Carbon monoxide poisoning typically occurs from breathing in carbon monoxide (CO) at excessive levels. Symptoms are often described as "flu-like" and commonly include headache, dizziness, weakness, vomiting, chest pain, and confusion. Large exposures can result in loss of consciousness, arrhythmias, seizures, or death. The classically described "cherry red skin" rarely occurs. Long term complications may include feeling tired, trouble with memory, and movement problems. In those exposed to smoke, cyanide toxicity should also be considered.
Risk of death 1 to 30%.
Carbon monoxide poisoning can occur accidentally or as an attempt to end one's life. CO is a colorless and odorless gas which is initially non-irritating. It is produced during incomplete burning of organic matter. This can occur from motor vehicles, heaters, or cooking equipment that run on carbon-based fuels. It can also occur from exposure to methylene chloride. Carbon monoxide primarily causes adverse effects by combining with hemoglobin to form carboxyhemoglobin (HbCO) preventing the blood from carrying oxygen. Additionally, myoglobin and mitochondrial cytochrome oxidase are affected. Diagnosis is based on a HbCO level of more than 3% among nonsmokers and more than 10% among smokers.
Efforts to prevent poisoning include carbon monoxide detectors, proper venting of gas appliances, keeping chimneys clean, and keeping exhaust systems of vehicles in good repair. Treatment of poisoning generally consists of giving 100% oxygen along with supportive care. This should generally be carried out until symptoms are no longer present and the HbCO level is less than 10%. While hyperbaric oxygen therapy is used for severe poisonings, the benefit over standard oxygen delivery is unclear. The risk of death among those affected is between 1 and 30%.
Carbon monoxide poisoning is relatively common, resulting in more than 20,000 emergency department visits a year in the United States. It is the most common type of fatal poisoning in many countries. In the United States non-fire related cases results in more than 400 deaths a year. Poisonings occur more often in the winter, particularly from the use of portable generators during power outages. The toxic effects of CO have been known since ancient history. The realization that hemoglobin was affected by CO was determined in 1857.
Carbon monoxide is not toxic to all forms of life. Its harmful effects are due to binding with hemoglobin so its danger to organisms that do not use this compound is doubtful. It thus has no effect on photosynthesising plants. It is easily absorbed through the lungs. Inhaling the gas can lead to hypoxic injury, nervous system damage, and even death. Different people and populations may have different carbon monoxide tolerance levels. On average, exposures at 100 ppm or greater is dangerous to human health. In the United States, the OSHA limits long-term workplace exposure levels to less than 50 ppm averaged over an 8-hour period; in addition, employees are to be removed from any confined space if an upper limit ("ceiling") of 100 ppm is reached. Carbon monoxide exposure may lead to a significantly shorter life span due to heart damage. The carbon monoxide tolerance level for any person is altered by several factors, including activity level, rate of ventilation, a pre-existing cerebral or cardiovascular disease, cardiac output, anemia, sickle cell disease and other hematological disorders, barometric pressure, and metabolic rate.
3,200 ppm (0.32%), (3.2‰) Headache, dizziness and nausea in five to ten minutes. Death within 30 minutes.
6,400 ppm (0.64%), (6.4‰) Headache and dizziness in one to two minutes. Convulsions, respiratory arrest, and death in less than 20 minutes.
12,800 ppm (1.28%), (12.8‰) Unconsciousness after 2–3 breaths. Death in less than three minutes.
The main manifestations of carbon monoxide poisoning develop in the organ systems most dependent on oxygen use, the central nervous system and the heart. The initial symptoms of acute carbon monoxide poisoning include headache, nausea, malaise, and fatigue. These symptoms are often mistaken for a virus such as influenza or other illnesses such as food poisoning or gastroenteritis. Headache is the most common symptom of acute carbon monoxide poisoning; it is often described as dull, frontal, and continuous. Increasing exposure produces cardiac abnormalities including fast heart rate, low blood pressure, and cardiac arrhythmia; central nervous system symptoms include delirium, hallucinations, dizziness, unsteady gait, confusion, seizures, central nervous system depression, unconsciousness, respiratory arrest, and death. Less common symptoms of acute carbon monoxide poisoning include myocardial ischemia, atrial fibrillation, pneumonia, pulmonary edema, high blood sugar, lactic acidosis, muscle necrosis, acute kidney failure, skin lesions, and visual and auditory problems.
One of the major concerns following acute carbon monoxide poisoning is the severe delayed neurological manifestations that may occur. Problems may include difficulty with higher intellectual functions, short-term memory loss, dementia, amnesia, psychosis, irritability, a strange gait, speech disturbances, Parkinson's disease-like syndromes, cortical blindness, and a depressed mood. Depression may occur in those who did not have pre-existing depression. These delayed neurological sequelae may occur in up to 50% of poisoned people after 2 to 40 days. It is difficult to predict who will develop delayed sequelae; however, advanced age, loss of consciousness while poisoned, and initial neurological abnormalities may increase the chance of developing delayed symptoms.
One classic sign of carbon monoxide poisoning is more often seen in the dead rather than the living – people have been described as looking red-cheeked and healthy (see below). However, since this "cherry-red" appearance is common only in the deceased, and is unusual in living people, it is not considered a useful diagnostic sign in clinical medicine. In pathological (autopsy) examination the ruddy appearance of carbon monoxide poisoning is notable because unembalmed dead persons are normally bluish and pale, whereas dead carbon-monoxide poisoned persons may simply appear unusually lifelike in coloration. The colorant effect of carbon monoxide in such postmortem circumstances is thus analogous to its use as a red colorant in the commercial meat-packing industry.
Chronic exposure to relatively low levels of carbon monoxide may cause persistent headaches, lightheadedness, depression, confusion, memory loss, nausea, hearing disorders and vomiting. It is unknown whether low-level chronic exposure may cause permanent neurological damage. Typically, upon removal from exposure to carbon monoxide, symptoms usually resolve themselves, unless there has been an episode of severe acute poisoning. However, one case noted permanent memory loss and learning problems after a 3-year exposure to relatively low levels of carbon monoxide from a faulty furnace. Chronic exposure may worsen cardiovascular symptoms in some people. Chronic carbon monoxide exposure might increase the risk of developing atherosclerosis. Long-term exposures to carbon monoxide present the greatest risk to persons with coronary heart disease and in females who are pregnant. In experimental animals, carbon monoxide appears to worsen noise-induced hearing loss at noise exposure conditions that would have limited effects on hearing otherwise. In humans, hearing loss has been reported following carbon monoxide poisoning. Unlike the findings in animal studies, noise exposure was not a necessary factor for the auditory problems to occur.
