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Confronting the opioid problem in San Antonio
Melissa Fletcher Stoeltje Oct. 26, 2017 Updated: Oct. 26, 2017 10:04 p.m.
1of4Peer counselor at Rise Recovery Josh Green (from left); Colleen Bridger, director of the San Antonio Metropolitan Health District; Dr. Timothy Grigsby, assistant professor of community health at UTSA; Bryan Alsip, chief medical officer of University Health System; and moderator Francine Romero participate in "The Opioid Crisis" town hall meeting Thursday at the UTSA downtown campus.Photo: Billy Calzada /San Antonio Express-News
2of4Bryan Alsip, chief medical officer of University Health System, makes a point as moderator Francine Romero listens during "The Opioid Crisis" town hall meeting Thursday.Photo: Billy Calzada /San Antonio Express-News
3of4Audience members listen during "The Opioid Crisis" town hall meeting Thursday at the UTSA downtown campus.Photo: Billy Calzada /San Antonio Express-News
4of4Peer counselor at Rise Recovery Josh Green speaks about possible solutions as Colleen Bridger, who is director of the San Antonio Metropolitan Health District, listens during "The Opioid Crisis" town hall meeting Thursday.Photo: Billy Calzada /San Antonio Express-News
To kick off a town hall meeting addressing the opioid crisis in Bexar County and the nation, a panel of four experts Thursday night rattled off a host of distressing statistics.
In 2016, more people died from opioid-related deaths nationally than did those who died from HIV in 1995, when that disease was at its peak.
Last year, drug-related overdose was the leading cause of accidental death, and more than half those deaths were attributable to opioids, be they prescription painkillers such as OxyContin or illicit drugs like heroin.
Two-thirds of people who misused prescription pain pills got them from friends or relatives, often by stealing them.
But perhaps the most telling statistic came when Timothy Grigsby, assistant professor of community health at the University of Texas at San Antonio, asked for those in the audience of 200-plus to raise their hands if they had or knew of someone who had opioid prescription medication at home.
Almost everyone in attendance raised their hands.
The town hall meeting, co-sponsored by the San Antonio Express-News and UTSA, sought to address the growing opioid crisis in San Antonio by taking pre-delivered questions from those in the audience. The result was a far-ranging dialogue between three public health experts and one recovered addict on the extent of the local problem and what can be done to fix it.
Dr. Bryan Alsip, chief medical officer of University Health System, noted that there is not one single demographic that captures the at-risk population for opioid abuse in the city.
"This problem is blind regarding ethnicity, race, socio-economic status and gender," he said. "This is an equal-opportunity epidemic."
But Colleen Bridger, director of the Metropolitan Health District, pointed out there were many reasons for optimism around the opioid crisis, which is too often "fraught with despair.'
"We know what makes a difference; we know what works," she said. "The solutions are out there." One "rogue" idea she put forth: Coming up with pain medication that has little chance for addiction.
Josh Green, a recovery coach with Rise Recovery, spoke of the need for those in recovery to have long-term help and support because opioid addiction requires more than the traditional detox and 30-day stays in rehab.
"You need to really have someone walk you through to each level of recovery," he said.
Other topics included the need to reduce the stigma around drug addiction, the efficacy of medication-assisted treatment such as methadone and buprenorphine, and the vast need to increase treatment availability to the low-income and uninsured.
In Bexar County, opioid overdoses peaked in 2011, when 145 people died. The toll dipped to double digits over the years until 2015, when it surged 50 percent to 108 fatal overdoses. The county's fatality rate of 5.7 overdoses per 100,000 residents is the third-highest in the state.
To address the crisis, the county formed a task force in August to come up with solutions. Among the goals: Expand access to Naloxone, or Narcan, an opioid overdose reversal drug, and better educate physicians and the public about the risks of prescription opioids.
The panelists agreed that President Donald Trump's announcement that he was making the opioid problem a public health emergency was a good thing, but they said it didn't go far enough. The announcement frees up no new money, although it does let states shift funding to treatment.
"We're going to need a lot more resources to address this crisis," Alsip said.
mstoeltje@express-news.net
Melissa Fletcher Stoeltje
Follow Melissa on:
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Melissa Fletcher Stoeltje has been a reporter for more than 30 years. She began her career as a calendar listings/file clerk at the now-closed San Antonio Light, where she went on to write for the Sunday magazine She then spent eight years writing features for the Houston Chronicle.
She returned to her hometown in 2001 and has worked at the Express-News since then in various capacities – columnist, feature writer, social services reporter. She currently covers general assignments for the Metro section.
She holds bachelor's and master's degrees in English from the University of Texas at San Antonio and has won a number of local, state and national journalism awards during her career.
National and city leaders come together to fight domestic violence
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Megan Hamilton
Megan Hamilton has traveled extensively throughout the Southern United States, Mexico, and parts of Central America. A lifelong atheist, these travels have informed her political views. She currently lives in a remote location with a large herd of cats and four dogs.
Posts By Megan Hamilton
Bad Coronavirus Takes
Landlord changes locks on church after pastor refuses to abide by coronavirus lockdown order
A church that serves as the landlord of The Cross Culture Christian Center, based in Lodi, California, changed the church's locks after...
Church defies coronavirus lockdown orders — now 71 parishioners are infected and one has died
A California church based in Sacramento County has earned the dubious distinction of being an epicenter of the coronavirus pandemic in the...
Mike Huckabee: The 'virus of sin' is more deadly than the coronavirus
Former Arkansas Republican Governor Mike Huckabee has been busy lately, appearing on a Thursday episode of Outnumbered on Fox News, where he...
Texas governor says religious gatherings are 'essential services' and can continue as coronavirus spreads
Law enforcement officials have arrested two pastors for holding services in violation of social distancing orders, but Texas Governor Gregg Abbott is...
Pastor packs in over 1,200 worshippers after being charged for defying coronavirus lockdowns
A right-wing Louisiana pastor remains defiant after being charged with violating an executive order that bans churches from holding large gatherings. Pastor...
Another Christian pastor charged after packing in 500 worshippers during coronavirus lockdown
Another right-wing pastor is in trouble with the law for flouting a ban on large gatherings while the novel coronavirus continues its...
Christian pastor announces 'blowout' church service in defiance of lockdown orders: 'It'll be like Woodstock'
Now that right-wing pastor Rodney Howard-Browne has been arrested and charged with unlawful assembly and violating health emergency rules — both second-degree misdemeanors...
Founder of pro-Trump group hosts 'corona potluck' so guests can infect each other and build up 'immunity'
In an interview with The New York Post, Lucian Wintrich, the gay far-right Trump supporter who founded "Twinks4Trump," discussed the "corona potluck"...
De Blasio threatens to permanently shut down churches and synagogues that defy lockdown orders
New York City Mayor Bill De Blasio is furious at synagogues that continue to hold services as the novel coronavirus continues its...
Pastor refuses to close church doors: 'If you have coronavirus, I declare you healed in Jesus' name'
A pastor in Westmoreland County, Pennsylvania continued to hold services Sunday as coronavirus continues to spread throughout the state. More than 100...

