text:
John Cena eyed for role in 'Suicide Squad' sequel
He will join actors Idris Elba and Margot Robbie in the film
Published: April 18, 2019 11:11 IANS
John Cena, a cast member in the upcoming film "Playing with Fire," addresses the audience during the Paramount Pictures presentation at CinemaCon 2019, the official convention of the National Association of Theatre Owners (NATO) at Caesars Palace, Thursday, April 4, 2019, in Las Vegas. (Photo by Chris Pizzello/Invision/AP) Image Credit: Chris Pizzello/Invision/AP
Actor-wrestler John Cena is circling a role in the upcoming 'Suicide Squad' sequel.
According to sources, Cena is in talks to join actors Idris Elba and Margot Robbie in the follow-up to 2016's 'Suicide Squad', reports variety.com.
Robbie is set to return as Harley Quinn and Jai Courtney is back as Captain Boomerang.
It was first reported that Warner Bros decided to have Elba play a brand-new character instead of taking on Deadshot, a character portrayed by actor Will Smith in the first film.
It's currently unknown who Cena and Elba will be playing.
James Gunn will write and direct the movie. It is scheduled to hit the theatres on August 6, 2021.
The film will mark Cena's first comic-book role. Cena made his foray into acting after years as one of the top WWE (World Wrestling Entertainment) stars.
Cena's latest big-screen roles include 'Blockers', alongside Leslie Mann and Ike Barinholtz. He was also seen in movies including 'Transformers' spinoff 'Bumblebee' with Hailee Steinfeld.
Cena has been tapped by fellow WWE alum Dwayne Johnson to star in 'The Janson Directive'. He will also voice a character in fantasy-adventure 'The Voyage of Doctor Dolittle', co-starring Robert Downey Jr and Selena Gomez.

redpajama_set_name: RedPajamaCommonCrawl


text:
What Do We Know About Autonomous Vehicles?
Autonomous vehicles are currently subject to a lot of hope, hype and hysteria, especially after the recent fatality in Arizona, when a pedestrian was struck and killed by one of Uber's self-driving cars. Autonomous vehicles will likely have as significant an impact on our lives as electricity, computers and the internet all did. However, just like the aforementioned innovations, we cannot predict all the varied impacts and implications, both positive and negative, of self-driving vehicles. Here, we'll offer a brief overview of what we do know and what's still up in the air.
Autonomous vehicles are coming.
In fact, they're already here. Autonomous buses and shuttles are currently being deployed in city centers , sprawling work sites, and airports; driverless trucks are delivering beer long distances; and Waymo's test set of self-driving cars have clocked five millions miles on public roads. Even autonomous flying taxis seem to be in our near future. It's no longer a matter of if, but when.
Autonomous vehicles will change the fabric of a city.
In a future where fully autonomous vehicles are the norm, there will be no need for lanes or road signs or stoplights. Cars will be connected by high-speed internet and able to communicate with one other, their occupants, as well as any central or local coordinating infrastructure. Getting lost will be a thing of the past, thanks to lightning-fast access to the latest, most accurate maps and finer resolution GPS (coming soon). Road furniture, as we know it today, will be obsolete.
Thanks to more precise and safer driving, theoretically, roads could become even narrower, allowing for more of the city to be given back to the community, pedestrians, and other modes of transport. Urban life as we know it, will change drastically.
The flow of traffic will be smoother.
If vehicles are explicitly communicating with each other, or with a remote coordinator, they can efficiently accelerate or decelerate so that stopping becomes altogether unnecessary at intersections — assuming, of course, that roads don't all become sets of "Boring" underground tunnels). With this logic, compared to an intersection with similar density of traffic and human-manned vehicles, traffic flow should be significantly more seamless and efficient in a world run by autonomous vehicles. In addition, if vehicles are sharing explicit intent with each other, the others on the road can adjust and plan accordingly. Vehicles can change lanes or speed gently, surprising no one, leading to better safety and a smoother, more fuel efficient ride.
Automated Vehicles


text:
Officials Say Trump Has Full Confidence in Chief of Staff John Kelly
Aides also defend president's comments in wake of Rob Porter's resignation amid abuse allegations
Various White House officials said Sunday that President Donald Trump has full confidence in his chief of staff, John Kelly. seen Friday with the president.
Photo: Olivier Douliery/Press Pool
Rebecca Ballhaus
@rebeccaballhaus
rebecca.ballhaus@wsj.com
Updated Feb. 11, 2018 2:42 pm ET
WASHINGTON—President Donald Trump has full confidence in John Kelly, White House officials said Sunday, after the president in recent days had privately criticized his chief of staff's handling of domestic-abuse allegations against a senior aide.
Top officials also defended Mr. Trump's recent public statements about abuse, in which he emphasized that many people's lives were "shattered" by accusations of abuse, but didn't express concern for the victims of the abuse.
White House adviser Kellyanne Conway said Mr. Trump's view is that his chief of staff is "doing a great job and that he has full faith in him."
"I spoke to the president last night," Ms. Conway said in an interview on CNN with jake Tapper. "He said, 'please tell Jake that I have full faith in chief of staff John Kelly and that I'm not actively searching for replacements.' "
On NBC, White House legislative affairs director Marc Short said the president has "absolute confidence" in Mr. Kelly. Mr. Short also disputed reports that Mr. Kelly had told the president he was willing to resign over his handling of the allegations against Rob Porter, the White House staff secretary who resigned last week after two reports of allegedly abusive behavior toward his ex-wives.
Walmart:
Walmart promo code: $10 off all categories


Guest Preacher: DAVE HARVEY is a Teaching Pastor at Summit Church in Fort Myers/Naples, Florida, and serves as the Executive Director of Sojourn Network. Dave has 30+ years of pastoral experience, with 19 years as a lead pastor. Dave chairs the board for the Christian Counseling and Educational Foundation (CCEF) and has traveled nationally and internationally doing conferences where he teaches Christians, equips pastors and trains church planters. Dave has a D-Min from Westminster Theological Seminary and contributes regularly at For The Church and The Gospel Coalition. He is the author of When Sinners Say I Do, Am I Called, and Rescuing Ambition, and Letting Go, a book he co-authored with Paul Gilbert. Married for 35 years, Dave and Kimm have four kids and two grandchildren.


There are two levels at which a senior marketer can think about his or her leadership. The first is the way in which they lead their team in the Marketing function, seeking to maximise its performance and impact. The second is the role they play cross-functionally in leading the whole company in being customer-centred.
Both of these levels are important. They are also mutually dependent – you can't fully succeed in one without also succeeding in the other. But it is the second which deserves particular attention, not only because it is the most challenging but because it also requires the biggest change in mindset for people coming through from the junior ranks of the Marketing function.
Marketers have a vital role to play in helping companies create value for their customers. Look at the fantastic work done at Nike with the Nike+ proposition, at Waitrose with the award winning Essentials range and at O2 in establishing their Fair Deal by rewarding loyal customers and not just newly acquired ones. In each case, the marketing teams identified exciting market opportunities and created insightful, innovative propositions in response.
Success of this sort is not dependent solely on excellent technical marketing. It also requires a host of activities across the whole company to be aligned behind these customer-focused opportunities. How can this broader leadership challenge be achieved? Here are three steps to help.
The first and most important step is simply to make a conscious decision to define one's leadership in terms of the whole company, rather than at just a functional level. This may sound obvious, but it is far from commonplace.
A good starting point is to make sure brand strategy is central to the whole business strategy, rather than simply the basis for advertising and promotion. For marketers to make promises to customers via their brand communication is one thing – to ensure the whole company is aligned and consistent in delivering against those promises is another thing entirely.
The impact of successful brand development must also be explained in financial language so that other functions can appreciate the full commercial value of Marketing's role. In the words of Unilever's CMCO Keith Weed, 'if Finance counts where the money's going, Marketing must count where it's coming from'. Marketers will only earn the right to play a leadership role in the business if they can demonstrate how creating better value for customers will ultimately translate into improved top and bottom line growth.
In practice, this means clarifying how Marketing will interact with the rest of the business. Clear roles and decision-making responsibilities must be established, as must strong inter-personal relationships with key stakeholders to support effective collaboration on a day-to-day basis.
Once the organisation of the company is set up to serve the customer, the third step is to make sure the people working within it are motivated and empowered to do so in practice. An inspiring brand purpose is a powerful foundation for emotional engagement, as proven recently by businesses as diverse as Red Bull (Energise the World) and Boots (Feel Good).
But too often internal brand engagement programmes begin and end with employee inspiration. More focus is needed on the support systems needed to ensure that good intentions are embedded in true behaviour change. A good example is the work done by British Gas in recent years to reduce customer complaints by 90% by sorting out its faulty IT billing systems.
To conclude, let's go back to the first step. If you are a marketing leader, ask yourself this question: who are you really leading for? Is it for yourself, your team, your function, or your whole company? The bigger you think, the bigger your impact is likely to be.


