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ASHA / Practice Portal / Professional Issues /
Bilingual Service Delivery
Bilingualism is the ability to communicate in more than one language and can be thought of as a continuum of language skills in which proficiency in any of the languages used may fluctuate over time and across social settings, conversational partners, and topics, among other variables (Grossjean, 1989; Bialystok, 2001). Bilingualism can be difficult to define due to the number of individual differences demonstrated by those who use more than one language. As a result, terms related to bilingualism often represent attempts to describe the process of language acquisition and include
Simultaneous bilingualism—the acquisition of two languages at the same time, typically with both languages introduced prior to the age of 3
Sequential bilingualism—a second language introduced after age 3, at which time some level of proficiency has been established in the primary language, also referred to as successive bilingualism or second language acquisition
Dual language learners—individuals learning two languages simultaneously from infancy or who are learning a second language after the first language
English language learners—"language minority students in the United States who are learning English, the majority language, for social integration and educational purposes ... also referred to as limited English proficient (LEP) students" (p. 265).
(Paradis, Genesee, & Crago, 2011)
Given the complexities involved in bilingualism and the significant variability that exists among the linguistic skills of multilingual individuals, clinicians must be prepared to address the unique situation of each client. Complex cases may lead to misdiagnosis, which in turn feeds into larger problems, such as disproportionality concerns in schools and health care disparities in hospitals and long-term care facilities.
Service Provision for Bilingual Clients
The answer to the question of who provides audiology and/or speech-language pathology services to bilingual clients varies depending on each client's linguistic abilities in his/her first and second language.
Bilingual clinicians who have the necessary clinical expertise to treat the client may not always be available. There are circumstances in which a clinician who does not have native or near-native proficiency in the target language is able to use the skills he or she does have to provide services to a client. In determining the appropriateness of this solution, the clinician considers both his or her own language proficiency in the target language and the language demands of the client and family.
When a bilingual speech-language pathologist (SLP) and/or audiologist is not available, using an interpreter is a viable option. For additional information related to working with interpreters in spoken and manually coded languages, please see the Practice Portal page on Collaborating With Interpreters.
As indicated in the Code of Ethics, audiologists and SLPs are obligated to provide culturally and linguistically appropriate services to their clients and patients, regardless of the clinician's personal culture, practice setting, or caseload demographics. In providing services to bilingual individuals, SLPs consider how communication disorders or differences might be manifested, identified, or described in the client's/patient's cultural and linguistic community and integrate this knowledge into all areas of practice, including assessment, diagnosis, treatment, and treatment discharge.
Bilingual Service Providers
Audiologists or SLPs who present themselves as bilingual for the purposes of providing clinical services must be able to speak their primary language and to speak (or sign) at least one other language with native or near-native proficiency in lexicon (vocabulary), semantics (meaning), phonology (pronunciation), morphology/syntax (grammar), and pragmatics (uses) during clinical management. In addition to linguistic proficiency, the audiologist or SLP must have the specific knowledge and skill sets necessary for the services to be delivered.
Bilingual audiologists must be able to independently provide comprehensive diagnostic and treatment/rehabilitative services for auditory, vestibular, and related impairments using the client's/patient's language and preferred mode of communication. They must also have the linguistic proficiency to
select and interpret culturally and linguistically appropriate assessment materials, tools, and methods;
instruct and assess the client/patient in direct clinical techniques using behavioral, physiologic, and developmental measures;
administer and interpret standardized self-report measures of communication difficulties and of psychosocial and behavioral adjustment to auditory dysfunction.
Bilingual SLPs must be able to independently provide comprehensive diagnostic and treatment services for speech, language, cognitive, voice, and swallowing disorders using the client's/patient's language and preferred mode of communication. They must also have the linguistic proficiency to
describe the process of normal speech and language acquisition—for both bilingual and monolingual speakers of that language, including how those processes are manifested in oral and written language (or manually coded languages when applicable);
select, administer, and interpret formal and informal assessment procedures to distinguish between communication differences and communication disorders;
apply intervention strategies for treatment of communication disorders in the language or mode of communication most appropriate for the needs of the individual.
Bilingual Service Provision Training Programs
ASHA does not accredit or approve specialty training programs for bilingual service providers, nor does ASHA review, evaluate, or rank such programs in any way. Some graduate schools offer bilingual specialty training programs, but it should be noted that the depth and breadth of training in this area is variable from program to program.
State Certification/Licensing
Laws and regulations for bilingual service providers in audiology and/or speech-language pathology vary from state to state. Differences may be reflected in a number of requirements, including proficiency in oral and/or written language, education, continuing education, titles used to identify bilingual service providers, and regulations or laws or lack thereof. Audiologists and SLPs should check with their state licensure boards and/or departments of education for the requirements for specific practice settings.
ASHA Principles of Ethics I, Rule C from ASHA's Code of Ethics states that "Individuals shall not discriminate in the delivery of professional services." Audiologists and SLPs who are not competent to provide services to bilingual clients still have professional responsibility for ensuring that a client receives appropriate services.
