text:
The Access to Justice Research Network (AJRN) aims to connect a wide range of justice stakeholders who are passionate about access to justice in Canada. Coordinated by the Canadian Forum on Civil Justice the AJRN allows its members to share research, resources and other material related to access to justice. …………………………………………………………. Le but du Réseau de recherche sur l'accès à la justice (RRAJ) est de relier un vaste éventail d'intervenants en matière de justice. Le RRAJ est entretenu par le Forum canadien sur la justice civile (FCJC) et il permet aux membres du réseau de partager facilement des ressources d'accès à la justice.
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Justice Metrics
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New Book Examines What is Working and Not Working to Improve Access to Civil and Family Justice
September 2, 2020 September 2, 2020 ajrn1	Leave a comment
The Justice Crisis: The Cost and Value of Accessing Law edited by Trevor C.W. Farrow and Lesley A. Jacobs is a newly published book that provides an in-depth look at what is working and not working to improve access to civil and family justice in Canada.
The Justice Crisis uses new empirical research to explore the value associated with the provision of an effective justice system and the costs – individual and collective – of not providing accessible justice. The national and international importance of and the need for this kind of research is widely acknowledged.
Contributors to The Justice Crisis: The Cost and Value of Accessing Law include: Carolyn Carter, Thomas A. Cromwell, Ab Currie, Matthew Dylag, Trevor C.W. Farrow, Heather Heavin, Lesley A. Jacobs, Devon Kapoor, Michaela Keet, Jennifer Koshan, Herbert M. Kritzer, Moktar Lamari, Marylène Leduc, M. Jerry McHale, Lisa Moore, Janet Mosher, Pierre Noreau, Mitchell Perlmutter, Catherine Piché, Noel Semple, Lorne Sossin, Michael Trebilcock, Wanda Wiegers and David Wiseman.
The book's foreword is written by The Honourable Thomas A. Cromwell, CC.
The Justice Crisis: The Cost and Value of Accessing Law is part of the 7-year Cost of Justice project led by the Canadian Forum on Civil Justice. The Cost of Justice project was funded by the Social Sciences and Humanities Research Council.
The Justice Crisis: The Cost and Value of Accessing Law was published by UBC Press and is available here: www.ubcpress.ca/the-justice-crisis.
View the press release for The Justice Crisis: The Cost and Value of Accessing Law online here: https://news.yorku.ca/2020/09/02/new-evidence-on-the-justice-crisis-making-the-case-for-reform/.
New Report Highlights Importance of Community-Based Access to Justice
July 17, 2020 July 17, 2020 ajrn1	Leave a comment
"Community Justice Help: Advancing Community-Based Access to Justice" is a discussion paper by Julie Matthews (Executive Director of Community Legal Education Ontario) and Professor David Wiseman (University of Ottawa Faculty of Law) that explores the role of community justice workers in improving access to justice. The paper also discusses support mechanisms and tools that could further advance the contributions of community justice helpers.
"Community Justice Help: Advancing Community-Based Access to Justice" offers a framework that describes important elements of good quality community justice help. These include:
Community justice helpers have the knowledge, skills and experience they need;
Community justice helpers work within a not-for-profit organization and an ethical infrastructure; and,
Community justice helpers provide holistic support to meet clients' multi-dimensional needs.
The framework is intended to support the recognition of the following, important elements for improving community-based access to justice:
That community justice help is an important and valid component of the broader ecosystem of access to justice services
That all components of the ecosystem must be adequately supported through public funding and other means; and
That community justice help already aligns with the regulatory framework overseen by the LSO for the practice of law and the provision of legal services.
The Community Justice Help paper is informed by a literature review, discussions with members of the justice, not-for-profit and academic communities, and interviews with key staff working in community-based organizations.
"Community Justice Help: Advancing Community-Based Access to Justice", a discussion paper by Julie Matthews and David Wiseman is available online here: https://cleoconnect.ca/wp-content/uploads/2020/07/Community-Justice-Help-Advancing-Community-Based-Access-to-Justice_discussion-paper-July-2020.pdf.
Osgoode Hall's Centre for Refugee Studies to Host Seminar on Legal Aid for Refugee Claimants
August 23, 2019 August 23, 2019 ajrn1	Leave a comment
In April 2019, Legal Aid Ontario's (LAO's) funding was cut by $133 million, a 29% reduction in LAO's budget. Further, in reducing funding tor LAO, the provincial government indicated that provincial funds could no longer be used for matters related to refugee and immigration law.
On Wednesday, September 11 from 2:30pm – 4:00 pm the Centre for Refugee Studies at Osgoode Hall Law School will host a seminar to discuss the impacts of these cuts, advocacy efforts in response to the cuts in legal aid funding, the one-time injection of $26 million in funding provided by the federal government to help offset the impacts of the cuts, as well as the future of access to justice for refugee claimants and non-citzens in this context.
For more information on the upcoming Legal Aid for Refugee Claimants Seminar, visit the following page: https://crs.info.yorku.ca/archives/event/crs-seminar-legal-aid-for-refugees?instance_id=158.
This event is co-sponsored by the Centre for Refugee Studies, the Canadian Forum on Civil Justice and the Canadian Associaion of Refugee Lawyers (Osgoode Students).
Canadian Forum on Civil Justice Launches Project to Measure Long-Term Impacts of Access to Legal Help
July 4, 2019 July 4, 2019 ajrn1	Leave a comment
The Canadian Forum on Civil Justice (CFCJ) has announced the launch of the first phase of a project aimed at "Measuring the Impacts of Legal Service Interventions". This new project, which is funded by the Law Foundation of Ontario (LFO), will focus on the development of a longitudinal impact study that assesses the effectiveness of different types of legal service interventions on the outcome of particular types of legal disputes. The study will also seek to measure the impacts on the long-term health of clients, while providing necessary insights into the costs and benefits of such interventions.
Having a better and more accurate understanding of how different types of legal interventions impact the outcome of a dispute can help to provide the public with the knowledge they need to make informed decisions about how to deal with their legal problem(s) and potentially improves their legal capabilities. It can help governments, policy makers and funders to understand which justice pathways and tools show the most promise in particular scenarios, and this type of information can also assist legal service providers with decisions around how to allocate budgets and scale different services.
The press release for this newly launched Law Foundation of Ontario funded project can be accessed here: http://cfcj-fcjc.org/wp-content/uploads/Measuring-the-Impact-of-Legal-Service-Interventions-CFCJ-LFO-Press-Release.pdf.
Justice for All: Canadian Launch of the Report of the Task Force on Justice
May 23, 2019 May 23, 2019 ajrn1	Leave a comment
On May 30th, 2019, the Global Centre for Pluralism will be hosting the Canadian launch of the Task Force on Justice's "Justice for All" report. The event is being hosted in partnership with the Task Force on Justice and the International Development Research Centre. The "Justice for All" report explores the extent of the global justice gap, the cost of injustice, the benefits of investing in justice, along with other important, topical access to justice issues.
The launch of the report will take place from 8:30-10:00 am EDT in Ottawa and will also be live-streamed. This launch is one of many events that has been organized as part of the Open Governance Partnership Summit (Tuesday 28 – Friday 31 May, 2019): https://www.justice.sdg16.plus/ogpjustice.
Additional information on the Open Governance Partnership Summit and the launch of the report can be found here: https://www.pluralism.ca/event/justice-for-all-canadian-launch-of-the-report-of-the-task-force-on-justice/.
The "Justice for All" report is available in English, French and Spanish here: https://www.justice.sdg16.plus/report.
National Action Committee Publishes New Report on Canada's Progress on Justice Development Goals
April 30, 2019 April 30, 2019 ajrn1	Leave a comment
A recently released report by the national Action Committee on Access to Justice in Civil and Family Matters (Action Committee) offers insights into new developments, research, initiatives and other efforts that are contributing to improvements in access to justice in Canada. This report represents the most recent review by the Action Committee of Canada's progress on nine goals that are deemed essential for better access to justice. The report tracks achievements during 2018 using the Justice Development Goals as a common framework for coordinating efforts, sharing innovations, and measuring progress on access to justice.
Canada's nine Justice Development Goals are to:
Address Everyday Legal Problems
Meet Legal Needs
Make Courts Work Better
Improve Family Justice
Analyze and Learn
Improve Funding Strategies
The new Action Committee report, "Working Toward Accessible Justice: Tracking Progress on the JDGs in 2018" is available online in English here: http://www.justicedevelopmentgoals.ca/sites/default/files/2018jdgsworkingtorwardsa2jreport.pdf.
Vous pouvez télécharger << Travaillent pour une justice accessible : Suivi des progrès réalisés sur les objectifs de développement en matière de justice au Canada en 2018 >> ici : http://www.justicedevelopmentgoals.ca/sites/default/files/2018ojdstravaillentpoura2jrapport.pdf.
Learn more about the Justice Development Goals here: http://www.justicedevelopmentgoals.ca/goals.
Pour plus d'informations sur les objectifs de développement en matière de justice, cliquez ici : http://www.justicedevelopmentgoals.ca/fr.
Access to Justice: Next Year a Big One for the Action Committee / Accès à la justice : prochaine année occupée pour le Comité d'action
December 19, 2018 January 2, 2019 ajrn1	Leave a comment
Thomas Cromwell and Beverly McLachlin
La version française suit.
There are big transitions occurring at the Action Committee on Access to Justice in Civil and Family Matters. Former Chief Justice Beverly McLachlin has this month assumed the chair of the committee which she had convened a decade ago.
The Chief Justice of Canada, Richard Wagner, has agreed to take on the role of honorary chair, carrying on the practice of his predecessor. Justice Elizabeth Corte and Mark Benton are in place as vice-chairs. With the support of the Ontario and British Columbia Law Foundations, the action committee is preparing a transition plan, a strategic plan and a governance plan, all to be presented and discussed at the committee's annual summit in the early spring of next year. And the work of promoting and reporting on Canada's Justice Development Goals is in full swing.
I had the opportunity recently to speak with the former chief justice McLachlin about her hopes and plans for the committee under her leadership. Here is what she had to say.
Thomas Cromwell (TC): What were your expectations when you convened the action committee in the fall of 2008 and how does the committee's work since then match those expectations?
Beverly McLachlin (BM): My expectations were to start a conversation about access to justice that involved key players from all parts of the country and from all sectors — the legal profession, governments, courts, NGOs and academe — with a view to examining the roadblocks and coming up with insights on how to remove these barriers and improve people's access to justice.
The committee's accomplishments far surpassed my expectations. The broad cross-country conversation I hoped for has been engaged, and many new ideas on how to improve access to justice have emerged.
The level of engagement has far surpassed my expectations. As a result, new innovative ideas have actually been implemented — ideas that are improving Canadian's access to justice "on the ground." When we launched the committee in 2008, I had no idea that it would have produced such a rich dialogue, much less concrete results.
TC: What do you think are the most urgently needed changes to improve access to justice?
BM: I believe the most urgent change we need is a change in public and government attitudes. Instead of viewing justice as a frill or something lawyers and governments are grudgingly obliged to support, we should recognize (1) that access to justice in all its forms is a marker of a just society and (2) that supporting access to justice — providing people with legal help, counselling and more — will pay off in lower prison costs, lower court costs and enhancing the productivity of citizens. It is the right thing to do and the smart thing to do.
TC: Where do you hope to see the action committee go and what do you hope that it will accomplish under your leadership?
