New law on settlement payments spurs concerns from defense bar; ITLA president says it "codifies common sense"
A new law that sets requirements for the payment of settlements has some defense attorneys concerned about how it will affect their clients, as well as the overall process of negotiating and settling civil cases.
The Illinois Association of Defense Trial Counsel (IDC) joined the Illinois Insurance Association and the Property Casualty Insurers Association of America earlier this month to host a seminar about the new law, which will take effect Jan. 1, at Hinshaw & Culbertson in Chicago.
Among other provisions, Public Act 98-548 will require settling defendants to tender a release to the plaintiff within 14 days of an agreement and to pay the settlement within 30 days of the receiving the executed release.
Pushed by the Illinois Trial Lawyers Association (ITLA), the measure was introduced in February as Senate Bill 1912, passed by both chambers of the General Assembly by the end of May and signed into law in August.
Springfield attorney and lobbyist R. Mark Mifflin told attendants at the Nov. 8 seminar the IDC worked with the business community, as well as the Illinois State Medical Society, to try to make changes to the measure, but with the exception of an increase to the deadline for paying out settlements, were ultimately unsuccessful in their efforts.
"No one knows for sure how this is going to play out," said Mifflin, IDC's second vice president.
Saying that he finds some of the new law's provisions problematic in that they don't fully address liens and provide deadlines that may be unreasonable in certain situations, Mifflin urged defense attorneys to be diligent to avoid negative consequences for their clients.
He said the idea behind the measure came out of a conversation Chicago trial lawyer Bob Clifford, a past president of ITLA, had with attorneys about a New York law that sets requirements regarding the prompt payment of settlements.
Saying that the new law simply intends to ensure plaintiffs get paid, Phillips said there are instances in which plaintiffs, through their lawyers, "have to fight to get paid" because some, not all, insurance companies "throw up obstacles" to delay paying out settlements.
As an example, Phillips, a Chicago attorney, said he settled a case in October and was told his client would get paid by Nov. 1, but that he has still yet to see the settlement payment.
"Sometimes it can take a few months to get paid," he said.
While the IDC claims the issue of payment can currently be handled by the courts through motions to enforce settlement agreements, Phillips said that prior to the passage of SB1912, there was nothing on the books that gave trial lawyers the "teeth" they needed to ensure the prompt payment of their clients' settlements.
"When cases settle and the plaintiff is entitled to money, they should receive money in a prompt, timely fashion and not have to spend their time, lawyers' time and court time trying to get an agreement enforced," Phillips said.
Levitt, who doubles as IDC's president-elect, said he believes the new law "will slow settlements" and likely end the days of being able to settle cases with opposing counsel on the courthouse steps or over the phone.
On behalf of ITLA, Phillips said he disagrees with the contention the new law will slow down the settlement process.
Based on the new law's provisions that trigger deadlines upon the tender and receipt of releases, Levitt said he will no longer make oral settlement offers, will require everything to be put in writing and be cautious in responding to emails from opposing counsel regarding settlements.
In addition to getting everything in writing, Chicago attorney Stephen Loverde told attendants at the IDC seminar that they should also ask their opposing counsel to waive provisions of the new law when working on settlements.
He said he is optimistic that plaintiffs' attorneys will agree to do so, especially in cases that are more complex in nature and involve multiple defendants.
Phillips, ITLA's president, said he believes most trial lawyers "put everything in writing anyway" and would be open-minded to waiving the provisions of the new as long as they have good, working relationships with defense counsel.
He said he can think of several attorneys and insurance companies that he "wouldn't blink" twice about in agreeing to requests to waive the law's provisions. If the defendant insurance company, however, has a reputation of delaying payments, Phillips said he would likely be less inclined to do so.
Mifflin and Frank Stevens, an insurance defense attorney in Chicago who also spoke at the IDC seminar, said they also have concerns over liens.
As such, the speakers at the IDC seminar urged defense attorneys to address any possible lien issues during negotiations and before entering into settlements.
Mifflin said because defendants are liable for liens until they are paid, it leaves defense counsel in the tough position of having to rely on the plaintiff's lawyer to protect their client's interest in the settlement.
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text:
Vehicle importers may soon need radioactive-free certificates- Environment Minister
Posted by: GxMedia in News Friday, 10 January 2014, 23:49	0
Importers of vehicles and vehicle spares from Japan may have to produce certificates showing that their imports are free from worrying levels of radioactive material, in the wake of a shipment of Guyana-bound spares being seized in Jamaica because of elevated levels of radiation.
"We will have to require certificates that they are free from radioactive material. We will not allow that to happen here- the exposure to human health and the environment," Environment Minister, Robert Persaud told Demerara Waves Online News (www.demwaves.com).
He said Guyana would be seeking more information from Jamaica and Japan about the shipment that has been seized at a Kingston wharf and being prepared for return to the supplier. Among the enquiries would be whether the shipment of spares was contaminated in Japan or elsewhere.
The Environmental Protection Agency (EPA) and the Guyana Revenue Authority (GRA), the minister said, would have to collaborate closely to pick up imports that are tainted with radioactive material. He added that Guyana would also be examining international rules that could be used to address the potentially hazardous threat.
Persaud was not entirely sure how equipped was the GRA to test and intercept items with radioactive material.
In the case of Jamaica, authorities there were able to detect the radiation levels by using sophisticated equipment that have been provided by the United States Department of Energy to conduct radiation tests on all vehicles and spare parts coming from Japan.
The Jamaica Gleaner on Friday quoted that island's Assistant Commissioner of Customs Velma Ricketts as saying that last month a trans-shipment container carrying used motor-vehicle parts destined for Guyana was scanned at the Kingston Container Terminal and its radiation levels was determined to be "elevated.
Jamaican authorities have been on high alert for radioactive material ever since the 9.0 earthquake that rocked Japan in 2011, triggering a tsunami that struck the Fukushima nuclear plant.
Jamaica's Commissioner of Customs, Major Richard Reese also cited the need to hold talks with Japanese authorities about the need for enhanced inspection mechanisms before goods are shipped out of Japan.
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redpajama_set_name: RedPajamaCommonCrawl


I wanted to get birthday cards in the mail today for all the March birthdays I want to celebrate. I need over a dozen cards this month, so I keep trying to come up with fresh ideas. I will not duplicate the cards I'm sending, so I look for inspiration in the card challenges. I came across the box with some In Color markers that I had hardly used, and decided that I would go to CAS Colors & Sketches Challenge #211 and use those beautiful colors. I found a fun layout at Match the Sketch Challenge No. 165, so I was ready to go.
I started with some Watermelon Wonder print from Affectionately Yours DSP, and then decided to tie it together with some pretty little flowers from Avant Garden, which I colored with the Watermelon and Peekaboo Peach. I added a greeting from Birthday Banners. It made for a fast and fun birthday card that's ready to mail tomorrow. That's nine birthday cards in the mail. Wait til you see the sweet one I have to show you tomorrow.
Bring on the winter stamping!


Not everyone is accustomed to treadmill running – especially when you live in a place like Sydney, with so many beautiful parks, trails and great weather all year round that really encourages outdoor training!
So we've put together 10 tips on how to better run on a treadmill. We hope you'll find them useful for your Corporate Treadmill Marathon training!
Run or walk at a slow, easy pace for 5-10 minutes. It's tempting to just jump on the treadmill and start running, but you should allow time for a warm up. Why not do a quick jog from your office to the gym before the event?
"For most people, two hours is enough time for food to empty from the stomach, especially if it's high in carbohydrate," says Colorado sports dietitian and marathoner Cindy Dallow, Ph.D. "If you don't wait long enough, food will not be properly digested, raising the risk of abdominal cramps, bloating, and even vomiting. You can probably run 90 minutes after a light, high-carb meal, while you may need up to three hours after a heavy meal that's high in protein and fat.
Also, just stick to familiar food. Don't eat or drink anything new before or during a race or hard workout!
A slight inclination of 1% to 2% is ideal when running on treadmills. A too steep incline (more than 7%) may lead to Achilles tendon or calf injuries.
The more steps you take per minute, the more efficiently you'll run. Elite runners run about 180 steps per minute. Determine your stride count by counting how often one foot hits the belt in a minute and then doubling that number. Try to improve your stride count during your run by focusing on taking shorter, quicker strides and keeping your feet close to the belt.
It's hard not to continually look to see how much time or distance you have left, but if you're looking down, your running form will suffer. Don't stare at your feet either. You're likely to run hunched over, which could lead to back and neck pain. Looking straight ahead is the safest way to run, whether you're on the treadmill or running outside.
You can lose even more water running on a treadmill then you would if you were running outside, since there's little air resistance to help to keep you cool. The gym can get hot, especially when there are so many people in one area. Keep a bottle of water within easy reach.
It's easy to hop off the treadmill when your workout is done and your heart rate is elevated. If possible, allow your heart rate to slow down before you get off. Cooling down will help prevent dizziness or the feeling that you're still moving when you step off the treadmill.


Choose this piece of artwork to anchor the room. It will really elevate your space.
If elegance and charm arev two qualities you are profoundly drawn to when it comes to the interior of your home, you may want to consider adding some vintage design elements to your home specifically, your living room. Use this suzani upholstery tapestry to section off your space or just hang them on your wall. You will realize that creating an oasis in your home is much easier than you would think. Hense, this Asian traditional embroidery art can be used for home decor, as curtains, table tops, decorate dwellings, dress decorating and more.


By Denise Marie Mari, Ph.D.
In today's world, adults and youth everywhere are using objects like food, drink, money, and computers in ways that are immature, addictive, or foolish. Frequent psychological reasons for irresponsible handling of such things include stress relief, dulling painful emotions, disappointment in love, and feeling more normal. Of course, these ends do not justify the means. In this book, health professional Denise Marie Mari, Ph.D. explains the path away from unsound relations with things toward living more beneficially with self, other people, and God.
More From Denise Marie Mari, Ph.D.