redpajama_set_name: RedPajamaCommonCrawl


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Made with our propetitary Gummy Zero™ forumla. Acts as a prebiotic with a low-glyemic index.


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Ultra Music Festival remains at the top of the game, announcing phase 2 lineup
4 years ago by Steph Evans
It's undeniable: Ultra Music Festival brings in the biggest, best, most diverse and thorough acts spanning the many genres in today's house music culture. The culmination of over a week of collaboration and showcasing during Miami Music Week and Winter Music Conference, the festival announced a stacked lineup featuring industry leaders from Zedd to Loco Dice to The Prodigy back in December. And now, the full details behind its phase 2 lineup have been released, and they're pretty mind blowing (as usual).
With stages headed up by OWSLA, Carl Cox, Space Ibiza and Armin Van Buuren's A State of Trance, the list of performers new to the stage or veterans in the industry will make appearances at Ultra in March of 2016. Check out full details below, and further ticketing information (though General Admission is sold out) is here.
Dance · Miami Events
by David Sikorski
Ultra Music Festival commits to environmental protection and sustainability for 2020 and beyond
Ultra Music Festival reveals 2019 Phase Two lineup featuring Adam Beyer, Camelphat B2B Solardo, Hot Since 82 and more
Ultra Music Festival unveils 2017 Phase One lineup
by Katey Ceccarelli
Miami Events


The Meizu Zero was released a couple of weeks ago and this smartphone prides as the worlds first holeless smartphone. No charging ports, no volume buttons, no headphone jack. Ever wonder what this phone would look like? One of the earliest video reviews of this smartphone just appeared online. The only holes on the fuselage of this smartphone are two tiny holes for mic and perhaps the rear fingerprint sensor space, that's if you consider that like a hole. To see the video, click HERE.
This smartphone comes in bright porcelain black and kiln white color. It is IP68 dustproof and waterproof certified and can survive for 30 minutes underwater. It is powered by a Snapdragon 845 processor and has a self-developed 18W wireless super fast charging technology. According to the company, it spent 2 years of research and development with 75 patented technologies on this smartphone. Its power is increased, heat is reduced by 67%, supports an exclusive charging base, USB 3.0 and Bluetooth 5.0.
Next OPPO trademarks the Find Z moniker, sequel to Find X could be in the making?


The data from HRG Brasil, a partner for Hogg Robinson Group (HRG), revealed double digit growth in Brasil, across corporate travel and events during 2012, with continued optimism for 2013 and beyond.
Findings from the Brasilian Corporate Travel and Meetings Index, unveiled at HRG's Second Latin American Forum in São Paulo, showed over 12% year on year growth in terms of corporate travel in 2012, while activity relating to meetings groups and events grew by 39%.
The Index, prepared by analysing transactions in Brazil, revealed a number of significant activity spikes during 2012, including a 67% year on year growth in November 2012.


Nissan has Infinity. Toyota has Lexus. Honda has Acura. It seems like nearly every manufacturer of sensibly priced automobiles has thrown their hat in the luxury car ring at this point with an offshoot brand that takes their standard chassis to the next level with luxury styling, trendy amenities, and engine upgrades, not to mention price tags that often start at double what you'd find on their original lineups.
In 2015, Hyundai took their upscale Genesis line and spun it into a standalone brand featuring luxury, rear-wheel drive sports sedans. However, like many luxury lines, they seem to have discovered that you can't get far without sporty SUVs that appeal to families, which is probably why they announced last year that the very first Genesis SUV was slated to hit the market in 2020.
The 2020 Genesis GV80, a mid-size crossover SUV, features a sleek, futuristic design that should stand out among popular competitors like MB's GLE, Porsche's Cayenne, and BMW's X5, and it's based on the newly redesigned platform that will also be found in the G80 sedan. What do drivers interested in a Genesis SUV have to look forward to? A lot, as it turns out.
The GV80 concept initially made its debut back in 2017. There's no telling if the finished consumer product will match the concept model, but it's speculated that it will stick fairly closely to the bold design choices featured in the concept.
The nice thing about the design of the Genesis SUV is that it strays from the boxy look that punctuates competitor vehicles. There's something truly appealing about the sleek curves that make up the rounded body of this automobile, which fairly resembles the head of a duck, with the hood scooping up into the headliner and curving gently back to the rounded tailgate. Your eyes can't help but caress the curvilinear surfaces.
Much like the G80 sedan, the GV80 SUV is expected to come in both rear- and all-wheel drive options, with choices for engines including a 3.8-liter V6, a twin-turbo 3.3-liter V6, and a 5.0-liter V8. Genesis also purportedly has plans to introduce alternative powertrain options, including hybrids and EVs, but there's no word yet if these will appear in time for the GV80 launch or if they'll show up on subsequent models.
The 2020 Genesis GV80 is slated to feature a starting price in the $50,000 range, which isn't terrible for the luxury SUV market. Although specific details are still a bit scant, we know the SUV will be based on existing Genesis products and share features and design with the redesigned G80 sedan.
If you're keen on Genesis sedans and you just want a little more leg and cargo room, a smaller crossover, the GV70, is slated for release in early 2021, so you should have some options for sizing if you're willing to wait a little longer. There is purportedly a sports coupe, the G90, on the horizon as well, but it's likely still a few years out as the SUV rollout seems to be taking the limelight at the moment.
Consumers and dealers interested in existing Genesis vehicles and upcoming models can conveniently connect with each other to buy, sell, and trade vehicles via the DealerStrip platform.


