Christian DiSapio, founder of FitnesScience has degrees in fitness and kinesiology and has been getting his clients' bodies into shape for 17 years. But DiSapio's services extend beyond conditioning muscles—he also provides expert design advice on creating the ideal at-home gym.
Long Island Pulse: What would your perfect home gym include?
Christian DiSapio: Eventually, the body will adapt to using the same type of equipment. The ability to switch or cycle between different types of resistance will be an important factor to keep the body challenged. Depending on the budget, there are three different options, the least expensive being a set of different strength resistance bands with some sort of door or wall attachment. A more expensive option would be a set of interlocking dumbbells. And the most expensive would be an adjustable multi-functional trainer or adjustable cable-crossover machine.
Pulse: What is the one item no home gym is complete without?
CD: An inflatable exercise ball. There is no other piece of equipment that can match the versatility that this $25 investment will provide. It can be used for strengthening, stretching and balance, along with being a substitute or option for a chair or bench.
Pulse: What consideration should be given to the design of the room?
CD: A home gym should ideally be in its own separate area that is used only for exercise. Similar to going to a gym or fitness facility, a home gym should be a sort of sanctuary associated with only fitness and exercise. A light and bright area will enhance mood and motivation. Rubber flooring to go under equipment and add some cushioning to the floor can be a good idea, or you could add shock-absorbing wood floors. The room should have the ability be kept at a cool 66-68 degrees. Try to keep a 4×6-foot open space for stretching in all directions and for a variety of movement options.
The biggest mistake I see most people make with their home gym is thinking they must have a treadmill. If you are a runner and have the need to be able to run anytime, then you will probably want to include a treadmill in your gym. However, for most people a quality elliptical machine is probably the better option.


text:
Galapagos Islands | With tour boats moored due to the coronavirus pandemic, the animals are out
Just south of Galapagos' Marchena Island is a dive spot known by locals as the "fish arena," where colorful fish, like these rainbow runners, swim in large schools. (Carolyn Cole / Los Angeles Times)
Six hundred miles west of Ecuador's coast, the Galapagos Islands are a chain of volcanic islands — some still active — home to some of the world's richest biodiversity and endemism. Nearly 80% of the species found on the islands aren't found anywhere else on Earth.
Along the rocky outcrops, marine iguanas bathe in the hot sun before plunging into the cool waters, where they swim alongside Galapagos penguins, and below the soaring, diving blue-footed boobies.
A confluence of oceanic currents meets at the Galapagos, giving rise to the extraordinary richness of wildlife — where southern ocean, cold-water creatures, such as penguins and fur seals, are found alongside equatorial and North Pacific critters, such as sea lions and hammerhead sharks.
On land, the ecosystems range from desert-like to lush and tropical — depending on altitude, wind exposure and geological age of the island. On Santa Cruz Island, for instance, the northern end is rocky, sandy and dry. But ascending the island's volcano, and to the south, the ecosystem becomes lush and cool. Giant tortoises amble through tall grasses, munching on banana leaves and — to many local farmers' annoyance — outdoor crops.
It is a crime to hurt or kill a tortoise in the Galapagos — penalties range from the low to high thousands. Car and truck drivers stop to lift tortoises seen crossing roads. Sometimes, however, the tortoises are too big to pick up. So everyone just has to wait.
A local resident stops to remove a Galapagos tortoise from the road on the island of Santa Cruz. (Carolyn Cole / Los Angeles Times)A white-tipped reef shark in the waters off North Seymour Island in the Galapagos. (Carolyn Cole / Los Angeles Times)A juvenile blue-footed booby practices flapping his wings before beginning to fly on North Seymour Island in the Galapagos. (Carolyn Cole / Los Angeles Times)A blue-footed booby tends to her chicks on North Seymour Island in the Galapagos. (Carolyn Cole / Los Angeles Times)With few tourists visiting the Galapagos, a baby sea lion has his first encounter with a human on North Seymour Island. (Carolyn Cole / Los Angeles Times)Frigate birds fly off the Galapagos Islands. The Galapagos Islands are the breeding ground for many species on land and in the sea. (Carolyn Cole / Los Angeles Times)A sea lion rests on a bus stop bench in Puerto Ayora, where tourism is down dramatically due to the pandemic. (Carolyn Cole / Los Angeles Times)Pinnacle Rock is a celebrated volcanic plug on Bartholomew Island, one of Ecuador's Galapagos Islands. (Carolyn Cole / Los Angeles Times)A red-footed booby sits above a group of iguanas on North Seymour Island, Galapagos. (Carolyn Cole / Los Angeles Times)
Don't Miss it US and Italy – current and former COVID-19 epicenters – are worlds apart in pandemic approach
Up Next Cuomo's COVID-19 book omits mention of Lt. Gov. Kathy Hochul
Coronavirus Videos EU stops short of coronavirus vaccine export ban – BBC News
Coronavirus News The states with and without travel restrictions amid the coronavirus pandemic
Coronavirus News COVID-19 relief bill affirms US stance on successor to Dalai Lama
Coronavirus News Cuomo urged to release $50 million to prevent COVID-19 election chaos
Coronavirus News Study finds COVID-19 vaccine may reduce virus transmission

redpajama_set_name: RedPajamaCommonCrawl


I am delighted and honored to have been accepted as an alaka'i candidate meaning that I am now training to become a teacher of Huna.
What is Huna? In brief, Huna is a form of Hawaiian shamanism that is taught by Serge Kahili King. Huna means secret, but not the form of a secret that can't be shared. It is instead esoteric knowledge that is available for everyone but is hard to see or find. In other words, it is the knowledge behind appearances.
Hu means movement in the sense of a fountain rising up and Na is the stillness of the center, a peaceful quiet awareness.
As a newly minted alaka'i candidate I would love to talk about it and share what I've learned and how its affected my life. There are so many gems of life in inherent in huna that I am thrilled to do my part in sharing them. In the coming weeks, I will be blogging about the 7 principles of huna (not laws or decrees but principles) so be sure to check it out. Questions welcome!


text:
Have They Finally Got to You? - the Firing of Dr Gu
Introduction - Dr Gu's History of Activism Made Him Unpopular at Vanderbilt
We first wrote in February, 2018, about the plight of Dr Eugene Gu, a surgical resident at Vanderbilt University Medical Center (VUMC). Dr Gu has a history of political activism, resulting in being blocked on Twitter by President Trump after Dr Gu criticized him online, until a court forced Trump to unblock him on First Amendment grounds. After Dr Gu posted a photography of himself kneeling in support of the protest of football player Colin Kaepernick, the mother of a pediatric patient apparently refused permission for Dr Gu to treat her child based on the kneeling post, and VUMC responded by suspending him.
Dr Gu Fired
The story reappeared in the media in June, first in the Duke University Chronicle, then in the Tenneseean and USAToday. From the latter,
A Tennessee doctor who became a social media sensation because of statements on President Donald Trump, racism and Colin Kaepernick - and who later sued the president over First Amendment rights - is losing his job at Vanderbilt University Medical Center.
Dr. Eugene Gu, 32, a Vanderbilt surgery resident, said Friday that Nashville's biggest hospital is ending his five-year residency after only three years.
Technically, Vanderbilt has decided not to renew his contract with the hospital, Gu said, but he argues the effect is 'no different than being fired.'
Dr Gu argued that the reason he was effectively fired was that VUMC disapproved of his political views as expressed on social media.
'The take-home message here is that there is an unwritten rule for surgical residents and that is rule is, always make your program look good and always make your hospital look good, and often that means stay silent,' Gu said.
VUMC denied that:
Vanderbilt said in an email statement Friday that the decision not to renew Gu's contract was not a result of his criticism of Trump, his lawsuit, or his public opposition to racism. The hospital has said previously that all disciplinary actions against Gu relate to his work performance and professionalism.
'Regarding other allegations that Dr. Gu is making about the Medical Center, I would ask that you please consider these as allegations and nothing more,' John Howser, a spokesman for the hospital, said in the email. 'To date, we have not engaged in a point by point rebuttal of Dr. Gu's many claims over the past two-plus years. At this time we will continue to maintain this stance.'
VUMC, however, has not provided any clear evidence of deficient performance or insufficient professionalism. The Duke Chronicle article noted arguments that Dr Gu made suggesting that it may not have had much such evidence. First,
After an appeal, a May 17 letter to Gu from VUMC General Counsel Michael Regier—delivered at the request of Jeffrey Balser, president and CEO of VUMC—cited a 'lack of sufficient improvement in performance and conduct in key areas' after the probation. The letter, which was obtained by The Chronicle, indicated that the most "significant areas of concern" were 'patient care, communication, and medical knowledge.'
