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New video with Emanuele Ronco in art REMS 182!
Guest of Loppis Galleria and Super Error he did a new amazing wall! A Skull for the end of the year, a skull ready for a new beginning. here a small video of the performance.


ZoneAlarm is a Windows application. Read more about how to uninstall it from your PC. The Windows version was created by Check Point, Inc. You can find out more on Check Point, Inc or check for application updates here. More information about the program ZoneAlarm can be seen at http://www.zonelabs.com. ZoneAlarm is typically set up in the C:\Program Files\Zone Labs\ZoneAlarm directory, regulated by the user's decision. C:\Program Files\Zone Labs\ZoneAlarm\zauninst.exe is the full command line if you want to remove ZoneAlarm. zlclient.exe is the ZoneAlarm's main executable file and it occupies circa 1,012.88 KB (1037192 bytes) on disk.
ZoneAlarm installs the following the executables on your PC, taking about 7.80 MB (8179352 bytes) on disk.
2. Run Advanced Uninstaller PRO. It's recommended to take some time to get familiar with the program's interface and number of functions available. Advanced Uninstaller PRO is a powerful Windows tool.
Star rating (in the lower left corner). This tells you the opinion other people have about ZoneAlarm, ranging from "Highly recommended" to "Very dangerous".
7. Press the Uninstall button. A window asking you to confirm will show up. Confirm the removal by clicking the Uninstall button. Advanced Uninstaller PRO will uninstall ZoneAlarm.
8. After uninstalling ZoneAlarm, Advanced Uninstaller PRO will ask you to run an additional cleanup. Press Next to start the cleanup. All the items that belong ZoneAlarm which have been left behind will be detected and you will be asked if you want to delete them. By removing ZoneAlarm with Advanced Uninstaller PRO, you are assured that no Windows registry items, files or folders are left behind on your disk.
This page is not a piece of advice to uninstall ZoneAlarm by Check Point, Inc from your PC, nor are we saying that ZoneAlarm by Check Point, Inc is not a good application. This page only contains detailed info on how to uninstall ZoneAlarm in case you decide this is what you want to do. The information above contains registry and disk entries that other software left behind and Advanced Uninstaller PRO stumbled upon and classified as "leftovers" on other users' PCs.


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Businesses invited to earn cash by reducing energy demand
The UK Government is calling on businesses to sign up to a new £20 million programme that could pay them for reducing their energy use during times of peak demand. […]
The UK Government is calling on businesses to sign up to a new £20 million programme that could pay them for reducing their energy use during times of peak demand.
Under the pilot scheme, projects will need to deliver efficiency savings at least during the winter between November and February, 3-7pm – when demand is at its highest. Businesses can bid for a slice of the cash by installing technologies such as more efficient motors, air conditioning and lighting measures.
There will be a minimum bid size of 100kW and a project plan with estimated savings and one for measuring and verifying these must be submitted.
The announcement is part of the Government's proposals set out in 2012 in an effort to dramatically cut electricity demand across the UK economy.
Energy Secretary Ed Davey said: "We're looking for brilliant organisations with bright ideas about how to lower our electricity use, help cut energy bills and bring down our emissions."
The Electricity Demand Reduction (EDR) pilot will be fully launched in June this year, with the closing date for applications in October.
bid demand reduction Ed Davey UK

redpajama_set_name: RedPajamaCommonCrawl


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I Love 'Newsom at Noon,' But It Needs a New Star
Joe Mathews: Governor, be the rare leader who learns. Be brave enough to step back from the airtime in service of the public good.
Joe Mathews
Let Nonpartisan Scientists and Doctors Lead the State's Daily COVID-19 Briefings
Dear Governor,
Your lunchtime COVID-19 briefings—"Newsom at Noon"—are must-see TV.
No California governor has ever had such a regular, closely observed platform, and you are making the most of it. Your memory, your command of policy and operational detail, and your rambling verbal dexterity, especially with the long words you favor (do you ever stop to breathe?), are almost superhuman. With these briefings, you are giving California's most preeminent polysyllabic performance since Julie Andrews sang "Supercalifragilisticexpialidocious" for Disney's Mary Poppins.
Your skilled delivery of so much epidemiological data and so many changing regulations has put you at the center of Californians' daily lives as we struggle through the pandemic and its associated social disruptions and economic earthquakes.
Which is precisely why you need to stop giving these briefings.
I can hear you and your aides guffawing at my above attestation, but I'm not kidding. You are simply too good at this sort of communication for the state's own good.
The problem is—to borrow two big words you love—fundamental and foundational. You are a politician, an elected official, with deep experience and strong, well-known views. For the most part, that's great. While many Californians (including this columnist) have criticized your rapidly changing guidance, I feel lucky that a person of your knowledge and judgment is our governor in this moment.
But we also are an overly politicized and badly polarized society in the midst of a pandemic. It's literally a matter of life and death that people listen to and follow your complicated public health instructions—on mask-wearing, social-distancing, and the opening and closing of businesses.
Governor, be the rare leader who learns. Be brave enough to step back from the airtime in service of the public good.
When a politician, no matter how skilled and public-spirited, is the one giving that information, the public health response is by definition politicized. The fact is that while many Californians voted for you, many others don't trust you. And so we are seeing the wearing of masks and the safety of public-facing institutions become a political issue. Two weeks ago, in northern San Diego County, I found myself in a park with more than 150 people watching a softball tournament, and not one person was wearing a mask or socially distancing. When I asked people why they weren't protecting themselves, many mentioned you, and none in a good way.
It's obvious that you understand the dangers of politicizing the briefings. I appreciate how careful you are to avoid partisan statements, and to halt your righteous criticism of the Trump administration during the pandemic (even though your reticence angers some of your core supporters). I also appreciate that you treat Californians as adults, that you rigorously avoid oversimplifying things, and that you explain the larger context of state and local governance in the Golden State.
I especially admire your habit of offering caveats to so many of your assertions, and of pointing out the weaknesses in your own policies. It's a sign of integrity—perhaps even a miracle—that none of the political consultants you've employed over the last 25 years has beaten that politically problematic habit out of you.
Of all the politicians who have taken the microphone in this moment, you are among the most responsible. But you can't change who and what you are. So you need to change the briefings.
Across the country and around the globe, myriad reports and leading public health experts have concluded that, in situations like this, scientists and doctors—not politicians—should be the ones leading public briefings. The good news is that our state has no shortage of such experts.
I suggest you elevate one or both of the esteemed state health officials who sometimes appear with you on "Newsom at Noon." Dr. Sonia Angell, the director of the California Department of Public Health, who worked at the CDC back when it was functional, is a warm and straightforward communicator. Dr. Mark Ghaly, the California health and human services secretary, has the reassuringly goofy-nerdy mien of a teacher in an '80s movie comedy. Neither will be able to talk with the facility or breadth you can about all facets of the crisis. But they are better messengers than you are right now.
There will be other advantages. With Angell and Ghaly handling the briefings, you'll have more time to work on stubborn problems—like opening the schools and fixing the failing unemployment system. Angell and Ghaly also speak with a simpler vocabulary and structure than you do. Some of your sentences—with their endless asides, moral persuasions, and wonk speak—remind me of the sentences that my seventh grade English teacher made me diagram as punishment for being a wise-ass.
Of course, nerds and Hegelians across the state will mourn that you are no longer on TV saying things like: "I recognize the dichotomy and to an extent, the dialectic."
But you might remember what Hegel, the early 19th-century German philosopher and master of dialectics, famously said: "We learn from history that we do not learn from history."
If you cancel yourself as the star of "Newsom at Noon," you will be losing a platform. But you will be meeting the moment.
Your constituent,
Zócalo Public Square
Newsom at Noon
gavin newsomCoronavirus Pandemicpandemic
Joe Mathews is California & innovation editor of Zócalo Public Square, where this article was originally published. He is a Little League coach and a fourth-generation Californian who was raised in Pasadena. He also was a staff writer at the Baltimore Sun and Wall Street Journal.
Follow joemmathews


