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Tree of Life with Gemstones
GARNET & Sterling Silver Tree of Life pendant & sterling silver chain: "Inner strength, love, nurture, inner strength, energy, emotional balance, courage & grounding". JANUARY BIRTHSTONE..
GARNET gemstone Tree of Life sterling silver pendant & chain
GARNET PROPERTIES: KEYWORDS: "Inner strength, nurture, love, energy, emotional balance, courage & grounding".
Beautiful sumptuous Almandine GARNET, (the birthstone for January), with its deep deep red wine colour that reveals its inner fire when the light hits it.
It's energies are gorgeously reassuring, working to both the HEART & ROOT/BASE CHAKRAS, and it has a beautiful nurturing energy, bringing a deep sense of emotional balance.
I have wired a gorgeous little faceted Garnet in sterling silver, to a beautiful solid sterling silver Tree of Life to make this classic pendant.
The circular tree is 18mm wide, a perfect size. Not too big ... and not too small. It comes complete with a choice of 18" or 16" Sterling Silver diamond cut curb chain, so it sits perfectly on the neckline, and it comes in pretty packaging, and full informatoin on the meaning of Garnet ready for gifting.
A distinctive, magical, mystical ancient symbol which has been important for centuries in nearly every culture, and whatever your belief system.
The Tree of Life is said to represent all of creation being connected, and symbol of love, friendship, family, and encouragement.
With its branches reaching into the sky, and roots deep in the earth it highlights the interconnection of all life on our planet, connecting all forms of creation, including our connection to heaven to the underworld uniting 'above and below'.
It also has a nurturing aspect, the branches symbolizing reaching out to accept the nourishment of the sun, the leaves capture the nourishment and transform it into life giving food. The roots dig deep into the earth recognizing the soil of earth as its mother 'mother earth', and the branches and leaves reach up to 'father sun'. It is a full recognition of the life that supports it, and its spiritual origins.
The Tree of Life is also known to represent eternal life, the healing of the soul, and immortality across many cultures for centuries with the tree symbolising the past, present and the future.
PAST (roots = ancestry),
PRESENT (tree body, knots included)
FUTURE (leaves & fruit)
KEYWORDS: "Nurture, Inner strength, security, love, energy, emotional balance, courage & grounding".
GARNET is deeply calming and grounding and when I tap into its energies of I feel a deep sense of reassurance, and I know that everything is going to be just fine.
GARNET works with both the heart & root chakra.
It works with the heart chakra and promote love and self-confidence. At the root it helps the body connect with the revitalising energy of the Earth to bring a sense of calm and grounded connection to the present, releasing any worry, fear or anxiety.
It can teach us to develop trust in the infinite abundance of the Universe, and is used to help the manifestation of one's heartfelt desires in the world.
It's properties also lend itself to help alleviate anxiety, worry or fear. Helping one to feel supported in one's needs and desires, and in giving and receiving love. Garnet is said to help stimulate past-life recall. Sharpens perceptions of oneself and others. Garnet can also help remove inhibitions and taboos. Can be helpful in supporting recuperation after injury. Has also been used to help access past-life memories and clearing karmic patterns.
References to Garnet date back to 3100 B.C. when the Egyptians used garnets as inlays in jewellery. Since antiquity garnets have been famous for their inner sparkle. The crown of the German emperor Otto (912-973 was decorated with the most famous garnet of all, known as 'the Wise One", and Knights and warriors decorated their weapons and shields with garnets. In Hinduism and Buddhism it is seen as a holy stone that enlightens the soul and gives wisdom.
Chrakras: Root & heart.
Element: Earth.
GARNET is the birthstone for January.
All my jewellery comes with full printed information on the properties of the crystals, how to tune into the crystal energy, care instructions and the pendant comes in pretty packaging ready for gifting.
All my jewellery is all infused with Reiki energy at master level by me ... for you (or the intended recipient) highest good.
Disclaimer - The information listed above is not intended for use in diagnosis, treatment, cure, or mitigation of any disease nor is intended to be a substitute for medical advice. The reader should always consult a qualified health provider for advice regarding a medical condition. Depression is a serious condition and you should always consult a medical professional. Crystal healing is a complementary therapy and efficacy is not guaranteed.
Sources & references: Judy Hall - The Crystal Bible 2003-9. Dr Flora Peschek-Bohmer & Gisela Schreiber Healing Crystals & Gemstones 2003. The Crystal healer – Philip Permutt 2007. The Book of Stones by Robert Simmons & Naisha Ashian. Affirmations by Naisha Ashian.
I work hard to keep my designs and concepts original. All rights reserved (c) 2012 - 2019. ALL designs, concepts, and photography are the intellectual property of Paula-Rose.
You can find me here too:-
Facebook:www.facebook.com/PaulaRoseReiki
Twitter: www.twitter.com/PaulaRoseReiki
Instagram: PaulaRoseReiki
Chain length -- 18" sterling silver curb chain & GARNET Tree of Life pendant 16" sterling silver curb chain & GARNET Tree of Life pendant


GST number of Miracle Business Solution is 33ABAFM8696B1Z9. This is a Partnership.
Miracle Business Solution is registered in Tamil Nadu state only as per our database. As per information available with us owner of this business do not have business in any other state. If you think our information needs to be updated, please verify GST number that you have.


1. Mos Def "N****s In Poorest"
Mos tackles Jay-Z and Kanye West's Hit-Boy smash beat for a new freestyle.
The solo version of A$AP's collaboration with Jon James makes it onto the internet.
3. Masspike Miles "Candy Store"
MMG's own releases a new record to get the masses ready for his Say Hello To Forever project, droppping Jan. 24.
The Australian female rapper takes on Nicki's track to drop some new bars.


Just born Janurary 28th, 2009! Sired by hanoverian stallion Liberty Gold (Londonderry x Walida) out of Buttercup ( Blue Eyed Dream x Wrummy). She is a beautiful deep red chestnut with a perfect star on her head. This is her dam's (Buttercup) first foal although London Dream was carried by a surrogate mare via embryo transfer. This filly is absolutley stunning and is going to make a wonderful upper level dressage horse one day! Shown above at her November 2009 AWR inspection. London was recently sticked at just a hair under 15.3 hands in Feburary 2011 just turning two years old!! She's sure to be a tall girl. She is very sweet and brave, loves to be groomed, stands well in he cross-ties, single-ties and stand well for the farrier.
Liberty Gold is a 16.2 hand chestnut stallion by Londonderry by Walida (by Weltmyer). Double Champion of both his Stallion Licensing in Verden and of the 11 month performance test at Adelheidsdorf, Germany. In 2005 he was awarded Grand Champion at Devon. In 2003 at his licensing Liberty took highest honors, excelling in his basic gaits, free jumping, confirmation, and overall suppleness. In 2004 he was victorious at Adelheidsdorf with a dressage index of 147.75 and an overall score of 140.93. When the final scores were tallied, we were astonished with his results: Liberty Gold scored 9.33 on trot, 9.5 on canter, 8 on walk, 9 on Character and Temperament, 9.667 on Rideability, and a 9 on his willingness to work.
Buttercup is a 16 hand Oldenburg x German Warmblood palomino mare bred by Equivale. Buttercup was awarded First Premium Premier at her American Warmblood Registry inspection as a weanling. She is sired by the imported ZFDP stallion Blue Eyed Dream and out of the Oldenburg mare Wrummy. Buttercup was scoring as high as 73% in Training Level dressage as a 4 year old and is now as a 5 y.o. moving up to first level so far scoring as high as 66%!