Understand the role of and implement appropriate hand hygiene.
Dr. Terézhalmy has done consulting work for Procter & Gamble and is a member of the dentalcare.com Advisory Board.
This course presents a prototypical, evidence-based, hierarchical infection control/exposure control protocol predicated on Standard Precautions (expanded with new evidence-based elements) and Transmission-based Precautions to prevent or minimize healthcare-associated infections in oral healthcare settings.
The primary obligation and ultimate responsibility of oral healthcare personnel (OHCP) is the timely delivery of quality care in the privacy of a comfortable and safe environment. While the transmission of pathogenic microorganisms in oral healthcare settings is rare, healthcare-associated infections (HAIs) do present a potential hazard to OHCP and patients alike. To prevent or minimize HAIs among OHCP and patients, oral healthcare facilities, like all healthcare facilities, are mandated to develop a written infection control/exposure control protocol predicated on a hierarchy of preventive strategies.
Historically, strategies to eliminate or reduce the risk of HAIs were based on Universal Precautions, i.e., the concept that patients with bloodborne pathogens can be asymptomatic (unaware that they are infectious) and, therefore, all blood and body fluids contaminated with blood were treated as infectious. Today, Standard Precautions (periodically expanded with new evidence-based elements) and Transmission-based Precautions provide the fabric for a hierarchy of preventive strategies to protect both OHCP and patients and apply to contact with blood and all other potentially infectious material (OPIM).
Infection control/exposure control strategies should be appropriate for the oral healthcare setting. As these strategies deviate from optimal design and implementation, the quality (value, outcome) of infection control/exposure control program decreases at an accelerated rate. It is recommended that an Office Infection-Control Coordinator (OICC) be appointed with responsibility for the development and management of the office infection control/exposure control program to ensure that the criteria are relevant, the procedures are efficient, and the practices are successful. However, the creation and maintenance of a safe work environment mandates the commitment and accountability of all OHCP.
OHCP shall participate in an education and training program at the time of initial assignment to tasks in which exposure to blood and OPIM may occur and at least annually thereafter.
Compliance with the exposure control/infection control protocol is significantly improved if OHCP understand the rationale for the written policies and practices intended to prevent HAIs. The objectives of the education and training program are to enlighten OHCP regarding (1) the risk of HAIs, (2) preventive strategies, (3) post-exposure evaluation and follow-up and (4) administrative controls.
a. Pathogens associated with HAIs are derived primarily from humans, but contaminated objects and environmental sources are also implicated.
a. Establishment of infection and its severity relate to the state of host defense mechanisms; however, the numbers, pathogenicity, virulence, and antigenicity of organisms are important determinants.
a. Pathogens may be transferred from the source to a host by contact transmission, i.e., direct or indirect contact transmission; or respiratory transmission, i.e., inhalation of droplets or droplet nuclei (airborne transmission).
A. An education and training program is completed by all OHCP prior to initial assignment to tasks and procedures in which exposure to blood and OPIM may occur and at least annually thereafter.
1. The program is scheduled at an acceptable time for and at no cost to OHCP.
2. The presentation is appropriate in content and vocabulary for the educational level of participants.
3. The program is conducted by person(s) knowledgeable about the subject.
4. The speaker provides an opportunity for interactive questions and answers.
1. An individual Training Record is maintained on all OHCP for the most recent 3-year period.
1. Hepatitis B vaccine is made available at no cost to OHCP, without a history of prior immunization, at the time of initial assignment to tasks in which exposure may occur.
3. If subsequently the person decides to submit to vaccination, while still covered under the standard, the hepatitis B vaccination series is made available at that time.
i. HBsAg-negative OHCP will be counseled about precautions to prevent HBV infection and the need to obtain HBIG prophylaxis for any known or probable parenteral exposure to HBsAg-positive blood.
ii. HBsAg-positive OHCP will be referred for post-exposure evaluation and follow-up and counseled about the need for work restrictions to prevent the transmission of HBV to others.
1. At this time, routine booster doses of the hepatitis B vaccine are not indicated; if at a future date booster doses are recommended, they will be made available at no cost to OHCP.
C. Other vaccines highly recommended for all OHCP include influenza, measles, mumps, rubella, varicella, and pertussis.
D. In certain circumstances, OHCP should also be vaccinated against meningococcal disease, typhoid fever, and poliomyelitis.
E. Vaccines recommended for adults in general include the pneumococcal polysaccharide vaccine, tetanus and diphtheria toxoids, human papillomavirus vaccine, zoster vaccine, and hepatitis A vaccine.
F. OHCP unable or unwilling to be vaccinated as recommended will be educated regarding their exposure risk and the management of work-related illness and work restrictions (if applicable).
To prevent or reduce the risk of disease transmission, personal protective equipment shall be worn by all OHCP when performing procedures that are likely to result in exposure to blood and OPIM.
Pathogenic organisms in blood and OPIM may come in contact with skin; conjunctival and oral mucosal tissues; and respiratory epithelium by inhalation of airborne microorganisms, i.e., droplets or droplet nuclei suspended in air. Personal protective equipment (PPE) is designed to protect the skin and mucous membranes (eyes, nose and mouth) and respiratory epithelium of OHCP from exposure to a source or reservoir of pathogenic organisms by contact transmission, i.e., direct or indirect contact transmission; and respiratory transmission, i.e., inhalation of droplets or droplet nuclei (airborne transmission).
A. Personal protective equipment, which does not permit blood or OPIM to pass through to or reach street clothes, undergarments, skin, or mucous membranes under normal conditions of use and for the duration of time that the protective equipment is used, is provided for and is routinely worn by all OHCP.
a. Gowns or lab coats with long sleeves are worn to protect the forearms when splash, spatter, or spray of blood or OPIM to the forearms is anticipated.
b. Protective clothing is changed daily, whenever it becomes visibly soiled, and as soon as possible if penetrated by blood or OPIM.
c. Protective clothing is removed before leaving the work area.
d. Dirty protective clothing is placed in designated areas for disposal or washing.
a. Non-surgical, surgical, or heavy-duty utility gloves are worn by all OHCP to prevent or reduce the risk of contaminating the hands with blood or OPIM and to prevent or reduce the risk of cross-infecting in the clinical process.
i. To reduce the risk of latex-related allergies, only powder-free, low-allergen latex gloves; and non-latex, nitrile or vinyl gloves are available.
ii. Non-surgical and surgical gloves are single-use items, which are used for only one patient and are then discarded.
iii. When torn or punctured, gloves are changed as soon as possible.
iv. Gloves may not be washed because it can lead to wicking (penetration of liquids through undetectable holes in the gloves) and subsequent hand contamination.
v. Double gloving is acceptable for extensive oral surgical procedures.
vi. Heavy-duty utility gloves are worn for all instrument, equipment, and environmental surface cleaning and disinfection.
vii. Wearing gloves does not eliminate the need for hand hygiene.
a. Surgical masks that cover both the nose and the mouth are worn by all OHCP during clinical activities likely to generate splash, splatter, and aerosols.
b. Surgical masks provided for routine use have filtration efficiency of 95% for microorganisms greater than 3 microns.
c. When a mask becomes wet from exhaled air or contaminated with infectious droplets, spray, or from touching the mask with contaminated fingers it is changed as soon as possible (between patients or even during patient treatment).
a. When airborne infection isolation precautions are necessary (e.g., transmission-based precautions for patients with TB), a National Institute for Occupational Safety and Health (NIOSH)-certified particulate-filter respirator (N95, N99, or N100) is used, which have the ability to filter 3 μm particles with a filtering efficiency of 95, 99, and 99.7% respectively.
a. Protective eyewear with solid side shields or a face shield is worn by OHCP during the clinical process likely to generate splash, splatter, and aerosols.
b. Protective eyewear with solid side shields is also provided for the patients to protect their eyes from spatter and debris generated during the clinical process.
c. Protective eyewear is cleaned with soap and water between patients.
a. Mouthpieces, pocket masks, and resuscitation bags are used when CPR is administered.
Hand hygiene procedures shall be implemented at the beginning of each work cycle, before gloving, after degloving, and before regloving, and anytime the hands are visibly contaminated with blood or OPIM.
The transmission of healthcare-associated pathogens most often occurs via the contaminated hands of OHCP. It is axiomatic that wearing gloves during patient care is an essential element of standard precautions, yet gloves do not provide complete protection against hand contamination and the hands are also frequently contaminated after the gloves are removed. It is axiomatic that hand hygiene is one of the most important infection control measures for preventing HAIs.
The acquisition of various healthcare-associated pathogens is reduced when hand hygiene is performed more frequently and the prevalence of HAIs is decreased as adherence to recommended hand hygiene practices is improved. Oral healthcare facilities are accountable for establishing a system in which OHCP have the knowledge, competence, time, and tools to practice hand hygiene; and OHCP have the duty to perform hand hygiene - perfectly and every time.
The term hand hygiene is a general term that applies to (1) handwashing (2) hand antisepsis, and (3) surgical hand antisepsis. Products used for hand hygiene in healthcare settings are detergents (surfactants, the term "soaps" is often used). Detergents are compounds that possess cleaning action and are composed of both hydrophilic and lipophilic parts. An antimicrobial soap is a soap that contains an antiseptic agent, a substance that when applied to skin reduces the microbial flora.
1. Natural or artificial fingernails are kept short to facilitate thorough cleaning underneath them and to prevent glove tears.
2. All jewelry and ornaments are removed from the hands and wrists if they interfere with glove use.
3. Sinks with electronic, foot, or knee action faucet controls are provided for asepsis and ease of function.
4. The preferred method for hand hygiene depends on the type of procedure to be performed, the degree of contamination, and the desired persistence of antimicrobial action on the skin.
v. Soap is rinsed off with the hands held under warm running water.
vi. Hands are dried with disposable paper towels.
vii. Hands and forearms are rubbed with an alcohol-based hand-rub product (containing 60 to 95% ethanol or isopropanol alcohol; alcohol-based preparations containing 0.5% to 1% chlorhexidine gluconate have persistent activity) until the hands and forearms are dry.
F. Hand hygiene products are stored and dispensed according to manufacturers' directions.
Engineering and work-practice controls shall be implemented to prevent or reduce the risk of exposure to blood and OPIM and to promote safer behavior in the workplace.
The unique nature of oral healthcare settings, dental procedures, and instrumentation require specific strategies to prevent the transmission of HAIs. Engineering and work-practice controls are intended to eliminate or isolate hazards and promote safer behavior in the workplace. Engineering controls take advantage of available technology to eliminate or isolate biohazards (blood or OPIM). When engineering controls are not available or are not practical, work-practice controls are implemented.
The direct patient care setting, i.e., the dental treatment room (DTR), is central to the delivery of oral healthcare, but there are other environments within oral healthcare settings that support the delivery of clinical services, i.e., dental radiography and dental laboratory facilities. While the following recommendations primarily relate to non-surgical dental specialty areas, they are sufficiently flexible to serve as a template for developing and implementing practice-specific infection control strategies.
1. Eating, drinking, smoking, applying cosmetics or lip balm, and handling contact lenses are prohibited in work areas where blood or OPIM may be present.
2. Food and drink are not kept in refrigerators, freezers, or cabinets or on shelves, countertops, or benchtops in work areas where blood or OPIM may be present.
3. All items used in patient care should be stored in closed cabinets or drawers. Mobile carts used for patient care should not be cluttered with excess materials.
4. Bulk items should be covered to prevent contamination and caution should be exercised when retrieving such items to ensure that the remaining items are not contaminated.
5. Begin each day with a routine handwash from fingertips to the wrist.
6. Use water that meets Environmental Protection Agency (EPA) regulatory standards, i.e., water containing <500 colony forming units (CFUs/mL of heterotrophic bacteria, for handwashing and as a coolant/irrigant for nonsurgical procedures.
a. If using water bottles, fill dental unit water bottle according to manufacturer's recommendations. Add continuous-use dental unit waterline (DUWL) cleaning product if indicated. Note: Follow dental unit and water bottle manufacturer's instructions for products and protocols for maintenance and monitoring DUWL quality.
a. Barrier protection: place protective plastic covers on clinical contact surfaces such as headrests, dental unit control switches, air and water line hoses, light handles, chairside light curing unit, and other hard-to-clean areas and equipment.
b. Have appropriate instrument packs and supplies ready to begin treatment. This includes all necessary PPE (gloves, masks, eye protection, etc.) for the provider, assistant and the patient.
c. Check all sterilized instrument packs and packages to ensure they are intact and the external chemical indicator has changed to the appropriate color.
i. Do not open packs in advance of the patient's arrival.
b. Provide the patient with safety glasses.
c. Open sterile instrument trays, pack(s) or cassettes with clean, ungloved hands and without directly touching the contents.
i. Observe internal indicator strip(s) for color change.
ii. Leave wrapping material underneath as a barrier for the work surface.
d. Perform hand hygiene, don gloves and other PPE.
i. Sterile gloves are used for invasive surgical procedures.
e. Connect hand pieces, air and water syringes, saliva ejector, and high-volume evacuation tips.
f. Use pre-sterilized burs and files, or manufacturer's pre-packaged single-use burs.
g. Use expandable items, such as cotton and gauze products that have been sterilized (within instrument packs or individual packages, such as paper or plastic peel pouches).
i. All procedures are performed in such a manner as to minimize splashing, spraying, spattering, and the generation of droplets (aerosols).
ii. Prior to such dental procedures, patients may rinse with chlorhexidine gluconate-, essential oil-, or povidone iodine-containing mouthwash.
iii. Use rubber dental dam, high volume evacuator (HVE) and other protective barriers, engineering and work practice controls wherever possible.
i. Use one handed "scoop" technique or a recapping safety device to recap anesthetic needles.
j. Use the unit dose concept for dispensing restorative and other dental materials.
i. If additional material is needed during treatment use aseptic technique to retrieve needed items (e.g., sterile cotton forceps or pliers, an over-glove barrier, or remove gloves and perform hand hygiene).
k. Complete charting and computer entries after removing gloves and performing hand hygiene.
l. Remove PPE and perform hand hygiene before leaving the treatment area.
m. Wear appropriate attire outside the DTR, e.g., a clean lab coat when exiting DTR to conduct business elsewhere in the clinic or administrative spaces.
a. Wear heavy-duty utility gloves and other PPE while handling contaminated instruments and cleaning contaminated surfaces.
b. Place all disposable sharps in designated sharps container in the DTR.
c. Dispose of all non-sharp, regulated medical waste following local policy.
d. Place instruments in cassette tray (or properly labeled and approved container) for transport to the central sterilization room (CSR).
e. Flush water and air lines for 20-30 seconds after each patient from any device connected to the dental water system that enters the patient's mouth (e.g., hand pieces, ultrasonic scalers, air and water syringes).
f. Remove dental hand piece(s), including slow speed hand piece motors, and other intraoral instruments that can be removed from air and waterline couplings of dental units.
g. Follow manufacturer's instructions for cleaning, lubrication, and sterilization of hand pieces and other intraoral instruments and devices removed from dental units.
h. Remove and dispose of all disposable barriers.
i. Clean and disinfect clinical contact surfaces that were not barrier protected with an EPA-registered hospital disinfectant with a tuberculocidal claim (i.e., intermediate-level disinfectant).
j. Remove gloves and perform hand hygiene.
k. Don a fresh pair of gloves and transport instrument trays, packs, and cassettes to the receiving side of CSR or another designated holding space.
l. Return to the DTR without touching any surfaces while en route to remove PPE and perform hand hygiene.
m. Prepare the DTR for the next patient.
a. Wear appropriate gloves, face protection, and eye protection while cleaning contaminated surfaces.
b. Clean and disinfect all contact surfaces, dental unit surfaces, and countertops with an EPA-registered disinfectant.
i. To facilitate cleaning, treatment rooms should be free of all unnecessary equipment and supplies.
c. Empty and clean amalgam trap container per dental unit manufacturer's recommendations.
d. Flush and clean the HVE system per manufacturer's recommendations.
e. Flush and clean each water line and suction hoses, follow manufacturer's instructions if waterline treatment products are used. Follow manufacturer's instructions for cleaning and maintenance of dental unit water bottles.
f. Dispose of regulated waste per local policy.
g. Clean and disinfect sink area.
h. Ensure only DTR cleaning materials and no patient care items are stored under the sink.
i. Inventory consumable unit dose packs, replenish as necessary per local policy. Note: Routinely check for expiration dates on solutions, materials and dispensable items per command policy.
j. Remove PPE (clean and disinfect reusable PPE) and perform hand hygiene.
a. Generally, blood and/or saliva-tinted items (e.g., clinic gowns, gloves, and patient bibs) are not considered regulated waste and are placed in the regular trash receptacle.
a. Regulated waste is disposed of according to the requirements established by local and state environmental agencies.
b. Disposable sharps (e.g., needles, local anesthetic cartridges, orthodontic wires, scalpel blades, suture needles, endodontic file, and broken instruments) are removed from cassettes, tray sets, or packs; and are placed in a rigid, puncture-resistant, leak-proof container with a secure lid for storage and transportation.
c. Other regulated waste (e.g., items that drip when held vertically, release fluid when compressed, have dried on fluid that could flake off in transit) is placed in small biohazard bag and are disposed of into a centralized Regulated Waste Receptacle after each appointment.
d. Biohazard labels (fluorescent orange or orange red, with lettering or symbols in a contrasting color) are affixed as close as feasible to containers of regulated waste by string, wire, adhesive, or other method to prevent their loss or unintentional removal.
e. Regulated waste that has been decontaminated is not labeled or color-coded and is placed in the regular trash receptacle.
1. Immediately, or as soon as possible after use, all cassettes, tray sets, or packs containing contaminated instruments and reusable sharps are transported to the central instrument processing area in a manner that minimizes the risk of exposure to persons and the environment.
a. Items are first cleaned with a hands-free process using an ultrasonic system with a strainer-type basket.