text:
Home Crouch-100 Careers In The Music Business
Crouch-100 Careers In The Music Business
The music industry has undergone radical changes in recent years, but abundant career opportunities still exist for beginners with talent, imagination, and a love of music. The record industry and its dealers have suffered recent setbacks, but most other aspects of the music business continue to flourish--and this book tells beginners how and where to find rewarding jobs. Highly talented singers, song writers, and instrumentalists are always in demand, but many lesser known and rewarding career opportunities exist, with new avenues opening virtually every day. Among job opportunities described in this book are artists' agents and managers, talent agents, sound technicians, film and Tv technicians, film and Tv production managers, advertising illustrators and copywriters, publicists, and many others. The author tells beginners how to match their own qualifications with potential job openings, seek and find job interviews, and get into the music business. For each job designation, she lists the special skills needed, describes a typical workday, and presents actual case studies of men and women who have found music career openings, and have gone on to make the most of them. Sidebar features include at-a-glance career tips and "voices of experience" notes citing the best and worst things about each job. New in this edition is information on how today's new technologies have influenced careers and created opportunities in the music business. The book's several appendices include lists of names, addresses, and web sites of music unions, organizations, directories, magazines, and schools offering degrees in music business management. There is also a glossary of music business and technical terms.


text:
Hans Norbye – calciatore norvegese
 Kaja Norbye – sciatrice alpina norvegese
 Martin Norbye – ex calciatore norvegese
 Tuva Norbye – sciatrice alpina norvegese

redpajama_set_name: RedPajamaWikipedia


text:
Bosnia and Herzegovina competed at the 2009 World Championships in Athletics from 15–23 August in Berlin.

Results

Men
Field events

See also
 Bosnia and Herzegovina at the World Championships in Athletics

References

External links
Official competition website

Nations at the 2009 World Championships in Athletics
World Championships in Athletics
2009