Principle of Ethics II, Rule A of ASHA's Code of Ethics states that "Individuals shall engage in only those aspects of the professions that are within the scope of their professional practice and competence, considering their level of education, training, and experience." With this in mind, clinicians must consider their own ability—including education, training, and experience—in determining the most appropriate means by which to provide services to bilingual clients. In all cases, the needs of the client are paramount.
These ethical principles require that clinicians continue in lifelong learning to develop knowledge and skills required to provide culturally and linguistically appropriate services. See the Cultural Responsiveness page and ASHA's Cultural and Linguistic Competence (2013) Issues in Ethics Statement for additional information.
Second-Language Acquisition
Understanding the normal processes and phenomena of second-language acquisition is important to ensure accurate assessment of bilingual clients. While the experience of learning a second language is unique to each individual, common phenomenon during the second-language acquisition process are listed below. See additional resources and information on Learning Two Languages.
Interference/Transfer
Interference or transfer occurs when an error is made in a second language (L2) due to the direct influence of an L1 (primary language) structure. ELL children may manifest interference or transfer from their first language (L1) to English (L2). In children who are simultaneous bilinguals, transfer may occur between the two languages. Patterns that are the result of interference/transfer are not indicative of a disorder.
Adults who are learning English as a second language—or who acquired English after their language system was established in a different language—may demonstrate ongoing differences from standard English. The clinician considers if differences are influenced by the individual's native language and are typical error patterns seen in this population or are an indication of a change relative to baseline status (Anderson & Centeno, 2007).
Silent Period
A silent period may occur during the initial phase of second-language acquisition while an individual focuses on listening and comprehension of the new language. "Children acquiring second languages typically exhibit a 'silent period' during which acquired competence is built up via active listening" (Krashen, 1982/2009). The main characteristic of this stage is that, after some initial exposure to the language, the learner is able to understand much more than she or he can produce.
Codeswitching
Codeswitching involves changing languages over phrases or sentences and is a normal phenomenon engaged in by many fluent bilingual speakers. In individuals who are simultaneous bilinguals, codeswitching does not occur randomly and is grammatically and socioculturally constrained. The vast majority of codeswitching demonstrated by bilingual children "is systematic and, specifically, conforms to the grammatical constraints of the two participating languages" (Paradis et al., 2011, p. 103). Adolescents and adults who are developing proficiency in a second language may demonstrate increased errors in codeswitching, as they lack the linguistic competence necessary for fluent codeswitching without errors. This is not to be considered indicative of a language disorder (Paradis et al., 2011).
Violations of typical codeswitching constraints in adolescents and adults who are fluent in multiple languages can be evident and may indicate cognitive and/or communication disorders. These errors are often noted due to deficits in executive function and decreased inhibition of the non-target language, dementia, aphasia, and other language disorders, among other deficits (Ansaldo & Marcotte, 2007).
Language Loss/Attrition
As some individuals learn a second language, they lose skills and fluency in their primary language (L1) if this language is not reinforced and maintained. This is called subtractive bilingualism (Haynes, 2010). Lexicon and grammatical systems are the areas most affected by language loss (Anderson, 2004), and language loss can result in a simplified grammatical system and vocabulary gaps (Haynes, 2010). Linck et al. (2009) noted attrition and inhibition of L1 (primary language) during immersion in L2 (second language), even during the short term.
Clinicians should consider the prior level of proficiency in L1 (primary language), individual motivation, societal factors, and previous education and consistency in learning and instruction in L1 if language loss is observed. Errors may be related to the individual's language history. Attrition and attenuation (language loss) of first language (L1) proficiency may negatively influence overall language performance (Anderson, 2004; Linck, Kroll, & Sunderman, 2009).
Accent, Dialect, Phonetic Patterns
Accent and dialect influence phonetic patterns in individuals who are bilingual. Accent describes the way people sound or the pronunciation. Dialect describes "a rule-governed, systematic variation of a language" (Goldstein, 2000, p.9; Wolfram & Schilling-Estes, 1998) and includes accent as well as grammatical structures and semantics. Clinicians differentiate the influence of accent and dialect from communication disorders, including phonological disorders.
Phonology seems to be the most difficult linguistic area to master and accounts for the ongoing presence of an accent in otherwise very proficient speakers of a second language (Centeno, 2009).
In children, order of acquisition in one language may influence phoneme acquisition in another language. Additionally, accent may affect phoneme use and substitutions in each language. Dialect may influence development of morphosyntax, syntax, and semantics in development, as interference/transfer may be evident across the languages the child is learning (Yavas, 2007).
In an adult population, an accent may continue to influence phonetic patterns. Learning the appropriate phonetic patterns of a second language may become more difficult with age and the influence of a first language on speech in a second language may be more evident. The clinician considers if the phonetic patterns observed are consistent with second- or dual-language acquisition and with the baseline for the individual or if they are the result of a communication disorder (Bell-Berti, 2007).
