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Court submission 1
Bill C-422 An Act respecting a National Lyme Disease Strategy
The Canadian Medical Association is pleased to present this submission to the House of Commons Standing Committee on Health regarding Bill C-422, National Lyme disease strategy. The Canadian Medical Association (CMA) is the national organization representing over 80,000 physicians in Canada; its mission is to serve and unite the physicians of Canada and to be the national advocate, in partnership with the people of Canada, for the highest standards of health and health care. Lyme disease is a growing problem in Canada. According to the Public Health Agency of Canada (PHAC) there were 315 cases of Lyme disease reported in Canada in 2012 -two and one-half times more cases than the 128 reported in 2009, the year that it became a reportable disease. In the Ottawa area, cases have increased almost 8 fold from 6 in 2009 to 47 in 2013. The PHAC surveillance indicates that established populations of blacklegged ticks are spreading their geographic scope, and are increasing in number, in much of southern Canada. In 2013 the US Center for Disease Control and Prevention released new estimates of Lyme disease that was 10 times higher than the previous yearly reported number of 30,000 reported cases.1 This highlights the difficulty in establishing the true burden of illness from Lyme disease. Why this matters to Canada's physicians The Canadian Medical Association supports the implementation of a national strategy that can address the breath of public health and medical issues surrounding the spread of Lyme disease in Canada. As with any new infectious disease threat, Canada needs to ensure that we are prepared to address the impact of Lyme disease on Canadians. CMA's policy on climate change and human health notes that changes in the range of some infectious disease vectors such as blacklegged ticks, are a possible consequence of climate change in Canada. Research has suggested that the tick vector of Lyme disease has been expanding into southeastern Canada which can lead to increased disease risk for those living in areas with tick populations.2 In this policy, CMA recommends that the federal government report diseases that emerge in relation to global climate change, and participate in field investigations, as with outbreaks of infectious diseases like Lyme disease, and develop and expand surveillance systems to include diseases caused by global climate change. The World Medical Association Declaration of Delhi on Health and Climate Change urges colleges and universities to develop locally appropriate continuing medical and public health education on the clinical signs, diagnosis and treatment of new diseases that are introduced into communities as a result of climate change. Diagnosis of Lyme disease can be difficult, as signs and symptoms can be non-specific and found in other conditions. 3 If Lyme disease is not recognized during the early stages, patients may suffer seriously debilitating disease, which may be more difficult to treat.4 Given the increasing incidence of Lyme disease in Canada, continuing education for health care and public health professionals and a national standard of care would improve identification, treatment and management of Lyme disease. Greater awareness of where blacklegged ticks are endemic in Canada, as well as information on the disease and prevention measures, can help Canadians protect themselves from infection. Recommendation The CMA supports a national Lyme disease strategy which includes the federal, provincial and territorial governments and the medical and patient communities. This strategy must address concerns around research, surveillance, diagnosis, treatment and management of the disease and public health prevention measures will advance our current knowledge base, and improve the care and treatment of those suffering from Lyme disease. Conclusion Once again, CMA is pleased to provide this brief to the Standing Committee on Health as part of its study on this important issue. Canada's physicians recognize the importance of monitoring all emerging infectious diseases in Canada. In addition, Canada's physicians recognize the importance of developing strategies to treat, manage, and prevent Lyme disease in Canada. 1 CDC provides estimate of Americans diagnosed with Lyme disease each year, media release August 19, 2013 Accessed at http://www.cdc.gov/media/releases/2013/p0819-lyme-disease.html on Feb 21, 2014. 2 Ogden, N., L. Lindsay, and P. Leighton. 2013. Predicting the rate of invasion of the agent of Lyme disease Borrelia burgdorferi. Journal of Applied Ecology. April, 2013. 50(2):510-518. 3 Mayo Clinic, accessed at http://www.mayoclinic.org/diseases-conditions/lyme-disease/basics/tests-diagnosis/con-20019701 on Feb 21, 2014. 4 Wormser GP, Dattwyler RJ, Shapiro ED, et al. The clinical assessment, treatment, and prevention of Lyme disease, human granulocytic anaplasmosis, and babesiosis: clinical practice guidelines by the Infectious Diseases Society of America. Clin Infect Dis 2006;43: 1089-134.
Canadian Medical Association Submission to Health Canada's Notice of proposed order to amend the schedule to the Tobacco Act
The Canadian Medical Association (CMA) is pleased to provide this submission in response to Health Canada's Notice of proposed order to amend the schedule to the Tobacco Act1, from October 14, 2014, on the restriction of the use of additives. Canada's physicians have been working for decades toward the goal of a smoke-free Canada. The CMA issued its first public warning concerning the hazards of tobacco in 1954 and has continued to advocate for the strongest possible measures to control its use. Background Flavoured tobacco products include candy or fruit flavoured products including cigarillos, water pipe tobacco, smokeless tobacco and blunt wraps. They come in flavours that are appealing to youth such as chocolate, mint, cherry, peach, or strawberry. Flavouring makes the tobacco products more palatable to youth and young adult smokers because they have a lower tolerance for irritation and an underdeveloped taste for tobacco smoke.2 Menthol is a long standing and common flavour used in cigarettes and is used to reduce the harshness of cigarette smoke. It is the most popular flavour among youth. Almost three out of 10 Canadian youth who smoked cigarettes in the last 30 days (29 per cent) reported smoking menthol cigarettes.3 Tobacco Use and Youth While tobacco use has declined in Canada we must remain vigilant in our efforts to reduce smoking rates. Today 16 per cent of Canadians continue to smoke on a regular basis and physicians are particularly concerned about the smoking prevalence among young adults and youth with 20 per cent of those aged 20-24, and 11 per cent of youth aged 15-19 currently smoking on a regular basis. 4 Flavoured tobacco products, with their appeal to young Canadians are a major threat to the health and well-being of our youth. A recent report, Flavoured Tobacco Use: Evidence from Canadian Youth based on the 2012/13 Youth Smoking Survey, shows that young people are using flavoured tobacco products at high levels. Results show that 50 per cent of high school students in Canada who used tobacco products in the previous 30 days used flavoured tobacco products.5 Previous Amendments Regarding Flavouring Agents The CMA supported efforts of the federal government in 2009 to limit the addition of flavouring agents to tobacco products through the 2010 Act to Amend the Tobacco Act. But the Act did not cover all tobacco products and it excluded menthol as a flavouring agent. Manufacturers have been able to modify the weight and packaging of their products to technically comply with the Act while they continue to market flavoured products. CMA Recommendations It is the CMA's position that the federal government has an important role in smoking cessation and prevention among youth. The CMA supports the proposed extension of the prohibitions on the use of certain flavouring additives in relation to the manufacture and sale of little cigars to cigars weighing more than 1.4 g but less than 6 g. The CMA remains very concerned that these amendments do not ban menthol flavouring in tobacco products. To that end, the CMA recommends that Health Canada extend its prohibition on flavouring additives to include a ban on the addition of menthol in all tobacco products. 1 Health Canada. Notice of proposed order to amend the schedule to the Tobacco Act. October 14, 2014. Accessed at: http://www.hc-sc.gc.ca/hc-ps/consult/_2014/tobacco-act-loi-tabac/index-eng.php 2 Carpenter CM, Wayne GF, Pauly JL, Koh HK, Connolly GN. New cigarette brands with flavors that appeal to youth: Tobacco marketing strategies: Tobacco industry documents reveal a deliberate strategy to add flavors known to appeal to younger people. Health Affairs 2005;24(6):1601-1610. 3 Manske SR, Rynard VL, Minaker LM. 2014 (September). Flavoured Tobacco Use among Canadian Youth: Evidence from Canada's 2012/2013 Youth Smoking Survey. Waterloo: Propel Centre for Population Health Impact, 1-18. cstads.ca/reports. 4 Canadian Tobacco Use Monitoring Survey 2012 , accessed at http://www.hc-sc.gc.ca/hc-ps/tobac-tabac/research-recherche/stat/ctums-esutc_2012-eng.php. 5 Manske SR, Rynard VL, Minaker LM. 2014 (September). Flavoured Tobacco Use among Canadian Youth: Evidence from Canada's 2012/2013 Youth Smoking Survey. Waterloo: Propel Centre for Population Health Impact, 1-18. cstads.ca/reports. Minaker L, Manske S, Rynard VL, Reid JL & Hammond D. Tobacco Use in Canada: Patterns and Trends, 2014 Edition - Special Supplement: Flavoured Tobacco Use. Waterloo, ON: Propel Centre for Population Health Impact, University of Waterloo. --------------- ------------------------------------------------------------ --------------- ------------------------------------------------------------ Canadian Medical Association 2 November 10, 2014
Canadian Medical Association Submission to the House of Commons Study on E-Cigarettes
On behalf of its more than 82,000 members and the Canadian public, CMA performs a wide variety of functions. Key functions include advocating for health promotion and disease prevention policies and strategies, advocating for access to quality health care, facilitating change within the medical profession, and providing leadership and guidance to physicians to help them influence, manage and adapt to changes in health care delivery. The CMA is a voluntary professional organization representing the majority of Canada's physicians and comprising 12 provincial and territorial divisions and 51 national medical organizations. The Canadian Medical Association (CMA) is pleased to provide this submission to the House of Commons Health Committee for its study on e-cigarettes. Electronic cigarettes, or e-cigarettes, which replicate the act and taste of smoking, but do not contain tobacco, are growing rapidly in popularity. The tube of an e-cigarette contains heat-producing batteries and a chamber holding liquid, mainly propylene glycol. When heated, the liquid is turned into vapour which is drawn into the lungs. Ingredients vary by brand but many contain nicotine. Flavourings are also added with the intention of boosting their appeal to young people. Issues have been identified with labelling of e-cigarettes, where upon inspection, there have been contaminants, and nicotine has been detected in products labeled without nicotine.1 Users are generally able to modify the contents of e-cigarettes, with the addition of other substances, including marijuana. Originally most e-cigarette manufacturers were small entrepreneurial companies; now, however, all major transnational tobacco companies are also producing e-cigarettes and competing for a share in the market. There are little data on Canadian use. In the U.S., one in five adult smokers has tried them, according to the Centers for Disease Control and Prevention2. Current Regulatory Status Health Canada issued a warning in 20093 about the potential dangers and the fact that e-cigarettes had not been fully evaluated for safety, quality and efficacy. The sale of e-cigarettes containing nicotine is currently illegal in Canada under the Food and Drugs Act regulations4 though they can still be purchased in the US or over the Internet. However, those that do not make any health claim and do not contain nicotine may legally be sold in Canada under the same regulation. Health Canada is considering additional regulatory measures but none have yet been introduced. Some municipal jurisdictions are also considering regulation changes. Internationally, regulation of e-cigarettes is just beginning, and approaches vary. A few countries - such as Brazil, Norway and Singapore - have banned them outright. France plans to regulate e-cigarettes in the same way as tobacco products, and the US Food and Drug Administration is considering a similar approach. On the other hand, Britain will regulate e-cigarettes as non-prescription drugs starting in 2016.5 Health Implications Current evidence is insufficient to estimate the health effects of e-cigarettes. There are both defenders and opponents, though their arguments are based largely on opinion since e-cigarettes are only beginning to undergo rigorous clinical testing.6 Proponents, including some health officials and groups, say they are safer than tobacco cigarettes since they do not contain the tar and other toxic ingredients that are the cause of tobacco related disease.7 Some believe they serve a useful purpose as a harm reduction tool or cessation aid, although marketing them as such is not permitted since that claim has never been approved by Health Canada. Opponents are concerned that the nicotine delivered via e-cigarettes is addictive and that the e-cigarettes may contain other toxic ingredients such as nitrosamines, a carcinogen. Also, they worry that acceptance of e-cigarettes will undermine efforts to de-normalize smoking, and that they may be a gateway to use of tobacco by people who might otherwise have remained smoke-free.8 The use of flavouring agents and attractive packaging could entice children and youth, and survey data in some countries has shown that teens are increasingly experimenting with e-cigarettes. There has also been a dramatic increase in cases of nicotine overdose by ingestion or through dermal contact, particularly in children.9 The number of these incidents seems to be rising in countries that monitor poisonings. The World Health Organization recently released a report on the health impacts of electronic nicotine delivery systems (ENDS) use which incorporates the 2013 deliberations and scientific recommendations by the WHO Study Group on Tobacco Product Regulation. It concludes that "ENDS use poses serious threats to adolescents and fetuses. In addition, it increases exposure of non-smokers and bystanders to nicotine and a number of toxicants." The report says that it is possibly less toxic for the smoker than conventional cigarettes but it is unknown by how much.10 This report suggests that governments should have the following regulatory objectives: * impede the promotion and uptake of e-cigarettes with nicotine by non-smokers, pregnant women and youth; * minimize potential health risks to e-cigarette users and non-users; * prohibit unproven health claims from being made about e-cigarettes; and * protect existing tobacco-control efforts from commercial and other vested interests of the tobacco industry.11 Given the absence of solid evidence of harms or benefits, CMA recommends that: 1. E-cigarettes containing nicotine should not be authorized for sale in Canada. 2. The sale of all e-cigarettes should be prohibited to Canadians younger than the minimum age for tobacco consumption in their province or territory. 3. Smoke-free policies should be expanded to include a ban on the use of e-cigarettes in areas where smoking is prohibited. 4. Research on the potential harms and benefits of electronic cigarette use should be supported. 1 Institut national de santé publique du Québec (INSPQ). (Mai 2013). La cigarette électronique: état de situation. Available : http://www.inspq.qc.ca/pdf/publications/1691_CigarElectro_EtatSituation.pdf 2 Centers for Disease Control and Prevention. About one in five U.S. adult cigarette smokers have tried an electronic cigarette. Centers for Disease Control and Prevention Press Release. February 28, 2013 Available: http://www.cdc.gov/media/releases/2013/p0228_electronic_cigarettes.html (accessed October 31, 2014) 3 Health Canada. Health Canada Advises Canadians Not to Use Electronic Cigarettes (archived). Available: http://www.healthycanadians.gc.ca/recall-alert-rappel-avis/hc-sc/2009/13373a-eng.php (accessed October 31, 2014) 4 Health Canada. Notice - To All Persons Interested in Importing, Advertising or Selling Electronic Smoking Products in Canada. Available: http://www.hc-sc.gc.ca/dhp-mps/prodpharma/applic-demande/pol/notice_avis_e-cig-eng.php (accessed October 31, 2014) 5 Kelland, K. & Hirschler, B. Insight - No smoke, plenty of fire fuels e-cigarettes. Reuters. June 13, 2013. http://uk.reuters.com/article/2013/06/13/uk-ecigarettes-insight-idUKBRE95C0F720130613 (accessed October 31, 2014) 6 Non-Smokers Rights Association. Product Regulation: The Buzz on E-Cigarettes. Available: http://www.nsra-adnf.ca/cms/page1385.cfm (accessed October 31, 2014) 7 Weeks, C. Could e-cigarettes save smokers' lives? Some health advocates think so. The Globe and Mail April 29, 2013. Retrieved from http://www.theglobeandmail.com/life/health-and-fitness/health/could-e-cigarettes-save-smokers-lives-some-health-advocates-think-so/article11583353/?cmpid=rss1 8 Toronto Public Health. E-cigarettes in Toronto. Staff report to the Toronto Board of Health. August 1, 2014. Available: http://www.toronto.ca/legdocs/mmis/2014/hl/bgrd/backgroundfile-72510.pdf (accessed October 31, 2014). 9 Centers for Disease Control and Prevention. Notes from the Field: Calls to Poison Centers for Exposures to Electronic Cigarettes - United States, September 2010-February 2014. Morbidity and Mortality Weekly Report, 63(13): 292-293. April 4, 2014. Available: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6313a4.htm?s_cid=mm6313a4_w (accessed October 31, 2014). 10 World Health Organization. Electronic nicotine delivery systems. Conference of the Parties to the WHO Framework Convention on Tobacco Control. Sixth session Moscow, Russian Federation, 13-18 October 2014. Provisional agenda item 4.4.2. Available: http://apps.who.int/gb/fctc/PDF/cop6/FCTC_COP6_10-en.pdf?ua=1 11 Ibid.
