Pilar Pederson and Kelly Hurd enjoying the Davis Mountains' view on their sure footed horses, Ute and Angel.
Davis Mountains SP main headquarters entrance. Be sure to check in here and show proof of negative Coggins. The main entrance has a nice circular drive way making it easy to turn your rig around here.
Equestrian day use / camping entrance.
Equestrian Day Use and Camping area is called, Limpia Canyon Primitive Area , and is located on north side of Texas 118 about two miles outside of Fort Davis. The entrance has a brown metal gate locked with a chain and combination lock. You can get the combination from headquarters or call before 5pm if you will be getting there after 5pm to get the code. The entrance is short, so if you have a long rig, more than 30 feet and the gate is closed the backend of your rig will be sticking out in the road while you are opening the gate. Park headquarters is located on the opposite side of TX 118 from the equestrian use area. If you are coming from Fort Davis, the entrance is on the right just before you get to the park headquarters entrance. If you are coming from IH 10 going south and then east on TX 118, then you will pass the park headquarters on your right and the equestrian area will be the next entrance on the left.
Road leading to the equestrian use area at Limpia Canyon.
Limpia Canyon equestrian use area.
Camping: Horse camping is allowed at Limpia Canyon Primitive Area.
Facilities: Horse day use and camping is allowed in a cabled off section at Limpia Canyon Primitive area. This is an open field with one water trough. Nothing else is located in this field. There are no horse pens, no shade trees, no mounting blocks, no picnic tables, no electricity, and no porta potty. There are two large rocks which could be used as mounting blocks. The area is cabled off on 0ne side with three foot wood posts and a wire cable running through them. On the back side is a brush tree line and decline leading to Limpia Creek. I was able to lead and ride my horse to the creek to drink. The surface of the equestrian area is fairly flat/level terrain, but bumpy due to mole's digging up the ground. The area is slightly narrow but long, sort of like a rectangel. This area would be easy for a truck and averaged sized two horse trailer to maneuver but a little more difficult for a larger rig or living quarter trailer. The entrance is fairly narrow but manageable if not crowded.
Our campsite set up at Limpia Canyon.
You can tie your horses to the trailer, high tie between trailers, bring panels, or use an electric fence. There are really no suitable trees to tie to. For this trip my husband, Chris, put together an electric pen. This was the first time I've used an electric pen for camping. We do have electro braid fences at home so my horse is used to it. The ground was cooperative in some areas and uncooperative in other areas in accepting the step in posts and grounding rod. In the end it all worked out great and Angel respected the fence. Thanks Chris! Davis Mountains SP also offers RV camping with water/electric hook ups, a hotel (Indian Lodge) with swimming pool, and restaurant on the south side of TX 118. However, horses are not allowed on that side of the park. There are also restrooms and shower facilities on the south side of the park.
Cell Phone Service: poor to no cell service in most areas.
Travis and his Doberman Pinscher.
Pets/Dogs: Pets/dogs are allowed but must be on leash and not left unattended.
Trail Users: Equestrians, hikers, and mountain cyclists. No motorized vehicles are allowed on the trail.
Trail Markers: I only saw two or three trail markers at most, the trails are very poorly marked. However, the park does have new trail signs they plan on installing soon. On the upper loop the location of the water well and primitive dry tent campsites numbered 94 – 100 are also marked on the map below and can be used as well as the views of the MacDonald Observatory center, Indian Lodge, Limpia Canyon campsite, and park headquarters to help navigate.
Mileage: North of state highway TX 118 Davis Mountains SP has approximately 11-12 miles of multiuse trails to include equestrians. Horses are not allowed on the other side of the park, south of TX 118. The trail from Limpia Canyon Primitive Area up to the loop is about 2.5 miles one way and the outer loop on top of the mountain is about 6 miles. There are also some jeep trails on the top which are not included in this mileage.
Map: A map of the facility (posted above) can be found on line but does not show much detail regarding the equestrian trail. You can ask for a slightly more detailed map at park headquarters showing the multiuse equestrian trail and it is also posted here below. According to park staff they are in the process of creating a new trail map. So be sure to ask at headquarters for their most up to date map.
Terrain: The terrain is rugged, hilly, and of course rocky. Shoes/boots for your horse are a must. To get up to the loop, one section of the trail consist of switch backs to decrease the incline and another short section of the trail on the way up and back down has a drop off on one side. The park states they plan to eventually widen this section of the trail. There is no shade or cover on the trail so bring along your hat and sunblock.
Difficulty Level: The trail is challenging in areas and I'd recommend riders to be at least moderately experienced.
Angel is enjoying Limpia Creek just behind our campsite.
There is a non-potable water trough located in the horse camping area at Limpia Canyon Primitive campsite. When we arrived this trough was empty but the park later turned it on. Also at the back of the camp is Limpia Creek. During our visit the creek was small but my horse was happy to drink from it. There is no other water sources at the campsite.
Limpia Canyon primitive equestrian use area water trough.
On the lower part of the main trail (leaving Limpia Canyon) you cross Limpia Creek three times. At the first crossing there was a great watering hole to the south but the other two crossings were dry. However, I'm sure this varies depending on how much it has rained. From the looks of the old bank boundaries carved out by high waters, Limpia creek has been more than a creek in the past and is even prone to flooding in the right conditions.
Pilar is encouraging Ute to drink from the well.
Once on the upper part of the trail, Sheep Pen Canyon Loop, I only saw one water source, the well, which is marked on the map.
Signature date carved into the well.
Remains of the windmill wheel that used to pump the now solar powered well.
Description: Ride high in Davis Mountains State Park just a few miles west of the highest town in Texas. At 5,050 feet, the mile high west Texas city of Fort Davis is the most elevated city in the state. Davis Mountains SP encompasses approximately 2,700 acres. The park opened in 1933 and was one of the Civilian Conservation Corps earliest projects. Texas Highway 118 runs right through the state park cutting it into north and south sections. The north section is on approximately 1,500 acres and has eleven miles of designated rugged multiuse trail for equestrians, hikers, and mountain bicyclists waiting to be explored. Six miles of this trail was most recently completed in 2015. The new trail makes a loop at the top of the mountain and is named Sheep Pen Canyon Loop. Starting at 4,900 feet in Limpia Canyon Primitive Area the rocky trail winds up 800 feet to the top of the mountain reaching 5,700 feet in elevation. Once on top, you can see for miles and miles!
Karen and her horse Kitty heading out.
I decided to visit Davis Mountains State Park for two reasons; to combine two delightful tasks in one. Number one, to visit a life long high school friend, Karen, and her family who reside in Fort Davis. Number two, to ride my horse in a park which I've never visited before for a write up on Where The Trails Are. Arriving in early March made for perfect weather. Although due to the higher altitude, it was a bit cooler during the evenings than I had expected. I've heard the Texas Summer heat is much milder here and there really is not much humidity in this location. Since we were due to arrive after 5pm I called the park before 5 to determine the check in procedures for late arrivals. We were given the go ahead to drive directly to our camp site, the combination lock for the gate was provided, and we were to check in and show proof of negative Coggins at the main office the following morning. A few RV non-equestrian campers came over from the other side of the park. Evidently they were all full on the South side due to spring break. We were the only equestrian overnight campers during our stay. Our new non-horsey friends enjoyed petting Angel and taking a few pictures of her. They were also curious about our living quarters horse trailer. Chris made camp and set up the electric pen for Angel. We enjoyed a tasty taco dinner made by Karen's husband Tim. The skies were clear and night fall brought on a whole new perspective. Dense unpolluted darkness made for a spectacularly brilliant star studded night. Each time I woke up to check on Angel the skies capture my eyes and filled my heart with wonder. You can't visit Fort Davis without also making a trip to the MacDonald Observatory, as this is some of the best country for star gazing. Karen had made reservations for us to visit the observatory the day before our departure!
Karen and Kitty crossing a rocky dry creek bed and heading back to our campsite.
The following day my good friend Karen joined me for a short ride to try out her new horse, Kitty. It was like old times when we used to ride together as teenagers! After our ride Karen enjoyed the peace and tranquil views of Limpia Canyon while visitng with Chris. Before riding back out on Angel to explore the mountaim trails a day rider arrived from Alpine. I was excited to make some new friends and have someone to share the trail with. Pilar with her BLM Mustang, Ute, and her friend Travis with his rescued Doberman Pinscher were happy to have me join them on the trail. This was also their first trip to the park. Travis is a cross country runner and had no trouble keeping up with us on foot.
Leaving the Limpia Canyon and heading out on the main trail.
Setting out from Limpia Canyon Primitive area, the trail was initially flat and took us across Limpia creek three times. At the first crossing there was a great watering hole to the south but the other two crossings were dry. From the looks of the old bank boundaries carved out by high waters, Limpia creek has been more than a creek in the past and is even prone to flooding in the right conditions. The creek was mostly dry on this day exposing tons of rocks made smooth from years of water streaming over them. The first trail sign steered us to the right and gradually zig zigged north up the mountain. The trail straightened out following the side of a hill before starting up again. We passed over the base through a two trunked tree growing up out of the ground in a V shape. On our return Angel felt she had to snort at this odd tree before stepping through it again. The trail did narrow some with a short section having a drop off on one side. Once on top we took Sheep Pen Canyon Loop to the left. Views of the mountain range, ranches, MacDonald Observatory, Indian Lodge, and Fort Davis stretched out for miles before our eyes. Angel seemed to enjoy looking out at the horizon as much as I did. However, she did grow impatient with my constant picture taking.
Angel is enjoying the miles and miles of mountain range views as much as I am.
Along the trail we came upon an unusual looking stone well with a water trough at it's base. "Abirel 8 1948" was etched in cement at the base of the well. I could not help but wonder if that was the Spanish word for April (Abril) misspelled or if it is someone's name? An old rusty windmill base rested on the ground with it's twisted wheel a few feet away. At one point I'm sure this old windmill ran the well, but now it was laid to rest on top of the mountain. Sunrays soaked up by solar panels now keep this well running strong. Angel was a little hesitant to drink from the well but soon realized there was no harm. Take time here to really encourage your horse to drink, as I saw no other water sources at the top on Sheep Pen Canyon Loop.
This two track path at the top is not apart of the Sheep Pen Canyon Loop but it is an alternate route that is flat and has less rocks compared to Sheep Pen Canyon Loop.
From the well, we followed a two track jeep trail going north. Pilar saw a more interesting one track trail to the left just to the outside of the jeep trail. She followed that trail and I stayed on the jeep path for a while. We were able to keep each other in sight most of the time. Angel called out to Ute a few times. The Jeep trail ended up going down into a shallow ravine and disappeared. Pilar rode over and we went back to the one track trail which was most likely the Sheep Pen Canyon loop. The jeep trail seems to run north and south of the well to the primitive mountain campsites and is the only path on top of the mountain which has a fairly level surface with less rocks. We continued on Sheep Pen Canyon Loop and eventually came to the primitive tent campsites numbered 94 – 100. This gave us a good idea where we where when looking at the map, as this is also marked on the map. Currently there are hardly no trail markers. Instead of circling around to the right which would eventually take us back down the mountain and back out the way we came in, we headed to the left / southwest and were going up an incline. There is a section of trail that heads that way and just dead ends, according to the map. I think that is what we were on. Since we were ready to head back, Pilar scouted out a bit to pick up our return trail and we ended up back tracking to the primitive campsite area to pick up the correct trail and head back. On our way back we had a great view into Limpia Canyon Primitive Area campsite. I wanted to yell out hello to Chris who was down below, but decided against it as I did not want him to think I was yelling for help. On our way out of the loop the sweet fragrance of Mountain Laurels were strong as we passed a few of them on the verge of blooming. The treck back down the mountain went smoothly and we were back to camp in no time. Although we had only covered about 11-12 miles of trail we were out for about four hours as we stopped often to admire the views and for me to get a few pictures. Due to the rocky terrain a walk was the gate we maintained most of the time.
Pilar and Travis enjoying the view, discuss the best route.
The following day before leaving I took Angel on a short last ride in the park. Because I saw a serious looking mountain cyclist heading up the mountain I stuck to the lower trails. I did not want to be heading up some of the narrow sections of trail while the cyclist was coming down. Chris walked LB (our sweet little brindle Pit Bull mix) along with me part of the time and we got some good pictures by the first watering whole. I also explored a very short spur of trail which leads out of camp and curves back around to the main trail. This trail was a little hard to follow near the creek but we were able to pick it back up. Angel did a great job crossing the creek where it deepened and narrowed with thick sand on both sides.
Great shot Chris took of Kelly and Angel.
For the rest of our time in Fort Davis we camped out at my friend, Karen's place and had a blast with them visiting the fort and observatory. We also were invited to get a quick look at the Davis Mountains Preserve (DMP), part of The Nature Conservancy. The DMP is opened a handful of times a year to equestrians, campers, hikers, and cyclist. The horse pens were in great shape and this looks like another great place to ride in the Fort Davis area. I'll definitely be back to explore these trails.
Heading back to camp on the little side trail following Limpa Creek.
Additional Trail Photos: View the Davis Mountains SP album on our Facebook page for more photos.
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In order to maximise our training efforts, we must ensure a strong recovery. Here's a summary of the evidence around what works so you know where to spend your precious time.
Warming up – a Norwegian study in 2012 found a 20 minute warm up was more effective than a cool down for reducing delayed onset muscle soreness.
Compression – there is evidence to suggest compression does reduce next day soreness and speed up style recovery. My tip – keep compression garments on for 1-2 hours post exercise if possible.
Massage – massage has been shown to reduce inflammatory markers in the muscle. The mechanism unknown, but there certainly is a place for massage as a training aid.
Dry needling – Needling post exercising may assist recovery as it works to deactivate trigger points and relaxes muscle. A spasm muscle is reputed to have reduced blood flow, which results in less oxygen and nutrients.
Ice baths – the research is still not out as every few months, an article claims they are effective, followed by one claiming they don't work. Ice bath if it makes you feel better. Either that or a dip in the ocean.
Indulge – sleep in, don't set an alarm to allow the body a rest.
Variety – swim, bike, yoga or foam rolling should complement your training.
Have a training program – this will help you to know when to add recovery days, heavy load sessions and de-load sessions.
Monitor your resting heart rate – high resting heart rate may indicate you need rest.
Listen to your body, it might be suggesting you need a rest or recovery day.
Sleep – aim for 8 hours per night.
Nutrition – see a dietitian.
How are you feeling – instability and fluctuating moods could suggest you need a break.
Andrew Ilieff has experience across cardio respiratory, rehabilitation, sports physiotherapy and aged care – spending an extensive period of time in private practice. For credible information on training and injury prevention check out Andrew's Instagram page here and website and services here.