However, Dr Gu cited one example of a criticism of his performance that seemed rather trivial.
when he was serving on consult call, meaning he would respond to any surgical needs throughout the night. There was a patient for whom he was supposed to identify the course of treatment—which he did, correctly, as he did with the imaging and other relevant details. His colleagues, nevertheless, 'nit-picked' Gu about 'every little detail on the case'—claiming he didn't 'dot all of his i's and t's' by not providing the patient's height and weight—which Gu said were irrelevant.
Also, he noted that
Kyla Terhune, the residency program director for general surgery, was two-faced in her interactions with him. A text message obtained by The Chronicle showed that Terhune wrote 'Nice presentations' to Gu after he spoke at the Veterans Affairs Medical Center Tumor Board. He said she complimented him for his performance after going through two surgeries for him. But when it came time for performance review, Terhune said his performance was 'terrible' in those same instances, Gu noted.
Given the local and social media attention this story has received, one might wonder why, if VUMC had such a strong case against Dr Gu, it has avoided ever airing any details about it.
Furthermore, the article noted an apparent anomaly in the narrative of how the patient's mother came to complain about Dr Gu.
Before the story broke, VUMC declined to comment more than a dozen times, saying that it does not comment on personnel matters. After it was published, Howser wrote in a statement that Gu did not need to change his political views.
'Dr. Gu has never been told that he must change his political views or the substantive content of his personal participation on social media platforms,' the statement read. 'He has been advised of the need to adhere to VUMC's social media policy, which requires that persons who are identified as representatives of VUMC clearly state that their views are their own. He has also been advised that resident physicians should be professional and respectful in their interactions and communications with and about one another.'
In the kneeling photo, one cannot make out that his badge says Vanderbilt Medical Center on it, even when zoomed in on. Gu's Twitter bio had no reference to Vanderbilt, though he had tweeted about Vanderbilt seven times prior. Twice, he tweeted that his views communicated on Twitter do not represent VUMC.
Yet Vanderbilt, after first suspending Dr Gu, ended his residency prematurely. Since surgical residency normally lasts five years, it seems reasonable to say Dr Gu was fired, and that such Vanderbilt's action will likely damage his career. Since Vanderbilt has not provided any convincing evidence that Dr Gu was incompetent or unprofessional, one is left with the nasty suspicion that it fired him because refused to stay silent about political beliefs that did not accord with those of Vanderbilt leadership.
This story suggests that in our current political era, health care professionals, particularly trainees or others at the bottom of the totem pole, may be increasingly beholden to the political sensibilities of their bosses, and hence increasingly wary of espousing political views that run counter to those of their bosses.
While it is reasonable for residency programs to require their trainees to be professional, since when did "professional" mean stifling political views that might offend hospital corporate leadership?
As we wrote in February,
It may not be unreasonable to expect physicians and physician-trainees, as medical professionals, to avoid getting into political arguments with patients. However, it is unreasonable to expect physicians to avoid making any public political comments that could ever be expected to offend any patient or relative.
And this case also raises the question of whether it was the patient's mother's offense, or the Department Chairman's offense, that mattered.
Attempts to censor political speech in academia are unfortunately not rare (see the website of FIRE, the Foundation for Individual Rights in Education, for many examples). However, they have not seemed to be that frequent in medical education. (Our most recent example before this case was from 2015.)
I wonder, though, if the ongoing attacks on free speech and the free press (e.g., look here and here) by the current President and his cronies are emboldening censorship in US society. The President does set the tone and agenda for the country. A president who personally threatens free speech and a free press will encourage other would-be censors to crawl out of the woodwork.
We will only be able to restore the freedoms promised in our Constitution, and ostensibly inherent in the nature of academic organizations, if we can get a new president who upholds the worth of these freedoms, and actually will preserve, protect and defend the Constitution of the United States.
Some lyrics from Dr Wu, Steely Dan, by Fagen and Becker
Are you with me Doctor Wu
Are you really just a shadow
Of the man that I once knew
She is lovely yes she's sly
And you're an ordinary guy
Has she finally got to you
Can you hear me Doctor
Labels: academic freedom, anechoic effect, Donald Trump, free speech, post-graduate medical education, Vanderbilt University
Dander Still Up. Drowning in Great Dismal Swamp. Film at Eleven.
Maybe this is the last in my series of dander-raising essays, as recent national and world events have most definitely left so many of us with a raging case of TDS. (Trump Derangement Syndrome, look it up it's a thing).
So many damned browser tabs sitting there open. So little time.
Or maybe not. Who knows. Where are all these suicides coming from?
My editor keeps telling me, "don't let it make you paralytic." Hey, I'm trying.
Just sensing a kind of coalescence in all the corruption our bloggers keep writing about. How do we even differentiate these activities across so many sectors of society. We were going to see our swamp drained. He promised. But instead there's just this big brand new bodacious cesspool. There it is in all the revolving-door sectors. Federal government. Private sector. Health care non-profits and even academia.
Just read back over recent weeks and months of this, your favorite blog.
The coalescence of corruption is certainly made easier by our enjoyment of a remarkable and possibly quite barmy Confabulator-in-Chief. He's just sort of paved the way for what one pundit recently characterized as a sort of race-to-the-bottom. No corruption is too small (cone of silence? nifty office furniture? wipe out environmental health? give Big Pharma another bye?). Or, of course, too large.
None of this is terribly new, just the way it's all melded into what the cancer biologists call a syncytium. There are no winners and losers in all this. Just a lot of organelles swimming around and causing havoc at our expense. Just a bunch of top-level narcissists and then, under them, a phalanx of careerist stronzi streaming out of academic backwaters and think tanks to grab their fifteen minutes of ... what?
Surely not fame, unless you're looking for a spot on an SNL cold open. Microphone time maybe? Let's call out a few of them.
The careerist gets fifteen minutes, max, by the way. The turn-over in government, especially, in the federal executive, is many-fold that of any previous administration. If this were tennis we'd all have whiplash. Everybody seems to be trying to find their own inner Scaramucci.
Just now, in fact, it seems to've gelled intoone great big scandal. Adam Serwer in The Atlantic: "there is only one scandal." While the Chest Thumper-in-Chief runs around doing what he does best--sullying the western world and laying down cover for his army of swampy miscreants--the careerists continue to run up a debt whose bill will surely come due. Of course by then, so many will have cashed out. Guess who'll be left to pay the tab. You, me, our sickest, our poorest. Mother Earth.
In the private sector it may take years for the ins and the outs to get in and then back out. But of late in both Big Pharma and in Health IT, both the revolving door and the Invasion of the Body Snatchers (aka baleful effect of activist investors and hedge funds) have taken their toll and we pick up the pace. Most recent casualty: Bush family scion and alleged wife-beater Jonathan B, thrown out of possibly the most innovative, but not quite profitable enough, athenahealth EHR company he once founded. Offed just now by the Elliott organization, which is headed up in turn by ultra-right political donor Peter Singer. (Here and here and pretty much everywhere--don't get stuck in his cross-hairs.)
Ah, yes, these are the glory days for the Big Families. Donorship gets you a whole party of your own. The Prince-DeVos family, the Koch family, the Uihlein family, the Mercer family. And Las Vegas Gambling Tycoon Sheldon Adelson, who almost single-handedly handed Binyamin Netanyahu an unearned win in Jerusalem.
Their common goal: effacement of government, Ron Reagan's great "problem child," in favor of its replacement the Great Dismal Swamp. (In fact much of the real GDS, out of North Carolina, was actually bought up by Betsy DeVos's brother Erik to train Blackwater mercenaries.) So now, on to the Great Dismal Swamp of outsourced everything. Outsourcing, along with the revolving door and the Anechoic Effect, these form the inner dynamic, the secret history of what's happening now. Outsource security. Outsource VA health care. (See my earlier blog on a secretary's attempt to resist that.) Outsource public education. Outsource, or at least deregulate, clinical trials of unproven drugs. Privatize, don't shade your eyes (apologies to Tom Lehrer).
(Note that in the course of all this privatizing the common weal, these Big Dogs not infrequently can turn on each other. Singer turns on Bush. Koch the Elder turns on Koch the Younger. The dollar is king and the beat goes on and Throw Momma From the Train.)