Carbon monoxide is a product of combustion of organic matter under conditions of restricted oxygen supply, which prevents complete oxidation to carbon dioxide (CO2). Sources of carbon monoxide include cigarette smoke, house fires, faulty furnaces, heaters, wood-burning stoves, internal combustion vehicle exhaust, electrical generators, propane-fueled equipment such as portable stoves, and gasoline-powered tools such as leaf blowers, lawn mowers, high-pressure washers, concrete cutting saws, power trowels, and welders. Exposure typically occurs when equipment is used in buildings or semi-enclosed spaces.
Riding in the back of pickup trucks has led to poisoning in children. Idling automobiles with the exhaust pipe blocked by snow has led to the poisoning of car occupants. Any perforation between the exhaust manifold and shroud can result in exhaust gases reaching the cabin. Generators and propulsion engines on boats, especially houseboats, has resulted in fatal carbon monoxide exposures.
Poisoning may also occur following the use of a self-contained underwater breathing apparatus (SCUBA) due to faulty diving air compressors.
In caves carbon monoxide can build up in enclosed chambers due to the presence of decomposing organic matter. In coal mines incomplete combustion may occur during explosions resulting in the production of afterdamp. The gas is up to 3% CO and may be fatal after just a single breath. Following an explosion in a colliery, adjacent interconnected mines may become dangerous due to the afterdamp leaking from mine to mine. Such an incident followed the Trimdon Grange explosion which killed men in the Kelloe mine.
Another source of poisoning is exposure to the organic solvent dichloromethane, found in some paint strippers, as the metabolism of dichloromethane produces carbon monoxide.
The precise mechanisms by which the effects of carbon monoxide are induced upon bodily systems, are complex and not yet fully understood. Known mechanisms include carbon monoxide binding to hemoglobin, myoglobin and mitochondrial cytochrome oxidase and restricting oxygen supply, and carbon monoxide causing brain lipid peroxidation.
Carbon monoxide shifts the oxygen-dissociation curve to the left.
Carbon monoxide has a higher diffusion coefficient compared to oxygen, and the only enzyme in the human body that produces carbon monoxide is heme oxygenase, which is located in all cells and breaks down heme. Under normal conditions, carbon monoxide levels in the plasma are approximately 0 mmHg because it has a higher diffusion coefficient and the body easily gets rid of any CO made. When CO is not ventilated it binds to hemoglobin, which is the principal oxygen-carrying compound in blood; this produces a compound known as carboxyhemoglobin. The traditional belief is that carbon monoxide toxicity arises from the formation of carboxyhemoglobin, which decreases the oxygen-carrying capacity of the blood and inhibits the transport, delivery, and utilization of oxygen by the body. The affinity between hemoglobin and carbon monoxide is approximately 230 times stronger than the affinity between hemoglobin and oxygen so hemoglobin binds to carbon monoxide in preference to oxygen.
Hemoglobin is a tetramer with four oxygen binding sites. The binding of carbon monoxide at one of these sites increases the oxygen affinity of the remaining three sites, which causes the hemoglobin molecule to retain oxygen that would otherwise be delivered to the tissue. This situation is described as carbon monoxide shifting the oxygen dissociation curve to the left. Because of the increased affinity between hemoglobin and oxygen during carbon monoxide poisoning, little oxygen will actually be released in the tissues. This causes hypoxic tissue injury. Hemoglobin acquires a bright red color when converted into carboxyhemoglobin, so poisoned cadavers and even commercial meats treated with carbon monoxide acquire an unnatural reddish hue.
Carbon monoxide also binds to the hemeprotein myoglobin. It has a high affinity for myoglobin, about 60 times greater than that of oxygen. Carbon monoxide bound to myoglobin may impair its ability to utilize oxygen. This causes reduced cardiac output and hypotension, which may result in brain ischemia. A delayed return of symptoms have been reported. This results following a recurrence of increased carboxyhemoglobin levels; this effect may be due to a late release of carbon monoxide from myoglobin, which subsequently binds to hemoglobin.
Another mechanism involves effects on the mitochondrial respiratory enzyme chain that is responsible for effective tissue utilization of oxygen. Carbon monoxide binds to cytochrome oxidase with less affinity than oxygen, so it is possible that it requires significant intracellular hypoxia before binding. This binding interferes with aerobic metabolism and efficient adenosine triphosphate synthesis. Cells respond by switching to anaerobic metabolism, causing anoxia, lactic acidosis, and eventual cell death. The rate of dissociation between carbon monoxide and cytochrome oxidase is slow, causing a relatively prolonged impairment of oxidative metabolism.
The mechanism that is thought to have a significant influence on delayed effects involves formed blood cells and chemical mediators, which cause brain lipid peroxidation (degradation of unsaturated fatty acids). Carbon monoxide causes endothelial cell and platelet release of nitric oxide, and the formation of oxygen free radicals including peroxynitrite. In the brain this causes further mitochondrial dysfunction, capillary leakage, leukocyte sequestration, and apoptosis. The result of these effects is lipid peroxidation, which causes delayed reversible demyelinization of white matter in the central nervous system known as Grinker myelinopathy, which can lead to edema and necrosis within the brain. This brain damage occurs mainly during the recovery period. This may result in cognitive defects, especially affecting memory and learning, and movement disorders. These disorders are typically related to damage to the cerebral white matter and basal ganglia. Hallmark pathological changes following poisoning are bilateral necrosis of the white matter, globus pallidus, cerebellum, hippocampus and the cerebral cortex.
Carbon monoxide poisoning in pregnant women may cause severe adverse fetal effects. Poisoning causes fetal tissue hypoxia by decreasing the release of maternal oxygen to the fetus. Carbon monoxide also crosses the placenta and combines with fetal hemoglobin, causing more direct fetal tissue hypoxia. Additionally, fetal hemoglobin has a 10 to 15% higher affinity for carbon monoxide than adult hemoglobin, causing more severe poisoning in the fetus than in the adult. Elimination of carbon monoxide is slower in the fetus, leading to an accumulation of the toxic chemical. The level of fetal morbidity and mortality in acute carbon monoxide poisoning is significant, so despite mild maternal poisoning or following maternal recovery, severe fetal poisoning or death may still occur.
Finger tip carboxyhemoglobin saturation monitor (SpCO%). Note: This is not the same as a pulse oximeter (SpO2%), although some models (such as this one) do measure both the oxygen and carbon monoxide saturation.