The Brother Rice Business Alliance was pleased to host its Fall Mixer at the Bank of Birmingham, 33583 Woodward Avenue, Birmingham, MI, on Wednesday, November 16th from 5:30-7:00 p.m. Our featured guest speaker was Bank of Birmingham President and CEO Rob Farr.
Mr. Farr spoke on the entrepreneurial story of how the Bank of Birmingham was created and founded in 2006 as a community based bank. Mr. Farr focused on the importance of networking, relationship building and information technology inherent in the Bank's success.


An overdose is when you take more than the normal or recommended amount of something, often a drug. An overdose may result in serious, harmful symptoms or death.
If you take too much of something on purpose, it is called an intentional or deliberate overdose.
If the overdose happens by mistake, it is called an accidental overdose. For example, a young child may accidentally take an adult's heart medicine.
Your health care provider may refer to an overdose as an ingestion. Ingestion means you swallowed something.
An overdose is not the same as a poisoning, although the effects can be the same. Poisoning occurs when someone or something (such as the environment) exposes you to dangerous chemicals, plants, or other harmful substances without your knowledge.
An overdose may be mild, moderate, or serious. Symptoms, treatment, and recovery depend on the specific drug involved.
You should call if you have any questions about an overdose, poisoning, or poison prevention. You can call 24 hours a day, 7 days a week.
A large overdose can cause a person to stop breathing and die if not treated right away. The person may need to be admitted to the hospital to continue treatment. Depending on the drug, or drugs taken, multiple organs may be affected, This may affect the person's outcome and chances of survival.
If you receive medical attention before serious problems with your breathing occur, you should have few long-term consequences. You will probably be back to normal in a day.
However, an overdose can be deadly or can result in permanent brain damage if treatment is delayed.
Pincus MR, Bluth MH, Abraham NZ. Toxicology and therapeutic drug monitoring. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 23rd ed. St Louis, MO: Elsevier; 2017:chap 23.


text:
← Work and Life Coaching: The Immaterial – Part 1
Collapse: a documentary by Chris Smith →
Collapse Part II: The revenge of Malthus
Posted: August 11, 2011 | Author: brucem | Filed under: Strategy and Execution | Tags: Chris Smith, Collapse, commodity prices, Julian Simon, Limits to Growth, Malthus, Paul Ehrlich, peak oil, Population Bomb |Leave a comment
As part of the ongoing question of whether or not we have, or will increasingly, reach limits to growth, The Economist (August 6, 2011) had this interesting take on commodity prices, which is one proxy for quantifying the extent of resource scarcity vis-a-vis demand. Of course, if the world economy enters a period of stagnation, then perhaps this new peak will abate as demand lessens.
THE surge in commodity prices over the past decade has revived an old debate. Will mankind's insatiable demands exhaust the planet's finite resources? Or will human ingenuity lead to the more efficient use of existing raw materials and the discovery of new sources of supply?
The last, big commodity boom occurred in the 1970s. That coincided with the rise of the ecological movement, many of whose members saw the rise in prices as a sign that growth in the developed world was unsustainable. This led in 1980 to a bet between a prominent ecologist, Paul Ehrlich, author of "The Population Bomb", and Julian Simon, an economist at the Cato Institute, a free market think-tank. The two camps were dubbed the Malthusians (after a British economist who forecast that population would outstrip food supply) and the Cornucopians, thanks to their belief in endless abundance.
Faced with a challenge from Mr Simon, Mr Ehrlich selected five metals—copper, chromium, nickel, tin and tungsten—whose prices he thought would rise in real terms over the following ten years. Mr Simon bet that prices would fall. It is clear in retrospect that Mr Ehrlich showed bad timing, since the late 1970s saw a cyclical zenith for commodity prices. But Mr Simon also had history on his side: real commodity prices fell steadily throughout the 20th century.
Mr Simon duly won the bet. The economic boom of the 1980s and 1990s also contradicted Mr Ehrlich's wilder claims—that a billion people would starve to death and that, by 1985, America would be trapped in an "age of scarcity".
But what if Mr Ehrlich had taken up Mr Simon's 1990 offer to go "double or quits" for any future date? All five have risen in price since the rematch was proposed. Furthermore, Jeremy Grantham of GMO, a fund-management group, points out that Mr Ehrlich would have won the original bet were it recalculated today (he is still alive; Mr Simon died in 1998). An equally weighted portfolio of the five commodities is now higher in real terms than the average of their prices back in 1980 (see chart).
The Cornucopians might argue that today's metals prices are due to the buoyancy of demand in the developing world rather than any cataclysmic shortages in supply. But the Malthusians might retort that man's famed ingenuity has not stopped prices from rising in real terms over an extended period. Place your bets.