Other major features of this secret history:
The Scorching of the Earth. Both literally (health consequences of climate change), and figuratively: the flaming rhetoric of the careerists. The most glaring recent example, albeit outside of our health purview, White House National Trade Council Director and temporary-in-from-the-cold academic Peter Navarro, awarding "a special place in hell" to Canada. (Wait, what?!? Canada?) Why? Because it dared to cross his new boss. Cross the boss, thump the chest. Ten points for the thumper, zero points for the country--either one. We'll learn later this year, and again in 2020, whether there's enough of the vaunted "base" left to be snookered by all this guff. The chest-thumpers may discover a special place in hell meted out to folks closer to home. The charlatans. The quislings. Pretty clear now who they all are.
The Swamp-Ooze of the Careerists. Navarro's one high placed example. Another newly high-placed with a more direct impact on health care, and also flaming the air waves, is National Economic Council Director and former CNBC correspondent Larry Kudlow. In the recent presidential travels Kudlow did not speak cosmologically of heaven and hell, but only politically. He called Canada's measured response "betrayal." On health insurance, he's agin it. It kills jobs, per Mr. Kudlow. And he ought to know how things really work, right? In 2007 he famously predicted the continued success of an earlier deregulatory GOP economic policy suite in that once-great organ National Review. William Buckley turned over in his grave. The headline read: "Bush Boom Continues." The following tag line: "you can't call it a recession." (Emphasis his.) The date: December 10, 2007. (Despite which, get well quick Larry. Maybe find a less stressful job would help.)
Health and the Environment. Ah, yes, and in environmental health we have Scott Pruitt heeding HMV while lining his own pockets and lobbying for his wife's Chick-fil-A franchise (honest I can't make this stuff up), all the while dumbing down any expertise on health. This dumbing down and anti-science motif pervades the Great Dismal Swamp. Never before has there been such a dearth of scientific, pedagogical, or health expertise in any of the departments that so direly need those capabilities. Interestingly, the small-bore corruption of these characters seems more prominent in the upper, Pruitt-like, echelons than in the Small Fry. Or are we just not hearing about the little guys?
Lesser Careerists. You can't have a syncytium without both big and little organelles. The little guys are actually among the more damaging, as they tend to be true believers with claimed expertise that goes poof when examined closely. Among the most famously wrong-minded recent ones we have the Press Secretary herself, Ms. Sanders, who from the depths of her health policy experience pronounced last fall that "I can't think of anything worse than having the government be more involved in your health care instead of less involved." Oh, Miss Sarah, I can. Even more peculiar is the role of the rather more obscure Ms. Katy Talento, of the White House Domestic Policy Council. She gets to act as conduit and house pundit for the new HHS secretary Alex Azar. It's fascinating. In several easily-reached venues she's described, by self or others, as "an epidemiologist." Harvard's master of science (not MPH) degree in epidemiology and public health can be obtained, as she did, in something between three and twelve months. Not exactly a board certification. Then she went on to build her career in ideological rightist causes and organizations, including anti-abortion campaigns and one notable set of pronouncements on the supposed link of birth control to miscarriage.
Came the time for Azar to prep his new boss on last month's Big Speech on reducing drug costs, Talento broadcast the news that "no ox would be gored." Said she, "This is a fearless president and he doesn't know or care why things have always been done. It's not like your typical Republican authorizing committee that protects this model that they helped write for decades...." Wait, one little thing. It didn't happen. The big play available, as I said in a previous post, would've been having Medicare bargain for prices. Instead--and clearly Azar could've tried and failed to get this--the Caregiver-in-Chief declared that drug prices in the US should come down by having other countries pay more. What so strange about this is not merely the absurdity of such a statement, coming from a former Pfizer top exec. It's the fact that here's a lower-level careerist who went straight into RNC speech writing and working for a right wing southern Republican (Tillis, NC), then became the "epidemiologist" for Mr. Azar.
Hold the phone. Among all the young staffers willing to sell their souls to get the Big Show on their CVs--don't they know it's a shabby little show?--what about the wonderful lady who dissed the ailing John McCain as inessential (just now he's incredibly essential), because, after all, he's going to die soon? Out the door she went, but of course her Republican friends got her a soft landing. Her name is Kelly Sadler, a real comer. Or goner.
The Rise of the Druggists. Last but not least, part of the secret history that, now I see it, has really got the dander way up, is how in health care and health policy, Pharma's now fully the tail-that-wagged-the-dog. CVS is moving into health care--see Dr. Poses's recent posting on just how well that organization understands their responsibilities. Actually having pharmaceutical and pharmacy folks elbowing out health care professionals who understand professionalism, it's not a new thing. Philadelphia Big Donor Leonard Abramson founded U.S. Healthcare and made a mint when he discovered how easy it was to make Managed Care actually Denied Care, then, with this proof-of-concept, cashing out and selling to Aetna. That goes way back. More recently, though, the pace of They Come at Night has picked up, viz. the firing of David Shulkin MD at the VA and the hiring of Alex Azar at HHS. These clearly result from both the privatization motive and the Pharma tail wagging the dog. At least two of the three branches of the federal government understand the business model of Pharma. They don't come anywhere near understanding the professional ethics of doctors--even while relying on their personal physicians to exercise such ethics.
Business ethics in medicine, as practiced by Pharma, have been laid out in many, many places in this blog. I and others have laid the blame for a big chunk of the opiate crisis at the door of Purdue pharma and the Sackler family. I regret to remind that the early Sacklers were physicians. But they were first and foremost business folk, possessed of a truly novel business model, which may be called outright dissimulation. (For a fascinating and harrowing description of one high-functioning Ivy-League opiate addict's experiences at Yale, with all its Sackler money and Oxy pills traded on the New Haven Green, see this Guardian piece.)
Actually, I've talked to a lot of pharma execs and they're often quite ethical and responsible. They have their hands full fighting off the PBM companies. They get singled out for their K Street spending, but many of them actually have rather low budgets for that, the recent Novartis scandal notwithstanding. Other execs blush at this Novartis nonsense and want nothing to do with it. I say all this mainly to point out some dreadful outliers. It's not just the brand name drug makers, either. Teva, the Israeli generics giant, is allegedly a real problem. As I write this, good old Ron Wilson, the Wisconsin Republican who just keeps on giving his gifts, is blocking his Ranking Member Claire McCaskill from obtaining information Teva's contributions to the opioid crsis. He's saying leave it to the courts.
OK, as I just hinted, I agree with you. None of this recent stuff is really secret. Not even really novel. It's just coalesced like never before into into a dismal swamp. (Orwellian doublespeak: yes, we've seen the swamp drained. Of what? What was he promising to drain? Yes, drained, if that meant getting rid of people ("Deep State"?) who know stuff. So people who don't know stuff can get on with the business of ripping us off.)
Hence in my current rant I just wanted to point to those commonalities that are, right about now, more egregious than ever. Honestly, they are. When the history is written, it will prove me right. Oh, wait, Alexander Hamilton wrote it already, hundreds of years ago.
When a man unprincipled in private life desperate in his fortune, bold in his temper, possessed of considerable talents, having the advantage of military habits—despotic in his ordinary demeanour—known to have scoffed in private at the principles of liberty—when such a man is seen to mount the hobby horse of popularity—to join in the cry of danger to liberty—to take every opportunity of embarrassing the General Government & bringing it under suspicion—to flatter and fall in with all the non sense of the zealots of the day—It may justly be suspected that his object is to throw things into confusion that he may "ride the storm and direct the whirlwind."
Posted by Cetona at 6:45 PM No comments:
Why Did CVS Health Betray its Charitable Giving Policy and Social Responsibility Agenda to Donate to a Sketchy Non-Profit Devoted to Trump's Agenda?
Many big health care organizations, including for-profit corporations, have high-minded mission statements, and proclaim their social responsibility. Unfortunately, we have shown that many leaders of such organizations seem indifferent to these seemingly exemplary goals, and even exhibit mission-hostile management.
A recent example involving CVS Health provided an unprecedented example of mission-hostile management, or something worse.
Introduction: CVS Health and the Promotion of Social Responsibility
CVS Health is a huge corporation that runs a large chain of pharmacies, many of which contain MinuteClinics, touted as quick albeit limited sources of primary care, staffed by nurse practitioners.
It thus employees numerous health care professionals with strong professional values. For example, the American Pharmacists Association has a code of ethics which includes respecting the covenantal relationship between pharmacists and patients, promoting "the good of every patient," acting with "honesty and integrity," serving "individual, community and social needs."
CVS Health proclaims its "social responsibility." This includes "keeping the planet in balance," and making "quality health care more affordable, more accessible and more sustainable."
CVS claims to act socially responsible by making charitable contributions for
improving health and health care nationwide. We support programs that improve access to health care services, provide chronic disease management and promote smoking cessation and prevention.
That seems fine and dandy, but then....