b. Wearing heavy-duty gloves, protective eyewear, and protective clothing the instruments are visually inspected for residual debris and damage.
c. Residual blood, OPIM, cement and other visible debris are removed using a long-handled brush.
d. Damaged instruments are replaced.
3. Non-critical items, i.e., items that contact only intact skin during their intended use.
a. Disinfected with an EPA-registered intermediate-level hospital disinfectant with tuberculocidal claim (e.g., products containing chlorine, quaternary ammonium compounds with alcohol, phenolics, or iodophors).
4. Semi-critical items, i.e., items that touch, but do not penetrate, nonintact skin or mucous membranes; and critical items, i.e., items that penetrate soft tissues and bone during their intended use.
a. Heat-sensitive items are sterilized with ethylene oxide or an FDA-registered sterilant (e.g., products containing glutaraldehyde, glutaraldehyde with phenol, hydrogen peroxide, or hydrogen peroxide with peracetic acid).
i. After sterilization, all items are rinsed with sterile water to remove toxic or irritating residues.
ii. Handled using sterile gloves and dried with sterile towels.
iii. Delivered to the point of use in an aseptic manner.
b. Heat-tolerant items are heat sterilized in an FDA cleared device.
a. The cleaned and inspected instruments are assembled into cassettes, tray sets, or packs with hinged instruments open and unlocked.
b. An internal chemical indicator is placed in each cassette, tray set, or pack.
c. If the internal indicator is not visible from the outside of the wrapped and sealed package, an external chemical indicator is placed on each cassette, trays set, or pack to monitor sterilization process.
i. The sterilizer is loaded according to manufacturer's recommendation, in single layers or in racks to increase circulation around the instruments.
ii. The cycle time, temperature, and pressure are set according to the manufacturer's recommendation.
iii. Upon completion of the sterilization cycle, the packages are allowed to dry and cool before removing them from the sterilizer.
i. Sterilized items are stored in a clean, enclosed, and dry environment.
ii. Sterilized packages remain sterile indefinitely, unless an event causes it to become contaminated (e.g., torn or wet packages).
i. Mechanical - Confirm cycle time, temperature, and pressure by observing the gauges or displays on the sterilizer for each load.
ii. Chemical - Note color changes of time and temperature sensitive internal and external chemical indicators, which reflect physical conditions during the sterilization process.
iii. Biological - Monitor weekly the sterilization process by an appropriate spore test (according to manufacturer's time, pressure, and temperature recommendation).
a. Spore strip or vial is placed inside the cassette, tray set, or pack.
b. Cassette, tray set, or pack containing the biological indicator is placed in the center of the load (hardest area to penetrate).
c. A control strip (which is not heat processed) is used as a control with each spore test.
d. A record is maintained of the weekly spore testing results.
iv. Additional biological monitoring is performed whenever there is a change in the packaging process, following equipment repair, and when training new employees.
v. Quality assurance procedures following a positive mechanical, chemical, or biological monitoring test.
a. Secure sterilizer from further use.
b. Make proper log entries.
d. Take corrective action (repair or replacement).
e. Retest sterilizer using biological monitors (CDC recommends to retest 3 times using an empty chamber).
f. Loads dating back to the last negative biological indicator should be recalled, rewrapped, and resterilized.
1. All handpieces (i.e., high- and slow-speed motors, nose cones, contra-angles, motor-to-angle adapters and prophylaxis angles), unless disposable, are heat sterilized between patients.
i. Before removing handpiece from hose the lines are flushed for 20-30 seconds.
ii. Handpiece (with the bur removed) is scrubbed thoroughly under running water, rinsed thoroughly, and dried.
iii. Handpiece requiring pre-sterilization lubrication is lubricated.
v. Fiberoptics are cleaned with a cotton swab, dampened with isopropyl alcohol to remove excess lubricant.
vi. Handpieces are packaged and sterilized in a steam autoclave.
1. Prevent backflow in low-volume suction lines.
a. Position the section of the suction tubing holding the tip above the patient's mouth.
b. Instruct patient not to create a seal around the suction tip.
c. Avoid the simultaneous use of other evacuation devices, i.e., high-volume suction.
a. Cover clinical contact areas with a protective barrier before seating the patient.
2. Exposing and processing films.
a. Hand hygiene and PPE before initiating the process.
b. Use disposable or heat-sterilized film-holding and positioning devices.
c. Use FDA-cleared film barrier pouches.
i. After exposure, remove the film packet from pouch and place in a clean container.
a. Transport/handle exposed radiographs in an aseptic manner to prevent contamination of developing equipment.
3. Digital radiography sensors and other high-technology instruments are cleaned and heat-sterilized or high-level-disinfected according to manufacturer's recommendation.
a. Place disposable plastic cover over bite guide before the patient is positioned in the machine.
i. If no barrier is used, use a sterile bite guard.
1. Perform surgical hand asepsis.
a. When using laser or electrosurgical units, the thermal destruction of tissue creates laser plumes or surgical smoke, which may contain aerosolized infectious material.
3. Use only sterile saline or sterile water as a coolant/irrigant.
a. Use specifically designed irrigating devices (e.g., bulb syringe, single-use disposable products, or sterilizable tubing).
1. Specimens are placed in leak-proof, puncture-resistant container with a secure lid for storage and transportation.
2. If the outside of the container becomes visibly contaminated, it is cleaned and disinfected or placed in an impervious bag.
3. The container is labeled with the biohazard symbol.
1. Potentially infectious and are disposed as regulated waste.
2. Teeth sent to the laboratory for shade and size comparisons.
a. Cleaned and disinfected with an EPA-registered, intermediate-level hospital disinfectant with tuberculocidal claim (e.g., products containing chlorine, quaternary ammonium compounds with alcohol, phenolics, or iodophors).
3. Teeth containing dental amalgam are disposed of according to local and state regulations.
4. Extracted teeth can be disinfected and returned to patients, upon request.
5. Extracted teeth in an educational setting.
a. The teeth are cleaned of visible blood and gross debris and maintained in a hydrated state (e.g., water or saline) in a well-constructed closed container.
b. Before clinical exercises or study, the teeth are heat-sterilized (autoclave cycle for 40 minutes).
i. Teeth with amalgam restorations are disinfected by immersion in 10% formalin solution for 2 weeks.
a. Review MSDS for occupational safety and health concerns.
1. Environmental surfaces are barrier-protected or cleaned and disinfected.
2. Use PPE when handling items received in the laboratory until they have been decontaminated.
a. Impressions, prostheses, and other devices.
i. Rinse under running tap water to remove blood and OPIM.
ii. Disinfect with an EPA-registered intermediate-level hospital disinfectant with tuberculocidal claim (e.g., products containing chlorine, quaternary ammonium compounds with alcohol, phenolics, or iodophors).
iii. Thoroughly rinse under running water before handling.
b. Laboratory case is sent off-site.
i. Written information is provided regarding the method used to clean and disinfect the material (i.e., type of disinfectant used and exposure time).
c. Burs, polishing points, rag wheels, or laboratory knives.
i. Heat-sterilized, disinfected, or discarded between cases following manufacturer's recommendations.
i. Heat sterilized between patients.
i. Cleaned and disinfected between patients according to manufacturer's recommendation.
f. Unless waste generated in the laboratory falls under the category of regulated waste, it is discarded with general waste.
1. Charts are notated and radiographs viewed before gloving or after the gloves are removed and the hands are washed, unless cover gloves are worn.
Appropriate environmental infection control measures shall be implemented to keep the oral health care facility in a clean and sanitary condition.
Environmental surfaces such as walls, floors, and sinks do not appear to contribute to significant cross-contamination in the oral healthcare setting. Other surfaces that are frequently touched may serve as reservoirs for microbial contamination and are categorized as clinical contact surfaces (e.g., light handles, switches, radiographic equipment, dental chairside computers, reusable containers of dental materials, drawer handles, faucet handles, countertops, pens, telephones, and doorknobs) and housekeeping surfaces (e.g., walls, window drapes, other vertical surfaces, floors, sinks, carpeting, and cloth furnishing).
1. To prevent contamination, use materials impervious to moisture (e.g., plastic wrap, bags, sheets, tubing, and plastic-backed paper).
a. Coverings are removed and discarded between patients.
i. After removing the barrier, the surfaces are examined for visible soil.
ii. Surfaces with visible soil are cleaned and disinfected with an EPA-registered intermediate-level hospital disinfectant with tuberculocidal claim, e.g., products containing chlorine, quaternary ammonium compounds with alcohol, phenolics, or iodophors.
iii. After removing gloves and performing hand hygiene, clean barriers are placed before the next patient.
b. If barriers are not used, wearing appropriate PPE, the surfaces are cleaned and disinfected between patients using an EPA-registered intermediate-level hospital disinfectant with tuberculocidal claim, e.g., products containing chlorine, quaternary ammonium compounds with alcohol, phenolics, or iodophors.
c. At the end of each day, general cleaning and disinfection of clinical contact surfaces are performed regardless of barrier protection.
i. To facilitate daily cleaning, treatment areas are kept free of unnecessary equipment and supplies.
1. Unless visibly contaminated, cleaning walls, window drapes, and other vertical surfaces is unnecessary.
a. Floors and sinks are cleaned regularly with a detergent and water or an EPA-registered hospital disinfectant/detergent designed for general housekeeping purpose.
b. Carpeting and cloth furnishing cannot be reliably disinfected and are avoided in patient care, laboratory, or instruments processing areas.
1. Wearing appropriate PPE, visible organic material is removed using disposable paper towels, which are then discarded in a leak-proof and appropriately labeled container.
2. The contaminated surface is cleaned with a detergent and water and disinfected with an EPA-registered intermediate-level hospital disinfectant with a tuberculocidal claim.
Following an exposure to blood or OPIM, OHCPs shall immediately undergo a confidential medical evaluation and subsequent follow-up by a qualified health-care professional in accordance with current recommendations of the U.S. Public Health Service.
Exposure to blood or OPIM, including saliva (even when blood is not visible), must be considered potentially infectious. Consequently, post-exposure evaluation and follow-up is a critical element of a comprehensive infection control/exposure control protocol.
1. Wash injuries with soap and water and apply an antiseptic agent (if available).
2. Report the exposure incident immediately to the Office Infection-control Officer or other designated person.
3. Complete the Uniform Needlestick and Sharp Object Injury Report Form.
1. A copy of the completed Uniform Needlestick and Sharp Object Injury Report Form.
2. A copy of the OHCPs Medical Record (see Figure 2 below).
3. Any information available about the source individual.
a. With the source person's consent, the source person's blood is tested as soon as feasible to determine hepatitis B and C virus, and HIV infectivity.
c. The OHCP is informed of the applicable laws and regulations concerning the disclosure of the identity and infectious status of the source person.
4. Post-exposure management and prophylaxis.
a. After percutaneous, mucous membrane, or non-intact skin exposure to blood or OPIM, the consulting physician will initiate post-exposure management (prophylaxis) according to the latest CDC recommendations.
b. The consulting physician's written report is obtained within 15 days of the post-exposure evaluation and is made available to the OHCP.
i. Dates of vaccinations (where appropriate or available).
ii. Evidence of immunity (where applicable or available).
iii. Documentation relative to the individual's inability to receive the vaccinations required or highly recommended.
iv. A signed copy of the mandatory hepatitis B vaccination declaration form (See II. Vaccinations).
b. A copy of all results of examinations, medical testing, and other post-exposure follow-up procedures.
c. The medical record is available for examination by the OHCP and a copy is provided upon request.
i. The content is confidential and is not disclosed to anyone, without the OHCP's expressed written consent, except as require by law.
To prevent the transmission of Mycobacterium tuberculosis (MBT), transmission-based precautions based on a three-level hierarchy of administrative, environmental, and respiratory-protection controls are to be implemented.
The primary risk of exposure to Mycobacterium tuberculosis (MBT) in the oral healthcare setting is contact with patients with undiagnosed or unsuspected infectious tuberculous (TB) disease. A high index of suspicion and rapid implementation of precautions are essential to prevent and interrupt the transmission of MBT.
A. Identification of patients with suspected or confirmed TB disease.
i. Chronic ill health, coughing with hemoptysis, low-grade fever, weight loss, and night sweats.
1. Routine dental care is postponed until a physician confirms that the patient does not have infectious TB or until it is confirmed that the patient is no longer infectious.
2. Patients requiring urgent dental care are referred to an oral healthcare facility that meets the requirements for appropriate environmental and respiratory-protection controls.
a. National Institute for Occupational Safety and Health (NIOSH)-certified particulate-filter respirators (N95, N99, or N100) are used, which have the ability to filter <.3 μm particles with a filtering efficiency of 95, 99, and 99.7%, respectively.
A. Applies to any person with signs of illness when entering the oral healthcare facility, i.e., cough, congestion, rhinorrhea, or increased production of respiratory secretions.
1. The absence of fever does not always exclude a respiratory infection.
1. Education of oral healthcare workers (OHCWs), patients, and visitors.
2. Posted signs, in language(s) appropriate to the population served, with instructions to patients and accompanying family members and friends.
a. Covering the mouth/nose with a tissue when coughing and prompt disposal of used tissues.
b. Using a surgical mask on the coughing person when tolerated.
c. Hand hygiene after contact with respiratory secretions.
d. Spatial separation, ideally >3 feet, of persons with respiratory infections in common waiting areas.
i. Wear a mask and perform appropriate hand hygiene when examining and caring for patients with signs and symptoms of a respiratory infection.
Oral health care facilities shall have written policies to protect patients and OHCWs with latex allergies, to protect OHCWs who are susceptible to opportunistic infections, and to protect patients from OHCWs with transmissible infections.
OHCPs and patients may become susceptible to latex-related adverse reactions, OHCPs may also develop acute or chronic conditions, which may predispose them to opportunistic infections, or OHCPs may acquire potentially transmissible infections. Such individuals should discuss the problem with their personal physician or other qualified authority to determine if the condition might affect their ability to safely perform their duties.
A. Minimize latex allergy-related health problems among OHCPs and patients.
1. Reduce exposure to latex-containing materials by substituting non-latex products when appropriate and using appropriate work practice controls.
3. Monitor signs and symptoms of latex sensitivity among OHCWs and patients.
4. Refer OHCP with signs and symptoms suggestive of latex allergy to a physician to confirm diagnosis.
B. Minimize the exposure of OHCPs with acute or chronic diseases to patients who have been diagnosed with a transmissible infectious disease.
a. Determine if condition(s) might affect ability to safely perform duties.
C. Minimize the exposure of patients to OHCPs who have been exposed to or have been diagnosed with an infectious disease (Table 1 through Table 4).
c. Level of circulating viral burden.
d. Level of risk for the transmission of a pathogen in association with a procedure.
2. Procedure-related risk for bloodborne pathogen transmission (Table 5).
a. No evidence of having transmitted infection to patients.
b. Obtained advice from an Expert Review Panel about continued practice.
c. Follow-up twice a year to demonstrate the maintenance of an acceptable viral burden.
d. Follow-up by personal physician with expertise in the management of infections with bloodborne pathogens.
e. Consulted with an expert about and strictly adhere to optimal infection control procedures.
f. Agreed to and signed a contract or letter from the Expert Review Panel that characterizes responsibilities.
Standard Precautions in combination with Transmission-based Precautions and Respiratory Hygiene/Cough Etiquette provide a hierarchy of preventive strategies to eliminate or minimize HAIs. This guideline is designed to provide practical information for an effective infection control program in oral healthcare settings.
1. Bolyard EA, Tablan OC, Williams WW, et al. Guideline for infection control in healthcare personnel, 1998. Hospital Infection Control Practices Advisory Committee. Infect Control Hosp Epidemiol. 1998 Jun;19(6):407-63.
2. Advisory Committee on Immunization Practices; Centers for Disease Control and Prevention (CDC). Immunization of health-care personnel: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2011 Nov 25;60(RR-7):1-45.
3. Department of Labor, Occupational Safety and Health Administration. 29 CFR Part 1910.1030. Occupational exposure to bloodborne pathogens; final rule. Federal Register 1991;56:64004-64182. Accessed on May 28, 2015.
4. Huber MA, Terezhalmy GT. HBV and HCV: Infection control/exposure control issues for oral healthcare workers - 2012. Available at dentalcare.com.
5. Huber MA, Terezhalmy GT. HIV: Infection control/exposure control issues for oral healthcare workers - 2009. Available at dentalcare.com.
6. Huber MA, Terezhalmy GT. Measles, mumps, rubella: Infection control/exposure control issues for oral healthcare workers - 2012. Available at dentalcare.com.
7. Huber MA, Terezhalmy GT. HSV and VZV: Infection control/exposure control issues for oral healthcare workers - 2009. Available at dentalcare.com.
8. Huber MA, Terezhalmy GT. Mandated, Highly Recommended, and Other Vaccines for Oral Healthcare Personnel Workers - 2015. Available at dentalcare.com.
9. Huber MA, Terezhalmy GT. Adverse reactions to latex products: preventive and therapeutic strategies - 2010. Available at dentalcare.com.
10. Kohn WG, Collins AS, Cleveland JL, et al. Guidelines for infection control in dental health-care settings-2003. MMWR Recomm Rep. 2003 Dec 19;52(RR-17):1-61.
11. Panlilio AL, Cardo DM, Grohskopf LA, et al. Updated U.S. Public Health Service guidelines for the management of occupational exposures to HIV and recommendations for postexposure prophylaxis. MMWR Recomm Rep. 2005 Sep 30;54(RR-9):1-17.
12. Porteous NB, Terezhalmy GT. Tuberculosis: Infection control/exposure control issues for oral healthcare workers - 2010. Available at dentalcare.com.
13. Siegel JD, Rhinehart E, Jackson M, et al. 2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings. Accessed on May 28, 2015.
16. U.S. Public Health Service. Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HBV, HCV, and HIV and Recommendations for Postexposure Prophylaxis. MMWR Recomm Rep. 2001 Jun 29;50(RR-11):1-52.
Professor and Dean Emeritus, School of Dental Medicine, Case Western Reserve University, Cleveland, Ohio; and Consultant, Naval Postgraduate Dental School, Walter Reed National Military Medical Center, Bethesda, Maryland.
Dr. Terézhalmy earned a B.S. degree from John Carroll University; a D.D.S. degree from Case Western Reserve University; an M.A. in Higher Education and Human Development from The George Washington University; and a Certificate in Oral Medicine from the National Naval Dental Center.
Dr. Terézhalmy held more than 30 positions in professional societies, served as editor or contributing editor for several publications, co-authored or contributed chapters for several books, published over 225 papers and abstracts, and accepted invitations to lecture before many local, state, national, and international professional societies.