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Chapter: 6 Diabetes Mellitus
« Previous: 5 Cardiovascular Disease
Suggested Citation:"6 Diabetes Mellitus." Institute of Medicine. 2000. The Role of Nutrition in Maintaining Health in the Nation's Elderly: Evaluating Coverage of Nutrition Services for the Medicare Population. Washington, DC: The National Academies Press. doi: 10.17226/9741.
Diabetes mellitus type 1 is an autoimmune disease that destroys the beta cells of the pancreas, leading to insulin deficiency. The resulting hyperglycemia can lead to microvascular and macrovascular disease. The microvascular complications include retinopathy, nephropathy, and neuropathy. The macrovascular complications include coronary artery disease, peripheral vascular disease with amputation, stroke, and renal disease. The disease usually manifests early in life, although it can also occur in adulthood.
Diabetes mellitus type 2 is a familial hyperglycemia that occurs primarily in adults but can also occur in children and adolescents. It is caused by an insulin resistance whose etiology is multiple and not totally understood. The net result of the insulin resistance is to initially cause a compensatory hyperinsulinemia. Subsequently, the beta cells of the pancreas fail to meet the compensatory need, less insulin secretion occurs than is required for the adequate elimination and utilization of glucose, and hyperglycemia results. Dyslipidemia and hypertension are common in patients with type 2 diabetes, and about 80 percent of patients with type 2 diabetes are obese (LaPorte et al., 1995). The complications arising from this condition are the same as those described for type 1 diabetes mellitus. Because of the later age of onset in persons with type 2 compared to type 1 diabetes, evidence of clinically significant microvascular complications is less.
Estimates of prevalence have increased over the years in part due to more stringent diagnostic criteria as well as the continued rise in obesity.
In 1997, the diagnostic criterion for a diagnosis of diabetes was lowered from a fasting glucose tolerance test result of 140 mg/dL to 126 mg/dL (American Diabetes Association, 1997). Based on the diagnostic criteria of a fasting glucose tolerance test of 110 to 126 mg/dL as impaired glucose tolerance and greater than or equal to 126 mg/dL as diabetes, 18.4 percent or 6.3 million people age 65 or older have diabetes. Approximately 40 to 45 percent of persons age 65 years or older have either type 2 diabetes or impaired glucose tolerance. Diabetes is the seventh leading cause of death in the United States, and more than 187,000 persons died from the disease and its complications in 1995 (HCFA, 1999).
Individuals with diabetes mellitus, regardless of type, typically have several risk factors associated with increased morbidity and mortality. The risk factors include abnormal fasting glucose, postprandial glucose, hemoglobin A1c (HbA1c), low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, microalbuminuria, blood pressure, a procoagulant state, and abdominal obesity.
EVIDENCE THAT A CHANGE IN RISK FACTORS CHANGES MORBIDITY AND MORTALITY
A series of long-term, randomized, controlled trials shows the effect of tight glucose and HbA1c control on complications of the disease and are described below.
Diabetes Control and Complications Trial
Investigators in the Diabetes Control and Complications Trial (DCCT), a randomized controlled trial, followed 1,400 patients with type 1 diabetes, between the ages of 15 and 39 years, for 7 years to determine what effect normalizing blood glucose and HbA1c had on chronic complications of the disease (DCCT Research Group, 1993). The study showed a sustained difference in the levels of glucose and HbA1c between the conventionally treated group and the tightly controlled experimental group. The trial was stopped after 7 years because of the significant lowering of microvascular complication rates in the experimental group compared to the conventionally treated control group. Microvascular disease was defined as retinopathy, neuropathy, and urinary albumin excretion. All three end points showed a significant difference. Macrovascular disease events in diabetes usually include myocardial infarction, sudden death, stroke, and peripheral vascular disease. While the DCCT study lacked the statistical power to detect a difference in macrovascular disease in this relatively young population with type 1 diabetes, a trend toward a lower
incidence of macrovascular end points was suggested in the tightly controlled group.
Stockholm Diabetes Intervention Study
This small randomized clinical trial of 102 patients with type 1 diabetes included a group that was treated intensively and a group with usual care (Reichard et al., 1993). The patients' age at baseline was 30 ± 8 years in the intensive group and 32 ± 7 years in the standard group. The intensive group had extensive educational intervention, including blood glucose monitoring, and most of the patients (82 percent) took at least three insulin injections daily. The standard treatment group continued with routine diabetes care. The patients were followed for 7.5 years. As in the DCCT, intensive glucose control led to a decreased incidence of microvascular complications (retinopathy, nephropathy, and neuropathy). Macrovascular end points were not assessed.
Kumamoto Study
This randomized controlled trial in Japan (Ohkubo et al., 1995) studied the effect of multiple insulin injections versus conventional insulin injections in 110 middle-aged patients with type 2 diabetes. The appearance and progression of retinopathy, nephropathy, and neuropathy were evaluated every 6 months over a 6-year period. The group with the tight control had significantly lower HbA1c values and developed fewer microvascular complications. Although the study lacked the statistical power to measure the effect on macrovascular disease, the trend was for fewer events in the tightly controlled group.
Veterans Affairs Diabetes Feasibility Trial
Investigators in this pilot study randomized 153 men with type 2 diabetes to either conventional or intensive insulin therapy (Abraira et al., 1997). The mean age was 60 ± 6 years and the length of diagnosis of non-insulin-dependent diabetes mellitus was 7.8 ± 4.0 years. While the standard treatment was one injection each morning, intensive insulin therapy was a stepped plan with up to multiple insulin injections as necessary to attain near normal glycemia. Despite a 2 percent absolute HbA1c difference in glycemic control between the two groups, which were followed for an average of 27 months, the trial reported no significant difference in cardiovascular events (when adjusted for baseline characteristics). Cardiovascular events were defined as myocardial infarction, stroke, and
sudden death. This pilot study did not have the statistical power to come to a definite conclusion concerning macrovascular end points.
United Kingdom Prospective Diabetes Study
The United Kingdom Prospective Diabetes Study (UKPDS) was a large, multicenter randomized control trial in which 3,867 patients with type 2 diabetes were followed for 10 years (UKPDS Group, 1998). The median age of patients was 54 years at baseline, with a range of 48 to 60 years. The study compared the effects of intensive blood glucose control with either sulfonylureas, insulin, or conventional treatment on both microvascular and macrovascular complications. Treatment for all groups included a standard diet, exercise prescription, and/or drugs as needed to attain the designated level of blood glucose control for each group. The aim in the intensive group was a fasting plasma glucose (FPG) of less than 108 mg/dL. The aim in the conventional group was the best achievable FPG with diet or exercise alone. Drugs were added in the conventional group only if there were hyperglycemic symptoms or FPG of at least 270 mg/dL. To assess differences between conventional and intensive treatment the study focused on three aggregate end points:
any diabetes-related end point (sudden death, death from hyperglycemia or hypoglycemia, fatal or nonfatal myocardial infarction, angina, heart failure, stroke, renal failure, amputation, vitreous hemorrhage, retinopathy requiring photocoagulation, blindness in one eye, or cataract extraction);
diabetes-related death (defined as death from myocardial infarction, stroke, peripheral vascular disease, renal disease, hyperglycemia or hypoglycemia, and/or sudden death); and
all-cause mortality.
All analyses included the intention-to-treat model, where all patients assigned to a particular protocol are followed to the end as part of that group, whether they carry out the intervention or not. Over 10 years, HbA1c was 7.0 percent in the intensive group and 7.9 percent in the conventional group. Compared to the conventional group, the risk in the intensive group was 12 percent lower for any diabetes-related end point, 10 percent lower for any diabetes-related death, and 6 percent lower for all-cause mortality. There was a 25 percent reduction in microvascular end points in the intensive compared to the conventional group (p = 0.0099). Tighter control significantly reduced the development of retinopathy and nephropathy, and was borderline with regard to neuropathy. Epidemiological analysis of the UKPDS data showed a continuous rela-
tionship between the risk of microvascular complications and glycemia. For every percentage point decrement in HbA1c (e.g., 9 to 8 percent), a 35 percent reduction in the risk of microvascular complications occurred. The effect of tighter control on macrovascular disease resulted in a nonsignificant trend, with a 16 percent reduction in the risk of combined fatal or nonfatal myocardial infarction and sudden death in the intensively treated group. Tight control of blood pressure (<134/82 mm Hg) had a profound effect on both micro- and macrovascular complications in both the intensive and the conventional treatment groups, significantly reducing strokes, diabetes-related deaths, heart failure, microvascular complications, and visual loss. This landmark study confirms that for inpatients with type 2 diabetes, lowering blood glucose is definitely beneficial in reducing macrovascular complications and reemphasizes the importance of blood pressure control in patients with diabetes mellitus.
THE ROLE OF NUTRITION INTERVENTION IN THE MANAGEMENT OF DIABETES
Nutrition intervention is considered an essential component in the management of diabetes. For this reason, it has been provided to participants in both control and intervention groups of studies designed to evaluate the impact of improved glycemic control on the development of diabetic complications in both patients with type 1 and 2 diabetes (DCCT Research Group, 1993; UKPDS Group, 1998). While there are few studies in which nutrition intervention is the only variable (Bitzen et al., 1988; Franz et al., 1995; Kulkarni et al., 1998), many studies have demonstrated the effectiveness of multidisciplinary patient education which includes a nutrition component on glycemic control (Agurs-Collins et al., 1997; García and Suárez, 1996; Gilden et al., 1989; Glasgow et al., 1992).
While these studies demonstrate improved outcomes, it is difficult to tease out benefits specifically attributable to the nutritional component of the education. Researchers have studied diabetes patient education extensively. Three meta-analyses have shown that patient education is effective in improving knowledge, skills, psychosocial adjustment, and metabolic control (Brown, 1988, 1990; Padgett et al., 1988). Overall, evidence from many types of studies involving nutrition therapy in the management of diabetes is supportive of nutrition intervention. The American Diabetes Association has recognized the value of medical nutrition therapy and considers it an essential component of diabetes management (American Diabetes Association, 1999b).
Nutrition Intervention in Trials of Intensive Management
In the DCCT study, the control and intervention groups both received counseling by a dietitian. However, while the control group received nutrition counseling every 6 months, the intensive management group received nutrition counseling every month. In the DCCT, several behaviors were shown to be associated with lower HbA1c levels among patients with type 1 diabetes randomized to intensive insulin therapy (Delahanty and Halford, 1993). Within the intensively managed group, those who reported following their prescribed diets had average HbA1c levels 0.9 percent lower than those who did not follow their meal plan. Adjusting food and/or insulin resulted in significantly lower HbA1c levels. This substudy on 687 patients provides evidence that dietary behaviors positively alters indicators of glycemic control when used in combination with appropriate insulin management (Delahanty and Halford, 1993).
In the UKPDS study, all treatment and control groups received nutritional advice from a dietitian every 3 months. Initial monthly clinic visits resulted in an average weight loss of 5 kg after 3 months (UKPDS Group, 1995).
Nutrition Intervention as a Component of Diabetes Education
García and Suárez (1996) described a continuing interactive educational model for elderly patients with diabetes. Elderly individuals who had previously attended the Diabetes Basic Information Course at the National Institute of Endocrinology in Havana, Cuba were invited to participate in small interactive groups (≤15 participants) with no more than two health professionals over a period of 5 years. The health professionals included an endocrinologist, health educator, teaching nurse, dietitian, podiatrist, and social worker. A total of 148 elderly individuals (mean age 72 years) along with many spouses attended the monthly sessions. Data showed a significant increase in diabetes self management knowledge and skills (p < 0.001), a reduction in body weight (p < 0.01), and a reduction in the need for medication (p < 0.05). Overall, mean levels of HbA1c declined from 12.4 percent to 7.9 percent after 5 years (p < 0.02). The need for emergency services declined from 97 percent in the year before the course to less than 2 percent after 5 years (p = 0.000). In addition, the social support and education received through this interactive model overall resulted in patients feeling "less sick, depressed and isolated" (García and Suárez, 1996).
Gilden and colleagues (1989) demonstrated improvement in quality of life outcomes for older patients and their spouses. They evaluated the
outcomes of 45 older male patients who ranged in age from 65 to 82 years (mean age 70 years) following 6 weeks of diabetes education (one session per week). A multidisciplinary team including a diabetologist, nurse-educator, dietitian, psychologist, podiatrist, and social worker administered the program. Results indicated a reduction in stress that correlated with their increase in knowledge (p < 0.05) and their improved diet-related quality of life (p < 0.02). The decrease in stress level was still apparent 6 months later (p < 0.01). Their perceived quality of life with regard to lifestyle modifications such as diet and exercise increased (p < 0.01) and was still evident after 6 months (Gilden et al., 1989).
The Diabetes Care for Older Adults Project was a 3-year randomized clinical trial that compared an intensive team care program to conventional therapy in 103 participants with a mean age of 70 years. Diabetes education and social support were provided by an interdisciplinary team consisting of a clinical nurse specialist, a dietitian, both of whom were certified diabetes educators (CDE), and a social worker. Glycosylated hemoglobin dropped an average of 3.2 percentage points in the treatment group versus 1.0 percentage point in the control group after an 18-month intervention period in which groups met 12 times (Funnell et al., 1997; Halter et al., 1993).
Glasgow and colleagues (1992) studied 102 patients over the age of 60 with type 2 diabetes in a crossover intervention using a multidisciplinary team that included a registered dietitian. Results demonstrated a significantly greater reduction in caloric intake and percent of calories from fat in the intervention group compared to the control group who received delayed intervention. In this crossover study, the intervention resulted in a decline in HbA1c from 6.8 percent to 6.3 percent. The HbA1c rebounded to 6.7 percent during the subsequent control period. When control patients crossed over to the intervention, their HbAlc declined from 7.4 percent to 6.4 percent (Glasgow et al., 1992).
In a randomized control trial, researchers randomly assigned 64 overweight African-American patients (55–79 years) with type 2 diabetes to one of two groups. Subjects participated in either one individual and eighteen group sessions given by a registered dietitian or in a "usual" care program, which included one group meeting and two follow-up mailings. Topics focused on nutrition and exercise interventions. The intensive intervention participants had significantly greater decreases in HbA1c (–1.6 compared to –2.4 percent, p < 0.01) and an average of 2 to 2.5-kg reduction in weight (p = 0.006) compared to controls (Agurs-Collins et al., 1997).