CVS Will Stop Funding America First Policies After Three of its Leaders were Revealed to Have Made Racist, Misogynistic, and pro-Nazi Remarks
CNN reported on June 1, 2018, that
CVS Health said Friday that it would no longer donate to America First Policies, a nonprofit group that works to promote President Donald Trump's agenda, after CNN and other outlets reported racist comments made by staffers of the organization.
The details were,
[Carl] Higbie has a history of making racist, sexist, Islamophobic and anti-LGBT comments. Some of his more inflammatory statements were that the 'black race' had 'lax' morals and that Americans should be allowed to shoot undocumented immigrants crossing the border with Mexico. Following CNN's January report, Higbie resigned from his position as chief of external affairs for Corporation for National and Community Service, which manages volunteer services for the federal government. He joined America First Policies in March.
Higbie initially apologized for his remarks but later defended them and said they were taken out of context.
John Loudon, a policy adviser for the group, has also made inflammatory comments about Muslims and women, CNN's KFile reported in May, such as calling Barack Obama 'the Islamchurian candidate' and joking about 'crack whore Dem voter.'
In May, Mediaite reported that Juan Pablo Andrade, another America First Policies adviser, praised Nazis and said that, 'The only thing the Nazis didn't get right is they didn't keep f***ing going!' Andrade claims the video is out of context and he was quoting someone else. He has said he is looking for the full video, which would exonerate him.
One wonders if CVS Health had vetted America First Policies prior to making its contribution, since the presence in the latter's leadership of three such people suggest there just could be a bit of a corporate culture problem.
In any case, the CVS Health response came courtesy spokesperson Carolyn Castel:
Comments made by employees of America First Policies that were reported after we made our contributions are unacceptable to us. We have zero tolerance for discriminatory actions or behaviors, and as such we will not be making contributions to this organization in the future.
CVS Health's denial of further donations to America First Policies seemed admirable, but begged the question of why it made its initial donation. In the Providence Journal, Brian Amaral reported on June 1 that CVS justified its initial contribution to America First Policies as a way to "to support the tax cuts signed into law last year," saying that it "supported this legislation and used the tax savings it created to invest in the growth and success of our employees,..."
However, that rationale seemed at best very loosely related to CVS Health's stated policy of making donations to improve health and health care. I suppose that perhaps if tax cuts did lead to happier CVS employees, the indirect result would be better health care. However, at least the purpose of the contribution did not seem in direct conflict with the stated goals of CVS charitable giving.
Nonetheless, the result of the CVS Health contribution to America First Policies seemed retrospectively a spectacular case of mission-hostile management.
But wait, there is more.
America First Policies Also Advocated Multiple Positions at Odds with CVS Health's Support of Social Responsiblity
As noted above, CVS Health suggested that it supported America First Policies because it was dedicated to tax reforms that would result in increased CVS Health's revenues. Their website does list "tax cuts that put America first," as one of its issues.
CVS Health's comments suggested that this is America First Policies' only issue. It is not. The America First Policies website lists advocacy on 13 other issues.
One is "repeal and replace Obamacare." In particular,
America First Policies believes Obamacare is a disaster, burdening our country with rising premiums, unaffordable deductibles, fewer insurance choices, and higher taxes. Congress needs to repeal and replace this law, including rescinding the individual mandate and eliminating taxes that drive up costs,
This issue certainly has to do with quality and accessibility of health care. However, whether most CVS Health employed health care professionals, or customers think that dismantling the Affordable Care Act would lead to better or worse, or more or less accessible health care is doubtful. Certainly CVS Health management did not explicitly justify how supporting America First Policies was informed by the company's stated objectives for charitable giving that supports health and health care.
Another issue addressed by America First Policies is "securing our border." In particular, the organization advocates for
a wall to stop illegal immigration and drug smuggling; putting an end to sanctuary cities; and deporting illegal aliens with criminal records.
These issues seem to have nothing directly to do with health care, or with the company's stated reasons for charitable giving. Many people might argue that these objectives could harm the health care, at least of some immmigrant groups.
So far, it is not clear why CVS Health really chose to donate to America First Policies.
But wait, there is more...
America First Policies Appears to be a Partisan Political Operation of Dubious Legality
A Political Agenda from the Start
A few more minutes of Google searching reveals that America First Policies has an advocacy agenda that seems in direct conflict with the CVS committment to social responsibility, and that America First Policies does not in the least resemble the sort of charitable organization that CVS says it intends to fund. Recall that CVS says that the purposes of its charitable giving are
improving health and health care nationwide.
We support programs that improve access to health care services, provide chronic disease management and promote smoking cessation and prevention.
Yet when America First Policies was started, initial coverage, like this AP report from January, 2017, per WJLA, said it was a political operation.
Six of President Donald Trump's top campaign aides have banded together to start a nonprofit called 'America First Policies' to back the White House agenda.
In addition,
'Some of the same like-minded individuals who put their energy into getting Mr. Trump elected are now going to be part of a grassroots group to go out there and help with the agenda, help the White House be successful,' [former Trump campaign digital director Brad] Parscale said.
Was it about improving health and health care?
America First Policies will conduct research into public policies and promote Trump's favored causes, such as dismantling and replacing President Barack Obama's health care law and changing immigration policies.
Again, many would argue such actions could harm health and health care.
For a Non-Profit "Social Welfare Organization," Doing Political Polling May be Illegal
In March, 2018, CNBC did a long investigative article on America First Policies political polling operation.
Last summer, America First Policies took an unprecedented step for a politically allied nonprofit: It started using three top polling firms from Trump's 2016 presidential campaign to produce a steady stream of Trump-focused polls, strategy memos and reports that continue to this day. The three firms initially put their own logos on the polling they did for the group, but over time the America First Policies logo gradually replaced theirs on some of the documents.
CNBC reviewed many of the polls it conducted. One example of an obviously political poll was
A September poll showed that America First Policies was exploring ways to defeat Arizona Republican Sen. Jeff Flake in a primary, a month before Flake, a Trump critic, announced his retirement.
Note that America First Policies worked closely with a political polling firm which was founded by a close Trump associate who now works in the White House, but somehow obtained an ethics waiver allowing her to continue working with this firm.
The America First Policies polling effort operates as a network of coordinated groups, with two lesser-known firms, National Research Inc. and Baselice & Associates, working alongside a well-known Washington firm, The Polling Company, which was founded by former Trump campaign manager-turned-White House counselor, Kellyanne Conway.
When Conway sold her firm in September 2017, The Polling Company had already been working for America First Policies for more than two months, judging from the company's logo on polls that it conducted for the group in June and July.
Conway was granted a special ethics waiver last June so she could engage in 'communications and meetings' with former clients of The Polling Company without violating Trump's two-year ban on communications with former employers or clients. Conway has been called the 'Trump whisperer' for her ability to influence the often mercurial president. In a 2016 interview with MSNBC, she described herself as a 'discreet advisor' to Trump who was expected to use her data and strategy experience to help Trump craft his message.
CNBC interviewed ethics experts on the legality of what America First Policies was doing.
'AFP is doing the type of polling that would typically be done by a presidential campaign or a major party committee like the RNC or the DNC,' said Brendan Fischer, an election law expert at the nonprofit Campaign Legal Center. 'So even though they claim to be committed to a set of issues, the available evidence here indicates that they're operating as a polling shop for the president.'
Stephen Spaulding, a former special counsel at the Federal Election Commission and now director of strategy for the nonpartisan watchdog group Common Cause, agreed. 'There are ample grounds here to investigate whether America First Policies has been raising money that's subject to limits and disclosure requirements because it's being used for political purposes,' he said.
Finally, the article suggested that America First Policies was a way for wealthy donors, who could be individuals or corporations, to fund Trump's political agenda while hiding their identities and circumventing legal limits on direct political contributions.
'So you have a situation where large donors are contributing to America First Policies with the understanding that their secret donations are going to be seen as valuable by the president, because this group appears to work so closely with the White House,' said Campaign Legal Center's Fischer. 'And because these donors are secret, the public and Congress will never know if the White House later took action to advance a donor's interests.'
So it appears that CVS Health was one of those wealthy corporate donors who was secretly giving to a obviously political operation, possibly to be seen as "valuable to the president," which may be a way of saying to bribe the president?
America First Policies' Founders Included Shady Characters
The early AP article about the founding of America First Policies stated that the people involved included,
The group includes Trump's digital and data director Brad Parscale, onetime deputy campaign manager Rick Gates and two campaign advisers to Vice President Mike Pence, Nick Ayers and Marty Obst.