Improving Seniors Care in an Era of Surplus. 2014-2015 Pre-budget Brief
"The 2014-15 budget signals the end to a tough but necessary period of fiscal consolidation. Current expectations are for a surplus of $6.4-billion in 2015-16, plus a contingency reserve of $3-billion; there is finally some room to manoeuvre in the years ahead." Glen Hodgson, Senior VP and Chief Economist Conference Board of Canada - February 2014 Having emerged from the global economic downturn, now is the time for the federal government to make strategic investments that will ensure Canada's long-term economic sustainability. The ageing of Canada's population is the most pressing policy imperative of our time. As highlighted in Finance Canada's 2012 report, Economic and Fiscal Implications of Canada's Ageing Population, action to prepare for an ageing population will support the sustainability of Canada's public finances and social programs. The CMA's recommendations for the 2014-15 federal budget focus on strategic investments in three key areas: 1. Supporting Canadian families and seniors A) Pan-Canadian Seniors Strategy The CMA is concerned that Canada is ill-prepared for the demographic shift already underway. By 2036, it is expected that a quarter of Canada's population will be over age 65; almost double the proportion of today. Already, patients aged 65 and older account for nearly half of Canada's health care spending. Seniors also face challenges accessing health services across the continuum of care. These challenges are getting worse, despite growing efforts to provide sustainable, high-quality health care for seniors, and despite most provinces having seniors care strategies in place. Canadians share our concern. According to an Ipsos Reid poll commissioned by the CMA, a majority of respondents (83%) said they were concerned about their health care in their retirement years. This poll found that nine out of ten Canadians (93%) believe Canada needs a national strategy for seniors health care that integrates home care, hospitals, hospices, and long-term care facilities into the continuum. Recommendation: The CMA recommends that the federal government provide targeted funding to support the development of a pan-Canadian strategy to address the needs of the aging population. B) Incenting savings for future continuing care needs According to the Organization for Economic Cooperation and Development (OECD), long-term care spending in Canada averaged 1.2% of GDP over the 2006-10 period and could more than double to 2.5% by 2060. The Canadian Life and Health Insurance Association estimates there will be an unfunded long-term care liability of $590 billion over and above existing government programs as the boomer generation passes through their old age1. Of the approaches available to address this unfunded liability, encouraging and incentivizing individuals to save for their future continuing care needs is the least demanding of public finances as compared with increased personal or business income taxes or mandatory contributions. There has been increasing interest among Canadians with focused savings vehicles established by the federal government. There continues to be increased uptake with Registered Education Savings Plans (RESPs) to support post-secondary education. The growth in RESP assets was significant in 2011 and 2012, representing an average annual rate of 12.6%.2 There has also been increased uptake in the use of tax sheltered individual savings vehicles, such as the Tax Free Savings Account (TFSA). According to a Finance Canada report, as of 2011 there were 8.2 million individuals with a TFSA, representing 31% of tax filers, and they contributed $30.7 billion in that year. The report noted that the greatest proportionate growth in TFSA uptake was observed among those with incomes of less than $20,000, with their participation rate almost doubling from 11% in 2009 to 20% in 20113. Recommendation: The CMA recommends that the federal government use its economic levers to encourage Canadians to save over their lifetime for future continuing and long-term care needs not covered under the Canada Health Act. C) Promoting Healthy Ageing The Public Health Agency of Canada (PHAC) defines healthy ageing as "the process of optimizing opportunities for physical, social and mental health to enable seniors to take an active part in society without discrimination and to enjoy independence and quality of life." Such initiatives could focus on: * Physical activity - 57% of seniors in 2008 reported being physically inactive4; * Injury prevention - 40% of admissions to nursing homes, 62% of injury-related hospitalizations, and almost 90% of hip fractures are due to falls by seniors5; * Nutrition - 28% of men and 31% of women over 65 were obese (BMI = 30); this is higher than the population average. Underweight is also a problem among seniors, 17% of whom report a BMI of 20 or less6. The federal government has already undertaken steps to address healthy ageing among Canada's seniors, such as 'Seniors: Active. Engaged. Informed'. In funding over 13,000 projects across Canada, the New Horizons for Seniors Program has demonstrated success in enabling new programs to achieve specific goals; this program can be harnessed to deliver projects focused on promoting healthy ageing. Recommendation: The CMA recommends that the New Horizons for Seniors program be expanded by $5 million per year to include funding for programs promoting healthy ageing activities for Canadian seniors. 2. Ensuring the availability and access to continuing care "When we poll CARP members, they call for leadership in helping Canadians save for retirement, get home care when they need it and get access to affordable drug." Susan Eng, VP, Advocacy for CARP - February 2014 A) Addressing the Continuing Care Infrastructure Crisis A major issue facing health care systems across the country is the high number of alternate level of care patients (ALC) in acute care hospitals. ALC patients-many of whom are seniors-are those who have completed the acute care phase of their treatment but remain in an acute care bed or who are admitted into a hospital bed due to the lack of more appropriate assisted living settings. The CMA supports efforts to allow Canadian seniors to remain in the community as long as possible. However, there are increasing pressures on the continuing care sector given the rise in the number of seniors with complex health and social needs. These pressures not only relate to the construction of new facilities, including assisted living units and other innovative residential models for seniors, but apply as well to the need to upgrade and retrofit existing facilities7. Despite increasing the availability of home care, Canada will face a significant infrastructure shortage in the continuing care sector. The CMA estimates this infrastructure shortage costs the health care system about $2.3 billion a year; this cost is estimated to skyrocket as our population ages. Recommendation: The CMA recommends the federal government deliver $2.3 billion in funding to leverage provincial/territorial strategic investment in the construction, renovation and retrofitting of assisted living units, other innovative residential models, and long-term care facilities. B) Supporting Caregivers The 2011 Budget introduced a new non-refundable Family Caregiver Tax Credit to provide tax relief to those who provide informal care for a dependent relative within their home. However, the credit is limited to 15% of a maximum $2,040 in expenses for 2013 or a maximum sum of $306. While this credit can be added to other tax credits, the total amount is small in relation to the burden experienced by caregivers and it remains non-refundable. The CMA is concerned that the scarcity of financial support and programs supporting caregivers represents significant risks in relation to economic costs, lower productivity, impacts on the labour market, inefficiencies within the health care system and, most importantly, patient care. Informal caregivers are the backbone of any health care and social care system. The work of the 1.5 to 2 million caregivers in Canada is estimated at $25-26 billion annually, while incurring $80 million dollars annually in out-of-pocket costs8. The role of informal caregivers will only increase with the move to providing more care at home. Recommendation: The CMA recommends the federal government make the Family Caregiver Tax Credit a refundable tax credit as part of an effort to better support informal caregivers. 3. Accelerating innovation in health care through enhanced use of electronic medical records (EMRs) "The need for innovation ..., both in terms of medical technologies and healthcare delivery systems, is one of the most pressing public policy challenges of our times." Hon. Rona Ambrose, Health Minister - January 2014 The CMA supports prioritizing continuing the development and meaningful use of electronic medical records (EMRs). A recent report estimates the costs of a pan-Canadian electronic health record (EHR) between $7.9 billion and $16.0 billion9 while total gross savings over a 20-year range were projected at over $82 billion. To date, approximately $2.1 billion in federal funding has been invested. Five national benefit evaluation studies have been commissioned since 2008 and these analyses estimated $7.7 billion in benefits to date as a result of this investment10. This initial investment has resulted in digitized health care information and paper processes, and created a robust marketplace for innovation by EMR vendors. As such, the value of investments in EMRs is emerging. The 2013 National Physicians Survey11 indicated that: * Almost 70% of medical general practitioners (GPs) and specialists now use an EMR, up from 56% in 2012 and 37% in 2009. * 45% of GPs and 40% of specialists report increased or greatly increased efficiency due to the use of EMRs. * 63% of GPs and 50% of specialists report the quality of patient care they provide is better or much better since they started using an EMR. The next step in the evolution of EMRs is enhanced use. In Canada, federal investment does not extend beyond the equivalent of the first stage of the U.S. framework for Meaningful Use. There remain significant gaps in funding to achieve enhanced use of EMRs by clinicians, regional interoperability, and to structure EMR data to leverage big data analytics. Recommendation: The CMA recommends the federal government continue to fund Canada Health Infoway (CHI) to administer remaining project funds from the $500 million allocated in 2009, and allocate an additional $500 million, to be administered by CHI, for projects to achieve enhanced use of EMRs. 1 Canadian Life and Health Insurance Association. Helping Canadians prepare for long-term care costs. CLHIA report on long-term care policy. 2014. 2 Employment and Social Development Canada. 2012 CESP Annual Statistical Review. http://www.esdc.gc.ca/eng/jobs/student/reports/statistics/cesp_2012.shtml#h2.4-h3.1 3 There is a detailed analysis of the TFSA in the 2012 Tax Expenditures and Evaluations report by Finance Canada (Pages 31-42 in http://www.fin.gc.ca/taxexp-depfisc/2012/taxexp-depfisc12-eng.pdf). 4 PHAC 2010 5 PHAC 2010 6 PHAC 2010 7 Canadian Medical Association, The Need for Health Infrastructure in Canada. Submitted to Hon. Denis Lebel, PC, MP Minister of Transport, Infrastructure and Communities. March 18, 2013. 8 Hollander, M.J, Liu, G., Chappeell, N.L. (2009). Who cares and how much? The imputed economic contribution to the Canadian health care system of middle aged and older unpaid caregivers providing care to the elderly. Healthcare Quarterly, 12(2), 42-59. 9 https://www.infoway-inforoute.ca/index.php/resources/video-gallery/doc_download/86-canada-health-infoway-s-10-year-investment-strategy-vol-3 10 Remote Patient Monitoring (RPM) Evaluation; EMR Evaluation; Telehealth evaluation; Drug Information Systems (DIS) evaluation; Diagnostic Imaging (DI) systems evaluation 11 http://nationalphysiciansurvey.ca/wp-content/uploads/2013/10/2013-National-ENr.pdf
Submission to Advisory Panel on Healthcare Innovation
