not associated with significantly increased blood pressure, the findings of this study suggest that patients with minimally symptomatic OSA [obstructive sleep apnea] are at increased cardiovascular risk, as has been demonstrated in more severe disease."
"It was previously known that people with OSA (obstructive sleep apnea) severe enough to affect their daytime alertness and manifest in other ways are at increased risk of cardiovascular disease, but this finding suggests that many more people — some of whom may be completely unaware that they even have OSA — are at risk than previously thought," Kohler says in a news release.
In an accompanying editorial, Geraldo Lorenzi-Filho MD, PhD, points out that just one in five patients with sleep apnea complains of drowsiness during the day. "It is now recognized that OSA triggers a cascade of biological reactions, including increased sympathetic activity, systemic inflammation, oxidative stress, and metabolic alterations that are potentially harmful to the cardiovascular system," he writes in the editorial.
Kohler and colleagues are now investigating the effects of continuous positive airway pressure (CPAP) therapy on arterial stiffness and endothelial function in patients with sleep apnea.
Disrupted Sleep Linked With Early Sign Of Alzheimer's: Study – Tampa
Having trouble staying asleep at night could spell trouble for your memory in old age, a new study suggests.
Research that will be presented in April at the annual meeting of the American Academy of Neurology shows that people who reported waking up more than five times in an hour also had an increased risk of having build up of amyloid plaques — which are linked with Alzheimer's disease — in their brains.
"Further research is needed to determine why this is happening and whether sleep changes may predict cognitive decline," study researcher Yo-El Ju, MD, of the Washington University School of Medicine in St. Louis, said in a statement.
Researchers examined the sleep patterns of 100 people ages 45 to 80 who didn't have dementia by having them fill out sleep diaries and questionnaires, and placing a device on them as they slept for two weeks. Half of the study participants had a family history of Alzheimer's disease.
The scientists found after the study that 25 percent of people had evidence of amyloid plaques in their brains. The average night's sleep for the study participants was eight hours, and the average time actually spent sleeping (due to periods of wakefulness during the night) was 6.5 hours a night.
Researchers found that the more "efficient" sleepers — that is, the people who spent more than 85 percent of time in their beds actually sleeping — were less likely to have the amyloid plaques than the "inefficient" sleepers — defined as people who spent less than 85 percent of time in their beds actually sleeping.
Past studies have also shown that sleep has other beneficial impacts on the brain.
In 2005, researchers from the Beth Israel Deaconess Medical Center found that getting a good night's sleep is linked with improvement in motor skills. That research was published in the journal Neuroscience.
And just last year, researchers from Stanford University published a study in the journal Proceedings of the National Academy of Sciences that showed that having constantly interrupted sleep is linked with an impaired ability to learn new things, the Los Angeles Times reported. That study was conducted in mice.
Surprising reasons you're tired all the time – Tampa
By Julie Evans
We all tend to blame fatigue on a too-busy lifestyle. And much of the time we're right.
If you feel tired all the time, don't blow it off. Give yourself about 2 to 3 weeks to make some lifestyle changes. Get more sleep, trim your social calendar, eat more wholesome foods, drink more fluids, take a multivitamin, and cut back on caffeine and alcohol.
"If you're still feeling the symptoms of fatigue after those changes, then you need professional help," says Sandra Adamson Fryhofer, MD, an internal medicine doctor in Atlanta. Excess exhaustion could be the sign of a more serious medical condition that can be treated. Here are the 6 most common problems to know about.
1. Anemia
This condition is more common in women with heavy periods or who don't consume enough iron.
The fatigue caused by anemia is the result of a lack of red blood cells, which bring oxygen from your lungs to your tissues and cells. You may feel weak and short of breath. Anemia may be caused by an iron or vitamin deficiency, blood loss, internal bleeding, or a chronic disease such as rheumatoid arthritis, cancer, or kidney failure. Women of childbearing age are especially susceptible to iron-deficiency anemia because of blood loss during menstruation and the body's need for extra iron during pregnancy and breastfeeding, explains Laurence Corash, MD, adjunct professor of laboratory medicine at the University of California, San Francisco.
The symptoms: Fatigue is a major one. Others include extreme weakness, difficulty sleeping, lack of concentration, rapid heartbeat, chest pains, and headache. Simple exercise, such as climbing the stairs or walking short distances, can cause fatigue.
The tests: A thorough evaluation for anemia includes a complete physical exam and blood tests, including a complete blood count (CBC), to check the levels of your red blood cells. It's also standard to check the stool for blood loss.
More than a million people are diagnosed with type 2 diabetes every year, but many more may not even know they have it.
Sugar, also called glucose, is the fuel that keeps your body going. And that means trouble for people with type 2 diabetes who can't use glucose properly, causing it to build up in the blood. Without enough energy to keep the body running smoothly, people with diabetes often notice fatigue as one of the first warning signs, says Christopher D. Saudek, MD, professor of medicine and program director for the General Clinical Research Center at the Johns Hopkins University School of Medicine.
The symptoms: Aside from exhaustion, other signs include excessive thirst, frequent urination, hunger, weight loss, irritability, vaginal yeast infections, and blurred vision.
The tests: There are two major tests for diabetes. The fasting plasma glucose test, which is more common, measures your blood glucose level after fasting for 8 hours, usually first thing in the morning. With the oral glucose tolerance test (OGTT), blood is drawn twice: just before drinking a glucose syrup, then 2 hours later.
3. Thyroid Disease
When your thyroid hormones are out of whack, even everyday activities will make you feel wiped out.
The thyroid gland, about the size of the knot on a man's tie, is found in the front of the neck and produces hormones that control your metabolism. Too much thyroid hormone (hyperthyroidism), and metabolism speeds up. Too little (hypothyroidism), and metabolism slows down.
The symptoms: Hyperthyroidism causes muscle fatigue and weakness, which you may notice first in the thighs. Exercises such as riding a bike or climbing stairs become more difficult. Other symptoms include unexplained weight loss, feeling warm all the time, increased heart rate, shorter and less frequent menstrual flows, and increased thirst. Hyperthyroidism is most commonly diagnosed in women in their 20s and 30s, but it can occur in older women and men too, says Robert J. McConnell, MD, codirector of the New York Thyroid Center at Columbia University Medical Center in New York City.
Hypothyroidism causes fatigue, an inability to concentrate, and muscle soreness, even with minor activity. Other symptoms include weight gain due to water retention, feeling cold all the time (even in warmer weather), heavier and more frequent menstrual flows, and constipation. Hypothyroidism is most common in women over age 50. In fact, as many as 10% of women past 50 will have at least mild hypothyroidism, says McConnell.
The tests: Thyroid disease can be detected with a blood test. "Thyroid disorders are so treatable that a thyroid test should be done in all people who complain of fatigue and/or muscle weakness," says McConnell.
More than "the blues," depression is a major illness that affects the way we sleep, eat, and feel about ourselves and others.
Without treatment, the symptoms of depression may last for weeks, months, or even years. So it's important to recognize the warning signs and get help.
The symptoms: We don't all experience depression in the same way. But commonly, depression can cause decreased energy, changes in sleeping and eating patterns, problems with memory and concentration, and feelings of hopelessness, worthlessness, and negativity.
The tests: There's no blood test for depression, but your doctor may be able to identify it by asking you a series of questions. If you experience five or more symptoms below for more than 2 weeks, or if they interfere with your life, see your doctor or mental health professional. Your doctor may also recommend a thorough physical exam to rule out other issues.
•Fatigue or loss of energy
•Sleeping too little or too much
•A persistent sad, anxious, or "empty" mood
•Reduced appetite and weight loss, or increased appetite and weight gain
•Loss of interest or pleasure in activities once enjoyed
•Restlessness or irritability
•Persistent physical symptoms that don't respond to treatment, such as headaches, chronic pain, or constipation and other digestive disorders
•Difficulty concentrating, remembering, or making decisions
•Feeling guilty, hopeless, or worthless
•Thoughts of death or suicide
5. Rheumatoid Arthritis
This autoimmune disease is not always easy to diagnose early, but there are some subtle clues to look for.
RA happens when your immune system turns against itself and attacks healthy joint tissue, sometimes resulting in irreversible damage to bone and cartilage.
The symptoms: Many symptoms (such as fatigue, low energy, loss of appetite, and joint pain) are shared by other health conditions, including other forms of arthritis such as fibromyalgia and lupus. Also, anemia and thyroid disorders, which also cause fatigue, are even more common in people with RA, according to John Klippel, MD, president and CEO of the Atlanta-based Arthritis Foundation.
Rheumatologists look for at least four of the following criteria in diagnosing RA: morning stiffness in and around the joints lasting at least 1 hour before maximum improvement; at least three joint areas with simultaneous soft tissue swelling or fluid; at least one joint area swollen in a wrist, knuckle, or the middle joint of a finger; simultaneous involvement of the same joint areas on both sides of the body; lumps of tissue under the skin; and bone erosion in the wrist or hand joints, detected by x-ray.
The tests: A thorough physical exam by a rheumatologist can provide some of the most valuable evidence of the disease, but there is also a test for the presence of rheumatoid factor, an antibody found in the blood. About 80% of people with RA test positive for this antibody, but the test is not conclusive.
6. Sleep Apnea
You could have this sleep-disrupting problem if you wake up feeling tired no matter how much rest you think you got.
Sleep apnea is a disorder characterized by brief interruptions of breathing during sleep. In the most common type, obstructive sleep apnea, your upper airway actually closes or collapses for a few seconds, which, in turn, alerts your brain to wake you up to begin breathing again. Someone with obstructive sleep apnea may stop breathing dozens or even hundreds of times a night, says Roseanne S. Barker, MD, former medical director of the Baptist Sleep Institute in Knoxville, TN.
The symptoms: Sleep apnea is often signaled by snoring and is generally followed by tiredness the next day. Because sleep apnea can lead to heart disease, high blood pressure, and stroke, it's important to be tested.