Impact of the Intensity of Nutrition Intervention on Glycemic Control
Franz and associates (1995) completed a randomized trial in 179 persons, 38 to 76 years of age, with type 2 diabetes, comparing the usual nutrition care of one visit to a more intensive nutrition intervention of at least three visits led by a dietitian. The results demonstrated that any nutrition intervention provided by dietitians resulted in significant improvements in medical and clinical outcomes, with FPG decreasing by 50 to 100 mg/dL and HbA1c dropping by 1 to 2 percentage points. Both groups demonstrated improvement in diabetes control, with the more intensive nutrition intervention reducing FPG by 10.5 percent and the usual care by 5.3 percent. A similarly treated but nonrandomized control group who had no contact with a dietitian resulted in HbAlc levels showing no improvement during the same 6-month period of study (8.2 versus 8.4 percent) (Franz et al., 1995). In a prospective randomized trial, Kulkarni et al. (1998) also compared the use of a more intensive nutrition intervention in patients with type 1 diabetes to a control group who received standard nutrition intervention. At 3 months, the HbA1c improved in 88 percent of the participants who had received the more intensive nutrition intervention and in 53 percent of those receiving the standard nutrition intervention. The patients who received the more intensive nutrition intervention also achieved greater decrements in HbA1c levels than the usual care patients (–1.00 versus –0.33, p < 0.05). Both of these studies demonstrate that regardless of the intensity of the nutrition intervention, improvements in blood glucose levels can be achieved with nutrition therapy. In addition, these studies indicate that when practice guidelines are used, increasing the intensity of the nutrition therapy by both time spent and the number of visits, greater improvements in glycemic control result.
Bitzen and colleagues (1988) studied the effect of dietary intervention in 38 hyperglycemic patients who had never been treated by diet or medication (insulin or oral hypoglycemic agents). The participants had a mean age of 63 years. Each received a standardized meal plan by a nurse and weight reduction was advocated for all participants who were above ideal body weight (36 of 38 participants). The education was reinforced at 2- to 3-week intervals over a 10-week period. Each participant also received at least one home visit during the study period. After 10 weeks, 82 percent of participants were found to have significantly reduced both fasting blood glucose (148 mg/dL to 117 mg/dL, p < 0.001) and HbA1c (7.6 percent to 6.7 percent, p < 0.001).
PROVIDERS OF NUTRITION THERAPY FOR DIABETES
In the studies cited above, the formats for interventions varied from multiple individualized visits with dietitians to group sessions with an interdisciplinary team that included a nutrition professional. The DCCT clearly demonstrated the value of a multidisciplinary team in the care of patients with diabetes. Health professionals who contribute to the management of patients with diabetes include physicians, nurses, dietitians, pharmacists, podiatrists, exercise specialists, and social workers. In the management of care for elderly persons, the inclusion of a health professional with particular expertise in the care of elderly persons would be optimal (Fonseca and Wall, 1995).
Prior to results of the DCCT in 1992, data had been less clear regarding the impact of specific nutrition interventions. This, in part, was due to the role of the dietitian in diabetes management intensifying given the demonstrated need for dietary adherence in the DCCT. Since this landmark trial, dietitians have become more focused on individualizing nutrition therapy for patients with diabetes (Delahanty et al., 1993).
The individualized approach requires changes in the lifestyle and goals of each patient and can result in complex dietary interventions. Individualization involves a knowledge of food as it relates to culture, nutrient composition, and meal preparation. For this reason, the American Diabetes Association (1999b) has recommended that a registered dietitian, knowledgeable and skilled in implementing nutritional interventions, be the team member providing nutrition education. In addition, the American Diabetes Association (1999c) has also recommended that education be conducted in the outpatient or home setting because of less frequent and shorter acute care admissions for patients with diabetes.
MEDICARE REIMBURSEMENT FOR DIABETES SELF-MANAGEMENT TRAINING
Prior to July 1, 1998, Medicare Part B covered diabetes education only if provided to registered patients of hospital outpatient departments. These diabetes education programs were required to address diet, exercise, and blood glucose self-monitoring; establish treatment plans for insulin-dependent patients; and motivate patients to manage their conditions. Services could be provided in group or individual sessions. Like other hospital outpatient services, reimbursement was on a "reasonable cost" basis.
Section 4105(a) of the Balanced Budget Act of 1997 added a new benefit to the Medicare program for diabetes self-management training services. This legislation provided coverage for educational and training
services furnished in an outpatient setting by qualified personnel to patients with diabetes, if a physician certifies that such services are needed as part of a comprehensive plan of care. The services are paid under the Medicare physician fee schedule in amounts determined by the Secretary of Health and Human Services. The law specifies that payment may be made to "certified providers" who meet quality standards as determined through regulation, and who also are eligible to receive payment for providing other services to Medicare beneficiaries.
The new benefit has been partially implemented since July 1, 1998. Final implementation is expected early in 2000. In the interim, diabetes self-management training programs that meet the National Standards for Diabetes Self-Management Education Programs and are recognized by the American Diabetes Association, or programs that were receiving reimbursement, are considered to meet the requirements for Medicare coverage. As of October 1999, nationwide there were a total of 978 diabetes self-management education programs sites recognized by the American Diabetes Association. There are, however, widespread rural areas in which access to approved diabetes self-management training is severely limited.
To be an approved provider of diabetes self-management training services, a program must meet certain quality standards. Standards proposed by the Health Care Financing Administration include, among other things, that training be conducted by a team consisting of at least a registered dietitian and a CDE (although for an initial 3-year period a nurse may substitute for the CDE) (HCFA, 1999). Training must address 15 subject areas, including nutrition and the relationships among nutrition, exercise, medication, and blood glucose levels.
The proposed regulations would allow reimbursement for 10 hours of training during a 12-month period and one follow-up training session in each subsequent year. In general, training is to be in group sessions, although individual sessions would be allowed under certain circumstances (e.g., when no group session is available) or with certification that the patient has special needs (e.g., physical impairments, severe language challenges). Patients eligible for the initial 10 training sessions would include those who, within a year before referral, (1) experienced new onset diabetes, (2) had poor glycemic control, (3) experienced a change in medication or use of insulin, (4) had high risk for complications from poor glycemic control, or (5) had experienced certain complications of the foot, eye, or kidney.
Under the proposed rule, entities eligible to provide diabetes self-management training programs include settings such as hospitals, renal dialysis facilities and clinics, and certain independent practitioners who by current law are eligible to receive Medicare reimbursement. These
health professionals include physicians, advanced practice nurses, clinical social workers, psychologists, nurse midwives, and pharmacists. Ironically, at present, the current regulation does not allow the specific health professionals who are required to provide the service (dietitians and CDEs) to bill and receive reimbursement for their services.
Payment for diabetes self-management under the Medicare physician fee schedule is proposed to be $32.62 for group sessions and $55.41 for individual sessions in 1999 (adjusted for geographic variation according to Medicare fee schedule rules). Medicare deductible and coinsurance requirements would apply; thus beneficiaries would pay 20 percent of the proposed amounts, if they had satisfied the $100 annual Part B deductible.
There is a distinct need for repeated training throughout the life of a person with diabetes. The DCCT showed that the diet adherence of a patient occurs in peaks and valleys (DCCT Research Group, 1993). The ability to attain adequate control to prevent costly complications requires continued attention to changes in the severity of the disease, weight, life style, and age. Corrective nutritional education is often necessary.
LIMITATIONS OF DATA AND FUTURE RESEARCH NEEDS
Although a number of studies support the usefulness of nutrition therapy in helping patients attain better control of diabetes and improving outcomes, the number of randomized, controlled trials that specifically explore this question are few. In addition, most of these studies involve nutritional intervention as part of an overall team approach to diabetes education. Therefore, it is not possible to dissect out the specific benefit of the nutritional intervention as a single component of therapy. In addition, it is seldom clear from the studies what type of provider is needed to effect a positive nutritional intervention in patients with diabetes. It is important to extend these studies so that the best provider mix and intensity of intervention can be determined. Additional studies focusing on special populations, such as the elderly and cultural minorities, are also indicated. There is a need for more definitive research on group versus individual formats, the number of encounters and methods needed to achieve improved clinical outcomes in weight, HgA1c levels, lipid levels, blood pressure, and patient satisfaction.
Diabetes mellitus is one of the most prevalent diseases among the U.S. population. This is especially true in the elderly, where nearly 18.4 percent of persons older than 65 have diabetes (American Diabetes Asso-
ciation, 1997). There is reasonable evidence from randomized clinical trials that nutrition intervention as part of overall diabetes education improves blood glucose and HbA1c levels in persons with diabetes, including data in substantial numbers of individuals over age 65. Although nutrition therapy is best carried out when a patient is first diagnosed, it appears to be effective at any time during the disease process and refresher therapy may be of value.
The American Diabetes Association, other national diabetes organizations, and the World Health Organization all support a recommendation for nutrition therapy in patients with diabetes mellitus.
The committee recommends that individualized nutrition therapy, provided by a registered dietitian, be a covered benefit as part of the multidisciplinary approach to the management of diabetes which includes diet, exercise, medications, and blood glucose monitoring. This recommendation is consistent with that of the American Diabetes Association (1999a).
Summary of Evidence: Nutrition Therapy for Diabetes
Recommended as part of the standard of care by the American Diabetes Association (1999a) and the World Health Organization (1994)
Supportive evidence (Agurs-Collins et al., 1997; Bitzen et al., 1988; Delahanty and Halford, 1993; Franz et al., 1995; García and Suárez, 1996; Gilden et al., 1989; Glasgow et al., 1992; Kulkarni et al., 1998)
Reasonable (DCCT Research Group, 1993; UKPDS Group, 1998)
Meta-analyses of trials:
Supportive evidence (Brown, 1988, 1990; Padgett et al., 1988)
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American Diabetes Association. 1997. Diabetes facts and figures. Available at: http://www.diabetes.org/ada/c20f.asp. Accessed September 8, 1999. American Diabetes Association. 1999a. Clinical practice recommendations. Diabetes Care 22:S1–S114.
American Diabetes Association. 1999b. Nutrition recommendations and principles for people with diabetes mellitus. Diabetes Care 22:S42–S45.
American Diabetes Association. 1999c. Translation of the diabetes nutrition recommendations for health care institutions. Diabetes Care 22:S46–48.
Bitzen PO, Melander A, Schersten B, Svensson M. 1988. Efficacy of dietary regulation in primary health care patients with hyperglycemia detected by screening. Diabet Med 5: 640–647.
Brown SA. 1988. Effects of educational interventions and outcomes in diabetic adults: A meta-analysis revisited. Nurs Res 37:223–230.
Brown SA. 1990. Studies of educational interventions in diabetes care: A meta-analysis of findings. Patient Edu Counseling 16:189–215.
DCCT (Diabetes Control and Complications Trial) Research Group. 1993. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med 329:977–986.
Delahanty LM, Halford BM. 1993. The role of diet behaviors in achieving improved glycemic control in intensively treated patients in the Diabetes Control and Complications Trial. Diabetes Care 16:1453–1458.
Delahanty L, Simkins SW, Camelon K. 1993. Expanded role of the dietitian in the Diabetes Control and Complications Trial: Implications for clinical practice. J Am Diet Assoc 93:758–762.
Fonseca V, Wall J. 1995. Diet and diabetes in the elderly. Clin Geriatr Med 11:613–624.
Franz MJ, Monk A, Barry B, McClain K, Weaver T, Cooper N, Upham P, Bergenstal R, Mazze RS. 1995. Effectiveness of medical nutrition therapy provided by dietitians in the management of non-insulin-dependent diabetes mellitus: A randomized, controlled clinical trial . J Am Diet Assoc 95:1009–1017.
Funnell MM, Arnold MS, Fogler J, Merrit JH, Anderson LA. 1997. Participation in a diabetes education and care program: Experience from the Diabetes Care for Older Adults Project. Diabetes Educ 23:163–167.
García R, Suárez R. 1996. Diabetes education in the elderly: A 5-year follow-up of an interactive approach. Patient Educ Couns 29:87–97.
Gilden, JL, Hendryx M, Casia C, Singh S. 1989. The effectiveness of diabetes education programs for older patients and their spouses. J Am Geriatr Soc 37:1023–1030.
Glasgow RE, Toobert DJ, Hampson SE, Brown JE, Lewinsohn PM, Donnelly J. 1992. Improving self-care among older patients with type II diabetes: The Sixty Something Study. Patient Educ Couns 19:61–74.
Halter J, Anderson L, Herman W, Fogler J, Merritt J, Funntell M, Arnold M, Brown M, Davis W. 1993. Intensive treatment safely improves glycemic control of elderly patients with diabetes mellitus. Diabetes 42:146A.
HCFA (Health Care Financing Administration). 1999. Medicare program: Expanded coverage for outpatient diabetes self-management training services. Fed Reg 64:6827–6852.
Kulkarni K, Castle G, Gregory R, Holmes A, Leontos C, Powers M, Snetselaar L, Splett P, Wylie-Rosett J. 1998. Nutrition practice guidelines for type 1 diabetes mellitus positively affect dietitian practices and patient outcomes. J Am Diet Assoc 98:62–72.
LaPorte RE, Matsushima M, Chang Y-F. 1995. Prevalence and incidence of insulin-dependent diabetes. In: Diabetes in America, 2nd ed. Publication No. 95-1468. Bethesda, Md.: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases.
Ohkubo Y, Kishikawa H, Araki E, Miyata T, Isami S, Motoyoshi S, Kojima Y, Furuyoshi N, Shichiri M. 1995. Intensive insulin therapy prevents the progression of diabetic microvascular complications in Japanese patients with non-insulin-dependent diabetes mellitus: A randomized prospective 6-year study. Diabetes Res Clin Pract 28:103–117.
Padgett D, Mumford E, Haynes M, Carter R. 1988. Meta-analyses of the affects of educational and psychosocial interventions on management of diabetes mellitus. J Clin Epidemiol 41:1007–1030.
Reichard P, Nilsson B-Y, Rosenqvist U. 1993. The effect of long-term intensified insulin treatment on the development of microvascular complications of diabetes mellitus. N Engl J Med 329:304–309.
UKPDS (UK Prospective Diabetes Study) Group. 1995. U.K. prospective diabetes study 16. Overview of 6 years' therapy of type II diabetes: A progressive disease. Diabetes 44:1249–1258.
UKPDS (UK Prospective Diabetes Study) Group. 1998. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 352:837–853.
World Health Organization. 1994. Management of Diabetes Mellitus: Standards of Care and Clinical Practice Guidelines. Geneva: World Health Organization.
Next: 7 Renal Disease »