Difference vs. Disorder
Identifying a communication disorder in a bilingual individual requires careful consideration of the multitude of factors that influence communication skills. True communication disorders will be evident in all languages used by an individual; however, a skilled clinician will appropriately account for the process of language development, language loss, the impact of language dominance fluctuation, and the influence of dual language acquisition and use when differentiating between a disorder and a difference. Language dominance may fluctuate across a patient's/client's lifespan based on use and input and language history (Kohnert, 2012).
When differentiating between a difference and a disorder, clinicians consider the following.
Phonology—Linguistic development in bilingual children can manifest in patterns different from those observed in monolingual children and may include phonological patterns as the result of transfer or interference from another language (Goldstein & Gildersleeve-Neumann, 2012). Recognizing dialectal variations and the influence of accent is an essential component of phonological assessment.
Morphology—Grammatical structures are not constant across languages. Pronouns, verb conjugation and verb inflection structures, tense, etc. may not exist equally in each language spoken by a bilingual individual. Assessment considers the frequency and types of errors and morphological patterns observed in individuals in determining if they are the result of a disorder or of a difference resulting from bilingual language development.
Morphosyntax—Some research suggests that morphosyntactic language development in bilingual individuals may be similar to that of monolingual individuals in rate and order of acquisition (Bedore, Cooperson & Boerger, 2012). However, studies are limited and individual performance may vary based on a number of factors.
Syntax—Due to the variability of syntactic structures across languages, underlying syntactic deficits will likely manifest differently across languages. Difficulty in development of syntactic structure may also be influenced by the perceptual salience of morphemes and syntactic structures. Children with SLI are noted to demonstrate significant deficits for morphemes with limited perceptual salience (Restrepo & Guiterrez-Clellen, 2012). Additionally, grammatical structures in either language may be influenced by the other (Paradis et al., 2011). Consider if the patterns observed are due an underlying deficit, which may manifest differently across languages, or due to a difference, such as transfer of a grammatical structure from one language to another.
Semantics—Clients may learn specific words and/or categories of words in their home language and other words in the language used in academic environments (Paradis et al., 2011).
The clinician also considers the nature of language demands in a given interaction and the effects that contextual support, or lack thereof, may play in language proficiency. To explain this, Cummins (1984) distinguished between two types of language proficiencies:
Basic interpersonal skills (BICS) are the context-embedded, everyday language that occurs between conversational partners, typically requiring 2 years under ideal conditions to acquire proficiency.
Cognitive academic language proficiency (CALP) is the context-reduced language of academics, typically requiring 5 to 7 years under ideal conditions to develop a level commensurate with native speakers.
An individual may be fluent in conversational communication (BICS), yet continue to have difficulties with communication needs in an academic arena (CALP). Observing an individual's language skills in both areas is essential to develop a comprehensive understanding of his/her linguistic abilities.
See an informational video regarding bilingual language development.
Dynamic Assessment and Response to Intervention
Early intervening services are used to determine which children have intrinsic learning problems that cannot be explained on the basis of lack of experience with the tasks. Response to intervention (RTI) and dynamic assessment (DA) are early intervening approaches that can be used to decrease unnecessary referral to special education by determining if speech and language patterns are the result of a normal phenomenon of dual language acquisition or are the result of a communication disorder. Both approaches are highly focused on the intended outcomes, the individual's needs, and the data resulting from reliable screening measures (Hosp, n.d.).
Clinical Service Delivery
The two primary goals of clinical service delivery for bilingual individuals are
the accurate differential diagnosis between communication disorders and normal linguistic variations (from life experiences, including bilingual/multilingual backgrounds), and
the design of intervention approaches and contexts that would provide the optimal stimulation to enhance linguistic recovery, minimize the extent of the functional impact of the disorder
(Centeno & Anslado, 2013).
The Assessment Process
When a clinician works with a bilingual individual, information related to language history is particularly relevant. Information gathered includes
age and manner of acquisition of the language(s),
dialect of the language used,
language(s) used at home and at school/work,
language(s) used within the family,
length of exposure to each language,
language of choice with peers,
progress in receiving English as a second language (ESL) services or adult English language learning classes,
contact with native speakers of L1 (primary language),
language of academic instruction,
academic performance in each language,
age of immigration.
(Rimikis, Smiljanic, & Calandruccio, 2013)
A client interview is often included in patient intake and case history. See cultural competence for information related to ethnographic interviewing.
Use of parent surveys for young bilingual children can be an effective way to gather information about early language development (Thal, Jackson-Maldonado, & Acosta, 2000). Parent surveys used during a preliminary screening of a bilingual child have the potential to yield valid and reliable information (Guiberson & Rodriguez, 2010).
Oral-Peripheral Examination
Bilingual clients/patients may benefit from visual modeling of commands to facilitate comprehension of tasks during oral-peripheral examination. Cultural and individual differences may influence how clients perceive tasks, such as a sticking out their tongues; therefore, it may be necessary to explain the reason for requested activities.