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OCCAR awards ESSOR Operational Capability 1 (OC1) contract
The OCCAR Director, Arturo Alfonso Meiriño and the a4ESSOR SaS president, Lino Lagana signed today, 2 November, in Bonn the contract for ESSOR Operational Capability 1.
The ESSOR Programme launched by Finland, France, Italy, Poland, Spain and Sweden managed by OCCAR since its definition, started in 2008 and the first phase successfully ended in 2015. Since then, several ESSOR demonstrations to the main actors of the international Software Defined Radio (SDR) community have proven the value of the ESSOR products. In November 2016, a field demonstration was held in Finland where, for the first time worldwide, radio platforms, independently developed within different national programmes by three contractors, were able to seamlessly interoperate on the field, in a realistic operational scenario.
Motivated by the success of the first phase, Finland, France, Italy, Poland, and Spain have decided to pursue further the development of the ESSOR High Definition Radio Wave Form to Operational Capability 1 (OC1), enhancing it with new features and functionalities. However, the scope of OC1 is much more than just technical; entailing definition and dissemination of global SDR standards (for both architecture and waveform) based on ESSOR and developing a consistent Through Life Management approach for its lifecycle over the next 20 years.
OCCAR, thanks to its best practices and Programme Management principles, will ensure the success of this effort, managing all the contractual activities and coordinating the harmonisation of the mid- to long-term expectations of the stakeholders.
The ESSOR Programme has raised the bar for new generation tactical communications, paving the way to interoperable tactical SDR communications with a strong European identity. It will continue to do so, thanks to the coordinated efforts of the Participating States, Industry and OCCAR.
The success of ESSOR is today widely recognised by the international SDR community: new partners have already expressed interest in joining the cooperation and new communication system projects using these ESSOR outputs are already under consideration.


We comprehend very little of our world, yet we purport to understand everything. We look to the stars yet can't understand what is happening before us on this little rock. We understand what it takes to keep our bodies going, yet we don't know how we came to be.
We notice the big events in our lives, the successes and often the failures. Ingrained on our timelines are wars, famine, football results. Life on a whole though passes us by until we stop and take stock. Then we start to realise that, unknown to us, we've missed huge moments in our lives and take for granted all the technology that allows us to continue our existence. Yet we don't know how we came upon these moments. Is technology just like evolution?
We live in a world where we rely and revere more on the technology, than on the gods of old. Faith is in a product or system rather than in an unexplainable feeling. We find ways to use technology against us, divide us. Every invention can be used for greed. We find ways of turning these new technologies against ourselves, of maiming and destruction.
The internet brings us closer together, makes communication easier, yet we use it to abuse everyone. We bully by remote control, stoke anger in souls to make them send bombs of destruction to others. We misuse so many of these new technologies to enslave humans, our free will is eaten away by our reliance on this method of technology. We are sucked in and hooked like drug addicts.
Was it evolution in which we mutate from single cells in a broth of amino acids or was some power elsewhere in this cosmos responsible. Are we inhabitants of this planet or are we refugees from another world? Could it be that homo-sapiens are the aliens here? Are we just an experiment by some out of world body, like white mice in a maze, being observed to note our reactions to new stimuli?
Each night people look at the heavens above looking for a sign that we're not alone. Radio telescopes point to the sky listening for artificial sounds, a ripple in the background of the universe's symphony. We wait for that 'Wow' moment, yet what would we do if we found it? Would we be happy or would fear take over?
We yearn to find the meaning of our lives, yet we are scared that it might turn into a nightmare. Our anxieties kick in. We make plans to defend ourselves, so sure that we are that we will be threatened by what we may find. Yet we still look, rather like a child searching under the bed for the bogie man. Are we programmed to think the worst in people or is it what we're told is 'human nature'?
We have this deep distrust of our fellow dwellers of this orb. We are scared that somehow, they are out to rob us or kill us. We automatically put up walls around our nations, refusing access to those who need help in case a minutia may be 'bad'. Instead of thinking that they may enhance us as a nation, we automatically brand them as alien. After all who are we to doubt our leaders? They only want the best for us, don't they? If we can't trust our fellow homo sapiens, then how would we react to space ships in our atmosphere? We wouldn't for one-minute think they were there to help us, or seek our assistance. We'd assume they were there to do us harm. After all that's the way we treat each other.
Films show us that aliens are bad. We assume the worst, that when others come to our borders they are here not for refuge, for safety. We think our world is the best, we tell everyone each day how great we are. Isn't it any wonder that everybody who listens to the messages of our exalted leaders would want to be part of it?


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Online Support Domain Names
Australia .COM.AU domain name Registration Rules
Article ID: 3354 Published: 13 Jan 2015 Updated: 5 Jul 2019 Authored by: Crazy Domains Support
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What are you waiting for? Go ahead and register your .COM.AU domain name now!
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You can renew your domain name manually or you can set up Auto Renewal which is an optional feature available with all domains. The renewal date depends on whether you manually renew your domain name or set it to auto renew. We will attempt auto renewal on the 7th day prior to the domain name's expiration date. If the renewal attempt fails, we re-attempt renewal again on the 3rd day prior to the domain name's expiration date.
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Khloe Kardashian to Arrive At Her Wedding in Style
Sep. 24 2009, Published 5:56 a.m. ET
It looks like everything is in place for Khloe Kardashian's not-so-secret wedding this Sunday to Lakers player Lamar Odom.
And now, Khloe's big sis Kim Kardashian is confirming the big news (sort of) and revealing more details on her Twitter page.
On Thursday, the eldest Kardashian thanked the good people at Platinum Motorsports for providing Khloe with a stylish ride for her big day.
"Thanks for the Rolls Royce Phantom from Platinum Motorsports for the wedding!" Kim tweeted.
Keeping it stylish and simple, Khloe and Lamar have given limited information on the invitation. But RadarOnline.com can tell you the wedding will be at the home of family friend and music manager Irving Azoff.
Click here to see pics of Khloe's sister Kourtney showing off her growing baby bump
The invitations have been sent to more than 200 guests including Odom's LA Lakers teammates as well as other A list stars.
Khloe and mom go ring shopping
It's been a whirlwind of a romance, the two met on August 27 at the Ron Artest party at Halo in Hollywood and instantly hit it off, Khloe's sister Kim has gushed about how happy they are together.
Click here to see photos of Khloe and her sisters in Miami
"The whole family is excited about the wedding," a source close to Khloe tells RadarOnline.com. "They can't wait to welcome Lamar into the family."


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Salary: £30000 - £50000 per annum + Incentives / Commission / Equity
LHi Group Ltd., an international recruitment agency that placed #1 on Best Companies' Top 40 Recruitment Companies in the UK 2021, #1 on the Top 50 mid-sized companies in London 2021, and #6 on the Top 100 mid-sized companies in the UK 2021. Needless to say, our impact is making waves, and are looking for those to make a difference with us.
Standard of living - Classy Manhattan, up and coming to New Jersey or Historic Brooklyn.
Less saturated markets - Emerging markets of Life Sciences, Renewables & Emerging Tech.
Higher basic salaries - Starting salaries of 30k+ GBP.
Higher billings - Average fees of 30k GBP with Exclusive & Retained work the norm.
Relocation packages - Flights, Visa, Office set up & Relocation assistance.
Better future opportunities - Internally mobility, diversify into niches & ample opportunities to build your own team.
Independence and personal development - Strong ex-pat community, 6 tier L&D program & be mentored by some of the best in the business.
LHi-In is our Diversity, Inclusion, and Belonging toolkit. It is just one part of a Group Wide CSR policy, focusing on the 'Younger You' ethos of creating a world that is better for the next generation.