Since 2010, the Canadian Medical Association (CMA) has been calling for health care transformation in Canada to better meet the needs of Canadians. A high performing health care system must be able to respond to the changing nature of its population's health needs. The CMA believes that seniors care is the paramount health care issue of our time. Our older population will double over the next 20 years, while the 85 and older group is set to quadruple. Currently, we spend almost half of all our health care dollars on seniors. Improving seniors' care will go a long way to fixing our health care system; this is because strategies to address the needs of this population can be leveraged to address the needs of other population groups. That is why CMA has called for the development of a Pan-Canadian Seniors Strategy as a necessary first step. The CMA welcomes the creation of the Advisory Panel on Healthcare Innovation to better prepare health systems across the country for the above challenges and to contribute toward the sustainability of Canada's public finances and social programs. This brief identifies five important innovations that will not only benefit Canada's growing seniors population but the broader Canadian population as well. Five Innovations to Improve our Health Care System 1. Supportive living models and palliative care Canada suffers from a lack of integrated community/residential supports and palliative care models, contributing to poor patient outcomes, significant inappropriate use of health care resources, and higher health care costs. An obvious sign of this gap is the significant number of alternate-level-of care (ALC) patients-most of whom are seniors-languishing in hospitals across Canada. ALC patients are those inpatients that no longer require acute care and are waiting for placement in a more appropriate setting. According to a 2009 Canadian Institute for Health Information (CIHI) report, dementia accounted for almost one-quarter of ALC hospitalizations and more than one-third of ALC days.i Dementia is the leading cause of dependency and disability among older persons. The Wait Time Alliance (WTA) has stated that the most important action to improve timely access to specialty care for all Canadians is by addressing the issue of alternate-level-of-care (ALC) patients.ii The creation of supportive and integrated living models particularly for the frail elderly and those with dementia would lead to improved health outcomes for these patients as well as savings to the health care system. * Supportive living models can involve providing technology and human resources to support seniors to stay in their home. It has been estimated that tele-homecare could yield an annual reduction in approximately $540 million in inpatient costs and $23 million in emergency department visit costs.iii * For others, particularly those with dementia, residential care models are required that can properly support their needs and provide the highest quality of life possible. A few such models are already in existence but more are required. Models include the Bruyère Village in Ottawa (http://www.bruyere.org/bruyere-village) and Saskatoon's Sherbrooke Community Centre (http://www.sherbrookecommunitycentre.ca/). CMA recommends that federal and provincial infrastructure programs allow for innovative residential care options to be eligible for funding. * Despite the vast majority (96%) of Canadians supporting the use of palliative and hospice care in end-of-life care, only 16-30% of Canadians who are dying have access to or receive hospice, palliative and end-of-life servicesiv. This issue must be addressed immediately across the country. Currently, there is no standard palliative and hospice care model in Canada. However, there are some innovative programs around the country that are leading the way to higher quality palliative care (e.g., West Island Palliative Care Residence in Quebec). The CMA is currently preparing a report to inform health care decision makers including physicians on tools to integrate palliative and hospice care services in their respective communities. But assistance is required to implement innovative practice models across the country. 2. Integrated strategies for high-users of health care and at-risk populations It is now recognized that a targeted approach is necessary to make substantive change to improve the health status of populations; including reducing health inequities and ensuring more appropriate access to health care resources by those citizens who have a range of socio-economic needs. Approximately five percent of patients account for two-thirds (66 percent) of provincial health expenditures-many of whom are elderly. This picture is consistent across the country.v This high use is often due to systemic issues, such as poor integration or lack of access, rather than the choices of these patients. There is general agreement that multi-sectoral approaches are necessary that involve the integration of clinical and social care as well as other sectors to best address this population group that often has polymorbidities. Programs are being implemented in a few provinces at the regional or provider level to try and accommodate the needs of the high-users population by coordinating and integrating care for the benefit of the patient and the family. Examples include Health Links in Ontario and the Regional Integrated Complex Patient Care Planning (RICP2) program at Vancouver Coastal Health Authority. However, funding models-particularly for inter-sectoral approaches-to support the wide-spread adoption of these approaches are rare. In addition to the high-users are those populations that feature a high burden of illness. Hundreds of research papers have confirmed that people in the lowest socio-economic groups carry the greatest burden of illness.vi Those within the lowest socio-economic status are 1.4 times more likely to have a chronic disease, and 1.9 times more likely to be hospitalized for care of that disease.vii As with the high-user group, a multi-sectoral approach is required to address the social determinants of health. While it is important for society to strive to eliminate poverty and provide adequate housing and food security, the health care sector can also contribute. Some innovative programs have been put in place such as the Well North program in the United Kingdom that is targeted at improving the health of the poorest fastest, reducing premature mortality and reducing worklessness.viii In Canada, the St. Michael's family health team has an income security specialist on their multi-disciplinary team. This individual helps patients to navigate the government's social services system, will help patients reduce expenses, complete their taxes, set up bank accounts, access free programs, budget and save for emergencies. These patients are identified through screening conducted by family physicians on the team. There are innovative approaches being developed to address the needs of high-volume users as well as at-risk populations. As many of these innovations involve greater integration between health and the community sector and attention to issues not traditionally funded through health care payment systems, there is a need to provide access to funds to enable these innovations to continue and be spread across the country. A targeted, integrated approach to identify communities in need is required and this must be based on reliable community data (i.e., meaningful use of patient data) which can be used to integrate resources to improve health status. The Canadian Primary Care Sentinel Surveillance Network (CPCSSN) is Canada's first multi-disease electronic medical records (EMR) surveillance and research system that allows family physicians, epidemiologists and researchers from across the country to better understand and manage chronic care conditions for their patients. Health information is collected from EMRs in the offices of participating primary care providers (e.g. family physicians) for the purposes of improving the quality of care for Canadians suffering from chronic and mental health conditions and three neurologic conditions including Alzheimer's and related dementias. CPCSSN makes it possible to securely collect and report on vital information from Canadians' health records to improve the way these chronic diseases and neurologic conditions are managed (http://cpcssn.ca/). Despite this innovative approach to sharing information to better manage chronic care conditions, its five-year federal funding terminates in 2015. The estimated cost of continuing the project is approximately $3 million per year. 3. Optimal prescribing Poor prescribing can lead to poor patient outcomes and unnecessary costs to the health care system (e.g., fractured hips from falls). The evidence is clear that many seniors in Canada are exposed to inappropriate drug therapy. Data from European countries such as Denmark, , show that inappropriate prescribing can be controlled with only 5.8% of elderly patients using an inappropriate medication in a four month period in 2001. In Canada, CIHI studied senior's drug claims from public programs in four provinces from 2000 to 2006 and found that the rate of inappropriate drug use in 2005-06 varied from 25.2% in Manitoba to 31.3% in New Brunswick. The rate of regular use of such medications ranged from 12.9% in Alberta to 18.8 % in New Brunswick. E-prescribing decreases the likelihood of adverse drug events or interactions, and provides tools to monitor both patient adherence and practitioner prescribing patterns. One component of an optimal prescribing strategy would be to provide support to provincial/territorial ministries of health to complete the implementation of drug information systems and regional e-prescribing solutions, and/or to develop an agenda to accomplish the enhanced use of electronic medical records. A second component of an optimal prescribing initiative would be the development of a collaboration of content experts and professional associations to raise awareness of inappropriate prescribing among physicians and other health professionals and then to develop online educational courses and practice tools to assist at the point of care. Initially the focus might be on prescribing for seniors, but subsequently could expand to cover other priority topics such as inappropriate antibiotic use or the use of narcotics for non-cancer pain. 4. Choosing Wisely Canada - Reducing the provision of low value care A disconcerting proportion of health care, estimated in the United States to be as much as 30%, confers little of no benefit on patients and may, through exposure to excess radiation, drug reactions, adverse events during procedures, or the worry associated with false positive tests, actually cause harm. This represents both sub-optimal quality of care and poor stewardship of scarce health care resources. The provision of unnecessary care is driven by many elements including physician habit, lack of up-to-date clinician knowledge, patient demand, and structural or financial incentives in the health system. To counter these diverse influences the CMA partnered with the University of Toronto to launch Choosing Wisely Canada, a campaign to facilitate evidence-informed conversations between physicians and patients about the necessity of tests and treatment about low-value tests and treatment. As of October 2014, 102 recommendations have been developed by national specialty societies about clinical activities that generally should be avoided. For example, the Canadian Geriatrics Society advises physicians and patients against the use of antipsychotics as a first choice to treat behavioural and psychological symptoms of dementia as well as against the use of benzodiazepines or other sedative-hypnotics in older adults as a first choice for insomnia, agitation or delirium. Within its first year of operation the campaign enlisted over 30 national specialty societies, the College of Family Physicians of Canada, the Royal College of Physicians and Surgeons of Canada, all provincial and territorial medical associations, and six large citizen groups. To date the campaign has been resourced by seed funding from the Ontario government, direct contribution from the CMA, and a modest contribution agreement from Health Canada. If the early success of Choosing Wisely Canada is to be sustained, secure long-term funding is essential. Such resources are necessary to support the development and dissemination of materials to raise physician awareness, provide educational opportunities, make available point-of-care tools, assist with implementation at the practice level, and contribute to data collection for evaluation. The medical professional has clearly stepped forward to take ownership of the low value care challenge; they deserve federal support to ensure a successful long-term outcome. 5. National Health Care Guidance Institute Clinical practice guidelines (CPGs) have a unique ability to enhance quality of care. The peer-reviewed literature provides robust evidence that guideline use is associated with a positive impact on both processes of care and patient outcomes. Additionally, a number of studies have reported that the application of specific CPGs result in cost-effective care, including, for example, those used in the treatment of community-acquired pneumonia, stroke prevention in primary care, traumatic brain injury, and the use of lipid-lowering drugs. Conditions such as these gain particular significance in the face of an aging population: what is the out-patient antibiotic of choice in an elderly patient with pneumonia?; in an older patient with a cardiac arrhythmia what are the comparative risks of treatment with anticoagulants versus possible cerebrovascular accident?; at what age is it no longer helpful to treat hyperlipidemia? CPGs available at the point of care provide evidence-based answers to such questions. Internationally, national governments have recognized the value of CPGs and taken a leadership role in ensuring their quality and making them available to practitioners. Three among many examples are: United States (Agency for Healthcare Research and Quality, National Guideline Clearinghouse); United Kingdom (National Institute for Health and Clinical Excellence); and Australia (National Health and Medical Research Council, National Institute of Clinical Studies). The challenge is that CPGs are not uniformly utilized across Canada nor do we possess a national body or systematic approach to CPG development and dissemination. There are various models that can be implemented to execute this function (e.g., full function agency, collaborative virtual agency) to perform such key functions as prioritizing areas for guideline development, maintaining a national repository and driving active dissemination. The key is having a dedicated agency that can oversee the development and dissemination of CPGs at a pan-Canadian level to improve the quality of care that Canadians receive. Federal mechanisms to support health innovation All health systems in Canada and elsewhere are facing the challenge to better meet the needs of their seniors' population. National governments can provide necessary direction and support. The federal government must play a leadership role on seniors care and supporting health care innovation in concert with the provinces and territories and as a system manager itself for those patients falling under federal jurisdiction (e.g., armed forces). This can begin with a First Ministers' Conference as part of the development of a Pan-Canadian Seniors Strategy. CMA recognizes there are elements of transformation already taking place in the country across the continuum of care that are being supported by technological innovation or clinical innovation (e.g., Choosing Wisely Canada). However, in many cases, there is little funding available to fund projects beyond pilot project status or bring them up to scale, and there is very little cross-country awareness of these "pockets of excellence" due to the absence of mechanisms to share best practices. Accordingly, CMA recommends the establishment of a National Health System Innovation Fund targeted to provinces and territories to support the adoption of health system innovations including those identified in this brief. Funding criteria should be designed to not only support the development of these innovations but to incent their adoption on a scaled-up basis. Finally, recognizing the relationship of the social determinants of health on the demands of the health care system, the federal government should implement a requirement for all cabinet decision-making to include a health-in-all policies approach whereby all polices from tax, to transportation, to trade would undergo a health lens to ensure that negative health impacts were minimized/eliminated and positive health outcomes were supported or expanded. This would help to minimize the often unintended health consequences that arise from policies outside of the health sector. Conclusion This brief identifies five opportunities for innovating Canada's health care system by improving seniors care-the paramount health care issue of our time. Our proposed innovations would not only improve the efficient delivery of health care but more importantly the quality of care provided to all Canadians. These innovation initiatives require medical leadership at the point of care level in tandem with change at the broader system level with federal support. Together, these innovations can further contribute to the transformation of Canada's health care system-one that better meets the needs of Canadians today and into the future. i Canadian Institute for Health Information. Alternate level of care in Canada. Ottawa (ON): The Institute; 2009. Available: https://secure.cihi.ca/free_products/ALC_AIB_FINAL.pdf ii Wait Time Alliance, Shedding light on Canadians' total wait for care. Report card on wait times in Canada. June 2012. iii Telehealth Benefits and Adoption: Connecting People and Providers Across Canada. Praxia and Gartner. May, 30, 2011. iv Canadian Hospice Palliative Care Association. 2014. Fact sheet: hospice palliative care in Canada. [Accessed 11 November 2014]. Available from http://www.chpca.net/media/330558/Fact_Sheet_HPC_in_Canada%20Spring%202014%20Final.pdf v Canadian Institute for Health Information. Pan-Canadian forum on high users of health care-Summary report. The Institute: 2014. vi Dunn, James R. (2002) The Health Determinants Partnership Making Connections Project: Are Widening Income Inequalities Making Canada Less Healthy? Available at: http://www.opha.on.ca/our_voice/collaborations/makeconnxn/HDP-proj-full.pdf vii CIHI/CPHI (2012) Disparities in Primary Health Care Experiences Among Canadians with Ambulatory Care Sensitive Conditions. http://secure.cihi.ca/cihiweb/products/PHC_Experiences_AiB2012_E.pdf viii http://www.healthscotland.com/uploads/documents/12107-WhatIsWellNorth.pdf