Criterion-referenced assessment tools can be used to identify and evaluate a client's strengths and weaknesses, as opposed to norm-referenced testing, which assesses an individual relative to a group. Standardized test scores are not valid for an individual who is not reflected in the normative sample for a given assessment; however, these assessments may still provide valuable descriptive information about a client's abilities and limitations in the language of the test (i.e., a test given in English will speak to a child's ability in English; a test given in Spanish will speak to a child's ability in Spanish). When possible, use culturally and linguistically adapted test equivalents in both languages to compare potential deficits.
Note that no test can be completely culture free. Most formal testing is unfamiliar to individuals who have not had exposure to the mainstream educational context and the culture of testing, which includes both nonverbal and verbal components. See cultural responsiveness.
Accommodations and Modifications to Standardized Assessment Procedures
An accommodation, for the purpose of this page, refers to an adjustment or change to the environment or mode of client/patient response in order to facilitate access and interaction and to remove barriers to participation.
A modification, for the purpose of this page, refers to a change in material, content, or acceptable response.
Accommodations and modifications during the assessment process may be necessary to gain useful information about the client's abilities and limitations. However, some changes may invalidate the standardized score.
Examples of accommodations and modifications include
rewording and providing additional test instructions other than those allowed when presenting test items,
providing additional cues or repeating stimuli which may not be permitted on test or task items,
allowing extra time for responses on timed subtests,
skipping items that are inappropriate for the individual (e.g. items with which the client has had no experience),
asking the individual for an explanation of correct or incorrect responses (when not standard procedure),
using alternate scoring rubrics.
It is not appropriate to translate standardized assessments to reach a standard score. Problems that arise when tests are translated include
language items often do not have a one-to-one translation;
languages vary in their order of acquisition or vocabulary, morphology, and syntactic structures;
languages vary in their syntactic structures and not all structures that are assessed on English tests exist in other languages;
standardized scoring cannot be reported for translated tests;
standardized assessments that are not normed on bilingual populations are to only be used as informal probes with no accompanying scores.
(Goldstein, 2000)
It is the responsibility of the clinician to document all accommodations and modifications made during the assessment process in any and all reporting of the client/patient.
Speech and Language Sample
Speech and language samples offer a window of opportunity to observe and analyze communicative skills as they are functionally used and may provide more insight than the typical standardized or criterion-referenced test. Single-word and connected-speech (conversation or narrative) samples should be obtained in all languages used by the client, through collaboration with an interpreter if necessary, to allow for an in-depth assessment of the individual's morphological, syntactic, phonological, and lexical systems. While a comparison of each of these areas across languages used can be informative, clinicians must keep in mind that skills across languages may not be easily comparable. Phonological acquisition will not be parallel across a bilingual child's two languages, especially when the two languages have vastly different phonemic systems (Goldstein & Fabiano, 2007). Morphological markers will look different across languages as will the syntactic complexity.
Audiology Assessments
Speech perception testing measures how well an individual is able to understand speech and predicts how well he or she will perform in everyday listening environments. Speech reception thresholds and word recognition ability should be evaluated using culturally and linguistically appropriate recorded test materials that reflect the background of the client. Best practices utilize pre-recorded materials to ensure consistency across trials (Mendel & Owen, 2011). Monitored live voice testing may be used, given a client's unique needs, such as age or ability. Careful consideration of accent, dialect, and linguistic background is given for the speaker used in live voice testing.
Age of acquisition (of the second language) has been shown to influence speech perception results. Shi and Sánchez (2010) found that patients who acquired a second language at 10 years of age or later performed more favorably on speech perception testing in their dominant language. The researchers recommended that patients who acquired a second language between the ages 7 and 10 years be evaluated in both languages. Mayo, Florentine, and Buus (1997) found that patients who acquired a second language before the age of 6 (i.e., early bilinguals) were better able to process speech in noise than patients who acquired a second language after the age of 14 (i.e., late bilinguals).
Questionnaires have been developed to indirectly measure speech perception abilities by asking questions related to the benefits of treatment in the patient's everyday listening environment. These tools must be translated appropriately into the patient's first language.
Digit pairs have been shown to be appropriate stimuli for speech recognition threshold (SRT) testing in non-native speakers of English. As with spondees, listeners must be familiar with this closed set of stimuli (Ramkissoon, Proctor, Lansing, & Bilger, 2002).
While research with this population has been limited, children who are ELLs perform more poorly in noisy classroom conditions than children whose native language is English (Crandell & Smaldino, 1996). When tested in their second language, even fluent bilingual speakers who acquired a second language at an early age (i.e., before the age of 6 years) have poorer speech recognition ability in noise than monolingual speakers (Rogers, Lister, Febo, Besing, & Abrams, 2006). Implications of this research include recognition of the importance of effective classroom acoustics and the suggestion that hearing loss due to aging may have an even greater negative impact on speech understanding of bilingual speakers.