As the New York Times reported in February, 2018, Rick Gates pleaded guilty to the federal crimes of financial fraud and lying to investigators,
A former top adviser to Donald J. Trump's presidential campaign has agreed to cooperate with the special counsel inquiry into Russia's interference in the 2016 election after pleading guilty on Friday to financial fraud and lying to investigators.
The adviser, Rick Gates, is a longtime political consultant who once served as Mr. Trump's deputy campaign chairman
Note that Mr Gates had previously been charged with many more crimes,
The deal came as the special counsel, Robert S. Mueller III, has been raising pressure on Mr. Gates and Mr. Manafort with dozens of new charges of money laundering and bank fraud unsealed on Thursday. Both men were first indicted in October and pleaded not guilty.
By that time, it was likely that Mr Gates was increasingly involved in America First Policies. As of March, 2017, an article in Politico noted that,
Rick Gates, a former Trump aide who served as Paul Manafort's deputy, is increasingly involved day-to-day [in America First Policies].
Also, Brad Parscale, the 2016 Trump campaign digital director, was involved with Cambridge Analytica's highly questionable operations on behalf of the campaign. Per a New York Times article of March 17, 2018,
Under the guidance of Brad Parscale, Mr. Trump's digital director in 2016 and now the campaign manager for his 2020 re-election effort, Cambridge performed a variety of services, former campaign officials said. That included designing target audiences for digital ads and fund-raising appeals, modeling voter turnout, buying $5 million in television ads and determining where Mr. Trump should travel to best drum up support.
A New Yorker article published on March 21, 2018 stated,
Cambridge Analytica contractors worked with Trump's digital team, headed by Brad Parscale and Jared Kushner. Alongside all of them were Facebook employees who were embedded with the Trump campaign to help them use Facebook's various tools most effectively—including the so-called 'dark posts,' used to dissuade African-Americans from showing up to vote. Did any of them know that the data that Cambridge Analytica was using to target voters, craft ads and blog posts, and determine Trump's travel schedule came from millions of American Facebook members whose data had been taken without consent and sold for a million dollars—what Cadwalladr is calling a massive data "breach"?
CVS Health says it donates to charity to improve health and health care, and that it has a social responsibility agenda to again improve health and keep the planet in balance. Yet it secretly donated to a "social welfare" organization that explicitly was devoted to upholding the Trump agenda, founded by former Trump campaign officials, at least two with questionable ethics, one of which pleaded guilty to federal crimes, and which ran a political polling operation that may have been illegal. When its donation was discovered, and the racist sayings of two, and apparently pro-Nazi sayings of another of the organization's leaders were exposed, CVS then said it would not donate further.
Why did CVS Health donate to America Health Policies in the first place?
Given what transpired, at least CVS Health should immediately explain the reasons for this donation, and why it was made despite its obvious conflicts with CVS Health's stated policies and mission.
CVS Health should also disclose whether it has made any similar donations in the past, and what its policy on donations will be in the future.
Until such disclosures are made, we are left with further, exceedingly troubling questions.
Was this merely a case of severe and mission-hostile (mis)management? However, it is difficult to believe that CVS Health managers did not know what the purpose of America First Policies was, and who its leaders were.
Was the donation to America First Policies an effort to cozy up to the Trump regime, arguably the most conflicted and corrupt presidential administration (look here), in hope of securing economic favors for CVS Health and/or its managers?
Did the donation somehow otherwise support top CVS Health managers' self-interest? Given that President Trump has failed to condemn white supremicists and neo-Nazis (look here), and has recently proclaimed he is above the law, and thus called by editorialists a president who would be a king (e.g., here in the New York Times), are CVS Health managers closet monarchists, authoritarians or fascists?
Is this case unique? Are other corporations that proclaim their social responsibility secretly funding groups like America First Policies? Are these corporations thus covertly undermining not only patients' and the public's health, but the foundations of the American republic?
The frogs must figure out how to get out of the pot of now boiling water.
Labels: bribery, conflicts of interest, crime, CVS, dark money, Donald Trump, fraud, health care corruption, mission-hostile management
The Stealth Shutdown of the US Agency for Healthcare Quality and Research (AHRQ) National Guideline Clearinghouse
The Quiet Announcement of the Shut Down
Apparently as of late April, a terse announcement appeared on the website of the US AHRQ National Guideline Clearinghouse:
The AHRQ National Guideline Clearinghouse (NGC, guideline.gov) Web site will not be available after July 16, 2018 because federal funding through AHRQ will no longer be available to support the NGC as of that date. AHRQ is receiving expressions of interest from stakeholders interested in carrying on NGC's work. It is not clear at this time, however, when or if NGC (or something like NGC) will be online again. In addition, AHRQ has not yet determined whether, or to what extent, the Agency would have an ongoing role if a stakeholder were to continue to operate the NGC. We will continue to post summaries of new and updated evidence-based clinical practice guidelines until July 2, 2018. For any questions, please contact Mary.Nix@ahrq.hhs.gov.
There was no further explanation.
This announcement has been largely anechoic, noted only by a few blogs and websites, e.g. the American Bar Association.
The Importance of the National Guideline Clearinghouse
The shutdown is significant because the Clearinghouse was an important source of information on diverse practice guidelines useful to clinicians, but also to medical and health care educators and researchers.
It is noteworthy that AHRQ has recently endeavored to assure the trustworthiness of the posted guidelines. While guidelines have been long and widely touted as a way to improve the quality of health care, there have been continuing questions about their validity and usefulness. In particular, there was accumulating evidence that many available guidelines were biased by conflicts of interest, based on an incomplete sample of available evidence, and were not necessarily informed by rigorous review of the available evidence, as we discussed here.
In response, in 2011, the US Institute of Medicine (IOM) published standards for trustworthy guidelines (look here). These standards were more rigorous and better justified than any prevous attempts to assure guideline quality.
The summary of the IOM report included:
Most guidelines used today suffer from shortcomings in development. Dubious trust in guidelines is the result of many factors, including failure to represent a variety of disciplines in guideline development groups, lack of transparency in how recommendations are derived and rated, and omission of a thorough external review process. To be trustworthy, clinical practice guidelines should:
• Be based on a systematic review of the existing evidence;
• Be developed by a knowledgeable, multidisciplinary panel of experts and representatives from key affected groups;
• Consider important patient subgroups and patient preferences, as appropriate;
• Be based on an explicit and transparent process that minimizes distortions, biases, and conflicts of interest;
• Provide a clear explanation of the logical relationships between alternative care options and health outcomes, and provide ratings of both the quality of evidence and the strength of recommendations; and
• Be reconsidered and revised as appropriate when important new evidence warrants modifications of recommendations.
Additionally, as reflected in the committee's standards for developing trustworthy clinical practice guidelines, guideline development groups optimally comprise members without conflict of interest. The committee recognizes that in some circumstances, a guideline development group may not be able to perform its work without members who have conflicts of interest—for example, relevant clinical specialists who receive a substantial portion of their incomes from services pertinent to the guideline. Therefore, the committee specifies that members of the guideline development group who have a conflict of interest should not represent more than a minority of the group.
However reasonable these standards may have appeared, by 2012 the IOM standards were largely ignored (as discussed here).
Yet, in 2017, at least one study appeared suggesting that many guidelines in the Clearinghouse did not meet the IOM standards (look here). That year the AHRQ proclaimed that it would start assessing guidelines' adherence to the IOM standards (look here).
This is noteworthy again considering that the standards have had otherwise unfortunately little impact.
And now it seems the AHRQ's worthwhile effort to disseminate guidelines whose trustworthiness can be assessed will end.
So it seems that the report on clinical practice guidelines emphasized two issues highly relevant to Health Care Renewal, the need for transparency in guideline development, and the need to avoid conflicts of interest affecting the development process.
Perhaps more because than despite that, as we noted above, by 2012 the IOM standards were largely ignored (as discussed here). We speculated that these standards may have discomfited many people. They could have cost a lot of medical societies considerable commercial funding, and a lot of health care professionals on guideline panels considerable personal wealth. These standards could probably also have cost a lot of companies whose products and services were addressed by guidelines to lose revenue. Their implementation could have cost too many people who are financially benefiting from the status quo too much money. And these people, that is, leaders of professional societies dependent on commercial outside funding, health care professionals and academic used to financial support from commercial interests, and health care corporations are good at making sure their interests are not ignored, even if their interests conflict with those of patients, the public, and well-intentioned health care professionals.
The Trump regime has exhibited great coziness with those who lead large corporations, including health care corporations, and other such plutocrats (look here). The Trump regime appointed a person who was a manager of commercial information technology firms, not a health care professional or researcher, as head of the AHRQ (look here). So it should come as no surprise that the AHRQ leadership under that regime was unable to maintain a Guideline Clearinghouse that attempted to uphold such standards of guideline trustworthiness.