Breath CO monitor displaying carbon monoxide concentration of an exhaled breath sample (in ppm) with its corresponding percent concentration of carboxyhemoglobin.
As many symptoms of carbon monoxide poisoning also occur with many other types of poisonings and infections (such as the flu), the diagnosis is often difficult. A history of potential carbon monoxide exposure, such as being exposed to a residential fire, may suggest poisoning, but the diagnosis is confirmed by measuring the levels of carbon monoxide in the blood. This can be determined by measuring the amount of carboxyhemoglobin compared to the amount of hemoglobin in the blood.
The ratio of carboxyhemoglobin to hemoglobin molecules in an average person may be up to 5%, although cigarette smokers who smoke two packs per day may have levels up to 9%. In symptomatic poisoned people they are often in the 10–30% range, while persons who die may have postmortem blood levels of 30–90%.
As people may continue to experience significant symptoms of CO poisoning long after their blood carboxyhemoglobin concentration has returned to normal, presenting to examination with a normal carboxyhemoglobin level (which may happen in late states of poisoning) does not rule out poisoning.
Carbon monoxide may be quantitated in blood using spectrophotometric methods or chromatographic techniques in order to confirm a diagnosis of poisoning in a person or to assist in the forensic investigation of a case of fatal exposure.
A CO-oximeter can be used to determine carboxyhemoglobin levels. Pulse CO-oximeters estimate carboxyhemoglobin with a non-invasive finger clip similar to a pulse oximeter. These devices function by passing various wavelengths of light through the fingertip and measuring the light absorption of the different types of hemoglobin in the capillaries. The use of a regular pulse oximeter is not effective in the diagnosis of carbon monoxide poisoning as people with carbon monoxide poisoning may have a normal oxygen saturation level on a pulse oximeter. This is due to the carboxyhemoglobin being misrepresented as oxyhemoglobin.
Breath CO monitoring offers an alternative to pulse CO-oximetry. Carboxyhemoglobin levels have been shown to have a strong correlation with breath CO concentration. However, many of these devices require the user to inhale deeply and hold their breath to allow the CO in the blood to escape into the lung before the measurement can be made. As this is not possible in people who are unresponsive, these devices may not appropriate for use in on-scene emergency care detection of CO poisoning.
There are many conditions to be considered in the differential diagnosis of carbon monoxide poisoning. The earliest symptoms, especially from low level exposures, are often non-specific and readily confused with other illnesses, typically flu-like viral syndromes, depression, chronic fatigue syndrome, chest pain, and migraine or other headaches. Carbon monoxide has been called a "great mimicker" due to the presentation of poisoning being diverse and nonspecific. Other conditions included in the differential diagnosis include acute respiratory distress syndrome, altitude sickness, lactic acidosis, diabetic ketoacidosis, meningitis, methemoglobinemia, or opioid or toxic alcohol poisoning.
Prevention remains a vital public health issue, requiring public education on the safe operation of appliances, heaters, fireplaces, and internal-combustion engines, as well as increased emphasis on the installation of carbon monoxide detectors. Carbon monoxide is tasteless, odourless, and colourless, and therefore can not be detected by visual cues or smell.
The United States Consumer Product Safety Commission has stated, "carbon monoxide detectors are as important to home safety as smoke detectors are," and recommends each home have at least one carbon monoxide detector, and preferably one on each level of the building. These devices, which are relatively inexpensive and widely available, are either battery- or AC-powered, with or without battery backup. In buildings, carbon monoxide detectors are usually installed around heaters and other equipment. If a relatively high level of carbon monoxide is detected, the device sounds an alarm, giving people the chance to evacuate and ventilate the building. Unlike smoke detectors, carbon monoxide detectors do not need to be placed near ceiling level.
3. Detectors must be located on every habitable level and in every HVAC zone of the building.
Gas organizations will often recommend to get gas appliances serviced at least once a year.
The NFPA standard is not necessarily enforced by law. As of April 2006, the US state of Massachusetts requires detectors to be present in all residences with potential CO sources, regardless of building age and whether they are owner-occupied or rented. This is enforced by municipal inspectors, and was inspired by the death of 7-year-old Nicole Garofalo in 2005 due to snow blocking a home heating vent. Other jurisdictions may have no requirement or only mandate detectors for new construction or at time of sale.
Despite similar deaths in vehicles with clogged exhaust pipes (for example in the Northeastern United States blizzard of 1978 and February 2013 nor'easter) and the commercial availability of the equipment, there is no legal requirement for automotive CO detectors.
Initial treatment for carbon monoxide poisoning is to immediately remove the person from the exposure without endangering further people. Those who are unconscious may require CPR on site. Administering oxygen via non-rebreather mask shortens the half-life of carbon monoxide from 320 minutes, when breathing normal air, to only 80 minutes. Oxygen hastens the dissociation of carbon monoxide from carboxyhemoglobin, thus turning it back into hemoglobin. Due to the possible severe effects in the baby, pregnant women are treated with oxygen for longer periods of time than non-pregnant people.
Hyperbaric oxygen is also used in the treatment of carbon monoxide poisoning, as it may hasten dissociation of CO from carboxyhemoglobin and cytochrome oxidase to a greater extent than normal oxygen. Hyperbaric oxygen at three times atmospheric pressure reduces the half life of carbon monoxide to 23 (~80/3 minutes) minutes, compared to 80 minutes for oxygen at regular atmospheric pressure. It may also enhance oxygen transport to the tissues by plasma, partially bypassing the normal transfer through hemoglobin. However, it is controversial whether hyperbaric oxygen actually offers any extra benefits over normal high flow oxygen, in terms of increased survival or improved long-term outcomes. There have been randomized controlled trials in which the two treatment options have been compared; of the six performed, four found hyperbaric oxygen improved outcome and two found no benefit for hyperbaric oxygen. Some of these trials have been criticized for apparent flaws in their implementation. A review of all the literature concluded that the role of hyperbaric oxygen is unclear and the available evidence neither confirms nor denies a medically meaningful benefit. The authors suggested a large, well designed, externally audited, multicentre trial to compare normal oxygen with hyperbaric oxygen.