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On the Level: Determine what's causing dry-nail pops
Rick Hutzell: Being editor of Capital Gazette has been a job I love, but it's time to say goodbye. | COMMENTARY
Fort Meade: Preparing for U.S. census before April 1 deadline
Tom Muha: Feeling 'in love' is deeply misunderstood. Here's why.
'They were just getting started': Family, friends mourn newlyweds killed in Valentine's Day crash
Habitat for Humanity brings a new Annapolis neighbor to Clay Street
Fried twice, prayed over it and 'sent it up to God': Bowie comedian hails Popeyes chicken sandwich in commercial
Anne Arundel police officer who allegedly put his knee on a suspect's neck challenges recommendation he be fired
Navy-Uconn football at a glance
Bill Wagner discusses Navy's upcoming game with Connecticut.
NAVY KEY: Establish the fullback dive; hit a few big plays
The Midshipmen have been effective running the fullback up the middle. Starter Chris Swain is averaging 124.5 yards through two games while backup Quentin Ezell has contributed 44.5 yards per game. That must continue against a stout Connecticut defense that will be looking to take away the No. 1 element of the triple-option. UConn has a pair of huge defensive tackles and will be trying to clog the middle, forcing quarterback Keenan Reynolds to take the ball outside. The Midshipmen cannot become one-dimensional and allow the Huskies to flow defenders to the perimeter. It figures to be tough sledding against the nation's fifth-ranked rushing defense and the Mids will probably need to produce a few big plays. It would be huge if Reynolds could connect on a couple deep passes to keep the secondary honest.
CONNECTICUT KEY: Run the ball and control possession
Connecticut's formula for success is centered on ball control, a tactics that is normally a Navy specialty. The Huskies held the ball for 39 minutes against Army and also won the time of possession battle against No. 25 Missouri last Saturday. Coach Bob Diaco knows playing keep-away is the best method of defending Navy's triple-option offense. Navy must find a way to slow the power running game of UConn that features 226-pound tailback Ron Johnson. Possessions will probably be at a premium in this one and both offenses must capitalize on scoring opportunities.
INJURY REPORT: Navy – Starting left guard E.K. Binns (elbow) and backup outside linebacker Myer Krah (leg) are out. Connecticut – Starting outside linebacker Marquise Vann (leg) is questionable. Backup wide receiver Dhameer Bradley (leg) is out.
[More from sports] How a former NBA assistant and a passion for basketball brought Serbian twins Milos and Veljko Ilic to Loyola Maryland »
SERIES HISTORY: Navy leads 6-1 with five of those wins coming from 1975 through 1979 when Connecticut played at the Division I-AA level. This marks the first meeting between the schools since 20006.
OF NOTE: It is a season full of firsts for Navy, which is making its debut as a football-only member of the American Athletic Conference. This is the first conference road game for the Midshipmen and coach Ken Niumatalolo is eager to see how his troops react.
"That's definitely something we want to see. We've got a lot of first-time starters, a lot of inexperienced guys. This will be their first time playing on the road as a starter. We have to get ready for a good team that's playing well and could easily be 3-0," Niumatalolo said.
Connecticut's offense features 15 starters or backups who are sophomores or freshmen. One of those youngsters is Severna Park High graduate Chris Lee, a true freshman who is listed as the backup tight end.
Navy is seeking to start a season 3-0 for the first time since 2006. The Mids have won six straight and eight of their last nine dating back to last season. Navy has not won seven straight games since 1978-79.
QUOTE-UNQUOTE: "This is a tough, hard-nosed, physical football team. You can see how they play on both sides of the ball. Coach Diaco has done a really good with their program in just two years. Mentality-wise, they have changed," Navy coach Ken Niumatalolo said.
Latest Navy
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"Great team. Special team. Best Navy team I've seen. Been playing Navy for a while now and this is the best Navy team I've seen in all three phases to date. They have a veteran group, a strong group, a talented group and they look like the stiffest competition among our first four opponents," Connecticut coach Bob Diaco said.
Ken Niumatalolo
30th annual Annapolis Spring GreenScape coming in April