"In the Long Dance of life. . .
for in the instance of eternal time the new always refreshes and cleanses."
The contribution for the Long Dance is $150. If you are not able to donate "green energy," we invite you to discuss with us how you might donate your time or services to the Center as your energy exchange. No dancer is ever turned away for financial reasons.
Please see the dance information page for information on what to bring, how to prepare, etc.


AHTS Aiviq with the arctic drilling rig Kulluk in tow. Picture by Ric Shrewsbury.
Katrina Morrison (SVO 11′) took this quick phone picture of one of Crosby's big tugs letting out wire with the Tetra Hedron on the other end. Cool stuff.
I was cruising yacht world last night and found this beauty for sale, 26′ Mackenzie and the only original parts are the stem and keel.
My view (well one of them) for the last few days.


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University Hospitals of Morecambe Bay NHS Foundation Trust (UHMB or UHMBT) is an NHS Foundation Trust in North West England, providing services in South Cumbria and North Lancashire in the Morecambe Bay area.  It has about 6,000 employees and provides services for some 350,000 people.

Services
It provides services at:
 Royal Lancaster Infirmary in Lancaster
 Furness General Hospital in Barrow-in-Furness
 Westmorland General Hospital in Kendal, where the trust is headquartered.
 Queen Victoria Hospital in Morecambe
Ulverston Community Health Centre (outpatients).

The Trust was the first to deploy Lorenzo patient record systems in the NHS. It implemented electronic patient record system Lorenzo Release 1.9 in June 2010.

In 2013 the Care Quality Commission stated that there had been problems with the Commission's oversight of the trust in 2010, that the Commission had "provided false assurances to the public" and that "[it] should not have registered UHMB without conditions", on publication of a report by Grant Thornton.

Jackie Daniel, chief executive said in June 2016 that she hoped to make her hospital "as small as humanly possible" as part of its new care model plans.  Emergency and maternity services are to continue in Barrow and Lancaster, but about 65 weekly outpatient clinics will be replaced by community provisions and beds will be reduced. A new chief executive, Aaron Cummins, was appointed on 1 April 2018, as was Ian Johnson as the new Trust Chair.

The trust joined the Waterloo House GP practice in Millom in October 2016 to run the business side of the practice as part of the Better Together vanguard project.

Performance

The Trust was highlighted by NHS England as having 3 of 148 reported never events in the period from April to September 2013.