text:
Trends in health care–associated infections in acute care hospitals in Canada: an analysis of repeated point-prevalence surveys
Robyn Mitchell, Geoffrey Taylor, Wallis Rudnick, Stephanie Alexandre, Kathryn Bush, Leslie Forrester, Charles Frenette, Bonny Granfield, Denise Gravel-Tropper, Jennifer Happe, Michael John, Christian Lavallee, Allison McGeer, Dominik Mertz, Linda Pelude, Michelle Science, Andrew Simor, Stephanie Smith, Kathryn N. Suh, Joseph Vayalumkal, Alice Wong and Kanchana Amaratunga; for the Canadian Nosocomial Infection Surveillance Program
CMAJ September 09, 2019 191 (36) E981-E988; DOI: https://doi.org/10.1503/cmaj.190361
Public Health Agency of Canada (Mitchell, Rudnick, Alexandre, Gravel-Tropper, Pelude, Amaratunga), Ottawa, Ont.; University of Alberta Hospital (Taylor, Granfield, Smith), Edmonton, Alta.; Alberta Health Services (Bush), Calgary, Alta.; Vancouver Coastal Health (Forrester), Vancouver, BC; McGill University Health Centre (Frenette), Montréal, Que.; Infection Prevention and Control Canada (Happe), Edmonton, Alta.; London Health Sciences Centre (John), London, Ont.; Hopital Maisonneuve-Rosemont (Lavallee), Montréal, Que.; Mount Sinai Hospital (McGeer), Toronto, Ont.; Department of Medicine, McMaster University and Hamilton Health Sciences (Mertz), Hamilton, Ont.; Hospital for Sick Children (Science); Sunnybrook Health Sciences Centre (Simor), Toronto, Ont.; The Ottawa Hospital (Suh, Amaratunga), Ottawa, Ont.; Alberta Children's Hospital (Vayalumkal), Calgary, Alta.; Royal University Hospital (Wong), Saskatoon, Sask.
Geoffrey Taylor
Wallis Rudnick
Stephanie Alexandre
Kathryn Bush
Leslie Forrester
Charles Frenette
Bonny Granfield
Denise Gravel-Tropper
Jennifer Happe
Michael John
Christian Lavallee
Allison McGeer
Dominik Mertz
Linda Pelude
Michelle Science
Andrew Simor
Kathryn N. Suh
Joseph Vayalumkal
Alice Wong
Kanchana Amaratunga
BACKGROUND: Health care–associated infections are a common cause of patient morbidity and mortality. We sought to describe the trends in these infections in acute care hospitals, using data from 3 national point-prevalence surveys.
METHODS: The Canadian Nosocomial Infection Surveillance Program (CNISP) conducted descriptive point-prevalence surveys to assess the burden of health care–associated infections on a single day in February of 2002, 2009 and 2017. Surveyed infections included urinary tract infection, pneumonia, Clostridioides difficile infection, infection at surgical sites and bloodstream infections. We compared the prevalence of infection across the survey years and considered the contribution of antimicrobial-resistant organisms as a cause of these infections.
RESULTS: We surveyed 28 of 33 (response rate 84.8%) CNISP hospitals (6747 patients) in 2002, 39 of 55 (response rate 71.0%) hospitals (8902 patients) in 2009 and 47 of 66 (response rate 71.2%) hospitals (9929 patients) in 2017. The prevalence of patients with at least 1 health care–associated infection increased from 9.9% in 2002 (95% confidence interval [CI] 8.4%–11.5%) to 11.3% in 2009 (95% CI 9.4%–13.5%), and then declined to 7.9% in 2017 (95% CI 6.8%–9.0%). In 2017, device-associated infections accounted for 35.6% of all health care–associated infections. Methicillin-resistant Staphylococcus aureus (MRSA) accounted for 3.9% of all organisms identified from 2002 to 2017; other antibiotic-resistant organisms were uncommon causes of infection for all survey years.
INTERPRETATION: In CNISP hospitals, there was a decline in the prevalence of health care–associated infection in 2017 compared with previous surveys. However, strategies to prevent infections associated with medical devices should be developed. Apart from MRSA, few infections were caused by antibiotic-resistant organisms.
See related article at www.cmaj.ca/lookup/doi/10.1503/cmaj.190948
Health care–associated infections represent substantial burden on health care systems in highly developed countries, including Canada.1–3 In 2002, health care–associated infection developed in an estimated 5% of patients admitted to hospital in the United States, resulting in 1.7 million infections and 98 000 deaths.1 A study using 2015 data from the European Antimicrobial Resistance Surveillance Network (EARS-Net) from 30 countries estimated 426 277 infections with antibiotic-resistant bacteria were associated with health care, with an attributable mortality of 33 110.2 A point-prevalence study conducted in 2015 estimated that there were 687 200 health care–associated infections in US hospitals.3
Timely data on the occurrence of health care–associated infections and antimicrobial resistant organisms in Canadian hospitals are essential to the response to an evolving epidemiologic situation. Internationally, prevalence surveys are widely used to estimate the incidence and burden of disease from these infections. 3–10 The Canadian Nosocomial Infection Surveillance Program (CNISP) provides data on the incidence of selected health care–associated infections and antimicrobial resistant organisms11–15 and conducted point-prevalence surveys in 2002 and 2009.16,17 In 2017, we replicated a point-prevalence survey in CNISP hospitals, to provide an up-to-date estimate of the burden of health care–associated infections and antimicrobial-resistant organisms causing these infections in Canadian hospitals, and to describe the trends observed over time in the 3 surveys.
Sources of data and study population
The Canadian Nosocomial Infection Surveillance Program is a collaboration of the Public Health Agency of Canada (PHAC) and sentinel hospitals across Canada that participate as members of the Canadian Hospital Epidemiology Committee, a subcommittee of the Association of Medical Microbiology and Infectious Disease Canada (Appendix 1, available at www.cmaj.ca/lookup/suppl/doi:10.1503/cmaj.190361/-/DC1). Canadian Nosocomial Infection Surveillance Program hospitals from 9 provinces participated in the 2002 and 2009 descriptive point-prevalence surveys, and hospitals from all 10 provinces participated in 2017. Patients of any age who were admitted to a participating CNISP hospital for 48 hours or longer were eligible for inclusion. Patients who had been admitted for less than 48 hours but were admitted within the last month to the survey hospital were also included. We excluded patients admitted to long-term care, maternity, mental health, day surgery or rehabilitation units.
Case definitions
We defined health care–associated infections using the Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network standard definitions,18 except for central line–associated bloodstream infections for which we used the CNISP definition.19 We considered an infection to be present if the patient was symptomatic of, or was receiving antimicrobial therapy to treat, a health care–associated infection on the day of the survey. We collected data on the following: pneumonia, urinary tract infection (UTI), primary and secondary bloodstream infection, infection at surgical sites and infection caused by Clostridioides difficile.
We identified eligible patients by hospital census on a specified day in February of each survey year. The 2002 survey was conducted in February owing to the timing of budget allocation. To limit the influence of seasonal variation in health care–associated infections and to permit comparison among surveys, the 2009 and 2017 surveys were also conducted in February.
Experienced and trained staff reviewed the medical records of eligible patients for demographic data (age, sex, date of admission and type of ward where the patient was located on the day of the survey) and information on health care–associated infection (infection type, specimen collection date and microbiological etiology when available). In 2017, we collected data on ventilator-associated pneumonia, surgical site infections associated with a prosthetic implant, catheter-associated UTI and central line–associated bloodstream infections. We collected data on methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci and extended-spectrum β-lactamase–producing organisms for all 3 surveys. Carbapenemase-producing organisms emerged as a concern in Canada in 2010 and were surveyed in 2017 only.14 Hospital staff who were experienced in collection of surveillance data, use of National Healthcare Safety Network case definitions and trained in the use of the prevalence survey protocol (infection control professionals) collected data on a standardized form and submitted these forms to the PHAC for data entry, validation and analysis. We performed double-entry verification, and any inconsistencies in the data were compared with the submitted form and verified by the hospital if required. The Canadian Nosocomial Infection Surveillance Program collects hospital-level data (e.g., bed size, specialized services provided and type of hospital) annually using a standardized hospital profile form. We extracted hospital profile data for CNISP hospitals that participated in the 3 surveys and included this data in the analysis.
We analyzed the data using SAS software (version 9.3). We compared the characteristics of participating hospitals and patients who were surveyed, the prevalence of health care–associated infections and organisms causing infection using standard differences,20 χ2 tests, Fisher–Freeman–Halton exact tests for categorical variables or Kruskal–Wallis tests for continuous variables. We considered a 2-sided p value of 0.05 or less as significant.
We calculated the prevalence of health care–associated infection as the percentage of the number of patients with at least 1 infection over the total number of patients surveyed. We used Poisson regression with the survey year as the exposure variable to calculate the differences in prevalence of infection. We used generalized estimating equations to account for clustering by hospital, and to calculate p values and robust standard errors.
These surveys were either considered exempt as quality assurance projects or approved by the research ethics boards at participating hospitals if required by institution-specific policies.
Twenty-eight of 33 CNISP acute care hospitals (6747 patients) participated in the 2002 point-prevalence survey (response rate 84.8%), 39 of 55 hospitals (8902 patients) in 2009 (response rate 71.0%) and 47 of 66 hospitals (9929 patients) in 2017 (71.2% response rate). Table 1 provides the characteristics of the participating hospitals. Over the 3 surveys, the hospitals remained similar with respect to geographic distribution, bed size, hospital type and specialized services provided.
Table 1:
Selected characteristics of participating hospitals for the point-prevalence surveys (2002, 2009 and 2017)
Table 2 provides the characteristics of the patients who were surveyed. Although there were differences in the age distribution and there was an increased proportion of patients located in the intensive care unit (ICU) in 2017, the size of the effect was small (< 0.2) for all characteristics.