redpajama_set_name: RedPajamaCommonCrawl


text:
Shipwreck Scavengers Are Dumping The Bodies Of Lost WW2 Soldiers
Indonesia's Java Sea is a gold mine for World War Two shipwrecks, meaning it's also a haven for scrap metal scavengers. Now there are grim reports that metal scavengers are illegally dumping the bodies of soldiers and sailors in mass underwater graves.
Thousands of Dutch, British, US, Australian, and Japanese sailors died during the Battle of the Java Sea in 1942, one of the most important naval battles of the Pacific campaign. For the Allies, it was also one of the most devastating defeats at sea during WW2. Three Dutch boats – HNLMS De Ruyter, Java, and Kortenaer – and three British boats – the HMS Exeter, Encounter, and Electra – were among the ships that sunk beneath the waves during this battle.
In 2016, Dutch divers headed to the Java Sea with the plan of placing commemorative plaques on the shipwrecks, but they were nowhere to be found. It turned out these ships were among the dozens of wrecks that had been dismantled and sold off by illegal organized rackets of salvaging thieves. Teams of scavengers head out to track down the shipwrecks. Divers are then sent down and place explosives within the wrecks. The metal is then collecting and sold off to shady "under the counter" traders across Southeast Asia.
A contractor for one of the scavenging rings recently told Indonesian news site Tirto.id that they have regularly come across human skulls, hips, hand bones, and ribs during their work. After these remains are collected, they are either dumped back in the sea or put in sacks and buried in shallow graves near the harbors.
Understandably, since these remains almost undoubtedly belong to lost soldiers, the authorities are not too happy with these reports.
"There is new information that has reached us through the media. We must determine whether it is correct. We hope to do that quickly, because it is a very bad thing for the relatives of the war heroes who died in the Java Sea," Halbe Zijlstra, the Dutch Minister of Foreign Affairs, told De Telegraaf.
The UK Ministry of Defense issued a similar statement to the Guardian. "Desecration of wrecks of war and merchant vessels causes distress to loved ones of those lost on board and is against international law. A military wreck should remain undisturbed and those who lost their lives onboard should be allowed to rest in peace," it said.
The UK and Dutch governments are now looking into using a naval presence and technology to deter further grave robberies.
Source: ifl Science
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text:
HomeUnitsBattalions 600s628th Tank Destroyer Battalion
628th Tank Destroyer Battalion
Unit History: Established 15 December, 1941, from the 28th Infantry Division Antitank Battalion (Provisional), Indiantown Gap, PA. Originally a Light Towed Battalion. Shipped from New York port of embarkation on Jan. 29, 1944, on the Aquitania and arrived at Greenock, Scotland, on 6 February, 1944 and disembarked at Utah Beach on 30 July, equipped with M10s. Committed to battle on 2 August near Perier, France. Participated in envelopment of Falaise Pocket. Dashed east to the Belgian border, arriving on 2 September. Helped liberate Luxembourg, began assault on the Siegfried Line on 13 September. Conducted artillery missions in October. Converted to M36's in November, then committed to fighting in the Hürtgen Forest in December. Shifted to Aachen sector on 8 December only to be ordered to the Ardennes during the Battle of the Bulge. Fought to eliminate Bulge in January 1945. Crossed Roer River beginning 25 February and reached the Rhine on 10 March. Crossed the Rhine on 31 March at Wesel. Slashed through Germany to the Elbe River by 11 April. Attacked back west to eliminate German pockets. Took up occupation duties on 26 April near Peine. Attached to: 82d Airborne Division; 3d, 5th Armored divisions; 75th Infantry Division. Deactivated at Camp Myles Standish, MA on Nov. 14, 1945. History text from the book The Tank Killers by Harry Yeide. Used by permission.
Combat Equipment: 8/44 - M10; 11/44 - M36.
Commanding Officers: William M. Hernandez (KIA 8/20/44). William J. Gallagher (8/20/44)
Code Name/s: Victory, Highstorm
Campaign Credits: Northern France..............Jul. 25, to Sept. 14, 1944
Rhineland........................Sept. 15, 1944 to Mar. 21, 1945
Ardennes-Alsace..............Dec. 16, 1944 to Jan 25, 1945
Central Europe.................Mar. 22, to May 11, 1945
Awards: Distinguished Unit Citation -29 Nov-8 Dec 44, WD GO 31-47, Co. C only Croix De Guerre (French or Belgium "Cross of War")
Location August 1945: Neersen, Germany
Additional Information/Materials:
1.) Detailed History of the Unit - Official Unit History "Victory TD" done by the unit on June 7, 1945. From the Combined Arms Research Library of the Command and General Staff College, Fort Leavenworth, Kansas.
Section 1.............Pages Cover to 39 (Includes unit losses and early history)
Section 2.............Pages 40 to 77 (Cont. of history, enemy loss stats and HQ Staff section)
Section 3.............Pages 78 to 110 (Staff cont. A and B Companies)
Section 4.............Pages 111 to 147 (Staff cont. B and C Companies)
Section 5.............Pages 148 to 176 (Staff cont. C and Recon. Companies/Medical Detachment)
Awards and Decorations.........7 Pages (Originally part of Unit History)
Commendations....................2 Pages (Originally part of Unit History)
Unit Roster..........................18 Pages (Originally part of Unit History)
Map of Travels in U.S.A..........1 Page (Also included in Unit History)
Map of Travels in Great Britain 1 Page (Also included in Unit History)
Map of Travels in Europe.........1 Page (Also included in Unit History)
2.) Officers of the 628th Tank Destroyer Battalion - Photo taken Jan. 6, 1944, at Fort Dix, NJ.
NOTE: Interestingly, the photo listed above was provided to me by the family of Capt. R.J. Arendt. In that photo, seated center and center right are the two senior officers. Seated just right of center is Battalion Commander, Lt. Col. William M. Hernandez. Just right of Hernandez is Maj. William J. Gallagher, Battalion Executive Officer. On August 20th, 1944, while directing indirect fire during the Battle of the Seine River, near Douains, France, Lt. Col. Hernandez was killed at 1630 hours. At 1700 hours Maj. Gallagher assumed command of the unit. Capt. Arendt is shown seated, 6th from the right. He transferred to the HQ Co. 6th TD Group (my father's unit) along with Capt. Thomas M. Cook, while they were stationed in southern England preparing for the D-Day invasion. 1st Lieutenant Herbert A. Pratte is shown sitting, fifth from the right.
3.) After Action Reports - from the Combined Arms Research Library of the Command and General Staff College, Fort Leavenworth, Kansas.
Aug. 1 to 31, 1944..............7 Pages (Includes casualties)
Sept. 1 to 30, 1944..............7 Pages (Includes casualties)
Oct. 1 to 31, 1944...............3 Pages (Includes casualties)
Nov. 1 to 30, 1944..............3 Pages (Includes casualties)
Dec. 1 to 31, 1944...............7 Pages (Includes casualties)
Jan. 1 to 31, 1945...............6 Pages (Includes casualties)
Feb. 1 to 28, 1945...............3 Pages
Mar. 1 to 31, 1945.............10 Pages (Includes casualties, awards & reinforcements)
Apr. 1 to 30, 1945.............13 Pages (Includes casualties)
4.) Unit Journals-from the Dwight D. Eisenhower Presidential Library, Museum and Boyhood Home, Abilene, Kansas.
Sept. 1-30, 1944.................9 Pages
Oct. 1-31, 1944..................4 Pages (Page 3 is illegible)
Nov. 1-30, 1944.................5 Pages
Dec. 1-31, 1944................10 Pages
Jan. 1-31, 1945..................9 Pages
Feb. 1-28, 1945..................6 Pages (Page 5 missing)
5.) Miscellaneous Documents-from the Dwight D. Eisenhower Presidential Library, Museum and Boyhood Home, Abilene, Kansas
Combat History, HQ Company, Aug. 2-Dec. 7, 1944.....................7 Pages
Company Diary, A Company, Nov. 28, 1944-Jan. 25, 1945...........6 Pages
Company Diary, C Company, Oct. 1-31, 1944..............................1 Page
G-3 Periodic Reports, Feb-June, 1944..........................................6 Pages
Battle Experience Report, Sept. 30, 1944.....................................2 Pages
Effect of 90mm gun on Enemy Tanks...........................................1 Page
G. O. #59, Lt. Col. Hernandez DSC Award, Sept. 13, 1944............1 Page
History, 1944.........................................19 Pages (Includes casualties & awards)
Various Documents, 1941-1945...............31 Pages (Includes awards)
6.) B Company Group Photo - Taken in April of 1942, at Camp Livingston, Louisiana, while the unit was station there. The unit was commanded by 1st Lt. Charles A. Cocoran who came from the 107th Field Artillery Bn. and 1st Lt. Leonard Dotson who came from the 108th Field Artillery Bn. Cocoran would end the war as a Lt. Colonel. The unit history indicates that all of the officers came from Field Artillery uinits. A full roster is provided at the top of the photo. Courtesy of Paul Stevens.
7.) Photo Gallery