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Parmer
Bovina, TX Arrest Records
Bovina, TX is among the safest cities in the USA with 3.43 per 1,000 residents crime rate compared to national 4.69 average. It is the 45th safest city in Texas among the 574 cities.
Bovina, TX property crime has lower rate than the national average of 28.42, with 4.00 average property crimes recorded in 2016 of which 4 larceny theft related arrests that decreased by 60.00% compared to 2015.
Bovina Crime Rate
Total arrests in Bovina 2016 decreased by 7.14% compared to 2015 and has lower crime rate than national average of 33.12. Violent crimes increased from 1 to 6 while non-violent crime decreased by 46.15% from 13 to 7.
5 Crimes In Bovina, TX in 2016 with the Most Arrests
Aggravated assault 5
Larceny-theft 4
Legacy rape 1
Motor vehicle theft 1
Other Cities in Texas with the Most Arrests
Among the 574 cities in state the most dangerous is Houston with 23,960 violent crimes that's 24.59% of total of 97,437. South Padre Island has the highest number of records per 1,000 people that is above the state average of 37 and higher than national average of 33.
South Padre Island 184.80
Port Aransas 110.23
Humble 107.04
Kemah 81.85
Webster 80.53
Safest Cities in Texas
Are you planning a move to Texas? Here are the safest cities in Texas with the lowest arrest rates. Your chance of being a victim of a violent crime in Bovina is 1 out of 201 up by 0.08% compared to previous year. The lowest rate of violent crime is in Muleshoe and the safest city to encounter a property crime is in San Saba.
San Saba 1.00
Jourdanton 1.38
Danbury 2.24
Crane 2.49
Cumby 2.53
Violent crime rate in Bovina increased by 500% from 2015 and decreased by 45.45% during the last 5 years since 2011 from 11 to 6. In 2016 violent crime rate in Bovina was 26.94% lower than the national average. Your chances of being a victim of a violent crime is 0.343%.
Property crime rate in Bovina decreased by 46.15% from 2015 and decreased by 46.15% in the last 5 years since 2011 from 13 to 7. In 2016 property crime rate in Bovina was 85.93% lower than the national rate. Your chances of being a victim of property crime is 0.4%.
How Bovina stands up against other cities
Bovina vs. Lorena
You'll be in more safety in Bovina compared to Lorena that had 154.57% higher crime rate compared to Bovina according to the FBI.
Assault rates of 2.8571 per 1,000 people is higher than national of 2.8422 per 1,000 people and higher than average 0.5731 in Lorena city.
Motor Vehicle Theft rates of 0.5714 per 1,000 people is lower than national of 2.8637 per 1,000 people and lower than average 1.7192 in Lorena.
Bovina vs. Sour Lake
You'll be in more safety in Bovina compared to Sour Lake that had 174.57% higher crime rate compared to Bovina according to the FBI.
Assault rates of 2.8571 per 1,000 people is higher than national of 2.8422 per 1,000 people and higher than average 0.5666 in Sour Lake city.
Arson rates of 0.5714 per 1,000 people is higher than national of 0.1465 per 1,000 people and higher than average 0.0000 in Sour Lake.
Names with the most arrests in Bovina
Mayco Rocha-leon
Linda Andrade
According to the matching records on PoliceArrests.com 60% are people aged between 31-40. Misdemeanor records are popular among white population of the city.
The overall crime rate in Bovina is 0.78% lower than the national average.
For every 1,000 residents, there are 2.04 daily crimes that occur in Bovina.
Bovina is safer than Lorena.
In Bovina you have a 1 in 135 chance of becoming a victim of any crime.
Year over year crimes in Bovina have decreased by 7.14%.