In December 2013 it was announced that despite the Furness General Hospital maternity ward deaths investigation, Cumbria Clinical Commissioning Group intends to maintain consultant-led maternity services at Furness General Hospital "for the foreseeable future".

In June 2014 the trust was placed in special measures by Monitor (NHS) after safety and leadership were rated inadequate by the Care Quality Commission.  Services at Westmorland General Hospital were given an overall rating of "good", but Furness General Hospital and the Royal Lancaster Infirmary both "required improvement".

In February 2015 it was announced that the Clinical Commissioning Groups planned for inpatient elective surgery at Westmorland General Hospital to be transferred to Royal Lancaster Infirmary and Furness General Hospital.

The trust decided in October 2015 to contract out its outpatient pharmacy services to a private provider.

In 2014/5 the trust was given a loan of £21 million by the Department of Health which is supposed to be paid back in five years.  It spent 7.2% of its total turnover on agency staff in 2014/5.

The trust was taken out of special measures in December 2015 after a further inspection.

NHS Tariff
In August 2014 it was announced that the Trust would make an application to Monitor (NHS) for an increase in the prices paid for treatment by the NHS because its remote location made it impossible to manage within the national Payment by Results tariff.

In July 2015 the trust was the first, and so far only, to get an increase in the NHS tariff for its services agreed by Monitor (NHS) because of its "increased costs associated with this trust running health services across multiple sites in rural locations". It will get paid more per episode for accident and emergency, surgery, trauma and orthopaedics, paediatrics, women's health, and non-elective medical conditions. This is expected to increase the trust's income by more than £20 million per year.

See also
 Furness General Hospital scandal
 Healthcare in Cumbria
 List of hospitals in England
 List of NHS Trusts

References

External links

NHS foundation trusts
Organisations based in Cumbria
Organisations based in Lancashire
Health in Cumbria
Health in Lancashire

redpajama_set_name: RedPajamaWikipedia


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Bryson "Boom" Paul | July 27, 2022
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redpajama_set_name: RedPajamaCommonCrawl


According to a recent report from the Robert Wood Johnson Foundation (RWJF), states that chose not to expand Medicaid experienced an increase last year in physician reimbursements. The increase for primary care doctors was 3.3 percent, and the increase for surgeons was 4 percent. The report also showed that states that expanded Medicaid experienced a 3 percent increase for primary care doctors and a 2 percent increase for surgeons. This is likely due to an increase in the rate of reimbursements.
"Reimbursements are up a bit, so physicians are doing okay," says Kathy Hempstead of the Robert Wood Johnson Foundation.
The report's analysis examined data from approximately 20,000 physicians. The data was extracted from a compendium forming part of the ACAView project, a joint venture between RWJF and athenahealth.
The increase in reimbursement comes from an average of all payers, including Medicaid, Medicare, and private insurance. While the report showed that the number of patient visits to doctors offices remained relatively unchanging, it is likely that primary care doctors are making up for the difference by treating more complex patient cases.
Analysts explain that, under the new paradigms such as those of accountable care organizations and patient-centered medical homes, it makes sense that primary care physicians may be undertaking increasingly complex cases.
Colloquially known as Obamacare, the Affordable Care Act was signed by President Obama on March 23, 2010. Designed to make quality health insurance more affordable to a larger demographic, the ACA expands both public and private coverage. It requires companies to cover all applicants within certain minimum standards, as well as offer them the same rates regardless of gender or any pre-existing conditions.


Marching Band Activity United Kingdom (MBAUK) is a refreshing new online area for anyone that loves music and marching to share positive stories and to share information about themselves, their past, or indeed about things they are aware of coming up in the world of music and marching throughout the United Kingdom that they feel would be of interest to other like-minded individuals or groups. A completely neural area where the only focus is on spreading the very positive news that is out there and boy is there some great news to share.
Founded by John Butler in May 2013, MBAUK now has a combined Facebook / Twitter following of approaching 10,000 which is very significant here in the UK.
In 2014, MBAUK partnered with Thurrock Marching Brass to attempt a new World Record for the Longest Fanfare Line using valved instrumentation. An attempt that saw success in setting a new World Record on Sunday 6 September 2014.
Also in 2014 the charity Autism Plus contacted Marching Band Activity United Kingdom in regards to their social enterprise Mayfield belllyres, since then many connections have been made through the charity including the launch of an Instrument Campaign, helping to connect music to autism users with many instruments already being donated.
Always looking for new and exciting ways in which to promote all that is good about music and marching a new web site has been created to start to share connections and contacts from across the United Kingdom and to create a central pool of information that is really useful for everyone to tap into. Band lists and locations, trusted suppliers, local and national events across the UK all form part of this ventral pool of available information.
As part of the promotion of good work that everybody does, MBAUK runs, amongst many other campaigns, marching band awareness and weekly recruitment campaigns for all groups, and uses its increasing reach to share that information with the wider audience. This doesn't just stop at the Facebook, Twitter or Web Site areas as we have also started to open up channels through local and national radio stations too.
Always looking to promote and to share, MBAUK welcomes all positive interactions and interest so that we can keep the benefit of free flowing information continually running, and that could include you too so feel free to get in touch with us at info [at] mbauk [dot] co [dot] uk and we will be happy to look at working with you to share your news or information.
Posted by News Editor on Saturday, April 9th, 2016. Filed under British Youth Band Association, Drum Corps U.K., FrontPage Feature.