redpajama_set_name: RedPajamaCommonCrawl


text:
Q: How to run an aggregate query via mongo_go_driver that has javascript in it? I'm using the mongo-go-driver (https://godoc.org/github.com/mongodb/mongo-go-driver/mongo) and I'm trying to do the equivalent of
db.getCollection('mycollection').aggregate([
    { $lookup: {
        from: "anothercollection",
        localField: "_id",
        foreignField: "foreignID",
        as: "matched_docs"
    }},
    { $match: { "matched_docs": { $eq: [] } } },
    { $project: { "matched_docs": 0 } },
    { $match: {"dateTimeGMT":{$lt: (new Date(Date.now()-1000*60*60*24)).toISOString()}} }
])

I can't figure out how to put the Javascript commands in using this method.
pipeline := bson.NewArray(
    bson.VC.DocumentFromElements(
        bson.EC.SubDocumentFromElements(
        //yada, yada, yada...
cursor, err := collection.Aggregate(ctx, pipeline)

(In general, I dislike this method, anyway.  I want to be able to design queries in Robo 3T and copy them to my code just like I do with MySQL Workbench and PHP)
This method yields an empty *bson.Array in pipeline
pipelineJSON := `[
    { $lookup: {
        from: "anothercollection",
        localField: "_id",
        foreignField: "interactionID",
        as: "matched_docs"
    }},
    { $match: { "matched_docs": { $eq: [] } } },
    { $project: { "matched_docs": 0 } },
    { $match: {"dateTimeGMT":{$lt: (new Date(Date.now()-1000*60*60*24)).toISOString()}} }
]`
pipeline, err = bson.ParseExtJSONArray(pipelineJSON)

I'd really love it if there were a way to send Mongo a command as a string (like I was typing it into Robo 3T) and get a *mongo.Cursor back.  Is there a better driver (that is still supported by someone) that I should use instead?  Do I need to code my own?
Thanks!

A:
I can't figure out how to put the Javascript commands in using this method.

Although I understand this is not the preferred method for your use case, this is how to construct the aggregation pipeline as bson.D using mongo-go-driver v1.0:
pipeline := mongo.Pipeline{
    {{"$lookup", bson.D{
        {"from", "tour"},
        {"localField", "_id"},
        {"foreignField", "foreignID"},
        {"as", "matched_docs"},
    }}},
    {{"$match", bson.D{
        {"matched_docs", bson.D{
            {"$eq", bson.A{}}},
        },
    }}},
    {{"$project", bson.D{
        {"matched_docs", 0},
    }}},
    {{"$match", bson.D{
        {"dateTimeGMT", bson.D{
            {"$lt", time.Now().AddDate(0, 0, -1).UTC().Format(time.RFC3339)},
            },
        },
    }}},
}

{ $project: { "matched_docs": 0 } },

You can also combined the two $match into a single pipeline stage instead, and then attach $project at the end. For example:
db.collection.aggregate([
    { "$lookup":{
        "from":"anothercollection",
        "localField":"_id",
        "foreignField":"foreignID",
        "as":"matched_docs"}
    },
    { "$match": { "matched_docs": { "$eq": [] },
                  "datetimegmt": { "$lt": (new Date(Date.now()-1000*60*60*24)).toISOString() }
                }
    },
    { "$project": { "matched_docs": 0 } }
]);

{ $match: {"dateTimeGMT":{$lt: (new Date(Date.now()-1000*60*60*24)).toISOString()}} }

Based on the $match value, it looks like you're storing date as string instead of a Date object. I would suggest to store dates as the proper Date objects for better index performance.

Using ParseExtJSONArray DOES work, but, unlike Mongo Shell, you cannot include JS or unquoted aggregation stages / expression operators

mongo shell provides some convienient methods/types i.e. ObjectID(), etc to construct MongoDB Extended JSON. The mongo shell is more than just a JavaScript shell.
If your aim just to evaluate a JavaScript expression, you can utilise a JavaScript interpreter for Go (otto). A rough example would be:
// Note the unquoted fields, as JSON is JavaScript native.
raw := `[
    { "$lookup": {
        from: "anothercollection",
        localField: "_id",
        foreignField: "foreignID",
        as: "matched_docs"
    }},
    { $match: { "matched_docs": { $eq: [] },
                "dateTimeGMT":{$lt: (new Date(Date.now()-1000*60*60*24)).toISOString() },
              }
    },
    { $project: { "matched_docs": 0 } },
]`
vm := otto.New()
// Evaluate JS expression
jsvalue, err := vm.Eval(raw)

// Export to Go interface{}
output, err := jsvalue.Export()

// Convert interface{} to bson.Document bytes
bsonbytes, err := bson.Marshal(output)

// Convert bson.Document bytes to bson.Document
pipeline, err := bson.UnmarshalDocument(bsonbytes)

Note as mentioned above, there are some objects that will not be recognised by a normal JavaScript interpreter i.e. ObjectId()

I want to be able to design queries in Robo 3T and copy them to my code just like I do with MySQL Workbench and PHP

Although currently does not support Go,  worth mentioning that MongoDB Compass has a feature to Export Query to Language. Current version (1.15) supports Java, Node, C# and Python3. Hopefully Go would be in the future.

A: Using ParseExtJSONArray DOES work, but, unlike Mongo Shell, you cannot include JS or unquoted aggregation stages / expression operators.  Note that the ISO date for the comparison is calculated in golang and the aggregation stages and aggregtion expression operators have been surrounded by quotes.
pipelineJSON := fmt.Sprintf(`[
    { "$lookup": {
        "from": "another_collection",
        "localField": "_id",
        "foreignField": "interactionID",
        "as": "matched_docs"
    }},
    { "$match": { "matched_docs": { "$eq": [] } } },
    { "$project": { "matched_docs": 0 } },
    { "$match": {"dateTimeGMT":{"$lt": "%s"}} }
]`, time.Now().AddDate(0, 0, -1).UTC().Format(time.RFC3339))
pipeline, err = bson.ParseExtJSONArray(pipelineJSON)

With the driver I asked about, that's the answer.

redpajama_set_name: RedPajamaStackExchange


text:
The joint at the base of the thumb which allows for the swivel and pivoting motions of the thumb is referred to as the basal joint or thumb CMC (carpometacarpal) joint. Because of its design, it tends to wear out and develop arthritis early in life. Basal joint arthritis is also common in people who have osteoarthritis.
It causes pain at the base of the thumb, particularly during pinching or gripping. It also results in weakness of pinch.
What caused it?
This joint appears to be particularly prone to wear and tear from normal use of the hand. Many people appear to be predisposed to arthritis in this joint, with or without arthritis in their other joints.
What can you do to help?
Ice for five to fifteen minutes at a time on the area which is most swollen and tender.
"Over the counter" non-steroidal anti inflammatory medication (NSAID), such as aspirin, ibuprofen, naprosyn, or ketoprofen. Check with your pharmacist regarding possible side effects and drug interactions.
A splint or brace which supports both the wrist and the thumb. A wrist support splint which doesn't support the thumb is not as effective as one that does.
Wait and watch.
What can a therapist do to help?
Provide a variety of hand splints to support the thumb and the wrist.
Help identify aggravating activities and suggest alternative postures.
Massage, heat, ice and other treatments aimed at making the area more comfortable.
What can a doctor do to help?
Confirm that this actually is the problem.
Prescribe stronger NSAID medication or cortisone type medication.
Prescribe hand therapy and/or a custom prescription splint.
Give a cortisone shot into the joint.
Perform surgery to reconstruct the joint.
There are many different operations that may be done for this condition, but a common approach is perform a total joint reconstruction, which involves three main steps.
First, the trapezium bone at the base of the thumb is removed. This bone has joint connections to three other bones - and any of these may develop arthritis.
The second step in the surgery involves making a connection between the adjacent sides of the base of the thumb and index finger - to maintain the thumb position. This connection is usually made with a tendon graft and can be done in several different ways.
The third step is to make a cushion to pad the space between the bones where the trapezium bone used to be. This cushion is usually also made from a tendon graft so that the base of the thumb rests on a pillow of your own body tissue, rather than on the rough surface of an arthritic bone.
Some surgeons then hold the bones in place with a temporary steel pin.
Recovery takes about three months. Therapy recommendations vary, but a rough guide is - splint continuously except for bathing 4 to 6 weeks, then progressive mobilization and strengthening exercises for another 4 to 6 weeks to recover of strength and dexterity. Most, but not all patients do this second phase supervised in therapy. Anticipate no two handed sports or heavy two handed lifting for 10 - 12 weeks after surgery. Most strength recovery occurs in the first few months, but can continue to improve for a year or more.
How successful is treatment?
Many people with mild symptoms will improve with a limited period of anti-inflammatory medication and avoiding painful activities.
A cortisone shot into the sore area helps most people - at least temporarily. When temporary, relief usually lasts about two months. One or two shots provide permanent relief for less than half of people with this problem.
Surgery helps over four out of five people with this problem, but as many as one out of five will have a new problem after surgery, such as numbness on the back of the hand or tenderness of the scar. Surgery is generally helpful in relieving pain, but two problems are not usually improved following surgery:
When the problem has caused the thumb to draw into the palm (thumb adduction contracture), surgery does not usually bring it back out, especially if the next joint further out on the thumb has stretched out and bent backward (thumb carpometacarpal hyperextension deformity)
Pinch strength may not improve adequately, although pain associated with pinch usually does.
The appearance of the base of the thumb may change with surgery.
What happens if you have no treatment?
It depends on how much it is bothering you - it really is a quality of life issue. This is not a problem which can spread to other parts of your body. Many people have thumb pain which subsides after a few years, when the arthritis and irritation in this joint "burns out".
However, there probably is a limited period of time during which surgery can give the best result. After a period of years, the thumb weakness and the loss of motion of the thumb may not be reversible even with surgery.
The main reason to do surgery is to relieve pain and, when possible, prevent the progressive weakness and deformity which may occur. Some people will have a mild problem which flares up from time to time, and treat it themselves or ignore it, others will have a severe problem which prevents them from doing many things with their hand, and feel that they have no choice but to have surgery.
Click here to see pictures of real hands with basal joint arthritis
Click here to search the web for basal joint arthritis