Treatment Considerations
Selecting the language of intervention is dependent on unique factors for each individual, including
language history and relative experience with each language,
frequency of use for each language,
proficiency in each language, including how well the individual understands and produces each language,
environment, including where and with whom the child uses each language,
family considerations and goals.
(Goldstein & Fabiano, 2007)
To account for the nature of bilingual language development, Kohnert and Derr (2012) and Kohnert, Yim, Nett, Fong Kan, and Duran (2005) proposed two main approaches to providing intervention to bilingual children. These approaches are models based on underlying research on language (including phonological) development in bilingual children. Relative to pediatric populations, there is a paucity of research for intervention in bilingual adults.
The bilingual approach supports beginning with goals in which one treats constructs common to both languages or errors or error patterns exhibited with relatively equal frequency in both languages (Yavas & Goldstein, 1998) and focuses on increasing language skills common to both languages. The initial treatment determination is the goal and not the language of intervention.
The cross-linguistic approach focuses on the linguistic skills unique to each language and is used to address errors and deficits noted in a specific language. This approach is often necessary—and may be used in conjunction with the bilingual approach—to address differences in the linguistic structures of the two languages. For example, aspirated affricates exist in Hmong, but not in English, and can only be remediated in the one language. Additionally, SLPs might use a cross-linguistic framework based on types of errors and/or error rates (Yavas & Goldstein, 1998). For example, final consonant deletion is more common in the English of Spanish-English bilingual children than in their Spanish (Goldstein & Fabiano, 2007).
In bilingual children, it is suspected that acquiring a "certain level of proficiency in L1 (primary language) should achieve comparable levels of proficiency in L2 (second language)" (Gutierrez-Clellen, 1999, p. 292). Treating targets common to both languages may be most beneficial in some populations before expanding to target features exclusive to just one language.
Common Core State Standards and Accommodations
The Common Core State Standards is a state-led initiative designed to establish a single set of educational standards in English language arts and mathematics for students in Kindergarten through 12th grade. Two consortia of states are developing common assessments—the Partnership for Assessment of Readiness for College and Career (PARCC) and the Smarter Balanced Assessment Consortium (SBAC). Both consortia offer guidance for districts and decision-making teams to ensure that all assessments yield valid results for students, including students who are English language learners (ELL).
State and Federal Legislation
A number of state and federal regulations have implications for the provision of audiology and speech-language pathology services to bilingual clients/patients. Differences in state regulations may be reflected in a number of requirements, including education. See ASHA's state-by-state page for a summary of state requirements.
Equal Educational Opportunities Act of 1974
The Equal Educational Opportunities Act of 1974 states, "All children enrolled in public schools are entitled to equal educational opportunity without regard to race, color, sex, or national origin." No state can deny students the right to equal education by "failure by an educational agency to take 'appropriate action' to overcome language barriers that impede equal participation by its students in its instructional programs" (20 USC Sec. 1701vê1758). Congress has interpreted bilingual education as an action a school district must take to teach non-English-speaking students how to speak English.
Individuals with Disabilities Education Act (IDEA)
The Individual with Disabilities Education Act (IDEA) was enacted to ensure that everyone, including children with disabilities, receives a free appropriate public education. IDEA 2006, Part B, Final Regulations supports nondiscriminatory service delivery by establishing the following:
assessment and other evaluation materials should not be racially or culturally discriminatory;
assessment and other evaluation materials are to be provided in the child's native language or other mode of communication and in the form most likely to yield accurate information on what the child knows and can do academically, developmentally, and functionally, unless it is clearly not feasible to do so;
the form in which evaluation materials are administered may vary from standard testing procedures when necessary in order to appropriately evaluate a student;
a child must not be determined to have a disability if the determinant factor is lack of appropriate instruction in reading or math or limited English proficiency;
parents are entitled to an interpreter at the individualized education program (IEP) meeting if needed to ensure that the parents understand the proceedings;
when an IEP is developed for a child with limited English proficiency, the language needs of the child must be considered.
In addition, regulations clearly define steps that states must take to address the problem of disproportionality in special education. See IDEA Part B Issue Brief: Culturally and Linguistically Diverse Students.
Title VI of the 1964 Civil Rights Act
Title VI of the 1964 Civil Rights Act prohibits discrimination in any federally funded program on the basis of race, color, or national origin. This includes any public or private facility—such as a hospital, clinic, nursing home, public school, university, or Head Start program—that receives federal financial assistance (e.g., grants, training, use of equipment, and other assistance). According to the Office of Civil Rights, all providers who work for any agency funded by the U.S. Department of Health and Human Services (HHS) are required to provide language access services to patients who do not speak English well.