Instructions for taking screenshots on Android tablets Samsung Galaxy Tab A 10.5. How to make screenshots on Samsung Galaxy Tab A 10.5. Save screenshots on Samsung Galaxy Tab A 10.5.
The screenshot can be done not only on smartphones but also on tablets and the procedure to capture the screenshot on Samsung is very similar but for those who did not know today we insert here a little tool in the blog to capture the screen of Samsung Galaxy Tab A 10.5.
Also on Samsung Galaxy Tab A 10.5 there is a keyboard shortcut with which you can create a screenshot quickly and easily.
Remember that taking a screenshot of the screen content means taking a picture of the content of the display and creating an image to be shared later, via email, via social networks, via Whatsapp, via Facebook, via Twitter etc.
Power On/Off Key Volume Minus (-) This combination of keys pressed at the same time creates a screenshot on the Samsung Galaxy Tab A 10.5.
Now the screenshot can then be viewed in the image gallery and edited there. Now you know how to create a screenshot on the Samsung Galaxy Tab A 10.5 quickly and easily.


text:
BEST RATED » MESA AZ » UROLOGISTS
Best Urologists in Mesa
Expert recommended Top 3 Urologists in Mesa, Arizona. All of our urologists actually face a rigorous 50-Point Inspection, which includes customer reviews, history, complaints, ratings, satisfaction, trust, cost and general excellence. You deserve only the best!
DAVID J. GROSSKLAUS, MD
6007 East Baseline Road, Suite 105, Mesa, AZ 85206 Directions
"Dr. David J. Grossklaus has earned his medical degree from the University of Arizona College of Medicine, University of Arizona College of Medicine in 1996. He is clinically interested in minimally invasive treatments for stones and both male and female voiding dysfunction and prostate disorders. Dr. David specializes in the newest techniques, including the DaVinci robot for urologic procedures. Dr. Grossklaus is an expert in robotic-assisted surgery for urologic cancer, and also utilizes laparoscopic and open approaches. He is affiliated with Saint Joseph Hospital & Medical Center, Banner Baywood Medical Center and Mercy Gilbert Medical Center."
SOUTHWEST UROLOGIC SPECIALISTS P.C. - Male and Female Voiding Dysfunction and Prostate Disorders, Bladder Diseases, Blood in Semen (Hematospermia), End-Stage Renal Disease, Erectile Dysfunction, Kidney Infection, Neurogenic Bladder, Kidney and Bladder Stones, Ureteral Stones & Urinary Tract Infection (UTI) Treatment
Insurance AcceptedAarp, Aetna, Aetna Medicare, Az Benefits Options, Az Foundation, Banner Choice Plus and Select, BCBS Blue Medicare Advantage, Blue Cross Blue Shield, Bridgeway Health Solutions, Care First Health Plan Arizona, Inc., City of Mesa/BCBS, Cigna, Secure Horizon Aarp, Medicare, PHCS, Tricare Standard, Lifewise, Geha, Scan Medicare Advantage Plan, Humana, Health Allied, Maricopa Health Plan, Secure Horizon Banner East Valley Network, United Health Care, First Health & Meritus
swurologic.com/david-gros...
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RAHUL MEHAN, MD
6116 East Arbor Avenue, Building 2, Suite 108, Mesa, AZ 85206 Directions
"Dr. Rahul Mehan is a skilled surgeon and dedicated to providing his patients with the highest quality medical care. Dr. Rahul has graduated from Wright State University Boonshoft School of Medicine in 2006 and completed an internship in general surgery and a residency in urology at the Indiana University School of Medicine located on the campus of Purdue University. He offers weight-loss programs, CoolSculpting fat reduction, hormone replacement therapies, and fitness performance enhancement. Dr. Mehan is expertise in erectile dysfunction treatment."
EVU CENTER - Balanoposthitis, Bladder Diseases, Blood in Urine (Hematuria), End-Stage Renal Disease, Erectile Dysfunction, Chronic Kidney Diseases, Incontinence, Kidney and Prostate Cancer Treatment, Male Infertility, Painful Urination (Dysuria), Vasectomy, UTI & Urinary Disorders
Insurance AcceptedAetna Choice POS II, Aetna HMO, Aetna Managed Choice POS Open Access, Aetna Whole Health, Banner Health Network HMO, BCBS Blue Card PPO, CIGNA PPO, CIGNA Open Access Plus, CIGNA HMO & CIGNA LocalPlus
evucenter.com/provider/ra...
KASHIF ALVI, MD
6750 East Baywood Avenue, Suite 507, Mesa, AZ 85206 Directions
"Dr. Kashif Alvi is a well-known, Board Certified Urologist practicing in the Phoenix metropolitan area. He has graduated from King Edward Medical College, the University of Punjab in 2001, and completed a residency at Massachusetts General Hospital. Dr. Kashif has been in practice for 18 years, and he has done hundreds of sling procedures for stress incontinence, as well as bladder and uterine prolapse procedures. Dr. Alvi has excellent academic credentials, which serve him to be one of the top urologists in Arizona."
UROLOGIC SURGEONS OF ARIZONA - Balanoposthitis, Bladder and Prostate Cancer Treatment, Enlarged Prostate, Kidney Stones and Infection, Chronic & Erectile Dysfunction
Insurance AcceptedAetna Choice POS II, Aetna HMO, Aetna Managed Choice POS Open Access, Aetna Whole Health Banner Health Network HMO, BCBS Blue Card PPO,CIGNA PPO, CIGNA Open Access Plus, CIGNA HMO, First Health PPO & Health Net AZ PPO HSA
azurologicsurgeons.com/ou...
Who is the best in Mesa, Arizona?
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The incredibly popular YouTube network Yogscast have started their annual joint effort with Humble Bundle to raise money for charity through selling exclusive games and giving shout-outs to donors.
With still 25 days to go, they have smashed their previous record of $2.5 million by hitting $3 million raised, the proceeds will then be split between these eight charities: Wallace and Gromit's Grand Appeal, Special Effect, the Whale and Dolphin Conservation, the Mental Health Foundation, Save the Children, Cancer Research, Charity: Water, and the International Lesbian, Gay, Bisexual and Intersex Association.
New games are unlocked every day for the bundle, and those who donate at least $5 will get a shoutout from the Yogscast.