Selected characteristics of patients who were surveyed in 2002, 2009 and 2017
For all 3 surveys combined, a total of 2647 health care–associated infections were reported in 2447 patients with infection (1.08 health care–associated infections per infected patient).
The prevalence of patients with at least 1 health care–associated infection increased from 9.9% in 2002 (95% confidence interval [CI] 8.4%–11.5%) to 11.3% in 2009 (95% CI 9.4%–13.5%) followed by a significant decline to 7.9% in 2017 (95% CI 6.8%–9.0%). For all 3 surveys combined, prevalence of health care–associated infection was higher in patients admitted to ICU, where 16.2% of these patients had at least 1 health care–associated infection compared with 8.7% of patients in all other units combined (p < 0.001). We observed a major decline in the prevalence of infection in patients in the ICU, decreasing from 20.1% in 2002 (95% CI 15.8%–25.5%) to 17.8% in 2009 (95% CI 13.9%–22.8%) to 12.6% in 2017 (95% CI 10.1%–15.7%).
In an analysis restricted to the 18 hospitals that participated in all 3 surveys, we found that the prevalence of patients with a health care–associated infection was 9.8% in 2002 (95% CI 7.8%–12.2%) 10.4% in 2009 (95% CI 7.9%–13.7%) and 8.0% in 2017 (95% CI 6.4%–10.1%). Similarly, the prevalence of health care–associated infections in patients in the ICU in these 18 hospitals also declined from 20.2% in 2002 (95% CI 14.9%–27.4%) to 14.3% in 2009 (95% CI 9.9%–20.5%) to 13.9% in 2017 (95% CI 10.8%–17.8%).
Over the 3 surveys, UTIs (31.9%) were the most common infection type, followed by pneumonia (23.4%), surgical site infection (20.2%), bloodstream infection (15.2%) and C. difficile infection (9.3%). The prevalence of patients with a UTI, surgical site infection and C. difficile infection declined over time, although not significantly. However, the prevalence of patients with pneumonia and bloodstream infection did significantly decrease from 2.9% in 2002 (95% CI 2.4%–3.6%) to 2.7% in 2009 (95% CI 2.1%–3.5%) to 1.8% in 2017 (95% CI 1.5%–2.3%) for pneumonia, and from 1.8% in 2002 (95% CI 1.4%–2.4%) and 2009 (95% CI 1.4%–2.3%) to 1.2% in 2017 (95% CI 0.9%–1.5%) for bloodstream infection (Figure 1).
Figure 1:
Prevalence of health care–associated infection types in Canada in 2002, 2009 and 2017. Note: BSI = bloodstream infection, CDI = Clostridioides difficile infection, PNEU = pneumonia, SSI = surgical site infection, UTI = urinary tract infection. Bars represent 95% confidence intervals.
In 2017, device-associated infections (i.e., ventilator-associated pneumonia, catheter-associated UTI, surgical site infections associated with a prosthetic implant and central line–associated bloodstream infection) accounted for 35.6% of all health care–associated infections (278 of 780 infections). Of the device-associated infections, catheter-associated UTI accounted for 37.1%, ventilator-associated pneumonia for 22.3%, central line–associated bloodstream infection for 21.2% and surgical site infections associated with a prosthetic implant for 19.4%.
Table 3 presents some selected antimicrobial resistant organisms that cause health care–associated infection. Overall, antimicrobial-resistant organisms remained an uncommon cause of health care–associated infection across all survey years. The most common resistant organism was MRSA, which was present in 6.2% of pneumonia infections, 5.6% of bloodstream infections, 5.0% of surgical site infections and 1.1% of UTIs. Of organisms associated with a bloodstream infection, the proportion of MRSA more than doubled from 3.8% in 2009 to 8.5% in 2017 (p = 0.1). Vancomycin-resistant enterococci infrequently caused infection at any site (1.0%, 0.5% and 0.8% of organisms associated with UTIs, surgical site infection and bloodstream infection, respectively). Carbapenemase-producing organisms were identified in only 3 infections (2 Escherichia coli and 1 Enterobacter species) in the 2017 survey. Infections associated with extended-spectrum β-lactamases significantly increased in frequency between 2002 (0.4%) and 2017 (2.8%) (p = 0.01), and were most common in patients with UTIs.
Selected antibiotic-resistant organisms causing health care–associated infection in 2002, 2009 and 2017
Among all health care–associated infections, the percentage of S. aureus isolates that were methicillin resistant remained consistent from 31.4% (2002) to 28.3% (2009) to 31.4% (2017). Conversely, the percentage of Enterococcus species isolates that were vancomycin resistant increased from 1.9% (2002) to 5.0% (2009) to 8.2% (2017) (p = 0.12).
We tracked the burden of health care–associated infections among sentinel Canadian acute care hospitals based on findings from 3 repeated point-prevalence surveys performed in 2002, 2009 and 2017. We found a significant reduction in health care–associated infections, representing a 30.1% decline in prevalence from 2009 to 2017. For patients in the ICU, we found a 29.2% decline in prevalence of infection from 2009 to 2017. Of the different types of infections measured in all 3 surveys, the prevalence of pneumonia and bloodstream infection significantly declined; however, we also observed a decrease for all other types. In addition, prevalence of health care–associated infections among patients in the ICU markedly declined. These results are consistent with other CNISP data,11,20 which suggests improvements in the prevention of health care–associated infections in Canadian acute care hospitals. This trend has occurred despite some changes in hospital patient populations that would be expected to increase infection risk, such as a higher proportion of patients in the ICU.
No single intervention is likely to have produced a decline in all infection types, suggesting that Canadian hospitals have undertaken multiple interventions to address health care–associated infections.21 Examples of interventions that have been adopted include improved hand hygiene compliance, multidisciplinary implementation of bundles (e.g., central catheter insertion and maintenance) and antimicrobial stewardship to prevent C. difficile infection.22–24 In our 2017 survey, device-associated infections accounted for 35.6% of all health care–associated infections. In the future, action to address both the need for and safety of these devices is likely to be the most successful approach to reduce the burden of these infections further.
An important finding of our study is that antimicrobial-resistant organisms other than MRSA remain an uncommon cause of health care–associated infection in the Canadian hospitals that were surveyed; however, their prevalence has increased. Methicillin-resistant S. aureus is now widely prevalent as a cause of infection across types, increasingly as a cause of bloodstream infection, reaching 8.5% in 2017. This is a cause for great concern because MRSA-associated bloodstream infection is associated with a mortality rate of greater than 20% in patients admitted to hospital.25
The prevalence of infection associated with extended-spectrum β-lactamases, while remaining low, was highest in 2017. We collected data on carbapenemase-producing organisms in the 2017 survey and found only 3 infections. The proportion of MRSA (31.4%) and very low frequency of carbapenemase resistance seen in 2017 compares to the prevalence of 45% for MRSA and 5% for carbapenemase-producing organisms in a study of infections in a sample of US hospitals in 2015.3 However, the rising MRSA bacteremia data and emerging signs of resistant gram-negative infections in 2017 indicates a need for vigilance and preventive actions to avoid a worsening antibiotic-resistance problem among infections in CNISP hospitals.
The prevalence of health care–associated infections in our surveys (11.3% in 2009 and 7.9% in 2017) are higher than those reported by the CDC (4.0% in 2011 and 3.2% in 2015).3 This is likely because our surveys represent data from large, tertiary care hospitals that typically serve patient populations at higher risk for infection compared with general hospitals that were included in the CDC surveys. The distribution and trends in infection in our surveys differed from those found by CDC: in their surveys, pneumonia and C. difficile infection were predominant; only surgical site infection and UTI fell in prevalence. The prevalence of health care–associated infections in our 2017 survey (7.9%) was comparable to results reported by a 2016/2017 prevalence survey by the European Centre for Disease Control and Prevention (7.1%) among tertiary care hospitals;5 however, by excluding low-to very low–risk units such as mental health and maternity, our prevalence could be expected to be slightly higher. Differences in frequency and trends in health care–associated infections among jurisdictions highlights the importance of collecting Canadian data to direct prevention strategies.
Our surveys have several limitations. First, our findings may not be representative of the general inpatient population in Canada because the populations examined in these surveys were mainly in large, tertiary acute care hospitals. However, our results provide a robust estimate of health care–associated infections in hospitals of this type in Canada. The Public Health Agency of Canada is conducting additional prevalence surveys in hospital settings that were not included or underrepresented in these surveys. Second, results were not disaggregated by province; this was to protect the confidentiality of individual hospitals because some provinces have few reporting hospitals. Third, slight changes to the National Healthcare Safety Network surveillance definitions occurred between the 2009 and 2017 surveys. For example, both the UTI and pneumonia definitions were more specific in 2017 than in 2009. In 2017, a reduction in follow-up period defining surgical site infections occurred, which could reduce the hospital prevalence of these infections.26 Fourth, laboratory practices have changed over time; for example, laboratories now use more sensitive assays to detect C. difficile infection, which could result in an increase in prevalence.27 Nevertheless, by adopting the same methods, timing, similar definitions, hospital type and case mix, we have attempted to minimize the potential for protocol variation. Fifth, there is a risk of inconsistent adjudication considering turnover of hospital staff reviewing the medical charts. However, we provided standardized training to data collectors to reduce inconsistencies in data collection. Sixth, although patients in maternity wards are susceptible to health care–associated infections, they were excluded as most infections among this population present after the patient's brief hospital stay. For consistency, and to permit comparison among surveys, the decision to exclude maternity patients in the 2002 survey was maintained in 2009 and 2017.