Further treatment for other complications such as seizure, hypotension, cardiac abnormalities, pulmonary edema, and acidosis may be required. Increased muscle activity and seizures should be treated with dantrolene or diazepam; diazepam should only be given with appropriate respiratory support. Hypotension requires treatment with intravenous fluids; vasopressors may be required to treat myocardial depression. Cardiac dysrhythmias are treated with standard advanced cardiac life support protocols. If severe, metabolic acidosis is treated with sodium bicarbonate. Treatment with sodium bicarbonate is controversial as acidosis may increase tissue oxygen availability. Treatment of acidosis may only need to consist of oxygen therapy. The delayed development of neuropsychiatric impairment is one of the most serious complications of carbon monoxide poisoning. Brain damage is confirmed following MRI or CAT scans. Extensive follow up and supportive treatment is often required for delayed neurological damage. Outcomes are often difficult to predict following poisoning, especially people who have symptoms of cardiac arrest, coma, metabolic acidosis, or have high carboxyhemoglobin levels. One study reported that approximately 30% of people with severe carbon monoxide poisoning will have a fatal outcome. It has been reported that electroconvulsive therapy (ECT) may increase the likelihood of delayed neuropsychiatric sequelae (DNS) after carbon monoxide (CO) poisoning. A device that also provides some carbon dioxide to stimulate faster breathing (sold under the brand name ClearMate) may also be used.
See also: Category:Deaths from carbon monoxide poisoning.
The true number of cases of carbon monoxide poisoning is unknown, since many non-lethal exposures go undetected. From the available data, carbon monoxide poisoning is the most common cause of injury and death due to poisoning worldwide. Poisoning is typically more common during the winter months. This is due to increased domestic use of gas furnaces, gas or kerosene space heaters, and kitchen stoves during the winter months, which if faulty and/or used without adequate ventilation, may produce excessive carbon monoxide. Carbon monoxide detection and poisoning also increases during power outages, when electric heating and cooking appliances become inoperative and residents may temporarily resort to fuel-burning space heaters, stoves, and grills (some of which are safe only for outdoor use but nonetheless are errantly burned indoors).
It has been estimated that more than 40,000 people per year seek medical attention for carbon monoxide poisoning in the United States. 95% of carbon monoxide poisoning deaths in the United States are due to gas space heaters. In many industrialized countries carbon monoxide is the cause of more than 50% of fatal poisonings. In the United States, approximately 200 people die each year from carbon monoxide poisoning associated with home fuel-burning heating equipment. Carbon monoxide poisoning contributes to the approximately 5613 smoke inhalation deaths each year in the United States. The CDC reports, "Each year, more than 500 Americans die from unintentional carbon monoxide poisoning, and more than 2,000 commit suicide by intentionally poisoning themselves." For the 10-year period from 1979 to 1988, 56,133 deaths from carbon monoxide poisoning occurred in the United States, with 25,889 of those being suicides, leaving 30,244 unintentional deaths. A report from New Zealand showed that 206 people died from carbon monoxide poisoning in the years of 2001 and 2002. In total carbon monoxide poisoning was responsible for 43.9% of deaths by poisoning in that country. In South Korea, 1,950 people had been poisoned by carbon monoxide with 254 deaths from 2001 through 2003. A report from Jerusalem showed 3.53 per 100,000 people were poisoned annually from 2001 through 2006. In Hubei, China, 218 deaths from poisoning were reported over a 10-year period with 16.5% being from carbon monoxide exposure.
The earliest description of carbon monoxide poisoning dates to at least 200 BC by Aristotle. Documented cases of carbon monoxide being used as a method of suicide date to at least 100 BC in ancient Rome. In the AD 350s, the Roman emperor Julian suffered from carbon monoxide poisoning in Paris, and later described it in his work Misopogon: "though the winter weather prevailed and continually increased in severity, even so I did not allow my servants to heat the house, because I was afraid of drawing out the dampness in the walls; but I ordered them to carry in fire that had burned down and to place in the room a very moderate number of hot coals. But the coals, though there were not very many of them, brought out from the walls quantities of steam and this made me fall asleep. And since my head was filled with the fumes I was almost choked. Then I was carried outside." This misunderstanding of the causes of carbon monoxide poisoning may have caused the death of Julian's successor, Jovian.
John Scott Haldane identified carbon monoxide as the lethal constituent of afterdamp, the gas created by combustion, after examining many bodies of miners killed in pit explosions. Their skin was coloured cherry-pink from carboxyhaemoglobin, the stable compound formed in the blood by reaction with the gas. As a result of his research, he was able to design respirators for rescue workers. He tested the effect of carbon monoxide on his own body in a closed chamber, describing the results of his slow poisoning. In the late 1890s, he introduced the use of small animals for miners to detect dangerous levels of carbon monoxide underground, either white mice or canaries. With a faster metabolism, they showed the effects of poisoning before gas levels became critical for the workers, and so gave an early warning of the problem. The canary in British pits was replaced in 1986 by the electronic gas detector.
As part of the Holocaust during World War II, German Nazis used gas vans at Chelmno extermination camp and elsewhere to kill an estimated over 700,000 prisoners by carbon monoxide poisoning. This method was also used in the gas chambers of several death camps such as Treblinka, Sobibor and Belzec. Gassing with carbon monoxide started in action T4, the programme developed by the Nazis in Germany to murder the mentally ill and disabled people before the war started in earnest. The gas was supplied by IG Farben in pressurized cylinders and fed by tubes into the gas chambers built at various mental hospitals, such as Hartheim Euthanasia Centre. Many key personnel were recruited from the T4 programme to murder much larger numbers of people in the gas vans and the special gas chambers used in the death camps such as Treblinka. Exhaust fumes from tank engines for example, were used to supply the gas to the chambers.
The use of oxygen as treatment began in 1868. The use of hyperbaric oxygen in rats following poisoning was studied by Haldane in 1895 while its use in humans began in the 1960s.
Carbon monoxide is produced naturally by the body as a byproduct of converting protoporphyrin into bilirubin. This carbon monoxide also combines with hemoglobin to make carboxyhemoglobin, but not at toxic levels.
Small amounts of CO are beneficial and enzymes exist that produce it at times of oxidative stress. Drugs are being developed to introduce small amounts of CO during certain kinds of surgery, these drugs are called carbon monoxide-releasing molecules.
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text:
Todd Ousley is an American prelate of the Episcopal Church who is the current bishop for the Office of Pastoral Development. Between 2006 and 2017, he also served as the second bishop of Eastern Michigan.