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Sunshine and clouds mixed. Temps nearly steady in the low to mid 30s. Winds SW at 10 to 15 mph..
Light snow this evening will transition to snow showers late. Low 22F. Winds W at 10 to 20 mph. Chance of snow 70%. Snow accumulations less than one inch.
Little Buckeye Museum Manager Suzanna Hammond (far left) and Executive Director Fred Boll (left) show their support for Shop Small. (Photo from November 2019)
Submitted photo
Little Buckeye Children's Museum wins big at Small Business Awards in December 2019.
At Little Buckeye Children's Museum, children are allowed to imagine to their hearts content.
By Tierra Thomas, Thrive Reporter
Little Buckeye calls on Richland community for Giving Tuesday
By Tierra Thomas, Content Specialist
Tierra Thomas
Thrive Reporter
Only 24 percent of children's museums are open across the country while the rest have been closed due to COVID-19. The pandemic has put a long-lasting effect on millions of lives in different ways, and one way includes the social and educational development of young children.
Little Buckeye Children's Museum closed in March and has not been able to reopen because of the risk factor. All employees aside from Executive Director Fred Boll and Museum Manager Suzanna Hammond were furloughed, and the museum has felt the loss of its local families and visitors.
"We can't earn any income right now. We haven't earned income since March 13," Boll said. "So we need to bridge that gap between COVID ending and the Imagination District starting."
After raising $5.2 million for the Imagination District and unveiling their initiative back in 2019, plans steamrolled ahead, and Boll and Hammond saw great progress in their new passion project. Unfortunately, their plans have slowed down since the beginning of the year, and they're calling on the community to help them raise operation funds on Giving Tuesday.
"This is the first time since I've been executive director and since Suzanna's worked at the museum that we've had to go out and ask people for operation funds," Boll said. "Before, we never had to ask or make that request again, and it's a short term problem for us. We fully anticipate once we can reopen to go back to being self-sufficient."
Without places such as Little Buckeye or the Imagination District available this year, children have had lesser opportunities to socialize and explore their minds.
However, even though progress has slowed down, work has continued. Boll and Hammond have moved forward with Imagination District, and over the summer they've still made Little Buckeye a part of kids' lives by providing Buckeye bags to the NECIC.
"Now more than ever, children need a safe place to play and to learn, and we've tried to provide that how we can during this time," Hammond said.
Play is an excellent tool for children to deal with stress and their environment. During the pandemic, the need has been much stronger. Boll hopes that once a vaccine comes and it's safe again, they can help build on the development that children have missed out on throughout 2020.
"It's a balance of safety for the short term, and then there's long term development," Boll said. "So yes, we're in that phase of safety for the short term, but the need for the museum is going to be there when people come out of COVID. Kids are going to need that play and that release time."
Boll and Hammond are looking forward to 2021 and have fully prepared for whatever comes their way. At the new location, there will be enough space for child programs unlike ever before at the Little Buckeye location. Hammond said the increased programming is going to be "really valuable to help kids socialize and start to learn the rules of like a classroom" as well as communicate and share with others.
Little Buckeye has always been a supporter of giving back to the community. Their contributions have led to other organizations following suit.
Christine Myers, founder of The Visual Bucket List Foundation, had met Boll through Leadership Unlimited after a visit to the museum itself. Upon learning about all that Little Buckeye has done to give back, she was inspired to make Visual Bucket List into more than what it was in the past.
"He has helped us with our foundation," Myers said. "He guided us on some things that we need like Richland Gives and so forth, because we were newbies. So he has been a huge asset in helping us navigate the nonprofit world."
Myers has a "passion" for what Little Buckeye brings to the community. She and her husband have made contributions in the past to the facility such as building the firetruck for the fire station exhibit as well as working with Ohio Eye and sponsoring the St. Peters exhibit.
"I think (Little Buckeye) is a great asset for our kids," Myers said. "Imaginative play is so important. I love what Fred does, and I think it's unique and fun for area children, so through all of this, Fred and I have kind of gained a friendship."
Myers' kids, 7 and 10, have used Little Buckeye to build their social and problem-solving skills. It's enhanced their behavior in terms of interacting with others, learning how to get along and how to share.
As someone who knows single handedly the importance of making a difference in a child's life, Myers hopes that the contributions Visual Bucket List and Little Buckeye have made don't go unrecognized.
"Little Buckeye enables kids to really do imaginative play, which is one of the best ways for them to learn," Myers said. "It's how they learn to grow socially, emotionally and mentally. It's where they are free to kind of develop at their own pace."
Giving Tuesday takes place on Dec. 1. To make a donation to Little Buckeye, visit www.richlandgives.mightycause.com.
This article was paid for by the nonprofit organization mentioned. Leading up to Giving Tuesday on December 1, we will feature profiles on various local nonprofits. Read all the stories here.
See Nonprofit Giving Guide
Fred Boll
Little Buckeye
Christine Myers
Suzanna Hammond
Tierra Thomas is the Thrive Reporter for Richland Source and Content Specialist for Source Brand Solutions. She graduated from Kent State University with a degree in Journalism. When she's not writing news, she's writing fiction or taking photos.
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Inside the mind of two street preachers
March 24, 2020 March 25, 2020 by Olivia Harter
Street Preachers have a long and controversial history on college campuses. I sat down with two to find out why, exactly, they do what they do.
Featured image illustration by Elisabeth Oster
Street preachers have been a fixture on university campuses for as long as most students can remember. Signs wave in students' faces denouncing drinking, smoking, and even rock music. These signs are a source of contention for most students, who may feel unsafe due to the strong and discriminatory language. The large banners that say members of the LGBTQ+ community are hell-bound evoke feelings of danger and uncertainty.
Street preaching is somewhat controversial in religious circles. Frequently quoted by those who support street preachers is bible verse Matthew 10:14: "If anyone will not welcome you or listen to your words, leave that home or town and shake the dust off your feet."
Well known street preachers, such as those who belong to the Westboro Baptist Church, have caused mountains of debate over their violent rhetoric towards LGBTQ+ people, Catholics, Muslim people, Jewish people, and more. For some religious people, such as author Neal Wooten, they believe street preaching turns people away from religion instead of toward it. In his article for Huffington Post, Wooten says "Yes, we are to share the Word and witness to others, but only when it's productive." But to others, street preaching (or "open-air preaching" as it is referred to occasionally) is the perfect way to spread the word of God.
My first experience with street preaching was my freshman year of college when I witnessed a group of girls get the word "slut" hurled at them by a street preacher who was angry at the length of their shorts. I was (and still am) horrified, yet also curious. The average person does not scream their convictions at strangers, yet here these street preachers stood, holding signs depicting fire, brimstone, and hell for all those who don't follow their religious code. Was what I once perceived as a narcissistic need to feel better than the common citizen actually a genuine sense of duty that led them to these street corners?
According to them, they do it out of love.
I met with Cory and Vijay, whose last names are withheld for privacy and safety concerns, to discuss the reasoning behind what they do. They are nondenominational street preachers who are often seen on various corners of Iowa City passing out fliers. These fliers tell the reader what Jesus will punish them for in Hell, including but not limited to sexual immorality, sodomy, lying, drinking, immodesty, and watching porn. With such a bold belief system, I was admittedly a bit wary of our meeting. That feeling quickly changed when both men greeted me politely and answered my questions fully.
Both men have come out on the other side of many hardships. Cory began to use methamphetamine at 16-years-old. At 17, he overdosed. Besides meth, he was also a frequent user of LSD, cocaine, alcohol, and marijuana.
"Anything that would get me high, I did it," he told me.
Vijay went through a divorce and lost his mother to breast cancer 15 years ago. His father now struggles with some degree of memory loss and cannot recognize Vijay when he travels home to visit him in India. Though their faith was tested through their struggles, both told me they still feel a strong duty to preach and owe that sense to their faith.
Street Preachers are a part of large events like Comic Con, according to The Verge. PHOTO courtesy of The Verge.
"We preach the message of love," Vijay said, referring to students and residents of Iowa City. "People think that it's a message of hate, [but]…The Bible [says] to love God with all your heart, soul, mind, and strength. That's the first greatest Commandment Jesus said. The second greatest Commandment is love your neighbor as yourselves. If I love them, I don't want them to go to Hell," he said.
Cory and Vijay are aware that their methods are not always received well, but made it clear they vehemently disagree with the Westboro Baptist Church, as they say they use hateful methods to spread their message. For Cory and Vijay, they believe the work they do street preaching is for our own good. They believe this sort of "tough love" through their preaching has the potential to save souls.
Cory compares their preaching to when he was using heavily and his grandmother would confront him about his actions and behavior. She was his guardian during this time in which he was a minor, and Cory said a lot of what he went through during his adolescence is why he is so devoted to faith now.
"She would ask me questions and I would not want to answer those questions," Cory said. "She would want me to look in the light when I got home to see if my eyes were bloodshot and those kinds of things, and at that time, all I could think about was 'my grandmother hates my guts'… I didn't realize how much she loved me. How much she cared about me."
Here, Cory began to tear up, overwrought with emotion as he recalled the trauma of his past usage and addictions to escape from the world around him. He then went on to explain that "Love is not tolerance…Jeffree Dahmer, love was for him to go out and find a boy and get him high and then rape him and then kill him and then eat him…Love is subjective. But not with God."
In their spare time, both men work jobs and spend time with their families. Vijay reads the Bible, plays tennis, spends time with his brother and kids, and even has a pilot's license. He describes himself as a "fun-loving guy," but urged me to not misrepresent him in this article.
"I will have all the fun in the world as long as it is not sinful," Vijay said.
Preacher in Iowa City. PHOTO by Alan Light.
Cory has a wife of fifteen years and two sons, with whom he enjoys spending time with and praying with. Both tell me early on in the interview that even the music they listen to is "Godly." They primarily listen to gospel music and hymns which are recorded from their church. They are both of the belief that there is no such thing as "Christian Rock" or "Christian Rap," because its origins are not godly.
The thing that struck me most during our interview is that both men genuinely seemed to be fearful for our souls. They impressed upon me that Judgement Day is coming and that they do not want people to suffer unnecessarily.
"We do believe [people] are in grave danger, and we want to pull them from the road of judgement," Cory says.
It is this fear for thy neighbor that drives Cory and Vijay to take to the streets, warning the general public of what may happen to us should we continue our "sinful" ways. When I set out to understand why Cory and Vijay do what they do, I was expecting to find hurtful intentions to put others down. Instead, I found an intention to help, despite their usage of an nontraditional practice.
Categories LOCAL, REVIEWTags campus, college students, controversial, iowa city, preachers, profile, signs, street preachers, university of iowa Post navigation
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I Got Zooted And Watched "Cats"
1 thought on "Inside the mind of two street preachers"
Two of some of the most famous college street preachers are Jed Smock and his wife. I had Jed Over to visit at my house. My wife met his wife, and from what my wife told me, it appears that what they say when preaching is a calculated show. My wife said Jed's wife Isn't anything like what she appears when she's "preaching".
Jed told us about his plans to be on a TV series, which fell through. He thinks highly of "bro"
Cope, who has usedFILTY profanity against One reproving him in public, and claims to have conversations with, and even give advice to God. The Arrogance Of such people is appalling. Smock carries a crucifix like the popes do, and considers Catholicism (with all its heresies) a branch of Christianity. He condones Joel Osteen, who is a obviously a false teacher (Obvious to those who truly know God and his word).


