There was a great deal of testimony on SB 2089 and SB 2129. As I mentioned in my prior posts, Texas Alliance for Life, the Texas Catholic Conference of Bishops, and the other "usual suspects" opposed these important reforms which would provide either a reprieve from the 10-day deadline or provide full due process rights which are now totally lacking. I'm going to provide you with some of that testimony here.
Now, naturally, I do not agree with everything that Methodist has said here, but I am not going to get into that here. (As I have mentioned before, I am an appellate attorney working on the Dunn appeal and I'm not going to say any more than you see here for now.) You can read the Appellants' briefing here, they filed the initial brief on 2/22/18 and the Reply on 3/5/18. But the natural death admission (which was repeated at least 20 times in Methodist's Response brief) is crucial to this sort of legislative gamesmanship and rhetoric by the pro-TADA crowd who like to say, as Dr. Pojman did in his testimony above, that Chris died an unnatural death in the ICU or that patients whose life-sustaining care is maintained as they are dying is not a natural death. That's not what Methodist says. But that language and position tells you plenty about how lost they are on this issue.
I'll also note that no doctor claimed his or her conscience was being pricked by continuing care to Chris Dunn. They also never formally diagnosed him. That diagnosis was completed by autopsy. In fact, let me point you to my prior post where I went through the entire case as it was up to that point, including how Methodist tried to obtain guardianship over Chris. Ms. Kelly mentions this in her testimony below.
Finally, true to the playbook, Pojman argued that Evelyn Kelly wanted everything done under the sun to Chris medically and that that is what all of these families want. I've addressed that nonsense before here and so did Elizabeth Graham in her testimony that I embedded in my prior post.
This was terribly painful for Ms. Kelly to endure. I was there, but she made that clear to everyone in the room. That apparently doesn't matter to the supporters of TADA. And, they do so support it, even as none of them could or did defend any due process in the statute in their briefing. They did not list how it complies with the basic due process required under the law. They did not because they could not. The term is mentioned twice in the Amici brief. Once on page 19 in quoting something the Appellants said in their brief and once on page 20 in addressing some case law. They focused on the mootness issue and avoided the merits of the due process argument entirely. As did Methodist. That is telling. My prior post, "Setting the Record Straight..." also addressed and showed how TAL, in its own written words, has come out in support of outright euthanasia. But you don't need me to tell you that. You can see that for yourself.
I think he provides a very good summary here of the issues, the stakes, and who is really protecting life here and I want to end this series of posts with Rich's excellent testimony.
I'm going to end my report about the testimony on pro-life bills heard on April 10, 2019, with a two-part series I'm calling "TADA Amendment Testimony: The Good, the Bad, and the Ugly." I want to start with the good. I want you to understand how others, experts in this area, see Texas' law.
In my prior post about the TADA amendments (Texas Advance Directives Act; specifically at issue is Section 166.046), I said I was going to present the testimonies of Wesley J. Smith and Bobby Schindler, each of whom traveled from across the country to come give a few minutes of testimony to help Texas fix its mess. They think it's that important - not just for Texas, but nationally.
Wesley Smith was "invited testimony" so he was allowed more time to testify when the bills were "begin laid out" earlier in the day. Please listen carefully to it. Note that he addresses this in a secular way and with recourse to bioethics. Note especially his poignant point that this life-sustaining care is not being stopped because it is not working; rather, it is being stopped because it is working. When he put it that way, I had one of those lightbulb moments. Yes, of course, that's the case. But the manner in which he stated it, made it so incredibly powerful. Take a moment and ponder that. Then think about it when I post Part II of this series.
Smith notes that Texas has the weakest - worst - law with regard to patient protection and patient rights to make their own decisions in this matter. Other states have a two-way street in terms of the decision-making process. In Texas, as he noted, the patient has a right to refuse case, but if the patient wants care, he has no right to that if the doctor refuses. Again, ponder this when you get to Part II in this series and see what a supporter of TADA and opponent of these basic, common sense reforms has to say - and how he said it.
Bobby Schindler also provided powerful testimony. He is, of course, the brother of Terri Schiavo who was starved to death over the course of nearly two weeks by her husband with the benefit of a court order. It's horrifying. It turned him into a patient advocate. A powerful one.
He talks as one who works on these issues nationally. He sees how it is everywhere. Texas is the worst. "Pro-life" Texas is the worst, people! And, certain individuals, organizations, and clergy who call themselves pro-life support this law. It's just unfathomable to me and to many others (and, I'm happy to say to an increasing number of many others).
Both Smith and Schindler have been very faithful in coming to Texas repeatedly to work on efforts to reform this law as well as to educate people about these issues. I am grateful to them as I know so many are.
As a personal note, both have been among my pro-life heroes for many years. I met Schindler briefly in January at the Boots on the Ground conference, but we did not have much opportunity to speak. I got to speak with him at length on April 10. I am so grateful for his work nationally and internationally. It is so important. There is such a need.
It was also a great treat to meet Wesley J. Smith. He is also an Orthodox convert and I'm grateful to him for his many years of clear, cogent writing on these issues. We need strong leadership and powerful writing and advocacy like his.
Significantly, what did not happen here is that there were not dozens of families testifying about how great it was when TADA was used to pull their family members' plugs against their will. No affected person got up to say how that denial of due process was the highlight of their lives and how they hope others go through the same. All you had were the usual suspects testifying against these due process and patients' rights reform efforts: Texas Alliance for Life, Dr. Robert Fine, the Texas Catholic Conference of Bishops, the Texas Medical Association, the Texas Hospital Association, some Catholic hospital ethicist guy who works for Christus, an attorney for those who submitted the Amici Brief in support of Methodist Hospital, etc. In other words, those who are paid to support this law in some fashion or who benefit financially from it or its existence and those who - by the words they chose to describe their view of patients and, especially Catholic Church teaching - betray what can only be characterized as a euthanasia mentality and dehumanizing view of ill and disabled individuals.
Finally, I have been remiss in not thanking both Senator Hughes for his authorship of SB 2089 (and to the co-sponsors Senator Hall and Senator Perry) as well as and Senator Creighton for his authorship of SB 2129.
So far, there has not been a vote on these bills in the committee. I am prayerful and hopeful that that will change soon. I will keep you posted.
The Texas Capitol. I took this from my room the night before the hearing.
These are the two pro-life bills offered to significantly amend Sec. 166.046 of the Texas Advance Directives Act ("TADA") this session, each of which would make a big difference. I discuss them in my written testimony which I provide below the video of my oral testimony. The Senate Health & Human Services Committee took these up at the same time and allowed 3 minutes of testimony.
I wanted to get this post up today with my testimony and that of Elizabeth Graham to set the stage for some future posts on the bills pending in the legislature right now that are truly pro-life. There are going to be additional posts on this subject in the very near future and we're going to get into more of the testimony offered for - and against - these bills.
You can read the text of SB 2089 and follow its progress as with all legislation in Texas. In summary, SB 2089 would do away with the 10-day deadline. I've written at length why that it a problem, as has Texas Right to Life, as it describes how families basically begged the legislature to fix this.
SB 2129 would completely rewrite the statute and actually insert due process there which does not currently exist. Let me be clear: there is not a modicum of due process in Sec. 166.046. Please do not confuse a "procedure" with "due process." They are not the same. Those who are so enamored of this statute will go on and on about the "process" that is in place in the statute. But it does not constitute "due process" which is a very specific legal term and has very specific legal requirements. Notably, no one has defended this alleged "due process" in the constitutional challenge in court (despite what a certain attorney for the Amici said under oath at the hearing), but more on that another day.
The opponents of these bills, who are the proponents of this denial of due process that culminates in the hastened and premature death of a patient against his will, claim TADA provides a means of "dialogue" between health care providers and families. That's bull. It's a total lie. Anyone who has been in the crosshairs of TADA will tell you that. Anyone who has tried to render aid to someone in the crosshairs of TADA will tell you that. You can read the text of the existing law and see that there is no right for a patient or his surrogate to speak at the hearing, no right to representation, no right to an appeal, not even a right to an impartial tribunal free of conflicts of interest, among the many other due process protections that one should be entitled to when one's life is at stake. This is basic stuff. And vitally important.
The people I am talking about, and doing my little part to support, want the diseases or whatever they suffer from (be it simply old age or a disability) in these situations to be the cause of their death, if they have to die at that point, and not to be killed through lack of ventilator, nutrition and hydration, etc. Now, again, as I have said before on this blog, there are situations where continuing care is actually doing more harm than good and is hastening the person's death. However, that is far more rare than what the proponents of euthanasia would have you believe.
I've not run into a case of it any time I've been called. In Chris Dunn's case, he was conscious and begging for his life on video. (How do you explain the use of TADA on him? Well, I'm going to show you in a future post.) In two of the cases I worked on, the person was unconscious, but he was assimilating food and nutrition just fine. His lungs and kidneys weren't filling up with fluid, etc. There was no sign of distress. He was just unconscious and the doctors said he had no quality of life. I've blogged about that here before and you'll see it in my testimony below.
Now let's look at that scenario a bit more closely: the patient who might make a full or partial recovery but who at the moment is critically ill. The classic example is one who is in a "coma" or "persistent vegetative state" or "brain dead." These are all inherently nebulous, vague, and ambiguous terms. They can mean, in many cases, whatever the doctor or hospital wants them to mean. The effect of their usage, however, is that rights start being taken away, then life-sustaining care or treatment, with the result of hastening a person's death against their or their surrogate's wishes, perhaps even denying that person a chance to fully or even partially recover. But they might recover and they need to be given time for a fuller evaluation to be made and for the body to have a chance to fully heal. If a doctor thinks it's pointless, transfer care. But they resist this. They fight it. They make it hard. The time ticks down and they pull the plug. That's wrong. That's where SB 2089 comes in.
Second, before we get to my testimony, I want to address one more thing. A few who testified of their love of TADA slapped at Texas Right to Life for their opposition to it now when they are alleged to have supported it before. I addressed that in my epic post where I covered not just the Dunn case, but Texas Alliance for Life's admitted support of euthanasia, and the battle between it and Texas Right to Life. If you are new to the pro-life workings in Texas (or this blog), it would be worth your time to read it. It is also worth your time to listen to Executive Director of Texas Right to Life, Elizabeth Graham's, testimony addressing this (again).