The MonoGame team are pleased to announce that MonoGame v2.5.1 has been released. This release contains bug fixes and minor updates. Recent additions include project templates for iOS and MacOS. The MonoDevelop.MonoGame AddIn also works on Linux. We have removed the dependency on the thirdparty GamePad library to allow MonoGame to be included in the debian/ubuntu repositories. There have been a major bug fix to ensure textures are disposed of correctly as well as some fixes to the audio system under iOS.
Removed links to the third party GamePadBridge.
Extra Special thanks to Flying Development Studio, makers of Infinite Flight, for giving back their code changes that added 3D support to MonoGame. These changes will form an important part of the next v3.0 release.
Uses OpenAL on all platforms except Android.
Moved DynamicVertexBuffer and DynamicIndexBuffer into its own files.
Added a new Installer to install the MonoDevelop and / or Visual Studio Templates and binaries.
App Backgrounding has regressed. A patch is already being tested in the develop branch and the fix will be rolled out as part of the v2.5.1.


A few years ago Ryan Bates wrote an application called Daily Stamp. With it we can enter something that we want to accomplish daily. We're then shown a calendar and a stamper that we can use to stamp the days that we accomplish that task.
What we'll focus on in this episode is the ability to customize the stamp. The app has a page where we can select from a preset list of stamps or upload an image of our own to turn into a custom stamp. Whatever image we upload is resized and has effects applied to make it look like a rubber stamp. We can also choose from a number of colours for our stamp. In this episode we'll show you how to add this type of image manipulation. A key ingredient of this is ImageMagick. A lot of people have a love-hate relationship with this as it can be difficult to set up and use, although it is a powerful piece of software once it's up and running. If we want to perform image manipulation this can take us quite far. A good place to start is with its command-line tools. These will give you a good idea of what ImageMagick is capable of and what steps are required to process an image with it.
Installing ImageMagick can be tricky. If you're running Mac OS X it's a good idea to use Homebrew to install it as then all that's needed is to run the command brew install imagemagick. This should give us a convert command, along with several others, for processing images.
In addition to the source image we'll be working with, which is a PNG of Github's Octocat, We also have another image, which is an overlay texture made up of a white image with some transparency to give it the appearance of a rubber stamp. Our first objective is to resize and crop the source image so that it composites nicely with our overlay texture. If we look at the documentation for the convert command we'll see the list of options that can be passed in, including options to crop or resize an image. Both of these options accept a geometry parameter and the documentation for this tells us the different ways that we can format the argument to change its behaviour. This is handy if you're trying to make a square thumbnail from an oddly-shaped image like we are. We'll use the option with a caret symbol which will allow us to fill the stamp image while maintaining the aspect ratio. We'll start off in the terminal and resize the image to 70x70 pixels. We'll also crop it to the same dimensions and supply an offset value then save the file as source.png.
The resulting image looks like this. It's dimensions are correct but it is off-centre. We want it to crop in the middle instead. This can be accomplished with the gravity option which we set before crop. Setting it to center will keep the image centered as it's cropped.
This crops the image correctly so we already have a command we can use to turn any image into a thumbnail. We want to turn this thumbnail into a greyscale image and also add some contrast so that it can easily be converted into a stamp. We can do this by adding some more options such as quantize to set the colour palette to greyscale, colors to do the conversion and contrast to make the image pop a little more. Note that the option passed to quantize is in uppercase.
We now have a greyscale image that we can composite the overlay on top of to give it the texture of a stamp. We can do this by using the composite command which will overlay one image on top of another. We'll composite the overlay image on to our source image and overwrite the source image with the new image.
The image now has the stamp texture overlaid on top and the next thing we want to do is add some colour. Not only can the convert command be used to process existing images we can also use it to create images from scratch. We'll make a new 70x70 pixel image that we'll colour red. We do this by using the canvas option, although note that some versions of ImageMagick expect as cx option instead.
This generates a square red image that we can composite with the source image. Instead of having to manage another file, however, we can handle to compositing in the same convert command. We'll load in the source image and configure how it should be composited with the other one. We'll use the copy-opacity opacity setting and tell it to composite the source image with the red canvas.
The generated image is close to what we want but it looks like we need to invert the source image to get the result we want. We can do this by passing in parentheses when we load in the image and by using the negate option to tell it to invert the colours on the source image when it's loaded in.
The image that's generated now looks exactly like we want it to. It's easy to configure our command to change the colour for different stamps. Now that we have this figured out we can merge the entire thing into one command so that the image is resized and make into a stamp in one go. This is a long and rather complicated looking command but it does exactly what we want.
The next step is to get this working in a Rails application. One option is just to execute this command from within Ruby and this isn't such a bad idea. There are a couple of gems available that will do just this. Image Sorcery is a thin wrapper around the command-line too and MiniMagick is similar. The interface to both of these gems can be a little cumbersome when we have to deal with extensive image manipulation so keeping the whole command in a string and executing it is often the best way to go. There's also the classic RMagick gem. This hasn't been updated recently and some people criticize it for leaking memory but it is a valid option if you're looking for an alternative to the command-line interface. It wraps the C library so its interface isn't always a one-to-one mapping with the command line but it does have a good user guide. Let's see what's involved in using RMagick to generate the same stamp image. First we'll need to install its gem.
First we require rmagick and then we load in the source image. Reading an image gives us an array of layer images and so we pick the first. We can then use the resize_to_fill method to crop and resize the image and call quantize on the thumbnail image that's returned to covert it to greyscale. Calling contrast and passing true will increase the image's contrast.
Next we composite the overlay image. We load it in in the same way as the main image then call composite! on the source image to composite the overlay on the source. We then create a new image with a red background and composite it on to the negated source image. Note the Magick::CopyCapacityCompositeOp argument which is the same as the -compose copy-opacity option we used on the command line. Finally we write the image out.
If we use this we need to take care to watch for shell injection attacks if we're accepting parameters from the user. Using RMagick feels more verbose but it's also more dynamic and we need to watch out for potential memory leaks.
We also have a Stamp model which mounts a CarrierWave uploader called StampUploader.
The StampUploader class is fairy standard apart from the processing code.
The processing is done in the stamp method. This is all that's needed to handle the stamped versions. What we do is loop through a list of colours and make a version for each one. The stamp method calls manipulate! which is a custom CarrierWave method and tells it that we want to use RMagick to generate a PNG image. This method takes a block that we pass the source image into. The code in the block should return the modified image and is basically the same code we used earlier with a couple of variables thrown in. If we were using this code in a production app we should move it off into a background process, but that's out of the scope of this episode. Since each colour is a different version we can easily change the colour of the stamp that's displayed in the view by passing in a different version.
Now our stamps are a different colour.


text:
Q: Gitlab personal server: Permission denied (publickey) I have installed a Gitlab server (15.1) and try to finalize configuration for my user.
I am able to connect with ssh to the server for administration purpose.with my user. I use rsa key pair for that. I connect on the 22002 port and everything works well.
Now I wanted to follow Gitlab instruction to create a project, a new pair of key and connect my repository to Gitlab using this key pair.
I have created keys (ed25519), copy the public part into the Gitlab web server and just try the command ssh -T myuser@gitlab.mydomain.com
I get the following result:

Permission denied (publickey)

I have searched for hours but didn't find what I have made wrong.
If I run ssh -Tvvv myuser@gitlab.mydomain.com I get the following result:
OpenSSH_9.0p1 Debian-1+b1, OpenSSL 3.0.4 21 Jun 2022
debug1: Reading configuration data /home/tasseb/.ssh/config
debug1: /home/tasseb/.ssh/config line 19: Applying options for gitlab-kb
debug1: Reading configuration data /etc/ssh/ssh_config
debug1: /etc/ssh/ssh_config line 19: include /etc/ssh/ssh_config.d/*.conf matched no files
debug1: /etc/ssh/ssh_config line 21: Applying options for *
debug1: Connecting to gitlab.mydomain.com [160.53.247.6] port 22002.
debug1: Connection established.
debug1: identity file /home/tasseb/.ssh/id_ed25519-gitlab type 3
debug1: identity file /home/tasseb/.ssh/id_ed25519-gitlab-cert type -1
debug1: Local version string SSH-2.0-OpenSSH_9.0p1 Debian-1+b1
debug1: Remote protocol version 2.0, remote software version OpenSSH_8.4p1 Debian-5+deb11u1
debug1: compat_banner: match: OpenSSH_8.4p1 Debian-5+deb11u1 pat OpenSSH* compat 0x04000000
debug1: Authenticating to gitlab.mydomain.com:22002 as 'sbe'
debug1: load_hostkeys: fopen /home/tasseb/.ssh/known_hosts2: No such file or directory
debug1: load_hostkeys: fopen /etc/ssh/ssh_known_hosts: No such file or directory
debug1: load_hostkeys: fopen /etc/ssh/ssh_known_hosts2: No such file or directory
debug1: SSH2_MSG_KEXINIT sent
debug1: SSH2_MSG_KEXINIT received
debug1: kex: algorithm: curve25519-sha256
debug1: kex: host key algorithm: ssh-ed25519
debug1: kex: server->client cipher: chacha20-poly1305@openssh.com MAC: <implicit> compression: none
debug1: kex: client->server cipher: chacha20-poly1305@openssh.com MAC: <implicit> compression: none
debug1: expecting SSH2_MSG_KEX_ECDH_REPLY
debug1: SSH2_MSG_KEX_ECDH_REPLY received
debug1: Server host key: ssh-ed25519 SHA256:ofs8tNkzOxuU5AwC2VYbFGPXfERPKXGOFrTatb8hV78
tlab.mydomain.com]:22002
debug1: load_hostkeys: fopen /home/tasseb/.ssh/known_hosts2: No such file or directory
debug1: load_hostkeys: fopen /etc/ssh/ssh_known_hosts: No such file or directory
debug1: load_hostkeys: fopen /etc/ssh/ssh_known_hosts2: No such file or directory
debug1: Host '[gitlab.mydomain.com]:22002' is known and matches the ED25519 host key.
debug1: Found key in /home/tasseb/.ssh/known_hosts:4
debug1: rekey out after 134217728 blocks
debug1: SSH2_MSG_NEWKEYS sent
debug1: expecting SSH2_MSG_NEWKEYS
debug1: SSH2_MSG_NEWKEYS received
debug1: rekey in after 134217728 blocks
debug1: get_agent_identities: bound agent to hostkey
debug1: get_agent_identities: ssh_fetch_identitylist: agent contains no identities
debug1: Will attempt key: /home/tasseb/.ssh/id_ed25519-gitlab ED25519 SHA256:7BtjWt7Ysd40SJ1xX1sBlZb7PJqUW5K2NhxDBvtIgfY explicit 7
debug1: SSH2_MSG_EXT_INFO received
debug1: kex_input_ext_info: server-sig-algs=<ssh-ed25519,sk-ssh-ed25519@openssh.com,ssh-rsa,rsa-sha2-256,rsa-sha2-512,ssh-dss,ecdsa-sha2-nistp256,ecdsa-sha2-nistp384,ecdsa-sha2-nistp521,sk-ecdsa-sha2-nistp256@openssh.com,webauthn-sk-ecdsa-sha2-nistp256@openssh.com>
debug1: SSH2_MSG_SERVICE_ACCEPT received
debug1: Authentications that can continue: publickey
debug1: Next authentication method: publickey
debug1: Offering public key: /home/tasseb/.ssh/id_ed25519-gitlab ED25519 SHA256:7BtjWt7Ysd40SJ1xX1sBlZb7PJqUW5K2NhxDBvtIgfY explicit
debug1: Authentications that can continue: publickey
debug1: No more authentication methods to try.
sbe@gitlab.mydomain.com: Permission denied (publickey).