text:
7027 Toshihanda è un asteroide della fascia principale. Scoperto nel 1993, presenta un'orbita caratterizzata da un semiasse maggiore pari a 3,9617157 UA e da un'eccentricità di 0,1947776, inclinata di 12,38167° rispetto all'eclittica.

Collegamenti esterni

Corpi celesti scoperti nel 1993
Toshihanda


text:
PC Magazine places Netcraft as a Top 100 Classic Web Site
PC Magazine has awarded Netcraft a place in its 2003 Top 100 Classic Web Sites. Classic sites are defined as "perennial favorite, category leading sites", which one would most miss if stranded on a desert island.
PC Magazine is one of the world's leading computer publications with 6 million readers.
Posted by Mike Prettejohn in Other
PC Magazine names Netcraft as Top 100 Web Site
14 Oct 2003 Other
Netcraft outage 26th August
27 Aug 2003 Other
Our site was inaccessible for about 9 hours yesterday between 5pm and 1:30am BST [9am - 5:30pm Pacific]. We are informed that this was caused by a serious fibre break on the Energis network. Apologies.
Incentives for Phishing Site Reporters
14 Nov 2013 Netcraft Services, Other, Security
We incentivise phishing reports from our community of reporters. The current list of prizes is as follows: On reaching 5,000 validated reports you become eligible for a monthly competition to incentivise large reporters. To report phishing sites to us,...