Using 3 sequential point-prevalence studies in a sentinel group of Canadian hospitals between 2002 and 2017, we found a reduction in the prevalence of health care–associated infections overall and that infections caused by antimicrobial-resistant organisms remain uncommon. However, continued efforts in infection prevention and control are required to reduce the burden of health care–associated infections further.
The authors gratefully acknowledge the contributions of the epidemiologists, infection control practitioners and staff for their data collection and submission at each participating hospital, as well as the following members of the Canadian Nosocomial Infection Surveillance Program who participated in the 2002, 2009 and 2017 point-prevalence surveys: Bonita E. Lee, Stollery Children's Hospital, Edmonton, Alta.; Camille Lemieux, University Health Network, Toronto, Ont.; Chelsea Ellis, The Moncton Hospital, Moncton, NB; Deanna Hembroff, University Hospital of Northern BC, Prince George, BC; Elizabeth Bryce, Vancouver General Hospital, Vancouver, BC; Elizabeth Henderson, Alberta Health Services, Calgary, Alta.; Eva Thomas, BC Children's Hospital, BC Women's Hospital, Vancouver, BC; Gerald A. Evans, Kingston General Hospital, Kingston, Ont.; Ghada Al-Rawahi, BC Children's Hospital, BC Women's Hospital, Vancouver, BC; Gregory German, Queen Elizabeth Hospital, Charlottetown, PEI; Ian Davis, QEII Health Sciences Centre, Halifax, NS; Janice de Heer, Interior Health Authority, Kelowna, BC; Jeannette Comeau, IWK Health Centre, Halifax, NS; Jerome Leis, Sunnybrook Health Sciences Centre, Toronto, Ont.; Jessica Minion, Regina Qu'Appelle Health Region, Regina, Sask.; Joanne Embree, Health Sciences Centre, Winnipeg, Man.; Joanne M. Langley, IWK Health Centre, Halifax, NS; Jocelyn Srigley, BC Children's Hospital, BC Women's Hospital, Vancouver, BC; Johan Delport, London Health Sciences Centre, London, Ont.; John Conly, Foothills Medical Centre, Calgary, Alta.; John Embil, Health Sciences Centre, Winnipeg, Man.; Karl Weiss, Maisonneuve-Rosemont Hospital, Montréal, Que.; Kathy Malejczyk, Reginal Qu'Appelle Health Region, Regina, Sask.; Kevin C. Katz, North York General Hospital, Toronto, Ont.; Lynn Johnston, QEII Health Sciences Centre, Halifax, NS; Marie-Astrid Lefebvre, Montreal Children's Hospital, Montréal, Que.; Mark Loeb, McMaster University and Hamilton Health Sciences, Hamilton, Ont.; Mary Vearncombe, Sunnybrook Health Sciences Centre, Toronto, Ont.; Natalie Bridger, Eastern Health-HSC, St. John's, Nld.; Nisha Thampi, Children's Hospital of Eastern Ontario, Ottawa, Ont.; Pamela Kibsey, Royal Jubilee Hospital, Victoria, BC; Paula Stagg, Western Memorial Hospital, Corner Brook, Nld.; Sarah Forgie, Stollery Children's Hospital, Edmonton, Alta.; Stephanie Smith, University of Alberta Hospital, Edmonton, Alta.; Susan Richardson, Hospital for Sick Children, Toronto, Ont.; Susy Hota, University Health Network, Toronto, Ont.; Titus Wong, Vancouver General Hospital, Vancouver, BC; Valerie Wood, Interior Health Authority, Kelowna, BC; Virginia Roth, The Ottawa Hospital, Ottawa, Ont.; Yves Longtin, SMBD-Jewish General Hospital, Montréal, Que.
Visual abstract available at www.cmaj.ca/lookup/suppl/doi:10.1503/cmaj.190361/-/DC2
Contributors: Robyn Mitchell and Wallis Rudnick performed the data analysis. Robyn Mitchell and Geoffrey Taylor interpreted the data and drafted the initial manuscript. All of the authors contributed to conception and design of the work, and data aquisiton; revised the manuscript critically for important intellectual content, gave final approval of the version to be published and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Funding: The Public Health Agency of Canada provided funding for the Canadian Nosocomial Infection Surveillance Program.
Data sharing: Study protocols are available. Data-sharing requests will be considered and reviewed by the Public Health Agency of Canada and individual site investigators.
Accepted July 11, 2019.
Calfee DP
. Crisis in hospital-acquired, health care-associated infections. Annu Rev Med 2012;63:359–71.
Cassini A,
Högberg LD,
Plachouras D,
Burden of AMR Collaborative Group. Attributable deaths and disability-adjusted life-years caused by infections with antibiotic-resistant bacteria in the EU and the European Economic Area in 2015: a population-level modelling analysis. Lancet Infect Dis 2019; 19: 56–66.
Magill SS,
O'Leary E,
Janelle SJ,
Emerging Infections Program Hospital Prevalence Survey Team. Changes in prevalence of health care-associated infections in U.S. hospitals. N Engl J Med 2018;379:1732–44.
Point prevalence survey of health care-associated infections and antimicrobial use in European acute care hospitals: 2011–2012. Stockholm: European Centre for Disease Prevention and Control; 2013. Available: https://ecdc.europa.eu/en/publications/Publications/healthcare-associated-infections-antimicrobial-use-PPS.pdf (accessed 2019 Mar. 26).
Suetens C,
Latour K,
Kärki T,
The Health care-Associated Infections Prevalence Study Group. Prevalence of health care-associated infections, estimated incidence and composite antimicrobial resistance index in acute care hospitals and long-term care facilities: results from two European point prevalence surveys, 2016 to 2017 [published erratum in Euro Surveill 2018;23:pii: 181122e1]. Euro Surveill 2018;23:1800516.
Eriksen HM,
Iversen BG,
Aavitsland P
. Prevalence of nosocomial infections in hospitals in Norway, 2002 and 2003. J Hosp Infect 2005;60:40–5.
Olona M,
Limón E,
Barcenilla F,
VINCat Program. Prevalence of nosocomial infections in acute care hospitals in Catalonia (VINCat Program). Enferm Infecc Microbiol Clin 2012;30(Suppl 3):7–12.
van der Kooi TII,
Manniën J,
Wille JC,
. Prevalence of nosocomial infections in The Netherlands, 2007–2008: results of the first four national studies. J Hosp Infect 2010;75:168–72.
Antonioli P,
Manzalini MC,
Stefanati A,
. Temporal trends of health care associated infections and antimicrobial use in 2011–2013, observed with annual point prevalence surveys in Ferrara University Hospital, Italy. J Prev Med Hyg 2016;57:E135–41.
Cai Y,
Venkatachalam I,
Tee NW,
. Prevalence of health care-associated infections and antimicrobial use among adult inpatients in Singapore acute-care hospitals: results from the First National Point Prevalence Survey. Clin Infect Dis 2017;64(Suppl 2):S61–7.
Katz KC,
Golding GR,
Choi KB,
Canadian Nosocomial Infection Surveillance Program. The evolving epidemiology of Clostridium difficile infection in Canadian hospitals during a postepidemic period (2009–2015). CMAJ 2018; 190: E758–65.
Boyd DA,
Mataseje LF,
Pelude L,
Canadian Nosocomial Infection Surveillance Program. Results from the Canadian Nosocomial Infection Surveillance Program for detection of carbapenemase-producing Acinetobacter spp. in Canadian hospitals, 2010–2016. J Antimicrob Chemother 2019;74:315–20.
Roth VR,
Mitchell R,
Vachon J,
Canadian Nosocomial Infection Surveillance Program. Periprosthetic infection following primary hip and knee arthroplasty: the impact of limiting the postoperative surveillance period. Infect Control Hosp Epidemiol 2017;38:147–53.
Abdesselam K,
. Results from the Canadian Nosocomial Infection Surveillance Program on carbapenemase-producing Enterobacteriaceae, 2010 to 2014. Antimicrob Agents Chemother 2016;60:6787–94.
Simor AE,
Gilbert NL,
Gravel D,
Canadian Nosocomial Infection Surveillance Program. Methicillin-resistant Staphylococcus aureus colonization or infection in Canada: national surveillance and changing epidemiology, 1995–2007. Infect Control Hosp Epidemiol 2010;31:348–56.
Rutledge-Taylor K,
Matlow A,
Canadian Nosocomial Infection Surveillance Program. A point prevalence survey of health care-associated infections in Canadian pediatric inpatients. Am J Infect Control 2012;40:491–6.
Taylor G,
Canadian Nosocomial Infection Surveillance Program. Assessing the magnitude and trends in hospital acquired infections in Canadian hospitals through sequential point prevalence surveys. Antimicrob Resist Infect Control 2016;5:19.
Horan TC,
Andrus M,
Dudeck MA
. CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control 2008;36:309–32.
Central venous catheter-associated blood stream infections in intensive care units in Canadian acute-care hospitals: surveillance report January 1, 2006 to December 31, 2006 and January 1, 2009 to December 31, 2011. Ottawa: Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada; 2014. Available: http://publications.gc.ca/collections/collection_2014/aspc-phac/HP40-90-2013-eng.pdf (accessed 2019 July 12).
Yang D,
Dalton JE
. A unified approach to measuring the effect size between two groups using SAS®. SAS Global Forum; 2012. Available: https://support.sas.com/resources/papers/proceedings12/335-2012.pdf (accessed 2019 June 12).
Yokoe DS,
Anderson DJ,
Berenholtz SM,
. Introduction to "A compendium of strategies to prevent health care-associated infections in acute care hospitals: 2014 updates" [published erratum in Infect Control Hosp Epidemiol 2014;35:1081]. Infect Control Hosp Epidemiol 2014;35:455–9.
AHS report on performance Q2 2018–19: hand hygiene compliance. Edmonton: Alberta Health Services; 2019. Available: www.albertahealthservices.ca/assets/about/publications/ahs-pub-pr-2018-19-q2-objective-07.pdf (accessed 2019 Mar. 26).
Gonzales M,
Rocher I,
Fortin E,
. A survey of preventive measures used and their impact on central line-associated bloodstream infections (CLABSI) in intensive care units (SPIN-BACC). BMC Infect Dis 2013;13:562.
Valiquette L,
Cossette B,
Garant MP,
. Impact of a reduction in the use of high-risk antibiotics on the course of an epidemic of Clostridium difficile-associated disease caused by the hypervirulent NAP1/027 strain. Clin Infect Dis 2007; 45(Suppl 2):S112–21.
Golding G,
Canadian Nosocomial Infection Surveillance Program. Determinants of outcome in hospitalized patients with methicillin-resistant Staphylococcus aureus bloodstream infection: results from national surveillance in Canada 2008–2012. Infect Control Hosp Epidemiol 2016;37:390–7.
Bagdasarian N,
Rao K,
Malani PN
. Diagnosis and treatment of Clostridium difficile in adults: a systematic review. JAMA 2015;313:398–408.
Vol. 191, Issue 36
You are going to email the following Trends in health care–associated infections in acute care hospitals in Canada: an analysis of repeated point-prevalence surveys
Robyn Mitchell, Geoffrey Taylor, Wallis Rudnick, Stephanie Alexandre, Kathryn Bush, Leslie Forrester, Charles Frenette, Bonny Granfield, Denise Gravel-Tropper, Jennifer Happe, Michael John, Christian Lavallee, Allison McGeer, Dominik Mertz, Linda Pelude, Michelle Science, Andrew Simor, Stephanie Smith, Kathryn N. Suh, Joseph Vayalumkal, Alice Wong, Kanchana Amaratunga
CMAJ Sep 2019, 191 (36) E981-E988; DOI: 10.1503/cmaj.190361
Health care-associated infections in Canadian hospitals: still a major problem
Physician choices in pulmonary embolism testing
Symptoms associated with a positive result for a swab for SARS-CoV-2 infection among children in Alberta
Diagnosis-wide analysis of COVID-19 complications: an exposure-crossover study
Show more Research
Epidemiology & epidemiological methods