The Every Student Succeeds Act (ESSA), Public Law 114-95 was signed into law on December 10, 2015 and will take full effect beginning with the 2017 – 2018 school year. This federal K-12 legislation reauthorized the Elementary and Secondary Education Act (ESEA) and its longstanding commitment to equal opportunity for all students. ESSA, which replaced No Child Left Behind (NCLB), provides greater flexibility to state and local governments to create their own accountability systems, academic goals, reporting, and other requirements when implementing programs; and ensures that all students are prepared for college and careers.
ESSA requires that states include English language proficiency in their accountability frameworks, alongside statewide math and language arts assessments, and report English proficiency progress by a growth measure for up to four years. States must clarify a standardized process for classifying English learners and re-designating students as English proficient, and must disaggregate English learners with a disability from English learners in general. States are also required to report on students who have not attained English proficiency within five years of identification as an English learner.
The U.S. Department of Education (ED) is developing regulations and other guidance to assist states, local districts, and schools with ESSA's implementation. Every Student Succeeds Act: Key Issues for ASHA Members contains information about how ESSA affects audiologists and SLPs working in schools.
Guidance relating to Executive Order 13166 and issued by HHS indicates that "health care organizations must offer and provide language assistance services, including bilingual staff and interpreter services, at no cost to each patient/consumer with limited English proficiency at all points of contact, in a timely manner, during all hours of operation" (Youdelman, 2008, para. 6). The guidance provided applies to any health care provider or entity that receives federal funding, including
Medicare Part A,
federally funded clinical trials,
Children's Health Insurance Program (CHIP),
Medicaid,
other patient populations.
ASHA Resources
Information for the Public:
The Advantages of Being Bilingual
Learning Two Languages
Issues in Ethics Statement: Cultural and Linguistic Competence
Phonemic Inventories Across Languages
Resources for the Recruitment of Bilingual Service Providers
Bilingual students and SLP Services in Schools
Perspectives of the Special Interest Groups
Pre-referral Procedures: Meeting Unique Needs of English Language Learners
Self-Identify as a Bilingual Service Provider
This list of resources is not exhaustive and the inclusion of any specific resource does not imply endorsement from ASHA.
Partnership for Assessment of Readiness for College and Career (PARCC): Accessibility Features and Accommodations Manual
U.S. Dept. of Education - Tools and Resources for Addressing English Language Learners with Disabilities [PDF]
U.S. Dept of Education - Our Nation's English Learners
American Speech-Language-Hearing Association. (2010). Code of ethics [Ethics]. Available from www.asha.org/policy/.
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Ansaldo, A. I., & Marcotte, K. (2007). Language switching in the context of Spanish-English bilingual aphasia. In J. Centeno, R. Anderson, & L. Obler (Eds.), Communication disorders in Spanish speakers (pp.214–230). Tonawanda, NY: Multilinugal Matters.
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Goldstein, B., & Fabiano, L. (2007, February 13). Assessment and intervention for bilingual children with phonological disorders. The ASHA Leader. Retrieved from www.asha.org/Publications/leader/2007/070213/f070213a/.
Grossjean, F. (1989). Neurolinguists, beware! The bilingual is not two monolinguials in one person. Brain and Language, 36, 3–15.
Guiberson, M., & Rodriguez, B. L. (2010). Measurement properties and classification accuracy of two Spanish parent surveys of language development for preschool-age children. American Journal of Speech-Language Pathology, 19, 225–237.
Gutierrez-Clellen, V. (1999). Language choice in intervention with bilingual children. American Journal of Speech-Language Pathology, 8, 291–301.
Haynes, E. (2010). What is language loss? (Heritage brief). Retrieved from Center for Applied Linguistics website: www.cal.org/heritage/pdfs/briefs/what-is-language-loss.pdf.
Hosp, J. (n.d .). Response to intervention and the disproportionate representation of culturally and linguistically diverse students in special education (Response to Intervention Action Network). Retrieved from www.rtinetwork.org/learn/diversity/disproportionaterepresentation.
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Kohnert, K., Yim, D., Nett, K., Fong Kan, P., & Duran, L. (2005) Intervention with linguistically diverse preschool children. Language, Speech, and Hearing Services in Schools, 36, 251–263.
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Content for ASHA's Practice Portal is developed through a comprehensive process that includes multiple rounds of subject matter expert input and review. ASHA extends its gratitude to the following subject matter experts who were involved in the development of the Bilingual Service Delivery page:
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The article presents several of the author's portrait-columns and their impact in their respective fields of work. The information service for cancer patients CANHELP was founded by the late Patrick Michael McGrady Jr. AIDS activism was the legacy of Christine Maggiore. Celia Farber's reports on the toxic effects of anti-HIV drugs stirred reactions from leaders of the HIV-AIDS establishment. Dorothy Mullen organized the Suppers for Sobriety in 2006, a nutritional support group for alcoholics.
Presents an obituary for Patrick Michael McGrady Jr., founder and director of cancer patients referral service Canhelp Inc.


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Urinary Tract Health and Antibacterial Benefits: Review
Cranberry Consumption Against Urinary Tract Infections: Clinical Stateof- the-Art and Future Perspectives.