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package eu.ydp.empiria.player.client.module.media.fullscreen;

import com.google.gwt.core.client.GWT;
import com.google.gwt.event.dom.client.TouchStartEvent;
import com.google.gwt.event.dom.client.TouchStartHandler;
import com.google.gwt.uibinder.client.UiBinder;
import com.google.gwt.uibinder.client.UiField;
import com.google.gwt.user.client.ui.Composite;
import com.google.gwt.user.client.ui.FlowPanel;
import com.google.gwt.user.client.ui.Widget;
import com.google.inject.Inject;
import eu.ydp.empiria.player.client.PlayerGinjectorFactory;
import eu.ydp.empiria.player.client.util.events.internal.bus.EventsBus;
import eu.ydp.empiria.player.client.util.events.internal.player.PlayerEvent;
import eu.ydp.empiria.player.client.util.events.internal.player.PlayerEventTypes;

public class VideoFullScreenViewImpl extends Composite implements VideoFullScreenView {

    private final EventsBus eventsBus;

    private static VideoFullScreenViewUiBinder uiBinder = GWT.create(VideoFullScreenViewUiBinder.class);

    interface VideoFullScreenViewUiBinder extends UiBinder<Widget, VideoFullScreenViewImpl> {
    }

    @UiField
    protected FlowPanel container;

    @UiField
    protected FlowPanel controls;

    @Inject
    public VideoFullScreenViewImpl(EventsBus eventsBus) {
        this.eventsBus = eventsBus;
        initWidget(uiBinder.createAndBindUi(this));
        container.addDomHandler(new TouchStartHandler() {

            @Override
            public void onTouchStart(TouchStartEvent event) {
                VideoFullScreenViewImpl.this.eventsBus.fireEvent(new PlayerEvent(PlayerEventTypes.TOUCH_EVENT_RESERVATION));
            }
        }, TouchStartEvent.getType());
    }

    /*
     * (non-Javadoc)
     *
     * @see eu.ydp.empiria.player.client.module.media.fullscreen.VideoFullScreenView#getContainer()
     */
    @Override
    public FlowPanel getContainer() {
        return container;
    }

    /*
     * (non-Javadoc)
     *
     * @see eu.ydp.empiria.player.client.module.media.fullscreen.VideoFullScreenView#getControls()
     */
    @Override
    public FlowPanel getControls() {
        return controls;
    }

}

redpajama_set_name: RedPajamaGithub


text:
Ice cream tests positive for COVID-19 –reports - An investigation is underway in Tianjin, China after three samples of ice cream reportedly tested positive for coronavirus. Anti-epidemic authorities are...
Noynoy leads partial, unofficial tally of PPCRV May 10, 2010, 7:57pm
Noynoy leads partial, unofficial tally of PPCRV
May 10, 2010, 7:57pm
Liberal Party standard bearer Benigno "Noynoy" Aquino Monday made an early lead in among his competitors in the presidential race, while Makati City Mayor Jejomar Binay is leading among the vice presidential hopefuls in the partial and unofficial tally of the Parish Pastoral Council for Responsible Voting (PPCRV).
Initial tally returns as of 7 p.m. Monday showed that Aquino was leading the pack of presidential aspirants with a total of 86,990 out of the 2,214,129 votes or 34.94 percent.
Aquino was followed by Pwersa ng Masang Pilipino (PMP) presidential candidate former President Joseph Ejercito Estrada with 67,425 votes or 27.11 percent and Nacionalista Party bet Manuel "Manny" Villar with 55,639 votes or 22.37 percent..... MORE
Source: The Manila Bulletin
URL: http://www.mb.com.ph/articles/256784/noynoy-leads-partial-unofficial-tally-ppcrv
PGMA, presidential bets heave sigh of relief May 10, 2010, 6:24pm "Hay Salamat!"
PGMA, presidential bets heave sigh of relief
"Hay Salamat!"
So declared President Gloria Macapagal Arroyo after a new poll machine successfully read and counted her ballot in a polling place here in the country's first automated elections.
The President, widely considered a shoo-in congresswoman in the second district of Pampanga, cast her ballot early Monday morning at the Clustered Precinct 1-A at the Lubao Central Elementary School after hearing a mass for peaceful and credible elections.
With a swarm of local and foreign poll observers and media monitoring her every move, the President, clad in an aqua sleeveless blouse and gray pants, checked her name at ers' list and then entered the designated polling precinct at around 7:08 a.m.... MORE
URL: http://www.mb.com.ph/articles/256765/pgma-presidential-bets-heave-sigh-relief
Confusion mars automated polls By MANILA BULLETIN NEWS TEAM May 10, 2010, 6:08pm
Confusion mars automated polls
But military officials say it's generally peaceful
By MANILA BULLETIN NEWS TEAM
Widespread reports of precinct count optical scan (PCOS) machine malfunction, vote-buying, voter disenfranchisement, and violence triggered chaos in the country's first automated elections Monday.
Despite this, the Armed Forces of the Philippines (AFP) described the first 12 hours of the election day as generally peaceful and manageable.
PCOS glitch
In Isabela, ABS-CBN News reported that as of noon Monday, 65 PCOS machines were defective, while six of the seven spare PCOS machines in Bocaue, Bulacan have already been used after regular voting machines malfunctioned.... MORE
URL: http://www.mb.com.ph/articles/256763/confusion-mars-automated-polls
Noynoy leads partial, unofficial tally of PPCRV Ma...
PGMA, presidential bets heave sigh of relief May 1...
Confusion mars automated polls By MANILA BULLETIN ...
Central African Republic: Rise in Food Prices Due to Escalating Conflict Tips More People Into Poverty in the Central African Republic - [World Bank] Bangui -- ccording to the latest « Price monitoring Bulletin » produced by Central African Institute for Statistics, Economic and Social Studi...
Australian Open players hit out at 14-day hotel isolation following flights - Dozens of top players are confined to hotel rooms for 14 days, throwing their training into disarray.
Official: Gunmen kill two women judges in Afghan capital - A court official says gunmen have fired on a car in northern Kabul, killing two women judges who worked for Afghanistan's high court and wounding the driver