Dr. Oz, the U.S. TV doctor whose following keeps growing ever larger, said on his Dec. 11 show that there's a great weight loss tool that came along in 2013. Ingesting probiotics, he said, is effective in weight loss and the supplement is easy to find.
The microscopic live organisms, Dr. Oz said, keep your digestive system and your immune system healthy, and lacking them can lead to digestive problems. Weight loss is an offshoot of taking probiotics.
On his program, he had on two women who took probiotics, making no other dietary changes, and lost 30 pounds. One of the better ways to get probiotics into your system is through yogurt and milk but it is many other food items and can be taken as a supplement.
The doctor said the worst weight-loss strategy of 2013 is gluten-free diets. Those who make gluten-free products often use sugar and other unhealthy ingredients when looking for something to replace the gluten, thereby causing weight gain.


Clarks Girls Sandals Sale – Fashion trends come and go, but one particular frequent in the world of footwear is the reliable sandal. Worn in several types considering the fact that ancient situations, no other kind of shoe has such a storied history. And, a lot more than almost every other shoe, they're a mainstay in the world of fashion. Boots, clogs, ballet flats, all adjust with annually designs. But when the models and colours may possibly modify from year to year, the general function and elegance of a sandal remains.


text:
Wyoming - Albany County Affidavit of Trust Form
All Albany County specific forms listed below are included in your immediate download:
Affidavit of Trust Form - Albany County
Included document last updated 1/6/2021
Affidavit of Trust Guide - Albany County
Completed Example of the Affidavit of Trust Document - Albany County
*The Following Wyoming and Albany County supplemental forms are included as a courtesy with your order.
Wyoming Statement of Consideration Form
When recording an instrument in Wyoming, a fully completed and sworn Statement of Consideration must be submitted. It is the responsibility of the BUYER (or the BUYER'S AGENT) to fully complete this statement and, if necessary, retain a copy of the completed form for their records.
The supplemental forms in this section can be used as loose certificates by notaries in the state.
Are these forms guaranteed to be recordable in Albany County	?
Yes. Our form blanks are guaranteed to meet or exceed all formatting requirements set forth by Albany County including margin requirements, content requirements, font and font size requirements.
Areas covered by these Affidavit of Trust Forms:
Bosler
What is the Wyoming Affidavit of Trust?
In a trust relationship, a settlor transfers one or more assets to another (the trustee), who holds and manages them for the benefit of a third (the beneficiary). In a living trust, the settlor indicates the intent to create a trust by executing a document called the trust instrument. This document sets out the trust's provisions and allows the settlor to plan how his assets will be distributed upon his death, without the requirement that his estate go through probate.
In the place of the entire trust document, a trustee in Wyoming may present an affidavit of trust to any person who is not a trust beneficiary. Codified as part of the Uniform Trust Code at Wyo. Stat. Ann. 4-10-1014, the document certifies that a trust exists and that the trustee has the authority to engage in the business at-hand with the recipient on behalf of said trust. Instead of summarizing the entire trust agreement, the affidavit contains only the information relevant to the current transaction, allowing the settlor to maintain the privacy of his/her estate plans (including the identity of trust beneficiaries).
As specified by statute, the affidavit is signed and sworn to before an appropriate official. Other requirements include the name and date of trust; the name of the settlor; the name and address of the current trustee; and a description of the relevant powers of the trustee. In addition, the document identifies any person who holds a power to revoke the trust, if applicable, and, if there are multiple trustees, it stipulates which trustees have signing authority and how many, if fewer than all, are required to act jointly to perform the powers listed. Wyoming also requires the trust's taxpayer identification number.
The form includes the name by which the trust vests title to property, and, when used in transactions pertaining to real property interests, may include a legal description of the subject property held in trust. Further, the trustee certifies that the trust has not been amended, modified, or revoked in a manner that invalidates any of the statements contained within the certificate. Persons dealing with trustees are protected by the provisions of 4-10-1014.
Consult a lawyer with questions regarding affidavits of trust or other issues relating to trust property in Wyoming.
Get your Albany County Affidavit of Trust form done right the first time with Deeds.com Uniform Conveyancing Blanks. At Deeds.com, we understand that your time and money are valuable resources, and we don't want you to face a penalty fee or rejection imposed by a county recorder for submitting nonstandard documents. We constantly review and update our forms to meet rapidly changing state and county recording requirements for roughly 3,500 counties.
The documents you receive here will meet, or exceed, the Albany County recording requirements for formatting. If there's an issue caused by our formatting, we'll make it right and refund your payment.
Back to Wyoming
Back to Wyoming Affidavit of Trust


In this week's episode of the 365 Message Center Show, we discuss an opt-in to try the new #Outlook on the web, new #SharePoint site branding with a footer and some header changes, a #SharePoint mega menu, a new way to save in #Office, and more!
— Now beginning to roll-out out the try 'The new Outlook' toggle in Outlook on the Web to organisations outside targeted release.
Users will try the feature. This will affect how your support desk troubleshoot support tickets. Users may log a ticket or call in with a problem using the new Outlook on the Web.
Your people on targeted release should suffice as early testing within your org. Don't feel compelled to release this preview switch to the whole organization if it's anticipated to cause support issues.
— The change the look panel gets some new options for updating the site header with two layout options, a new mega menu, and a new footer for your pages.
The mega menu is for horizontally oriented navigation controls only and is only the first iteration of this functionality.
The footer is initially for new and existing communications sites and will be turned on for ALL of them by default.
It would be a good idea to let people know about a planned change to navigation. People are adaptable, but any significant changes to navigation and commonly used sites should be forewarned.
— Use a custom date column from a SharePoint list or library to create an email reminder to be sent days in advance of the date.
E.g. T-10 Check the freshness of the content on the page before expiry.
It's a new feature, but not worthy of it's own special bulletin. Save this for your weekly or monthly feature update post or video you send to your organization.
— If your org is using Cloud Calling, the Auto-Attendant and Call Queues will be migrated and manged from the new Teams Admin Center.
No Adoption Notes – There are no visible changes for end-users.
— A new save dialog box will be rolling out to your Office clients. If you are signed into Office 365, it will display OneDrive for Business by default. Select 'More locations' to choose SharePoint and then a site.
This certainly affects your training documentation. For something as important as saving files, make sure your end users know the change in behavior.
The feature helps people save the files to a cloud location quickly, if they haven't saved already.
It may result in lots of files being saved into OneDrive unintentionally.


text:
laroyce hawkins weight loss
Born on May 4, 1988, in Harvey, Illinois, the USA to Leah Bradley and Leonard Hawkins, Laroyce Hawkins was raised alongside his siblings in the southern suburb of Chicago. He also has an account on Facebook which has almost 40,000 followers, and on which he posts behind the scenes photos from his work with "Chicago P.D." demonstrating his closeness with his fellow cast members. He has also played the same character during crossovers with "Chicago Fire". (function() { The show has been airing for at least seven seasons. BPWRFL x #donjulio #drankResponsibly ?? After matriculating from high school, he enrolled at Illinois State University on a full tuition scholastic scholarship, and studied for a degree in theatre arts, hoping to later find a career in acting. Wiki Biography, age, measurements, dating, Who is Janna Breslin? var rcel = document.createElement("script"); At present, he is residing and living a worry-free experience in his home in Chicago. He has an account on Instagram on which he has over 275,000 followers, using the platform to promote his work and showcase a bit of behind the scenes photos and footage. Laroyce Hawkins at the 2017 Aspen Challenge Opening Forum Chicago - Duration: 13:40. He loves working out and staying fit, especially since it is needed for his role on television. He is an actor, stand-up comic, musician, and spoken word artist, best known for being one of the stars of the NBC television series "Chicago P.D.", in which he plays Officer Kevin Atwater. He's been active in the industry since 2008, and has also worked on several films. His birth sign is Taurus.
(adsbygoogle = window.adsbygoogle || []).push({}); He also landed his first professional acting project while a student, gaining the role of Art Baker in the film "The Express; The Ernie Davis Story", based on the book entitled "Ernie Davis: The Elmira Express" written by Robert C. Gallagher. LaRoyce Hawkins was born on May 4, 1988, in Harvey, IL. Hence, it should come as no surprise that his weight is 80 kg/176 lbs now. As of 2019, Laroyce Hawkins's net worth is at $11 million. Talking about his personal life, Laroyce Hawkins is reportedly to be single and unmarried. Furthermore, he has also performed on the part of its spin-off series, Chicago Fire. Hawkins spreads his "Be Powerful" message anyplace he can. He went to Thornton High School, where he had a passion to play basketball. You can contact him at [email protected]. 2020 was the second year in a row that LaRoyce Hawkins held the title of Celebrity Kettle Ambassador for the Salvation Army. #iAintPlayin #ChicagoPD, Posted by LaRoyce Hawkins on Thursday, January 10, 2019. He even figured out how to have it shown on the recreation center divider at Dwight D. Eisenhower School in Blue Island where he tutors his niece's basketball crew. Wiki, Who is Geraldine Viswanathan? LaRoyce Hawkins was born on 4 May 1988, in Harvey, Illinois, USA. At the school, Laroyce excelled in basketball and became the state champion of the speech team in the school. She is most famous for hosting Inside Edition. His work with the Salvation Army is only one drop in the pot with regards to giving back. cast for years and he remains a favorite of viewers and other cast members.
LaRoyce Hawkins was born on May 4, 1988, in Harvey, IL. Hence, it should come as no surprise that his weight is 80 kg/176 lbs now.
He is most famous for being married to American model, Ashley Graham. Also, in his college years, he was cast as Davis's teammate, Art Baker in the movie The Express: The Ernie Davis Story in 2008.
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laroyce hawkins weight loss 2020