redpajama_set_name: RedPajamaCommonCrawl


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Dodging the Bullet: Reflecting on Experiences as First Year Ends
Home » Features » Dodging the Bullet: Reflecting on Experiences as First Year Ends
Posted By Taylor Jo Russo on May 3, 2019 | 0 comments
Taylor-Jo Russo has come a long way since she graduated high school (Photo Taylor-Jo Russo/The Gettysburgian).
By Taylor-Jo Russo, Staff Writer
As my first-year comes to a close and with my final Dodging the Bullet piece, I find myself reflecting on all the transformative moments I have had at Gettysburg thus far. I cannot narrow down my experience to one moment or even one event, so I will instead discuss the most meaningful experiences I have had in a broader format. I realized when I was looking back on all of my favorite experiences, they all were from the opportunities I have gotten involved with thus far. So, in a listicle, I will briefly discuss in no particular order each of the organizations and clubs I am involved with and the impact that they have had on my life:
The Center for Public Service (CPS)
It all started with GIV Day. I volunteered a lot in high school and knew I was going to continue throughout my life, so GIV Day seemed like the perfect opportunity to garner a relationship with CPS. After that day and the EXPO, I learned about the programs I wanted to join and I signed up, making no excuses otherwise. I will be a Program Coordinator next year and am so excited to take my passion for service into a leadership role. CPS has made me realize my privilege, made me a better community member, but most of all has shown me support. My advice: do something bigger than yourself; CPS makes that easy.
The Office of Multicultural Engagement (OME)
My first job on campus started with an office assistant position at OME. When I applied and got the job, never did I ever expect the impact that office and the staff would have on me. Growing up in a diverse place, Gettysburg came with an adjustment and OME was that ally to help that adjustment. From the events they sponsor to the consistent welcoming environment, they have made me feel important everyday and have shown me ways to better connect with all members of the community. My advice: spend time learning about differences, OME teaches you to embrace it.
As a new tour guide and ambassador, a position I have wanted since high school, I have learned so much in such a short period of time. From communication skills to putting stress behind me and giving my all to visiting families, I have gained so much from Admissions regarding professional and life lessons. But they have also always proven to brighten my days and put a smile on my face whether that be from other student workers or the counselors themselves. My advice: remember where you came from and help others through it, we wouldn't be where we are without Admissions.
Her Campus
Her Campus is a writing and social media feminist club on campus, that has shown me the ins and outs to advertising, promoting, and supporting a national organization. I hold a secretary position which has also helped my communications skills and jump-started my path to leadership on campus. The organization promotes a supportive atmosphere while emphasizing women's roles in college spaces. My advice: join organizations that support the values that you believe in.
Honor Commission
While this organization tends to hold a lot of stigmas in particular being the campus "snitches," I have learned the most about myself and my response to others through them. Being a part of the Honor Commission has taught me that I see the best in others and realize that everyone makes mistakes. It has also shown me the importance of the Honor Code as it is what promotes the respect and trust that allows the campus to be safe enough to leave our stuff everywhere. My advice: don't shy away from opportunities based on other's opinions.
The Eisenhower Institute
While I am not interested in pursuing a public policy or political science major or minor, I am interested in pressing issues that affect all of us. I decided to apply to the Women and Leadership program this year, and while I will do a larger reflection piece about it for the news section later, I will say this has taught me the most about myself, others, life, and has given me the best support group I could've ever imagined. My advice: don't shy away from opportunities based on labels that don't exactly align with your interests.
The Gettysburgian
Last but not least, The Gettysburgian. Not only have I gotten to exercise my love for writing, but I have been able to do it in a flexible and comfortable space. I have found myself happier than ever before in an academic environment and I feel that part of it is down to the amount of reflection I have been able to do. The Gettysburgian has forced me to reflect and communicate my opinions and thoughts, which I ultimately believe has made me more grateful. My advice: reflect often and flesh out your thoughts, it relieves so much stress.
While I will be continuing with all of these activities and am hoping to add more to this list during my next three years, these organizations are what made my first-year as special and as meaningful as it was. At the end of the day, the campus has so much to offer and as long as you get involved, there is no reason to not feel as enlightened and transformed as I do. These organizations have taught me a lot about life, professions, but mostly myself. I have grown in so many ways for the better and I expect to continue to do so. I hope to gain more leadership roles as I continue to make my Gettysburg experience as great as it has been. To all incoming first-years or even current students that feel that they are missing something, get involved. It teaches you more than you can even imagine. My advice: take control of your journey.
Editor's Note: This article is part of the 2018-19 edition of our series "Dodging the Bullet: The First Year Journal," in which The Gettysburgian's staff members from the Class of 2022 share stories, reflections, and perspective on their first year experience. (-M. Neiman)
Author: Taylor Jo Russo
Taylor (Taylor-Jo) Russo '22 is a staff writer for The Gettysburgian who writes primarily for the features section where she covers current events, discussions, and more. She is from Princeton, New Jersey and loves going on adventures and trying new things. She is majoring in Psychology and Philosophy and minoring in Economics. Follow her on Instagram @taylorjorusso.