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Rob Kardashian Life On and Off the Screen
Added by Tray Dingle on January 31, 2019.
Saved under Entertainment, Headlines
Tags: Kardashian, kardashin
On and Off the screen Rob Kardashian's life seems to be that of an ongoing novel.
Robert Arthur Kardashian was born in California In 1987. His parents are Robert Kardashian and Kris Jenner. He graduated from the University of Southern California in 2009, With a degree in business.
He and his siblings found success with their hit reality TV show in 2007, "Keeping Up with the Kardashians." He has also appeared on "Dancing with the Stars" and "The Choice."
Kardashian's designer sock business launched in 2012. The company's name came from a combination of him and his father's middle name; Arthur George.
In 2016, he was engaged to former stripper Blac Chyna. The two shared the screen in "Rob and Chyna." They welcomed there first child together in November and decided to end their engagement in December of the same year.
Since then his aim is to focus on the most important person in his life, his two-year-old daughter, Dream. A close source to the family says his biggest joy is being her dad.
He has intentionally chosen to stay out of the limelight, which means keeping off of the TV series. Sources say he does not like social situations or being on camera right now.
Kardashian is ready to leave the drama in the past with his daughter's mother as far as the relationship goes, according to reports. When it comes to Chyna, he wants to move on, because they do not have a relationship and they can deal with Dream through an intermediary.
He claims the restraining order and volatile relationship with Chyna have damaged his career and prohibits him from earning money. Filming for "Keeping Up With the Kardashians" came to a halt because his relationship took a turn for the worse with Chyna.
He claims the court order was widely publicized and he can under the scrutiny of the media. So, he has not participated in any family episodes since Chyna filed a request for a restraining order.
It has been difficult, he explained, he has no desire to participate in the family's reality show. He would like to try to recover from the emotional damage and maintain his privacy and explorer other business ventures.
Kardashian is striving to be the best father possible despite the court battles. To celebrate Dream's second birthday, the family shared sweet tributes. Grandma, Kris Jenner enthusiastically wrote on Instagram along with a precious photo.
Kim and Khloe told Andy that Rob was doing great when asked how their brother was doing. Kim said," I think he's going to be a little bit more in the next season, he has his moves. Sometimes, he's like I didn't sign up for this, and sometimes he's like I'm cool to do it."
Written by Leon Murray
Edited by Cathy Milne-Ware
HotNewHipHop: Rob Kardashian Will Be Returning To "Keeping Up With The Kardashians"
IMDb: Rob Kardashian Biography
People: Rob Kardashian
Featured and Top Image Courtesy of YouTube – Creative Commons License


Valid Thursday – Sunday through 3/15/19. Promotional rates are valid for reservations booked and purchased 14 days in advance at participating hotels. Select properties may require a Friday night stay. Rates may be available seven days a week at Resorts. Advance reservations required. Discount applied to best available rate at time of booking. Room & tax pre-paid at time of booking and is non-refundable and non-changeable. If cancellation or change to reservation takes place, guest will forfeit total room charge plus tax. Must quote promotional code ADP to receive the promotional rate. Some hotels may not be available at the rates shown. Promotion cannot be combined with any other offer, sale promotion, or prior purchase/reservation. Void where prohibited. Limited number of rooms are available for this promotion. Tax is additional. Offer does not apply to groups of 10 or more rooms. Offer cannot be combined with any other promotions. Blackout dates may apply. Advance reservations required. Other restrictions apply. Rates are per room, per night and based on availability at the time of reservations.


text:
Q: Как локализовать ошибку в плейбуке или роли ansible? Рефакторю роли в ansible. После некоторых изменений в очередной раз запускаю привычным способом (в точности такая команда уже не раз срабатывала):
ansible-playbook -s -v -i hosts/testing someplaybook.yaml

Получаю портянку стектрейса. Непонятно, можно ли как-то из этого локализовать ошибку?
 Traceback (most recent call last):
  File "/usr/local/bin/ansible-playbook", line 324, in <module>
    sys.exit(main(sys.argv[1:]))
  File "/usr/local/bin/ansible-playbook", line 264, in main
    pb.run()
  File "/Library/Python/2.7/site-packages/ansible/playbook/__init__.py", line 310, in run
    play = Play(self, play_ds, play_basedir, vault_password=self.vault_password)
  File "/Library/Python/2.7/site-packages/ansible/playbook/play.py", line 194, in __init__
    self._tasks      = self._load_tasks(self._ds.get('tasks', []), load_vars)
  File "/Library/Python/2.7/site-packages/ansible/playbook/play.py", line 664, in _load_tasks
    data = utils.parse_yaml_from_file(include_filename, vault_password=self.vault_password)
  File "/Library/Python/2.7/site-packages/ansible/utils/__init__.py", line 780, in parse_yaml_from_file
    process_yaml_error(exc, data, path, show_content)
  File "/Library/Python/2.7/site-packages/ansible/utils/__init__.py", line 713, in process_yaml_error
    %s""" % (path, mark.line + 1, mark.column + 1, before_probline, probline, arrow)
UnicodeDecodeError: 'ascii' codec can't decode byte 0xd0 in position 10: ordinal not in range(128)

Менял содержимое всего одной роли — расставил теги. Сейчас закомментировал их все, но ошибка воспроизводится. Я не могу опубликовать саму роль, но это и не нужно. Вопрос не о том, где у меня ошибка (я всегда могу сделать git checkout и всё будет хорошо), а о том, как искать эти ошибки, используя стектрейс или что-то ещё.

A: Очень мощное средство отладки плейбуков -- это как раз git diff, самого сколько раз спасало. ;)
Если же сконцетрироваться именно на стектрейсе ансибл, то самая полезная строка стектрейса - самая последняя, всё сразу становится на свои места. Если непонятно - то гуглим, вряд ли вы столкнётесь с чем-то уникальным, что ещё не спрашивали на so. )
Посмотрим конкретный пример - ваш:

UnicodeDecodeError: 'ascii' codec can't decode byte 0xd0 in position
  10: ordinal not in range(128)

Вот, например, сходу аналогичный вопрос на so.
И причина тоже в общем-то понятна - каким-то образом у вас в коде оказался символ не той кодировки (в том вопросе на so грешат на то, что терминал был выставлен не в utf-8; у вас возможно при копипасте из другого приложения взялось не то).
И понятно, почему вы не можете ничего поделать с ошибкой - ищете логическую, закомментировали все теги, а то, что ошибка не в алгоритме, не в коде, а в самом формате - и не подумали бы.
Вот вам ещё пример вопроса на so со стектрейсом, там тоже всё прозаично и понятно, но можно и погуглить подробности - вот пример.