Biography
Ousley was born in Waco, Texas, and studied at Texas A&M University between 1979 and 1981 and again in 1984 when he earned a Master of Arts. He also graduated from Baylor University in 1983. He graduated with a Master of Divinity from the Episcopal Theological Seminary of the Southwest in 1991, and a Doctor of Ministry in congregational development from Seabury-Western Theological Seminary in 2004.

He was ordained to the priesthood on February 1, 1992. He served as curate at the Church of the Good Shepherd in Austin, Texas between 1991 and 1993. He then became rector of the Church of the Holy Comforter in Angleton, Texas in 1993, while in 1997, he became rector of St Francis' Church in Temple, Texas. In 2001 he became canon to the ordinary at Episcopal Diocese of Eastern Michigan.

On May 6, 2006, Ousley was elected Coadjutor Bishop of Eastern Michigan and was consecrated as a bishop on September 9, 2006. He resigned his post in 2017 after he was named Bishop for the Office of Pastoral Development.

See also
 List of Episcopal bishops of the United States
 Historical list of the Episcopal bishops of the United States

References

Living people
Year of birth missing (living people)
Texas A&M University alumni
Baylor University alumni
Seminary of the Southwest alumni
Seabury-Western Theological Seminary alumni
Episcopal bishops of Eastern Michigan

redpajama_set_name: RedPajamaWikipedia


text:
The TUF's Position on COVID-19 and the Related Vaccination
VP Digital October 2, 2021 1:31 pm October 2, 2021 0
The TUF recognizes that:
– The world is facing a global health crisis caused by the coronavirus disease (Covid– 19) which is causing human suffering and death.
– What started as a health crisis has transformed into a human, economic and social crisis.
– The Covid-19 pandemic presents an unprecedented challenge to public health and the world of work and the economic and social disruptions caused by it are devastating.
– Covid-19 affects all segments of the population and it is particularly detrimental to members of those social groups that are most vulnerable.
– The crisis seriously impacts employment and labour issues, in particular workers' earnings, job security and their health and safety at the workplace.
– In particular, Doctors, Nurses, Fire Officers, Paramedics and other health care workers face several challenges personally and professionally which include being overworked and experiencing psychological burden managing patients and situations impacted by the pandemic. The TUF acknowledges that:
– Adhering to workplace safety and health practices; ensuring decent work and protecting labour rights at all workplaces are critical to addressing the crisis.
– Immediate, purposeful and culturally relevant action to save lives and livelihoods must be considered and taken. – Only with social partners working together in a spirit of mutual trust will the health, social and economic impacts of the pandemic be overcome.
– Proper adherence to the health protocols as suggested by the experts will contribute to a more effective reduction in transmission of the virus.
– High vaccination rates are necessary to reduce suffering, death and the pressures on the already burdened health care system and the negative impact on the economy.
The TUF observes that:
– A high level of misinformation is negatively impacting the fight against the virus. Indiscipline among too large a segment of the population is contributing to the transmission of the virus.
– A new form of divisiveness of vaccinated versus unvaccinated is emerging within the society and the TUF believes that this is counterproductive to effectively fighting the virus and its effects.
The TUF's position on Covid-19 and vaccination is based on the following principles:
– Decisions on managing the crisis have to be informed by expert advice and various stakeholders should be engaged in social dialogue to arrive at positions on managing the situation.
– There must be respect for the bodily autonomy of each individual person.
– In keeping with the International Labour Organization's (ILO's) standards, workers' rights, fairness and democracy must be practiced at every workplace.
– Discrimination in whatever form MUST NOT be practiced at the workplace.
– No employer has the right to unilaterally vary the employment contract of employees.
– High vaccination rates should be attained through encouragement and not by employer mandates. – Effective access to vaccines should be ensured for those who wish to have it.
– The voices of workers and their representatives should be respected at the workplace and in national consultations/dialogue.
Based on the above principles, the TUF advocates for:
– Government, employers, workers and workers' organizations to work together in a spirit of shared understanding and trust to design and implement measures to save lives and livelihoods.
– Education to be the means through which citizens are encouraged to accept vaccination and to overcome vaccine hesitancy.
– Health Authorities to more robustly engage workers/professionals in high-risks places in consultations aimed at encouraging them to accept vaccination as a necessary requirement.
– Workers voice and that of their Unions to be fully respected and that they be involved in a collaborative approach to dealing with workplace health and safety issues as well as any workplace adjustments resulting from the pandemic.
– An end to all discriminatory practices against unvaccinated workers/citizens. – Employers to pay for all testing that they deem necessary for workers' employment.
– Respect of terms of employment contract of all workers. The TUF remains – Committed to mobilizing expertise and experience that exist within its affiliates to support a meaningful national response to the crisis. – Determined to support any group of workers or individual worker who has to face discrimination or disrespect at the work place.
– Ready to participate in meaningful social dialogue on managing the crisis and other matters of national and workplace importance.
– Determined to support our health care professionals as they seek to help the nation and the TUF encourages individuals to do the same by doing what is necessary including considering taking the vaccine.
– Committed to participating in educational initiatives (and will also be devising its own) to inform workers of their rights and responsibilities during this crisis period and to encourage them to do what is necessary to mitigate against the spread of the coronavirus.

redpajama_set_name: RedPajamaCommonCrawl


Want to swap the accounts that you can access via EFTPOS or ATM machine on your card?
Do it yourself in Internet Banking!
Delinking is just as easy – just drag and drop the account off the card.
Internet Banking will even warn you about possible fees if you try to attach a Rapid Save account to your card. A nice touch to prevent fees.
How does that "ONLINE" slot work please?. Say, if I was to link an account for monthly debit subscriptions/bills (Netflix, Spotify, Skinny Broadband, Apps etc), would fees be taken from that linked account only? …or would it be to the overall card number as normal?.
That would be pretty cool if it's to the account!..so much easier than how I was managing it with Kiwibank.
Have just joined BNZ (yet to get my EFTPOS/FLEXI cards through mail), so I'm having a good ol' nosey and play around in here and online banking, hehe.
Any insight would be awesome, thanks.
That's correct for your Flexi Debit card. If you change the linked 'Online' slot, the payments you set up with the Flexi Debit card would now come out of that linked account.