Thanks for your help.

A: I was sure it was something simple that I have omitted.
So this morning I just continue to set up locally my git project and did the first push using my user and password. That has working well.
Then, I edit my .ssh/config file, changing my username by "git" as suggested by @VonC.
Re run the test, it asked for the passphrase for the key and everything is ok.
I thought I could set up the ssh before doing a first push or set the origin locally, but it seems no.
Thanks again for your precious comments.

A: Using SSH URL with a GitLab on-premise server should always involve the technical account git, not "myuser".
See "Verify that you can connect"
ssh -Tvvv git@gitlab.mydomain.com

GitLab will authenticate you through the public key registered to the GitLab user account SSH setting page.

redpajama_set_name: RedPajamaStackExchange


text:
About Irv
Irv in the Media
Irv's Blog
Football Death Flashback 7 (4/23/16): Ted Agu's Teammate Went to Berkeley Campus Police And Detailed Conditioning Coach Harrington's Role in Earlier Player-on-Player Assault
Football Death Flashback 6 (6/25/16): Cal's Damon Harrington's 'Massive Punishment Session Before Entire Team' and Extreme Drill Called 'Grave Digger'
Where University of Maryland Meets University of California: Collected Football Death Flashback Links
Our article earlier today noted the parallel circumstances — but not the parallel consequences — in the recent death of University of Maryland football player Jordan McNair and the 2014 death of University of California-Berkeley football player Ted Agu.
Concussion Inc. is following up with republication of our 2016 reports quoting depositions in the Agu family's lawsuit, which cited the same evidence of a "toxic culture " in the Cal program.
TED AGU PAPERS: Cal Football Teammate Went to Police Month After Player's Death; Detailed Strength Coach Harrington's Role in Earlier Player-on-Player Assault
Published April 23rd, 2016
by Irvin Muchnick
A teammate of Ted Agu, who watched him perish on a Berkeley campus hillside in 2014 during a bizarre early morning conditioning drill that would lead to a $4.75 million wrongful death lawsuit settlement by the university, was so distressed by the extreme methods of football strength coach Damon Harrington that he went to investigators for the Alameda County sheriff a month later. In his police statement, as well as in the deposition in the civil lawsuit, the teammate also detailed the incident three months earlier in which an altercation Harrington had instigated between two other players, J.D. Hinnant and Fabiano Hale, left the latter hospitalized with a concussion.
The second part is indisputable evidence that a January 2016 front-page San Francisco Chronicle story on the imminent Agu family civil settlement — a report on which the University of California's Graduate School of Journalism assisted, and which was said to have been based on leaked deposition transcripts and interviews — consciously withheld from the public critical and verified details on the dangerously out-of-control program of head coach Sonny Dykes and conditioning coach Harrington.
Concussion Inc. acquired this deposition and many others, and will be publishing them in full in the near future, along with other documents, in a project we are calling "The Ted Agu Papers."
Until the papers are published, this reporter generally will have a policy of not identifying the individuals who gave whistleblowing deposition testimony. Yesterday I contacted the deponent of this story by email and invited him to go on the record earlier.
This particular football player, who was questioned by attorneys in the Agu family lawsuit on February 26, 2015, spoke of his interview with Alameda County sheriff investigators more than a month after Agu's February 7 death. (In the deposition transcript, the date is pinned down as March 19 at one point, March 9 at another.) The teammate confirmed that he had reached out to the police, and added at various points in the deposition:
"I was concerned about the level of conditioning … so I brought it to the attention of people that would know."
"I was concerned that it was too difficult."
Asked to specify what concerned him about Harrington, the player said:
"I would say that the — the fact that he preached toughness to a point where I was concerned and thought that I needed to say something to the people — the representatives at Cal, because it was difficult and there was a very adamant preaching about being tough, no matter what."
The player added:
"We had Friday workouts for the non-travel group that were said to be geared towards toughness that didn't necessarily involve exercises that were to make us stronger, but to make us tougher."
He agreed — "Yes" — with the deposition questioner's characterization that he was concerned that the drills "were designed toward wearing everyone out and causing players to throw up."
The deposition transcript then has this passage:
Q. And you brought to the attention of the authorities a particular instance where the player was late or missed a drill and Coach Harrington suggested something needed to be done, but he wasn't going to do it. Do you recall that incident?
A. Correct.
Q.Why don't you describe that to the jury [that potentially could be viewing the videotape of the deposition]?
A.We had a kid miss a workout on Halloween, and the whole team was punished without that player being there. And so we were — were punished up on the field doing very different exercises, rolling on the field.
Q.[…] I know it's difficult, but you're going to have to describe what do you mean by that, difficult. What exactly were you asked — what were you ordered to do?
A. We did exercises of rolling a number of yards on the ground, bear walks, crab walks, up-downs, many up-downs, more rolling. And those are the ones that I recall the best.
Q. You estimate you rolled, what, 100 yards?
A. Yeah, I stand by my statement in the police report.
Q. And did the players — not just you — but did most of your surrounding players get unbelievably dizzy and, in your words, and nauseated, throwing up, sick?
A. I personally was very — was very dizzy, and from — but that's all I can speak of. I — I saw throw up. But that's all I know. I know what I saw and I know what I felt. That's it.
Q. Did you see other players throwing up and reacting much like you were?
A. I — I saw throw up, yes.
The questioning lawyer for the Agu family went on to confirm that, before the deposition, the deponent consulted with "a mentor from Cal" who "connected me to a defense lawyer" — Matthew Conant, lead counsel for the university in the lawsuit.
The plaintiff lawyer asked, "Do you feel uncomfortable criticizing Coach Harrington now as you sit here under oath — or the Cal program." The player replied, "I don't think I feel uncomfortable about telling the truth."
Then this:
Q. Is it Fabiano Hale [who missed the workout, leading to the non-travel group's collective punishment drill]?
A. Fabiano Hale, correct.
Q. Okay. And then what happened?
A. Later that day, from what I heard — I wasn't there, I didn't see it, but obviously, it happened — Fabiano was confronted by J.D. Hinnant and J.D. — I don't know how — all I know is J.D. performed some kind of a physical violence against him that caused him to go to the hospital.
Q. Okay. Let's don't talk about things. That's kind of speculation. That's what you understood to happen?
A. Right.
Q. You knew that Mr. Hale went to the hospital at some point in time subsequent?
A. Uh-huh.
Q. You knew from your personal experience and knowledge that he had been somehow physically assaulted, and as a result of that assault he went to the hospital? That's what you know?
A. Correct, correct, correct.
Q. [W]hat did the coach do, if anything, to elicit what you perceive to be some type of resultant conduct. What you saw, what did Coach Damon Harrington do?
A. He said he was not going to take care of it himself, and that it was on the team to take care of it.
Q. Did he make any physical gestures when he was doing that? With his fist and then demonstrate —
A. Yes, he — he —
Q. That's why I have this video, so you can show the jury what did he do.
A. Right. He held up his fist when he said that.
Q. And did he take his fist and hit it in his hand and suggested the team take care of it?
The questioning returned to why the deponent went to the police in March 2014.
A. My concerns were that he was being too — give — administering — what's the word — conditioning that was too difficult. And his — the way that he was speaking to the players was inappropriate.
Q. Okay. You didn't mention that yet. So let's talk about that.
Q. What are you — what are you saying? You've got experience. You're probably the oldest person on the team; is that right?
A. Uh-huh, correct.
Q. Okay. You've been around sports. What do you mean his — his speaking — his manner of speaking to the team?
A. Things that —
Q. I want specifics.
A. Things that he was — he was saying to us about not being soft.
Q. Like what?
A. What do you mean by —
Q. What was he saying?
A. Well, a lot of swearing with, don't be soft, you need to be tough. I can't — I can't give you exact quotes, other than it had to do with being soft, being tough. And there was a lot of lewd comments.
Q. Okay. And I'm not trying to embarrass you … but you know, the only way a jury is going to find out what was said … is if you say it…. So you specifically pointed out an instance that caused you great concern because of the younger players. The soft comments were made about what? About Berkeley and the atmosphere of this environment, this — this college environment?
A. Correct. I stand by my statement in the police testimony when I said that.
Q. Okay. And he used inappropriate language?
Q. A lot of profanity?
Q. Okay. And when the players were engaged in conditioning drills, was that the type of — of profanity and — and verbal abuse that you were talking about?
Q. Okay. Were there a lot of cuss words?
Q. Okay. What type of cuss words?
A. Would you like me to —
Q. Yes.
A. — state. Fuck.
Q. The player was struggling. What would — what would typically be said?
A. I mean, I can't give you verbatim quotes, but —
Q. Just give me some —
A. Fuck, shit, pussy, God, cock — I don't know.
Q. Didn't he specifically say something about [arch-rival] Stanford that you reported to the police?
Q. What was that?
A. He said that Stanford has you bent over with their cock in your ass.
Q. And you found that especially troubling because of the young players on the team?
A. That — that was my biggest concern with what he had to say.
The deponent responded to questions about his talking to the police about "a kind of culture that was established or attempted to be established by Coach Harrington."
"He was very adamant about toughness, and that was his main thing."
"[In his words,] tough as shit."
"And he was trying to make people throw up, spinning around."
"Doing all kinds of stuff that was basically kind of a punishment more, you know, torture type deal."
Returning to the precursor to the Hinnant assault of Hale, with the deponent reading from the his police statement:
Q. Okay. And then I asked earlier in your deposition about the fist. Do you remember? And then the lawyer for the defendant objected, saying I was leading you?
Q. Okay. Look at that line 15. What were you talking about when you were telling the police that he was standing in front of everyone. He brought everyone together. He said he wasn't going to punish anybody himself.
Q. But he put it on the team to take care of it. And he said — those are your words? What did he say?
A. By any means necessary.
Q. And by doing what, you mentioned?
A. Putting his fist into his hand.
More on what the deponent said in the police report about Harrington's "culture":
"If you're working out and you're throwing up, you have to keep going through the drill and still be throwing up."
"You can't be bending down to throw up or anything like that. So that's the mentality that we have."
The deponent's father, a retired National Football League player, was among those who prompted him to go to the police after Agu died. Indeed, going to the police had been discussed after the Hinnant-Hale incident, before Agu's death.
A. [A]fter the Fabiano Hale case and in consulting with my father, he contacted an administrator [in the Cal athletic department[ that said, go to the police. And that was — that was that. We didn't — we didn't go to the police [until later].
Q. Sorry. The Cal administrator that was contacted by your father, I understand your father expressed his concerns about what was going on and the reaction was, well if you've got something, go to the police. And you-all didn't — you-all decided not to go to the police.
Q. The time it was suggested to your father to talk to the police, rather than Cal, was about that incident you shared with us earlier?
A. When —
Q. Correct.
A. Okay. Like a Few Good Men incident where there was an inference that something be done to this player?
Defense lawyer Conant:I think that's —
THE WITNESS:I've never seen that movie.
Plaintiff lawyer Steve Yerrid:You should see it. It's good.
Earlier Concussion Inc. reports about the Hinnant-Hale incident, which suggested that the workout Hale skipped was a weightlifting session and that the punishment by Harrington was an extra set for the team members in attendance, were wrong in those details. But as we can see in the deposition transcript, the correct details are even worse.
A current Cal faculty investigation, outside the scope of the Agu Papers, has turned up additional and still worse details implicating not only strength coach Harrington but also head football coach Dykes, in the Hinnant-Fabiano incident foreshadowing the Agu death. Next week, Concussion Inc. will report on this aspect of the story.
Returning to the Agu Papers,, we then will examine the testimony pertaining to the "rope drill" itself during which Agu died. Here the key point is that with the exception of two witnesses, every single witness clearly remembered that Agu was in obvious deep distress throughout the fatal conditioning drill and had collapsed repeatedly at earlier junctures. The outlier exceptions to this account — who represented that Agu was leading the entire pack throughout the ten hill-climb laps, before suddenly collapsing on the last lap — were now-departed athletic trainer Robbie Jackson and strength coach Damon Harrington.
In response to an inquiry from Concussion Inc., Chancellor Nicholas Dirks declined comment on Harrington's status. University spokesman Dan Mogulof told us, "We don't comment on personnel issues."
2017 op-ed article for the Daily Californian on my Public Records Act lawsuit: http://www.dailycal.org/2017/04/25/lawsuit-uc-regents-emblematic-issues-facing-college-football/
Second op-ed article for the Daily Californian (published May 4): http://www.dailycal.org/2018/05/03/years-later-questions-remain-regarding-football-player-ted-agus-death/
"Explainer: How 'Insider' Access Made San Francisco Chronicle and Berkeley J-School Miss Real Story Behind Death of Cal Football's Ted Agu," https://concussioninc.net/?p=10931
Complete headline links to our Ted Agu series: https://concussioninc.net/?p=10877
New York Times on George Gibney
University of California Agrees to Pay $125,000 in Attorney Fees to Settle Our Public Records Case in Ted Agu Football Death Cover-Up
Cyberhack Disaster at U.S. Center for Safe Sport Further Exposes the Group's Overall Unprofessionalism and Diversionary Agenda
Irv says:
Investigative journalism is not "peer-reviewed scientific literature." It is a contact sport. My version of it favors transparent and interactive relationships with readers and sources. I also recognize that backstories and their interpretation are organic; I strive for what is, at best, the second draft of history.
I invite you all along for the ride.
Tweets by irvmuch
Tweet to @irvmuch
© 2020 Concussion Inc. - Author Irvin Muchnick. All Rights Reserved. | Developed by Seattle Webd