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TOKYO (1 p.m.)
110.2 ¥/$ (1 p.m.)
Got to know: Last year, Chuk Besher's son Noah approached his father and asked, "Papa, what does hāfu mean?" | COURTESY OF CHUK BESHER
Issues | THE FOREIGN ELEMENT
A son echoes his father's questions about identity in Japan
by Richard Solomon
In his 1971 song "Imagine," John Lennon asks listeners to imagine living in a world where all mankind can live together in peace. Speaking recently before Princess Hisako at an event in Tokyo organized by the Asiatic Society of Japan, Chuk Besher asked attendees to imagine the same.
Besher had come to talk about social diversity in Japan. The nation, he says, is more diverse and multicultural than most Japanese know or would care to admit. With a little imagination, people can come to accept others who look, think and act differently.
Besher was born in Kobe in 1962 to stateless Russian refugee parents. He received Japanese nationality at birth but is Caucasian, which means everyone assumes he's Western.
Because he looks so different, sometimes he feels excluded from Japanese society. Besher is even told by people he loves that he doesn't fit in.
"Being born and growing up in Japan, where I am often called a gaijin (foreigner), made me want to know what is meant by 'Nihonjin' (Japanese) — the group of people I am often told I don't belong to," he explains. "Why am I welcome to live in, but do not belong to, the people of my own country?"
Last year Besher's 8-year-old son, Noah, approached his father. "Papa," he asked. "What does hāfu mean?"
Noah had been called hāfu (half-Japanese) by a second-grade classmate at the local Japanese public school he attends. This was the first question he had ever asked his father about identity.
Growing up, Besher had also given much thought to his own identity and that of his countrymen. He even went to graduate school at Columbia University to study Japan and the subject of its origins. How was he to reply to Noah's question?
From Europe to the Far East
Other than in terms of appearance, Besher is little different from other Japanese citizens. Most are naturalized from intermingled people who immigrated to Japan from the Eurasian continent.
Besher's maternal ancestors were Huguenots who fled religious persecution, moving from France to Germany and then on to Moscow. His paternal ancestors were likely Russian landed gentry who lived somewhere along the Polish-Lithuanian Commonwealth's border with Russia during the 17th century. Besher's maternal grandparents immigrated to Harbin in China for work and to escape persecution in Russia around the time the Russian Empire collapsed in 1917. Each stayed, in order to avoid near-certain death.
His parents met in Harbin in the 1930s. Located in far eastern China, Harbin was mostly comprised of immigrants from the former Russian Empire. The couple married and gave birth to Besher's two older brothers. They lived in a Russian community within the city, spoke Russian and attended Russian Orthodox Church. Besher's parents considered themselves "white Russians in exile," even though they held Republic of China and Manchurian passports at various times.
Four years after the end of World War II, when Mao Zedong's new communist government forced people of European descent to leave China, the family fled Harbin as refugees, traveling on Red Cross travel documents. They took with them two small children and Besher's grandmother, along with whatever possessions and valuables would fit into carry bags and pockets of clothing.
It took the family four years to get to Japan — moving across China to Hong Kong, crossing the sea to Australia, before finally arriving in Yokohama in 1953. The family settled in Kobe, where Besher was born 10 years later.
Early lessons in belonging
For lack of a better explanation, Besher considers himself Russo-Japanese. He grew up in a bicultural family, speaking Russian to his parents, grandmother and brothers, while speaking Japanese to his sister and nanny. Largely, he grew up just like other Japanese boys. For example, he attended a local Buddhist kindergarten and a public elementary school.
Although happy and contented, Besher never quite fit in with the other children. Mostly he was treated with kindness by his fellow countrymen. Other times he was picked on, usually by older kids.
His mother enrolled him in the local police judo class to learn self-defense, discipline and respect for self and others. The class helped settle disputes. Once, he says, he pinned down a bully, shouting, "I am not a gaijin! Do you want to be friends or do you want to die?" Wisely, the bully chose the former.
On another occasion, when he was in third grade, Besher got on a public bus in Kobe and greeted the driver in the traditional Japanese way. Astonished by the boy's unusual appearance and behavior, the driver responded: "You speak perfect Japanese. How cute!"
A few stops later a Japanese-looking girl, probably in her teens, got on the bus and fumbled with her change. The driver, irritated as he became aware that she spoke little or no Japanese, insulted the girl. "Are you Korean, Chinese or what?" he shouted. She started to cry. Nobody on the bus said a word. Besher felt ashamed and angry.
Many Japanese become uncomfortable when they cannot accurately distinguish someone as being Japanese merely by looking at them. Besher wonders if it brings to mind questions about their own identity and ancestral roots. About one-third of the population of Kobe is of Korean or Chinese descent, he says, according to his own research on the topic.
Whenever Besher came home upset about having been called a gaijin on the street or at school, his nanny, Chiyo Hirata, would console him. She would say: "Ignore them. They don't know what they are telling you. You are more Japanese then they are. You are even more Japanese than I am," citing as justifications Besher's good education and better language skills.
Hirata provided Besher with an early window into Japan's not-so-obvious social diversity. She came from the Goto Islands in Nagasaki Prefecture. Before returning home on vacations, Hirata would often say "Kuni ni kaerimasu" ("I'm going back to my country").
In public, Hirata would greet new acquaintances by asking them "What kuni (country) are you from?" It was the accepted way of asking where in the Japanese archipelago a person's roots lay, says Besher. The greeting, she told him, was a vestige of pre-Meiji Era (1868-1912) Japan, when travelers referred to their home according to its han (feudal domain), with each having its own ruler, distinct culture, creeds, loyalties, language or dialect.
In the late 19th century, the Meiji state began passing laws to unify inherently diverse regional populations. To create a single state of loyal subjects, they enacted nationality laws — the same laws that, coincidentally, granted citizenship to Besher and other children born to stateless parents. Modern-day policymakers continue to describe Japan as having "one nation, one civilization, one language, one culture and one race," as did gaffe-prone minister Taro Aso in October 2005. Such myths may be a unifying source of national pride and identity, but they are best oversimplifications. At worst they are divisive.
A mixed-up archipelago
Ironically, the Ministry of Education more accurately described the myth of Japan's supposed mono-ethnic culture in a paper titled "The Road to Social Integration" released in 1942, while the Pacific War was raging: "The Japanese people are not monoethnic (tan'ichi minzoku). … We came to be 'one people' from a strong belief under the process of imperialization (sumeragi-ka). We have all been naturalized and intermingled from many peoples — indigenous, immigrants from the continent, and people from other places."
In fact, nobody living on the archipelago is "Japanese-Japanese." Stone age hunter-gatherers from the Eurasian continent started arriving in Japan as early as 35,000 years ago, during the last ice age. Most crossed into Japan on foot until about 20,000 years ago, when the polar ice caps melted and the sea levels rose to separate Japan from the continent. Others also likely came by boat, traveling along the chain of islands linking Taiwan, Okinawa and Kyushu. Thus, Japan is a country comprised of migrants who arrived on the archipelago through the ages from diverse origins — long before Japan was established as a modern state in 1868.
Alas, humankind may not have evolved sufficiently for people to accept this broader view. People still treat others based on how they look, speak and behave. They strive to define themselves as being part of the in-group, denying the legitimacy of other people. Political leaders continue to spin narratives that unite one group of people — with sometimes violent consequences — against other groups.
Besher closed his talk by returning to Noah's question: "Papa, what does hāfu mean?" Noah reasoned: "You and Mama are both Japanese, right? Am I not Japanese too? Am I not furu (full)?"
After a pause, Besher responded: "When they ask 'Are you hāfu?' tell them, 'Yes, you are hāfu. Everyone is hāfu, because everyone is half mama and half papa,'" he advised.
His answer gives hope to the next generation of truly global citizens. If enough people join Besher and his family, perhaps someday what Lennon could only imagine might be realized.
Richard Solomon posts regular Beacon Reports at www.beaconreports.net.
Send your comments and Community story ideas to: community@japantimes.co.jp
Besher's Japanese life less ordinary
Chuk Besher is the youngest of four children, separated by 15 years from youngest to eldest. When Besher was 14 years old in 1976, the family moved to San Francisco, where most of his siblings had settled. Speaking little English, Besher experienced a whole new set of challenges adapting to U.S. culture as he began attending a private junior high.
Later, he obtained a liberal arts degree at St. John's College in Annapolis, Maryland, where he studied the classics — from the Greeks through to the 20th-century thinkers in philosophy, math and science. On a Watson Fellowship, he spent two years traveling through Russia and Japan tracing both countries' attitudes toward foreigners. Besher holds a graduate degree from Columbia University's School of International and Public Affairs in East Asian studies and communication.
Today Besher works for Gree in media and advertising. His career spans politics, marketing, broadcasting and government relations. Most recently, he was in charge of Coca-Cola Japan's communication planning for two Olympics and a FIFA World Cup, as well as public affairs and sustainability. Besher lives in Tokyo with his wife and two sons.
Ancestral ties: A long and winding road
Chuk Besher's mother, Helen (Elena in Russian), was born in 1921 in Blagoveshchensk, a town in the Soviet Union's far east, close to the Chinese border along the Amur River. Her father, Alexander, was a chemist associated with the Russian imperial government. Helen's mother, Agrippina, was a nurse in Blagoveshchensk who worked at a Russian Army hospital.
Alexander fled St. Petersburg via Blagoveshchensk, married Agrippina, and then fled to Harbin with the family to escape persecution. Helen grew up and went to Russian and international schools in Harbin, where she met and married Joseph (Ioseph in Russian).
Joseph was born in Harbin in 1919. His father was a Moscow-educated engineer who worked for the Trans-Siberian Railway. He was later posted to Harbin to work on the railroad before the Russian Revolution. He remained there to avoid persecution, due to his Imperial Russian ties.
Joseph was adopted by his aunt when he was 7, after his father died. Joseph never knew his mother, only once referring to her as "some woman who showed up at his father's funeral and caused a commotion," according to Chuk.
After marrying Helen and graduating from college, Joseph worked as a journalist, writing about the arts. Later, he became a tradesman. He traveled to Japan in the 1930s as a journalist and on business, developing friends and an interest in the country. Joseph was determined to make Japan his new home after his family was forced to flee Harbin for their lives.
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text:
use core::num::NonZeroUsize;
use libtock_platform::Register;

/// `AllowDb` stores the currently-active Allow buffers, and is responsible for
/// preventing overlapping Allow buffers.
///
/// Functionally, it receives raw register data from the Allow system calls
/// implementations, verifies the new buffer does not overlap any active buffer,
/// and converts the register values into usable reference types (such as
/// `&'static mut [u8]`). When a buffer reference is returned, it removes it
/// from its database and returns the raw register values.
// TRD 104 (Tock's system call ABI) says that allow buffers only overlap if they
// have a memory address in common, so zero-sized buffers cannot overlap.
//
// Read-Write Allow and Read-Only Allow are invoked through
// RawSyscalls::syscall4, which is unsafe, and requires its caller to pass
// arguments that are valid for the system call. Those requirements require that
// either the length field is zero, or the address and length field represent a
// valid slice. Several of the steps in this file require that property.
//
// Therefore AllowDb does not need to check for overlaps with zero-sized
// buffers.
#[derive(Default)]
pub struct AllowDb {
    // List of all active buffers, excluding zero-sized buffers. Contains both
    // read-only buffers and read-write buffers.
    // Key: address of the buffer.
    // Value: length of the buffer.
    // Invariant: These buffers never overlap, and represent valid slices
    // (although they can't be converted to slices because fake drivers may have
    // a &mut [u8] pointing at the buffer).
    buffers: std::collections::BTreeMap<*mut u8, NonZeroUsize>,
}

impl AllowDb {
    // Adds a new buffer, or returns an error if it overlaps with any existing
    // buffers. Requires that address and len represent a valid slice.
    unsafe fn insert_raw(
        &mut self,
        address: *mut u8,
        len: NonZeroUsize,
    ) -> Result<(), OverlapError> {
        // The new buffer spans the address range [address, address + len - 1],
        // so the highest-address buffer it overlaps with starts at
        // address + len - 1. It can overlap with a buffer that starts with any
        // address less than that (if that buffer's length is large enough), so
        // we don't give a lower bound for the range.
        //
        // If the last buffer in this range does NOT overlap the new buffer,
        // then that buffer's memory range is strictly less than the new buffer.
        // Because buffers in self.buffers cannot overlap, all of the buffers in
        // the range would need to be strictly less than the new buffer.
        // Therefore we only need to check for overlap with the last buffer in
        // this range.
        //
        // range_end is one past the end of the range to check.
        let range_end = unsafe {
            // Safety: The function's preconditions require that address and len
            // represent a valid slice, which guarantees that this sum does not
            // oveflow.
            address.add(len.get())
        };
        if let Some(existing_buffer) = self.buffers.range(..range_end).next_back() {
            let (&existing_address, &existing_len) = existing_buffer;
            // Check if existing_buffer overlaps with the new buffer. Note that
            // existing_address.add(existing_len) generates a pointer one past
            // the end of the existing buffer, which is why the inequality is
            // strict.
            // Safety: self.buffers has an invariant that its values represent
            // slices, so this sum cannot overflow.
            if unsafe { existing_address.add(existing_len.get()) } > address {
                return Err(OverlapError);
            }
        }
        self.buffers.insert(address, len);
        Ok(())
    }