Now we will lose an important resource for teaching, research, and evidence-based practice, whose loss will make it easier to hucksters to promote drugs, devices, and programs that are not as efficacious or safe as advertised. But the good times will continue to roll.
We could call for the reinstatement of the AHRQ National Guideline Clearinghouse. Ah, but we may as well try and catch the wind.
We have been writing about health care dysfunction since 2003, and publishing this blog since 2004. A major concern all along has been how threats to health care professionals' core values generate health care dysfunction. Up through 2016, these threats came principally from large private health care organizations. While the US government was not always as good at defending these values as it could have been, at least it rarely presented its own set of active threats. Under Trump, that situation has been changing for the worse. This is obviously hugely dangerous, (and made more so by the regime's threats to other core values of US society, to US law, and the US Constitution.)
To prevent the decline and fall of US health care, and maybe the entire US experiment in representative democracy, health care professionals, academics, patients and citizens concerned about health care will have to join up with the larger populace to defend our core values while they still have any force.
Musical Interlude - Donovan, Try and Catch the Wind, 1973
Posted by Roy M. Poses MD at 12:18 PM No comments:
Labels: AHRQ, anechoic effect, Donald Trump, evidence-based medicine, guidelines
Dander Still Up. Drowning in Great Dismal Swamp. F...
Why Did CVS Health Betray its Charitable Giving Po...
The Stealth Shutdown of the US Agency for Healthca...


Marsèll for men fuses classic craftsmanship with a modern twist. Luxe leather is reworked into textured and distressed finishes whilst traditional silhouettes take on an off-beat aesthetic. These off-white lace-up ankle boots are crafted from leather and suede and feature a round toe, a flat rubber sole, a lace-up front fastening, an ankle length and a pull tab at the rear.


text:
3rd Movement From String Symphony No. 12 In G Minor
Performers Achim Fiedler (Conductor)
Festival Strings Lucerne (Orchestra / Ensemble)
Composers Felix Mendelssohn-Bartholdy
* 3/2/1809, Hamburg, Germany
† 4/11/1847, Leipzig, Sachsen, Germany
Date of recording 26 January 2009 - 20 March 2009
The Complete String Symphonies
Achim Fiedler
Record Label Oehms Classics / OC 740
Year of production 2009
Tracks - CD 1
Symphony For Strings No. 1 In C Major (MWV N 1)
1. 1. Allegro
2. 2. Andante
Symphony For Strings No. 2 In D Major (MWV N 2)
5. 2. Andante, dolce
6. 3. Allegro vivace
Symphony For Strings No. 3 In E Minor (MWV N 3)
7. 1. Allegro di molto
Symphony For Strings, No. 4, in C minor (MWV N 4)
10. 1. Grave - Allegro
11. 2. Andante, dolce
12. 3. Allegro vivace
Symphony For Strings, No. 5, in B flat major (MWV N 5)
14. 2. Andante
15. 3. Presto
Symphony For Strings, No. 6, in E flat major (MWV N 6)
16. 1. Allegro
17. 2. Menuetto - Trio I - Menuetto da capo - Trio II
18. 3. Prestissimo
Symphonic Movement, No. 14, In C Minor (MWV N 14)
19. Grave - Allegro molto
Symphony For Strings, No. 7, in D minor (MWV N 7)
2. 2. Andante amorevole
3. 3. Menuetto e Trio
4. 4. Allegro molto
Symphony For Strings, No. 8, In D Major (MWV N 8)
5. 1. Adagio e grave - Allegro
6. 2. Adagio
7. 3. Menuetto - Trio. Presto - Menuetto da capo
8. 4. Allegro molto - Coda più presto
String Symphony No. 9 In C Major. Swiss (MWV N 9)
9. 1. Grave - Allegro
10. 2. Poco adagio
11. 3. Scherzo - Trio un poco lento, Schweizerlied - Scherzo da capo
12. 4. Allegro moderato - Coda presto
Symphony For Strings No. 10 In B Minor (MWV N 10)
1. Adagio - Allegro - Coda più presto
Symphony For Strings, No. 11, In F Major (MWV N 11)
2. 1. Adagio - Allegro molto
3. 2. Scherzo. Comodo, Schweizerlied
5. 4. Menuetto. Allegro moderato
Symphony For Strings, No. 12, In G minor (MWV N 12)
7. 1. Fuga. Grave - Allegro
9. 3. Allegro molto - Coda più allegro


Our 2006 seminar on herd management and alpaca health.
The New Mexico Alpaca Breeders association, formed in 2002, is a volunteer organization designed to help our members succeed in the alpaca livestock business and dedicated to the promotion of the alpaca industry in New Mexico. We provide promotional and marketing opportunities, educational and networking opportunities and other resource tools and references. We are dedicated to maintaining the highest ethical standards within our industry and to do our utmost to insure the health and welfare of alpacas throughout the state.
Download an Application for Membership and apply today!
All Breeder Members are entitled to advertise their farm, their retail operation and their herdsire services through this web site. A listing on the NMAB website provides our members with thousands of hits each month. It's a great way to get your information "out there."
Associate Members participate in all membership communications and can avail themselves of the networking opportunities open to all members.
Only Breeder level members are allowed voting privileges.
Advertising pays! NMAB members can cooperate on print ads, sponsorships and group displays at shows and events. We also work to develop media opportunities to promote awareness about alpacas and the alpaca industry.
NMAB sponsors at least one educational clinic per year and provide ongoing resources through membership networking and email "blasts."
NMAB members provide assistance and share their knowledge with one another, particularly to help the newest of our breeders in the alpaca industry.
We invite you to join NMAB! You will find we offer you great cooperative marketing opportunities to enhance your alpaca business, helpful educational resources, and opportunities for dedicated alpaca breeders to work towards excellence in our fast growing industry.


text:
THE STRUCTURE OF THE NITRATE/NITRITE RESPONSE REGULATOR PROTEIN NARL IN THE MONOCLINIC C2 CRYSTAL FORM
DOI: 10.2210/pdb1A04/pdb
Classification: SIGNAL TRANSDUCTION PROTEIN
Deposition Author(s): Baikalov, I., Schroder, I., Kaczor-Grzeskowiak, M., Cascio, D., Gunsalus, R.P., Dickerson, R.E.
NarL dimerization? Suggestive evidence from a new crystal form
Baikalov, I., Schroder, I., Kaczor-Grzeskowiak, M., Cascio, D., Gunsalus, R.P., Dickerson, R.E.
(1998) Biochemistry 37: 3665-3676
DOI: 10.1021/bi972365a
The structure of the Escherichia coli response regulator NarL has been solved in a new, monoclinic space group, and compared with the earlier orthorhombic crystal structure. Because the monoclinic crystal has two independent NarL molecules per asymme ...
The structure of the Escherichia coli response regulator NarL has been solved in a new, monoclinic space group, and compared with the earlier orthorhombic crystal structure. Because the monoclinic crystal has two independent NarL molecules per asymmetric unit, we now have three completely independent snapshots of the NarL molecule: two from the monoclinic form and one from the orthorhombic. Comparison of these three structures shows the following: (a) The pairing of N and C domains of the NarL molecule proposed from the earlier analysis is in fact correct, although the polypeptide chain connecting domains was, and remains, disordered and not completely visible. The new structure exhibits identical relative orientation of N and C domains, and supplies some of the missing residues, leaving a gap of only seven amino acids. (b) Examination of corresponding features in the three independent NarL molecules shows that deformations in structure produced by crystal packing are negligible. (c) The "telephone receiver" model of NarL activation is confirmed. The N domain of NarL blocks the binding of DNA to the C domain that would be expected from the helix-turn-helix structure of the C domain. Hence, binding can only occur after significant displacement of N and C domains. (d) NarL monomers have a strong tendency toward dimerization involving contacts between helixes alpha 1 in the two monomers, and this may have mechanistic significance in DNA binding. Analogous involvement of helix alpha 1 in intermolecular contacts is also found in UhpA and in the CheY/CheZ complex.
Structure of the Escherichia Coli Response Regulator NarL.
Baikalov, I.,Schroder, I.,Kaczor-Grzeskowiak, M.,Grzeskowiak, K.,Gunsalus, R.P.,Dickerson, R.E.
(1996) Biochemistry 35: 11053
Molecular Biology Institute, University of California, Los Angeles 90095-1570, USA.