You need to know that others who may have initially supported this law in the beginning have come to regret that because whatever was intended, assuming arguendo that there was ever anything benevolent intended here by the doctors' and hospitals' lobbies, that is not what happened and that is not what goes on behind closed doors. We have to fix what is in this law and how it is used and be honest about those problems. Having some misguided loyalty (or worse) to a law you helped create 20 years ago that is a disaster only speaks to your issues but not to the realities of the law. Nor does that undermine or shine a negative light on the others who saw the error in the law and have worked tirelessly to fix it and help those affected by it. Those who attack Texas Right to Life on this point are wrong to do so. Their arguments are as unpersuasive as they are illogical, absurd, and, in some cases, based on outright lies (and I'm going to prove that to you soon). And, if Texas Right to Life is a little less likely to believe the medical lobby and those supporting the medical lobby, well, the old saying "Fool me once...." applies here in spades.
I submit this written testimony in support of both SB 2129 and SB 2089. These bills reflect two efforts to reform a draconian and utterly unconstitutional statute that is at least two decades overdue. The current state of §166.046 and related provisions of the Texas Advance Directives Act ("TADA"), contain no patients' rights protections whatsoever. There is no due process for the patient or his or her family, despite the fact that the end result of the exercise of TADA in this context results in withdrawal of his life-sustaining treatment ("LST") against the patient's will and hastens his unnatural death.
I have been quite involved in the Chris Dunn appeal which is challenging the constitutionality of the law and am extremely aware of the flaws in it. Prior to this I have written and analyzed the provision extensively. Reform efforts to this shameful law have been nearly impossible for a variety of political reasons and those having to do with an inherent disregard – and even contempt – for the lives of those who are simply ill. Some are infants who are ill, disabled who are ill, or elderly who are ill. Some are severely injured. But their only crime is that they are ill or injured and a doctor has decided their lives are not worthy of receiving LST. Some will never be cured or be fully well again or as they were before, but they desire that their illnesses are what they die of – not a lack of LST withdrawn early to hasten their death. While much needs to be fixed in this law which is addressed in SB 2129 – and in the way society views the ill – addressing this the 10-day deadline as is done in SB 2089 and allowing more than 10 days – is meaningful reform which affirms life and the ability of people to make their own healthcare decisions without having their deaths hastened by the withdrawal of their LST.
Due process requires, among other things, that the patient be given a right to be heard, be given proper notice of the hearing, be given an ability to prepare for it (by knowing what the reasons are for withdrawing care), be entitled to have representation at the hearing, that there be an impartial tribunal free of conflicts of interest, and that there be an appeals process. In this case, hospitals act under color of state law to exercise power reserved to the state to sentence patients to premature deaths. Section 166.046 gives hospitals the power to decide a patient is no longer worthy of life-sustaining treatment. This grant of authority allows even a private hospital, which is taking action under the statute, to performing a State function. The ability to take formal action which will result in death is not available to the public.
Understanding how these decisions are made is critical to understanding why even a small reform can be so impactful, but also why an overall redrafting of the law is absolutely required to make it even remotely constitutional. After denial of one basic due process right after another – rights that even murder suspects and those convicted of murder receive – a patient can be involuntarily passively euthanized (by withdrawal of his LST, done expressly to hasten his death) in 10-days after the final decision is made by the hospital "ethics" committee. All that can be done now under the statute is to attempt to hastily find a new facility, but that is nearly impossible in this mere 10-day window. The ability to go to court for more time is difficult because the movant has to show "by a preponderance of the evidence, that there is a reasonable expectation that a physician or health care facility  will honor the patient's directive will be found if the time extension is granted." Sec. 166.046(g). That is the sole recourse to court that a patient or his family has.
My experiences, and those of others, is that these decisions are not made because a doctor's conscience is pricked by continuing care that he deems is causing the suffering of the patient. Moreover, removing care to alleviate suffering would be mercy killing which is prohibited by Sec. 166.050. The very definition of euthanasia, according to Merriam-Webster, is: "the act or practice of killing or permitting the death of hopelessly sick or injured individuals (such as persons or domestic animals) in a relatively painless way for reasons of mercy." Thus, the law prohibits euthanasia on the one hand, yet permits that very thing on the other – and without due process and against the will of the patient or his family. And, it should go without saying that persons are not animals and should not be treated as such. But as you will see, that is exactly one doctor's attitude about a patient in one ethics hearing I attended.
If a doctor's conscience actually should be pricked by continuing LST, and I have only heard that in the context of legal briefs (but not with supporting affidavits or evidence by doctors, just unsupported argument by counsel) and legislative committee hearings, but never in a hospital hearing, why not just move the patient or have another doctor in that facility provide care until transfer is completed? Why make moving him so hard and place obstacles in the way as so many hospitals do? Further, whether the patient actually is "suffering" or wishes to continue LST until his condition resolves itself one way or the other – naturally – while LST is continued, is a decision that the patient or his family or surrogate makes, not the doctor or hospital committee. He has the superior interest, as it is literally his life at stake.
It is also worth noting that in the case challenging the constitutionality of this provision of TADA, that the hospital defendant has admitted that continuing LST allows the patient a "natural death." In fact, one of the arguments that the hospital made is that it did nothing wrong and no rights were violated because the patient died a "natural death" when the hospital did not withdraw LST "voluntarily" but notably only after the lawsuit was filed. While the hospital is wrong about the nature of due process rights and how they manifest at every step of the procedure, it is a very important point for this committee to consider that maintaining LST for even a terminal patient allows that patient a natural death from his disease or injury rather than hastening it – rather than euthanizing him involuntarily and passively through the removal of his care.
· "Man was not meant to be sedentary this long; if he were an animal in the wild and had been still this long, he would have been eaten." Stated by the neurologist advocating for the termination of this patient's care and life to the family of the patient.
· "What we are saying is his quality of life will never change." Primary doctor recommending termination.
Because this person had a poor prognosis at becoming the person he was, according to the doctors who never knew him before he was ill, these doctors did not want to give more time. This is despite the family reporting seeing improvement, such as turning toward sounds, being startled when something fell and made a loud sound, and sobbing when the doctors discussed amputating his leg in front of him and his family. All of this was dismissed – illogically – as reflexes by the doctors who proceeded to make the comments above, among others. The main doctor – a neurologist – advocating for this man's death likened him to an animal several times in front of the family. This is also despite the growing record of cases where patients recover from a PVS or comatose state years later. The brain can recover. It just needs time.
The doctors also refused to consider less expensive in home care for the patient provided by a family member who was a trained ICU nurse. When the subject was broached, they were silent – they were unprepared for that. Then they all quickly said that was "not in the best interest of the family or the patient" without stating why except for resorting back to the "quality of life" mantra.
Later, I was asked to attend another "ethics committee" meeting where the hospital was seeking to withdraw LST from a young man against his family's wishes. That family is here today to testify and I am grateful to them. The family had never heard of this law, were taken aback by what was happening to them, and could not believe that this was possible in America at all, let alone "pro-life" Texas. The family was unanimous and unified in their opposition to the withdrawal of LST for their loved one. It violated their religious beliefs, among others. I met with the family and we attended the hearing together.
The family was allowed to speak and expressed – with medical literature – why they believed their loved one should not be killed by withdrawal of his LST. The two primary members of the committee dozed off repeatedly during the meeting, including the one who was chairing it. That's right. The two members of the committee most eager and vocal about withdrawing care to hasten a man's death against his family's wishes SLEPT during parts of the meeting while the family addressed them. THEY. SLEPT.
It was abundantly clear that anyone who would dare oppose the hospital's edict to kill a man prematurely by withdrawing his care enraged these members. Another one of the committee members, a doctor, asked what law we were even talking about. He was completely ignorant of the legal authority they were using even as he sat on the committee that would potentially render the final decision to kill a man. It was as if he was shocked that they even needed to have a law to allow them to make these determinations. That says so much.
I have never been in a meeting with more blatant hostility and anger than this one toward a family, who remained calm and composed. Besides the lack of civility and kindness exhibited by these committee members, I was also appalled by the aforementioned doctor who was totally ignorant of the law. He was utterly confused by references to law at all. I had to explain to him that there was a statute and that that was why they could even have this meeting in the first place. Only two of the 12 or so there uttered a single kind, calm word; the two already mentioned two were hostile when they were not sleeping; one was ignorant of the law and confused; and the others were dead silent, avoided interaction with anyone, avoided eye contact, and/or looked bored or disinterested, if not annoyed by being there at all. When the family finished their presentation, not a single member asked a question.
In another committee hearing I attended at this same hospital, one of the same members was there and again slept through parts of that hearing as well.
I relay these experiences to make clear that TADA must be reformed. I would like to see it completely rewritten and compliant with every facet of due process – at a minimum, which is only right in as much as hospitals are using it to sentence people to premature and, admittedly, unnatural deaths. But I am wary of any law that would ultimately take someone's life against their will. Understand also that the use of this provision of TADA is commonplace.
Time is of the essence. If the committee cannot see to a full scale rewriting of the law under SB 2129, it should at least vote for SB 2089 and repeal the 10-day deadline to provide some sort of mitigation of what will still be an otherwise unconstitutional law as it will still lack due process for patients. The mitigation will be that the patient cannot have that final deprivation of due process – his unjust death sentence carried out.
Let us all do what we can to establish as a matter of law that all life has value and needs to be protected, especially the most vulnerable among us. One of these days, that vulnerable person could be you or your loved one. It is not pro-life to hasten death by the withdrawal of LST against a patient or his family's wishes without due process and with a mere 10 days to find another facility. We err, if we err at all, on the side of life. Always.
 https://www.merriam-webster.com/dictionary/euthanasia (Last accessed 4/09/19) (Emphasis added).
Those supporting patients' rights outnumbered those in favor of killing them against their will 9:1.
Again, as I said in my prior post, those numbers matter. Two witnesses in particular, Bobby Schindler and Wesley J. Smith traveled across the country to give a few minutes of testimony to help Texas fix this mess because it's so important. I'm going to dedicate a blog post to them and what else we can take from that in the near future.
So that's our second update about the big hearing and Pro-Life Activism Day last week. More in the very near future!
NOTE: This was updated to correct the Senate Bill number and link to SB 2129. In two places, it was incorrectly written as SB 2191.