I finally took the time to make a diaper tricycle and take pictures of the steps along the way.
To begin, I used 15 (size one or two) diapers for each back wheel and 25 diapers for the front wheel. Roll one diaper up into a fairly tight roll. Then start layering the other diapers around the spacing the ends out to make the tread for the wheels. Secure with rubber bands to hold in place.
I have done this enough to have the top of the last diaper meet the bottom of a previous one. As a type A gal, I like that the orderliness of this. Use as many rubber bands as you need to keep the circle going. I think I use about three. In the end you will cover them up with pretty ribbon.
There may be a better way to secure the ribbon around each wheel but I prefer to do so with a safety pin. I personally can never find one when I need one around here so I like the usability of the pins in the final product. The wheels will be strategically placed to hide all our secrets. Rinse and repeat with the 25 diapers to create the front wheel. Once the wheels are assembled, poke your fingers through to create an opening.
I think the most fun part of this project is mixing and matching the accessories to create the trike. You will need two cotton receiving blankets (the stiffer the better), two bibs, one bottle, and a pair of coordinating socks. Individually roll up the blankets as tightly as you can. These will become what holds the trike together. Then insert one blanket through the front wheel.
Place the back wheels on either side of the front wheel. I like for the treads of my back wheel to face backwards and the front to run forward. Thread the blanket from the front wheel into the outside back wheels. Pull together tightly and secure (again I use a safety pin). Then I slide the blanket around so the pinned part is hidden inside one of the back wheels.
Next thread the other rolled blanket evenly through the front wheel. Place a bib over the front wheel to create the fender. I like to tuck my bib around to the back for added interest. Place the other bib over the back of the trike to create the seat.
If the bib is large enough I like to fasten the seat bib through the front wheel . If not I just tuck so that it is secure and orderly. Place a bottle on top of the front bib, pull up the second blanket to create bunny ears and secure with a rubber band. Work with the blanket to get the handles just right. It may take a bit for gravity to help the handle bars lay down the way you want them.
Finally add the finishing touches! Conceal the rubber band at the handle bars with a ribbon tied into a pretty bow. Use the socks on each end of the handle bars to create grippers (aren't they adorable?).
Then fluff and adjust until you get it just the way you want it.
For a beautiful presentation, wrap your diaper tricycle with tulle and tie with a coordinating ribbon. You'll have everyone oohing and ahhing over your skills at the shower!
I hope this helps you create gifts for your friends and family. If you decide to craft one (or twelve) please shoot me a picture of how it turns out! If you are crafty challenged or just don't have the time for a project like this you can order one from me and I'll ship to you or the gift recipient!
Fantastic tutorial! Cute as a sweet new baby,Would be a great gift for baby shower just brilliant!
This is adorable~ I'm going to have to bookmark this for the next baby shower I give.
Oh My Gosh! That's amazing! Thanks for sharing ~ please stop by sometime!
holy cow! that is like. THE cutest thing ever! totally puts those diaper cakes to shame! definetely bookmarking this for later use!
This is absolutely adorable!! I have never seen this before, thanks for sharing the tutorial!!
What a fantastic spin on the diaper cake! I'm featuring this in my Friday Favorites this week!
Thank you so much for this tutorial. I made it this past weekend and everyone fell in love with. It was exactly what I was looking for.
I just had to share this with my readers!
This was so much fun to make! Thanks for posting such a wonderful tutorial! Mine turned out really cute and I also made a wagon to attach to the back of it with the baby's name on it. I know it will be a great hit at the shower!
Oh my gosh! I'm going to a baby shower this weekend a wagon would be sooo cool!!
Thank you so much for posting the tutorial! My sister gave birth to a baby boy this morning, tonight the diaper tricycle is standing proud on my dining room table, will deliver it tomorrow!
I just made one of these this morning…..it is so darn cute, I can't wait for the baby shower to display it!
Great tutorial! Just finished making it for a baby shower tomorrow….hope the snow storm doesn't cancel the shower. It is adorable on the computer monitor, but soooo much cuter in person!! Thank you!!!
Yay to everyone who has had success with this tutorial. Please send me a picture of your finished project so I can share in a gallery to inspire others!
Thank you so much for these great DIY instructions!! I just made one and it looks great!!
Great tutorial! This was the first time I have ever attempted anything like this! Here is a link to my finished product.
I used your tutorial today! Here's a link to my blog for pictures. My friend and I loved your tutorial!
I have a diaper shower to go to this weekend and this is just what I needed! It seems simple enough! Thanks for the tutorial!
So I've made the motorcycle version of this and thought that this would be the same. It was. This time around, however, I was struggling with the wheels. I used ribbon originally to secure the wheels, but the darn stuff kept popping loose. I used rubber bands, but they kept snapping. Eventually I laced several rubber bands together and then reinforced it with ribbon. I'm not sure what I'm doing wrong. But after a few four letter words, it's ready for the baby shower tomorrow!
Thanks for sharing the tutorial. Too many people get weird and proprietary over this kind of thing – I'm glad you're willing to share!
Awesome tricycle cake! I always wanted to make one and I've never had.
This is an awesome creation and a great tutorial. Thank you for sharing! I have a baby shower coming after Christmas, if I can pull it off, this will certainly impress the mommy-to-be!
Hi! I have a question: what would be the ideal dimensions for the blankets to make sure that they are neither too big nor too small to get around the whole thing?
I just used this tutorial to make a trike for a friend of mine. I am hosting her shower this weekend, and it came out great!! It is an absolutely adorable idea! Thank you much for the tutorial! It was super easy to follow!
I used your tutorial for making the diaper trike and it turned out just beautiful. I used a sippy cup instead of the bottle for the headlight and used the handles of the sippy cup to feed the sides of the baby blanket thru for the front wheel. I also used a onesie folded into a triangle for the seat of the trike. I got several rave reviews of my creation and the expectant parents just loved it. I will definitely be using this idea again in the future. Thank you so much for the very easy instructions!
Thank you for such great instructions! I made one for my best friends shower. Took me about an hour and was very easy and fun to make! I had a little trouble with the handlebars but out a chop stick behind it to hold it up! Thanks again, it is so cute!!
I have two great-grandbabies due in 2013. I had seen pictures of this tricycle, but yours is the first with instructions. Thank you so much – you made my day.
My grandson is due in a few weeks & this is such an. ADORABLE idea!! More clever than a diaper cake!
I have made several of these and have one consistent problem… my handle bars are droopy. How did you get your blanket to stay so 'erect'? Thanks.
This was such a. great tutorial!! Thanks so much! I do have a quick question.. The tires on my tricycle look a little "flat" any suggestions on how to fix?