text:
"""Common tools used for the Tradfri test suite."""
from homeassistant.components import tradfri

from . import GATEWAY_ID

from tests.common import MockConfigEntry

async def setup_integration(hass):
    """Load the Tradfri integration with a mock gateway."""
    entry = MockConfigEntry(
        domain=tradfri.DOMAIN,
        data={
            "host": "mock-host",
            "identity": "mock-identity",
            "key": "mock-key",
            "gateway_id": GATEWAY_ID,
        },
    )

    entry.add_to_hass(hass)
    await hass.config_entries.async_setup(entry.entry_id)
    await hass.async_block_till_done()

    return entry

redpajama_set_name: RedPajamaGithub


Mozilla, which launched the latest beta of Firefox 4 last week, has started to drop features from the still-under-construction browser.
Firefox 4 Beta 5 shipped Sept. 7, and included support for a new audio API (application programming interface) that allows developers to tap raw audio data from within the browser, as well as support for HTTP Strict Transport Security, a Web security protocol that lets site designers force Firefox to automatically use a secure connection.
The latter is meant to help stymie "man-in-the-middle" attacks, in which hackers essentially eavesdrop on users' Web traffic -- most often at public Wi-Fi hotspots -- in the hope of snatching clear-language transmission of passwords or credit card numbers.
Firefox 4 also switched on Windows hardware acceleration by default in Beta 5; Mozilla had included the technology in August's Beta 4, but had left it turned off, requiring users to edit the browser's "about:config" file if they wanted to try it out.
Firefox 4, like rival Microsoft 's Internet Explorer 9 (IE9), relies on Windows' Direct2D API to boost browser performance by shifting some chores from a computer's central processor to the graphics processor.
The hardware acceleration switched on in Beta 5 requires Windows Vista or Windows 7 ; the more popular Windows XP lacks the necessary graphics infrastructure, a fact that's prompted Microsoft to drop XP from IE9's supported operating systems.
Mozilla isn't going to that extreme. Although Firefox 4 won't boost content rendering in Windows XP, Mozilla does plan to increase the speed of "compositing" -- the process of assembling the various pieces of a site -- in the nine-year-old operating system by leveraging the Direct3D API in a future preview.
But as Mozilla's self-imposed deadline for building a feature-complete beta nears, the company has also started dumping features it once hoped to squeeze into the upgrade.
First to go was Account Manager, which Mozilla ditched late last month.
The beefed-up password manager was supposed to take full responsibility for site sign-ons, relieving users of the chore of remembering and then entering various usernames and passwords. An experimental add-on is still available, but only works with a limited number of sites, including Google , Facebook and Yahoo !
Mozilla has also dumped "Inspector," a tool aimed at Web designers and developers who want to drill down for more information on each element in an HTML page.
"Given the number of outstanding bugs and some widget-related problems, there was no telling how many additional bugs would be discovered during the run up to final release," explained Mozilla developer Rob Campbell last Friday about the decision to pull Inspector.
"Making that decision now allows us to focus on shoring up the Web Console..., [which] is the one that will most-likely affect Web site developers the most," Campbell added.
Another feature, silent updates , may also get the axe, according to progress notes posted on Mozilla's site last week. Silent updates would be Mozilla's answer to Chrome's behind-the-scenes patching practice, at least on Windows.
As late as August, the feature was "on track" for Firefox 4, but has been tagged as "at risk" by Mozilla for the past two weeks.
Mozilla now plans to freeze Firefox 4's features -- locking in what will be included, dropping what won't -- on Wednesday, Sept. 15 in preparation for delivering Beta 6 later this month.
A final version of Firefox 4 is to ship before the end of this year.
Firefox 4 Beta 5 can be downloaded for Windows, Mac and Linux from Mozilla's site in 35 different languages.


... regulatory process, specific, common expertise in FSHD, and an engaged patient population ready to conduct efficient, high quality clinical trials.
He graduated from the University of Nevada, Reno under the mentorship of W. Larry Williams and Steven C. Hayes.
Dr. Follette is Professor of Psychology and Director of Clinical Training in the Department of Psychology at the University of Nevada, Reno.


text:
UConn president Susan Herbst reaches out to BC about ACC
By Andrew Porter Sep 22, 2011, 12:32pm EDT
Share All sharing options for: UConn president Susan Herbst reaches out to BC about ACC
As anyone following the never-ending flame-war that DerbyGuy has been waging in the comments against Boston College fans knows, BC does not want UConn in the Big East. In fact, they're actively trying to block the Huskies. However, UConn president Susan Herbst isn't taking the news lying down. Instead, she's reached out to BC president Fr. William Leahy, S.J., according to a report from Ed Diagneault.
No one knows how much, if at all, this will help UConn's attempt to get an ACC invite, but it can't hurt. As BC fans never tire of pointing out, UConn was part of a lawsuit against them, and as I've pointed out, the players have changed. Hopefully they get along better this time.
Sidenote: Daigneault joined twitter today. Give him a follow.