I took this as we were leaving the Capitol Wednesday evening.
The mockingbird called to me and stayed put while I took its photo.
I'm preparing for my talk tonight at the University of North Texas in Denton hosted by the UNT Eagles for Life, but I wanted to put up a couple of quick posts with my oral and written testimony on the bills that were heard last Wednesday before the Senate Health & Human Services Committee as well as some other information. I have additional posts planned regarding last week, probably two or three more. Instead of doing some very long posts, I'm going to divide them up into groups of testimony by subject or theme.
I want to start now, however, with the first pro-life bill we testified in favor of: the Preborn Non-Discrimination Act ("PreNDA"), Senate Bill 1033. You can read the text of the bill and follow its progress on Texas Legislature Online. I like this bill a great deal and think that it shows the humanity of all unborn, which we all so need to promote and help others understand. There are many exceptions to the 20-week abortion ban Texas put into place in 2015 and it amounts to nothing short of discrimination in many cases. That should not be. That's not pro-life. Importantly, the bill also provides some very real help for those facing such a pregnancy. I am always in favor of more information and more help to people facing any difficult situation and think we owe it to them.
When I was working on my testimony at the hotel Tuesday night, I was in the business office trying to print my written testimony to submit. A man came in after midnight to do the same. I had a feeling he was "one of us." We started talking and he told me his story. Daniel Crawford and his wife, Kelly, faced such a pregnancy and carried their baby, Abel, to term knowing he was probably going to die soon thereafter. He did. But, as Daniel told me, "We loved him for 15 days before he went to be with our Lord." In the midst of that grief, they started an organization to help others facing similar circumstances, Abel Speaks. They were without much help, support, and information as they navigated their way through a devastating diagnosis. There is such beauty in what they did and in their testimony given before the Senate HHS Committee.
The Crawfords were not alone. We heard from so many who did likewise. You can see the entirety of the testimony here. Some were given grim diagnoses and recommendations for abortion and their sweet babies are now sweet children. Some have disabilities, but all are loved and valued and were given every chance at life. No preborn baby deserves anything less. Families facing this situation need support not a quick recommendation for abortion and no other information. That doesn't honor the unborn child's humanity or the parents either. Texas Right to Life reported on the testimony as well.
Also important to the discussion is that babies at this age can feel pain. They are human, after all. That they have potential or actual disabilities, health problems, or whatever, does not change this fact. Again, we have a 20-week abortion ban here but there are very broad exceptions. My friend, and roommate in Austin, Dr. Sheila Page, gave powerful testimony on this very fact.
I always learn so much from her and have been blessed to listen to her and get to know her better since we first met in 2013.
In my testimony, I wanted to focus on the discrimination aspect of this and how that mentality leads to euthanasia and overall disregard for all human life. (You'll note a theme among my posts lately. I am deeply disturbed and concerned about the way society views humanity and the effects and consequences of that.) I also wanted to point out how the failure to give women this information is not providing informed consent. There has always been a double standard here - even among feminists. I've heard feminists say, on the one hand, women are powerful and should be completely autonomous and decide who lives and who dies. Then they say, on the other hand, women are fragile and should not be given too much information lest they be scared away....from what? Abortion? Medical professionals sometimes oppose these bills and why would that be? In any other context it would be medical malpractice to perform a procedure on a person and not provide them the information they need for full and complete informed consent. Why the double standard? So they might not choose something else? Like life, maybe? I think the idea that pro-abortion people want fewer abortions becomes harder to believe sometimes just by listening to what they say.
Anyway, we were only give two minutes, which is hardly enough time to say anything very useful, so many of us submitted written testimony as well. Mine follows the video of my oral testimony.
I submit this written testimony in support of SB 1033. Among other things, this bill addresses two critical areas which demonstrate an inconsistency and hypocrisy in the law in the context of abortion which leads to a devaluing of all human life, including the preborn child and women, who are not provided the protection they deserve. First, it addresses ongoing legal discrimination against the most vulnerable segment of the population that is no less worthy of protection from such lethal discrimination in this case than anyone else. It closes the gaping loopholes in Texas' existing law that allow for late-term abortion of a viable child even for nebulous reasons such as the "prevent[ing]…a substantial risk of serious impairment to the…mental health of the woman." Second, it requires true and full informed consent on the part of the mother as to the preborn child's actual condition and palliative care measures available should the worst case scenario be realized. This is information not currently offered.
Society has an inherent disregard for – and, in some cases – actual contempt for certain human life deemed less worthy of dignity, protection, and the ability to continue living. For the preborn, we now see efforts to stop laws that would prevent rendering care even to those infants born alive despite an abortion attempt. This level of societal depravity must end and we in Texas can do something to roll this back. This bill is an important step in that direction.
First, this bill addresses discrimination against the preborn. One of the last widely acceptable means of discrimination in our society, including among many who consider themselves "pro-life," is that which is against preborn who may be ill, disabled, an undesired gender, and so forth. We also see this discrimination extended to those already born who are ill, the disabled who are ill, or simply the elderly who are ill and permitted (and even encouraged) by the laws in Texas allowing for the withdrawal of and refusal to provide healthcare to them as well. We'd not have one form of discrimination without the other. Not only does the current law allow for this discrimination against the preborn to continue, it actually encourages it based on the breadth of the reasons allowing late-term abortions of viable infants. The result of this legally sanctioned discrimination is the certain death of people whose lives are no less worthy of value, care, and protection than anyone else.
The bill also specifically prohibits abortion based on discriminatory reasons such a gender, ethnicity, race, and the "probability of diagnosis of or having a disability of the woman's unborn child" or by the "use of force or threat of force to intentionally injure or intimidate a person in order to coerce the performance or attempted performance of an abortion based" on these reasons. It would prevent abortions based on a non-life threatening disability or even suspected disability of the child and other discriminatory reasons and is based on existing anti-discrimination laws that hypocritically and inconsistently do not currently extend to the unborn. How can we expect any life to be valued if the least among us are routinely and easily discarded for the pettiest of reasons? Second, this bill addresses the lack of information given to women prior to an abortion which results in a medical procedure being performed without informed consent, something that would, in any other context, be violative of the law and medical ethics. The one area of "medicine" where is it permissible and encouraged to perform a procedure without obtaining fully informed consent is in the area of abortion. Indeed, both practitioners of this macabre procedure and lobbyists do everything they can to avoid fully informing a woman of the nature of the procedure, the true condition of her unborn baby and his or her state of development, the risks and complications of the abortion procedure, and the negative long-term consequences of undergoing such a procedure. Far from empowering a woman, proponents of abortion seek to keep her ignorant and push her into a something she may not have chosen had all the facts been given her beforehand.
Under this bill, such a late-term abortion would be restricted to those preborn children who receive a diagnosis of a life-threatening disability but only after the mother receives information about perinatal palliative care which includes care from the moment of diagnosis to the delivery of the baby and possible death. This care includes not just medical care, but also social and mental health care, and counseling. The term "palliative care" also includes health care provided by maternal-fetal specialists, obstetricians, neonatologists, anesthesia specialists, clergy, social workers, and other individuals focused on alleviating fear and pain and ensuring the pregnant woman, her preborn child, and her family as a whole experience a supportive environment. The informational materials will also include information about services for the provision of this care and medical assistance benefits that may be available.
Currently, an expectant mother receives a grim diagnosis and a recommendation to abort without any other information and without recommendations to other specialists to learn more about the diagnosis and a second opinion. Decisions are made hastily – and out of fear and even ignorance – because information is not made readily available to a woman. This is largely because the mindset of too many is that no child should be given the opportunity to be born with such a diagnosis and so the woman is "encouraged" to make a decision where certain death looks like the best and only option. Everything about the current system prevents informed consent and ensures discriminatory abortion under the law.
In addition, this bill would restrict abortion also to only those cases where there is a medical emergency for the mother as that is defined in §171.002(3) "a life-threatening physical condition aggravated by, caused by, or arising from a pregnancy that, as certified by a physician, places the woman in danger of death or a serious risk of substantial impairment of a major bodily function unless an abortion is performed." Truthfully, almost no abortion – especially a late-term abortion – would meet this definition because many times to the extent that the pregnancy itself is causing those risks, the post-viable preborn baby can be delivered prematurely and both the mother and baby receive medical care. Abortion is not healthcare and does not treat any medical condition. Killing a child at this stage does nothing to help the mother. Ending the pregnancy by delivering the child alive and treating both mother and baby helps everyone and affirms all life.
This is life affirming legislation that this state needs for the sake of women, preborn children, and society as a whole. When society under color of law, targets the least among us as unworthy of life and disposable, how can we expect any life to be valued by the average person? No action occurs in a vacuum. These philosophies grow and spread and we see that in how society now views euthanasia and how Texas law treats the ill which we discuss today as well. We'd not be there without abortion. All life has value. And, if we are to err at all, we err on the side of life. Always.
I will be posting more videos soon and discussing them. In the interim, you can see a number of them on my friend Yvette D's YouTube page. I really appreciate her taking the time to do this and sharing them with me.
I am so grateful for all those who came out to support these bills. As Texas Right to Life reported, the support of the bill was overwhelming.
It says a great deal about an organization and an issue when you get numbers like that. I'm going to be writing more about that in the future as well.
Note that the companion bill to SB 1033, which is HB 2434, is being heard before the House Health & Human Services Committee Wednesday, that is, tomorrow. If you can get down there to register in support of the bill or testify in support of it, or both, please do so. It matters a great deal to show those who represent us what we want.
Texas is not as pro-life as it could be. At the end of life, it is the worst. We're going to talk about that next. We can make a difference and the show of numbers matters to the difference we can make because those who lobby against these life-saving bills are quite monied and politically well-connected and influential. We have to make up the difference in numbers and hard work.
So, that's our first update on the testimony.
UPDATE: I should have mentioned that the bill was left pending in the Committee. At some point we hope that they will vote it out of the Committee so it can be taken up by the full Senate.