NITRATE/NITRITE RESPONSE REGULATOR PROTEIN NARL
Gene Names: narL (frdR)
Find proteins for P0AF28 (Escherichia coli (strain K12))
Go to UniProtKB: P0AF28
Full Protein Feature View for P0AF28
b = 38.527 β = 131.91


Fincantieri has signed a contract with Mazagon Dock Limited (MDL), one of the most important Indian shipyards, controlled by the Ministry of Defence and specialized in the building of naval and offshore units, to provide technical advice within the Project 17A. This project envisages the construction of 7 stealth frigates ordered this year in February by the Indian Navy to the two shipyards MDL and Garden Reach Shipbuilders & Engineers (GRSE). This important agreement allows the group to establish a long-term cooperation with the two shipyards and to consolidate its commercial presence in the country.
The Project 17A-class frigate is a follow-on of the Project 17 Shivalik-class frigate built at Mazagon between 2000 and 2010 - for the Indian Navy. It regards the construction of a total of 7 frigates of 149 meters in length with a displacement of 6,400 tons. With a basic and functional design developed by the Indian Navy, the ships will be built at MDL and GRSE, which will be modernized and enhanced thanks to Fincantieri's advice in order to use the modular construction technique as well as the one known as "integrated construction". This experience will also bring about a significant return of technology and know-how for Fincantieri, with the creation of system advisors, useful for other programs in which the group is involved too.


text:
GAO replaces top official behind error-riddled report on for-profit colleges
Jonathan Strong Jonathan Strong, 27, is a reporter for the Daily Caller covering Congress. Previously, he was a reporter for Inside EPA where he wrote about environmental regulation in great detail, and before that a staffer for Rep. Dan Lungren (R-CA). Strong graduated from Wheaton College (IL) with a degree in political science in 2006. He is a huge fan of and season ticket holder to the Washington Capitals hockey team. Strong and his wife reside in Arlington.
The Government Accountability Office (GAO) is replacing the official behind an error-riddled report the agency released on for-profit colleges and is placing new constraints on the unit that produced the report.
Rick Hillman, a career-long GAO employee, is replacing Greg Kutz as head of a special investigations unit responsible for the agency's undercover sting operations and "forensic auditing" investigations, according to an internal GAO memo obtained by The Daily Caller.
The GAO is the investigative arm of Congress. The agency's normally unimpeachable reputation was stained in November when it made scores of corrections to a report that played a key role in the Education Department's push to strictly regulate for-profit schools.
Top GOP oversight official Rep. Darrell Issa praised the GAO's moves to reform the unit, saying the changes are "important and necessary."
Beyond the change in leadership, the special investigations unit's work will come under new scrutiny from top GAO officials. New "methodology experts" will pre-approve the unit's reports. Investigators will undergo new training. External peer reviewers will periodically study the unit's investigations. The unit is also being renamed.
Melanie Sloan, the director of Citizens for Responsibility and Ethics in Washington (CREW), a key watchdog non-profit group that has been eying the issue closely, said the extent of the changes showed the GAO recognized it had a "structural problem."
"This wasn't just a one time issue," Sloan said about the corrected report, "they recognized they had some problems and they're trying to fix them."
The GAO's study on for-profit colleges played a key role in a sometimes bitter debate over Education Department regulations of the sector.
In the fight, Wall Street short-sellers hoping to profit from the sector's demise are aligned with the Obama administration and a slew of left wing interest groups in pushing for strict regulations, but the well-funded for-profit colleges have been pushing back fiercely.
Critics of the schools say they trick unprepared students into enrolling with false promises of high wages from the jobs they'll get after graduation.
Industry representatives say the charges are overblown and warn the regulations will decimate the sector, rather than reform it.
The GAO waded into that debate with an Aug. 4 report based on an undercover sting operation in which investigators posed as prospective students.
The apparently devastating results of the sting were released just in time for a major congressional hearing on the matter held by Democratic Iowa Sen. Tom Harkin, who heads a key panel overseeing the matter.
However, the GAO issued scores of corrections to the report on Nov. 30. In one example, the investigation supposedly showed recruiters for a for-profit college telling prospective students a massage therapist could make up to $100 an hour – an hourly rate far above what massage therapists are actually paid.
In reality, the recruiter told prospective students the instructors and directors of the massage therapy school could make $150-200 an hour. "This may be possible," the GAO said in the revised report.
Since the GAO's reports are held in high esteem on Capitol Hill, the corrections provoked a series of oversight actions and document requests by congressional watchdogs like Issa.
The GAO has provided numerous documents to Issa and others, but many of those documents have not been released.
Issa said the new move to reform the special investigations will help the GAO restore trust in its reports.
"GAO is now making important and necessary changes in response to concerns that GAO's Forensic Audit and Special Investigation unit was not meeting its full obligation to provide Congress with clear, unbiased, and objective information about government programs. GAO has a critical role but can only be effective if Congress and the public has full confidence in its findings and recommendations," Issa said in a written statement.
Kutz, who previously was in charge of the unit, will now head its director of audit services. The GAO said the move "will allow us to take better advantage of Kutz's wealth of experience in forensic and other audit services."
Tags : darrell issa government accountability office
Jonathan Strong


Beautiful brick home featuring 3 bedrooms and 1.1 bathrooms. Fenced lawn with enough space to enjoy outdoor relaxing. Spacious living room with bay window that brings in plenty of sunshine! Gorgeous kitchen with newer cabinets, granite counters, tile backsplash, and SS appliances. Nicely sized bedrooms offer plenty of space and ample closet storage. Come see this home today!
I am interested in 3350 N Panama Avenue, Chicago, IL 60634.


text:
Digital Copyright Canada
All Canadian Citizens are "Rights Holders"!
About/Sitemap
Copyright Jargon
IT Property Petition
Users' Rights Petition
Home » Blogs » Russell McOrmond's blog
Is Canada trying to block a WIPO treaty for blind people's access to written material?
As the headline suggests I've become skeptical of the wide reporting of Canada's involvement in trying to stop a WIPO treaty that would facilitate grater access for blind people to written material. I had read this many times, but when I heard Jesse Brown mention in the June 1'st episode of his podcast that he tried to get an interview with Bruce Couchman and that Bruce never got back to him. Since I have met Bruce many times I decided to send a letter to Bruce and to Jesse about this issue. While Bruce got back to me right away and has been sending multiple messages on this issue since, Jesse Brown hasn't yet acknowledged receipt of the material I have sent him. Bruce was unaware of an interview request, so there may be problems with Jesse's email/etc.
While I hope that a professional journalist like Jesse will cover this issue, I'll do my best to let people know what Bruce has been sending me. My hope is that Jesse will see this, carry out the interview which Bruce seems willing to offer if requested, and possibly set the record straight.
Bruce indicated that Canada was neutral on whether a treaty should move forward, and did not understand how anyone could misinterpret what was actually said as opposition. I've tried to trace back links to indicate opposition, and nearly everything seems to eventually link back to comments by James Love. I will be interested to see if anyone else finds it ironic that Jesse mentioned this issue at the very end of a podcast on how the Conference Board of Canada came to invalid conclusions by relying on what effectively amounted to a single source for their report.
A few things were sent by Bruce which I think others should read and form their own opinions.
SUMMARY of WIPO SCCR 18, May, 25-29, 2009 (included below)
A link to an MP3 recording of the meeting titled Meeting the Needs of the Visually Impaired Persons: What Challenges for IP?. This meeting included comments from Douglas George, Director of the Intellectual Property, Information and Technology Trade Policy Division at Foreign Affairs and International Trade Canada.
Press release detailing the above meeting
My own opinion on this issue come from board principles. While I believe this specific treaty should move forward, I think this is only the first step to fixing a number of policy problems at WIPO.
Limits and exceptions to copyright should have the same level of enforcement in WIPO treaties as other aspects of copyright. If WIPO is to be seen as having any legitimacy beyond supporting a few special economic interests, times where a WIPO treaty sets a "minimum" level of copyright protection it should also articulate a "maximum".
"Any 'hardware assist' for communications, whether it be eye-glasses, VCR's, or personal computers, must be under the control of the citizen and not a third party" (See my homepage). While not specifically mentioned, this obviously includes screen readers (or any other technology that reads out loud), or any other technology used by citizens to enhance or augment their senses in order to access copyrighted work. I do not believe that copyright holders have any legitimate interests in this area, and copyright should be limited to ensure it never restricts this hardware assistance.