text:
Kate Reagan, President
Senior Director of Marketing and PR
Lincoln Memorial University
Contact Kate
For over 14 years Kate Reagan has been at the helm of Lincoln Memorial University's public relations and marketing operations, serving as senior director for marketing and public relations. Reagan is responsible for LMU's integrated marketing plan and directs all media buys. She also serves as the University's official spokesperson and primary media contact and disseminates University news through press releases and direct media pitching. Reagan came to LMU after a brief stop in retail advertising, where she worked as a copywriter in the corporate office of Proffitt's/McRea's in Maryville, Tennessee.
Tami Wallace, Conference Manager
Director of Public Relations
Contact Tami
Tami Wallace is the Director of Public Relations for Volunteer State Community College. Prior to joining Vol State, she was Director of Marketing for the Outreach Program at Auburn University at Montgomery. She began her career as an events publicist for Lake Lanier Islands Resort and continued in the field at Six Flags Over Georgia in Atlanta. She has also held marketing and public relations positions at Visionland Theme Park in Birmingham, Alabama and Ruby Falls in Chattanooga.
Harley Stickney, Treasurer
Art Production and Design Manager
Tennessee Wesleyan University
Contact Harley
Harley Stickney serves as the Art Production and Design Manager for Tennessee Wesleyan University where she has worked as the institution's only graphic designer. Her responsibilities range from designing admissions pieces, digital and print advertising, advancement & alumni materials, and promotional products, to coordinating photography and videography while maintaining the physical appearance of the TWU brand. She began her career after attending Jacksonville State University and obtaining a Bachelor of Fine Arts in Graphic Design then working at TWU while obtaining her MBA in Marketing from Lincoln Memorial University.
Davis Seal, Secretary
Director of Operations for External Affairs
Motlow State Community College
Contact Davis
Davis Seal currently serves as the director of operations for external affairs at Motlow State Community College where he oversees web and social media strategy as well as daily operations and marketing for Motlow's workforce development — including the new state of the art Automation and Robotics Training Center in McMinnville. Before his current position, Davis served three years as Motlow's Webmaster Media Specialist where he oversaw the College's digital marketing strategy. He also previously served as Director of Communications at Venture Church in Hattiesburg, Mississippi. Davis holds a bachelor's degree in Political Science from Middle Tennessee State University where he was a member of the nationally recognized Moot Court team.
Denise Colwell, Sponsor Relations
Contact Denise
Denise Colwell is the Administrative Assistant to the Chief Communication Officer for Communications and Marketing at Tennessee Tech. She is also responsible for planning and coordinating a wide range of presidential events, including Commencement. Denise ensures that special events hosted by the university are executed at the highest level.
Matthew Gann, President Emeritus
Associate Vice Chancellor for Marketing, Digital Strategy and Public Relations
Tennessee Board of Regents
Matthew Gann currently serves as the assistant vice chancellor of marketing and digital strategy at the Tennessee Board of Regents where he oversees strategy and development of all marketing and digital initiatives for the Board and its administrative offices, programs and initiatives, and serves as a consultant for all 40 of the Board's institutions. Before joining the TBR, Gann spent three years as the web and digital media director at Tennessee Tech University and three years as the vice president of marketing and promotions at Wellness Healthcare Products. In addition, Gann serves as a consultant providing development and planning services for real estate firms, sports marketing agencies, non-profit organizations and healthcare providers.


From the long curves of the Portugal WRC Spéciales, to the deep sands of MxGP in Lommel, from the scary rocks of Val di Sol World Cup Downhill to the never ending and bumpy roads of Dakar Rallye, BOS Suspension is only focused on two things : Performance & Security.
We did that, and much more, the last two decades, and thanks to our beloved athletes, championships titles are proving us to keep working this way.
Our goal is simple : redefining standards days after days, cause we think you deserve the best.


Ubiquinol is a form of co-enzyme Q10. This enzyme is present in most cells, and forms a part of the energy release process that occurs in mitochondria. This involves the transport of electrons in a chain like mechanism, to eventually produce the molecule ATP. Over 95% of the body's energy is produced this way. Co-enzyme Q10 has the ability to exist in both a fully reduced and fully oxidised form – or in other words, completely saturated with electrons or completely void of electrons. Because of this it can act as an electron carrier in the energy release process. The different forms come with different names, and ubiquinol is the fully reduced form, or the form fully saturated with electrons.
Where Does Ubiquinol Come From?
Ubiquinol does not need to be consumed; it is produced by the body in almost every cell. However there are food sources of the molecule, and most meat products will contain some percentage of ubiquitol. It is found in its highest levels in cardiac tissue, then liver, and then all other meats. This is due to the energy requirements of different parts of the body; those organs with the highest energy requirements will have the highest levels. Plant products also have a minimal level of ubiquitol, in particular seeds, nuts and legumes.
Being so ubiquitous in the body (hence the name), ubiquinol has many health benefits when supplemented.
Increased levels in the brain have been associated with a reduction in the symptoms of depression, in both bipolar and chronic stress examples. It also appears to reduce the occurrence of episodic headaches or migraines, although the mechanism behind this effect is unknown.
Cardiovascular health is greatly influenced by ubiquinol. The progression of heart disease can be slowed through supplementation, and recovery rate after a heart attack can be improved. Due to its antioxidant properties, blood pressure may also be lowered by ubiquinol. It seems to preserve the activity of nitric oxide, which is involved in the expansion of blood vessels. A study on obese individuals saw a definitive increase in blood flow after one month's supplementation.
It is due to these antioxidant properties that ubiquinol can have a positive effect on blood cholesterol too. It protects lipoproteins from oxidation, and hence reduces the endothelial damage that occurs to blood vessels from their oxidised form. It has also been noted to reduce this damage directly by suppressing the inflammatory effect of the cells, in part through nitric oxide pathways.
Ubiquinol can slow the effects of several diseases, in particular the neural associated Huntington's and Parkinson's diseases, by preserving nerve function for longer. This is most likely due to its antioxidant effects. Fibromyalgia also seems to be associated with altered ubiquinol levels; in preliminary studies, supplementation could reduce symptoms fairly effectively. It also shows some future prospects for chronic-fatigue syndrome, although this may be due to its association with depression.
Due to its role in energy production ubiquinol can have significant effects on exercise performance and muscle tissue. Higher levels of ubiquitol in the skeletal muscles can increase their capacity for oxidation, and hence can improve aerobic performance. In a simulated marathon one study found that participants with a naturally higher level of the enzyme could perform for longer.
The reasons behind this are most likely due to an increase in PGC1ά, a factor that is known to increase during exercise. It is produced by the mitochondria and incubation of cells with ubiquinol increased these production levels. Muscle fibres with a higher oxidative capacity tend to have a higher level of PGC1ά, and have reduced muscle fatigue rates. One study found that 8 day supplementation could keep performance at a high level for longer during a cycling test. Muscle fatigue is also reduced via alternative mechanisms. It is thought that ubiquinol stabilises the membrane of muscle cells, reducing damage and allowing longer performance. Overall this means that higher levels of ubiquinol could lead to longer workout sessions.
In some studies power output in those supplemented with ubiquinol increased, generally assessed with leg extensions. Although this occurred generally with those deficient in ubiquitol such as those on certain drug therapies, it does hold promise for the fitness industry with further research. Ubiquinol may also increase oxidation of fat that is induced by exercise, and hence could assist with fat loss in exercising individuals.
Its role in nitric oxide preservation may also help to improve and sustain the pump, the feeling of muscular engorgement during exercise.
Although very high doses of ubiquinol in some animals appear to accelerate aging, but do not increase mortality, in humans no negative effects have been observed or hypothesised. Doses of up to 2000 mg can be taken with to no ill effect, higher than this may be associated with mild digestive distress.
Supplements of 500 mg have been shown to have a maximal result, higher than this will not substantially increase the benefits. Generally 250 mg is adequate to produce observable effects. Due to its fat soluble nature, ubiquinol needs to be taken with some form of lipid; often it is taken with a meal to stimulate bile production and hence absorption.
Ubiquinol is generally taken as a stand-alone supplement, bought in capsule form, and is definitely one of the more expensive supplements available. It is also included in some antioxidant supplements and amino acid supplements to assist with energy production such as Syntec Synabol.
Ubiquitol is found to positively interact with many bodybuilding supplements. A combination of ubiquinol with creatine, L-carnitine or alpha-lipoic acid with increase the benefits much higher than either taken alone, due to the energy pathways being more effectively utilised, as well as minimising rate reduction due to a limiting nutrient.