text:
2nd millennium
The 2nd millennium encompasses the High Middle Ages, the Renaissance, the Early Modern Age, the age of Colonialism, industrialization, the rise of nation states, and culminates in the 20th century with the impact of science, widespread education, and universal health care and vaccinations in many nations. The centuries of expanding large-scale warfare with high-tech weaponry (of the World Wars and nuclear bombs) are offset by growing peace movements from the United Nations, the Peace Corps, religious campaigns warning against violence, plus doctors and health workers crossing borders to treat injuries and disease and the return of the Olympics as contest without combat.
Scientists prevail in explaining intellectual freedom, and new technology is developed by governments, industry, and academia across the world, with education shared by many international conferences and journals. The development of movable type, radio, television, and the Internet spread information worldwide, within minutes, in audio, video, and print-image format to educate, entertain, and alert billions of people by the end of the 20th century.
From the 16th century, humans migrated from Europe, Africa Asia to the New World, beginning the ever-accelerating process of globalization. The interwoven international trade led to the formation of multi-national corporations, with home offices in multiple countries. International business ventures reduced the impact of nationalism in popular thought.
The world population doubled over the first seven centuries of the millennium, (from 310 million in AD 1000 to 600 million in AD 1700), and later increased tenfold over its last three centuries, exceeding to 6 billion in AD 2000.