    /// Adds a read-only buffer to the database, and returns it as a
    /// `RoAllowBuffer`.
    ///
    /// # Safety
    /// `address` and `len` must be valid as specified in TRD 104: either `len`
    /// is 0 or `address` and `len` represent a valid slice.
    pub unsafe fn insert_ro_buffer(
        &mut self,
        address: Register,
        len: Register,
    ) -> Result<RoAllowBuffer, OverlapError> {
        let len: usize = len.into();
        if let Some(nonzero_len) = NonZeroUsize::new(len) {
            // The buffer is not zero-sized. Add it to the database (checking it
            // does not overlap an existing buffer).
            // Safety: `len` is nonzero, so by this function's precondition
            // `address` and `len` represent a valid slice.
            unsafe { self.insert_raw(address.into(), nonzero_len) }?;
        }
        Ok(RoAllowBuffer {
            address: address.into(),
            len,
        })
    }

    /// Adds a read-write buffer to the database, and returns it as a
    /// `RwAllowBuffer`.
    ///
    /// # Safety
    /// `address` and `len` must be valid as specified in TRD 104: either `len`
    /// is 0 or `address` and `len` represent a valid slice.
    pub unsafe fn insert_rw_buffer(
        &mut self,
        address: Register,
        len: Register,
    ) -> Result<RwAllowBuffer, OverlapError> {
        let address: *mut u8 = address.into();
        let len: usize = len.into();
        if let Some(nonzero_len) = NonZeroUsize::new(len) {
            // The buffer is not zero-sized. Add it to the database (checking it
            // does not overlap an existing buffer).
            // Safety: `len` is nonzero, so by this function's precondition
            // `address` and `len` represent a valid slice.
            unsafe { self.insert_raw(address, nonzero_len) }?;
        }
        Ok(RwAllowBuffer { address, len })
    }

    /// Removes a read-only buffer from the database and returns its raw
    /// register values.
    ///
    /// The returned value is the tuple (address, len) passed into the
    /// insert_ro_buffer call that created the RoAllowBuffer.
    pub fn remove_ro_buffer(&mut self, buffer: RoAllowBuffer) -> (Register, Register) {
        self.buffers.remove(&(buffer.address as *mut u8));
        (buffer.address.into(), buffer.len.into())
    }

    /// Removes a read-write buffer from the database and returns its raw
    /// register values.
    ///
    /// The returned value is the tuple (address, len) passed into the
    /// insert_rw_buffer call that created the RwAllowBuffer.
    pub fn remove_rw_buffer(&mut self, buffer: RwAllowBuffer) -> (Register, Register) {
        self.buffers.remove(&buffer.address);
        (buffer.address.into(), buffer.len.into())
    }
}

#[derive(Debug, Eq, PartialEq, thiserror::Error)]
#[error("allow buffers overlap")]
pub struct OverlapError;

/// A read-only reference to a buffer that has been shared via the Allow system
/// call. This reference is non-Copy, so `AllowDb` can determine when all
/// references to the buffer have been destroyed.
#[derive(Debug)]
pub struct RoAllowBuffer {
    // Safety invariant: Either length is 0, or address and length can be
    // soundly converted to a &'static [u8]. Note: that means that no &mut [u8]
    // references may overlap the slice described by address and len.
    address: *const u8,
    len: usize,
}

impl Default for RoAllowBuffer {
    fn default() -> RoAllowBuffer {
        RoAllowBuffer {
            address: core::ptr::null(),
            len: 0,
        }
    }
}

// Allows access to the pointed-to-buffer. The returned reference has the same
// lifetime as the &self reference, so the caller can't keep the reference for
// longer than it has access to the RoAllowBuffer.
impl std::ops::Deref for RoAllowBuffer {
    type Target = [u8];
    fn deref(&self) -> &[u8] {
        match self.len {
            0 => &[],
            // Safety: Because length is nonzero, the safety invariant on
            // address and len says this conversion is sound.
            _ => unsafe { core::slice::from_raw_parts(self.address, self.len) },
        }
    }
}

/// A read-write reference to a buffer that has been shared via the Allow system
/// call. This reference is non-Copy, so `AllowDb` can determine when all
/// references to the buffer have been destroyed.
#[derive(Debug)]
pub struct RwAllowBuffer {
    // Safety invariant: Either length is 0, or address and length can be
    // soundly converted to a &'static mut [u8]. Note: that means that no
    // references may overlap the slice described by address and len.
    address: *mut u8,
    len: usize,
}

impl Default for RwAllowBuffer {
    fn default() -> RwAllowBuffer {
        RwAllowBuffer {
            address: core::ptr::null_mut(),
            len: 0,
        }
    }
}

// Allows access to the pointed-to-buffer. The returned reference has the same
// lifetime as the &self reference, so the caller can't keep the reference for
// longer than it has access to the RwAllowBuffer.
impl std::ops::Deref for RwAllowBuffer {
    type Target = [u8];
    fn deref(&self) -> &[u8] {
        match self.len {
            0 => &[],
            // Safety: Because length is nonzero, the safety invariant on
            // address and len says this conversion is sound.
            _ => unsafe { core::slice::from_raw_parts(self.address, self.len) },
        }
    }
}

// Same purpose as the Deref implementation, but for mut references.
impl std::ops::DerefMut for RwAllowBuffer {
    fn deref_mut(&mut self) -> &mut [u8] {
        match self.len {
            0 => &mut [],
            // Safety: Because length is nonzero, the safety invariant on
            // address and len says this conversion is sound.
            _ => unsafe { core::slice::from_raw_parts_mut(self.address, self.len) },
        }
    }
}

redpajama_set_name: RedPajamaGithub


Technology in our society is advancing at a rapid rate. As science improves and more breakthroughs are occurring, smart devices like cell phones are progressing in ways which people never thought could be possible. Cell phones are miraculous inventions that if used properly can be quite helpful on a daily basis. However, has their prominence in our daily life gotten to the point that they are now problematic in American society? Ask almost any teenager and their answer would likely be no. However, if one were to take a look at the people throughout America, they would likely see that teenagers are in fact the ones who show just how detrimental technology has become. No matter where I go, I feel as though I am observing a massive herd of sheep, conforming as they obsessively stare at their cell phones. Social media and other applications on cellular devices are distracting people from the real world surrounding them. I will argue that technology has become problematic for my generation, and that it would be highly constructive for teens to start to use their phones in more beneficial ways.