On the subject of immigration, which is also said to be a significant factor driving the Brexit campaign, Fico has argued that his country has no obligation to house Muslim refugees and that, unlike the United States and leading Western European nations, Slovakia had little experience of Muslim immigration.
"Since Slovakia is a Christian country, we cannot tolerate an influx of 300,000 to 400,000 Muslim immigrants who would like to start building mosques all over our land and trying to change the nature, culture and values of the state," he said in January 2015.
"Multiculturalism is a fiction. Once you let migrants [Muslims] in, you can face such problems," referring to the spate of attacks on women in public spaces in the German city of Cologne around New Year's Eve by Muslim migrants.
Next week, Slovakia will be replacing the Netherlands for EU presidency.
This article originally appeared on Washington Post.
Multiculturalism is a fiction…. Why we muslim dont understand this. Once we understand this and realize that all these Americans & EU & India are our open enemies and they are afraid of us as when all the Muslim countries will be united where they will gohe.
What this person has suggested is very sane advice. It is good for everyone and to maintain peace also. Every country and nation has right to make laws that protects her identity. Such thinking and practice already exists in Japan, China and other far eastern asian countries.
His views support Jinnah TNT.
What differs Muslims and a non-Muslims in general is that Muslims dont change their country if they dont like countries values, culture and laws, they start demanding Sharia and shooting people.
What has to Happen will Happen. Inshallah. Islam is every human destiny and it will get to places where people thought it won't.
How much progress has the Islamic community made in ridding the mosques of radical preachers? None.
Has the practice of systematically indoctrinating their children at a young age been addressed? No.
Agreed, that we Muslims have to live in today's world and not in yesteryears.
Agreed, we have to change our behavior and learn some manners.
Agreed, that Yugoslavia masterminded the pogrom of Muslims before breaking up into states.
Agreed, that the future upsurge in Islam will be a thing to see and agree to.
Agreed, we all pray to be alive to see the miracle.
Need of the hour is introspection. Course correction is unavoidable. What do we find instead? Apologists scapegoating "others"!
Unfortunately, the Muslim world is divided. There is a leadership vacuum. Internal deficiency and external pressure is creating chaos and instability.
@Oranges and apples. people like to settle in other countries for variety of reasons. One of the the reason is the geographic location of Europe on the world map. Says a European country was in the Sahara Desert, would people want to live there?
Slovakia didn't invade any muslim countries or take part in bombings. So you playing the victim card has no place here. The whole Eastern Europe is very different from the rest of EU. It has no guilt about anything, because it didn't do anything wrong. Instead it's been screwed up by the west, by getting abandoned and just given as a gift to USSR.
You're the uneducated one. Slovakia didn't take part in any exploitation of resources of poor African and Asian countries. Nor did it take part in colonialism or crusades (even though the image of crusades being all negative is beyond silly). The lands that form Slovakia now have only suffered from oppressive muslim regimes in the past, while dealing none of that suffering in return (unless you considering throwing muslim invaders out).


Achieving incredible goals in both ancient, and modern times. You can either believe it or not. But, I'll tell you that there is a power that can make this possible. You can either believe it or not.... Often referred to as "the science of life" and "the mother of all healing," Ayurveda looks at the whole being (body, mind, and spirit) to find the underlying sources of imbalance and disease, as opposed to simply treating symptoms.
Note that you do not need to grab this Ancient Tome if you do not wish to fight the Ancient Threat world boss at the end. If you do want to fight the world boss, you must have this buff as you cannot damage Ancient Threat without it.... Ancient Power is a Quest in Skyrim. Description. Feran Sadri has sent me to retrieve the Remains from Dungeon. After infusing the magical essence lingering in the remains into the Bloodstone Chalice, the power granted to us from drinking it will last longer.
22/09/2015 · It learns ancient power at level 38. If you have gone past this you will need to use the move relearner. how to help awkward skater Ancient Power deals damage and has a 10% chance of raising all the user's stats at once - Attack, Defense, Special Attack, Special Defense and Speed - by one stage each. Stats can be raised to a maximum of +6 stages each.
The chaotic entity Aluneth bends to your will, further empowering your spells. Increases Arcane damage by 1%. This is an Arcane Mage Artifact Trait. how to fix my toyota prius 2005 passenger power windows This page was last edited on 3 November 2015, at 13:58. Content is available under CC BY-SA 3.0 unless otherwise noted. World of Warcraft content and materials are trademarks and copyrights of Blizzard or its licensors.
How do you obtain ancient power on Pokemon Leaf Green?
Ancient Power You need to level up an Aerodactyl. you need to level up aerodactyl and togepie by obtaining it from the man north west of 5 island.
Quick Walkthrough . Speak to Feran Sadri. Retrieve the Ancient Vampire remains. Return to Feran Sadri. Detailed Walkthrough . Speak to Feran Sadri and he will tell you his theory that adding the blood of an ancient vampire to the Bloodstone Chalice can lengthen the amount of time its effects last.
It was the BiS for caster DPS pre-ulduar, and this is the REAL stepping stone up to Sash of ancient power. I'd say, if you want to get a BiS and have a lot of cash.... Go with the sash.
Ancient Power Cells have been added as a once per day reward to the following missions on the Kobali Prime Adventure Zone: *At the Gates *The Last Stand So how do we trigger these missions? I've been wandering around the summit for half an hour now, and not seen Last Stand.


When you stumble upon a recipe that promises to fill your house with the warm scent of strawberries and cake, and berry-stained fingers afterward, you can't say no, or pretend to be uninterested and click on to the next page. I definitely couldn't. These strawberry scones lingered in my memory for two whole days and by saturday evening, I had a block of butter and a punnet of strawberries in the fridge waiting to be elevated into something even more glorious.
This isn't the first time I've shared a recipe that a recipe that marries berries and pastry, but what can I say? Some things don't change, especially when they are very, very good.
The last two weeks saw my life in its most unrecognizable form — a flurry of opportunities and unexpected grace, but paid for with non-stop 5am nights, a work table strewn with academic journal articles that never got put away, sundays in school. On wednesday, I got fed up, took a gamble with my good-girl self, sent in an incomplete thesis draft for review and rushed off to the theatre for a few hours to see cooling off day. Yesterday I took a whole day off, ate tokyo bananas, made the trek to katong to collect reserved magazine back issues with my mother. It was glorious.
Today is another sunday and I am still in school. Most of the time it feels like my mind has been buzzing non-stop, but with what? It's a blurry, prickly, nameless feeling. My thoughts are tangled up and I'm too tired to unravel the knots, and where word clouds once existed in my mind, all there is now is…static. Static, and a longing to stay in bed just a little longer. On the bright side, almost everything tickles my funny bone lately (have you seen pusheen or the new despicable me 2 teaser?), kenny brought us milk pan buns, and we are moving forward to a new future every day!!
When suppertime in Singapore rolls around, my thoughts always go back to 3am dim sum nights in Hong Kong — stealing out of the HKU dorms past the sleeping receptionist, dizzying cab rides down the slopes of Hong Kong island, and into the fray of Sun Hing at 10 Hau Wo St to gobble down salted egg yolk custard buns glinting with so much goodness. I can taste it in my mouth just looking at that photo!!
Sorry I haven't been here in a while, school and thesis work has kicked off hard and heavy! I spend most of my days staring at 'Reply Email' text boxes, so the wordpress post editor is not high on my list of preferred sights, but rest assured I am still alive, thinking and feeling, loving and enjoying life intensely, as always ;) Please accept these photos of Malaysian culinary treasures as penance?
These pictures were collected as my family and I ate our way through Malaysia, starting from Penang, up to my dad's hometown, Alor Setar. I loved every bite, but if you're ever in Penang, you need to go to the hawker centre on Lebuh Presgrave and hunt down the ice kacang and hokkien prawn noodles in the last two photos. Ask for frozen-peanut-butter-flecked vanilla ice cream on your shaved ice and pink syrup, and extra pork ribs in your noodles, and you'll be on your way to happy rumbly tummy days.


text:
City panics at prospect of Boris Johnson as prime minister
More than 80% of respondents to an FN poll believe the former foreign secretary is the wrong person to replace May and will be bad news for the Square Mile
Christopher Furlong/Getty Images
Chris Newlands,
Lina Saigol and
Shruti Chopra
Thursday May 30, 2019 3:20 am
Financiers in the City have expressed deep concern at the prospect of Boris Johnson replacing Theresa May at Number 10, fearing the former mayor of London's appointment would be very detrimental to the Square Mile.
Executives have baulked at the possibility of Johnson becoming the next prime minister, expressing fears his appointment would increase the likelihood of Britain crashing out of the EU without a deal and inflame the risks of a UK recession.
According...