redpajama_set_name: RedPajamaCommonCrawl


text:
<?php

/**
 * LaterPay core logger processor web.
 *
 * Plugin Name: LaterPay
 * Plugin URI: https://github.com/laterpay/laterpay-typo3-extension
 * Author URI: https://laterpay.net/
 */
class tx_laterpay_core_logger_processor_web implements tx_laterpay_core_logger_processor_interface {

	/**
	 * Server data array
	 * @var array|\ArrayAccess
	 */
	protected $serverData;

	/**
	 * Extra fileds
	 *
	 * @var array
	 */
	protected $extraFields = array(
		'url' => 'REQUEST_URI',
		'ip' => 'REMOTE_ADDR',
		'http_method' => 'REQUEST_METHOD',
		'server' => 'SERVER_NAME',
		'referrer' => 'HTTP_REFERER'
	);

	/**
	 * Constructor of object
	 *
	 * @param array|\ArrayAccess $serverData Array or object w/ ArrayAccess that provides access to the $_SERVER data
	 * @param array|null $extraFields Extra field names to be added (all available by default)
	 */
	public function __construct($serverData = NULL, array $extraFields = NULL) {
		if ($serverData === NULL) {
			$this->serverData = & $_SERVER;
		} elseif (is_array($serverData) || $serverData instanceof \ArrayAccess) {
			$this->serverData = $serverData;
		} else {
			throw new \UnexpectedValueException('$serverData must be an array or object implementing ArrayAccess.');
		}

		if ($extraFields !== NULL) {
			foreach (array_keys($this->extraFields) as $fieldName) {
				if (! in_array($fieldName, $extraFields)) {
					unset($this->extraFields[$fieldName]);
				}
			}
		}
	}

	/**
	 * Record processor
	 *
	 * @param array $record Record data
	 *
	 * @return array processed record
	 */
	public function process(array $record) {
		// skip processing if for some reason request data is not present (CLI or wonky SAPIs)
		if (! isset($this->serverData['REQUEST_URI'])) {
			return $record;
		}

		$record['extra'] = $this->appendExtraFields($record['extra']);

		return $record;
	}

	/**
	 * Add extra filed
	 *
	 * @param string $extraName Name of field
	 * @param string $serverName Server name
	 *
	 * @return $this
	 */
	public function addExtraField($extraName, $serverName) {
		$this->extraFields[$extraName] = $serverName;

		return $this;
	}

	/**
	 * Append extra field
	 *
	 * @param array $extra Name of extra filed
	 *
	 * @return array
	 */
	private function appendExtraFields(array $extra) {
		foreach ($this->extraFields as $extraName => $serverName) {
			$extra[$extraName] = isset($this->serverData[$serverName]) ? $this->serverData[$serverName] : NULL;
		}

		if (isset($this->serverData['UNIQUE_ID'])) {
			$extra['unique_id'] = $this->serverData['UNIQUE_ID'];
		}