text:
Ethics and medical professionalism 33
Health care and patient safety 33
Health human resources 30
Health information and e-health 8
Pharmaceuticals/ prescribing/ cannabis/ marijuana/ drugs 22
Physician practice/ compensation/ forms 22
Population health/ health equity/ public health 55
Parliamentary submission 12
Policy resolution 44
Access to public long-term care homes
The Canadian Medical Association will raise the federal government's awareness of the inequitable access to public long-term care homes that is experienced by patients with financial, cultural and/or linguistic barriers.
https://policybase.cma.ca/en/permalink/policy9886
The Canadian Medical Association, in collaboration with provincial/territorial medical associations, strongly urges governments that decisions regarding the allocation of resources for new and existing health care treatments, programs, policies and products be consistent with the best available scientific evidence.
An Act providing for the development of a framework on palliative care in Canada
The Canadian Medical Association supports Bill C-277, An Act providing for the development of a framework on palliative care in Canada.
Application of evidence-based medicine
The Canadian Medical Association calls on the Association of Faculties of Medicine of Canada, faculties of medicine, College of Family Physicians of Canada and Royal College of Physicians and Surgeons of Canada to greatly expand efforts to familiarize medical students and residents with the application of evidence-based medicine, including systematic reviews, clinical practice guidelines, care pathways and related techniques to improve quality, safety and efficiency in medicine.
Building a Comprehensive Post-Market Surveillance System : Canadian Medical Association Response to Health Canada's Discussion Paper "Designing a Mandatory System for Reporting Serious Adverse Reactions"
Parliamentary submission
Building a Comprehensive Post-Market Surveillance System Canadian Medical Association Response to Health Canada's Discussion Paper "Designing a Mandatory System for Reporting Serious Adverse Reactions" Submitted to Health Canada July 28, 2005 Overview The CMA believes that all stakeholders should work together to improve adverse drug reaction (ADR) reporting, in the interests of improving patients' safety and health. However, we believe that activity in pursuit of this end must be based on two fundamental premises: a) Reporting is only one part of a comprehensive post-market surveillance system. In order to effectively monitor the safety of Canada's drug supply, this system should include: * a simple, comprehensive and user-friendly reporting process; * rigorous analysis of reports to identify significant threats to drug safety; * a communications system that produces useful information, distributed to health care providers and the public in a timely, easily understood manner. There is no point in enacting a mandatory reporting requirement until all of these elements are in place. We wonder why mandatory reporting has been singled out for discussion when a holistic approach to reforming Canada's drug safety system is called for. b) Health care providers should be encouraged to participate willingly and voluntarily in the reporting process. To be successful, Canada's post-market surveillance system will depend on the active participation of physicians and other health professionals. Experience with health system quality and safety improvement efforts over the past several years has demonstrated that meaningful acceptance is most effectively obtained when those involved are willing participants. If you build a comprehensive, efficient and effective post-market surveillance system, physicians will participate actively in it. Forcing them to participate before the system has been built will result in alienation, frustration and failure. Comments on Discussion Paper a) Is Mandatory Reporting Necessary? This is a fundamental question and the discussion paper does not satisfactorily address it. There are two reasons why we question the necessity for imposing an ADR reporting requirement on health professionals. First, as awareness of the drug-safety system's importance has increased, the number of ADR reports has increased along with it - more than 10% in 2004, as the discussion paper notes - without a mandatory reporting requirement. Given this trend, it is highly probable that time, education, adequate resources and increasing familiarity with the surveillance system will raise reporting rates to the desired level (however defined) without mandatory reporting. Second, as the discussion paper points out, there is no evidence that mandatory reporting has been effective in other jurisdictions where it has been implemented. The paper offers no clear explanation for this lack of success. More importantly, it does not indicate how Health Canada plans to ensure that mandatory reporting will succeed in this country when it has proven ineffective elsewhere. A primary principle of any system change is that we should not repeat the mistakes of others. Before launching a program whose success has not been proven, other viable, and possibly more effective, alternatives should be examined. b) Addressing known barriers to reporting The CMA acknowledges that ADRs are under-reported, in Canada and worldwide. The discussion paper identifies a number of barriers to reporting, and its list mirrors the observations and experiences of our own members. We believe most of these barriers can, and should, be overcome. We also agree that it is necessary to raise health professionals' awareness of the importance of, and process for, ADR reporting. But we question the curious assertion that "Mandatory reporting could raise awareness of the value of reporting simply by virtue of the public debate." Surely there are more positive ways to raise awareness than publicly speculating about the punitive consequences of non-compliance. We suggest that instead, Health Canada work with physicians and other health professionals to address the existing barriers to reporting. Specifically, we recommend that Health Canada implement: * a well-funded and targeted awareness-raising campaign focused on provider education and positive messaging, * a user-friendly reporting system, including appropriate forms, efficient processes and adequate fees. These measures are within Health Canada's purview in the existing policy and legislative environment. We believe they would increase reporting without the need for coercive measures. At a minimum, positive system improvements should be tried first before considering a mandatory-reporting requirement. With regard to specific questions posed in the discussion paper: Question 1: Health professionals should be explicitly protected from any liability as a result of reporting an adverse drug reaction. This should be the case regardless of whether reporting is voluntary or mandatory. Question 2: Professionals should be compensated for all meaningful work including the completion of forms and any follow-up required as a result of the information they have provided. We would be happy to expand further on this issue on request. Question 3: Issues of confidentiality should be covered in legislation. The CMA has developed an extensive and authoritative body of knowledge on privacy issues in health care, which we would be pleased to share with Health Canada. c) Improved report quality We agree that increasing the quality and richness of ADR reports is as important as increasing their number. Perhaps it is even more important, since high-quality reports allow for high-quality analysis. Mandatory reporting will not improve the quality of ADR reports; it will simply increase their quantity. It may even compromise the system's efficiency and effectiveness by increasing the volume of clinically insignificant reports. Experience elsewhere has taught us that true quality cannot be legislated or imposed; any attempt to do so would be pointless. If ADR reports included the information listed in Table 4, this would improve their usefulness and the effectiveness of the overall surveillance process. However, it is unrealistic to expect all reports to contain this level of information. The treating physician may not be able to provide all of it, especially if he or she is not the patient's regular primary care provider. Some of this information, particularly about outcomes, may not be available at the time of the reporting, and gathering it would require follow-up by Health Canada. Health Canada should consider measures other than mandatory reporting to improve the quality of ADR reports. The CMA suggests that consideration be given to: * Improving follow-up capacity. We agree that it should be made easier for Health Canada officials to contact reporters and request details on follow-up or outcomes. This should be considered as part of a comprehensive initiative to improve Health Canada's capacity to analyze ADR reports. * Establishing a sentinel system. Another option for increasing high-quality reports would be to establish a "sentinel" group of practicing physicians who would contract to report all ADRs in detail. These physicians, because of their contractual obligation, would be committed to assiduous reporting. Sentinel systems could be established concurrently with efforts to increase voluntary ADR reporting by the broader health professional community. In addition to the current information provided, consideration should be given to including on reporting forms the option to allow Health Canada officials to act on information the physician provides; for example, in the reporting of sexually transmitted diseases physicians provide certain information and have the option to request that public health officials undertake follow-up and contact tracing. d) Minimize administrative burden We agree that Health Canada should give consideration to making the ADR reporting system user-friendly, non-complex and easy to integrate into the patient-care work stream. These reforms can and should be implemented regardless of whether a mandatory requirement is in place. They do not need mandatory reporting to make them work; in fact, they are more likely to encourage ADR reporting than any form of coercive legislation. Rather than making a mandatory reporting requirement "fit" with the traditional patient-care framework, we invite Health Canada to work with us to increase health professionals' capacity to report ADRs voluntarily. We are already working with Health Canada to improve physicians' access to drug safety material. Health Canada's ADR reporting form can now be downloaded from the cma.ca web site, which also posts the latest drug alerts from Health Canada and from the Food and Drug Administration in the U.S. We have developed an on-line course in partnership with Health Canada, to teach physicians when and how to make ADR reports. We hope to build on this collaboration, with the goal of making it possible for physicians to report ADRs online via cma.ca. This will permit them to fit reporting more conveniently into their daily workflow. (Note: the "MedEffects" Web portal now being developed at Health Canada does not fit well into the workflow and therefore will not make reporting easier for health professionals.) In the future, we hope that ADR reporting can be built directly into the Electronic Medical Record (EMR). We think this will