Enjoy playing Caldara's Sebben, Crudele accompanied by concert pianist, Lisa Maresch. Thanks to our unique interactive video player, you can easily speed up and slow down the tempo of the piano accompaniment audio/video track, set up loops and markings - all while reading your violin part from the same video. A useful tool for any musician.


Friday around 5 lordaerith and I left to go visit queencimmy at SLC. We got there with almost no hassle at all. With Aerith's help I was actually able to SEE the sign to turn onto the 3rd highway for unlike last time. We got there and ended up waiting for Cimmy and her suitemate, Pirate Wench (so called b/c of her obsession w/pirates and the fact that she spent a semester at sea), for about half an hour before I finally called them to see what was up. They thought we were getting in a little later than we did. So, we went back to their suit, which is in a dorm called "Titsworth" *giggle*. After hanging out for a little bit and finding out that Pirate Wench and I are too alike for our own good, we went to see Secretery b/c neither of our hosts had seen it and well, Aerith and I really like it.
Saturday morning we got up early to go to the Faire. The drive there was pretty easy and painless, except for the time I didn't see the break lights ahead of me (i was looking at road signs) and so had to hit the breaks really fast. Yay for good breaks, boo on squeeling tires and the smell of burnt rubber, but at least I didn't hit anything :). We got to the faire a little later than we wanted to (we wanted to make it for opening, oh well) and it was kind of drizzly out. We changed into garb (all nice and laced up) and went in.
Oh, and honey, I don't need to use my hands get this look.
Aerith bought some bracers (which I thought were to keep his sleeves out of his food, but were really to keep them out of the way of the ring) and a pouch from this leather store and we saw these really pretty pewter goblets. The woman selling them said that they were good for weddings, and I showed her my hand and said "do you see a ring?" Little did I know what was to happen later that day.
We had soup bowls for lunch b/c by the time we were hungry we were also very cold and the rain had soaked through part of our cloaks. After lunch we went by Moresca and Cimmy tried on a full outfit.
After we all rested we were like "let's go take pictures at the Kissing Bridge." Well, you know what happened there. Aeirth proposed.
I was so happy. I really couldn't believe it happened. I think the first thing I said, after "yes", was "is this for real?" And I have to confess, I made Aerith write down what he said. Once he got on his knees, I heard what he was saying, but it wasn't registuring b/c I was so happy and was in such total shock.
We walked around some more and made more bawdy jokes with the pickle venders and the guy selling frozen balls of strawberry and orange flavored ice. We saw a live action chess game, but it sucked a lot and was no where near as cool as SSFFSs ever are. Then we ran into witch-child and her mother (who we used to game with) and DJ P from Haven. And there was more ring showing. After that we were tired and soaking wet so we decided to leave, but not before Cimmy bought Aerith and I the glasses that we had been looking at earlier. I got to show the woman that i had shown a hand with no ring the same hand now with a ring.
After that we left and Aerith drove back to SLC. I called my mother along the way. She knew it was going to happen. After getting back and calling a zillion people, I found out that a lot of my friends knew it was coming, so did my tartot cards even, but somehow they all kept it secret from me. Then we went to this "block party" thing at the Pub. Free food and getting to show off my ring, yay! The music, while oldies, which i love, was way too loud and once again I discoved that I just can't dance to it.
I'm so happy. I can't believe it's finally happened. We've been dating for almost 5 years now ;) Tonight wild horses couldn't keep me away from Haven.