		return $extra;
	}
}

redpajama_set_name: RedPajamaGithub


A neighborhood friend of mine, when I was teenager, owned a friendly junkyard dog of no discernable pedigree named Butch. One of us discovered that Butch's tail connected to his demeanor. Lift his tail and he held his head a little higher, his ears perked up and he would get all happy. Push his tail down between his legs and his ears would droop, his head would lower and he would mope about for a while. Try this with your own dog and you may see a similar response. Let us know what you discovered by posting a comment below. A change in posture—tail position—was all that was required to evoke an apparent emotional shift in Butch. A similar story told by Lee Pascoe in her book The Magic of Make Believe reminded me of my own experience. But what has that got to do with self hypnosis?
The connection is indirect but very important as it has to do with one of the powerful forms of autosuggestion—anticipatory role behavior, which is sometimes utilized in direct suggestions during self-hypnosis.
Anticipatory role behavior is acting or role playing in the present—that's the behavior part—in ways as you would expect, believe or predict for a particular future circumstance in which you expect or wish to find yourself—the anticipatory part.
In his book Mind Over Mind: The Surprising Power of Expectations author Chris Berdik describes how players of the on-line role-playing game World of Warcraft who have "taller and better looking avatars bested the shorter, uglier ones even though appearance confers no actual functional advantages" to one over the other.
Berdik goes on to explain how researchers also discovered that wearing better looking avatars "gave college students the confidence to contact more attractive potential dates" in real life. This was an unintended consequence of role-playing but illustrates the power and subtle influence that role playing exerts. What about those with short ugly avatars? They were more inclined to misrepresent their height—claiming to be taller than they actually are.
Something as seemingly benign as role playing an on-line fantasy game can lead to altered behavior in real life. Wouldn't it be beneficial and desirable to learn how to role play in a way that brings about intentional change?
First imagine yourself as if you have already arrived at the situation you are anticipating. See yourself doing things as you want to be doing them in the future, or responding to situations in ways in which you want. See how your life has changed and how circumstances have changed around you. At this stage you are engineering or architecting how you want things to be in the future and it pays to write all of this down.
Determine what things you need to do, or how you would need to act in the present in anticipation of that future circumstance. While acting or role playing you might take on new physical characteristics, such as: changes in hairstyle, manners of walk, talk and wardrobe; or emotional traits, such as: calmness, cheerfulness or happiness; or mental attitude, such as: patience, acceptance, openness or curiosity—to name just a few. And these things should be written down as well.
Commence role playing according to your plan from the present moment right up to that future event or circumstance. When that future circumstance arrives you will no longer be role playing, but rather, giving the appropriate real-time response for the situation.
This approach works for many, but not all circumstances—as you might imagine. So use the technique when it is appropriate to do so.
My goal was to find myself making easier contact with group leaders and department heads to learn about project activities and opportunities within the large technology company where I worked.
I imagined myself interacting with them in a high visibility venue where there was a high concentration of group leaders and department heads at one time. I envisioned myself networking, doing introductions and being introduced—making contacts and learning about projects and project plans. While doing that visualization it occurred to me that business attire was a good predictor of an employee's rank in the organization. Senior execs wore 3-piece suits, department heads wore blazers or sports jackets and tie, group leaders wore business casual with ties, the rest of us dressed in business casual—no ties.
So I took on a new physical characteristic by putting on a tie, and began taking lunch in the cafeteria at the same time most of the other managers did. That's all it took to elevate myself up one notch in the eyes of those around me. It worked. Soon I was making significant peer to peer contact with others in the company.
Why does anticipatory role behavior (without self hypnosis) work? By changing the way in which you think, look and/or act the external circumstances and people surrounding you adjust and evolve to include, or possibly to exclude, the new behavior(s). You may gain new friends or lose old friends, or make stronger or looser connections to existing friends. You may be drawn to other activities or locations. Some would say that what you put out comes back to you; that it's a law of attraction. But in any case the behaviors which you project out to the world ultimately change your environment. People around you will change in response to that. And when people change, events change. It is our relationship and interactions with the people around us that create the greatest opportunities for change in our personal ecosystem and environment.
Anticipatory role behavior is something which can be acted out in your imagination during self-hypnosis to good effect because it is very suited for direct suggestion. To do so imagine yourself as if you have already arrived at the situation you are anticipating; see the desired end result. See yourself doing things as you want to be doing them in the future, or intentionally responding to situations in desirable ways. See how your life has changed in full color, with sounds, smells—all the touchy-feely full sensory-channel information your imagination can conjure up.
Always plan your direct suggestions and imagery, as I have taught in Mastering the Art of Self Hypnosis, before going into self-hypnosis. Improvising during self-hypnosis can get you haphazard results.
Why does anticipatory role behavior (with self hypnosis) work? Because the subconscious always operates in the "now" and it is very goal directed. When presented with images for things that are not a part of the "now", the subconscious understands them to be part of a goal that is to be accomplished. Once the subconscious accepts those ideas it will do everything in its power to accomplish the goal. It will exert its own influence to begin changing events through behavior modifications.
Always track your results and monitor where you are headed. Make adjustments with self-hypnosis to maintain proper course. Never leave your subconscious unattended.


Based on the song for the Entwives by Tolkien.
I have finally pulled this whole mess into a semblance of order. So many ideas...I haven't been this excited in ages!
I have decided to divide the patterns by the book/movie they come from; a trilogy of knitting!
I have tried, whenever possible, to include both a variety of techniques and a variety of accessory types within each cycle. Wouldn't want anyone to feel bogged down or bored!
I do not have a firm schedule for the patterns, beyond a commitment to thee first coming out May 1st and the others following every 6-8 weeks. Some will obviously take longer than others.
I want to be flexible - if a pattern is ready to release in four weeks, I don't want to hold it until a certain date. Conversely, if a pattern takes eight weeks to complete, I don't want to be pushed into release before it is truly ready. I hope you will understand my reluctance to place firm dates upon the series. Creativity is hard to structure.
I can promise you we will be done within the year (or sooner) and then we will move on to the next installment - The Two Towers - and the next mystery shawl pattern.
Sign ups begin March 1st, 2010.
Patterns will be available individually as they are issued for $8 each. Those who purchase in advance get a price break - $40 for the Fellowship of the Rings series (first six patterns).
First pattern will be released May 1st, with others following every 6 to 8 weeks until complete.
Here's some preliminary pics to whet your appetite.
I know for every pattern on which I have begun the design process, there are avid knitters wanting to cast on. I know I design far more than I have time to knit. I know there are knitters out there who are disappointed in this new development and what it means to my other projects, which have been tabled for the current moment.
I beg you forgiveness and your patience. All things happen for a reason and all in our world works towards the good. I believe I am meant to follow this muse, where ever she may lead. I will get back to these projects, I promise. Like Isildur's heir, I shall return.
Tomorrow at 6:00 PM EST the first clue comes out for the Evenstar Mystery Shawl KAL , however we are still taking sign-ups till February 19th.
Yesterday I signed up with an automated email service to better manage the large number of people involved. The business has officially outgrown my home server.
You should have received an email from Aweber on my behalf, requesting you to confirm your membership in the KAL by clicking on the link at the bottom. Make sure you have done this before 6:00 tomorrow or your first clue will be delayed.
And now, if you will excuse me, I am off to make final corrections to tomorrow's clue.
Wonderful! I'm so excited for this trilogy.
Aren't the signups through February 19th? Not Jan??
This is really a great idea. I can't wait to sign up for the whole thing.
Does the $45 cover all three books/movies sections? Or is it $45 per section?
I am chomping at the bit over that Ringwraith stole. After you posted that swatch the other day, I can't stop thinking about it. Luckily Evenstar starts tomorrow so I'll have a distraction.
I'm confused about signing up for $45 for 7 patterns. How does that work when one already signed up for Evenstar? Does that mean that on March 1, I can sign up for the Fellowship series and pay $45 - $8?
the KALs are billed and signed up for separately. Each one is $8.
The other 7 patterns are $45, if you but them as a group in advance or $8 each if bought individually.
Can't wait for this to start, and even worse, can't wait to sign up for the rest of the patterns. I have been chomping at the bit for the pattern since finishing my swatch! I'm heading down your way this weekend to visit #2 son and family for Valentine's Day. Hope the weather is better!
You have certainly set high goals for yourself. But the excitement comes through in your words. It's Friday and the first clue comes out in 9 hours. Can you tell I'm excited?
Thanks! My DH has been bugging me for ages to knit something in mithril!
I can't wait for all the patterns!!
I'm so excited about this project and am committed to the whole series, but if you take the KALs out of the equation as being a separate project, each section is left with 6 not 7 patterns (except for Return of the King). That might be where some people are getting confused.
Such a challenge! I think I want to knit them all, and I'm the world's slowest knitter.
Isn't the magic of a big inspiration wonderful?
i need to know how to sign up to get the patterns...these are fantastic!!
Over on the sidebar Shelly!