BM: The passionate women and men who have worked on the committee for the past decade have accomplished much and laid an excellent foundation for addressing the complex challenges that remain in achieving access to justice for everyone. I hope we will be able to establish a permanent umbrella organization to support innovative thinking, ensure that the accomplishments to date are not eroded and move on with new projects that will continue to enhance access to justice.
TC: As a final note, I am delighted that Beverley McLachlin has also agreed to take over this space. Beginning in January, she will be a regular contributor on access to justice. Next year is shaping up to be an exciting new phase of the ongoing efforts to improve access to justice in Canada.
The Honourable Thomas Cromwell served 19 years as an appellate judge and until recently chaired the Chief Justice's Action Committee on Access to Justice in Civil and Family Matters. He retired from the Supreme Court of Canada in September of 2016 and is now senior counsel to the national litigation practice at Borden Ladner Gervais.
The Right Honourable Beverley McLachlin served as chief justice of Canada from 2000 to mid-December 2017. She now works as an arbitrator and mediator in Canada and internationally and also sits as a justice of Singapore's International Commercial Court and the Hong Kong Final Court of Appeal. She chairs the Action Committee on Access to Justice in Civil and Family Matters.
This article originally appeared on The Lawyer's Daily on December 19, 2018.
De grands changements s'opèrent au Comité d'action sur l'accès à la justice en matière civile et familiale (le Comité d'action). Ce mois-ci, l'ancienne juge en chef Beverly McLachlin est devenue présidente du Comité d'action, qu'elle avait créé il y a une dizaine d'années.
Le juge en chef du Canada, Richard Wagner, a accepté d'assumer le rôle de président honoraire, poursuivant ainsi l'usage instauré par sa prédécesseure. Les juges Elizabeth Corte et Mark Benton occupent les fonctions de vice-présidents. Avec l'aide de la Fondation du droit de l'Ontario et de la Law Foundation of British-Columbia, le Comité d'action prépare un plan de transition, un plan stratégique ainsi qu'un plan de gouvernance, qui seront tous présentés et débattus à l'occasion du sommet annuel du Comité d'action au début du printemps prochain. Par ailleurs, aucun effort n'est ménagé pour promouvoir les Objectifs de développement en matière de justice au Canada et produire des rapports à cet égard.
J'ai récemment eu l'occasion de m'entretenir avec l'ancienne juge en chef McLachlin au sujet de ses souhaits et de ses projets pour le Comité d'action sous sa présidence. Voici ce qu'elle avait à dire à ce propos :
Thomas Cromwell (TC) : Quelles étaient vos attentes lorsque vous avez créé le Comité d'action à l'automne 2008 et, depuis, comment ses travaux répondent-ils à ces attentes?
Beverly McLachlin (BM) : Je souhaitais entamer une discussion sur l'accès à la justice à laquelle participeraient les principaux intervenants de partout au pays et de tous les secteurs – de la communauté juridique, des gouvernements, des tribunaux, des organisations non gouvernementales et des universités – en vue d'examiner les obstacles et de trouver des moyens de les éliminer et d'améliorer l'accès à la justice pour la population.
Les réalisations du Comité d'action ont largement dépassé mes attentes. La vaste discussion nationale que j'espérais a été amorcée, et de nombreuses idées nouvelles sur la manière d'améliorer l'accès à la justice ont vu le jour.
Le niveau d'engagement a aussi grandement dépassé mes attentes. Par conséquent, de nouvelles idées novatrices ont été mises en œuvre – des idées qui améliorent concrètement l'accès des Canadiens à la justice. Lorsque nous avons formé le Comité d'action en 2008, je ne pensais pas qu'il donnerait lieu à un dialogue si fructueux, et encore moins à des résultats réels.
TC : Selon vous, quels sont les changements les plus urgents pour améliorer l'accès à la justice?
BM : Je crois que le plus urgent est de faire évoluer les mentalités chez le public et le gouvernement. Au lieu de considérer la justice comme une chose accessoire ou comme quelque chose que les avocats et les gouvernements sont obligés de soutenir à contrecœur, nous devrions reconnaître que 1) l'accès à la justice sous toutes ses formes constitue l'indicateur d'une société juste et 2) le fait de faciliter l'accès à la justice – fournir aux gens de l'aide juridique, des services de consultation juridique et plus – se traduira par une baisse des frais d'incarcération et de justice ainsi que par une hausse de la productivité des citoyens. Il s'agit d'une stratégie à la fois juste et sensée.
TC : Quel avenir espérez-vous pour le Comité d'action et que souhaitez-vous qu'il accomplisse sous votre présidence?
BM : Les femmes et les hommes passionnés qui ont travaillé au sein du Comité d'action au cours de la dernière décennie ont réalisé beaucoup de choses et jeté de solides bases pour faire face aux défis complexes qui restent à relever pour assurer l'accès à la justice pour tous. J'espère que nous serons en mesure d'établir une organisation-cadre permanente pour nourrir la réflexion novatrice, veiller à ce que les réalisations à ce jour ne soient pas menacées et aller de l'avant avec de nouveaux projets qui continueront d'améliorer l'accès à la justice.
TC : Pour conclure, je suis ravi que Beverley McLachlin ait également accepté de reprendre le flambeau. À compter de janvier, elle sera une collaboratrice régulière en matière d'accès à la justice. La prochaine année s'annonce comme une nouvelle étape emballante dans les efforts soutenus pour améliorer l'accès à la justice au Canada.
L'honorable Thomas Cromwell a été juge d'appel pendant 19 ans et, jusqu'à tout récemment, a présidé le Comité d'action sur l'accès à la justice en matière civile et familiale créé par la juge en chef. Il a pris sa retraite de la Cour suprême du Canada en septembre 2016 et agit désormais comme avocat-conseil principal au sein du groupe national des litiges chez Borden Ladner Gervais.
La très honorable Beverley McLachlin a été juge en chef du Canada de 2000 jusqu'à la mi‑décembre 2017. Elle travaille maintenant comme arbitre et médiatrice au Canada et à l'étranger. Elle siège également à la Cour commerciale internationale de Singapour et au Tribunal d'appel de dernière instance de Hong Kong. Elle préside le Comité d'action sur l'accès à la justice en matière civile et familiale.
Access to Justice: Highs and Lows of Pro Bono Week
November 7, 2018 November 7, 2018 ajrn1	Leave a comment
By Thomas Cromwell
The last week of October is Pro Bono Week, a global celebration of the pro bono ethic in our profession. Across Canada and around the world, thousands of legal professionals provide their services without cost for the public good. In Canada, where there is a wide and growing gap between the need for legal services and people's ability to gain access to them, pro bono is a part of the effort necessary to fill that gap.
We entered Pro Bono Week on a wave of optimism and achievement generated by the Seventh National Pro Bono Conference held in Vancouver on Oct. 4 and 5. The packed agenda included presentations by the chief justice of Canada, the chief justice of British Columbia, the attorney general of British Columbia and the president of the American College of Trial Lawyers.
The message from the top was clear: pro bono work by lawyers is part of our professional responsibility and its importance to the welfare of our community cannot be overstated. The large attendance at the conference and the lively engagement evident in all of the sessions generated optimism and enthusiasm.
While we can and must do more, there is much to celebrate.
But not all of the news about pro bono is good. Pro Bono Ontario (PBO) has indicated that in December it will have to close its court-based programs — two in Toronto and one in Ottawa — for want of funding for the administrative support essential to running these programs. PBO says that each year, volunteer lawyers help more than 18,000 clients in the civil, non-family justice system and, at the same time, reduce delays in the courts' handling of these matters. An evaluation of the programs concluded that they provided a 10:1 return on investment. In other words, the public purse saved $10 for every dollar in funding. But that is apparently not enough to persuade potential funders to inject the modest resources needed to assure that these programs continue.
David W. Scott, one of the "parents" of these programs, has for many years spent a morning each month at the Law Help Centre at the Ottawa courthouse. He told me that during his October shift, he saw five people:
a single mother who is being pursued by a government department for support payments;
a friend of an Arabic woman who speaks no English who is defending herself from a landlord's claim for rent;
a young man on parole who was the victim of a fraudulent claim when he was incarcerated;
a young mother who was being sued for return of employment insurance; and
a woman being sued for alleged non-payment of taxes.
Through the court-based program, David was able to provide modest but critical help. The closure of the Law Help Centre will mean that people like those who David saw — people in their thousands — will be left to their own devices. The need for these services is obvious and compelling.
The willingness of legal professionals to provide these pro bono services has been demonstrated. The business case for doing so seems unanswerable. But even this is not enough to save these programs.
Scott says that he is heartbroken. The rest of us should be ashamed. Who can seriously contend that we cannot find the modest resources needed to maintain these valuable services? If we wanted to, we would.
This article originally appeared on The Lawyer's Daily on November 5, 2018. It is the twelfth article in The Honourable Thomas Cromwell's exclusive Lawyer's Daily column dedicated to access to civil and family justice.
The Honourable Thomas Cromwell served 19 years as an appellate judge and chairs the Chief Justice's Action Committee on Access to Justice in Civil and Family Matters. He retired from the Supreme Court of Canada in September of 2016 and is now senior counsel to the national litigation practice at Borden Ladner Gervais.
Access to Justice Week Begins Soon in Saskatchewan and Ontario
October 19, 2018 October 19, 2018 ajrn1	Leave a comment
Saskatchewan's second annual Access to Justice Week will run from October 20 – 26, 2018. The week will include discussions and activities that will engage different actors in the access to justice conversation as well as highlight projects and programs that aim to improve access to justice for all Saskatchewan residents. The week-long events will build on themes from the University of Saskatchewan College of Law's 2017 Dean's Forum on Access to Justice and Dispute Resolution and will include:
Legal information, Legal Advice, and Access to Justice; and
Expanding Engagement: Creating Connections
Learn more about Access to Justice Week in Saskatchewan here: https://law.usask.ca/createjustice/saskatchewan-access-to-justice-week.php. For a list of events scheduled for the 2018 Saskatchewan Access to Justice Week, visit: https://law.usask.ca/createjustice/A2J2018-AtAGlance.pdf.
Monday, October 22, 2018 marks the start of the third annual Access to Justice Week in Ontario, hosted by The Action Group on Access to Justice (TAG). The week will include a range of sessions including:
Mental Health – Access and Ethics
Indigenous Language Speakers and the Canadian Justice System
Addressing the Access to Legal Representation Gap in Family Law; and
Justice, Innovation and Community
Visit the TAG Access to Justice Week webpage for information on the sessions and to register to attend events by webcast or in person: https://theactiongroup.ca/access-to-justice-week/.
Canadian Forum on Civil Justice Publishes New Cost of Justice Reports
October 3, 2018 October 3, 2018 ajrn1	Leave a comment
The Canadian Forum on Civil Justice (CFCJ) has published three new reports based on data from their national Everyday Legal Problems and the Cost of Justice in Canada study.
EVERYDAY LEGAL PROBLEMS AND THE COST OF JUSTICE IN CANADA – SURVEY DATA
The full data set from the CFCJ's Everyday Legal Problems and Cost of Justice of Justice in Canada survey is now available! As part of the CFCJ's national 7-year study on the Cost of Justice, over 3,000 adults in Canada were asked about their experiences with civil and family justice problems, the costs (monetary and non-monetary) of experiencing one or more civil or family justice problems and their views on the justice system.
The data from this national Cost of Justice survey has been published and is available on the CFCJ website here: http://cfcj-fcjc.org/wp-content/uploads/Everyday-Legal-Problems-and-the-Cost-of-Justice-in-Canada-Cost-of-Justice-Survey-Data.pdf.
EVERYDAY LEGAL PROBLEMS AND THE COST OF JUSTICE IN CANADA – INCOME
Is there a connection between annual household income and experiences of civil or family justice problems in Canada? A new Cost of Justice report is now available that includes data from the CFCJ's national Cost of Justice survey organized into three annual income groups: Less than $60,000, $60,000 – $125,000, and More than $125,000.
View the Everyday Legal Problems and the Cost of Justice in Canada – Income report on the CFCJ website here: http://cfcj-fcjc.org/wp-content/uploads/INCOME-Everyday-Legal-Problems-and-the-Cost-of-Justice-in-Canada.pdf.
EVERYDAY LEGAL PROBLEMS AND THE COST OF JUSTICE IN CANADA – SPENDING ON EVERYDAY LEGAL PROBLEMS