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text:
SportsFootballJets
Le'Veon Bell describes how and why he joined the Jets in SI interview
Le'Veon Bell in the AFC Championship Game against the New England Patriots at Gillette Stadium on January 22, 2017. Photo Credit: Getty Images/Jim Rogash
By Al Iannazzone al.iannazzone@newsday.com Updated March 20, 2019 1:42 PM
Jamal Adams wasn't the only Jet to recruit Le'Veon Bell. Quarterback Sam Darnold also contacted Bell during free agency, and he helped get the playmaker in a Jets uniform.
Darnold has put himself on good footing with the Jets' new star. This is a significant development since Bell, in an interview with Sports Illustrated, said he didn't have the kind of relationship he wanted with Steelers quarterback Ben Roethlisberger. Bell revealed it was "a factor" in him leaving Pittsburgh for the Jets.
"I would have liked it to be more open, more genuine, more real, like we're friends, like we're teammates," said Bell, who is featured on the cover of this week's Sports Illustrated.
Bell painted a picture – similar to ex-Pittsburgh receiver Antonio Brown – that Roethlisberger acts like he's above his teammates and the Steelers organization allows it to be that way.
The Jets are grooming Darnold to be their franchise quarterback. But by no means does he have the power that Roethlisberger, a two-time Super Bowl winner, has with the Steelers. Darnold is in just his second season, and carries himself differently.
Now Darnold knows how Bell, who signed a four-year, $52.5 million deal with the Jets, wants to be treated and the kind of relationship he wants with his quarterback. He's off to a good start.
Everyone with the Jets is.
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Bell, a three-time Pro Bowl back, sat out last season because of a contract dispute with the Steelers. He spoke at length at why he feels the Jets were the right team for him at the right time. He said the Jets were more welcoming and that he immediately felt comfortable with new coach Adam Gase in ways he never did with his former coach, Mike Tomlin.
"When I got to the Jets and New York, I felt loved instantly," Bell said. "When I talked to Coach Gase I felt like me and him are at the same level. He's not talking to me like I'm under him. He's the head coach but he's talking to me like we're at the same level. When I talk to the GM, he talked to me like we're at the same level.
"When I first got to Pittsburgh I didn't get that feeling. Not saying they greeted me wrong. When I got to New York and the Jets, and like the teammates, I felt welcome. I felt it. You can sense when people genuinely want you around, they genuinely want you here. They genuinely want you to be good. 'We want you to be good here.' That's the vibe I got. It didn't hit me until I was a free agent and I'm talking to Adam Gase on the phone. That's when it hit me, I'm talking to him like normal. I'm talking to him like I'm talking to my friend. I'm talking to him like I'm at the same level."
Bell said he and Gase immediately started talking about plays and how he would use him, and asked him what he likes to run. Bell said it took a few years where could talk to Tomlin that way, but he never felt as if he could suggest they run a certain play.
"He's excited, I'm excited," Bell said of Gase. "He talked to me about plays I like, and designs, what routes I like to run, how comfortable am I playing different positions. That's why I'm so excited. I feel comfortable talking to him like that, like, 'We should try to run this.'"
Bell also said one of the reasons he was unhappy in Pittsburgh was because the fan base didn't want him to have interests outside of football. If he wasn't on the field, he had to be working out, he said.
Yet, Bell said if the Steelers had given him the same guarantee as the Jets did - $35 million – last summer he would have signed the long-term deal to remain in Pittsburgh. Bell was reportedly offered a five-year, $70 million, but he said just the first year was fully guaranteed.
Bell said he planned to sign the franchise tag and return to the Steelers after Week 1. But after some of the Steelers publicly criticized him, he decided to sit longer. He thought about returning after the bye week, but he continued to hold out.
Eventually, Bell forfeited the entire $14.5 million he would have gotten from the franchise tag, and continues to say he has no regrets because he's physically and mentally fresher than ever - and happier.
"I feel amazing," he said. "To be honest I feel like the decision I made and all the layover and the long sitting out it paid off in the long run. I'm happy where I am today.
"I can't remember the last time I felt this good," Bell said. "I literally can't remember feeling this happy and being in such a good spot and feeling this way about myself."
By Al Iannazzone al.iannazzone@newsday.com
Latest Jets headlines
NFL win totals, odds for 2019
Jets TE Herndon suspended four games
Former Jets coach Walt Michaels dies at 89
New Jets GM Douglas filling out front-office staff
McCown takes pride in his career as he retires


This attractive point-of-sale display includes six each of 10 different Sport Plates. Refill empty hooks with your choice of 20 different Sport Plates. Includes: Baseball, Coach, Bowling, Soccer, Softball, Football, Cheer, Golf, Basketball and Sports Fan Sport Plates.


text:
Lycaena kochi är en fjärilsart som beskrevs av Embrik Strand 1902. Lycaena kochi ingår i släktet Lycaena och familjen juvelvingar. Inga underarter finns listade i Catalogue of Life.