text:
Obama's State of the Union: Are You Ready to Go Ba...
FAFSA and the Angst of Getting Aid for College
Jordan Goldman, Founder, Unigo
Secretary of Education Arne Duncan in Brooklyn
NYU Students Occupy Building, Demand Audience
Kristoff Calls Education America's Sorriest Hallmark
University of the People -- Shai Reshef, speaker a...
University of the People -- Shai Reshef, speaker at EIIF
Blackboards Without Borders:
Introducing University of the People
New Online Institution Revolutionizes
Higher Education with Tuition-Free Model
Visit University of the People
Pasadena, CA (January 26, 2009) –Millions of people never have the chance to attend college because of economic and geographic constraints. With the help of technology and a visionary educator, this is about to change. In April 2009, entrepreneur Shai Reshef is opening the virtual gates to the world's first tuition-free, internet-based academic institution. As a non-profit venture, the University of the People (UoP; www.UoPeople.org) promises to revolutionize higher education by providing universal access to college studies—even in the poorest parts of the world.
"Education, just like democracy, should be a right, not a privilege," said Shai Reshef, Founder and President, University of the People. "With a few keystrokes, UoP takes the concept of social networking and applies it to academia, providing a global chalkboard for all students." Reshef credits open-source technology and increasing access to the Internet in making higher education available to people all over the world.
Long distance learning is a growing trend in the U.S. According to a survey by the Sloan Consortium, approximately 4 million students are enrolled in online education. As a tuition-free service, UoP will take the concept of eLearning to an unprecedentedly broader – worldwide – audience.
UoP will be able to effectively function on a limited budget without sacrificing quality of education by using collaborative and open-source eLearning. UoP will embrace peer-to-peer teaching to make the best use of a student body from around the world. Within online study communities, students will share resources, exchange ideas, discuss weekly topics, submit assignments and take exams. The curriculum will be supported by respected scholars. A community of educators, comprised of active and retired professors, librarians, master level students and other professionals, will participate and oversee the assessment process. They will also develop ongoing procedures for curriculum evaluation and development.
In lieu of tuition, UoP plans to charge nominal application and examination fees ($15-$50 and $10-$100 respectively), which may be adjusted on a sliding scale based on the economic situation in the student's country of origin.
UoP will be open to any student with access to a computer and Internet connection, who can submit a certificate of graduation from secondary school and demonstrate proficiency in English (or pass two preliminary English courses at UoP).
UoP anticipates tens of thousands of students to enroll within the first five years of operation. Although the University will cap enrollment at 300 students in the first semester, the peer-to-peer pedagogical model will encourage rapid expansion of the student body in following years.
Parlaying a successful career in education and worldwide travel, Reshef discovered one issue that unites countries, cities and states around the globe – a need for improved education. His pioneering initiative fulfills a personal desire to give back to society and develop the world through knowledge and academics.
"The University of the People represents a huge leap in the democratization of education by reaching those who until now viewed college as a pipedream," added Reshef. "Education is a proven mechanism for upward mobility. Our goal is to positively impact the life chances of as many people as possible."
In the initial stages, UoP will offer two undergraduate degrees: a BA in Business Administration and a BSc in Computer Science. Fulltime students will be able to complete the undergraduate degree in approximately four years. All students will be eligible for an associate degree after two years. UoP intends to apply for accreditation from recognized authorities as soon as the waiting process for eligibility is met.
About Shai Reshef:
Shai Reshef has twenty years of experience in the international education market. From 1989 to 2005, he served as Chairman of the Kidum Group – the largest for-profit educational services company based in Israel. Reshef joined Kidum in 1989 when it was a single product company with revenues of $100,000. Under his leadership Kidum grew to become a company with annual revenues in excess of $25 million, with over 1,000 employees and 50,000 students a year. In 2005, he sold the company to Kaplan, one of the world's largest education companies and a subsidiary of the Washington Post. Between 2001 and 2004, while continuing as the chairman of Kidum, Reshef lived in the Netherlands where he chaired KIT eLearning, a subsidiary of Kidum. KIT is the eLearning partner of the University of Liverpool and the first online university outside of the U.S. KIT provides MBA and M.Sc. degrees in IT. The company was sold in 2004 to Laureate. In August 2007, after three years in London and New York, Reshef returned to Israel. Currently, Mr. Reshef acts as chairman of the board of Cramster.com, the leading online study community of students, educators and subject enthusiasts. Launched in 2003, Cramster.com is the 21st century answer to the traditional college study group, helping students anywhere, anytime. With over 100,000 active members each month, ranging from gifted 17-year-old high school students to 80-year-old subject enthusiasts, Cramster has the community to support the 24-hour needs of students across the globe.
Reshef holds a BA, magna cum laude, from Tel Aviv University and an MA from the University of Michigan in Chinese Politics.


FENG Qiangqiang,WANG Ling,CHENG Xiaoguang,et al.Quantitative analysis of bone density of adults with non-traumatic femur head necrosis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2018,30(10):25-29.
Objective:To explore the characteristics of bone density of adults with non-traumatic femur head necrosis(FHN).Methods:Thirty-one patients who were diagnosed as non-traumatic FHN(necrotic group)by computerized tomography(CT)examination in Beijing Jishuitan Hospital from June 2015 to June 2017 were collected.The patients(48 hips)consisted of males(36 hips)and females(12 hips),and ranged in age of 47.42+/-15.29 years,and the FHN belonged to ARCO phaseⅡ(21 hips)and ARCO phaseⅢ(27 hips).None of these patients had a history of trauma and surgery of pelvis or hip and received any drug intervention.Meanwhile,fifty-two patients who received hip CT examination for unilateral hip fracture(non-necrotic group)in Beijing Jishuitan Hospital from June 2015 to June 2017 were selected.The patients(52 hips)consisted of males(38 hips)and females(14 hips),and ranged in age of 47.42+/-15.29 years,and no abnormality was found in contralateral femur.The bone density of FHN area,FHN surrounding area,femoral neck,greater trochanter and intertrochanteric area of necrotic group and the bone density of center of femoral head,edge of femoral head,femoral neck,greater trochanter and intertrochanteric area of non-fractured side of non-necrotic group were determined by using non-synchronous quantitative CT,and then the measured data were statistically analyzed.Results:The bone density of FHN area of necrotic group was higher than that of center of femoral head of non-necrotic group(348.44+/-78.77 vs 284.05+/-45.88 mg/cm(-3),t=4.942,P=0.000).The bone density of FHN surrounding area of necrotic group was higher than that of edge of femoral head of non-necrotic group(218.59+/-47.82 vs 141.37+/-31.93 mg/cm(-3),t=9.419,P=0.000).There was no statistical difference in the bone density of femoral neck,greater trochanter and intertrochanteric area between the 2 groups(98.63+/-58.43 vs 81.14+/-63.78 mg/cm(-3),t=1.426,P=0.157; 45.38+/-37.15 vs 52.55+/-31.23 mg/cm(-3),t=-1.048,P=0.297; 48.14+/-34.07 vs 45.37+/-42.60 mg/cm(-3),t=0.357,P=0.722).The bone density of FHN surrounding area(ARCO phaseⅡ)of necrotic group was higher than that of edge of femoral head of non-necrotic group(228.97+/-49.64 vs 141.37+/-31.93 mg/cm(-3),t=7.486,P=0.000).There was no statistical difference in the bone density of FHN(ARCO phaseⅡ)area,femoral neck,greater trochanter and intertrochanteric area between necrotic group and non-necrotic group(307.31+/-64.15 vs 284.05+/-45.88 mg/cm(-3),t=1.513,P=0.141; 100.71+/-45.88 vs 81.14+/-63.78 mg/cm(-3),t=1.277,P=0.206; 65.39+/-26.72 vs 52.55+/-31.23 mg/cm(-3),t=1.653,P=0.103; 59.97+/-31.76 vs 45.37+/-42.60 mg/cm(-3),t=1.417,P=0.161).The bone density of FHN area(ARCO phaseⅢ)of necrotic group was higher than that of center of femoral head of non-necrotic group(380.42+/-74.99 vs 284.05+/-45.88 mg/cm(-3),t=6.110,P=0.000).The bone density of FHN(ARCO phaseⅢ)surrounding area of necrotic group was higher than that of edge of femoral head of non-necrotic group(210.52+/-45.64 vs 141.37+/-31.93 mg/cm(-3),t=7.853,P=0.000).The bone density of greater trochanter was lower in necrotic group(ARCO phaseⅢ)compared to non-necrotic group(29.81+/-37.03 vs 52.55+/-31.23 mg/cm(-3),t=-2.879,P=0.005).There was no statistical difference in the bone density of femoral neck and intertrochanteric area between necrotic group(ARCO phaseⅢ)and non-necrotic group(97.01+/-67.43 vs 81.14+/-63.78 mg/cm(-3),t=1.029,P=0.307; 38.94+/-33.49 vs 45.37+/-42.60 mg/cm(-3),t=-0.682,P=0.497).The bone density of FHN area was lower and the bone densities of greater trochanter and intertrochanteric area were higher in ARCO phaseⅡcompared to ARCO phaseⅢ(t=-3.565,P=0.001; t=3.771,P=0.001; t=2.208,P=0.032).There was no statistical difference in the bone density of FHN surrounding area and femoral neck between ARCO phaseⅡand ARCO phaseⅢ(t=1.337,P=0.188; t=0.225,P=0.823).Conclusion:The bone densities are higher in FHN area and FHN surrounding area compared to normal femoral head.
 ANN,DOROTHY,KING,et al.Magnetic resonance imaging staging of nasopharyngeal carcinoma in the head and neck[J].World J Radiol,2010,91(5):159-165.
 WENBAO,WANG,JEFFREY,et al.Longitudinal evaluation of time related femoral neck narrowing after metal-on-metal hip resurfacing[J].World J Orthop,2013,80(2):75-79.
 ZAINO CJ,LEALI A,FETTO JF.Bone density and mechanical properties in femoral bone of swim loaded aged mice[J].Clin Orthop Relat Res,2010,468(1):276-282.
 VANDE BERG BC,LECOUVET FE,KOUTAISSOFF S,et al.Bone marrow edema of the femoral head and transient osteoporosis of the hip[J].Eur J Radiol,2008,67(1):68-77.
 BROWN JK,TIMM W,BODEEN G,et al.Asynchronously Calibrated Quantitative Bone Densitometry[J].J Clin Densitom,2017,20(2):216-225.
 WANG L,SU Y,WANG Q,et al.Validation of asynchronous quantitative bone densitometry of the spine:Accuracy,short-term reproducibility,and a comparison with conventional quantitative computed tomography[J].Sci Rep,2017,7(1):6284.
 JOINT SURGERY GROUP OF THE ORTHOPAEDIC BRANCH OF THE CHINESE MEDICAL ASSOCIATIPN.Guideline for diagnostic and treatment of osteonecrosis of the femoral head[J].Orthop Surg,2015,7(3):200-207.
 MANN J,HOLDSTOCK G,HARMAN M,et al.Current concepts on osteonecrosis of the femoral head[J].World J Orthop,2015,13(8):590-601.
GONG Jianghao.A combination therapy of proximal femoral nail antirotation and anti-osteoporotic drugs for the treatment of unstable femoral intertrochanteric fractures in the aged[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(10):29.