text:
Ward Glacier
Ward Glacier (The name as it would appear in a gazetteer)
Ward Glacier (The name as it would appear on a map)
Feature type: None recorded.
Ward Glacier (New Zealand)
Small glacier between Terminus Mountain and Howchin Glacier on the E side of the Royal Society Range in Victoria Land. Named by Taylor of the BrAE (1910-13) for L. Ward, a Tasmanian geologist.


Drawings from left to right: rear view, right side view with top cover, right side view without top cover.
Drawings from left to right: rear view, right side view with top cover.
Mount the device in a vertical position (±10°). This is required for cooling the device.
Do not mount the device close to heat sources.
Leave sufficient free space so that the air required for cooling purposes can circulate from the bottom to the top of the drive.


text:
Home / News / Local / Navy's newest ship, USS Kansas City, arrives in its home port
SAN DIEGO (May 24, 2020) " The Navy's newest littoral combat ship, the future USS Kansas City (LCS 22), arrives at its new homeport at Naval Base San Diego. The Navy will commission LCS 22, the second ship in naval history to be named Kansas City, June 20, 2020, via naval message due to public health safety and restrictions of large public events related to the novel coronavirus (COVID-19) pandemic. (U.S. Navy photo by Mass Communication Specialist 1st Class Woody Paschall)
Navy's newest ship, USS Kansas City, arrives in its home port
Kansas City will once again be the name of a US Navy vessel. The next ship to be commissioned and carry the Kansas City moniker arrived at its homeport in San Diego, May 24.
The future USS Kansas City (LCS 22) arrived for the first time at Naval Base San Diego, where the Navy will commission the Independence-variant littoral combat ship (LCS) June 20.
The future USS Kansas City. Photo: US Navy.
The ship is an Independence-class littoral combat ship of the United States Navy. She is the second ship to be named for Kansas City, the largest city in the U.S. state of Missouri. Total price tag for the project was $4.5 billion.
The vessel was built in Mobile, Alabama by Austal USA. The ship was christened on September 22nd, 2018 in Mobile and she was launched October 19th, 2018 into the Mobile River.
Get a close-up look in this video:
"I am extremely proud of all the hard work the crew has done to complete the sail around and prepare us to officially join the fleet on commissioning day," said Cmdr. RJ Zamberlan, Kansas City's commanding officer. "We are honored and excited to represent the Navy, the nation, and our namesake, as well as fulfill the ship's motto, 'United We Stand, Divided We Fall.'"
Here are her specifications:
Number of Austal-built Ships: 14
Program Value: $4.5 billion
Class & Type: Independence Variant Littoral Combat Ship
Displacement: 3,104 metric tons
Beam: 104 feet
Draft: 14 feet
Speed: 40 knots (46mph)+ | 47 knots (54mph sprint)
Range: 4,300 nm at 20 knots (23mph)
Payload: 180 MT
Accommodations: 98
The ship's website states that it is "a fast, maneuverable and networked surface combatant, the Independence variant LCS provides the warfighting capabilities and operational flexibility to accomplish multiple, critical missions including mine warfare, anti-submarine warfare and surface warfare with inherent capabilities that also support missions such as special operations and maritime interdiction."
Kansas City's other navy ship was the USS Kansas City (AOR-3). It was a replenishment oiler in service from 1970 to 1994 when it was scrapped under the Clinton administration.
Just before the end of World War II, construction began on a heavy cruiser which was also to be commissioned as the USS Kansas City. The project was scrapped at the war's end.
As for St. Louis, there are plans to build the USS St. Louis (LCS-19), a Freedom-class littoral combat ship. She would be the seventh ship in naval service named after that city.
With events and churches cancelling services, the advertising that Metro Voice relies on for support is ending. For 31 years, Metro Voice has been a leader in the faith-based community. We have historically relied on advertising to fund the mission of our publication and sharing the Good News. We are now seeking donation partners who want to support our publication and our mission of faith-based journalism.
alabama austal combat ship LCS 22 missouri mobile navy San Diego st. louis us uss kansas city uss st louis 2020-05-27
Tagged with: alabama austal combat ship LCS 22 missouri mobile navy San Diego st. louis us uss kansas city uss st louis
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text:
Episode 14 | Margaret River Soup Kitchen
[This video was originally hosted on KoldCast TV]
In this episode we're first off to Augusta in Western Australia to visit Kevin and his family. We chat to Kevin about his experiments with bush regeneration and his old car, which he has converted to run on used deep frying oil. Then we're off to meet Dave Seegar at the Margaret River Soup Kitchen.
We first met Dave during a visit to a local winery in Margaret River, where his band Four Bean Mix was providing the entertainment. It was the manager of the place who put us on to him and told us about the soup kitchen when he heard about our odyssey.
See our photos from episode 14 here.
The "Soupie" has been going since the 90s. Dave told us it was his response to the musings of a grumpy old man that came to town as the editor of the local newspaper. In his first editorials, he had expressed concern that the town was full of "ferals and hippies" and that he thought Margaret River needed to be above that. What this news editor didn't realise was how closely connected the local community is, and the importance of those he thought were "undesireable" for the local industries.
"Margaret River is a small town with a cosmopolitan attitude," says Dave.
"People here like that we're all different and the community is accepting and inviting. It's a great place to live."
The community sings praise for the man who started the weekly vegan feast.
"It's always a great meal, and it's a great place to catch up. You can let the kids run around. There are always plenty of other kids to play with and it's very social for the rest of us too. I come here as often as I can," a local mother of three told us.
In late 2012, Dave and the soup kitchen received an official acknowledgement for their efforts, as a finalist in the Prime Super Community Group of the Year Award at the 2012 Regional Achievement and Community Awards.
If you visit Margaret River, make sure to try the communal dining experience. The Soupie is on every Monday and Wednesday at the community centre.
Posted on Saturday, February 16th, 2013 at 2:02 pm.	Filed under: All Episodes, All Videos Tags: Augusta, Dave Seegar, Margaret River, Soup Kitchen, Soupie, Steinar Ellingsen, The Inland Sea	RSS 2.0 feed.
One Response to "Episode 14 | Margaret River Soup Kitchen"
In the words of Dave: I love it!
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