Trusted intermediaries should be legally allowed to "step into the shoes" of citizens who are not able to exercise their rights on their own. This in my mind applies equally to teachers exercising "fair dealing" on behalf of students, librarians on behalf of their patrons (already confirmed by the Supreme Court), or the CNIB exercising limits and exceptions on behalf of the blind
Compulsory licensing, exceptions, or copyright reversion (IE: back to human creator if current copyright holder does not exploit) should be employed in situations where copyright holders refuse or no longer license works. This to me applies to the antiquated concept of "out of print" books (representing far more printed material than commercially exploited), as well as for the production of accessible versions in situations where appropriate citizen controlled hardware assistance is not viable.
While listening to the audio from the July 13'th meeting I heard some pretty familiar things. My own summary of the meeting would be as follows.
Representative of the blind: We want equal access to copyrighted works in ways that do not harm the legitimate rights of copyright holders.
Representative of publishers: Copyright and copyright holders are not villains. They demand there be no copyright exceptions, and market based approaches should be used
Representative of Digital Accessible Information System (DAISY) Consortium: Technology exists today, we just need to get the social/legal aspects in line (Note: DAISY has Microsoft involvement. I am sceptical any time Microsoft is mentioned in the context of a "standard" given their history has always been to create vendor-dependent technology solutions, contradicting my second principle)
Representative of Canada: Canadian law may be a good model to follow (See section 32 of the Canadian Copyright Act). Canada willing to engage further on this issue
The most telling moment comes in the discussion from the floor when a delegate brought up the issue of an eBook reader (Amazon Kindle) where the book publishers blocked the "read out loud" function. The representative of the book publishers said the issue was that Amazon had not yet cleared the rights for that functionality, suggesting it related in some mysterious way to audio books.
My question is this: what legitimate rights exist that should need to be cleared? I don't believe there are any, and my hope is that eventually WIPO will rise to the task of creating international instruments that carve the copyright holder out of any hardware assistance that citizens use to access legitimately purchased content. We should not require permission from copyright holders to have a book read out loud to us, whether that be electronically or by family/friends.
In this venue and in others I have heard representatives of the book publishing industry oppose all of my own principles I articulated above. It is amusing that someone who started his speech suggesting that the ideas and people he represents shouldn't be seen as the villains had his last words about an issue where the publishers clearly are the villains.
SUMMARY of WIPO SCCR 18, May, 25-29, 2009
The first day of the meeting (May 25) was an information meeting on developments in broadcasting.
For the presentations go to:
http://www.wipo.int/meetings/en/details.jsp?meeting_id=17762
http://www.wipo.int/meetings/fr/details.jsp?meeting_id=17762
The substantive SCCR meeting started on May 26.
The documents related to that meeting may be found at:
Of particular importance are the Conclusions:
http://www.wipo.int/meetings/en/doc_details.jsp?doc_id=123192
(Currently available only in English but check website for future translation)
the draft treaty on the visually impaired submitted by Brazil, Ecuador and Paraguay:
http://www.wipo.int/meetings/fr/doc_details.jsp?doc_id=122732
[Provisional French translation]
and the Interim Report of the Stakeholders' Platform:
Also of relevance is the WIPO press release "SCCR to Expedite Work in Favour of the Reading Impaired" summarizing the meeting
http://www.wipo.int/pressroom/en/articles/2009/article_0012.html
http://www.wipo.int/pressroom/fr/articles/2009/article_0012.html
The three substantive issues discussed at the meeting were:
(1) limitations and exceptions (especially access by the reading impaired to copyright material),
(2) protection of audiovisual performances, and
(3) protection of broadcasting organizations.
The Canadian delegation made two interventions at the meeting, one on access by the visually impaired to copyright works (on May 27) and the other the proposed treaty on broadcasters' rights (on May 28).
The substantive discussion on access by the visually impaired focussed primarily on the Brazil, Ecuador and Paraguay draft treaty.
The Canadian intervention on this issue included the following elements:
1) It noted that it would be premature for the Canadian delegation to comment specifically on the Brazil, Ecuador and Paraguay draft treaty (given that it was introduced during the meeting).
2) It said that any instrument should allow a variety of mechanisms for the production of accessible copies for domestic purposes, e.g. an exception, a compulsory licence or a conditional exception.
3) It expressed general principles that should feature in any eventual solution. The principles expressed were intended to apply regardless of the type of instrument (i.e. binding or non-binding) which might be adopted.
4) It noted that countries should be allowed to have different types of limitations or exceptions with respect to different types of adapted materials.
(Note: for example, a country might have an exception to produce Braille material but a compulsory licence to produce audiobooks.)
5) It noted that it is not necessary to have a uniform rule in all countries to allow the international exchange of adapted materials.
6) It noted that it would be necessary to discuss the norms which would apply to the exchange of materials among countries which have different limitations or exceptions for the production of adapted material.
(Note: for example the export of an adapted copy made under an exception to a country which used a compulsory licence.)
7) It noted that any instrument should facilitate the international exchange of adapted material.
8) It would be necessary to clarify how the three step test for limitations and exceptions applies to the import and export of material made under a limitation or exception.
The Conclusion on Access by the Visually Impaired.
This issue will remain on the agenda for the next meeting. The proposed draft treaty along with any other possible proposals or contributions will be further discussed at that time.
Other Issues Related to Limitations and Exceptions
The study on limitations and exceptions for the benefit of educational activities is expected to be available before the 19th session of the SCCR. (See the Conclusions)
The Draft Questionnaire on Limitations and Exceptions
The Committee took note of the draft questionnaire on limitations and exceptions and invited delegations to send any comments by July 15. The next draft of the questionnaire will be distributed one month before the next session of the SCCR with a view to finalizing it at that meeting.
The draft questionnaire is at:
Protection of Audiovisual Performances
There was a diplomatic conference on the protection of audiovisual performances in December 2000 but it failed to come to a conclusion.
Information on the diplomatic conference may be found at:
http://www.wipo.int/meetings/en/details.jsp?meeting_id=4231
http://www.wipo.int/meetings/fr/details.jsp?meeting_id=4231
The key paragraphs from the Conclusions on this issue are:
"The Committee requested the Secretariat to prepare a background document on the main questions and positions.
"The Committee requested the Secretariat to organize, in Geneva, informal, open-ended consultations among all members of the Committee on possible solutions to the current deadlock."
Protection of Broadcasting Organizations
The Canadian delegation made an intervention on this issue.
It said that it favoured Option B in the Chair's informal paper of November 3, 2008
It said that it maintained its position that countries should be allowed to permit the retransmission of free over-the-air signals within their territory subject to certain conditions.
The limitations which the Canadian delegation has proposed on retransmission may be found in document SCCR/S2/3 (June 18, 2007)
http://www.wipo.int/meetings/en/doc_details.jsp?doc_id=79452
http://www.wipo.int/meetings/fr/doc_details.jsp?doc_id=79452
It also said that it might eventually be desirable to consider other options which are not in the Chair's Informal Paper.
The following is the relevant part of the Chair's Informal Paper:
"The following two options arise from the assessment above in this informal paper:
"A – A continuation of the process
Another try could still be suggested on the basis of the document SCCR/15/2 rev. In addition, discussions could be based on informal papers. This endeavor should be open, inclusive and flexible. In the end, there could be an understanding that a new treaty might be established by a clear majority.
"B – A possible new avenue
A model based roughly on Articles 2 and 3 of the Geneva Phonograms Convention of 1971 could be envisaged; similar to that of the Brussels Satellite Convention.
That model is different from those included so far in the working documents of the SCCR.
That model could achieve the main objective of an international protection and the prevention of signal theft.
To provide the delegations with an idea of the structure of such an option, its core provisions might be as follows:
"The Contracting Parties shall protect broadcasting and cablecasting organizations, who are nationals of other Contracting Parties, against unauthorized acts, including:
- retransmission
- fixation
- [other acts that might be agreed on].
The means by which this Treaty is implemented shall be a matter for the domestic law of each Contracting Party. The means shall be adequate and effective, and shall include one or more of the following:
- protection by means of copyright, rights related to copyright, or other specific rights;
- protection by means of the law relating to unfair competition or misappropriation;
- protection by means of administrative legislation or penal sanctions." "
Conclusion on the Protection of Broadcasting Organizations
This issue will remain on the agenda for the next meeting.
Next Session of the WIPO SCCR
No date was set for the next meeting of the SCCR.
By Russell McOrmond at 2009/07/19 - 11:27
Russell McOrmond's blog
This site and forum sponsored and managed by FLORA Community Consulting.
Other key sites
CIPPIC
Howard Knopf
Sara Bannerman
Meera Nair
OpenMedia
Other search...
Now closed, the main 'discuss' list had a simple search interface.
Subscribe to email via FeedBurner.
Russell McOrmond
chris_brand
Darryl Moore
ablair
rakerman
jlam
Jem Berkes
Garthgraham