Källor

Juvelvingar
kochi

redpajama_set_name: RedPajamaWikipedia


text:
Boost Your Memory with Brain-Boosting Supplements
Wednesday, February 25, 2009 by: James J. Gormley
Tags: brain function, health news, Natural News
https://www.naturalnews.com/025722_supplement_brain_memory.html
(NewsTarget) Where did I leave my keys? Who am I supposed to call again? What did I mean by that scribbled note, anyway? Everybody experiences these incidents of forgetfulness.
As we get older, these kinds of memory lapses can become routine, and are casually attributed to "advancing years" by many baby boomers, according to Dr. Heidi White, assistant professor of geriatric medicine at Duke University Medical Center.
Age isn`t the only factor in memory loss, however, says White. She notes that among possible causes for cognitive decline are medications (such as sedatives, which can dull the mind), depression (which affects concentration), and hearing or vision impairment.
Baby boomers and the battle for the mind
Keeping the brain healthy much longer is a goal of many of us, especially people who, as of this writing, were 45 to 63 years old - otherwise called baby boomers. If you consider that a baby boomer turns 50 every 7.5 seconds, by the year 2024 there will be 115 million people over age 50 in the U.S.
Today, approximately 78 million people, about 26 percent of the total U.S. population, were not only born between 1946 and 1964 but are, say demographers and researchers, greatly concerned about loss of memory and the aging of the mind.
True failing memory is different from the forgetfulness of a busy person or the stereotypical absentminded professor. Clinically speaking, failing memory is often accompanied by a person`s declining sense of well-being, and is often described by symptoms such as a lack of mental clarity (brain fog), altered mood (as in depression), decreased mental abilities, worsening sleep patterns, and declining overall energy.
Age of Information Overload
Whence the brain drain? Some researchers believe our brains are overtaxed today. Not many would disagree that we`ve moved beyond the Information Age into the "Age of Information Overload." It`s believed that our cognitive processing, and maybe even our memory storage capacity itself, can become overburdened as we age.
To one extent or another, there`s little doubt that all of us are bombarded by work and personal e-mail, Internet spam and junk mail, faxes, magazines, 24-hour news, digital pages, telemarketer calls, cell phone voice-mail and even the arcane logistics of play-date scheduling for the kids after school!
Cognition is sensitive to a wide variety of nutritional factors, and modern nutritional science is uncovering that we can improve our mental powers effectively, and even powerfully, through a wide array of nutrients and supplements, including antioxidants, herbs, fats and other targeted dietary supplements.
A November 2008 review in the Journal of the American Nutraceutical Association pointed to benefits of a variety of bioactive nutritional supplement ingredients (often called nutraceuticals), some of which we will look at, in slowing age-associated memory impairment. Vinpocetine and acetyl-L-carnitine were especially effective, followed by huperzine A; rhodiola; ginseng and alpha lipoic acid. The least effective compounds were the drugs, Aricept and Nemanda.
The brain train - vitamins to the rescue
Vitamin C. To test whether vitamin C protects against mental decline, called "cognitive impairment" in this study, researchers from Australia`s University of Sydney looked at 117 elderly people in a retirement community over a four-year period --- those who took vitamin C supplements and those who did not. Seniors who took vitamin C supplements experienced a lower incidence of severe cognitive decline. The authors concluded that, "Vitamin C might protect against cognitive impairment."
Vitamin E. Research from Italy and the U.S. has shed new light on vitamin E`s role in brain health. A July 2005 study by Italian researchers from Perugia`s Institute of Gerontology and Geriatrics (the InCHIANTI study) included 1,033 participants aged 65 and older. The research group found that people with the lowest blood levels of vitamin E had the highest incidence of senile dementia and "cognitive impairment" compared to those who had the highest vitamin E levels.
Another 2005 study, this out of Chicago`s Rush Institute for Healthy Aging, studied 6158 people 65 years of age or older between 1993 and 2002, including a subset of 1,041 patients who were clinically evaluated. The researchers, led by Martha C. Morris, Sc.D., found that higher intakes of vitamin E were associated with a reduced incidence of Alzheimer`s disease.
Other recent studies have looked at different combinations of vitamins and minerals, with vitamins C and E as a foundation.
ALA anyone?
Alpha lipoic acid is a very powerful brain-friendly antioxidant that has been found to directly restore vitamin C and glutathione to their active forms (after they have been used up) and to indirectly restore vitamin E to its powerful form, as well.
In animals, alpha lipoic acid protects brains cells against beta amyloid plaque, the buildup of which is associated with dementia and Alzheimer`s disease. In fact, animal studies published in 2002 and 2003 showed that treatment with alpha lipoic acid prevented or reversed cognitive impairment similar to dementia in humans.
In 2001, researchers gave nine patients with Alzheimer`s disease 600 mg each day of ALA in addition to Aricept or Exelon for an average of one year. This was the first such study to find that treatment with alpha lipoic acid may be "neuroprotective" against Alzheimer`s disease and related dementias.
In a 2007 follow-up, 43 ALA-supplemented patients were observed for a period of up to 48 months. In patients with mild dementia, the disease progressed extremely slowly; in patients with moderate dementia, dementia progressed twice as slowly.
B is for brain
In the American Journal of Geriatric Psychiatry, researchers looked at 69 people with Alzheimer`s disease, including 33 patients who were taking a multivitamin supplement of folic acid, vitamin B6 and vitamin B12.
In the 66 patients who were available for the eight-week follow-up, the high-dose B-vitamin supplement significantly reduced levels of homocysteine, which is important since high levels of homocysteine may be associated with the breakdown of the myelin sheaths that encase nerves and may be partly responsible for the symptoms of Alzheimer`s-like dementia.
Botanical brain boosters
Ginkgo. Since stress in humans is associated with decreased memory and learning function, Polish scientists gave an extract of Ginkgo biloba (EGb 761 or Ginkgold) to rats that had been chronically stressed. According to their study, the supplement improved memory and cognition in all rats, including those that had been stressed.
The last 30 years have yielded a large body of evidence supportive of ginkgo supplementation for brain-boosting, although some studies have studied the wrong groups, have looked for the wrong results or have used too low a dose. According to 2000 review by New York University`s P.L. LeBars, daily dosages of 240 mg a day appeared to demonstrate the most benefit in patients with memory disorders or dementia.
Ginseng. In 2008, a group of South Korean researchers published the results of an open-label study in which patients with Alzheimer`s disease received Panax ginseng extract or a placebo for 12 weeks. In the ginseng-supplemented group, all main measures cognitive performance began to show improvements and continued for up to 12 weeks. After discontinuing ginseng, the improved scores declined to the levels of the control group. According to the authors, "These results suggest that Panax ginseng is clinically effective in the cognitive performance of [Alzheimer`s disease] patients."
Pomegranate. A 2005 rodent study found that drinking pomegranate juice during pregnancy may lower the risk of hypoxia ischemia-related brain injuries (a condition caused by decreased blood flow and oxygen to the fetal brain) in babies. The authors said their results "demonstrate that maternal dietary supplementation with pomegranate juice is neuroprotective for the neonatal brain."
A more recent study in newborn mice, published in 2007, suggest that special compounds in pomegranate, polyphenols, should be further investigated as a potential treatment to decrease brain injury due to neonatal hypoxia-ischemia.
Vinpocetine. Vinpocetine is a supplement that`s derived from vincamine, an extract of the periwinkle plant (Vinca minor). Widely used and studied in Europe for over 25 years, awareness of this product and the research behind is now starting to come into its own.
A 2001 review (meta-analysis) in the Journal of the American Nutraceutical Association by the University of Miami`s Bernd Wollschlaeger, M.D., winnowed down 39 vinpocetine studies involving 1,912 subjects into three studies - from 1986 through 1991 - involving a total of 174 patients treated with vinpocetine and 114 given a placebo.
According to Wollschlaeger, all three studies "suggest a significant [mental] improvement in the cognitive function of patients suffering from dementia or other symptoms of cerebrovascular diseases." Based on several mental-performance tests, the significant improvement in cognitive function, in these three studies, says Wollschlaeger, "suggest[s] a clinical application of vinpocetine in the early phases of mild cognitive impairment" before full-blown "senile dementia" or Alzheimer`s disease start to develop.
"Designer" supplements for brain support
Acetyl-L-carnitine (ALC). A 2004 review of 21 double-blind, placebo-controlled studies using acetyl-L-carnitine in the treatment of "mild cognitive impairment" and mild Alzheimer`s disease showed significant improvements versus the placebo or "dummy" pills.
CDP-choline. A relative of phosphatidylserine (PS), cytidine-5-diphosphocholine, or CDP-choline, has been attracting some recent research interest. In 2005, scientists from the Massachusetts Institute of Technology (MIT) found, in an animal study, that long-term supplementation with CDP-choline may hold back memory impairment.
Huperzine A. Huperzine A is a purified substance derived from Chinese club moss (Huperzia serrata). A 2005 paper on this supplement speculated that the beneficial effects in Alzheimer`s disease are probably due to several cell- and neuro-protective effects operating at the same time.
Food-based mental mojo?
In a 2004 observational study from the U.K. looking at dietary supplement use, people born in 1936 received mental ability testing in 1947 and later in 2000-2001. At age 64, cognitive function was better in dietary supplement users than in non-users, especially in those people who were also taking marine oil supplements.
Quality of mind = quality of life
Many would argue that quality of mind - a well functioning brain - is truly at the elemental core of quality of life; therefore, ways in which we can improve our mental abilities and functions, and fend off the memory and general cognitive declines associated with aging, should be more than welcome - especially when these ways are holistic, supplement-based, and without the profound unwanted side effects often associated with synthetic pharmaceutical drugs.
Gormley J and Liberman S. User`s Guide to Brain-Boosting Supplements. North Bergen, NJ: Basic Health Publications, 2004.
Reynolds J et al. Retarding cognitive decline with science-based nutraceuticals. Journal of the American Nutraceutical Association. 11(1):19-27, 2008.
Paleologos M et al. Cohort study of vitamin C intake and cognitive impairment. Am J
Epidemiol. 148(1):45-50, 1998.
Cherubini A et al. Vitamin E levels, cognitive impairment and dementia in older persons: the InCHIANTI study. Neurobiol Aging. 26(7):987-994, 2005.
Morris MC et al. Relation of the tocopherol forms to incident Alzheimer disease and to cognitive change. Am J Clin Nutr. 81(2):508-514, 2005.
Arivazhagan P and Panneerselvam C. Neurochemical changes related to ageing in the rat brain and the effect of DL-alpha-lipoic acid. Exp Gerontol. 37(12):1489-1494, 2002.
Sharma M and Gupta YK. Effect of alpha lipoic acid in intracerebroventricular streptozotocin model of cognitive impairment in rats. Eur Neuropsychopharmacol. 13(4):241-247, 2003.
Farr SA et al. The antioxidants alpha-lipoic acid and N-acetylcysteine reverse memory impairment and brain oxidative stress in aged SAMP8 mice. J Neurochem. 84(5):1173-1183, 2003.
Hager K et al. Alpha-lipoic acid as a new treatment option for Alzheimer type dementia. Arch Gerontol Geriatr. 32(3):275-282, 2001.
Hager K et al. Alpha-lipoic acid as a new treatment option for Alzheimer`s disease - a 48 months follow-up analysis. J Neural Transm Suppl. 72:189-193, 2007.
Aisen PS et al. A pilot study of vitamins to lower plasma homocysteine levels in Alzheimer`s disease. Am J Geriatr Psychiatry. 11(2):246-249, 2003.
Walesiuk A et al. Ginkgo biloba extract diminishes stress-induced memory deficits in rats. Pharmacol Rep. 57(2):176-187, 2005.
LeBars PL and Kastelan J. Efficacy and safety of a Ginkgo biloba extract. Public Health Nutrition. 3(4A):495-499, 2000.
Lee ST et al. Panax ginseng enhances cognitive performance in Alzheimer disease. Alzheimer Dis Assoc. Disord. 22(3):222-226, 2008.
Loren DJ et al. Maternal dietary supplementation with pomegranate juice is neuroprotective in an animal model of neonatal hypoxic-ischemic brain injury. Pediatr Res. 57(6):858-864, 2005.
West T et al. Pomegranate polyphenols and resveratrol protect the neonatal brain against hypoxic-ischemic injury. Dev Neurosci. 29(4-5):363-372, 2007.
Wollschlager B. Efficacy of vinpocetine in the management of cognitive impairment and memory loss. Journal of the American Nutraceutical Association. 4(2):25-30, 2001.
Ames BN and Liu J. Delaying the mitochondrial decay of aging with acetylcarnitine. Ann N Y Acad Sci. 1033:108-116, 2004.
Teather LA and Wurtman RJ. Dietary CDP-choline supplementation prevents memory impairment caused by impoverished environmental conditions in rats. Learn Mem. 12(1):39-43, 2005.
Wang R Tang XC. Neuroprotective effects of huperzine A: a natural cholinesterase inhibitor for the treatment of Alzheimer`s disease. Neurosignals. 14(1-2):71-82, 2005.
Whalley LJ et al. Cognitive aging, childhood intelligence, and the use of food supplements: possible involvement of n-3 fatty acids. Am J Clin Nutr. 80(6):1650-1657, 2004.
James Gormley is an award-winning health journalist, bestselling author, and member of both the American Society of Journalists and Authors (ASJA) and the Association of Health Care Journalists. He is a senior policy advisor for Citizens for Health and a board member of the National Health Research Institute (NHRI). He writes a regular political and health advocacy column for NOW Foods and his blogs include "The Gormley Files" (http://thegormleyfiles.blogspot.com and "Health Books Navigator" (http://healthbooksnavigator.blogspot.com/) and his books include User's Guide to Natural Treatments for Lyme Disease. Visit him at http://www.linkedin.com/in/jamesgormley.
Brain function at FETCH.news