text:
It might seem difficult to measure the value of nature. But researchers in Norway are taking on the task. Photo: Colourbox
Toggle image description
What is nature worth?
Climate change is not the greatest threat to the diversity of species on Earth. The main problem is that animal and plant habitats are disappearing.
By Steinar Brandslet - Published 30.11.2021
What is nature worth? Can we even put a value on nature at all? A group of researchers at NTNU intend to investigate that question.
They will delve into the major reason why at least one million species are threatened with extinction, summed up in the not so catchy term "land-use change." In fact, the term means that we are using ocean and land areas for something else than what they were used for previously. The habitats of animals and plants are disappearing.
A growing population that wants a higher standard of living needs land.
"The increased need for land and resources is really an important reason – globally – for the degradation of nature", says Ivar Herfindal, a researcher at the Centre for Biodiversity Dynamics (CBD) at NTNU.
40 PhD positions for sustainability
Several NTNU departments are collaborating on a project to find values in nature. Participating in the study are the geography, biology, natural history and industrial economics and technology management departments.
Four doctoral students will be admitted, one to each department. These positions are part of a massive call for proposals from NTNU this autumn, where up to 40 PhD positions within sustainability will be advertised at once.
The project leader is Professor Bernt-Erik Sæther, who is also the director of CBD. In addition to Ivar Herfindal, Professors Gunhild Setten, Ottar Michelsen and Associate Professor James D. M. Speed will each head their own work package.
The goal is for the research to include a large degree of interdisciplinary collaboration and overlap. For example, students will largely work with biodiversity from the same geographical area, such as selected municipalities in Trøndelag county. Shared meeting places will enable discussion and exchange of experiences and ideas.
"Land is needed for a growing population that also wants a higher standard of living," he says. "With the growing numbers, ever more people want ever more things."
By identifying a number of values for different types of ocean and land areas, the research group wants to create a tool that can be used to help choose between nature and other values. For example, is it right to build wind turbines that kill birds and perhaps insects?
What values does nature actually have? Can they be measured? Photo: Colourbox
Climate change rarely to blame – so far
With all the attention being paid to climate change, a lot of people would probably be surprised to hear that the global rise in temperature is not the biggest threat to Earth's species diversity.
The Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services (IPBES) consists of researchers and partners from 132 countries. They are closely linked to the UN.
In 1950, one million wild lions roamed Africa. Today their number is just over 60 000. Not a single one of these lions has disappeared due to climate change.
The IPBES ranks land-use change as the greatest threat to biological diversity. The second biggest threat is the direct use of natural resources, such as hunting and fishing, gathering plants for food and medicine, and deforestation for firewood and building construction. Climate change is the third worst factor, according to the IPBES.
In 1950, one million wild lions roamed Africa. Today their number is just over 60 000. Not a single one of these lions has disappeared due to climate change. Instead, lions disappeared because humans needed their land or simply killed them to protect their livestock.
This does not mean that climate change isn't a problem. It could become more important in the future. But other threats are much bigger and more immediate right now.
We won't save wild lions by stopping climate change. Photo: Per Harald Olsen, NTNU
Different reasons in rich and poor countries
Norway already has a high standard of living, and land uses in rich countries often change for different reasons than they do in poor ones.
"Infrastructure is probably one of the most important causes of encroachment and destruction of the Norwegian natural environment in recent decades. For example, motorways require very wide lanes that strongly disturb both wild natural settings and cultivated land," says Herfindal.
But infrastructure is far from the only cause of environmental destruction in Norway and the rest of the world.
"Urbanization and more intensive agricultural practices also create major changes in land use," he adds.
Nature is affected in Norway too, because we believe we need to have more.
When previously cultivated land in Norway grows back, we'll see fewer flowering plants that provide food for insects, which in turn will provide less food for birds. As agriculture in Eastern Europe became more streamlined and modernized after the fall of the Berlin Wall, the variation in habitats decreased, and both insects and birds have been affected.
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Nature is affected in Norway too, because Norwegians believe they need to have more.
"For example, one argument for a lot of wind power development is that we'll need more and more energy going forward. Because this development often takes place far from where the energy is used, building the infrastructure to transport the energy will also result in major encroachments on the environment," says Herfindal.
In the same way, the aquaculture industry also affects large areas. One of the industry's main arguments is that aquaculture can offer more efficient food production for a growing population.
Agriculture has changed tremendously in recent generations, and so has species diversity. This photo is from Ramsdalen in Rogaland county around 1906. Photo: Severin Malmin, State Archives in Stavanger
We need to have tools
Is all the development worth it? The researchers believe that this question is a big reason for why we need new tools that can quantify the values of an area.
"This is where we have to watch our step. Assigning a concrete value to a natural area isn't important for a lot of people. But political decisions are often based on weighing different considerations against each other. So it could be important to know the value that different areas have in terms of biodiversity and recreation, or for clean water, food, peace and quiet, local affiliation and identity," says Herfindal.
We also have to recognize that we'll need new areas for infrastructure and other human activity in the future as well, he says.
"It will then be important to know something about the value of various natural areas. But the challenge is that a value like this can rarely be made in dollars and cents. This makes it difficult to compare the cost of an invasive intervention in a natural area with the socio-economic benefit of a development. That kind of benefit is easier to quantify in a way that politicians and other decision-makers can use," he says.
The method will be applicable globally, but it also depends on local conditions.
An important goal for the research group is to make visible – and to document – the values of natural settings, both ones that are intact and ones that have already been developed.
"A number of tools already exist, but these haven't been used very much," says Ottar Michelsen, a professor at the Department of Industrial Economics and Technology Management at NTNU. "One of our goals is to create a method that companies and businesses can use."
A method like this will be applicable globally but at the same time be dependent on local conditions, for the simple reason that different ecosystems may respond differently to interventions and impacts. The possibilities for restoring areas will also vary," Michelsen said.
From the protests in 1979, when up to 800 protesters tried to stop the power development of the Alta-Kautokeino watercourse. Photo: The people's action against the Alta development.
Is it possible to assign a value?
But is it really possible to quantify the value of nature? For example, what is the value of conserving a locally critically endangered species as measured against more renewable energy and lower electricity prices?
"A lot of people might think that a single species seems unimportant measured against our need for food or clean energy. But often endangered species are a good indicator that the type of habitat they live in has high biodiversity or other important values."
Even in Norway, nature has not been mapped nearly well enough. We simply don't know what we have, and so we don't know what we stand to lose, either.
"Unfortunately, we know far too little about the prevalence of both endangered and common species in our environment. We don't even know what species exist in numerous habitat types – which means that we can't assess how important an area is for biodiversity locally or for an entire region, like a county," Herfindal says.
Even in areas where nature has changed, it has value.
Gunhild Setten, a professor in NTNU's Department of Geography, points out that we also have to remember that opinions about the concept of value can vary widely. While the value of a motorway can be measured in shorter travel time, traffic safety or jobs, quantifying the value of nature for people who experience how the surrounding areas are being destroyed is more difficult.
"And, it's important to emphasize that even in areas where nature has changed, it has value. So we need to take a closer look at what nature really means for different interests. Different ways of valuing nature need to become more nuanced and visible, and we have to stress the value of nature better when we consider interventions," says Setten.
What is the value of a landscape? Can we sacrifice it if the price is high enough? Photo: Shutterstock, NTB
Can everything be sacrificed if the price is right?
But can this kind of information be misused? Couldn't assigning a concrete value mean that some natural areas might be in even greater danger of development, if the value of what we get back is high enough? Just because a certain model deems it profitable?
"I find it difficult to imagine that more information and knowledge could make the situation worse, if we look at how major development cases have been carried out in recent decades," Herfindal said.
The environmental basis underlying many decisions is often quite deficient.
The wind turbines at Smøla have killed more than a hundred sea eagles.
"Our impression is that the lack of documenting important environmental values will be interpreted as meaning that no important such values exist in an area that someone plans to develop. One of the reasons for this lack of knowledge is that few or no specific content requirements are set for impact assessments to identify the environmental effects of encroaching on a natural area. We also lack a more comprehensive management of natural areas," Herfindal says.
Log forests and kill sea eagles?
Clear rules are needed. Recent international news reported that natural areas like the Blue Mountains in Australia and Yosemite in the USA emit more CO2 than they absorb. Taken to the extreme, the thought could cross someone's mind that we should get rid of the forests and instead put up some wind turbines or solar panels in the name of climate.
Yosemite in the United States. Would you cut down the trees here for the sake of the climate? Photo: Colourbox
This is not always just theory either. The wind turbines at Smøla in Møre og Romsdal county have killed hundreds of sea eagles.
"These examples show that we need to do a better job communicating what we know. The debate about environmental destruction is often unnuanced," says Herfindal.
The discussion about how the forest industry can contribute to reducing CO2 emissions is one example. Most of the carbon in forests and other habitats on land is bound in the soil.
Unnuanced debates
"To demolish forests or cut down old-growth forests to plant fast-growing 'climate-friendly tree species' means that carbon is released. The result is a much larger emission of carbon – and a strengthening of the greenhouse effect and climate change – than if the forest had been left alone," says Herfindal.
We want to contribute to a more nuanced understanding of the costs embedded in a planned intervention in nature.
He believes the value of sea eagles versus electricity also lacks nuance. Wind turbines have major environmental impacts in addition to killing many bird species.
"Sea eagles probably attract the most attention because they're an iconic species that almost went extinct a few decades ago. The high number of sea eagles killed by wind turbines is a very good indicator that several other species are also negatively affected by the wind turbines. The sea eagle has become a symbol of how wind turbines impact nature."
This kind of symbol can be a positive way to create awareness of the issue. But it can also lead to an unsophisticated debate because we can easily throw all the societal benefits of wind turbines up against a single species.
The world's population has quadrupled in 100 years. That has a high price. Illustration photo: Colourbox
The world's population 100 years ago was less than two billion. Today, we are fast approaching eight billion.
"Through our project, we'll be able to contribute to a more nuanced understanding of what costs planned encroachments on nature will have. It also means that we will need to clarify what we include in the term 'cost,'" says Herfindal.
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Is there actually any hope?
The world's population 100 years ago was less than two billion. Today, we are fast approaching eight billion, a quadrupling in just a few generations. Norway has doubled its population to 5.3 million in the same period.
Isn't the underlying problem simply that the world is gaining ever more people who all want to have ever more things? Is there any hope of change there?
"Yes, there is hope. Surveys show that the vast majority of people want to experience an intact environment and that Norway needs to stop destroying nature. We also see that companies are facing increasing demands to document that their activity is sustainable, including for biodiversity. For that they need tools that make it possible to meet the requirements of sustainability. The EU has been an important driving force in this regard. That's why we're optimistic when we see that biodiversity and environmental values are given priority by most people and at the highest political levels," Herfindal says.
Contact Ivar Herfindal
Contact Gunhild Setten
Contact Ottar Michelsen
Contact James D.M. Speed
Contact Bernt-Erik Sæther
Biology Energy and environment Environmental monitoring Sustainability Norwegian nature Biology Faculty of Economics and Management (OK) Geography Industrial Economics and Technology Management
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Home Features 'Paths to Freedom': Chronicles of the Namibian Struggle by Andreas Thomas
'Paths to Freedom': Chronicles of the Namibian Struggle by Andreas Thomas
Windhoek –Veterans of the Namibian liberation struggle narrate how the two-decade struggle for independence against the South African colonial administration began in a documentary to be launched soon.
The documentary produced by filmmaker, Richard Pakleppa, will be launched at the National Theatre of Namibia, in the capital Windhoek on July 27, 2014.
Film director, Pakleppa, and his production team of local talent spent four years working on the historical documentary, 'Paths to Freedom', which covers an important period in Namibia's history, her path to national consciousness and her formation.
In the documentary, liberation icons, Namibia's President Hifikepunye Pohamba; Founding President, Dr Sam Nujoma; Andimba Toivo ya Toivo; Mzee Kaukungwa; Helao Shityuwete; Kambo Shixungileeni; Ben Amathila; Gerson Veii, and many others, tell how they organised the struggle from the beginning of labour struggles and protests, to the launch of the armed struggle at Omugulugwombashe in 1966.
Women, among them Lahya Iyambo and Justina Amalwa, also tell of how, together with their families, they provided crucial support for the freedom fighters.
The film contains rare interviews with struggle heroes, John Nankudhu and Priskilia Tuhadeleni ‑ who passed away during the course of the production, as well as a unique interview with Philemon Shuuya Castro – who was deputy commander of SWAPO's army in 1966 before being removed from his post in late 1967.
The production team used extensive archive footage and still images found in Namibia, South Africa and Germany as well as recently declassified South African military documents, said Leading Edge Management Consultants in a statement issued on July 5, 2014.
The Windhoek-based consultancy emphasised that 'Paths to Freedom' covers many key experiences in the formation of Namibia's modern history up to 1966.
Such experiences include the degrading experience of contract labourers, the movement of peasants to find work all over Namibia and Southern Africa, the politicising and uniting impact of contract labour, the formation of Owamboland People's Congress, Owamboland People's Organisation and SWAPO, the Old Location shooting in 1959, the exodus of SWAPO activists and leaders to Tanganyika, events at the United Nations and the International Court of Justice, the conflicts with South African appointed tribal leaders, the visit of UN Investigator, Carpio, in the early 60's, the return of the first SWAPO fighters to Namibia in 1965 and 1966, preparations for war and the Battle of Omugulugwombashe on August 26, 1966.
"The film's fascinating interviews are supported by a poetic visual narration and an original sound track created by Hishishi Papa and Philip Miller. The narrative voice of the film is Tshoopara Johannes Tshoopara," said Leading Edge Management Consultants, which deals with publicity and distribution of 'Paths to Freedom'.
About 1 300 copies of the DVD will be distributed for free to schools, museums, multi-purpose centres and education institutions nationwide.
"And the DVDs will be accompanied by a facilitator's guide, for use of the film for teaching purposes and for discussion and dialogue on the aspects of Namibia's history that are presented in 'Paths to Freedom'. Beyond this, the film will be available for sale with half the proceeds of all sales going to the Robben Island Veterans Trust Fund," said Leading Edge Management Consultants.
The film was produced by On Land Productions, in partnership and with support from various institutions including the National Archives of Namibia and the Ministry of Veteran's Affairs, the Embassy of Finland, First National Bank of Namibia, Namibian Broadcasting Corporation, the Namibia Film Commission, and the Carl Schlettwein Foundation in Basle, Switzerland.
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» What California employers should know about the new marijuana law
What California employers should know about the new marijuana law
Sep 23, 2022 | Employment litigation
Ever since California legalized marijuana for recreational use in Nov. 2016 employees and employers have faced a problem. There was nothing in the law forbidding employers from firing or not hiring someone who tested positive for cannabis in a pre-hiring or random drug test. That meant California employees' use of a legal substance outside of work could cost them their job – or prevent them from getting one.
That is going to change thanks to a law just signed by Gov. Gavin Newsom. The law states that most employers cannot screen for "nonpsychoactive cannabis metabolites" in random drug testing or in making employment decisions, including hiring and firing.
Nonpsychoactive vs. psychoactive metabolites
These nonpsychoactive metabolites indicate only that someone ingested cannabis at some point in the recent past. However, they are not indicative of current impairment. THC, which is the psychoactive ingredient in cannabis that causes the "high," becomes nonpsychoactive as the high wears off, but can remain in a person's system for up to a week after they last consumed the drug
Marijuana legalization advocates and unions have celebrated the passage and signing of the bill into law, even though it won't take effect until the beginning of 2024. One labor union official said, "No employee deserves to feel stigmatized and unsafe at work because of an outdated testing method." He also noted, "There are much more accurate, modern-day cannabis testing methods, like oral swabs, that are able to detect recent use and increase workplace safety."
There will be exceptions
There are some exceptions in the law for employers in the construction industry. Another exception involves federal jobs since marijuana is still illegal under federal law.
Employers still have over a year to prepare for the new law. However, it's better to begin preparing sooner rather than later to ensure that you're fully in compliance on Jan. 1, 2024. Having experienced legal guidance can help.
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