Almost 50% of people who experience an everyday legal problem spend some money trying to resolve their problem. Based on findings from the CFCJ's national Cost of Justice study, average spending on legal problems is approximately $6,100. That is almost as much as Canadian households spend on food in a year. The newly published Everyday Legal Problems and the Cost of Justice in Canada – Spending on Everyday Legal Problems report offers additional insights on monetary spending on civil and family justice problems based on demographic characteristics recorded in the CFCJ's Cost of Justice survey, as well as pathways used to try to resolve legal problems.
This new Cost of Justice report is available on the CFCJ website here: www.cfcj-fcjc.org/wp-content/uploads/SPENDING-Everyday-Legal-Problems-and-the-Cost-of-Justice-in-Canada.pdf.
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Not mentioned here before but DHs sister has been seriously ill for a while, but he's had the call this morning to say she's not going to last more than a couple of days at the most.
Obviously he can go to the funeral and I can keep running the business, I'd rather be there for him, but it's a two day trip.
It's peak season, we're fully book and so are most others, so what do we do. There's no-one we could get to carry on running the place full steam, I have wondered about getting someone to just house sit and tell the guests there'd be limited breakfast and give them discount. We could close up and try and find somewhere else for bookings, offer to pay the difference?
I wonder if any of you have been in similar situation and what you did?
Sorry this happened, but so glad you went in quickly. Some people wait and then it can't be repaired.
This will be a year to remember!
What a summer we've had.... as if the car crash and loosing DH's sister wasn't enough I ended up in hospital last week. That's why I've been quiet recently.
I've had problems with my eye since March, optician said it was a posterior vitreous detachment, apparently happens to lots of people as they get older, more so for the short sighted like me. Then I started seeing shadows at the bottom of my vision, ended up in A&E and they kept me in and operated the next morning, retina detachment. Had to lay on my back for 3 days, couldn't do much for a week. Worst possible month in the year for this to happen, poor DH had to do everything.
Had a checkup with the surgeon this week, all healed fine, so I'm back to normal now.
Yikes! Glad to turned out okay.
That's awful - hope your eyes are ok as they are so key to your entire life - also hugs to DH as I know how much of a close team you are and how busy your location is - he must be run ragged!
Doing this alone, these types of stories scare the beejeezus outta me. So glad you are doing ok now and sorry for your discomfort.
So happy to hear all is well again. Take care.
Wow! Glad you are better. That's scary stuff.
Wow that is scary . Glad to hear you are on the road. But try and take it slowly eye sight is so very important. Good thing it was caught on time. To DH good guy carrying the flag . It good to hear how we support each other when there is a problem . Good job well done.
Thank you everyone for your kind words, I took your advice, it has all been sorted.
The funeral is Monday next week, I have a friend who will house sit Monday night and do a light breakfast Tuesday morning. I have a group of 4 in but they are here for 3 nights leaving Tuesday and we had Tuesday blocked as a day off already.
Luckily the people who are checking out Monday morning are regulars and I've emailed and asked if they wouldn't mind an earlier check-out so we can turn their room around for the friend who's staying. They were fine.
So we'll do an earlier breakfast Monday, check two out, give keys the the remaining 4. Dash around and clean as much as possible, off to the airport leaving here at 10, funeral in the afternoon and then fly back Tuesday morning.
Well I can't believe this all worked. On Monday the regulars checked out by 9am, all the others had gone out for the day by 9.15.
That meant we could clear breakfast, get certain items washed and dried and the tables laid for breakfast on Tuesday morning. We also cleaned the vacated room ready for our friend to use last night.
Was out of here at 10am for a 11.30 flight. Arrived at families house at 1.30 for a 3.30 arrival of the funeral cars.
This morning we caught the 9.30 flight back and was home by 11.30. Spoke to friend who said it all went smoothly. I Gave folks a discount so they were happy, left a bottle of wine and a thank you note in the regulars room to say thanks for agreeing to check out early. So I think everyone was ok.
You did a great job pulling this together under stress. Glad it all worked out so you could be there for DH when he really needed you.
Happy to hear it came together.
You two are grace under pressure.
I'm glad things worked out as well as they did. Things like that do have a way of working out and hopefully you had enough family time while you were gone and can get some rest now that you are home.
Things happen the way they're supposed to. Glad it all worked out for you and sorry again for your loss.
So glad you got it sorted out so you could go. We try not to let the inn run us and it makes such a difference about how we feel about what we do.
My deepest condolences. I'm so glad you're ok. Cars can be replaced, but hearts take longer to heal. Take care of yourselves.
Our condolences. Sad news. And on top of a car accident. Your body and mind will ache, try to take it easy for some time, defer and delay. Wishing you the strength to sustain you during this difficult time.
so very sorry. i hope you have found someone to watch the place so you can go.
I'm adding my condolences. So sorry.
Hope you can take the time to rest both the soul and the body.
Trying to find a car I know can be hard . Hopefully all will fall into place quickly.
I'm glad you weren't more seriously injured in the accident. It sounds like it could have been much worse.
I'm very sorry for your loss, and that it comes at a time when your business is demanding. Hopefully you and your DH have found someone to run things in some manner so you can both get away.
This morning was the closest I've ever been to wanting to throw all the guests out and just shut the front door.
Yesterday we went out on one of our regular shopping trips after finishing the rooms, got half way into town and some idiot pulled out in front of us, hit him at 45mph. The car went off onto the bank on the other side of the road, thank heavens it didn't turn over and there was nothing coming the other way. We both got out, but dh hit his head and we both had aches in our ribs. Got taken by ambulance to the hospital and were checked over / had chest x-rays. both ok, just bruised. The car is a write-off.
And if that wasn't enough this morning whilst we're getting ready for breakfast dh had the call to say his sister passed during the night.
But we laughed with guests and carried on, now there all gone we both feel wretched.
Keeping you in our thoughts with an innkeepers' understanding. Very grateful you are not more seriously injured and sorry to hear you had to put on the face at such a difficult time.
So sorry for you both. Our thoughts and prayers are with you.
There is never a good time to be in an accident...but the timing of this one just adds to your misery. So sorry to hear of your loss and hope that life will look better soon.
So very sorry. Hugs to both of you.
I am so sorry for the loss of DH's sister. Please accept our condolences. It is difficult, even when one has had time to prepare.
Thankful that neither of you were HURT, just hurting. Cars can be replaced. Prayers are with you in this time of double turmoil.
How scary for you. I am so glad you were not hurt badly. And so very, very sorry for your loss. Hugs.
So sorry to hear. May your heart and soul find peace and comfort.
So glad you are both ok. My deepest sympathy to both of you.
Go if you can, but your partner will understand if it just can't happen.
Good guests will understand, send them each a nice note giving the set up you have arranged and if you know of a neighboring B&B that has availability share that as well, giving that as an option.
We have had this issue three times since being in the business, both times were trying but we managed with the help of our adult children. 1st time DH stayed behind while DS and I went for the last days of Mother's life, DH and DD joined us for the funeral. 2nd time DH and I had traveled to see Dad, within an hour after we got home (9hr drive) Dad had passed. Guests were coming in so DH stayed behind and DS and I attended funeral. The other time DD stayed and handled guests while DH and I went to his father's funeral.
While not all of us could attend we all did the best we could do under the circumstances. No regrets on how it was handled. You can have best laid plans but every day is different. You have been there for your partner and will remain that way and I am sure it is appreciated no matter what the final plan.
I have been thinking about this and you HJ, and hope you were able to sort it out and do whatever was best in your heart of hearts. This is when innkeeping is very difficult. We love you!
Late seeing the post, but we hope you sorted it out so you could do what you thought was best.
My DH just lost a brother and we had to sort it out quickly. We were prepared to go across the ocean if needed, but it turned out that several others were going and we could fill a role later that would be more helpful.
Pretty much like you were thinking and others have affirmed, we would have just had someone house sit a couple of nights and discounted the rooms.
GO. You won't regret it.
A few years ago my mother (89 yrs old) fell and broke her leg in FL. She lives alone in her own home and I am the one in charge of her. So there was no choice for me but to go. Fortunately my brother volunteered to go with me so DH could man the fort here with a full house. But if DH had come with me we would have hunted up a housekeeper/sitter, given the guests a voucher to a nearby restaurant for breakfast and hoped that they understood.
As it turned out, DH sent them out for breakfast and they were all just fine. He's not much of a housekeeper so in hindsight it might have been better to hire someone!
So sorry, HJ. I'm inclined to agree with the others who say go to the funeral. If circumstances don't work out, remember not to beat yourself up. We love you, and I'm sure your partner will understand.
If you can get a friend or housesitter, do it. The guests are people you do not know and all you need to do is give them the bed they need and something to call breakfast. Yes, do the discount but do not stress one moment more about it. You and your DH are the important part of this equation. YOU NEED to be there for DH. Period. People come and go - some are nice and some are pissants. Family FIRST.
Condolences to both of you. Bring there for each other is important - that is why you ARE together.
Twice I had to get friends to cover - not funerals (my family timed things better - Mom before we opened and Daddy when we were brand new and not busy. And his siblings did not even tell us about Ma until 3 months AFTER she died) - but for his 40 year class reunion and then when my son got married. The first was a full-house for a football game and never heard from any of them again. The second one refused to do both nights of the package at the other B & B - even when I told them I watched my son being born and I was going to be there to watch him "die" as he got married. No regrets - Family first. I am sorry it is under these circumstances - go and let everything else sort itself out.
If you can get the house/guest sitter, then go! I really do think that's better than finding other arrangements for them. My deepest sympathy to you and your DH. I know what a stressful time this can be for both of you.
I would go with DH or I'd regret not doing so forever to support him. I just saw how much my sister supported my brother-in-law at the funeral of his Dad last week. If you can get a house sitter, do so and go. Since everything is booked up, people will probably be quite happy that you don't cancel them.
If I had to do this, I'd go get $30 gift certificates for my local diner and leave one in each room so they can get breakfast there for each day you'll be gone. (NO BIG ROOM DISCOUNT, after all you're not canceling on them, just reducing breakfast which isn't worth a 1/2 price discount.) I'd have the house sitter put out coffee and I'd pre bake some scones and muffins and put out a bowl of fruit and maybe a bowl of ice holding some packaged yogurts. Those that want to use the GC can and get a full breakfast and those who are fine with the limited choice will be happy too.
I like the idea of the GC for breakfast nearby. We've done that when the power is out here.
So sorry for you and your DH. Go and support him and the family. If you can get a housesitter, that will be good. At least you won't have to cancel reservations. But a discount would be good for them. As long as they have a bed to sleep in most folks should be very understanding given the situation.
I say go with him. Get someone to house sit and give the guest atleast a place to stay. (they can always go somewhere to eat) Prayers for your family.
If you can get someone to house sit and do the limited breakfast and give a discount I would go that way. With a head's up most guests understand that life happens.
You want to spend the least time sorting this out as possible.
If someone balks and you know of an opening elsewhere send them there and pick up the difference.