Since it's all over with now, I thought I'd tell you what happened to my car. Oh yeah! I got a car in January! It's a '96 Toyota Camry, it's dark green (but likes to pretend it's dark blue in the sunlight), and it runs like a dream. I mean, for a first car. The best part? It only cost me $700.
It's amazing how much better life is when you've got your own car. I was able to go anywhere, anytime, not having to feel bad about hogging the family car every time I wanted to go hang out… I even took him to Texas and spent an extended weekend down there. Learned how to drive like a Texan! Had a blast!
One morning, I went outside to start my car so the windows and such could defrost. Ran inside to grab a few things for work. Came back outside. My car was gone. No, seriously, gone. Stolen out from right under my nose. I freaked out, ran inside to grab my mom (who was awake at the time), who had the presence of mind to call in a police report. They came and took my information. I went to work and probably cried all day; I don't even remember.
Two days later, just as I had given up on ever seeing him again, Mom texted me at work and told me to call the police; they had found my car. Turns out, whoever had taken it had rode it around for two days and then parked it in front of what seemed to be an abandoned house outside of Tecumseh. They ripped out the ignition, stole the spare tire, tore the stereo out, and were starting to strip things out of the car when, apparently, a light came on in the house. They saw it, got spooked, and ran off. My car was reported to the Sheriff's office and it immediately came up as my car.
It cost me loads of money to not only get it out of impound but to have it towed to my house as well; thankfully the guy with the tow truck actually lives up the street and took pity upon me and didn't charge me full price for the towing. I was so happy to see my car back, I literally cried.
Thank goodness my dad is a mechanic; he was able to track down another Camry in a salvage yard and get another steering column. The dummies who ripped out the ignition did such a terrible job with it that the whole column had to be replaced. Just this last week, he got the last couple of things in order and — behold! — my car runs again, good as new!
So that's my car tale… pretty traumatic, losing your first car right from under your nose, I'm not even gonna lie. But it's awesome having him back and feeling independent again. Lesson learned — ALWAYS lock your car up, no matter where you are or what time it is.
Ahh! I'm so glad you got your car back! I saw that it was stolen, but I never found an update on it.
It's handy to have a mechanic around, especially in an age where nearly everyone has a vehicle, and most of the need repairs. haha.
You're lucky to have it back! I was hoping you would say they knew who stole it and you're getting a bunch of money. Darn.
I like the non-tv-shows-I-don't-watch related posts. I feel left out when I read the other ones.