We are going to tell you readers something they may not realize in Clarksville, Tennessee, at least not yet. We are going to tell you something they may not know at Kenwood High School yet. No, we aren't going to give you the identity of the new Head Coach of the Knights for 2019, though we believe we know the answer to that too. What we are going to tell you is who will start at QB for the Knights in 2019. What makes us so sure? Well, truthfully he may already be the most coveted QB prospect in Clarksville, Tennessee right now and he has yet to take a snap.
Ladies and Gentlemen, your starting QB at Kenwood in 2019 and for however much longer he has eligibility and remains healthy is…Treyvon Jefferson, Class of 2022. Jefferson comes to Clarksville, Tennessee and resides in the Kenwood High School zone and is presently enrolled by way of Bayshore High School in Bradenton, Florida.
Jefferson, who will be a sophomore next season, is in the neighborhood of 6-4 and weighs somewhere around 190-pounds. He is a pro-style QB who was awarded the top QB-prospect at the WKU Prospect Academy the summer before this 8th grade year. He tossed the ball in the air 50-yards then…no telling how far he can toss it now. Jefferson ran a 5.0 40-yard dash the summer just following his 8th grade season, there is no telling who fast he runs the 40 today. Frankly, he was 6-3 and weighed 180-pounds when playing varsity football at Bayshore as only a ninth grader. We have estimated both his height and weight, there is virtually no telling his true size today.
While there are lots of things about Treyvon Jefferson we don't know, there is a few things we feel comfortable enough to say we do. We know he is an extraordinarily-gifted athlete. We know he has a howitzer draped from off his right shoulder. We know there isn't another QB like him anywhere in the corporal city limits of Clarksville, Tennessee. Finally, we know this…he will be the starting QB for the Knights in 2019 regardless of whom gets hired to coach them. If they hire a coach who can't recognize what this kid both is and has the potential to be, then they will have made a terrible mistake.
Congratulations to Treyvon Jefferson, Class of 2022, QB, for being our Meeks & Meeks, Attorneys, Montgomery County Area Player of the Week!


text:
require 'puppet/util/ipajson'
require 'puppet/provider/ipabase'

Puppet::Type.type(:ipa_hbacrule).provide(:ipa, :parent => Puppet::Provider::IPAbase) do

  mk_resource_methods
  @ipa_resource=:hbacrule

  class << self
    alias_method :super_get_def, :get_def

    def get_def(instance)
      properties=super_get_def(instance)
      [:anyuser,:anyhost,:anyservice].each do |cat|
        properties[cat] ||= :false
        properties[cat]   = :true if properties[cat] =='all'
      end
      properties
    end

  end

  def add_instance
    ipa.hbacrule.add(@resource[:name],{ :description => @resource[:description] })
    [:user,:host,:service].each do |type|

      single = "#{type}s".to_sym
      group  = "#{type}groups".to_sym
      cat    = "any#{type}".to_sym

      modify_members(single,@resource[single],[]) if @resource[single]
      modify_members(group, @resource[group],[])  if @resource[group]
      ipa.hbacrule.mod(@resource[:name],{ cat => 'all' }) if @resource[cat]==:true

    end

  end

  def del_instance
    ipa.hbacrule.del(@resource[:name])
  end

  def modify_members(property,members,current_members)

     method="#{property}".sub(/s$/,'')
     add_members = []
     del_members = []

     Array(members).each do |member|
        add_members << member unless current_members.include?(member)
      end
      current_members.each do |member|
        del_members << member unless members.include?(member)
      end

      ipa.hbacrule.send("add_#{method}".to_sym, @resource[:name],add_members) if !add_members.empty?
      ipa.hbacrule.send("remove_#{method}".to_sym, @resource[:name],del_members) if !del_members.empty?
      @property_flush.delete(property)

  end

  def mod_instance

    # arses.
    # when user/service/hostcategory = all, then you have to delete all the relevant user/service/group definitions in IPA
    # sanest thing to do is overwrite the should values for the user/host/group contents with []
    # then the user can just remove the user/host/servicecategory = all from he manifest and get hte old settings back

    [:user,:host,:service].each do |type|

      single = "#{type}s".to_sym
      group  = "#{type}groups".to_sym
      cat    = "any#{type}".to_sym

      # future state is all = true. We need to wipe the single/group properties before applying the 'all setting'
      # the type itself looks after overriding the single/group
      if ( !@property_flush.has_key?(cat) and @property_hash[cat] == :true) or @property_flush[cat]==:true

        modify_members(single,@property_flush[single],@property_hash[single]) if @property_flush.has_key?(single)
        modify_members(group, @property_flush[group],@property_hash[group])  if @property_flush.has_key?(group)
        ipa.hbacrule.mod(@resource[:name],{ cat => 'all' }) if @property_flush[cat]==:true

      # future state is all = false and requires a change to 'all' setting before applying single/group membership
      elsif @property_flush.has_key?(cat) and @property_hash[cat] == :true

        ipa.hbacrule.mod(@resource[:name],{ cat => '' }) if @property_flush[cat]==:false
        modify_members(single,@property_flush[single],@property_hash[single]) if @property_flush.has_key?(single)
        modify_members(group ,@property_flush[group],@property_hash[group])  if @property_flush.has_key?(group)

      # just flush the single/group members
      else

        modify_members(single,@property_flush[single],@property_hash[single]) if @property_flush.has_key?(single)
        modify_members(group ,@property_flush[group],@property_hash[group])  if @property_flush.has_key?(group)

      end

    end

    ipa.hbacrule.mod(@resource[:name],{ :description => @property_flush[:description]}) if @property_flush.has_key?(:description)

  end

end

redpajama_set_name: RedPajamaGithub


text:
Home » Tech » Blockchain ID system lets drivers pay tolls, parking fees automatically
Blockchain ID system lets drivers pay tolls, parking fees automatically
Tech 14 October 2019
Steve Kaaru
Motorists in the U.S. may never have to pay for parking using cash or their debit cards again thanks to a blockchain project by major automakers. The project seeks to use blockchain technology to automate payments such as parking fees and highway tolls. It also seeks to expand into the creation of mobility networks in which vehicles can communicate with each other seamlessly.
The project is part of the Mobility Open Blockchain Initiative (MOBI), a global foundation that seeks to accelerate the use of blockchain technology. It brings together Ford, GM, BMW, Honda, Groupe Renault and more.
The project will establish a blockchain-based vehicle identity system, enabling the association of vehicle payments to the vehicle itself and eliminating the need to connect it with a bank account. According to the press release, the system will then use smart contracts to enable "direct and low cost micropayments to and from multiple parties in response to detectable events. This will accelerate existing trends toward pay per use mobility and mobility as a service."
The Vehicle ID system will assign digital IDs to individual vehicles which will be linked to data such as service histories and ownership. This data will be used to recognize the vehicle on the road which will in turn enable the automation of fees payment.
The project intends to target payments such as parking fees, tolls, maintenance costs and even rest stop snacks. As reported by the Nikkei Asian Review, the project will begin field tests in the U.S. starting November.
Andre Luckow, the head of emerging technologies at the BMW Group commented, "The Vehicle Identity Standard is a critical enabler for future blockchain-based vehicle and mobility services. We are excited to participate in the multi-stakeholder Proof-of-Concept to foster the advancement of the standard and to explore its application."
MOBI expects that the project will give government and transit operators new tools to combat congestion and pollution, setting the stage for safer and more affordable mobility. The foundation, which boasts of having over half of all vehicle makers as members, believes that the project will also facilitate the creation of mobility networks "in which vehicles can communicate with each other and track movement: speed, location, direction of travel, braking, and even intention."
vehicle ID system
Tech 28 January 2023
Hydro-Quebec CEO behind push to ban new power allocation to BTC miners to leave post
Sophie Brochu has been the CEO of Hydro-Quebec for three years and during her tenure, she called on regulators to suspend the allocation of 270MW to BTC miners.
Argo Blockchain regains Nasdaq compliance as price recovers
Argo received a warning from Nasdaq in December that it would be delisted if its price stayed below the threshold $1 mark as it struggled in the bear market.
Brunei's national police shuts down 2 illegal block reward mining operations
Law enforcement confirmed that block reward mining rigs and machines were discovered at the two locations, and both used illegal electricity connections to mask their mining activity.


Northumbrian piper and fiddler Kathryn Tickell, awarded BBC Radio 2's 2005 Folk Musician of the Year, in a duo with harpist Corrina Hewat, one of the most distinctive, original and versatile artists on the contemporary Scottish scene. Two excellent musicians and a CD which compliments the talents of both. Great playing and singing.


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The aim of the game is recolouring multi-coloured game blocks placed on a field, on grey colour. The recolouring occurs if in one or several directions, there were four or more blocks of one colour. The problem is that the blocks scatter in the different sides, and it is not so simpl to collect them together. Besides the recoloured blocks are not deleted from a field and prevent execution of the task.
There is a possibility of a choice from 9 levels of complexity in the game.
Release date: 2018-09-02; Version: 2.70; License: Freeware; Registration: USD0.00; Downloads: 13451; Operating systems: Windows 95/98/ME/2000/XP/Vista all/Win7 all; System req.: not special.
© 2005-2015 All rights reserved.


The Jerusalem Development Authority (JDA) has partnered with Thomas Cook Group to promote the destination to a wider target audience.
The partnership aims to bring about global exposure to the historical city of Jerusalem, and increase visitation by showcasing the city's highlights across Thomas Cook's multi-channel media channels.
Modern Ancient Life will be a fully integrated, multi-market campaign that promotes a modern and vibrant city emerging from its ancient and present history.
Mixologists, bakers, artists, techies and restaurateurs, all of whom are creating a modern life within the ancient city, will feature in the campaign through photographic and video content shot.
The campaign will be activated across Thomas Cook's online, social, direct and in store channels targeting affluent 25+ ABC1 adults travelling either as couples or in groups. In addition, Modern Ancient Life will have a significant trade market presence, educating agents in the capital's cuisine, art, culture and nightlife as well as the more traditional historical and religious associations.