Mantzorou M, Giaginis C.
Curr Pharm Biotechnol. 2018;19(13):1049-1063. doi: 10.2174/1389201020666181206104129
INTRODUCTION:Urinary tract infections (UTIs) represent a common and costly public health issue. The bacterium Escherichia coli is mainly responsible for most uncomplicated UTIs. Cranberry antibacterial effects have extensively been studied in order to understand the molecular mechanisms of action of its bioactive components and their clinical benefits against UTIs. In this respect, the present review aims to critically analyze the current clinical studies that have evaluated the efficacy of supplementing cranberry products against UTIs in different subpopulations.METHODS:PubMed database was comprehensively searched, using relative keywords in order to identify clinical trials exploring the efficacy of cranberry supplementation against UTIs.RESULTS:Current clinical evidence clearly indicates a possible benefit overall from the use of cranberries against UTIs. Cranberry consumption may prevent bacterial adherence to uroepithelial cells, reducing UTI related symptoms. Cranberry consumption could also decrease UTI related symptoms by suppressing inflammatory cascades as an immunologic response to bacterial invasion. The existing clinical trials have supported substantial evidence that the beneficial effects of cranberry against UTIs seem to be prophylactic by preventing infections recurrence; however, they exert low effectiveness in populations at increased risk for contracting UTIs. Moreover, a lack of cost-effectiveness for cranberry supplementation has been highlighted.CONCLUSIONS:Additional well-designed, double-blind, placebo-controlled clinical trials that use standardized cranberry products for long study periods are strongly recommended in order to determine the efficiency of cranberry on the prevention of UTIs in susceptible populations. At present, cranberry supplementation can safely be suggested as complementary therapy in women with recurrent UTIs.
A Review of Cranberry Use for Preventing Urinary Tract Infections in Older Adults.
Luczak T; Swanoski M.
Consultant Pharmacist. 33(8):450-453,
Urinary tract infections (UTIs) are one the of the most common types of infections in adults older than 65 years of age. Preventing UTIs with prophylactic antibiotics increases the risk of side effects and microbial resistance, and is costly. Cranberry fruit and juices contain the compound proanthrocyanidins (PACs), specifically proanthrocyanidin-A, which exerts antiadhesion characteristics against bacteria. Cranberry products therefore have been an attractive, nonantibiotic preventative option for UTIs; however, the current literature supporting cranberry use in older adults is controversial. This could be multifactorial owing to the heterogeneity of the older population as well as inconsistencies in the recommended dose of PAC in the current literature. Evidence supports that cranberry may be beneficial in preventing UTIs in specific populations such as catheterassociated UTI and postradiotherapy prostate cancer. The cost of daily capsules versus the cost of preventing a UTI in older adults is an important consideration for initiating therapy.
A Systematic Review of Non-Antibiotic Measures for the Prevention of Urinary Tract Infections in Pregnancy.
Ghouri F; Hollywood A; Ryan K.
BMC Pregnancy & Childbirth. 18(1):99
BACKGROUND: Urinary tract infections (UTIs) are common in pregnancy and account for the highest proportion of primary care antibiotic prescriptions issued to pregnant women in the UK. It is well known that antibiotic use is associated with increased antimicrobial resistance and therefore measures to minimise antibiotic use for UTI prevention have been studied. The efficacy and safety of these measures in pregnancy have not been addressed and therefore the aim of this study was to systematically review the literature to identify and evaluate potential measures to prevent UTIs in pregnant women. METHODS: Ten databases (EMBASE, AMED, BNI, CINAHL, Medline, PubMed, PsycINFO, Cochrane Trials, Scopus and Science Direct) were systematically searched in July 2017 for studies reporting non-antibiotic measures to prevent UTIs in pregnancy. The terms ("urinary tract infection" or UTI or bacteriuria or cystitis) AND (prevention) AND (pregnan*) were used. The quality of the publications was appraised using the Critical Appraisal Skills Programme (CASP) checklists for cohort study, case-control study and randomised controlled trial. The results were synthesised using a textual narrative approach. RESULTS: Search results yielded 3276 publications and after reviewing titles and removing duplicates, 57 full text articles were assessed for eligibility and eight were included in the review. Five different approaches (hygiene measures, cranberry juice, immunisation, ascorbic acid and Canephron N) have been identified, all of which are reported to be safe in pregnancy. CONCLUSION: The quality of the evidence varied considerably and only hygiene measures were supported by evidence to be recommended in practice. Future work needs to concentrate on strengthening the evidence base through improved design and reporting of studies with a focus on immunisation, ascorbic acid and Canephron N.
Cranberry Antioxidant Power on Oxidative Stress, Inflammation and Mitochondrial Damage.
Caldas, APS; Coelho, OGL; Bressan J.