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Coders concerned that computer-assisted coding will lessen or even eliminate their roles should relax, say experts.
With new diseases and procedures to learn each year, continuously changing regulatory requirements to comply with, and IT to implement, coders are likely to welcome any technology that promises to leave their jobs a little less complicated. But computer-assisted coding (CAC) has some in the industry wondering if the technology could completely wash out the need for coders' human touch.
Mark Morsch, vice president of natural language processing (NLP) and software engineering at A-Life Medical, compares the impact of CAC's introduction into the coding process with the advent of PC-based encoder software nearly 20 years ago. "The encoder software is a tool that coders use to help choose correct codes. Encoders have become a standard, indispensable tool of the HIM professional. In initial market specialties, computer-assisted coding also has become the standard, taking the process one step further by automatically selecting codes directly from the clinician's documentation," he says, adding that CAC reduces much of the paper handling in the coding process and eliminates most manual data entry tasks.
"CAC directly links codes to the supporting documentation, so coders take on the role of reviewer or auditor," Morsch says. As he describes it, CAC includes two distinct types of technology: one using NLP and a second using structured input (SI). "NLP technology can read transcribed clinician notes, extract the key clinical facts, and map those facts to appropriate codes. SI applications link phrases or terms selected by the physician directly to codes. Physicians use SI to build their clinical documentation, which typically requires a change in documentation practices," he says.
The advent of computers in the healthcare arena have undoubtedly introduced efficiencies, but this expansive automation into the HIM environment now has some coders leery, especially in regard to CAC. As computer programs take over more manual processes, will coders slowly become extinct?
Gail I. Smith, MA, RHIA, CCS-P, an associate professor and the HIM program director at the University of Cincinnati, says this uncertainty is likely a fear of the unknown. "I believe many coders have heard the phrase 'coding is going away,' and they are not exactly sure what that means and feel threatened. Until coders have had experience with the technology, it will remain a mystery," she says.
Smith says coders' concerns about CAC generally center around accuracy, productivity, and workflow changes. But she notes that coders are ultimately still in control of accuracy and suspects that the technology could shift coders from their traditional roles into something resembling coding compliance coordinators.
Suzanne Lappen, director of corporate development at MedLearn, says the coding technology will actually aid workflow and increase productivity since coders are largely validating code assignments instead of manually assigning them. "Since the introduction of CAC, workflow efficiencies have improved. Coders no longer need to jump between systems (from the main medical record system to the lab-data system) because CAC helps to integrate several systems into one. Everything is now in one place, cutting down on the number of key strokes each coder must make," she says.
As an added benefit, Lappen says CAC can also help coders prioritize their work tasks. "For instance, a coder may want to work on one physician's cases first thing in the morning because they are usually the most challenging. So each day, the CAC delivers that physician's cases first. It can also prioritize them by modality, which helps coders focus on the same code sets until finished rather than having to jump from one set of codes to another," she says.
While concerns certainly exist, Lappen says there are multiple factors driving CAC technology forward. "One is the growing increase in the demand for healthcare services from an aging population, which creates more patient records and thus more records to code. Another driving force is the new face of the U.S. healthcare system, which is being driven by two executive orders," she says.
In 2004, President Bush appointed a national coordinator for the National Health Information Network, with an overall goal of transforming healthcare with IT. "Then in 2006, the president signed an executive order for value-driven healthcare, which encourages the adoption of IT interoperability. Once the healthcare system becomes totally interoperable, we will have better pricing for healthcare, quality of care, and efficiency of care," says Lappen.
"In addition to the aging population, there is the need to control costs by reducing the proportion of administrative expenses in healthcare," adds Morsch. "Also, the coding and billing process has become increasingly complex due to PQRI [the Physician Quality Reporting Initiative], MS-DRGs [Medicare severity diagnosis-related groups], POA [present on admission], NCD/LCD [national and local coverage determinations], CCI [the Correct Coding Initiative], etc for both inpatient and outpatient services," citing the shortage of qualified coding professionals and the future implementation of the ICD-10 coding system as additional drivers.
Morsch says CAC technology is currently being used for the coding of outpatient specialties, chiefly radiology, pathology, cardiology, and emergency medicine. "Inpatient coding applications are still emerging, but early adopters are now deploying CAC in the hospital setting," he says.
Lappen says the enactment of the Deficit Reduction Act of 2005 drove radiology practices to be the most frequent implementers of CAC. "With the enactment of the Deficit Reduction Act of 2005, which cut Medicare reimbursement levels for imaging procedures, radiology practices had to improve efficiency and productivity in all aspects of their business. Computer-assisted coding has helped radiology practices streamline their coding operations and reduce administrative costs," she says.
Safian believes CAC's ability to integrate with electronic health records is driving its adoption but emphasizes that the technology doesn't eliminate the need for top-notch coders. "The user still needs to be a knowledgeable, educated professional to provide the correct input and to evaluate the results. The old adage 'garbage in, garbage out' is still true. If the coder is not trained to properly abstract the physician's notes and other documentation to identify the correct key components, then the CAC system cannot determine the correct code or codes," she says.
While Safian points out that training is always necessary with the implementation of new technology, "How much depends on the individual coder and their level of knowledge of coding and their adeptness at using the computer," she says, emphasizing that while the coding process is essentially the same, all learning curves will decrease productivity at first.
Morsch says worthwhile CAC applications are easy to use and require only a few hours of training, adding that facilities will benefit from an enhanced workflow after all staff have successfully grasped the solution. "These systems often provide functions to detect and filter out duplicate documents, group together visits for the same patient, integrate documents from multiple systems into a single view, apply payer-specific edits, and upload charges directly into a billing system," he says of some of CAC's capabilities.
The ease of training, as with the introduction of any technology, is dependent on who is educating users, says Lappen. "This is no different than any other new software implementation. The key is how well the managers educate and train their staff on the system," she says.
Safian believes training in both manual and digital systems will make for the most well-rounded coder. "This gives them the knowledge to have one system backing up the other for accuracy. CAC can provide some excellent prevention for coding errors, such as mistakenly using an invalid code or failure to include a manifestation code," she says, adding that CAC could work great for remote coding. "Secure networks can carry the data from the HIM department or from the coder's home office to the fiscal intermediary. The difference is the increase in availability of professional coders," she says.
"The CAC technology will become as indispensable as the encoder is currently. It is a cutting-edge tool and learning how to use it now and using it on a regular basis will place those coders on the front end of a trend that will, eventually, become entrenched in the HIM workplace," Lappen says.
Morsch says embracing CAC could also end up providing facilities with a more relaxed staff. "By making the coding workflow more efficient and outcomes more consistent, CAC technology can help reduce the stress level that is common in many coding operations that may be understaffed and struggling to keep up with complex reporting requirements from payers," he says.
All in all, Safian says there just isn't a good enough reason not to embrace technology that could play a part in improving the healthcare delivery system. "However, coders should not abdicate their obligation to accurate reporting by failing to participate in continuing education. The computer is still just a tool," she says.