With our purpose built office and workshop, maintenance is a breeze with even enough room for our large double deckers.
This enables us to maintain the highest level of condition for our fleet, keeping them in fantastic condition and maintaining superb service history.
We have a 14-metre inspection pit and are a DVSA Authorised Testing Facility (ATF) along with Lolar testing equipment.
We have invested a lot in our maintenance department so that we maintain the highest level of safety for our fleet of vehicles.


Secure Password Manager is a desktop utility that spares you the trouble of filling in your logins, passwords, and other personal data manually. You can automatically fill in password in ANY application (IE, Netscape, Opera, ICQ, MSN).
Secure Password Manager is a handy application that can manage , store and track passwords.
Secure Password Manager is well designed to let you store and track names, passwords, credit cards, software serial numbers and confidential notes in an encrypted form securely and easily.
It can automatically fill login information for you. Features include password generator, backup options, auto complete sequence editor, lock, windows clipboard support, and clipboard clearing.
As a result, you only have to remember one password, the one to your account.


text:
The GM Scandal Is Worse Than You Think
And by "you" I mean the media.
April 2, 2014 By David Harsanyi
Here's another reason why government should never own a business.
In February 2010, the Obama Administration's Transportation Secretary Ray LaHood told America, without a shred of evidence, that Toyota automobiles were dangerous to drive. LaHood offered the remarks in front of the House Appropriations subcommittee that was investigating reports of unintended-acceleration crashes. "My advice is, if anybody owns one of these vehicles, stop driving it," he said, sending the company's stock into a nosedive.
Even at the time, LaHood's comments were reckless at best. Assailing the competition reeks of political opportunism and cronyism. It also illustrates one of the unavoidable predicaments of the state owning a corporation in a competitive marketplace. And when we put LaHood's comment into perspective today, it's actually a lot worse. Not only did the Obama administration have the power and ideological motive to damage the largely non-unionized competition, it was busy propping up a company that was causing preventable deaths.
No one is innocent, of course, but not everyone is bailed out. So Toyota, after recalling millions of cars and changing parts and floor mats even before LaHood's outburst, and after years of being hounded by the administration, recently agreed to pay a steep fine for its role in the acceleration flap. This, despite the fact that in 2012, Department of Transportation engineers determined that no mechanical failure was present that would cause applying the brakes to initiate acceleration. The DOT conducted tests that determine the brakes could maintain a stationary car or bring one to a full stop even with the engine racing. It looked at 58 vehicles that were supposedly involved in unintended acceleration and found no evidence of brake failure or throttle malfunction.
Eric Holder kept at it, though, and Toyota finally agreed to a $1.2 billion settlement (it has around $60 billion in reserves) to make it go away. Though it looks like the company doesn't think the fight is worthwhile, for all I know it's guilty. I'm certain, though, that General Motors is. It announced this week that it too was recalling over a million vehicles that had sudden loss of electric power steering. This, after recalling nearly 3 million vehicles for ignition-switch problems that the company knew about since 2001 and are now linked 13 deaths.
GM has apologized. But does anyone believe the Obama administration took as hard a look at GM as it did Toyota? As early as 2007, the National Highway Traffic Safety Administration knew that there may be problems with airbags but never launched a formal investigation. The National Highway Traffic Safety Administration's acting chief David Friedman testified that GM never told them that faulty switches were at the root of the airbag problem. Fine. Before plowing billions of tax dollars into saving the United Automobile Workers, did the Car Czar or any other Obama officials take extra care to review DOT records to insure that taxpayers would not be funding the preventable deaths of American citizens? Would DOT or Holder exhibit the same zealousness for safety when it came to GM as they did when it came to Toyota? In the midst of the bailout debate and subsequent "turnaround," news of a coverup and major recall would have been a political disaster.
So it's difficult to understand why this isn't a huge scandal. If every obtuse utterance by an obscure Republican congressman gets the media juices flowing, surely the possibility of this kind of negligence is worth a look. Can anyone with access to the administration ask some of these questions? Because if you take credit for "saving" a company (actually, an "industry," as no one would ever driven again if Obama hadn't saved the day) you also get credit for "saving" the real-life unscrupulous version of the company. "I placed my bet on American workers," Obama told union workers in 2012. "And I'd make that same bet again any day of the week. And now, three years later that bet is paying off." Betting $80 billion of someone else's money to prop up sympathetic labor unions isn't exactly fraught with political risk. Unless it turns out that your administration was less concerned about the safety defects of the company you owned than the company you disliked. That would be corruption.
David Harsanyi is a Senior Editor at The Federalist and author of the The People Have Spoken (and They Are Wrong): The Case Against Democracy. Follow him on Twitter.
David Harsanyi is a former Senior Editor at The Federalist. He is the author of First Freedom: A Ride Through America's Enduring History with the Gun. Follow him on Twitter.
Photo White House
Photo The Trabant
Department of Transportation Eric Holder Ray LaHood