text:
Q: PHP touch() is not affected by file permissions? I have setup a demo "admin" website with all file permissions set to 555 for directories and 444 for files so that any "save" functionality is disabled. So far so good.
However, I noticed that the PHP touch() function is unaffected by file permissions? I am successfully running PHP touch() on directories that have no-WRITE permissions (555). Seems a bit odd. Is this intended behavior (PHP 7.2)?
I am trying to prevent touch() from being able to execute (via file permissions), but can't currently see how this is possible.
Thanks.

A: From the utimes(3) documentation:

The effective user ID of the process shall match the owner of the file, or has write access to the file or appropriate privileges to use this call in this manner.

So the owner can update the timestamps even without write access. You need to change the ownership of the files so they're not the same as the user running the PHP script.
If this is a problem, maybe you should use some other method to keep track of changes that the file modification times.

redpajama_set_name: RedPajamaStackExchange


text:
Violino o Cornetto
Cima Sonata per violino o cornetto
Frescobaldi Canzona terza
Castello Sonata seconda
Marini Sonata per sonar
Marini Sonata o cornetto
Uccellini Sonata Quinta
Stradella Sinfonia in F
Corelli Sonata in G minor I
Corelli Sonata in G minor V
Ask a question about this CD
NI6134
This recording explores the rise and development of the solo sonata in Italy, the land of its origin. In the early part of the seventeenth century the violin and cornett were considered virtually interchangeable and were equally prized for both their expressive and virtuosic capabilities. Early sonatas were composed with either instrument in mind and many were published with the written instruction "violino o cornetto". As the century progressed the violin gradually gained supremacy over the cornett and composers, often violinists themselves, wrote in an increasingly idiomatic style for the violin. Uniquely in modern times, Theresa Caudle plays both instruments and with the varied continuo team of her ensemble Canzona produces an abundance of instrumental colours and array of styles in this musical journey through the seventeenth century
"With its interesting and informative notes, its vivid recorded sound, its compelling performances, its embarrassment of textural riches, and its captivating premise, the recital deserves a place in every violin collection."
As the booklet notes by Theresa Caudle and Peter Leech explain in 19 pages of fine detail, Theresa Caudle and Canzona (including Mark Caudle playing bass violin and cello, Alastair Ross playing organ and harpsichord, and David Miller playing chitarrone) provide a 17th-century snapshot of the violin just as it peered out from behind the formerly predominant cornett. Often, the ensemble pairs sonatas, as at the beginning, with the cornett taking the lead in the first of Giovanni Paolo Cima's sonatas and the violin in the second. In such instances, it's easy to hear why the titles of the pieces often gave performers a choice ("violino o cornetto"). In fact, though, listening to the two instruments seratim like this strongly suggests the question of why some early period instrumentalists characterized the violin as a pinched, abrasive poor relation of its modern descendent. Theresa Caudle, who plays both cornett and violin on the recording, brings some of the commanding nobility of the cornett in the first Cima sonata to her playing of the second one on violin, although her violin (made by Paul Denley in the style of Giovanni Paolo Maggini) still sounds very reedy compared to her rounded tone on the cornett. Some of the power of the two performances derives from Mark Caudle's strong-minded characterization of the bass line on bass violin.
The next set pairs two canzonas by Girolamo Frescobaldi from his first book in 1628 of pieces by that title. Theresa Caudle plays the first of these, "La Lucchesina," on cornett, accompanied by organ and chitarrone, and the second, "La Bernadina," on violin supported only by harpsichord. Next come two sonatas, this time written by two different composers: the first by Giovanni Battista Fontana (Sonata Prima, 1641), played on cornett, and the second by Dario Castello, performed on violin and organ ( Sonata seconda a soprano solo , 1629). Caudle brings a heady virtuosic sense to Fontana's work, evidenced in the occasional run, but also a dignified sensitivity, and she engages in intelligent dialogue with David Miller. Although Castello's sonata doesn't specify the violin in its title, Caudle's performance on that instrument makes it seem as though the string instrument has an edge due in part to the sprightliness of her passagework.
The next pair of works begins with violin rather than cornett: Biagio Marini's Sonata per sonar con due corde from 1626. This sonata, lasting almost nine minutes, represents an early employment of double-stops, a technique that sets the violin apart technically from its wind alternate. Caudle plays it with harpsichord only; the violin's relative acrobatics perhaps require less support. The second sonata by Marini, from 1655, sounds more solemn, not only in presentation on cornett but also in its musical manner.
Although his Sonata Quinta (1649) may not seem altogether idiomatic to the violin, Marco Uccellini often figured in textbooks on music history (or the history of the violin) for his employment of the instrument's upper ranges. Arcangelo Corelli, who followed, reined in some of Uccellini's technical imagination; those who, beginning with Corelli, missed Uccellini and the Germans (Heinrich Franz von Biber, Johann Heinrich Schmelzer, and Johann Jakob Walther) have perhaps taken Corelli as a technical consolidator rather than as a technical reactionary. Caudle pairs Uccellini's work, in a way, with Maurizio Cazzati's Sonata Prima, "La Pellicana" (1670). This sonata, with its Christological reference, according to the notes, could have been intended for performance at Mass on Corpus Christi. The ensemble contrasts these works, so different in their effect, by giving Uccellini's on violin and harpsichord and Cazzati's on the sonorous combination of violin, bass violin, and organ.
The rest of the program, performed on violin, contains two sinfonias (in F Major and D Minor, the first accompanied only by harpsichord and the second by violin and organ) by Alessandro Stradella. In the first, Caudle plays the rapid movement with a buoyancy that wouldn't seem to have been possible on the cornett. But in the sterner second, the greater weight of the first movement and the succeeding lively fuguelike interchanges in which the two Caudles engage still might have been possible, at least musically, if not technically, on the cornett. In the fifth sonata from Corelli's influential op. 5, performers and listeners pass through the gates into fully idiomatic writing for the violin (though it might have been interesting to hear one of Corelli's aristocratic slow movements on cornett as a basis for comparison).
Most violinists and aficionados of the violin literature really shouldn't miss the opportunity Theresa Caudle and Canzona have provided to witness the violin come of age (and engage in a sort of expressive contest—perhaps to the death—with its precursor). As the recital makes clear, the outcome in the earliest works may not have been entirely certain, but by the time of Corelli's sonatas, a victor had clearly emerged, at least for the music of that time. With its interesting and informative notes, its vivid recorded sound, its compelling performances, its embarrassment of textural riches, and its captivating premise, the recital deserves a place in every violin collection - at least.
Robert Maxham, Fanfare Magazine