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Dr. Fauci Reveals "Disturbing" Way You'll Get COVID
"It was the game-changer," the infectious disease expert said.
One "disturbing" characteristic of COVID-19 made it clear the battle against coronavirus would be unlike any other disease-prevention effort, said Dr. Anthony Fauci, the nation's leading infectious disease expert: The fact that so many cases were passed along by people who had no symptoms. "We're seeing that even people without symptoms of transmitting it, and that to me is something that was the game-changer," said Fauci in an interview on Wednesday with California Gov. Gavin Newsom. "It was the game-changer in everything we did." It changed testing, because only testing symptomatic people would miss those who were asymptomatic, he explained. For more about how you'll potentially catch COVID-19, read on, and to ensure your health and the health of others, don't miss these Sure Signs You've Already Had Coronavirus.
This asymptomatic spread is one reason why masks are so important
Additionally, "Mask wearing became much more important, because if you're only worried about somebody who's symptomatic, then you'll know who you're dealing with," said Fauci. "But if you don't know who's infected, then everybody should be wearing a mask, which is the real fundamental rationale for saying we need universal and uniform wearing of masks."
The stealthy nature of the disease took even Fauci—who has served six presidential administrations over four decades—aback. "I guess you could use the word surprising. It was a combination of surprising and disturbing," he said.
RELATED: This is the #1 Way You'll Get COVID, According to Doctors
"I've never seen a virus like this"
"The other thing that has really been an issue is that I've never seen a virus like this—and I've been dealing with viral outbreaks for the last, you know, 40 years—where you have such a range of involvement of seriousness, from 40% of the people who get infected and have absolutely no symptoms at all, to those who have symptoms," added Fauci. "About 80% have mild to moderate symptoms that generally require staying at home for a few days, maybe sometimes a couple of weeks."
And then about 20% to 25% of COVID patients get severe enough symptoms that they require hospitalization and intensive care, "and then they die," said Fauci. "Hence the 335,000 deaths that we've had so far. Usually when you have a disease that is so very real, it can kill people, not just old people and not just people with underlying conditions. But now we're starting to see more younger, relatively healthy people can get involved."
That's what Fauci considers "the mystery" of COVID-19—how differently it can behave in different people. It is "one of the reasons why we have a messaging difficulty, because most of the people who do well are young people," he said.
According to the CDC, more than 19.4 million cases of coronavirus have been reported in the U.S., and more than 337,000 people have died.
As for yourself, do everything you can to prevent getting—and spreading—COVID-19 in the first place: Wear a face mask, get tested if you think you have coronavirus, avoid crowds (and bars, and house parties), practice social distancing, only run essential errands, wash your hands regularly, disinfect frequently touched surfaces, and to get through this pandemic at your healthiest, don't miss these 35 Places You're Most Likely to Catch COVID.
Coronavirus // Dr. Fauci // News
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Fauci Says U.S. Won't Get Back to Normal Until 'End of 2021'


As parenting guidelines released last week* advised parents of a "five-a-day" approach to bringing up their children, research from Bosch Power Tools shows that 45% of parents in fact have less than five hours to play and bond with their children per week.
The research also highlighted that only 31% of UK parents take part in educational play and life-skill development such as cooking, sewing or DIY. This is despite 93% of parents deeming it important to pass life skills down to the next generation and 90% admitting it could cause problems later on in their child's adult life.
Children are also concerned with 50% of kids aged between seven and sixteen stating they would relish more time with their parents to help them learn new things.
63% were eager to develop prowess in the kitchen and 52% also wanted to learn more about DIY and how to fix things in the home without calling for a builder.
In light of this, Bosch Power Tools is launching a campaign to encourage families to "build and bond" by building a tree house together in the back garden this summer.
Bosch Power Tools DIY Expert Chris Tidy comments, "It's really important for parents to take the time to teach kids these practical skills because otherwise, it's really going to cost them in the future. Once they leave home they could incur huge expenses when they are unable to rely on their parents. These skills will prove extremely cost effective as young adults in various elements of their life, such as simple DIY tasks, cooking for themselves, decorating their house and customising their clothes."
Of the tiny but questionable 7% of UK parents who didn't want to pass on skills, 64%, stated they didn't have time and worryingly, 33% claimed they didn't have any.
This press release was distributed by ResponseSource Press Release Wire on behalf of Ketchum in the following categories: Men's Interest, Leisure & Hobbies, Home & Garden, Women's Interest & Beauty, for more information visit https://pressreleasewire.responsesource.com/about.


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All That Remains, Red Fang + more on tonight's Metal Hammer Radio Show
By Metal Hammer ( Metal Hammer ) published 20 October 14
"I know now it seems like my vow was empty then, but in time you will see I'd do it all again..."
Tonight on the Metal Hammer Radio Show we're getting back to the New Wave Of American Heavy Metal (well, the early noughties wave) with All That Remains' debut album.
And we'll be spinning all the best from the likes of Purson, Bloody Hammers, Red Fang, Mastodon, Black Anvil, Cancer Bats and Down.
News has also reached Hammer HQ that an American tourist was locked inside a London bookshop for two hours after it shut while he was still browsing. Oops. Police were called to the shop after he described his plight on Twitter (of course he could have just called the cops).
But anyway, it got us thinking… have you ever been trapped or stuck anywhere?
You can listen live on Team Rock Radio and DAB at the NEW TIME OF 8PM BST.
And you can listen to the previous shows On Demand.
Founded in 1983, Metal Hammer is the global home of all things heavy. We have breaking news, exclusive interviews with the biggest bands and names in metal, rock, hardcore, grunge and beyond, expert reviews of the lastest releases and unrivalled insider access to metal's most exciting new scenes and movements. No matter what you're into – be it heavy metal, punk, hardcore, grunge, alternative, goth, industrial, djent or the stuff so bizarre it defies classification – you'll find it all here, backed by the best writers in our game.


Nicola Frost is a specialist family law barrister. Her thriving practice encompasses finance and private law matters. She is committed to achieving the best results for her clients and uses her strong negotiation skills to facilitate settlement, wherever possible. Nicola's clients appreciate her amiable and pragmatic approach to issues, alongside her meticulous preparation and tenacity at court.
Nicola is married with two young children. She enjoys running, swimming and singing. She is a governor at a primary school.
Nicola is an Accredited Mediator – Civil & Commercial Mediation (Bristol ADR Group).


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Q: Oracle SQL Regular Expression RegExp_SubStr End Of Line (chr(10) in search text returns null I am trying to get a specific part of a text with Oracle regular expression. If there is no end of line character (chr(10)) in the text, I get what I want. But if there is an end of line character, it returns null. You can see the sample sql codes below.