HOUSTON (March 13, 2016) — Arch-Con Construction, a design-build general construction company, is not only celebrating the opening of its Dallas office but is about to break ground on a 468,000 square foot cross-dock distribution center south of Dallas.
President and CEO Michael G. Scheurich founded Arch-Con Construction in 2000 as a company based on the design-build philosophy. Arch-Con is a combination of architecture and construction, promoting the collaborative affiliation between Arch-Con as the contractor and architect as the designer. Arch-Con strives to create an atmosphere of teamwork between the entire development team.
Arch-Con is structured into distinct and separate divisions, with a team of experts in their respective fields of retail, office, industrial, corporate interiors, hospitality and community.
It is a homecoming of sorts for Scheurich as he started his construction career in Dallas in the early 90's with projects like The Ballpark at Arlington and The Doctors Hospital at White Rock Lake.
Arch-Con's Dallas office is located in Preston Center at 8235 Douglas Ave., Suite 1000.
Arch-Con's Vice President Robert Martin leads the Office and Industrial Divisions for the Dallas office and oversees business development, estimating, project management and construction. Martin has more than 20 years of construction management experience, all in North Texas, and has completed more than $300 million in work. Martin has experience in multiple project types with projects ranging from 20,000 square feet to 1.6 million square feet.
Arch-Con is breaking ground in April on Park 20 Distribution Center in Lancaster, Texas for developer Huntington Industrial Partners. This will be a 468,000 square foot tilt-wall, cross-dock distribution center with a 32-foot clear height nestled on a 36-acre site. The architect is Meinhardt & Associates Architects, P.L.L.C.


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#33 Arlan Feiles: Come Sunday Morning
Come Sunday Morning sounds much more polished than Razing A Nation, but the themes are similar. Arlan remains true to the ideals he believes in and isn't afraid to speak out. While, at times, the music may be more upbeat than his previous release, it's still a folk album at heart; focusing on love and war, and souls seeking salvation.
Some of the most powerful songs Arlan has ever written are on this disc. One of the most impresive is "Viola," a gorgeous ballad that proves that some of the loudest voices arise from out of the quiet. Between the stunningly beautiful piano and call to arms, the song literally dares us to help change the world with a mantra that would make Martin Luther King Jr. proud.
Break these chains of silence
Break these chains of violence
We will walk these miles... and go home.
-- "Viola"
Arlan's voice transcends "I've Not The Heart To Tell Her" through spoken word and the spirit of Woody Guthrie watching on.
But the album's true masterpiece is "The Cannon's Blare." Tender piano follows the tale of a soldier longing to return home to his love.
This war is not over
And I'm afraid it's just begun
I'm feeling hung over
And I can't lift this heavy gun.
The flag's they wave higher
The cannon blare grow louder
And I just long to hold her...
-- "The Canon's Blare"
Highlights include "Come Sunday Morning," "I've Got No Choice," "Viola," "I've Not The Heart To Tell Her," and "The Cannon's Blare."
From the book Are You Listening? The Top 100 Albums of 2001-2010 by New Jersey Artists by Gary Wien


Cut the cauliflower into bite size flowerettes. Lay them onto the lined baking tray.
Slice spring onions into small 1/8" pieces and add to the baking tray.
Drizzle olive oil over the cauliflower and onions. Lightly sprinkle with sea salt and pepper.
Bake in oven for 30 minutes. Everything is done when cauliflower is fork tender. Serve while still hot.


Banquet Chef de Cuisine Simon Bowker moved to the U.S. to take on the kitchen management of a massive event space at the Fontainebleau Miami Beach. In the first part of our interview we got the lowdown on what it's like to work in Dubai, and how he handled the pressure of working in a Michelin 2-star restaurant in the UK. In this second installation, he discusses why it's a pain to feed President Obama, and that he doesn't mind slicing and dicing for the vegetarians he pities.
You've made a career out of working at extremely high end resorts, was that a conscious choice versus working at stand-alone restaurants?
I know that going for the high end hotels means the level of service and expectation are spread throughout the outlet, whether it's the banquet department or one of the signature restaurants. Everyone's got the same vision and it's just something I feel more comfortable with - working within a hotel.
You currently oversee a team of 70 people, does it take a village? What do they all do?
I can't take all the credit, I oversee to be sure that the function is rounded and executed how I want to see it. There is an Executive Pastry Chef that runs his pastry department, then there a head chef of the Garde Manger, the cold kitchen. They run their own operations, but it still boils down to me being responsible for the standards and the execution of the actual events. In my kitchen I have a Senior Sous and a Sous Chef and below that 30 cooks. If things go wrong it's on my shoulders, but when things go right I get the gratitude for it. You've got to take the rough with the smooth.
How do you manage to keep track of it all and do you feel that consistency is sometimes an issue?
It's such a big property 22 acres, 22,000 square feet of function space. To oversee all that you just need to have a lot of energy, and have your energy transpire into your team. It's a case of trying to be everywhere at once. You have to trust the people around you and the only way you can be certain of that is by ensuring that they are trained well. You've put your point and your vision across. I believe as long as your standard is in the right place that anyone who works around you or comes into contact with your operation, falls into line. If I were to be relaxed or lazy, people around you can see that straight away. That's not the way I work, and I've got a great team.
What's the biggest function you've handled at the Fontainebleau?
We did 3,100 last year for Outback Steakhouse corporate and we did S.P. Richards, which was 2,900 people. Fortunately they were just buffets. The largest plated function we've done here was 2,500, that was for Liberty Mutual Group, also last year. It's plated all while I'm there, we don't pre-box anything.
Are there any ingredients you really enjoy working with or particularly shy away from - especially working on those sized events?
To be honest, even though it's that large of a scale we avoid pre-fabbed food in general. I try not to buy frozen, you'd be surprised at how small my freezer is. Everything is as fresh as we can make it. If you buy everything in the guys you employ never learn to use a knife, never learn to cook, and you're just working in a factory. We try and find that balance between quantity needs and quality. That's not gonna happen if I start buying frozen vegetables. Our canapés are handmade, which is crazy when you think we do it for thousands of people. But people can tell the difference between frozen and freshly made when they put it in their mouth. I'm not scared of using any ingredient - there's always a way to figure it out.
I feel like scaling fresh fish for 3,000 people could be scary.
Yeah, but I get a butcher to handle that. It's scary for the butcher, not for me. My biggest hate is when people don't cook garlic properly. It needs to be cooked slowly. If it's thrown in raw and not cooked properly it winds me up. That's scary.
Any outrageous requests you've had to satisfy?
Seems people are more allergic than they ever were before. I'm sympathetic to people in those positions, though I am a bit skeptical sometimes. It's something we have to accommodate that can be a challenge when you've got to plate up to 2,000, but you need to make 10 varieties of the same dish because people can't eat certain things. I've seen it all before. When you've worked at Burj al-Arab in Dubai and the richest people in the world show up ready to pay anything for what they want, nothing's outrageous after that.
Any outlandish celebrity parties that were a challenge?
When Barack Obama comes. It's hard to get to work because the roads are closed, and it's hard to get around at work, because the Secret Service are everywhere. So when the President's eating, that's a real challenge.
Vegetarians, love em' or hate em'?
Everybody is allowed an opinion and if it's there choice to not eat meat, I respect that. But I feel sorry for them because their missing out on a whole world of goodness. That's their choice, and I've been trained to accommodate anyone. I would never hate on the vegetarians.
Where do you like to eat when you actually have time away from work?
My favorite restaurant in Miami is Scarpetta. It sounds biased because that's one of the Fontainebleau's signature restaurants, and the head chef is one of my mates, but it really is true. He had a turbot dish on recently which was really nice, and I always like the duck and foie gras ravioli. That's always a winner for me. And I get naughty at Burger and Beer Joint, they have to roll me out of that place.


Oubaai Hotel Golf & Spa is a Herolds Bay hotel providing accommodation in 99 guest rooms for tourists visiting the Garden Route region.
Deluxe 45 sq-metre room features plush king or twin bed and spacious bath with glass-enclosed shower, separate deluxe bath tub and environmentally friendly spa products. Enjoy modern amenities, such as 32-inch LCD TV and high-speed wired Internet..
A classic and spacious 96 sq-metre suite featuring a king bed with en-suite bathroom with deluxe bathtub, seperate walk-in shower and environmentally friendly spa products. The suite also boasts a seperate living area, a walk-out balcony offering ocean or mountain views, work area and moden amenities such as a 32-inch LCD TV with satellite TV channels, complimentary WiFi, bathrobes and slippers and individually controlled air-conditioning.
A superior stunning suite welcomes guests with a dramatic entrance hall leading you into an expansive 120-square metre master bedroom featuring a plush king bed with separate en-suite deluxe bathtub, walk-in shower and environmentally friendly bath products. The suite also boasts a balcony with scenic views, a separate living area and dining room and guest toilet. Moden amenities include a 32-inch LCD TV with satellite TV channels and DVD player, IPod docking station, complimentary WiFi, bathrobes and slippers and individually controlled air-conditioning.
Cucina Restaurant, featuring picturesque floor-to-ceiling windows and a show kitchen, serves breakfast, lunch and dinner, and offers outdoor seating. The Wine Room, a private dining room accented by a large wine wall and a fire-lit lounge, complements Cucina's elegant ambience.
In the resort's village area, the Waterside Grill is open for dinner only. This restaurant features a large outdoor seating area, an interactive show kitchen and a raw bar. The Waterside Bar is adjacent to the restaurant and offers cosy seating arrangements, an outdoor terrace and a unique bar, with service available from both inside and out.
Spacious 45-square-metre room offers contemporary style and home-like comfort, featuring a plush king bed or twin beds, balcony and deluxe bath with walk-in shower, separate tub and environmentally friendly bath products. Enjoy panoramic views of the Outeniqua Mountains, plus modern amenities such as 32-inch LCD TV and high-speed wired Internet access.
Spacious 45-square-metre room offers contemporary style and home-like comfort, featuring a plush king bed, balcony and deluxe bath with walk-in shower, separate tub and environmentally friendly bath products. Enjoy panoramic views of the Indian Ocean, plus modern amenities such as 32-inch LCD TV and high-speed wired Internet access.
Deluxe 45-sq-metre room features plush king bed, balcony and spacious bath with glass-enclosed shower, separate deluxe bath tub and environmentally friendly spa products. Enjoy modern amenities, such as 32-inch LCD TV and high-speed wired Internet.
Enjoy extra space and added amenities in a 96-sq-metre suite, featuring king bedroom and master bath with deluxe bath tub, separate walk-in shower and environmentally friendly spa products, plus living room and walk-out balcony offering ocean or mountain views. Amenities include 32-inch LCD TV, high-speed Internet and breakfast and canapes in private Club lounge.
Dramatic entrance hall welcomes you into an expansive, 120-sq-metre suite featuring plush king bedroom and master bath with separate deluxe bath tub, walk-in shower and environmentally friendly bath products, plus balcony, living room and guest toilet. Amenities include 42-inch flat-screen TV with DVD player, iPod docking station and wireless Internet.
Entertain or simply relax in a 191-sq-metre suite featuring king bedroom and master bath with handheld rain shower, built-in thermostat, tub and environmentally friendly bath products, plus living and dining rooms, full kitchen, work area and guest bath. Enjoy panoramic mountain or Indian Ocean views from a walk-out balcony, and amenities including LCD TVs and Internet access.