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Blog Horror
10 of the Best Horror Movies of 2022
How many of these amazing horror flicks have you seen?
by Chris Courtney Martin - updated on January 25, 2023
Spooky-tide is upon us, and nothing makes me feel more alive than the annual heyday of the undead. Below, I've listed (in no particular order) some of the best horror movies 2022 had to offer.
Some, I've seen. Some, I haven't. All of them, for better or worse, Diddy Bop atop my Interest Button — and likely, yours.
Writer: Jordan Peele, Director: Jordan Peele
Rotten Tomatoes Logline: "Two siblings who run a California horse ranch discover something wonderful and sinister in the skies above, and the owner of an adjacent theme park tries to profit from the mysterious, otherworldly phenomenon."
Jordan Peele has not only redefined the horror genre, but he also managed to successfuly mix westerns, sci-fi, and horror with Nope. Also, this cast is incredible, with Keke Palmer CONSISTENTLY killing it and Daniel Kaluuya's once-in-a-generation talent showing its versatility yet again. Aliens. Unscrupulous entrepreneurs. Existential dread. Sounds like the aptest representation of our post-pandemic zeitgeist.
If you want to dive deeper, check out our video essay about the meaning behind Jordan Peele's Nope.
Writers: Sarah DeLappe/Kristen Roupenian/Chloe Okuno/Josh Sharp/Aaron Jackson, Director: Halina Reijn
Rotten Tomatoes Logline: "When a group of rich 20-somethings plans a hurricane party at a remote family mansion, a party game goes awry in this fresh and funny look at backstabbing, fake friends, and one party gone very, very wrong."
Seeing Amandla Stenberg, Lee Pace, and Pete Davidson in the same movie is a little like getting yogurt and honey on my bacon at brunch — not quite what I would have asked for, but I absolutely do not hate it. Plus, spoiled rich kids getting slasher'd is a lot more fun and efficient than bringing back the guillotine.
Writers: Joshua Hull/David Ian McKendry/Todd Rigney, Director: Rebekah McKendry
Rotten Tomatoes Logline: "A heartbroken man finds himself trapped in a bathroom with a strange voice who says he may be the only hope in stopping a terrible event."
From True Blood to Dead Silence (which was WAY scary, thanks very much, haters) — it's safe to say Ryan Kwanten deserves to be treasured as a Scream King. Public restrooms are terrifying on many levels. This film is sure to have the next generation of Horror movie fans making sure they go at home.
Writer: Patrick Aison, Director: Dan Trachtenberg
Rotten Tomatoes Logline: "Set in the Comanche Nation 300 years ago, 'Prey' is the story of a young woman, Naru, a fierce and highly skilled warrior. She has been raised in the shadow of some of the most legendary hunters who roam the Great Plains, so when danger threatens her camp, she sets out to protect her people. The prey she stalks, and ultimately confronts, turns out to be a highly evolved alien predator with a technically advanced arsenal, resulting in a vicious and terrifying showdown between the two adversaries."
As our protagonist Naru, rising powerhouse Amber Midthunder steals the show from an extraterrestrial legend — with lovable Dakota Beavers bringing up the rear. Midthunder is the heiress to a quiet storm of a Hollywood dynasty. And her ability to carry this film, mostly on her back alone, shows us that her reign was written in the stars.
Writer: Carlota Pereda, Director: Carlota Pereda
Rotten Tomatoes Logline: "With the summer sun beating down on her rural Spanish town, Sara hides away in her parent's butcher shop. A teenager whose excess weight makes her the target of incessant bullying, she flees a clique of capricious girls who torment her at the town pool, only to stumble upon them being brutally kidnapped by a stranger, who drives off with them in his van. When the police begin asking questions, Sara keeps quiet. Intrigued by the stranger — an interest that's mutual — she's torn between revealing the truth and protecting the man who saved her."
Being "big-boned-ed-ed" myself, I can absolutely understand the appeal of this film when talking about creative catharsis. Messy-and-Complicated™ heroine Sara is giving "Carrie White With A Tighter Alibi" in this revenge-by-proxy flick. It also doesn't shy away from some philosophical questions, which always makes Horror a little juicier.
Writers: Ben Collins/Luke Piotrowski/David S. Goyer, Director: David Bruckner
Rotten Tomatoes Logline: "A new take on Clive Barker's 1987 horror classic in which a young woman struggling with addiction comes into possession of an ancient puzzle box, unaware that its purpose is to summon the Cenobites, a group of sadistic supernatural beings from another dimension."
The original Hellraiser is one of the films that scared the marshmallow fluff out of me as a young padawan — and I know I am not alone in that. This reboot is exciting in the way it embraces a more grimly gorgeous side of the macabre. Sumptuous design elements add a subtle allure to the "violent delights" these neo-Cenobites have to offer.
Writer: Alex Garland, Director: Alex Garland
Rotten Tomatoes Logline: "In the aftermath of a personal tragedy, Harper (Jessie Buckley) retreats alone to the beautiful English countryside, hoping to have found a place to heal. But someone or something from the surrounding woods appears to be stalking her. What begins as simmering dread becomes a fully-formed nightmare, inhabited by her darkest memories and fears in visionary filmmaker Alex Garland's (Ex Machina, Annihilation) feverish, shape-shifting new horror film."
Alex Garland has the whole Subtle Horror thing in the bag. With work chock full of intelligent commentary, it's easy to make it a point to just stay up-to-date on his releases. Besides, this seems like the quintessential example of Gaslight Horror since — well — Gaslight. (RIP, Angela Lansbury).
Writer: Ti West/Mia Goth, Director: Ti West
Rotten Tomatoes Logline: "Filmmaker Ti West returns with another chapter from the twisted world of X, in this astonishing follow-up to the year's most acclaimed horror film. Trapped on her family's isolated farm, Pearl must tend to her ailing father under the bitter and overbearing watch of her devout mother. Lusting for a glamorous life like she's seen in the movies, Pearl finds her ambitions, temptations, and repressions all colliding in this stunning, technicolor-inspired origin story of X's iconic villain."
When considering Pearl over its same-year prequel, X, there are a couple of factors working in the follow-up's favor — mainly that this one stars a Philadelphian. As well, there's just something about the setting and tone of the origin story which makes me wonder if it was the overall point of the franchise all along. Maybe Mia Goth's creative partnership is the secret sauce here, but this one makes me want to watch the films in the opposite order.
Writer: Parker Finn, Director: Parker Finn
Rotten Tomatoes Logline: "After witnessing a bizarre, traumatic incident involving a patient, Dr. Rose Cotter (Sosie Bacon) starts experiencing frightening occurrences that she can't explain. As an overwhelming terror begins taking over her life, Rose must confront her troubling past in order to survive and escape her horrifying new reality."
This one goes out to every individual who has ridden a train across from Creepy McSlasher-Smile. If you ever wondered what producers mean when they say they're seeking a "high concept project"— it's this. Smiles are canceled indefinitely.
The Black Phone
Writers: Scott Derrickson/C. Robert Cargill/Joe Hill, Director: Scott Derrickson
Rotten Tomatoes Logline: "Finney, a shy but clever 13-year-old boy, is abducted by a sadistic killer and trapped in a soundproof basement where screaming is of little use. When a disconnected phone on the wall begins to ring, Finney discovers that he can hear the voices of the killer's previous victims. And they are dead set on making sure that what happened to them doesn't happen to Finney."
Who doesn't want to see a brilliant kid Escape Room his way out of a hell-cell? Joe Hill's original short story by the same name definitely lays the groundwork for this riddle-ridden magic. But Cargill and Derrickson are a dynamic duo to be reckoned with. And as someone who's had the distinct honor of reading oracle cards for Scott — I can personally say, the guy is ascended AF.
Happy hauntin', Horror movie fans!
Read More: What Fandango's 2023 Most Anticipated Movies Can Teach Screenwriters
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21 Series Bibles That Every TV Screenwriter Should Read
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Has Jordan Peele Redefined Horror Movies?