redpajama_set_name: RedPajamaCommonCrawl


It's time for the Disney Wordless Wednesday Blog Hop and this week's theme is Celebrations! I'm about to get all wordy LOL…This takes me back to our first trip in September 2011. We were celebrating our belated honeymoon and 1 year anniversary with a WDW vacation. We arrived on a Sunday which was our actual anniversary.
We spent the afternoon/evening at Hollywood Studios where my husband persuaded me to ride Tower of Terror. I was all starry eyed and said yes…ha, will never, ever step foot on it again. Thankfully we do not have the picture to prove how terrified I was but here is a nice before picture!
Also on that trip, we celebrated at Shula's. This was a huge treat for us. The few years before this were rough financially so this was a "we made it" dinner celebrating all of our milestones.
Today I am recapping Day 3 of our April/May trip to Disney World! This was a super exciting day for me because I got to see my friend, Connie, again and I got to see the new Stampin' Up! catalog that was unveiled to demos a few days before at a movie premiere.
We started off with breakfast at our hotel's food court and then hopped the bus to Animal Kingdom for the Extra Magic Hour. Once inside, we raced towards Kilimanjaro Safaris.
Then we road Primeval Whirl…it's a spinning coaster, NOT a fan of that ride and will not do it again! I needed some time to settle my stomach so we went on Triceratop Spin next, which is similar to Dumbo. Just my speed LOL! We got in line to meet Goofy & Pluto next but the line started getting quite long so we ducked (ha, ha) out to meet Donald Duck who was behind their area. There was no organization whatsoever so everyone was just standing around waiting when this cast member came along and drew Mickey with water. It was pretty cool!
We headed over to the Asia area of the park so Mike could ride Expedition Everest. I tried it on our first trip and won't ride it again LOL!
While Mike was on the ride, I walked over to Flame Tree Barbeque to meet Connie. I ended up taking the scenic route LOL so it took a bit to find her. Thank goodness for cell phones! We found a table and she told me all about the premiere and showed me the catalog. Mike came and joined us for lunch which was delicious but scary! The birds around there are very aggressive and have no problems with trying to steal food. I didn't like being "on guard" the whole time.
We had some time before our Finding Nemo Musical show, so we saw the Tough to be a Bug show and then walked the Pangani Forest Exploration Trail.
Connie joined us for a little while at the Finding Nemo show and then had to leave. It was so fun to walk around the park with her. Usually we only have time for a quick lunch or dinner.
We took the bus to Animal Kingdom Lodge to check it out before going to Downtown Disney. What a gorgeous resort! I fell in love with the lobby, so many details to look and a nice place just to hang out. It was pouring rain by this point so no animals were out in the viewing areas.
The next recap will be our dinner at Bongo's and time spent at Downtown Disney!


text:
package android.support.v4.widget;

import android.content.Context;
import android.graphics.Rect;
import android.os.Bundle;
import android.support.v4.view.AccessibilityDelegateCompat;
import android.support.v4.view.MotionEventCompat;
import android.support.v4.view.ViewCompat;
import android.support.v4.view.ViewParentCompat;
import android.support.v4.view.accessibility.AccessibilityEventCompat;
import android.support.v4.view.accessibility.AccessibilityManagerCompat;
import android.support.v4.view.accessibility.AccessibilityNodeInfoCompat;
import android.support.v4.view.accessibility.AccessibilityNodeProviderCompat;
import android.support.v4.view.accessibility.AccessibilityRecordCompat;
import android.view.MotionEvent;
import android.view.View;
import android.view.ViewParent;
import android.view.accessibility.AccessibilityEvent;
import android.view.accessibility.AccessibilityManager;

import java.util.LinkedList;
import java.util.List;

/**
 * ExploreByTouchHelper is a utility class for implementing accessibility
 * support in custom {@link View}s that represent a collection of View-like
 * logical items. It extends {@link AccessibilityNodeProviderCompat} and
 * simplifies many aspects of providing information to accessibility services
 * and managing accessibility focus. This class does not currently support
 * hierarchies of logical items.
 *

 * Clients should override abstract methods on this class and attach it to the
 * host view using {@link ViewCompat#setAccessibilityDelegate}:
 *
 *

 * mAccessHelper = new MyExploreByTouchHelper(someView);
 * ViewCompat.setAccessibilityDelegate(someView, mAccessHelper);
 *

 */
public abstract class ExploreByTouchHelper extends AccessibilityDelegateCompat {
    /** Virtual node identifier value for invalid nodes. */
    public static final int INVALID_ID = Integer.MIN_VALUE;

    /** Virtual node identifier value for the host view's node. */
    public static final int HOST_ID = View.NO_ID;

    /** Default class name used for virtual views. */
    private static final String DEFAULT_CLASS_NAME = View.class.getName();

    // Temporary, reusable data structures.
    private final Rect mTempScreenRect = new Rect();
    private final Rect mTempParentRect = new Rect();
    private final Rect mTempVisibleRect = new Rect();
    private final int[] mTempGlobalRect = new int[2];

    /** System accessibility manager, used to check state and send events. */
    private final AccessibilityManager mManager;

    /** View whose internal structure is exposed through this helper. */
    private final View mView;

    /** Node provider that handles creating nodes and performing actions. */
    private ExploreByTouchNodeProvider mNodeProvider;

    /** Virtual view id for the currently focused logical item. */
    private int mFocusedVirtualViewId = INVALID_ID;

    /** Virtual view id for the currently hovered logical item. */
    private int mHoveredVirtualViewId = INVALID_ID;

    /**
     * Factory method to create a new {@link ExploreByTouchHelper}.
     *
     * @param forView View whose logical children are exposed by this helper.
     */
    public ExploreByTouchHelper(View forView) {
        if (forView == null) {
            throw new IllegalArgumentException("View may not be null");
        }

        mView = forView;
        final Context context = forView.getContext();
        mManager = (AccessibilityManager) context.getSystemService(Context.ACCESSIBILITY_SERVICE);
    }

    /**
     * Returns the {@link AccessibilityNodeProviderCompat} for this helper.
     *
     * @param host View whose logical children are exposed by this helper.
     * @return The accessibility node provider for this helper.
     */
    @Override
    public AccessibilityNodeProviderCompat getAccessibilityNodeProvider(View host) {
        if (mNodeProvider == null) {
            mNodeProvider = new ExploreByTouchNodeProvider();
        }
        return mNodeProvider;
    }

    /**
     * Dispatches hover {@link MotionEvent}s to the virtual view hierarchy when
     * the Explore by Touch feature is enabled.
     *

     * This method should be called by overriding
     * {@link View#dispatchHoverEvent}:
     *
     *
@Override
     * public boolean dispatchHoverEvent(MotionEvent event) {
     *   if (mHelper.dispatchHoverEvent(this, event) {
     *     return true;
     *   }
     *   return super.dispatchHoverEvent(event);
     * }
     *

     *
     * @param event The hover event to dispatch to the virtual view hierarchy.
     * @return Whether the hover event was handled.
     */
    public boolean dispatchHoverEvent(MotionEvent event) {
        if (!mManager.isEnabled()
                || !AccessibilityManagerCompat.isTouchExplorationEnabled(mManager)) {
            return false;
        }

        switch (event.getAction()) {
            case MotionEventCompat.ACTION_HOVER_MOVE:
            case MotionEventCompat.ACTION_HOVER_ENTER:
                final int virtualViewId = getVirtualViewAt(event.getX(), event.getY());
                updateHoveredVirtualView(virtualViewId);
                return (virtualViewId != INVALID_ID);
            case MotionEventCompat.ACTION_HOVER_EXIT:
                if (mFocusedVirtualViewId != INVALID_ID) {
                    updateHoveredVirtualView(INVALID_ID);
                    return true;
                }
                return false;
            default:
                return false;
        }
    }

    /**
     * Populates an event of the specified type with information about an item
     * and attempts to send it up through the view hierarchy.
     *

     * You should call this method after performing a user action that normally
     * fires an accessibility event, such as clicking on an item.
     *
     *
public void performItemClick(T item) {
     *   ...
     *   sendEventForVirtualViewId(item.id, AccessibilityEvent.TYPE_VIEW_CLICKED);
     * }
     *

     *
     * @param virtualViewId The virtual view id for which to send an event.
     * @param eventType The type of event to send.
     * @return true if the event was sent successfully.
     */
    public boolean sendEventForVirtualView(int virtualViewId, int eventType) {
        if ((virtualViewId == INVALID_ID) || !mManager.isEnabled()) {
            return false;
        }

        final ViewParent parent = mView.getParent();
        if (parent == null) {
            return false;
        }

        final AccessibilityEvent event = createEvent(virtualViewId, eventType);
        return ViewParentCompat.requestSendAccessibilityEvent(parent, mView, event);
    }

    /**
     * Notifies the accessibility framework that the properties of the parent
     * view have changed.
     *

     * You must call this method after adding or removing items from the
     * parent view.
     */
    public void invalidateRoot() {
        invalidateVirtualView(HOST_ID);
    }

    /**
     * Notifies the accessibility framework that the properties of a particular
     * item have changed.
     *