This interactive flowchart covers the clinical management of primary hypertension in adults.
High blood pressure (hypertension) is one of the most important preventable causes of premature morbidity and mortality in the UK. Hypertension is a major risk factor for ischaemic and haemorrhagic stroke, myocardial infarction, heart failure, chronic kidney disease, cognitive decline and premature death. Untreated hypertension is usually associated with a progressive rise in blood pressure. The vascular and renal damage that this may cause can culminate in a treatment-resistant state.
Blood pressure is normally distributed in the population and there is no natural cut-off point above which 'hypertension' definitively exists and below which it does not. The risk associated with increasing blood pressure is continuous, with each 2 mmHg rise in systolic blood pressure associated with a 7% increased risk of mortality from ischaemic heart disease and a 10% increased risk of mortality from stroke. Hypertension is remarkably common in the UK and the prevalence is strongly influenced by age. In any individual person, systolic and/or diastolic blood pressures may be elevated. Diastolic pressure is more commonly elevated in people younger than 50. With ageing, systolic hypertension becomes a more significant problem, as a result of progressive stiffening and loss of compliance of larger arteries. At least one quarter of adults (and more than half of those older than 60) have high blood pressure.
10 November 2016 Two Medicines and Healthcare products Regulatory Agency drug safety alerts covering angiotensin-converting enzyme (ACE) inhibitors added to step 1 ACE inhibitor or low-cost angiotensin II receptor blocker, step 2 ACE inhibitor or angiotensin II receptor blocker + calcium-channel blocker, step 3 ACE inhibitor or angiotensin II receptor blocker + calcium-channel blocker + thiazide-like diuretic and choosing antihypertensive drug treatment.
27 October 2015 Implanting a baroreceptor stimulation device for resistant hypertension (NICE interventional procedures guidance 533) added to step 4 resistant hypertension.
21 August 2015 Interactive flowchart restructured and summarised recommendations replaced with full recommendations.
20 March 2013 Hypertension in adults (NICE quality standard 28) added.
15 January 2013 WatchBP Home A for opportunistically detecting atrial fibrillation during diagnosis and monitoring of hypertension (NICE medical technologies guidance 13) added to measuring blood pressure.
These quality statements are taken from the hypertension in adults quality standard. The quality standard defines clinical best practice for hypertension in adults and should be read in full.
This quality statement is taken from the hypertension in adults quality standard. The quality standard defines clinical best practice for hypertension in adults and should be read in full.
People with suspected hypertension are offered ambulatory blood pressure monitoring (ABPM) to confirm a diagnosis of hypertension.
ABPM is the most accurate method for confirming a diagnosis of hypertension, and its use should reduce unnecessary treatment in people who do not have true hypertension. ABPM has also been shown to be superior to other methods of multiple blood pressure measurement for predicting blood pressure-related clinical events.
Evidence of local arrangements to ensure people with suspected hypertension are offered ABPM to confirm a diagnosis of hypertension.
Proportion of people with suspected hypertension who receive ABPM to confirm a diagnosis of hypertension.
Numerator – the number of people in the denominator who receive ABPM to confirm a diagnosis of hypertension.
Denominator – the number of people with suspected hypertension.
Service providers ensure systems are in place to offer ABPM to confirm a diagnosis of hypertension.
Healthcare professionals offer ABPM to confirm a diagnosis of hypertension.
Commissioners ensure they commission services that offer ABPM to confirm a diagnosis of hypertension.
People with suspected hypertension (high blood pressure) are offered ambulatory blood pressure monitoring (which involves wearing a blood pressure monitor during their normal waking hours) to confirm whether or not they have hypertension.
NICE clinical guideline 127 recommendation 1.2.3 (key priority for implementation).
Local data collection. Contained within NICE clinical guideline 127 clinical audit tool: diagnosing hypertension, criterion 1.
Clinical guideline 127 Hypertension: full guideline: Ambulatory blood pressure monitoring (ABPM) involves a cuff and bladder connected to electronic sensors which detect changes in cuff pressure and allow blood pressure to be measured oscillometrically. Systolic and diastolic pressure readings are deduced from the shape of oscillometric pressure changes using an algorithm built into the measuring device. A patient's blood pressure can be automatically measured at repeated intervals throughout the day and night, while they continue routine activities. Systolic and diastolic pressure can be plotted over time, with most devices providing average day, night and 24-hour pressures. NICE recommends recording a daytime average to confirm diagnosis.
NICE clinical guideline 127 recommendation 1.2.3 describes suspected hypertension as clinic blood pressure of 140/90 mmHg or higher without a confirmed diagnosis of hypertension.
ABPM may not be suitable for everyone, for example people with particular learning or physical disabilities. Some people may be unable to tolerate ABPM and some people may decline it.
Home blood pressure monitoring should be offered as an alternative to ABPM in such cases, in line with NICE clinical guideline 127 recommendation 1.2.4. If a person is unable to tolerate ABPM, home blood pressure monitoring (HBPM) is a suitable alternative to confirm the diagnosis of hypertension.
People with newly diagnosed hypertension receive investigations for target organ damage within 1 month of diagnosis.
Assessment of target organ damage can alert the clinician to possible secondary causes of hypertension, some of which are potentially life threatening and some that may be amenable to potentially curative interventions. It can also support the clinician to decide the appropriate blood pressure threshold at which to consider drug therapy for the treatment of hypertension.
Evidence of local arrangements for people with newly diagnosed hypertension to receive all investigations for target organ damage within 1 month of diagnosis.
Proportion of people with newly diagnosed hypertension who receive all investigations for target organ damage within 1 month of diagnosis.
Numerator – the number of people in the denominator who receive all investigations for target organ damage within 1 month of diagnosis.
Denominator – the number of people with newly diagnosed hypertension.
Service providers ensure systems are in place for people with newly diagnosed hypertension to receive all investigations for target organ damage within 1 month of diagnosis.
Healthcare professionals carry out all investigations for target organ damage for people with newly diagnosed hypertension within 1 month of diagnosis.
Commissioners ensure they commission services that carry out all investigations for target organ damage for people with newly diagnosed hypertension within 1 month of diagnosis.
People with newly diagnosed hypertension (high blood pressure) receive tests within 1 month of being diagnosed to check for any damage to organs such as their eyes, heart or kidneys.
NICE clinical guideline 127 recommendations 1.2.6 and 1.3.3.
Local data collection. Contained within NICE clinical guideline 127 clinical audit tool: diagnosing hypertension, criterion 3.
arrange for a 12-lead electrocardiograph to be performed.
NICE clinical guideline 127 recommendation 1.2.6 lists left ventricular hypertrophy, chronic kidney disease and hypertensive retinopathy as examples of target organ damage.
Quality statement 3 has been replaced by quality statements on primary and secondary prevention of cardiovascular disease in cardiovascular risk assessment and lipid modification (NICE quality standard 100).
People with treated hypertension have a clinic blood pressure target set to below 140/90 mmHg if aged under 80 years, or below 150/90 mmHg if aged 80 years and over.
Hypertension is associated with a higher risk of cardiovascular events. Setting blood pressure to recommended levels aims to promote primary and secondary prevention of cardiovascular disease, and to lower the risk of cardiovascular events.
a) Evidence of local arrangements to ensure people aged under 80 years with treated hypertension have a clinic blood pressure target set to below 140/90 mmHg.
b) Evidence of local arrangements to ensure people aged 80 years and over with treated hypertension have a clinic blood pressure target set to below 150/90 mmHg.
People with treated hypertension whose target blood pressure is achieved.
Service providers ensure systems are in place for people aged under 80 years with treated hypertension to have a clinic blood pressure target set to below 140/90 mmHg, and for people aged 80 years and over with treated hypertension to have a clinic blood pressure target set to below 150/90 mmHg.
Healthcare professionals ensure that people aged under 80 years with treated hypertension have a clinic blood pressure target set to below 140/90 mmHg, and people aged 80 years and over with treated hypertension have a clinic blood pressure target set to below 150/90 mmHg.
Commissioners ensure they commission services that have arrangements for people aged under 80 years with treated hypertension to have a clinic blood pressure target set to below 140/90 mmHg, and for people aged 80 years and over with treated hypertension to have a clinic blood pressure target set to below 150/90 mmHg.
People who are receiving treatment for hypertension (high blood pressure) have a target clinic blood pressure (blood pressure measured in their GP practice or clinic) below 140/90 mmHg if they are aged under 80 years, or a clinic blood pressure below 150/90 mmHg if they are aged 80 years or over.
NICE clinical guideline 127 recommendations 1.5.5 and 1.5.6.
Quality and Outcomes Framework (QOF) indicator HYP002:The percentage of patients with hypertension in whom the last blood pressure reading (measured in the preceding 9 months) is 150/90 mmHg or less.
Quality and Outcomes Framework (QOF) indicator HYP003:The percentage of patients aged 79 and under with hypertension in whom the last blood pressure reading (measured in the preceding 9 months) is 140/90 mmHg or less.
Clinic blood pressure refers to blood pressure measured in the clinic.
For a clinic blood pressure of 140/90 mmHg, the corresponding ambulatory blood pressure monitoring (ABPM) daytime average or home blood pressure monitoring (HBPM) average blood pressure is 135/85 mmHg.
For a clinic blood pressure of 160/100 mmHg or higher, the corresponding ABPM daytime average or HBPM average blood pressure is 150/95 mmHg or higher.
Treated hypertension includes treatment with antihypertensive drugs.
Targets are based on evidence of safe practice. A person aged 80 years or over with treated hypertension would not have a target clinic blood pressure of 150/90 mmHg if their blood pressure was already treated to below this threshold.
People with hypertension are offered a review of risk factors for cardiovascular disease annually.
People's blood pressure and cardiovascular disease risk will increase over time. A review of risk factors for cardiovascular disease delivered as part of an annual review of care should support identification of increased risk and provide an opportunity to address modifiable risk factors.
Evidence of local arrangements to ensure people with hypertension are offered a review of risk factors for cardiovascular disease annually.
Proportion of people who have had hypertension for 12 months or longer who have had a review of risk factors for cardiovascular disease within the past 12 months.
Numerator – the number of people in the denominator who have had a review of risk factors for cardiovascular disease within the past 12 months.
Denominator – the number of people who have had hypertension for 12 months or longer who do not have established cardiovascular disease.
Service providers ensure systems are in place to offer people with hypertension a review of risk factors for cardiovascular disease annually.
Healthcare professionals offer people with hypertension a review of risk factors for cardiovascular disease annually.
Commissioners ensure they commission services that offer people with hypertension a review of risk factors for cardiovascular disease annually.
People with hypertension (high blood pressure) are offered a review of risk factors for cardiovascular disease annually.
NICE clinical guideline 127 recommendation 1.7.3.
Quality and Outcomes Framework (QOF) indicator CVD-PP02: The percentage of patients diagnosed with hypertension (diagnosed on or after 1 April 2009) who are given lifestyle advice in the preceding 12 months for: smoking cessation, safe alcohol consumption and healthy diet.
Quality and Outcomes Framework (QOF) indicator SMOK005: The percentage of patients with any or any combination of the following conditions: CHD, PAD, stroke or TIA, hypertension, diabetes, COPD, CKD, asthma, schizophrenia, bipolar affective disorder or other psychoses who are recorded as current smokers who have a record of an offer of support and treatment within the preceding 12 months?
NICE clinical guideline 127 recommendation 1.7.3 recommends that an annual review of care should be provided to monitor blood pressure, provide people with support and discuss their lifestyle, symptoms and medication.
heart rate and rhythm (pulse measurement).
(adapted from NICE clinical guideline 67 recommendation 1.4.2).
Blood pressure should be measured more frequently than annually for patients who need more frequent monitoring.
People with resistant hypertension who are receiving 4 antihypertensive drugs and whose blood pressure remains uncontrolled are referred for specialist assessment.
People with resistant hypertension will usually be at high risk of cardiovascular disease. Specialist assessment and evaluation supports management of their condition.
Evidence of local arrangements for people with resistant hypertension who are receiving 4 antihypertensive drugs and whose blood pressure remains uncontrolled to be referred for specialist assessment.
Proportion of people with resistant hypertension who are receiving 4 antihypertensive drugs and whose blood pressure remains uncontrolled who are referred for specialist assessment.
Numerator – the number of people in the denominator who are referred for specialist assessment.
Denominator – the number of people with resistant hypertension who are receiving 4 antihypertensive drugs and whose blood pressure remains uncontrolled.
Service providers ensure local arrangements are in place for people with resistant hypertension who are receiving 4 antihypertensive drugs and whose blood pressure remains uncontrolled to be referred for specialist assessment.
Healthcare professionals refer people with resistant hypertension who are receiving 4 antihypertensive drugs and whose blood pressure remains uncontrolled for specialist assessment.
Commissioners ensure they commission services that refer people with resistant hypertension who are receiving 4 antihypertensive drugs and whose blood pressure remains uncontrolled for specialist assessment.
People with resistant hypertension (high blood pressure that is difficult to control) who are receiving 4 antihypertensive drugs (drugs to treat high blood pressure) and whose blood pressure is still high are referred for a specialist assessment.
NICE clinical guideline 127 recommendations 1.6.18 and 1.6.22.
Referral should be to a healthcare professional, usually in secondary care, with specialist expertise in high blood pressure.
NICE clinical guideline 127 recommendation 1.6.18 recommends that clinic blood pressure that remains higher than 140/90 mmHg despite step 3 treatment with the optimal or best tolerated doses of an angiotensin-converting enzyme (ACE) inhibitor or an angiotensin II receptor blocker (ARB) plus a calcium-channel blocker (CCB) plus a diuretic should be regarded as resistant hypertension. People aged 80 years and over are considered to have resistant hypertension if their clinic blood pressure remains higher than 150/90 mmHg despite optimal or best tolerated doses of step 3 treatment.
Recommendation 1.6.22 recommends that expert advice should be sought if blood pressure remains uncontrolled with step 4 treatment of optimal or maximum tolerated doses of 4 drugs if expert advice has not yet been obtained.