Free swimming for disabled people has been extended right across the borough following a lengthy debate at Council last night (Monday).
Officers had recommended scrapping free swims for disabled people in Armagh, instead making it a reduced concessionary rate of 65% across the borough.
But councillors on the the Leisure Services Committee agreed to offer disabled people free swims right across the Armagh, Banbridge and Craigavon district.
Sinn Fein councillor Garath Keating described the development as "hugely significant".
"I am delighted to have been able to convince the chamber to go against the recommendation of officials on the matter," said councillor Keating.
"I think a further inexpensive but highly positive initiative to get more of our people into better physical and mental health and wellbeing during difficult times was missed," he explained.
The decision will have to ratified at the full council meeting later this month.


For all those of you unlucky enough not to be able to enjoy Waitrose, the UK supermarket you probably haven't heard about their scan and shop system. Simply walk up to a row of scanners as you enter, swipe your credit card and then shop by scanning all the items you pick up. At the end, simply pay the total and go.


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text:
Movie Review: The Shed (2019)
Rupert Harvey
Feeling all horrored-out after your Halloween movie marathon? Don't hang up your crucifix yet — The Shed is a bite of gory fun to keep the party bleeding.
An arresting opening sequence sees a man named Bane (Frank Whaley, "Hustlers") desperately running from a vampire. Spoiler alert: He's caught, he's bitten, and he stumbles — dodging sun rays in classic Near Dark-style — into the relative safety of a garden shed.
The shed belongs to Stan (Jay Jay Warren, "Day of Reckoning") — or, more specifically, Stan's abusive ex-veteran grandpa, Ellis (Timothy Bottoms, "Pound of Flesh"). Stan's folks are long gone, and so are his prospects. A product of juvie on the cusp of adulthood, in this small town everyone figures him to be destined for jail, or worse.
Even Stan's best friend Dommer (Cody Kostro, "Living with Everyone") believes there's no hope. The only people with any faith in Stan are the two women in his life: The decent-but-fearsome Sheriff Dorney (Siobhan Fallon Hogan, "Going in Style") and Stan's would-be girlfriend Roxy (Sofia Happonen).
At his lowest ebb, Stan discovers the vampiric beast living in his shed. Through a series of unfortunate — dare I say, implausible — events, the day-shy Bane starts claiming lives. As the bodies pile up, and Stan's chances of looking anything except guilty vanish, Stan concludes he must vanquish the monster. Easier said than done.
It's not clear when The Shed is supposed to be set, although no one seems to have a cellphone and Stan listens to his "doomy" rock on a tape deck. This could be a symptom of overwhelming poorness, but it also points to the 1980s, which is where the film seems to be drawing so much of its inspiration. Though reticent to show its monster, this resolutely old-style film has an admirable commitment to practical makeup effects, along with simple spooky techniques like brightly backlit fog. It just lacks a sprinkle of the folklore element that gave movie like "Halloween" and "A Nightmare on Elm Street" that touch of depth.
This is Frank Sabatella's first full feature in ten years ("Blood Night: The Legend of Mary Hatchett" was out in 2009, in case you wondered), and he offers enough style and scares to hope that we don't need to wait another decade. The use of Steadicam is particularly impressive, providing a sense of woozy mobility, and offering the ideal way to frame characters inching ever closer to the charnel outhouse. Some scenes stand out in the wrong way — some rather inert fight scenes and a shoddy "tooling up" montage spring to mind — but mostly the action is pulled off with panache.
Sabatella's script isn't half bad either, if you're willing to overlook some curious character motivations (why does a terrified Roxy run into the arms of Stan after seeing body parts in his back yard?) and a last-act descent into house-siege cliché. There is a real sense that Sabatella has loaded the titular shed with meaning. It is, I think, the rage at the heart of men. This is something that frightens Stan — "If it gets out, it will kill me" — but intrigues his buddy Dommer, who longs to harness its power and overcome his own impotence. Rather than being a mere totem of terror, the shed is (for the first two thirds, anyway) the fulcrum around which other, more interesting personal rivalries and tensions circle.
With his unkempt mop of hair and vulnerable eyes, there's something of the late Anton Yelchin in Warren, and his fractious relationship with Kostro's Dommer is convincingly played between the pair. Happonen is good also, even if she is stuck with the clunkiest role. Roxy is strong and determined, but she does fall into the hackneyed role of the woman as the dampener of male rage.
The Shed is a hokey, flawed but impressive sophomore effort from a horror filmmaker I will follow with interest. It's got pace, energy, humor and style, and it's pleasingly bereft of winking self-reference. It's a raucous chiller, perfect for a chilly night.
Movie Review: The Circle (2017)
Movie Review: Terminator: Dark Fate (2019)
Tagged: bully, high school, revenge, teenager, vampire
About Rupert Harvey
A Film Studies graduate with a very healthy obsession with all things Kubrick, here I am surfing an internet awash with opinions to add mine to the ocean.
Movie Review: We (2018)
Movie Review: Stalked (2019)
Movie Review: The Fare (2019)
Movie Review: Harpoon (2019)
Movie Review: Mary (2019)
Movie Review: Haunt (2019)
Movie Review: Depraved (2019)
The Shed (2019)
Genre(s): Drama, Horror
MPAA Rating: NR
Director(s): Frank Sabatella
Actor(s): Jay Jay Warren, Chris Petrovski, Cody Kostro, Francisco Burgos, Frank Whaley, Siobhan Fallon Hogan, Sofia Happonen, Timothy Bottoms
Writer(s): Frank Sabatella
Producer(s): Cory Neal, Peter Block
Studio(s): Sideshow Pictures, A Bigger Boat, RLJE Films
Release Date(s): US: November 15, 2019
IMDb Info: The Shed
Official Page: The Shed
Movie Review: Shrek Forever After (2010)
Movie Review: Lucy (2014)
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text:
Secretary-General in The Former Yugoslav Republic of Macedonia
Secretary-General Speaks to Media at Camp for Ethnic Albanians in The Former Yugoslav Republic of Macedonia
Secretary-General Visits Albanian Refugees in The Former Yugoslav Republic of Macedonia
Refugee Family in The Former Yugoslav Republic of Macedonia
Family of Refugees From Kosovo in The Former Yugoslav Republic of Macedonia
Secretary-General with Aid Workers of UN Refugee Agency in The Former Yugoslav Republic of Macedonia
Nane Annan Comforts Refugees in the Former Yugoslav Republic of Macedonia
SECRETARY-GENERAL IN ALBANIA
Refugees Enter The Former Yugoslav Republic of Macedonia
Refugees in The Former Yugoslav Republic of Macedonia
Secretary-General Arrives in The Former Yugoslav Republic of Macedonia
Secretary-General Meets President of The Former Yugoslav Republic of Macedonia
Headline Secretary-General Meets Refugees in The Former Yugoslav Republic of Macedonia
Caption Description Secretary-General Kofi Annan (second left) with a man and his son, ethnic Albanian refugees from Kosovo in the Stenkovec I refugee camp.
Production Date 05/19/1999 12:00:00 AM
Country The former Yugoslav Republic of Macedonia
Credit UN Photo/Evan Schneider