     * You must call this method after changing any of the properties set
     * in {@link #onPopulateNodeForVirtualView}.
     *
     * @param virtualViewId The virtual view id to invalidate.
     */
    public void invalidateVirtualView(int virtualViewId) {
        sendEventForVirtualView(
                virtualViewId, AccessibilityEventCompat.TYPE_WINDOW_CONTENT_CHANGED);
    }

    /**
     * Returns the virtual view id for the currently focused item,
     *
     * @return A virtual view id, or {@link #INVALID_ID} if no item is
     *         currently focused.
     */
    public int getFocusedVirtualView() {
        return mFocusedVirtualViewId;
    }

    /**
     * Sets the currently hovered item, sending hover accessibility events as
     * necessary to maintain the correct state.
     *
     * @param virtualViewId The virtual view id for the item currently being
     *            hovered, or {@link #INVALID_ID} if no item is hovered within
     *            the parent view.
     */
    private void updateHoveredVirtualView(int virtualViewId) {
        if (mHoveredVirtualViewId == virtualViewId) {
            return;
        }

        final int previousVirtualViewId = mHoveredVirtualViewId;
        mHoveredVirtualViewId = virtualViewId;

        // Stay consistent with framework behavior by sending ENTER/EXIT pairs
        // in reverse order. This is accurate as of API 18.
        sendEventForVirtualView(virtualViewId, AccessibilityEventCompat.TYPE_VIEW_HOVER_ENTER);
        sendEventForVirtualView(
                previousVirtualViewId, AccessibilityEventCompat.TYPE_VIEW_HOVER_EXIT);
    }

    /**
     * Constructs and returns an {@link AccessibilityEvent} for the specified
     * virtual view id, which includes the host view ({@link #HOST_ID}).
     *
     * @param virtualViewId The virtual view id for the item for which to
     *            construct an event.
     * @param eventType The type of event to construct.
     * @return An {@link AccessibilityEvent} populated with information about
     *         the specified item.
     */
    private AccessibilityEvent createEvent(int virtualViewId, int eventType) {
        switch (virtualViewId) {
            case HOST_ID:
                return createEventForHost(eventType);
            default:
                return createEventForChild(virtualViewId, eventType);
        }
    }

    /**
     * Constructs and returns an {@link AccessibilityEvent} for the host node.
     *
     * @param eventType The type of event to construct.
     * @return An {@link AccessibilityEvent} populated with information about
     *         the specified item.
     */
    private AccessibilityEvent createEventForHost(int eventType) {
        final AccessibilityEvent event = AccessibilityEvent.obtain(eventType);
        ViewCompat.onInitializeAccessibilityEvent(mView, event);
        return event;
    }

    /**
     * Constructs and returns an {@link AccessibilityEvent} populated with
     * information about the specified item.
     *
     * @param virtualViewId The virtual view id for the item for which to
     *            construct an event.
     * @param eventType The type of event to construct.
     * @return An {@link AccessibilityEvent} populated with information about
     *         the specified item.
     */
    private AccessibilityEvent createEventForChild(int virtualViewId, int eventType) {
        final AccessibilityEvent event = AccessibilityEvent.obtain(eventType);
        event.setEnabled(true);
        event.setClassName(DEFAULT_CLASS_NAME);

        // Allow the client to populate the event.
        onPopulateEventForVirtualView(virtualViewId, event);

        // Make sure the developer is following the rules.
        if (event.getText().isEmpty() && (event.getContentDescription() == null)) {
            throw new RuntimeException("Callbacks must add text or a content description in "
                    + "populateEventForVirtualViewId()");
        }

        // Don't allow the client to override these properties.
        event.setPackageName(mView.getContext().getPackageName());

        final AccessibilityRecordCompat record = AccessibilityEventCompat.asRecord(event);
        record.setSource(mView, virtualViewId);

        return event;
    }

    /**
     * Constructs and returns an {@link AccessibilityNodeInfoCompat} for the
     * specified virtual view id, which includes the host view
     * ({@link #HOST_ID}).
     *
     * @param virtualViewId The virtual view id for the item for which to
     *            construct a node.
     * @return An {@link AccessibilityNodeInfoCompat} populated with information
     *         about the specified item.
     */
    private AccessibilityNodeInfoCompat createNode(int virtualViewId) {
        switch (virtualViewId) {
            case HOST_ID:
                return createNodeForHost();
            default:
                return createNodeForChild(virtualViewId);
        }
    }

    /**
     * Constructs and returns an {@link AccessibilityNodeInfoCompat} for the
     * host view populated with its virtual descendants.
     *
     * @return An {@link AccessibilityNodeInfoCompat} for the parent node.
     */
    private AccessibilityNodeInfoCompat createNodeForHost() {
        final AccessibilityNodeInfoCompat node = AccessibilityNodeInfoCompat.obtain(mView);
        ViewCompat.onInitializeAccessibilityNodeInfo(mView, node);

        // Allow the client to populate the host node.
        onPopulateNodeForHost(node);

        // Add the virtual descendants.
        final LinkedList<Integer> virtualViewIds = new LinkedList<Integer>();
        getVisibleVirtualViews(virtualViewIds);

        for (Integer childVirtualViewId : virtualViewIds) {
            node.addChild(mView, childVirtualViewId);
        }

        return node;
    }

    /**
     * Constructs and returns an {@link AccessibilityNodeInfoCompat} for the
     * specified item. Automatically manages accessibility focus actions.
     *

     * Allows the implementing class to specify most node properties, but
     * overrides the following:
     *

     *
{@link AccessibilityNodeInfoCompat#setPackageName}
     *
{@link AccessibilityNodeInfoCompat#setClassName}
     *
{@link AccessibilityNodeInfoCompat#setParent(View)}
     *
{@link AccessibilityNodeInfoCompat#setSource(View, int)}
     *
{@link AccessibilityNodeInfoCompat#setVisibleToUser}
     *
{@link AccessibilityNodeInfoCompat#setBoundsInScreen(Rect)}
     *

     *

     * Uses the bounds of the parent view and the parent-relative bounding
     * rectangle specified by
     * {@link AccessibilityNodeInfoCompat#getBoundsInParent} to automatically
     * update the following properties:
     *

     *
{@link AccessibilityNodeInfoCompat#setVisibleToUser}
     *
{@link AccessibilityNodeInfoCompat#setBoundsInParent}
     *

     *
     * @param virtualViewId The virtual view id for item for which to construct
     *            a node.
     * @return An {@link AccessibilityNodeInfoCompat} for the specified item.
     */
    private AccessibilityNodeInfoCompat createNodeForChild(int virtualViewId) {
        final AccessibilityNodeInfoCompat node = AccessibilityNodeInfoCompat.obtain();

        // Ensure the client has good defaults.
        node.setEnabled(true);
        node.setClassName(DEFAULT_CLASS_NAME);

        // Allow the client to populate the node.
        onPopulateNodeForVirtualView(virtualViewId, node);

        // Make sure the developer is following the rules.
        if ((node.getText() == null) && (node.getContentDescription() == null)) {
            throw new RuntimeException("Callbacks must add text or a content description in "
                    + "populateNodeForVirtualViewId()");
        }

        node.getBoundsInParent(mTempParentRect);
        if (mTempParentRect.isEmpty()) {
            throw new RuntimeException("Callbacks must set parent bounds in "
                    + "populateNodeForVirtualViewId()");
        }

        final int actions = node.getActions();
        if ((actions & AccessibilityNodeInfoCompat.ACTION_ACCESSIBILITY_FOCUS) != 0) {
            throw new RuntimeException("Callbacks must not add ACTION_ACCESSIBILITY_FOCUS in "
                    + "populateNodeForVirtualViewId()");
        }
        if ((actions & AccessibilityNodeInfoCompat.ACTION_CLEAR_ACCESSIBILITY_FOCUS) != 0) {
            throw new RuntimeException("Callbacks must not add ACTION_CLEAR_ACCESSIBILITY_FOCUS in "
                    + "populateNodeForVirtualViewId()");
        }

        // Don't allow the client to override these properties.
        node.setPackageName(mView.getContext().getPackageName());
        node.setSource(mView, virtualViewId);
        node.setParent(mView);

        // Manage internal accessibility focus state.
        if (mFocusedVirtualViewId == virtualViewId) {
            node.setAccessibilityFocused(true);
            node.addAction(AccessibilityNodeInfoCompat.ACTION_CLEAR_ACCESSIBILITY_FOCUS);
        } else {
            node.setAccessibilityFocused(false);
            node.addAction(AccessibilityNodeInfoCompat.ACTION_ACCESSIBILITY_FOCUS);
        }

        // Set the visibility based on the parent bound.
        if (intersectVisibleToUser(mTempParentRect)) {
            node.setVisibleToUser(true);
            node.setBoundsInParent(mTempParentRect);
        }

        // Calculate screen-relative bound.
        mView.getLocationOnScreen(mTempGlobalRect);
        final int offsetX = mTempGlobalRect[0];
        final int offsetY = mTempGlobalRect[1];
        mTempScreenRect.set(mTempParentRect);
        mTempScreenRect.offset(offsetX, offsetY);
        node.setBoundsInScreen(mTempScreenRect);

        return node;
    }

    private boolean performAction(int virtualViewId, int action, Bundle arguments) {
        switch (virtualViewId) {
            case HOST_ID:
                return performActionForHost(action, arguments);
            default:
                return performActionForChild(virtualViewId, action, arguments);
        }
    }

    private boolean performActionForHost(int action, Bundle arguments) {
        return ViewCompat.performAccessibilityAction(mView, action, arguments);
    }

    private boolean performActionForChild(int virtualViewId, int action, Bundle arguments) {
        switch (action) {
            case AccessibilityNodeInfoCompat.ACTION_ACCESSIBILITY_FOCUS:
            case AccessibilityNodeInfoCompat.ACTION_CLEAR_ACCESSIBILITY_FOCUS:
                return manageFocusForChild(virtualViewId, action, arguments);
            default:
                return onPerformActionForVirtualView(virtualViewId, action, arguments);
        }
    }

    private boolean manageFocusForChild(int virtualViewId, int action, Bundle arguments) {
        switch (action) {
            case AccessibilityNodeInfoCompat.ACTION_ACCESSIBILITY_FOCUS:
                return requestAccessibilityFocus(virtualViewId);
            case AccessibilityNodeInfoCompat.ACTION_CLEAR_ACCESSIBILITY_FOCUS:
                return clearAccessibilityFocus(virtualViewId);
            default:
                return false;
        }
    }