be a critical element in the bi-directional communicating that ADR reporting requires. It will also enable rapid integration of advisories into the EMR so that they can be available to physicians at the time they are writing a prescription. Before electronic ADR reporting can work, a standard for electronic data should be in place (at present it is not) and Health Canada should develop the capacity to accept data electronically. Health Canada's discussion paper makes reference to cost-benefit analysis. We recommend that you take great care not to over-emphasize cost-benefit when it comes to enhancing patient safety. Meaningful improvements in the post-market surveillance system will be costly whatever solution Health Canada eventually embraces, and it is impossible to measure financially the value of safety. What is an acceptable cost for one life saved? e) Minimize Over-Reporting The discussion paper acknowledges that not all adverse reactions need be reported. We strongly agree that one of the dangers of mandatory reporting is its potential to overwhelm the system with an unmanageable flood of reports. There is no reason to require reports of minor side effects that are already known to be associated with given drugs. We agree that the reactions Health Canada most needs to know about are those which are severe and/or unexpected. If Health Canada insists on implementing a mandatory reporting system, it should be limited to these reactions (possibly with the corollary that well known serious ADRs would not need to be reported). However, the operating definitions may need clarification, and we recommend that Health Canada consult with health professionals and others on operational guidelines for defining "serious adverse reaction." Health Canada's desire to encourage reports on drugs approved within the last 5 years is understandable (though some drugs may be on the market for longer than this before their true risks are known). In practice, however, many physicians do not know which drugs these are, and seeking out this information may impose a heavy administrative burden. As we move toward an EMR-based reporting system, a tag on the Drug Identification Number to tell when the drug was approved will allow physicians to identify which medications require special vigilance. Appropriate reporting could be encouraged, and over-reporting discouraged, by clear guidelines as to what should be reported as well as appropriate compensation for reporting. f) Match Assessment Capacities In our opinion, this is one of the most important sections in the document. What happens once the reports have been received is crucial if we want to identify a serious drug risk as quickly as possible. Under the current system, one of the most significant barriers to physicians' reporting is lack of confidence that anything meaningful will be done with their reports. Enhancements to the analysis function must be made concurrently with efforts to increase ADR reporting. ADR reports are only cyber-bytes or stacks of paper unless we can learn from them. This requires rigorous data analysis that can sort "signal from noise" – in other words, sift through thousands of reports, find the ones that indicate unusual events, investigate their cause, and isolate those that indicate a serious public health risk. This requires substantial resources, including an adequate number of staff with the expertise and sensitivity required for this demanding task. Unless Health Canada has this capacity, increasing the number of reports will only add to the backlog in analysts' in-boxes. The CMA recommends that Health Canada allocate sufficient resources to enable it to effectively analyze and respond to ADR reports and other post-market surveillance information. g) Respect privacy Privacy of both patient and physician information is a significant concern. Physicians' ethical obligation to maintain patient confidentially is central to the patient-physician relationship and must be protected. We acknowledge that issues of privacy and confidentiality must be resolved when designing an ADR reporting system, particularly as we work toward electronic communication of drug surveillance data and its incorporation into an EMR. For example, regulations should explicitly state that ADR reports are to be used only for the purpose for which they were submitted, i.e. for post-market drug surveillance. In addition, Health Canada should ensure that any privacy provisions it develops meet the legislative test outlined in Section 3.6 of CMA's Health Information Privacy Code (Attachment I). Health Canada can be assured that physicians take their privacy obligations seriously. The CMA has been a strong and pro-active player in debate on this issue, and our Privacy Code lays the groundwork on which we believe any privacy policies involving ADR reporting should be based. h) Compliance through sanctions Physicians are motivated to report ADRs by their concern for public health and their patients' well-being. In addition, they are guided by the CMA Code of Ethics and governed by regulatory authorities in every province. A clear ethical and professional obligation already exists to report anything that poses a serious threat to patient safety. If physicians do not comply with this obligation, sanctions are available to the provincial regulatory authorities. In fact, the most serious threat for physicians is loss of standing with the professional regulatory authority, not the courts or any external judicial system. It would be superfluous to add a second level of regulation or scrutiny when remedies already exist. The discussion paper presents few alternatives to the existing self-regulatory system. As the paper itself acknowledges, it is unrealistic to impose sanctions based on failure to report an ADR, since it is not always easy to determine whether an adverse effect is attributable to a health product. But the only suggested alternatives - requiring physicians to demonstrate knowledge, or to have the required reporting forms in their office - seem intrusive, crude and unreasonable; they are also meaningless since they have no direct relation to a physician's failure to report. If Health Canada is considering a large outlay of taxpayers' dollars for post-market surveillance, we suggest they target those funds to education and awareness raising, and to enhancing the system's ability to generate and communicate meaningful signal data, rather than to enforcing a mandatory reporting system based on weak compliance measures, with no evidence of its effectiveness in other jurisdictions. Physicians who are in serious breach of their ethical and legal responsibility to report are subject to sanctions by provincial regulatory authorities. Most provincial colleges have policies or guidelines regarding timely reporting and appropriate enforcement mechanisms. Medicine's tradition of self-regulation has served it well, and we recommend that Health Canada respect and support existing regulatory authorities as they maintain the standards for appropriate professional behaviour. As we have said before - the preferred quality improvement tools to enhance performance and encourage compliance are education and positive reinforcement, not legislation and the threat of sanctions. Conclusion In its discussion paper Health Canada has invited stakeholders to provide their input on how best to develop a mandatory system for reporting ADRs. The Canadian Medical Association believes that the best way to do this is not to develop one at all. Instead, we believe stakeholders should concentrate on building a sustainable, robust and effective post-market surveillance system which: * encourages and facilitates voluntary reporting, by designing a simple and efficient process that can be incorporated into a physician's daily workflow; * effectively uses reporting data to identify major public health risks; * communicates drug safety information to providers and the public in a timely, meaningful and practical way. The CMA is committed to working, in partnership with Health Canada and other stakeholders, toward the ultimate goal of a responsive, efficient and effective post-market drug surveillance system. This is part of our long-standing commitment to optimizing Canadians' safety and health, and achieving our vision of a healthy population and a vibrant medical profession.
Capacity of the medical educational and training infrastructure
The Canadian Medical Association calls on the federal government to commission an independent body to assess and report on the capacity of the educational and training infrastructure across Canada to expand enrolment in medicine and nursing programs.
Chalk River National Research Universal reactor
GC10-102
The Canadian Medical Association urges the federal government to make a public commitment to keep the Chalk River National Research Universal reactor operational for as long as necessary beyond the announced date of 2016 and until secure alternative supplies of isotopes or alternative radiopharmaceuticals are proven and available.
CMA's Presentation to the House of Commons Standing Committee on Finance: Pre-budget Consultations 2010-2011
The CMA brief contains seven recommendations to address pressing needs in the health care system. Before I get to those, I'd like to highlight why, from my perspective, our health care system is in need of the federal government's attention. Yesterday, at the Ottawa Hospital, where I am Chief of Staff: * Our occupancy was 100 per cent. * 30 patients who came to the emergency department were admitted to the hospital, but we had beds for only four of them. * 10 are still waiting on gurneys in examining rooms within the emergency department. * Six patients were admitted to wards and are receiving care in hallways. * Three surgeries were cancelled - bringing the number of cancellations this year to 480. * But while all this was happening, we had 158 patients waiting for a bed in a long-term-care facility. Equally, a few blocks from here and in communities across the country, the health status of our poorest and most vulnerable populations is comparable to countries that have a fraction of our GDP - despite very significant investments in their health. This is just my perspective. Health care providers of all types experience the failings of our system on a daily basis. We as a country can do better and Canadians deserve better value for their money. Canada's physicians are calling for transformative change to build a health care system based on the principles of accessibility, high quality, cost effectiveness, accountability and sustainability. Through new efficiencies, better integration and sound stewardship, governments can reposition health care as an economic driver, an agent of productivity and a competitive advantage for Canada in today's global marketplace. The Health Accord expires in March 2014, and we strongly urge that the federal government begin discussions now with the provinces and territories on how to transform our health care system so that it meets patients' needs and is sustainable into the future. Canadians themselves also need to be part of the conversation. To help position the system for this transformative change, the CMA brief identifies a number of issues that the federal government should address in the short term: First, our system needs investments in health human resources to retain and recruit more doctors