SELECT RegExp_SubStr('TEXT_BEGIN Line 1 Line 2 TEXT_END',
                     'TEXT_BEGIN(.+)TEXT_END', 1, 1, NULL, 1)
  FROM dual;

returns
Line 1 Line 2

with end of line char.

SELECT RegExp_SubStr('TEXT_BEGIN Line 1' || chr(10) || 'Line 2 TEXT_END',
                     'TEXT_BEGIN(.+)TEXT_END', 1, 1, NULL, 1)
    FROM dual;

returns
NULL

It may be a solution to convert the end of line characters in the text to a special character such as ## CHR10 ## before SubStr and then back after SubStr. But I want a simple solution without hack.

A: By default, the dot does not match the newline character.
The fifth argument to regexp_substr (which you have as NULL in your example) is used for a few modifiers. One of them is 'n' to allow the dot to match newline.
So - it's really easy: change the fifth argument from NULL to 'n'.

redpajama_set_name: RedPajamaStackExchange


Soil testing can be done at the local university Extension office.
Reapply the complete fertilizer granules every three to four months. Spray the bush with a foliar fertilizer that contains trace elements every three to four months.
Cut the flowers off of the bush as they fade. Prune in late winter. Remove branch sections that were damaged by frost and trim the rest of the branches back to control the height of very large species.
Raine, Reannan. "How to Plant a Mussaenda Bush." Home Guides | SF Gate, http://homeguides.sfgate.com/plant-mussaenda-bush-22976.html. Accessed 25 April 2019.


text:
Mauricio Pochettino defends Tottenham medical staff over Jan Vertonghen treatment
The Belgian was allowed to return to the field during the Champions League semi-final clash with Ajax after suffering a heavy blow to the head
Liam PrendervilleAssistant Sports Editor
Mauricio Pochettino has defended Tottenham's medical staff over their decision to let Jan Vertonghen return to the field against Ajax.
The Belgian defender suffered a heavy blow to the head during the Champions League semi-final but was given the all-clear to return to the field.
Referee Antonio Mateu Lahoz spoke to Spurs' medical staff before allowing the defender to return, only for the 32-year-old to quickly go off again.
Pochettino had to put his arm around him to help keep the groggy defender up, before he was carried down the tunnel.
Spurs' medical staff have been slammed for their treatment of the player but Pochettino insists concussion protocol was followed.
The defender clashed heads with teammate Toby Alderweireld (Image: Getty Images)
Jan Vertonghen provides nine-word injury update after suffering blow to the head
Tottenham boss Pochettino said: "I wasn't involved. I wasn't involved. It was the doctor's decision.
"I think it's so important things, the rules and the protocol are there, and our medical staff follow the protocol.
"I was never involved. The decision was the doctor and the referee asked.
"He goes in. In the next action, we need to put him out because he didn't feel well."
Jan Vertonghen of Tottenham Hotspur is given treatment (Image: Getty)
Arsene Wenger suggests Mauricio Pochettino was wrong to claim his players are tired
Pochettino said the medical staff will always be the "boss" in such situations and that he would have made the change sooner had he been instructed to as a player's health is always key.
UEFA brought in new concussion procedures across all of its competitions in September 2014.
The defender appeared groggy as he made his way off (Image: PA)
Ruud Gullit slams Dele Alli after Tottenham lose first leg to Ajax
Champions League regulations state: "Any player suffering a head injury that requires assessment for potential concussion will only be allowed to continue playing after the assessment, on specific confirmation by the team doctor to the referee of the player's fitness to do so."
Tottenham were criticised in 2013 after captain Hugo Lloris was allowed to remain on the pitch against Everton after being knocked out in a collision with Romelu Lukaku's knee.
Greg Rutherford: How Marcus Rashford inspired me to help lockdown fitness fight
Tokyo Olympic Games"Rashy is changing people's thought processes and getting things done. When I see someone so young having such an impact it totally inspires me"
Gareth Bale finds unlikely ally as Arsenal ace jumps to defence of Tottenham star
Gareth BaleBale has struggled for form since returning to Tottenham on loan - leading to speculation Jose Mourinho could send him back to Real Madrid in the January transfer window


3. Dragon Diction by Nuance Communication is a fabulous speech to text application. To use it, students speak into the microphone and their speech is converted to text. The accuracy is impressive, even with difficult words or background noise. Students can use Dragon Dictation to compose notes, email messages, tell a story, or have an oral book report recorded.
4. The Social Express, by The Language Express, Inc, uses engaging scenarios to teach users, with high functioning Aspergers or other similar conditions, how to think about and manage social situations so that they are better prepared to develop meaningful social relationships and succeed in life.
5. My First AAC by Injini is is an inexpensive augmentative/alternative communication application for the iPad that is designed specifically for the younger set who have delayed speech or severe speech disorders. Intuitive and child-friendly, this app helps young children to communicate with others.
6. Conversation Builder Teen by Mobile Education Store; a teen version of the popular and award winning Conversation Builder app, older students learn when it is appropriate to introduce themselves, ask questions, make observations and change the subject of the conversation. They will also be exposed to sarcasm and how to respond when someone is bullying them or someone around them.
7. Phonics Genius by Alligator Apps is loaded with content. One of the best ways to rapidly learn how to speak, read, and recognize words is through phonic awareness. This app is specifically designed to help students recognize and distinguish words by sounds, it is one of the most comprehensive phonics apps available.
8. SoundLiteracy by 3D Literacy, LLC is the first iPad app that brings your letter tiles in to the 21st Century. It is being used in 15 countries across the globe and growing quickly! The app is incredibly useful, employing the Orton-Gillingham method to help students recognize the spellings of English phonemes.
9. Letter School, by Boreaal teaches letter formation in a rich aesthetically pleasing environment, it offers many ways for your child to practice letters, including upper and lower case letters, as well as numbers. Letter School forces the child to have the correct length and formation of the letters and works on the extinction of lazy letters, while making writing fun. The children are able to make the letters while being entertained, but not frustrated.
10. Social Quest by Smarty Ears will have speech therapists, teachers, and parents engaging students in clever castle adventures while working on speech and language as well as social skills. This app is designed for older elementary, middle school, and high school-aged populations. Actual photographs make the experience more real and reinforce concepts. Students will love their picture being in the House of Heroes.
12. Speech With Milo by Doonan Speech Therapy is a series of nine speech apps to build language skills. They make their apps as interactive as possible, and they are designed for the child to be actively working with a parent or therapist. They also incorporate animation as much as possible so Milo demonstrates the word or skill that the child is working on, but does not detract from the focus of the skill.
13. i Get It! by I Get It, LLC are also a series of specialized apps, they offer two series of educational apps, the Identification Series and i-Seequence Series. These apps are designed to facilitate cognitive growth through building language skills. The i Get It! apps are appropriate for typically developing children as well as children with special needs such as language impairments, autism, ADHD, and auditory processing disorders.
Tagged as: 1-to-1, digital classroom, iPad, special ed.