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Ethereum ETH Kurs, Marktkapitalisierung & Charts
Live Ethereum Kurs von allen Märkten und ETH Marktkapitalisierung. Immer auf dem Laufenden sein mit den letzten Ethereum Preisentwicklungen. Snapshot Charts auschecken und den richtigen Zeitpunkt zum Ethereum Kaufen / Verkaufen finden.
>>> JETZT Kryptowährungen kaufen <<<
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Schlüsselinformationen
Ethereum is a decentralized platform that runs smart contracts: applications that run exactly as programmed without any possibility of downtime, censorship, fraud or third party interference. In the Ethereum protocol and blockchain there is a price for each operation. The general idea is, in order to have things transferred or executed by the network, you have to consume or burn Gas. The cryptocurrency is called Ether and is used to pay for computation time and for transaction fees.
If you want to earn block rewards from the network, you can join the network as a miner. Follow the link for a guide on how to mine Ethereum on a Windows Pc. The much easier but a bit more expensive way is to buy an Ethereum mining contract.
Ethereum is how the Internet was supposed to work. As long as you have enough funds to pay for your code to be run by the network, your contacts will always be up and running.
It was crowdfunded during August 2014 by fans all around the world. It is developed and maintained by ETHDEV with contributions from great minds across the globe. There is also an Ethereum foundation and there are multiple startups working with the Ethereum blockchain.
Ethereum is currently on the "Homestead" stage and all its related software is still considered Beta until the release of the next stage "Metropolis".
If you are looking for a GUI interface for your wallet, try the Ethereum Wallet DApp. It's still in beta so be careful when you use it.
Our block explorer data bellow is freely provided by etherchain.org and etherscan.io.
Erschaffungsdatum: 2017-06-07
Website: https://www.ethereum.org/
Ethereum is a platform that is intended to allow people to easily write decentralized applications (Đapps) using blockchain technology. A decentralized application is an application which serves some specific purpose to its users, but which has the important property that the application itself does not depend on any specific party existing. Rather than serving as a front-end for selling or providing a specific party's services, a Đapp is a tool for people and organizations on different sides of an interaction use to come together without any centralized intermediary.
Contracts generally serve four purposes:
- Maintain a data store representing something which is useful to either other contracts or to the outside world; one example of this is a contract that simulates a currency, and another is a contract that records membership in a particular organization.
- Serve as a sort of externally owned account with a more complicated access policy; this is called a "forwarding contract" and typically involves simply resending incoming messages to some desired destination only if certain conditions are met; for example, one can have a forwarding contract that waits until two out of a given three private keys have confirmed a particular message before resending it (ie. multisig). More complex forwarding contracts have different conditions based on the nature of the message sent; the simplest use case for this functionality is a withdrawal limit that is overrideable via some more complicated access procedure.
- Manage an ongoing contract or relationship between multiple users. Examples of this include a financial contract, an escrow with some particular set of mediators, or some kind of insurance. One can also have an open contract that one party leaves open for any other party to engage with at any time; one example of this is a contract that automatically pays a bounty to whoever submits a valid solution to some mathematical problem, or proves that it is providing some computational resource.
- Provide functions to other contracts; essentially serving as a software library.
Contracts interact with each other through an activity that is alternately called either "calling" or "sending messages". A "message" is an object containing some quantity of ether (a special internal currency used in Ethereum with the primary purpose of paying transaction fees), a byte-array of data of any size, the addresses of a sender and a recipient. When a contract receives a message it has the option of returning some data, which the original sender of the message can then immediately use. In this way, sending a message is exactly like calling a function.
Sandwich complexity model: the bottom level architecture of Ethereum should be as simple as possible, and the interfaces to Ethereum (including high level programming languages for developers and the user interface for users) should be as easy to understand as possible. Where complexity is inevitable, it should be pushed into the "middle layers" of the protocol, that are not part of the core consensus but are also not seen by end users - high-level-language compilers, argument serialization and deserialization scripts, storage data structure models, the leveldb storage interface and the wire protocol, etc. However, this preference is not absolute.
Freedom: users should not be restricted in what they use the Ethereum protocol for, and we should not attempt to preferentially favor or disfavor certain kinds of Ethereum contracts or transactions based on the nature of their purpose. This is similar to the guiding principle behind the concept of "net neutrality". One example of this principle not being followed is the situation in the Bitcoin transaction protocol where use of the blockchain for "off-label" purposes (eg. data storage, meta-protocols) is discouraged, and in some cases explicit quasi-protocol changes (eg. OP_RETURN restriction to 40 bytes) are made to attempt to attack applications using the blockchain in "unauthorized" ways. In Ethereum, we instead strongly favor the approach of setting up transaction fees in such a way as to be roughly incentive-compatible, such that users that use the blockchain in bloat-producing ways internalize the cost of their activities (ie. Pigovian taxation).
Generalization: protocol features and opcodes in Ethereum should embody maximally low-level concepts, so that they can be combined in arbitrary ways including ways that may not seem useful today but which may become useful later, and so that a bundle of low-level concepts can be made more efficient by stripping out some of its functionality when it is not necessary. An example of this principle being followed is our choice of a LOG opcode as a way of feeding information to (particularly light client) dapps, as opposed to simply logging all transactions and messages as was internally suggested earlier - the concept of "message" is really the agglomeration of multiple concepts, including "function call" and "event interesting to outside watchers", and it is worth separating the two.
Have No Features: as a corollary to generalization, the dev team often refuses to build in even very common high-level use cases as intrinsic parts of the protocol, with the understanding that if people really want to do it they can always create a sub-protocol (eg. ether-backed subcurrency, bitcoin/litecoin/dogecoin sidechain, etc) inside of a contract. An example of this is the lack of a Bitcoin-like "locktime" feature in Ethereum, as such a feature can be simulated via a protocol where users send "signed data packets" and those data packets can be fed into a specialized contract that processes them and performs some corresponding function if the data packet is in some contract-specific sense valid.
Non-risk-aversion: the dev team is okay with higher degrees of risk if a risk-increasing change provides very substantial benefits (eg. generalized state transitions, 50x faster block times, consensus efficiency, etc)
Marktkapitalisierung USD 24,807,668,469 Menge 24H USD 16,749,669,448
Marktanteil 0.04 % Verfügbare Menge 109,962,493
Veränderung % (1H) -0.20 % Maximale Menge 0
Veränderung % (24H) -0.06 % Totale Menge 109,962,493
Veränderung % (7D) 1.39 % Proof PoW
Algorithmus Ethash Upgedated: vor 2 Jahren
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Be careful what videos you watch from a guy who wants to get you into bed.
Anne is sent on an inspection... but what is really being inspected?
Mrs Markham demonstrates a most curious innovation.
A young Victorian woman is reprogrammed in advance of her wedding.
A program disc, and a webcam.


CBSE is trying its best to compile the results and publish by 26 May 2013. Once again, the CCE and the two streams (School based and Board Based) are identified as the causes for delay. All other boards have published their results, but CBSE has its reasons for delayed publishing of results.
It is expected that CBSE will start publishing the results by 25 and the entire results of all the regions of CBSE will be out by 27 May 2013.
Best of luck students !!!!