and nurses. Although we welcome measures in the last budget to increase the number of residency positions, we urge the government to fulfill the balance of its election promise by further investing in residencies, and to invest in programs to repatriate Canadian-trained physicians living abroad. Second, we need to bolster our public health e-infrastructure so that it can provide efficient, quality care that responds more effectively to pandemics. We recommend increased investment: * to improve data collection and analysis between local public health authorities and primary care practices, * for local health emergency preparedness, and * for the creation of a pan-Canadian strategy for responding to potential health crises. Third, issues related to our aging population also call for action. As continuing care moves from hospitals into the home, the community, or long-term care facilities, the financial burden shifts from governments to individuals. We recommend that the federal government study options for pre-funding long-term care - including private insurance, tax-deferred and tax-prepaid savings approaches, and contribution-based social insurance - to help Canadians prepare for their future home care and long-term care needs. And, as much of the burden of continuing care for seniors also falls on informal, unpaid caregivers, the CMA recommends that pilot studies be undertaken to explore tax credit and/or direct compensation for informal caregivers for their work, and to expand programs for informal caregivers that provide guaranteed access to respite services in emergency situations. Finally, the government should increase RRSP limits and explore opportunities to provide pension vehicles for self-employed Canadians. Mr. Chair, a fuller set of recommendations is contained in our report -- Health Care Transformation in Canada: Change that Works. Care that Lasts. These include universal access to prescription drugs; greater use of health information technology; and the immediate construction of long-term care facilities. We urge the Committee to consider both our short-term recommendations - and our longer term vision for transforming Canada's health care system. I look forward to your questions. Thank you.
CMA's Presentation to the Senate Standing Committee on National Finance: Bill C-9, An Act to implement certain provisions of the budget tabled in Parliament on March 4, 2010 and other measures
Thank you Madame Chair and Committee members for the opportunity to speak to you today. As mentioned, I am Briane Scharfstein, Associate Secretary General at the Canadian Medical Association (CMA). I am a family physician by training and a member of the Ad Hoc Working Group on Medical Isotopes. The working group was created to advise the Minister of Health in 2008 when the first major sustained shutdown of the Chalk River occurred. When I agreed to join the group, I certainly didn't expect it to still be going over two years later. And, while I am a member of the working group, I want to be clear, that today I am speaking on behalf of the CMA and our more than 72,000 physician members across the country. My comments are a reflection of the Working Group's June 2008 Lessons Learned report and I regret to say that a good portion of our observations are still true today. I congratulate the Senate for looking specifically at the AECL proposals and for looking at implications for patients. While the CMA is not taking a specific position on the proposal in Bill C-9 for Atomic Energy Canada Ltd (AECL), in whole or in part, to be sold off to the private sector, we do believe that it is in the best interests of our patients that Canada remains a leader in the sector. As well, Canada's doctors strongly believe that the impact on individual patient care must be considered and factored into any decisions that might result in disruptions of the supply of medical isotopes. The CMA acknowledges that the federal budget did include $48 million over two years for research, development and application of medical isotopes and alternatives. Further, there was another allocation of $300 million on a cash basis for AECL's operations in 2010/11 to cover anticipated commercial losses and support the corporation's operations to ensuring a secure supply of medical isotopes and maintaining safe and reliable operations at the Chalk River Laboratory. However, the CMA remains preoccupied with Canada's ability to ensure a long-term, stable and predictable supply of medically necessary isotopes. That is why we are uneasy about the federal government's exit strategy from the isotope production sector. The report of the federal government's Expert Panel on the Production of Medical Isotopes, (December 2009) and the federal government's response to that report, (March 2010) appears to focus on the viability of this specific sector of the nuclear industry and has not alleviated our concerns. The government's response to the Panel Report was disappointing to the medical community. The government's decision to abandon Canada's long-standing international leadership in this sector is disheartening. Of particular concern is the absence of both immediate and medium-term solutions to address the current and impending challenges facing nuclear medicine. This is simply unacceptable. The CMA, along with our colleagues in the medical community, continues to assert that ensuring access to safe and reliable medical procedures and the provision of high-quality patient care must be the fundamental consideration of government decisions. While the production cost of isotopes cannot be ignored, particularly in times of global fiscal challenges, the medical application and benefits received are of paramount importance and must be neither discounted nor dismissed. Early diagnosis and treatment are key factors in successful outcomes in cardiac and cancer cases. Without early diagnosis and treatment, patients have an increased risk of needing greater medical intervention later on. With more intensive treatment comes a corresponding increase in costs to the health care system and, most importantly, poorer outcomes for patients. Specific concerns identified by the CMA and the medical community include, but are not limited to the following: * Canada's current dependence on international reactors, without a practical back-up plan should these reactors experience difficulties, or shutdown for routine maintenance. This is especially worrisome as the international agency, the Association of Imaging Producers & Equipment Suppliers (AIPES) warns of the unprecedented level of shortages, in a large part due to the Canada's Chalk River nuclear reactor remaining off line until August 2010 or beyond. In a recent Supply Crisis Update, AIPES points out that with a number of international reactors off-line for scheduled maintenance, the remaining reactors -the OPAL (Australia), Maria (Poland) and REZ (Czech Republic) reactors-are producing Mo99, but their combined output is limited to 15 - 20 % of the world requirements. * The abandonment of Canada's international responsibilities and world leadership in this sector is counter to the government's own innovation and productivity agenda. * A growing reliance on emerging technology, cyclotrons and liner accelerators that have yet to be proven as a suitable secure alternative source of radiopharmaceutical. * A projected future supply chain that is reliant on external sources, rather than domestic production, in times of domestic supply shortages. As well, we are concerned that the federal government is leaving it to the marketplace, solely relying on current distributors to identify external sources supply, rather than searching to identify alternative safe sources of supply. * Basing Canada's supply strategy on relicensing of the Chalk River reactor five years past its current license with no current guarantees that the plant will return and remain in production, let alone meet relicensing standards. * The apparent lack of a federal contingency plan if, in 2016, alternative sources of supply and alternative emerging technology does not meet clinical needs. * An analysis of the overall costs to the health care system as a result of the increased costs incurred during the prolonged period of shortages of isotopes supply and the rising costs as the demand for the alternative diagnostic and treatment models is not apparent. * Initiatives to help mitigate increased costs for governments and particularly for nuclear medicine facilities do not exist. The just released survey by the Canadian Institute for Health Information found that two-thirds of nuclear medicine facilities reported that they experienced an increase in the cost of isotopes and that they were managing but exceeding their budget due to vendor surcharges. Only 2% reported that the isotope supply disruptions had no economic impact. Canada's medical community therefore strongly urges that consideration be given to: * investing in a mixed-use reactor for research and isotope production, as per the recommendation of the Expert Panel on Isotopes Production report of December, 2009; * putting in place appropriate strategies and contingency plans to meet the health needs of Canadians; in particular consider a national deployment of PET technology for cancer detection and follow up. * enhancing transparency by the government that provides more information on the short and medium-tern detailed plans to address isotope shortages; * increasing the direct consultation with the official representatives of the nuclear medicine and medical community; * making a public commitment to keep the Chalk River NRU reactor operational beyond the arbitrary date of 2016, as long as necessary and until secure alternative supplies of isotopes or alternative radiopharmaceuticals are proven and are in place; and, * ensuring that the CNSC resurrects the external medical advisory council to facilitate communication between the medical community and the commission. Prior to 2001, members of the council provided CNSC staff with insight into how operational and policy decisions would affect patient care across the country. Canada's doctors believe that the federal government must maintain a leadership role in this sector and must not compromise the medical needs of Canadians.
Collaborative development of patient-focused funding initiatives
The Canadian Medical Association will work with provincial/territorial medical associations to ensure meaningful consultations by governments with physicians who are accountable to the medical profession in the collaborative development of patient-focused funding initiatives.


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In the year 2017, we at Sailside set out on a mission: to become the world's most exclusive and innovative rental community for boating and yachting. If you think you know boat rentals but are unfamiliar with Sailside, then think again. We're not about meeting expectations. We're about exceeding them.
Whether you're looking for a boat for an afternoon, an overnight stay or a full-week charter, our service is second to none with an intuitive, hassle-free reservation process, and over four hundred fully equipped boats at more than fifty of the best locations worldwide to choose from. Besides, we are eager to hear about any special wishes you may have. At Sailside, we like to tend to your every need.
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