INDIANAPOLIS, IN—Saying the groundbreaking discovery could potentially silence even their fiercest critics, scientists at Indiana University's School of Medicine announced Tuesday that they had almost developed a life-saving vaccine that they could rub in the faces of all their doubters. "This injection, once it is approved, will have long-lasting ramifications for all of our haters within the medical community who apparently thought they were better than us," said lead researcher Professor Danielle Padilla, adding that it should only be a few more months until their scumbag PhD rivals, as well as "those cocky bastards at Yale" get their sorry asses handed to them. "In fact, preliminary tests have already shown that they'd better buckle up, because there's about to be a new big dog in the viral research community. As doctors, scientists, and sometimes patients ourselves, we can't wait until this product finally reaches the market so we can wipe the floor with those jealous losers for once and for all." At press time, researchers had quickly retracted all published mentions of the vaccine after FDA testing revealed it had a slew of life-threatening side effects.


text:
package org.jbehave.examples.core.needle.steps;

import static org.hamcrest.CoreMatchers.is;
import static org.hamcrest.MatcherAssert.assertThat;
import static org.hamcrest.Matchers.notNullValue;

import javax.inject.Inject;

import org.hamcrest.Matchers;
import org.jbehave.examples.core.service.TradingService;
import org.junit.Rule;
import org.needle4j.annotation.ObjectUnderTest;
import org.needle4j.junit.NeedleRule;

/**
 * Test Constructor injection for steps.
 * @author Jan Galinski, Holisticon AG
 */
public class NeedleTraderStepsTest {

    // PONR - Plain old needle rule
    @Rule
    public final NeedleRule needle = new NeedleRule();

    // should be created via constructor injection.
    @ObjectUnderTest
    private NeedleTraderSteps needleTraderSteps;

    @Inject
    private TradingService tradingServiceMock;

    @org.junit.Test
    public void shouldCreateNewInstanceViaConstructorInjectionWithMockedService() {
        assertThat(needleTraderSteps, Matchers.is(notNullValue()));
        assertThat(needleTraderSteps.getService(), is(tradingServiceMock));
    }

}

redpajama_set_name: RedPajamaGithub


The Health 2.0 conference in San Francisco earlier this week pointed to the future of what health care can become in many aspects: online, personalized, and real time.
There are a number of new online brain health tools that launched this year at the conference, with many more on the way soon. Some of these health technology firms bill themselves as online mental health platforms, and others as "social health gaming" tools, but they really serve the same purpose: promoting and maintaining a healthy, resilient brain.
SuperBetter has a refreshingly non-clinical take on ways to recover from a health crisis, or reach personal health goals. Created by an expert game designer who suffered a severe concussion (and then struggled through recovery), SuperBetter provides a path to reach health goals through achievable, incremental steps with help from the game and allies (friends & family) that you enlist.
Kairos Labs takes social health gaming to larger multi-player groups with the goal of achieving lasting, sustainable behavior change. Called Habitual, this online health tool draws on psychology research and behavior change theory to promote behavior change on a large scale – think how this could positively affect obesity rates and food choices, as an example.
In response to an overwhelming need to treat injured military service members who have suffered brain trauma, the Veterans Administration created PTSD Coach, a mobile brain heath application available on Android and Apple devices. Kudos to the dedicated VA staff that pulled this simple but useful tool together.
AbilTo and Empower Interactive are moving the traditional cognitive behavioral therapy (CBT) approach of one-to-one psychotherapy office visits to the web — with online video sessions, user guided online therapy education modules, and virtual therapist support teams. So who will pay for these new tools? In the future, probably your employer or health plan. Possible roadblocks for consumers: how "real" will online therapy feel, and how much personal online therapy details will be made available to employers and health plan sponsors.
Next week we'll detail some trends with wearable & home based health sensors that could have positive implications for cognitive health, especially for older adults.


boolean for logical or boolean values, true or false.
In reality, you learned about four data types. Special data type undefined contains just one value undefined.
Let's now take a look at more complex or compound data types: array and object.
We will analyze each of these types of data later, in the courses that are still to come.