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filter your search Books & JournalsAll JournalsRadical History Review
About Radical History Review
Volume 2013, Issue 115
Issue Editors
Melina Pappademos
Karen Sotiropoulos
Amy Chazkel
Other| January 01 2013
Jean Anil Louis-Juste, Prezan!
Toussaint Losier
Radical History Review (2013) 2013 (115): 213–217.
Toussaint Losier; Jean Anil Louis-Juste, Prezan!. Radical History Review 1 January 2013; 2013 (115): 213–217. doi: https://doi.org/10.1215/01636545-1724796
On January 12, 2010, several hours before a magnitude 7.0 earthquake struck Port-au-Prince, gunmen shot and killed Sociology Professor Jean Anil Louis-Juste as he was leaving the grounds of his department at the State University of Haiti. A tireless revolutionary and engaged academic, Louis-Juste had recently received multiple death threats for his role in organizing a series of university student demonstrations that sparked wildcat strikes at one of Port-au-Prince's largest textile assembly plants. By reflecting on Louis-Juste's political and intellectual development, this article seeks to draw attention to the ways in which those on the Haitian left have sought to contend with the political repression and economic marginalization that have hindered the promise of the 1986 popular uprising against Haitian President-for-Life Jean-Claude "Baby Doc" Duvalier.
© 2013 by MARHO: The Radical Historians' Organization, Inc.
National Myth, Transnational Memory: Ondaatje's Archival Method
Interpretations of Indian Political Development
God Mothers, Good Mothers, Good Lovers, Godmothers: Gender Images in Thailand
Christian and Turkish: Secularist Fears of a Converted Nation
Anil Prakash Amplifier of Cinema-Industrial Connections
Lei Feng, Tireless Servant of the People


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Baldwin deputy fires shots during armed robbery arrests, 3 suspects in custody
Warner Robins police chief says dozens more officers are needed
Chief John Wagner said hiring them all will be a multi-year process
Author: Zach Merchant
Published: 7:40 PM EDT August 7, 2019
Updated: 7:40 PM EDT August 7, 2019
WARNER ROBINS, Ga. — John Wagner has been with the Warner Robins Police Department for 28 years.
Many of them were spent as assistant chief. The last 5 months, as acting chief.
Now, his title's a little shorter: Chief John Wagner.
He was officially appointed the department's newest police chief in a ceremony Monday night.
RELATED: John Wagner appointed as new Warner Robins police chief
His wife pinned his new badge on his chest while his parents and son looked on.
After the ceremony, he was quick to lay out his goals for the department. His main priority wasn't hard to spot.
"We need to grow," he said. "We got behind when the city grew just exponentially. We've been call-driven for years, and we have to get to a point where we become proactive again."
He's serious about that. When we talked to him again two days later, Wagner doubled down.
According to him, the department is currently budgeted for about 120 sworn officers. His target number is a whole lot bigger: 155.
"We're low. We're really low," he said. "We have to start working on those numbers."
He maintains the department will keep its standards high as it expands.
"You do have to be picky about that because you are given so much power," he said. "You are given the power to take away a person's freedom."
He also willingly admits growing the department by more than 30 positions will be a long journey.
His first focus on the road to 155 is tackling the current shortage. He inherited about eight sworn officer vacancies.
Wagner says his goal is to have them filled by July of 2020.
According to him, a newly-passed pay raise for all officers will help him recruit and retrain employees.
RELATED: 'I'm going to do my very best:' Acting Chief John Wagner holds first event as top cop in Warner Robins


We also beloved the thoroughness of its resort reserving web site – it has essentially the most filters of any travel site we checked out, so you may get a clear image of exactly what you're paying for. You'll see whether every room has air con, a non-public rest room, a flat-display screen TV, free Wi-Fi, and 20 extra attainable amenities.
House Dialysis Supplies—ensure you pack all the pieces you may want for treatment—and convey a few extra days' price. Ask your dialysis nurse if you have questions on what to take—and focus on airline guidelines for traveling with medical gear and options in the event you're flying. Use our Travel checklist and Planning for dialysis when traveling for simple tips on what to pack and the right way to make traveling simpler.
Priceline is thought for its Identify Your Personal Value Device, though sadly it solely applies to automotive rentals now (they discontinued it for airfares in 2016). It works like this: you choose your dates, location, the basic kind of car you want, and enter the worth you are prepared to pay, per day, for that automotive. In case your bid wins, you will be linked via to the purchase page to finalize your details. If not, you may wait 24 hours to make the same bid or attempt adjusting your preferences.
Value is the undisputed king within the travel world. So that you may be stunned to be taught that since more than ninety five p.c of the online travel market is controlled by just two corporations (Expedia and Priceline), a lot of our travel sites discovered the exact same flights and cars for the very same worth. Our prime picks all constantly discovered us the very best prices for the most cost effective flights and rentals – though received prime crown for finding the most cost effective worth general and Priceline's unique device helped us luck into getting an ideal deal.
Priceline and Expedia every own multiple travel sites – so do it's a must to test all of their travel websites to get the perfect worth? For Expedia, the answer is not any. Expedia websites (together with Orbitz, Travelocity, and CheapTickets) all produced the identical search outcomes, and solely range barely in presentation and sorting abilities. Expedia has discovered a components that works and is running with it, which implies once you have searched one Expedia website, you've searched all of them – saving you time in comparison shopping.