Posted on 6/20/2016, 4:21 pm, by HSG, under Craftster Community Spotlight.
It's Summer! Yes, the temperatures are on the rise, the kids are getting out of school and time to hit the road. To get you and your family all set for your summer trip I have some travel crafts to share from around the World of Craftster.
First, let's all plan on doing a travel journal!
What better way to record your family trip for bribery posterity than in a journal. You can add pictures, keepsakes, postcards, etc. tendstowardschaos even made photo corners to add to your pictures.
Next you will need travel bags to put all your travel clothes, toothbrush, shoes, etc.
Now where will you put your cards, passport, cash, etc.?
. Well, in this travel wallet by stitch81, of course! How convenient to have it in one quick place, and she even used some tropical fabric.
If you're traveling with kidlets then you're gonna need some other things to carry along. One thing is this cute snuggly travel pillow for when they sleep.
Artisan82 shares the easy and free pattern.
Next you will need to keep the little ones busy on the road.
These travel Bingo sets by Misselthwaite will do the trick, and maybe even get the adults playing.
Now how about for you? Maybe get in some quality stitching time while traveling or relaxing on the beach.
This travel embroidery case by stitch81 has everything secure and ready to use.
While traveling this summer remember to be prepared. You can count on Craftster to give you lots of travel help. Check the tag cloud for more projects to take along, work on or just relax while doing this Summer. Don't make me pull this car over!
I love the idea of crafting on the go. Great round-up!


text:
US counterintelligence officials reportedly say Israel probably planted surveillance devices near the White House; Israeli government issues strong denial
Israeli Prime Minister Benjamin Netanyahu says it isn't true
Photo by Alex Wong/Getty Images
Israeli intelligence agents reportedly planted surveillance devices near the White House, according to reports from U.S. counterintelligence professionals.
On Thursday, Politico reported that state investigators discovered that Israel was likely behind the placement of StingRay phone trackers near the White House.
The investigation determined that Israeli intelligence agents reportedly intended to capture information from phones assigned to President Donald Trump and his administration.
One FBI official said that "it was pretty clear that the Israelis were responsible" for the devices.
Another official added, "The reaction ... was very different than it would have been in the last administration. With the current administration, there are a different set of calculations in regard to addressing this."
The outlet reported that the White House did not comment on the report, nor did the Department of Homeland Security, the FBI, or the Secret Service.
What is Israel saying about this?
Elad Strohmayer, a spokesperson for the Israeli Embassy in the United States, said that the allegations are "nonsense."
"These allegations are absolute nonsense," Strohmayer said. "Israel doesn't conduct espionage operations in the United States, period."
Israeli Prime Minister Benjamin Netanyahu said the report is a blatant lie.
In a statement, Netanyahu's office said, "There is a longstanding commitment, and a directive from the Israeli government not to engage in any intelligence operations in the U.S. This directive is strictly enforced without exception."
Israel Katz, Israel's minister of Foreign Affairs, echoed the sentiments.
"The U.S. and Israel share a lot of intelligence information and work together to prevent threats and strengthen the security of both countries," he said.
The news comes ahead of Netanyahu's fight for political survival in next week's elections. On Tuesday, the Israeli prime minister promised to annex up to one-third of the occupied West Bank if he were to win the reelection. You can read more about Netanyahu's annex announcement here.


text:
Finding Beauty in a Broken World
Terry Tempest Williams,
A renowned poet searches for healing in times of upheaval through the art of mosaic.
100% Sounds True Guarantee
We stand by our products »
We unconditionally guarantee your satisfaction with all Sounds True products for one year when purchased via our website or catalog. If a Sounds True product fails to meet your expectations—for any reason—simply return it with receipt for a full refund. For items purchased from Sounds True that are manufactured by other companies, we indicate the warranty period in the product description.
Please note: Refund requests over 120 days from the purchase date will receive a check, as funds cannot be returned to the credit card due to fraud protection policies.
All downloadable audio and video titles are also covered by a one-year guarantee.
Three CE credits available!
» Calculate how many home study hours are allowed per renewal period
Want to buy the CE credits only?
If you already purchased this title, you can purchase the CE credits separately.
NOTE: CE credits are available for US customers only.
When faced with the chaos of our times and tragedy in her own life, Terry Tempest Williams asked: "How do we pick up the pieces? And what do we do with these pieces?" To find her answer, this visionary author and naturalist embarked on a journey that took her around the globe.
In Finding Beauty in a Broken World, she delivers a story, a mosaic, that is both heartbreaking and hopeful—an unforgettable exploration of truth from a passionate artist and humanitarian.
Analyze the importance of community, unity, and language through the art of mosaic creation
Examine in-depth the art of ancient mosaic creation, and list its 11 rules
Discuss language and some of its potential, then some of its dangers when it is not understood
Describe the dangers when there is lack of communication
Discuss the dark violent side and the loving side of human beings
Examine some of the many forms of language
In this original author adaptation of her acclaimed book, Williams recalls an odyssey that began on the rocky shores of Maine, where she prayed for "one wild word" to follow after the events of 9/11. That word was "mosaic"—and it marked the first step on a path that took her to the artistic heart of Italy, through ecological struggles in the American Southwest, and ultimately to war-torn Rwanda and the seemingly inconceivable task of fostering healing through the art of mosaic in the midst of genocide as villagers and artists build a memorial together. Presented by the author in her own inimitable words, here is an inspiring story of how we can overcome even the most traumatic wounding the world can offer.
Finding Beauty in a Broken World is a call to listeners to create beauty in the world we find, each in our own way, each in our own time, each with our own gifts. By taking that which is broken and creating something whole, we can begin to embrace both empathy and engagement within our own communities.
This product can be shipped within the US and Canada only.
Sample: Finding Beauty in a Broken World
3 CDs (195 minutes)
AW01391D
1 Audio download (3 hours, 15 minutes)
Filetypes
M4B, MP3, PDF, ZIP
AW01391W


Our convenient service is tailored around you. If there is anything extra you would like please let us know. Our dedicated customer service team will be happy to help. We operate a Happiness Guarantee Service. If you are not happy, simply let us know and we will do our best to make you happy again.


You have chosen a medium tour suitable for active adults and fit teenagers.
Expect firm country roads, some gravel passages and some steeper and faster downhill parts.
All about the Cycling Tour – Skines – Contrasts of Olive and Orange.
On this active tour – with a few moderate rises – we bike on small asphalt roads and well-maintained agricultural trails (30%) through the lush green valley of the river Mavros until we reach Crete's largest orange growing area at Skines. On our route we cross through traditional villages and discover hidden Byzantine chapels. We'll find ample opportunity to taste oranges, avocados or kiwis right off the tree. After some Cretan refreshments (inclusive) in a village kafenion we rise to the top of the Coastal Chain where we start our downhill through ancient olive groves back to Agia Marina. No service van.
Suitable for active weekend bikers and kids from 14 years of age, who have already had a little experience with trekking or mountain bikes before and who feel secure enough to manage about 44 km without bus support.
It is suitable for children from 15 years old.
How many people will join this tour?Can I join a group late or leave it earlier?What type of ground transportation is used on this tour?Who are my travelling companions?Is availability guaranteed when I book online?Are your tours guaranteed to run?How do you send out tour documentation?Will the tour manager speak English?Do you offer group discounts?I have booked on-line. How do I get my ticket/voucher?Will you contact me if there is a problem?What else do you include in the tour price?What discount can you offer to us if we book more than two tours with your company?How much time do you spend at each attraction?What happens if I arrive late for a departure?If I lose something on your tour can I get it back?What if I want to cancel a tour?What is your booking policy?
How many people will join this tour?
Can I join a group late or leave it earlier?
We keep our group sizes low so you have the freedom to move around and get involved with your surroundings, as well as more personal attention from our local guides. This intimate size ensures that your group will not crowd your experience. You can expect up to 15 travelers for this tour. Check individual trip pages for maximum group sizes.