    /**
     * Computes whether the specified {@link Rect} intersects with the visible
     * portion of its parent {@link View}. Modifies {@code localRect} to contain
     * only the visible portion.
     *
     * @param localRect A rectangle in local (parent) coordinates.
     * @return Whether the specified {@link Rect} is visible on the screen.
     */
    private boolean intersectVisibleToUser(Rect localRect) {
        // Missing or empty bounds mean this view is not visible.
        if ((localRect == null) || localRect.isEmpty()) {
            return false;
        }

        // Attached to invisible window means this view is not visible.
        if (mView.getWindowVisibility() != View.VISIBLE) {
            return false;
        }

        // An invisible predecessor means that this view is not visible.
        ViewParent viewParent = mView.getParent();
        while (viewParent instanceof View) {
            final View view = (View) viewParent;
            if ((ViewCompat.getAlpha(view) <= 0) || (view.getVisibility() != View.VISIBLE)) {
                return false;
            }
            viewParent = view.getParent();
        }

        // A null parent implies the view is not visible.
        if (viewParent == null) {
            return false;
        }

        // If no portion of the parent is visible, this view is not visible.
        if (!mView.getLocalVisibleRect(mTempVisibleRect)) {
            return false;
        }

        // Check if the view intersects the visible portion of the parent.
        return localRect.intersect(mTempVisibleRect);
    }

    /**
     * Returns whether this virtual view is accessibility focused.
     *
     * @return True if the view is accessibility focused.
     */
    private boolean isAccessibilityFocused(int virtualViewId) {
        return (mFocusedVirtualViewId == virtualViewId);
    }

    /**
     * Attempts to give accessibility focus to a virtual view.
     *

     * A virtual view will not actually take focus if
     * {@link AccessibilityManager#isEnabled()} returns false,
     * {@link AccessibilityManager#isTouchExplorationEnabled()} returns false,
     * or the view already has accessibility focus.
     *
     * @param virtualViewId The id of the virtual view on which to place
     *            accessibility focus.
     * @return Whether this virtual view actually took accessibility focus.
     */
    private boolean requestAccessibilityFocus(int virtualViewId) {
        if (!mManager.isEnabled()
                || !AccessibilityManagerCompat.isTouchExplorationEnabled(mManager)) {
            return false;
        }
        // TODO: Check virtual view visibility.
        if (!isAccessibilityFocused(virtualViewId)) {
            // Clear focus from the previously focused view, if applicable.
            if (mFocusedVirtualViewId != INVALID_ID) {
                sendEventForVirtualView(mFocusedVirtualViewId,
                        AccessibilityEventCompat.TYPE_VIEW_ACCESSIBILITY_FOCUS_CLEARED);
            }

            // Set focus on the new view.
            mFocusedVirtualViewId = virtualViewId;

            // TODO: Only invalidate virtual view bounds.
            mView.invalidate();
            sendEventForVirtualView(virtualViewId,
                    AccessibilityEventCompat.TYPE_VIEW_ACCESSIBILITY_FOCUSED);
            return true;
        }
        return false;
    }

    /**
     * Attempts to clear accessibility focus from a virtual view.
     *
     * @param virtualViewId The id of the virtual view from which to clear
     *            accessibility focus.
     * @return Whether this virtual view actually cleared accessibility focus.
     */
    private boolean clearAccessibilityFocus(int virtualViewId) {
        if (isAccessibilityFocused(virtualViewId)) {
            mFocusedVirtualViewId = INVALID_ID;
            mView.invalidate();
            sendEventForVirtualView(virtualViewId,
                    AccessibilityEventCompat.TYPE_VIEW_ACCESSIBILITY_FOCUS_CLEARED);
            return true;
        }
        return false;
    }

    /**
     * Provides a mapping between view-relative coordinates and logical
     * items.
     *
     * @param x The view-relative x coordinate
     * @param y The view-relative y coordinate
     * @return virtual view identifier for the logical item under
     *         coordinates (x,y) or {@link #HOST_ID} if there is no item at
     *         the given coordinates
     */
    protected abstract int getVirtualViewAt(float x, float y);

    /**
     * Populates a list with the view's visible items. The ordering of items
     * within {@code virtualViewIds} specifies order of accessibility focus
     * traversal.
     *
     * @param virtualViewIds The list to populate with visible items
     */
    protected abstract void getVisibleVirtualViews(List<Integer> virtualViewIds);

    /**
     * Populates an {@link AccessibilityEvent} with information about the
     * specified item.
     *

     * Implementations must populate the following required fields:
     *

     *
event text, see {@link AccessibilityEvent#getText} or
     * {@link AccessibilityEvent#setContentDescription}
     *

     *

     * The helper class automatically populates the following fields with
     * default values, but implementations may optionally override them:
     *

     *
item class name, set to android.view.View, see
     * {@link AccessibilityEvent#setClassName}
     *

     *

     * The following required fields are automatically populated by the
     * helper class and may not be overridden:
     *

     *
package name, set to the package of the host view's
     * {@link Context}, see {@link AccessibilityEvent#setPackageName}
     *
event source, set to the host view and virtual view identifier,
     * see {@link AccessibilityRecordCompat#setSource(View, int)}
     *

     *
     * @param virtualViewId The virtual view id for the item for which to
     *            populate the event
     * @param event The event to populate
     */
    protected abstract void onPopulateEventForVirtualView(
            int virtualViewId, AccessibilityEvent event);

    /**
     * Populates an {@link AccessibilityNodeInfoCompat} with information
     * about the specified item.
     *

     * Implementations must populate the following required fields:
     *

     *
event text, see {@link AccessibilityNodeInfoCompat#setText} or
     * {@link AccessibilityNodeInfoCompat#setContentDescription}
     *
bounds in parent coordinates, see
     * {@link AccessibilityNodeInfoCompat#setBoundsInParent}
     *

     *

     * The helper class automatically populates the following fields with
     * default values, but implementations may optionally override them:
     *

     *
enabled state, set to true, see
     * {@link AccessibilityNodeInfoCompat#setEnabled}
     *
item class name, identical to the class name set by
     * {@link #onPopulateEventForVirtualView}, see
     * {@link AccessibilityNodeInfoCompat#setClassName}
     *

     *

     * The following required fields are automatically populated by the
     * helper class and may not be overridden:
     *

     *
package name, identical to the package name set by
     * {@link #onPopulateEventForVirtualView}, see
     * {@link AccessibilityNodeInfoCompat#setPackageName}
     *
node source, identical to the event source set in
     * {@link #onPopulateEventForVirtualView}, see
     * {@link AccessibilityNodeInfoCompat#setSource(View, int)}
     *
parent view, set to the host view, see
     * {@link AccessibilityNodeInfoCompat#setParent(View)}
     *
visibility, computed based on parent-relative bounds, see
     * {@link AccessibilityNodeInfoCompat#setVisibleToUser}
     *
accessibility focus, computed based on internal helper state, see
     * {@link AccessibilityNodeInfoCompat#setAccessibilityFocused}
     *
bounds in screen coordinates, computed based on host view bounds,
     * see {@link AccessibilityNodeInfoCompat#setBoundsInScreen}
     *

     *

     * Additionally, the helper class automatically handles accessibility
     * focus management by adding the appropriate
     * {@link AccessibilityNodeInfoCompat#ACTION_ACCESSIBILITY_FOCUS} or
     * {@link AccessibilityNodeInfoCompat#ACTION_CLEAR_ACCESSIBILITY_FOCUS}
     * action. Implementations must never manually add these actions.
     *

     * The helper class also automatically modifies parent- and
     * screen-relative bounds to reflect the portion of the item visible
     * within its parent.
     *
     * @param virtualViewId The virtual view identifier of the item for
     *            which to populate the node
     * @param node The node to populate
     */
    protected abstract void onPopulateNodeForVirtualView(
            int virtualViewId, AccessibilityNodeInfoCompat node);

    /**
     * Populates an {@link AccessibilityNodeInfoCompat} with information
     * about the host view.
     *

     * The following required fields are automatically populated by the
     * helper class and may not be overridden:
     */
    public void onPopulateNodeForHost(AccessibilityNodeInfoCompat node) {
        // Default implementation is no-op.
    }

    /**
     * Performs the specified accessibility action on the item associated
     * with the virtual view identifier. See
     * {@link AccessibilityNodeInfoCompat#performAction(int, Bundle)} for
     * more information.
     *

     * Implementations must handle any actions added manually in
     * {@link #onPopulateNodeForVirtualView}.
     *

     * The helper class automatically handles focus management resulting
     * from {@link AccessibilityNodeInfoCompat#ACTION_ACCESSIBILITY_FOCUS}
     * and
     * {@link AccessibilityNodeInfoCompat#ACTION_CLEAR_ACCESSIBILITY_FOCUS}
     * actions.
     *
     * @param virtualViewId The virtual view identifier of the item on which
     *            to perform the action
     * @param action The accessibility action to perform
     * @param arguments (Optional) A bundle with additional arguments, or
     *            null
     * @return true if the action was performed
     */
    protected abstract boolean onPerformActionForVirtualView(
            int virtualViewId, int action, Bundle arguments);

    /**
     * Exposes a virtual view hierarchy to the accessibility framework. Only
     * used in API 16+.
     */
    private class ExploreByTouchNodeProvider extends AccessibilityNodeProviderCompat {
        @Override
        public AccessibilityNodeInfoCompat createAccessibilityNodeInfo(int virtualViewId) {
            return ExploreByTouchHelper.this.createNode(virtualViewId);
        }