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Doctor Conspires to Kill Three to Save His Money
Prosecutors have revealed the plot of a New Jersey doctor who plotted to have his wife, his lover, and his former business partner – all three – murdered. The 63-year-old internist is still in jail with $2.5 million bail.
While the man was arrested last year as part of a Medicaid fraud investigation, authorities uncovered a disturbing series of plots. A New York Injury Lawyer reveals that it is not uncommon for police to question someone about one crime and inadvertently stumble onto information about another. Officials in the process of investigating one series of events will often find evidence of other wrongdoings, related and otherwise.
They learned that the doctor had long desired to hire an acquaintance of his to kill his lover. Why did he want to suddenly end this relationship? Because he owed her $250,000 and because he feared his wife would discover his philandering, according to a Queens Personal Injury Lawyer.
The discoveries didn't stop there. Another plot to kill his former business partner was soon uncovered. Why did the doctor want this man dead? He needed to settle a long-standing dispute, and apparently he felt the death of the other man was the only sure way to do so.
Later, while the good doctor was in jail because of the earlier Medicaid investigation, yet another plot unfolded when he tried to hire a man to kill his wife. What was his reasoning in attempting to hire an inmate? He feared his wife would divorce him and take his money.
The doctor – a person charged with ensuring the sanctity of life – plotted to kill three people in order to save his money from the hands of others, and he now faces three counts of attempted murder and conspiracy to commit murder. It is unclear at this time whether the doctor yet has an attorney.
There has been no word from the wife, the lover and the former business partner at this time. It is unclear if the plans to hire these people ever progressed to any actual act of violence.
Strains exist that stress families. Infidelity and fiscal improprieties are just two of the areas that create discord and result in a personal injury mishap. If you or a loved one has been injured in an accident, contact Stephen Bilkis and Associates for guidance and a free consultation.
Posted in: Personal Injury and Queens


Advanced Techniques In Limb Reconstruction Surgery - He is at the forefront of development of new surgical techniques, especially in minimal arthroscopy and reconstructive surgery. He has presented and published research papers locally and overseas on hand and upper limb topics as well as publishing text books and chapters on shoulder, elbow, wrist and hand.. A specialty orthopedics hospital in Houston, we provide acute and reconstructive trauma surgeons who treat the most challenging limb reconstruction and trauma cases. Limb reconstruction is a term used to describe a very specialized field in orthopaedic and plastic surgery. This encompasses a process whereby a destroyed / deformed limb or limb segment is reconstructed using the body's own tissues, implantable materials / prostheses or a combination of both..
Reconstructive surgery of the upper limb is a technically challenging and exciting subspecialty. This course blends lecture and cadaveric teaching and provides participants with fresh frozen cadaveric specimens, surgical instrumentation, and high quality supervision to learn, improve, or perfect many of the reconstructive possibilities in surgery to the upper limb.. Dr. Rozbruch is the Chief of the Limb Lengthening and Complex Reconstruction Service since 2005 and Director of the Limb Salvage and Amputation Reconstruction Center at the Hospital for Special Surgery. He is Professor of Clinical Orthopaedic Surgery at Weill Medical College of Cornell University.. Plastic and reconstructive surgery continues to evolve as new techniques open up new possibilities for the surgeon. In this groundbreaking textbook, contemporary approaches are explained and demonstrated to allow trainee and experienced surgeons alike to understand and assimilate best practice..
Christopher Iobst, MD, is a pediatric orthopedic surgeon who specializes in the fields of limb lengthening and reconstruction. He has presented his clinical and research work at national and international medical meetings and has been awarded the St. Giles Young Investigator Award by the Pediatric Orthopedic Society of North America.. diagnosis has been performed, using advanced imaging technology and traditional, physician reviews and observations. Surgery is only recommended once a determination has been made that a specific procedure is the most conservative option available to provide relief.. Our findings suggest that the modified induced-membrane technique is a reasonable alternative to other limb reconstruction techniques for bone tumors in children and has the advantage of not requiring a bone bank or an expensive metal prosthesis..
The reconstructive nature of amputation surgery and the potentially positive impact that proper technique can have on an individual's post-amputation function cannot be over emphasized. The success of every amputation surgery depends on the balance between these two main goals.. The Orthofix Limb Reconstruction System (LRS) is a series of modular monolateral external fixators to be used in reconstructive procedures for treatment of: Short stature. Bone loss. Open fractures. Non-union. Angular deformities.. Reconstruction surgery for fibular hemimelia involves foot deformity correction and limb length equalization. The SuperAnkle is a combination of bone and soft tissue procedures that stabilizes the.
Cosmetic Limb Lengthening Surgery Center The LimbplastX Institute is a dedicated medical practice that specializes in cosmetic limb lengthening surgical procedures. From the most advanced implant technology and surgical techniques available today to specialized radiology services and dedicated physical therapy regimens,. Finally, limb salvage surgery has been improved by the advancement of surgical techniques with im-proved and novel methods for excision and reconstruction, which in turn have improved functional outcomes and longevity. In this article, we will review imaging techniques and protocols, describe the vari-ous surgical techniques of limb salvage sur-.


In the tech capital of the nation, how does San Francisco's humble public transportation agency make a splash with its first mobile ticketing app? Well…aside from working with proven pros in the transit ticketing space, and ensuring the app illustrations were disarmingly adorable, you have a media event.
Not just any media event. One in a busy subway station. At the morning commute hour. With the Mayor's Office.
Throw in a few custom decorations, a few matching t-shirts and a swarm of energetic ambassadors and you've got yourself a public agency app launch.
I was responsible for organizing the launch event, coordinating look and feel, setting up temporary signage, collaborating with local SF Travel Visitor Information Center on partner promo through their network, organizing a swarm of on-street ambassadors, overseeing talking points and helping the public navigate the app in the meantime.
Read the corresponding blog post here. Also drafted the copy on the MuniMobile page here.
Launch of MuniMobile Mobile Phone Ticketing for Muni Fares | November 16, 2015. Photo by SFMTA Photography Department.
Previous post:Blog piece: It's MuniMobile Monday: Mobile Ticketing Is Here!


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Curso de enseñanza de posgrado sobre protección radiológica y seguridad de las fuentes de radiación
Programa tipo
Training Course Series No. 18
Spanish IAEA-TCS-18
Download PDF (643 KB)
IAEA offers postgraduate educational courses (PGECs) in radiation protection and the safety of radiation sources in five of its six official languages. The PGEC in Spanish has been conducted in Argentina for more than two decades. The aim of the course is to provide an initial basic professional training in radiation protection and safety for young professionals who will become trainers in later years. The standard syllabus has been revised to take into account the requirements and recommendations of the IAEA Safety Series No.115 (1996) and related safety guides. It is divided into eleven parts including the learning objectives, the prerequisites specified for each part, practical training sessions, training the trainers and a bibliography. The objective of the standard syllabus is to facilitate the integration of courses in radiation protection and the safety of radiation sources into the curricula of educational institutions in Member States and to achieve both consistency and a common level in the technical content of such courses.


Our Business Connect Conference was held on May 16/17, 2018. We had a full agenda of breakout sessions with expert speakers under the tent in the conference hall, 28 Trade Show booths and two Keynote addresses at lunch, the first day was the City and the second day was YG. Thank you to all participants for attending.


Counter-Strike plus drivable cars, customizable bases, and lots and lots of sand? This is no ordinary custom map.
RealFreemanTV posted a teaser of CTX and Jarro's CSGO: Truck Wars map, which they describe as an homage to Mad Max. It definitely looks the part.
Basically, the goal of each match is to fortify your base and then lead an assault on the other team's slice of desert paradise using all manner of cars and trucks—some of which have cute little teeth painted on the front. Fun!
It's an impressive-looking project. There aren't any release details yet, but it seems decently far along. I've asked for more information, and I'll pass along whatever I hear.


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  SPLIT
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    throw aardwolfEx;
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}

redpajama_set_name: RedPajamaGithub


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Lee Jones called up as Scotland Sevens prepare for 2022 season
Ex-Glasgow Warriors winger Lee Jones included in Scotland Sevens squad
By Stuart Bathgate @stuart_bathgate
FORMER Glasgow winger Lee Jones has been included in the Scotland Sevens squad for the 2022 season along with some of the stand-out performers from the recent Super6 campaign.
Now 33, Jones was freed by the Warriors in the summer, but his substantial experience at both sevens and 15s should prove invaluable to Scotland coach Ciaran Beattie, whose squad are returning as an independent entity after being subsumed into Team GB this year.
"It's probably always been in the back of the mind throughout my career that if there was ever a chance to get back and play a bit of sevens, that would be a choice I would make," said Jones, who is now in with a chance of competing at a fourth consecutive Commonwealth Games in Birmingham next summer, as well as possibly taking part in the Sevens World Cup. "As soon as Ciaran offered the opportunity, the first thing I'm thinking is 'Yes, 100 per cent'.
"I'd had a few conversations with some different folks and came to the conclusion that it was a really good fit for me. I still feel I've got a lot to offer the game. I wanted to play for at least another year, and for this opportunity to come up in what is a massive year for sevens - I want to grasp it with both hands. I'm delighted to get back into a sevens programme and get going.
"The Commonwealth Games is in Birmingham this coming season and you could argue it's a home games for Scotland, for the home nations. The opportunity to potentially go there and compete is a big driver for me.
"In 2010 I'd just signed for Edinburgh, so it was right at the start of my career. It seems like a long time ago, but the game has maybe not changed that much."
Beattie's squad also includes Alec Coombes and Ross McCann, who represented Great Britain at the Tokyo Olympics, and Jamie Farndale and Paddy Kelly, who are on Team GB duty in this week's Dubai event. The Super6 contingent includes Boroughmuir Bears duo Kaleem Barreto and Jordan Edmunds, Matt Davidson of Ayrshire Bulls, Harvey Elms from Watsonians and Callum Young of Heriot's. Femi Sofolarin will combine studying at Newcastle University with his playing duties, and Gavin Lowe will be out to improve on a points tally of 566 which already has him at fourth in Scotland's list of all-time top scorers.
Scotland Sevens core squad for 2022 (number of HSBC World Sevens Series events in brackets): Kaleem Barreto (2), Alec Coombes (16), Matt Davidson (0), Jordan Edmunds (0), Harvey Elms (21), Jamie Farndale (43), Lee Jones (25), Paddy Kelly (4), Gavin Lowe (40), Ross McCann (16), Femi Sofolarin (3), Callum Young (1).


The long-running legal dispute between adidas and Skechers appears to be over. For the moment anyway.
The two footwear giants have been locked in the IP battle since 2015, when the Three Stripes alleged that Skechers unlawfully used their trademarks and outright copied the Stan Smith design.
After an initial judgement in 2016, it was ruled that Skechers were to remove two IP-infringing styles from the market, citing the global recognition of the Three Stripes brand.
Recent developments, however, saw Skechers attempt to flout the sanctions and bring another faux Stan Smith to market. It all ended in a fizzle rather than a bang though, as the dispute was settled confidentially out of court.


inspector general of police (IGP), Mohammed Abubakar.
Zone 9, Umuahia, covering Abia, Imo, Enugu and Anambra State Commands.
CP Usman Gwary, is now in charge of Anambra State Police Command.
Borno, Yobe and CP Saidu Madawaki is now CP kogi state.