Surfnetkids » Tech Tips » Social Networks » Free Twitter Analytics for Everyone!
Free Twitter Analytics for Everyone!
Once only offered to advertisers, marketers, and verified users, now all Twitter users have access to free analytics to view how many people their tweets reached, and how much engagement they generated.
To see your Twitter analytics, just visit analytics.twitter.com.
Feldman, Barbara. "Free Twitter Analytics for Everyone!." Surfnetkids. Feldman Publishing. 29 Aug. 2014. Web. 20 Apr. 2019. <https://www.surfnetkids.com/tech/3094/free-twitter-analytics-everyone/ >.
By Barbara J. Feldman. Originally published August 29, 2014. Last modified August 29, 2014.


text:
Why not Wilmar?
DTE 96-97, December 2013
The name Wilmar looms large in the Europe-Indonesia agrofuels picture. This Singapore-based company sells Indonesia-made biodiesel to Europe as well as selling oil palm feedstock for making biodiesel in Europe.
Plantations, pumps and power stations
How oil palm produced in Indonesia ends up in Europe's transport and electricity systems
Policies and practice: favouring big business over communities
In this article we highlight some of the influences at work inside Indonesia which are contributing to the ongoing transfer of land from communities to corporations. These influences include national and local government policies, laws, governance and practices, whose provisions for supporting indigenous peoples and communities' rights and livelihoods have been deprioritised in favour of large-scale, commercial 'development' projects. The result is a growing disparity between rich and poor, worsening imbalance in the control over agrarian resources and more and more conflicts between communities, private sector and the state.
The international landgrabbing picture: an update
Last year DTE reported on the global land-grab phenomenon and its connection to the 2008 financial crisis, the global food price spike of 2007/2008 as well as the ongoing climate change & energy crisis.[1] Since then, more analysis of data on land deals has become available which fills in some of the detail in the picture. In this update, we take another look at the global rush for land with a focus on investors and their obligations to the people affected by land-grabbing.
Agrofuels: key driver in new landgrabbing wave
Agrofuels are often promoted by the agrofuels industry, investors and government officials as a means of providing livelihoods for rural communities, but how does this square with the fact that agrofuels are part of the landgrabbing problem in countries like Indonesia?
The global land-grab phenomenon
DTE 89-90, November 2011, Special Papua edition
The following report, by independent researcher Anna Bolin,[1] explores the global trends and influences at work behind agriculture mega-projects like MIFEE in Papua.
100 years of oil palm
Oil palm development in Indonesia has led to conflict, human rights abuses and the theft of community land; it has sparked massive fires which devastate forests, contribute significantly to climate change and affect human health.


text:
Small businesses and the ACA
Matt Paul, Reporter/Producer | 12.02.13
(Dover) -- The Obama administration announced this week that it is delaying the launch of an online health insurance marketplace for small businesses, known as the Small Business Health Options Program (or SHOP) exchange. But employers can still choose to buy the coverage offline, and they're still paying close attention to other provisions in the Affordable Care Act.
At Hively Landscapes in York County, late November is typically a time for planting and hardscaping jobs. But this year, its 27 employees are also making important health care enrollment decisions.
Owner Ted Ventre has opted for an early renewal on the company's existing employer-sponsored health insurance plan. He says the good news is premiums are only increasing by three percent; the bad news is he won't be permitted to provide Health Reimbursement Accounts (HRAs) next year.
Ted Ventre on the job at Hively Landscapes in Dover
"I said with this change -- that will cost you money, yes, it will cost you more money -- but with this change I will give you the same plan that you've had, that you're used to, that you know. You go to the same doctors, receive the same benefits," he says, recalling a recent conversation with his staff.
"It will manage our premium costs for up to a year, and we can sit back and we can watch how the federal and state exchanges shake out, and we can watch what happens with the ACA."
Ventre thinks locking in the grandfathered plan for one more year is the best option for his business and employees because they don't know how they'll be affected by the Affordable Care Act.
"Are our rates going to increase, are they going to decrease? Are plans going to change drastically in terms of what's available to us?" he asks. "Those are all things we weren't really sure about."
As a small business owner, Ventre is not required to provide insurance for his employees. But he thinks it's the right thing to do.
The line of demarcation with the ACA is 50 employees. Companies with 50 or more full-time equivalent employees will have to play by one set of rules. Businesses with fewer than 50 workers will play by another.
Rob Glus, a consulting actuary at Conrad Siegel, says new restrictions are being placed on small group health insurance ratings. No longer can insurance companies vary rates based on health status, health experience or gender.
"Having those limited variables now really changes the dynamic," explains Glus. "Depending on where you fall in that category, if you're a predominantly very young, very healthy group, you may see your costs go up a little bit. If you're a predominantly older, sicker, less healthy group, you may see your costs go down a little bit because there's no more medical underwriting for those groups anymore."
Rob Glus chats at Conrad Siegel's offices in Harrisburg
Generally, Glus says the new standards for comprehensive care, along with new taxes on insurance companies, are expected to put upward pressure on premiums.
He says small business owners also need to think about several new disclosures and administrative duties -- whether they want to or not.
"They want to be spending time thinking about their small business, and - in a fairly rough economy - how can I keep my business afloat. Not what other administrative or compliance issues do I have to be deal with as a business that could potentially put me in a position where I have penalties that I wasn't counting on," he says. "It's not feasible for small business."
Glus says he knows everyone will want to say on January 1st whether the Affordable Care Act was a success or failure. But he believes it's going to take some time for the insurance market to settle down after so many changes.
At Hively Landscapes, Ted Ventre thinks he may be faced with a tough decision next year: whether to continue offering competitive employer-sponsored health care, or opt to subsidize his workers' plans on the individual marketplace.
Dropping the perk completely hasn't crossed his mind.
"It's all driven by customer services. To keep the customers happy I want to keep the employees happy. To keep the employees happy I have to make sure they have the things they need to live their lives. And I think health care is part of that," Ventre says.
"If I can offer it, I will."
Listen to the story:
Tell us: Are you a small business owner? What are your thoughts about the Affordable Care Act and covering your own employees? Please leave a comment below.
Published in Affordable Care Act, Healthcare Transformation, PA Insurance Marketplace, Personal stories
Tagged under Affordable Care Act, audio, business, health insurance marketplace, SHOP