Should the JetBlue Amex Card Earn a Spot in Your Wallet?
I've made no secret of my disappointment over recent devaluations by legacy carriers. As I've considered which airline deserves the bulk of my business, I've been happy to try out new service, like my upcoming flight on JetBlue's new Mint Business Class to Los Angeles. Along with the actual flying, I've been contemplating which co-branded airline cards I plan to carry moving forward. Today, TPG Contributor Nick Ewen discusses one of the candidates.
In the world of airlines, there are legacies and upstarts. It's American/Delta/United vs. Southwest/Virgin America/JetBlue, and while it's difficult (or impossible) to redeem points and miles from the latter category for expensive international first or business class tickets, they do offer a variety of features that appeal to the casual flyer. As a result, the co-branded credit cards from these airlines should factor into your award travel strategy, and today I'll look at the JetBlue American Express Card to see if it's worth adding to your wallet.
Let's begin with a quick review of JetBlue's TrueBlue loyalty program. Just like those offered by Southwest and Virgin America, the TrueBlue program is revenue-based for both earning and redeeming points. You earn 3 points per dollar spent on all flights, but you can double that earning rate to 6 points per dollar when you book flights on JetBlue.com. You can earn an additional 200 points for purchasing an Even More Space seat, and another 300 points for traveling with your pet through the JetPaws program. You can also earn points with a variety of partners, and the program is a transfer partner of Amex Membership Rewards (250 MR points = 200 TrueBlue points).
JetBlue allows you to pool your points as a family, as my wife and I have done!
One thing I love about the TrueBlue program is the ability to pool your miles as a family. Each family account has a designated "Head of Household" who manages all points in the family account. He/she can then invite another adult and up to five children to join. When each family member accepts the invitation, they can contribute some (or all) of their current points to the family account, and then select a contribution percentage for all future earning. This percentage can be changed once per calendar year. My wife and I recently flew to San Juan, and her 683 points were automatically added to the family account. Even though TrueBlue points do not expire, this is a nice way to combine your accounts and earn free flights faster.
You can see that the flights have slightly different redemption values; the 6:20 am flight gives you a value of 1.51 cents/point, while the 7:20 am flight is a bit lower at 1.49 cents/point. I've seen values as high as 1.7 cents for redemptions on JetBlue's new Mint business class, but I've also seen values slightly below 1 cent/point.
This decreasing value trend makes sense, since the more expensive flights are likely in high demand (or close to full), so it costs you more to book them with points. This rule isn't set in stone, but understanding how flights tend to be priced can be helpful when trying to get the best bang for your buck.
While TrueBlue Mosaic isn't as rewarding as the frequent flyer programs of most legacy airlines, it still offers some decent perks.
The final aspect of TrueBlue is their elite status program, Mosaic. This is a relatively new program, but sadly, the benefits don't compare to any level of elite status with the legacy airlines. You get two free checked bags (instead of one), priority check-in/security/boarding, bonus points, and no change or cancellation fees. However, there are no free upgrades to Even More Space seats, even at the airport. JetBlue was offering status matches and challenges in the spring (which I took advantage of), but I was unimpressed with the benefits on my recent trip to San Juan.
For a regular JetBlue flyer, even those traveling just a handful of times each year, this card should be a no-brainer. The sign-up bonus is a nice boost to your TrueBlue account, and if you typically book your flights on JetBlue.com (as opposed to a third-party or corporate booking site), the bonus points add up quickly. You'll earn 8 points for every dollar you spend with this card on flights from JetBlue.com, so at the top end of the value spectrum, you're getting 13.6 cents back per dollar, which is a very nice rate of return!
With the JetBlue American Express, you'll receive a 50% discount (in the form of a statement credit) for most in-flight purchases. That makes these Eat Up boxes just $3!
The other great benefit is the 50% discount on in-flight purchases, which range anywhere from $4-12. A complete list of food and drink offerings is available here, and more information on movies for purchase is available here. If you purchase an Eat Up box ($6), movie ($5), and alcoholic beverage ($6-9) on a flight, you would save up to $10. Four such flights each year would cover your annual fee. Factor in the annual statement credit for JetBlue Getaway purchases and you more than make up for the annual fee.
These benefits look solid compared to a card like the Gold Delta SkyMiles Credit Card from American Express (with Delta implementing a revenue-based earning scheme in 2015, I think this comparison is valid starting in January). If you don't have Medallion status, starting in 2015 you'll earn 7 points for every dollar spent on Delta flights purchased with the Gold Amex (5 for the flight + 2 for using the card). TPG values SkyMiles at 1.2 cents apiece, so the Delta card offers only 8.4% back compared to 13.6% on the JetBlue Amex. Even at the low end of the TrueBlue value spectrum, you're still getting 8% back.
JetBlue Amex has a $40 annual fee (waived for the first year); the Delta Gold Amex has a $95 annual fee (also waived for the first year).
JetBlue Amex gives a 50% in-flight discount; the Delta Gold Amex only gives 20%.
The sign-up bonus on the JetBlue Amex is 20,000 points; on the Delta Gold Amex, it's 30,000 SkyMiles (and sometimes more). The Delta card wins this round.
The JetBlue Amex gives you $50 off vacation packages; the Delta Gold Amex discontinued its companion ticket benefit last year.
The Delta Amex provides a free checked bag, but JetBlue already offers a free checked bag for all passengers, so adding that benefit to the JetBlue card would be redundant.
The Delta Amex has no foreign transaction fees. while the JetBlue Amex charges 2.7%.
The Delta card has the advantage in a few categories, but in terms of pure return on spending, the JetBlue Amex is superior. This doesn't account for one important difference, which is that Delta SkyMiles can be redeemed on many more flights to many more destinations. If you're looking for a card to get you off the continent, clearly the Delta Amex is a better fit. Still, the benefits on the JetBlue Amex are quite compelling for a somewhat regular JetBlue flyer.
JetBlue's new Mint Business Class starts at 35,000 points one way.
As I said before, if you fly JetBlue regularly, the JetBlue Amex is easy money. Even if you just live in a JetBlue hub and some of the non-stop routes are convenient for you, I think you'll get good value out of it. However, JetBlue's network just isn't extensive enough to be very useful to most people outside of the East Coast, except those who travel frequently to (or near) one of the hubs. I think those flyers would get more value from one of the Southwest Rapid Rewards Plus Credit Card, which currently offers a sign-up bonus of 40,000 miles after spending $1,000 in the first 3 months.
Do you carry the JetBlue Amex? Please share your evaluations and recommendations in the comments section below!


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The city's mayor and councillors will be sworn into office on Dec. 4 during a ceremony at Tom Davies Square.
The event begins at 7 p.m. and will include members of council and their families, dignitaries and senior city staff. Mayor Brian Bigger will be giving his Inaugural address during the ceremony. The new term of council officially begins on Dec. 1 and runs until Nov. 30, 2022.
Due to limited seating, attendance at this event is by invitation only; however, the ceremony will be streamed live at livestream.com/greatersudbury.
The first regular meeting of the new city council will take place on Dec. 11 at 6 p.m. in the council chamber at Tom Davies Square. Residents are invited to attend. Council and committee meeting agendas are available at agendasonline.greatersudbury.ca.
Murray Street, Sudbury: Gas main repairs will close Murray Street at Leslie Street from Dec. 3-10. Detours signs will be in place.
Prete Street, Sudbury: Watermain installation will close Prete Street on the north side of York Street from Nov. 29 to Dec. 21. One lane will also be closed on York Street for the duration of the installation. Traffic control will be in place.
Lasalle Boulevard: Patch repairs will close the eastbound curb lane in front of 761 Lasalle Blvd. (Desimone's Foot and Ankle Centre) on Nov. 29. Work will be completed from 9 a.m. to 3 p.m.
Recipients of Ontario Works are asked to pick up their December benefit in person due to the Canada Post labour dispute. Clients are reminded that photo identification is required when picking up cheques.
– Nov. 29 in provincial boardroom A on the main floor at 199 Larch St.
– Nov. 30 in provincial boardroom B- Dec. 3 on the ninth floor at 199 Larch St.
Clients are asked to contact the social services department at 705-675-2411 for more information.
Huntington University is kicking off the festive season by providing a community gift of its own. On Tuesday, Kevin McCormick, president and vice-chancellor of Huntington University, toured the Wade Hampton House in Greater Sudbury. This is a home that provides a caring environment for 11 individuals with complex and ongoing health care issues related to an acquired brain injury. During the visit McCormick also announced a festive donation of $2,500 to support the March of Dimes Canada non-profit housing corporation's Moving A-Head capital campaign.
Northern Ontario experiences the highest rate of acquired brain injuries in the province, with the large majority of brain injury survivors between 18-40 years of age.
This type of living environment offers residents a better quality of life than hospital facilities and relieves the stress on families, who are generally not equipped to care for a loved one who has a significant disability.
The capital campaign goal is set at $726,000. The anticipated cost of the expansion project is $5.4 million. To make a donation and learn more about the Moving A-Head campaign, visit marchofdimes.ca. Huntington University will host its annual tree-lighting ceremony on Dec. 3 at 5 p.m. All are welcome.