А теперь, к сожалению, о грустном:
Больше ничего полезного из стектрейса не вытащить.
Как программист, вы должны хотя бы в общих чертах понимать разницу между языком программирования императивным (программа как набор команд/инструкций, шаг за шагом изменяющих состояние программы) и декларативным языком описания (например, html и yaml).
С ходу нагуглилась, например, такая статья на хабре.
Плейбуки ансибл - это файлы на языке Yaml + шаблонизатор Jinja2, по сути это декларативщина всё.
А стектрейс - это понятие из области императивных ЯП (какие функции вызывались по стеку), в нашем конкретном случае - описание состояния машины, которая выполняет наши декларативные описания.
В 99,99% случаев для вас стектрейс ansible бесполезен, разве что вы являетесь разработчиком ядра ansible и активным контрибутором ансибл на гитхабе.
Причина проста: ошибки при выполнении - это в основном наши ошибки в описании конфигурации, а не в самом движке ансибла. А посмотрите на стектрейс - вы хоть что-нибудь видите там от своих файлов или только общие места типа self, play_basedir и vault_password=self.vault_password?
PS Недавно была статья на хабре про тестирование плейбуков, дополню до кучи ответ (часть 1, часть 2) - основная идея в том, что плейбук через CI запускается на docker. Но это больше автоматизация процесса. У вас вопрос немного о другом, упор на траблшутинг - как разобраться в том, почему сломалось и как.
PPS Дополню ответ. Каждый шаг выполнения скрипта - это отдельный скрипт, который загружается на удалённый сервер и там отрабатывается. Из этого файла часто можно выжать больше детальной информации (наибольший интерес вызывает фвыа). Например, содержимое файла /home/<username_ansible_connected>/.ansible/tmp/ansible-tmp-1478975838.41-114286257956022/command:
if __name__ == '__main__':
    ZIPLOADER_PARAMS = '{"ANSIBLE_MODULE_ARGS": {"_ansible_version": "2.1.2.0", "_uses_shell": true, "_ansible_no_log": false, "_raw_params": "rsync -a user@vm5234271843336.hostname:/asdf/databases/ /databases/vm5234271843336/", "_ansible_verbosity": 3, "_ansible_syslog_facility": "LOG_USER", "_ansible_selinux_special_fs": ["fuse", "nfs", "vboxsf", "ramfs"], "_ansible_diff": false, "_ansible_debug": false, "_ansible_check_mode": false}}'

redpajama_set_name: RedPajamaStackExchange


30 30 Initially these issues were marked using the '##keywords##' field, but now this field is deprecated in favour of '##Labels##' field.
33 -** Label: [['##ux##'>>http://jira.xwiki.org/issues/?jql=labels%20%3D%20ux]] (%class='noitems'%)(not recommended)(%%) - is the user not having a great/delightful experience using the product?
33 +** Label: [['ux'>>http://jira.xwiki.org/issues/?jql=labels%20%3D%20ux]] (%class='noitems'%)(not recommended)(%%) - is the user not having a great/delightful experience using the product?
45 -** Label: [['##accessibility##'>>http://jira.xwiki.org/issues/?jql=labels%20%3D%20accessibility%20]] (%class='noitems'%)(deprecated)(%%) - are there accessibility problems users are facing while using the product?
45 +** Label: [['accessibility'>>http://jira.xwiki.org/issues/?jql=labels%20%3D%20accessibility%20]] (%class='noitems'%)(deprecated)(%%) - are there accessibility problems users are facing while using the product?


There are many, many ways we can help ourselves when we have illnesses like ME/CFS Fibromyalgia and Lyme disease. Many of them are small simple steps that may not have a huge impact in themselves, but put together they can make a big difference to well-being. Although I haven't quite reached full recovery again this time round, I've found that the steps I routinely take have led to a really good level of general functioning most of the time. Most of these steps I've had to build into my routine one at a time and some are just things I do occasionally, but having so many things that I can do for myself feels empowering, especially when there's nobody out there to wave a magic wand. I hope you'll find some inspiration from this list, if you do find things you'd like to add to your self-care, be kind to yourself and build things up one at a time. Ask your intuition to guide you towards the most important next step for you!
I've found that to keep up motivation to do the things I do, it helps to have a reason for them; an understanding of how they are contributing to my well-being and to pay attention to the intention I have for each of them when I start to do them.
Avoiding foods that aggravate my gut symptoms – it's a very long list but generally, sugars (including most fruit), gluten, high lactose products, yeast and mushrooms.
Paying attention to effort as an indicator that energy is dipping and stopping when it does!
3 day, 10% rule: only increasing activity by 10% if I've been feeling well for at least 3 days consistently. Making sure that level of increase is sustainable by not increasing again for at least another 3 days, etc.
Afternoon Yoga and meditation give me an energy boost, releasing tension, unblocking my energy channels and engaging my parasympathetic nervous system.
Understanding overwhelm means not having the resources to meet perceived demands and giving myself permission to step away and top up my resources.
Writing down what you think you have to do and putting it to one side until you have more resources. Culling the list as soon as you're feeling relaxed enough to concentrate.
Befriending unpleasant emotions that can be regular visitors such as frustration and disappointment. Acknowledging and accepting them, then choosing to pay attention to other things.
Positively reframing things that regularly get me down e.g. recognising the benefit of being clean, rather than resenting the energy involved in taking a shower.
Gentle reading in low light to settle the mind down, ready to catch an early sleep wave.
This list goes to show that there is so much involved in dealing well with an energy-limiting chronic illness! Why not make a list of all the things that you are doing for yourself to show yourself what a great job you are doing!


The conferences in parallel to the exhibition – ettc2018 European Test and Telemetry Conference and 19. ITG/GMA-Fachtagung Sensoren und Messsysteme 2018 – will enrich the event with scientific facts and outlooks for the future of this industry.
We will be presenting our RIC60A 60GHz radar chip with on silicon integrated antenna, which will be ready for commercial use in Q3 2018 with ramp up of mass production in Q4 2018. Additionally we will showcase the RIC60B 60GHz radar IC with several external antenna solutions.
We would like to invite you to meet us at our boot. This would be a great opportunity to meet you in person.
You can book here your personal ticket for SENSOR+TEST 2018.
We are looking forward meeting you at our Stand 1-127.