        @Override
        public boolean performAction(int virtualViewId, int action, Bundle arguments) {
            return ExploreByTouchHelper.this.performAction(virtualViewId, action, arguments);
        }
    }
}

redpajama_set_name: RedPajamaGithub


text:
1217 Betsy Hole Rd
1217 Betsy Hole Rd,
Bonneau, SC 29431
1217 Betsy Hole Rd is a single family home in Bonneau, SC. This home includes 1,348 square feet of living space. Additional features include a parking garage, and fireplace. Today, the estimated home value is around $121,300. Frequently asked questions about 1217 Betsy Hole Rd and the surrounding community.
How is the neighborhood? 1217 Betsy Hole Rd is located in a community that is home to 5,147 residents, which has decreased by -6.1% since 2000. 80.2% of the residents are families with children. The largest age group is between 45 to 54 (15.88%), while the second-largest age group is between 35 to 44 (13.06%).
What is the cost of living? The average family living near 1217 Betsy Hole Rd has a median household income of $45,886 and spends about $40,613 annually.
What is the crime rate? The neighborhood surrounding 1217 Betsy Hole Rd is relatively unsafe since the personal crime risk (including both violent and non-violent crimes) is 17.4%, which is higher than the state average of 13.6%. Property crime risk is 17.4%, which is higher than the state average of 11.1%.
How are the schools? The schools closest to 1217 Betsy Hole Rd include Berkeley County Middle College High, Henry E. Bonner Elementary, and Macedonia Middle. The average SAT score for this area is about 956 (477 for Math and 479 for English), which is higher than the state average SAT score of 945.
How's the job market? About 58.9% of the residents near 1217 Betsy Hole Rd have blue-collar jobs, while the remaining 41.1% have white-collar jobs. The unemployment rate is about 4.3%, which is higher than the state unemployment rate of 4.0%.
What is the weather like year-round? The average temperature for 1217 Betsy Hole Rd is about 46.0 degrees in January and 80.6 degrees in July. The average rainfall is around 49.1 inches per year. The average snowfall is around 1.0 inches per year.
Is there a risk of a natural disaster? 1217 Betsy Hole Rd resides in an area with low flood risk, high tornado risk, and high earthquake risk.
Hi - I was searching on HomeFinder.com, and I'd like to chat with you about properties for sale near Bonneau.
1113 Ole South Court,
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1229 Sheridan Court,
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2 Bd | 1 bath | 972 sqft
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414 Ambergate Lane,
Stephanie Lukac - Coldwell Banker Realty - 21001113
502 Chaff Lane,
Kimberly Lease - CENTURY 21 Properties Plus - 20032810
225 Whirlaway Drive,
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458 Four Seasons Blvd,
Ralph Wolcott - Coldwell Banker Realty - 20033782
327 Silverleaf Lane,
Lisa Provost - Coldwell Banker Realty - 20032118
2018 $444 $0 $0 $111,800
Henry E. Bonner Elementary PK-5 715 41 17.4 1.73 mi
Macedonia Middle 6-8 373 26 14.3 1.52 mi


text:
Home » News » Is the New Weight Loss Pill, Qsymia, Safe?
Is the New Weight Loss Pill, Qsymia, Safe?
December 3, 2014 Dangerous and Defective Drugs, FDA Announcements, For Your Safety, NewsNewsLeave a commentgaladmin
It has been years since the popular Fen-Phen pills were taken off the market due to serious health risks. The combination of Fenfluramine and Phentermine was considered toxic, mostly due to the Fenfluramine. A new weight loss pill called Qsymia is made up of Phentermine and the anti-seizure medication, Topiramate. But is this drug any safer for consumers?
Some experts believe that Qsymia could increase heart rate as well as other adverse side effects.
According to an ABC News report in July 2012, the U.S. Food and Drug Administration (FDA) was concerned about the serious side effects of Topiramate combined with Phentermine back in 2010. However, two years later, an expert panel approved the drug in an overwhelming majority. It is believed that there wasn't anything else available on the market to help severely obese people for whom dieting and exercise alone were not enough. The panel took into consideration the complications associated with obesity, such as heart disease and diabetes, and weighed them against the new diet pill, Qsymia, which contained only one of the disputed drugs in the original Fen-Phen pills, and felt that Qsymia would carry less of a risk than the danger of obesity.
Overweight Americans who have used Qsymia state they feel less hungry and say food has a different taste, decreasing one's desire to eat. One of the side effects of Topiramate is weight loss and Phentermine is known to suppress the appetite. In combination, these drugs make up the new weight loss pill, Qsymia.
Monthly pregnancy tests are required for women on a Qsymia regimen, as reported by Dr. Richard Besser, Chief Health and Medical Officer for ABC and Good Morning America.
Since Phentermine was a part of the Fen-Phen diet pill, the FDA is requiring Qsymia's manufacturer, Vivus, to implement long-term studies in order to monitor possible heart problems.
Regarding Qsymia use, Director of the Yale Prevention Research Center, Dr. David Katz, told ABC, "Honestly, I won't be surprised if adverse effects over time result in a reversal of the approval."
Even for patients who have been off Fen-Phen for many years, there is still cause to worry, as primary pulmonary hypertension can show up years later. For Fen-Phen patients who begin showing health problems linked to the now-banned diet drug, feel free to contact one of our Gacovino Lake attorneys to discuss options of a Fen-Phen lawsuit at 1-800-246-HURT (4878).
Do Red Light Tickets Violate Florida Law?
Study Reveals the 10 Most Dangerous Toys of this Year


text:
A 25-year-old male presented to a dental office for a checkup. Oral examination revealed a white, wrinkled area in the mucobuccal fold.
By Joen Iannucci Haring
The patient was unaware of the white area inside the mouth and denied any pain or sensitivity associated with the lesion. The patient did not report any history of trauma to the affected area.
At the time of the dental appointment, the patient appeared to be in an overall good state of health. No significant problems were obtained during review of the health history, and the patient was not taking any medications at the time of the dental examination.
The patient's past dental history included regular dental examinations and routine treatment. The patient's last dental visit had taken place approximately one year earlier for a checkup and dental prophylaxis. A review of the patient's record revealed no evidence of a white lesion in the mucobuccal fold at the last dental visit.
Physical examination of the head and neck region revealed no enlarged or palpable lymph nodes. The patient's blood pressure and vital signs were all found to be within normal limits. Extraoral examination revealed no abnormal findings.
Intraoral examination revealed a large, diffuse white area in the mucobuccal fold (see photo). The lesion appeared wrinkled or corrugated in texture. The lesion could not be removed by wiping or scraping. Further oral examination of the oral soft tissues revealed no other lesions present.
Clinical diagnosis
Based on the clinical information presented, which of the following is the most likely diagnosis?
o smokeless tobacco keratosis
o verrucous carcinoma
o proliferative verrucous leukoplakia
o frictional hyperkeratosis
o idiopathic leukoplakia
• smokeless tobacco keratosis
The term smokeless tobacco keratosis refers to an oral lesion that results from the use of a smokeless tobacco product. The development of such a lesion is related to the length of exposure to the smokeless tobacco product. There is a direct relationship between the use of smokeless tobacco and mucosal changes; exposure of the oral tissues to the tobacco product results in both chemical and cellular injury.
Smokeless tobacco products include both snuff and chewing tobacco. Snuff can be defined as a finely ground or powdered tobacco that is sold in both dry and moist forms. Snuff is not chewed; instead a small amount (referred to as a "pinch") is placed and held in the mucobuccal fold area between the cheek and gingiva, or between the lower lip and gingiva.
Tobacco sold in loose-leaf, compacted "plug" or brick form is known as chewing tobacco. As the name suggests, chewing tobacco is held in the mouth, typically inside the cheek, and chewed. While chewing tobacco most often is used by older adults, moist snuff is commonly used by teenagers.
For years, the use of snuff and chewing tobacco was traditionally limited to a small segment of the population. Previously identified as a habit of cowboys, men over the age of 65, and baseball players, smokeless tobacco products are now widely used by adolescents and young adults, especially athletes. The increase in smokeless tobacco use is believed to be the result of media advertising and peer pressure.
Although a smokeless tobacco keratosis is typically seen in young males, this lesion may be seen in any individual who uses a smokeless tobacco product. The lesion has a fairly characteristic clinical appearance and is found at the preferred site of tobacco placement. If more than one intraoral location is used to hold the tobacco products, multiple and less prominent lesions may be seen. The most frequent sites of involvement include the mucobuccal fold area in the incisor and molar regions.
The typical smokeless tobacco keratosis appears white with a raised or flat contour. The texture of the lesion appears smooth, granular, or corrugated. The appearance of the keratosis has been compared to that of an "ebbing" tide. A smokeless tobacco keratosis is asymptomatic and is usually discovered upon routine oral examination.
The diagnosis of a smokeless tobacco keratosis can be made based upon the history of product use and the characteristic clinical appearance. Histologic examination reveals chevron-shaped projections, acanthosis, and hyperkeratosis. Dysplasia and/or squamous cell carcinoma may be seen with a history of longtime use of smokeless tobacco products.
If the use of the smokeless tobacco product is discontinued, the lesion should disappear after two to six weeks. After discontinuing the use of smokeless tobacco, all lesions that last longer than six weeks must be biopsied.
An individual with a smokeless tobacco keratosis should be advised to discontinue using the tobacco product.
In addition, the dental professional can provide such patients with information on the effects of smokeless tobacco use and problems that may result. Patients should be advised that the long-term use of smokeless tobacco products may result in oral problems that not only include the smokeless tobacco keratosis, but periodontal tissue changes, dental caries, and dental abrasion. The use of smokeless tobacco products may also cause nicotine dependence, alterations of taste and smell, and high blood pressure.
Because smokeless tobacco products contain carcinogens known at nitrosamines, longtime exposure to such products may result in malignant changes and lesions such as verrucous carcinoma or squamous cell carcinoma.
For additional information concerning smokeless tobacco and how it affects the oral cavity, dental professionals may contact the American Cancer Society at www.cancer.org or at (800) ACS-2345, or the National Oral Health Information Clearinghouse at www.nohic. nih.gov.
Joen Iannucci Haring, DDS, MS, is a professor of clinical dentistry, Section of Primary Care, The Ohio State University College of Dentistry.


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