International Journal of Food Properties, 21:1, 582-592, DOI: 10.1080/10942912.2017.1409758
The American cranberry (Vaccinium macrocarpon) is one of the fruits containing antioxidants in great quantity and of high quality. From recent research, it is evident that both cranberry and its products, when consumed chronically or acutely, boost the antioxidant effect. Likewise, most studies revealed the anti-inflammatory potential of the cranberry polyphenols. Both effects exert direct action mechanisms, revealed by the ability of the polyphenols to remove the reactive oxygen species, as well as indirect effects, represented by the action of these phytochemicals on the cell signaling pathways and genetic expression. A limited number of articles that evaluated the effects of cranberry on mitochondrial damages are available. However, an enhancement in the functions of this organelle was confirmed by the increased production of adenosine triphosphate (ATP). Therefore, further studies are required to demonstrate the benefits credited to the use of cranberry, as well as to describe the action mechanisms of the polyphenols.
The Hospital-Acquired Conditions (HAC) Reduction Program: Using Cranberry Treatment to Reduce Catheter-Associated Urinary Tract Infections and Avoid Medicare Payment Reduction Penalties.
Saitone TL; Sexton RJ; Sexton Ward A.
Journal of Medical Economics. 21(1):97-106
OBJECTIVE: The Affordable Care Act (ACA) established the Hospital-Acquired Condition (HAC) Reduction Program. The Centers for Medicare and Medicaid Services (CMS) established a total HAC scoring methodology to rank hospitals based upon their HAC performance. Hospitals that rank in the lowest quartile based on their HAC score are subject to a 1% reduction in their total Medicare reimbursements. In FY 2017, 769 hospitals incurred payment reductions totaling $430 million. This study analyzes how improvements in the rate of catheter-associated urinary tract infections (CAUTI), based on the implementation of a cranberry-treatment regimen, impact hospitals' HAC scores and likelihood of avoiding the Medicare-reimbursement penalty. METHODS: A simulation model is developed and implemented using public data from the CMS' Hospital Compare website to determine how hospitals' unilateral and simultaneous adoption of cranberry to improve CAUTI outcomes can affect HAC scores and the likelihood of a hospital incurring the Medicare payment reduction, given results on cranberry effectiveness in preventing CAUTI based on scientific trials. The simulation framework can be adapted to consider other initiatives to improve hospitals' HAC scores. RESULTS: Nearly all simulated hospitals improved their overall HAC score by adopting cranberry as a CAUTI preventative, assuming mean effectiveness from scientific trials. Many hospitals with HAC scores in the lowest quartile of the HAC-score distribution and subject to Medicare reimbursement reductions can improve their scores sufficiently through adopting a cranberry-treatment regimen to avoid payment reduction. LIMITATIONS: The study was unable to replicate exactly the data used by CMS to establish HAC scores for FY 2018. The study assumes that hospitals subject to the Medicare payment reduction were not using cranberry as a prophylactic treatment for their catheterized patients, but is unable to confirm that this is true in all cases. The study also assumes that hospitalized catheter patients would be able to consume cranberry in either juice or capsule form, but this may not be true in 100% of cases. CONCLUSION: Most hospitals can improve their HAC scores and many can avoid Medicare reimbursement reductions if they are able to attain a percentage reduction in CAUTI comparable to that documented for cranberry-treatment regimes in the existing literature.
Cranberry for Urinary Tract Infection: From Bench to Bedside.
Nabavi SF; Sureda A; Daglia M; Izadi M; Nabavi SM.
Current Topics in Medicinal Chemistry. 17(3):331-339
Urinary tract infections are common infectious diseases which can occur in any part of the urinary tract such as bladder, kidney, ureters, and urethra. They are commonly caused by bacteria that enter through the urethra. Urinary tract infections commonly develop in the bladder and spread to renal tissues. Up to now, there are different antimicrobial agents which have beneficial role on urinary tract infections. However, most of them cause different adverse effects and therefore, much attention has been paid to the search for effective therapeutic agents with negligible adverse effects. Cranberry is known as one of the most important edible plants, which possesses potent antimicrobial effects against the bacteria responsible for urinary tract infections. Growing evidence has shown that cranberry suppresses urinary tract infections and eradicates the bacteria. Therefore, the aim of this study is to critically review the available literature regarding the antimicrobial activities of cranberry against urinary tract infection microorganisms. In addition, we discuss etiology, epidemiology, risk factors, and current drugs of urinary tract infections to provide a more complete picture of this disease.
Cranberry Reduces the Risk of Urinary Tract Infection Recurrence in Otherwise Healthy Women: A Systematic Review and Meta-Analysis.
Fu Z, Liska D, Talan D, Chung M
Journal of Nutrition. 147(12):2282-2288
Background: Cranberry (Vaccinium spp.) has been advocated for treatment of urinary tract infection (UTI); however, its efficacy is controversial. Women have a 50% risk of UTI over their lifetime, and ~20-30% experience a subsequent UTI recurrence.Objective: We conducted this meta-analysis to assess the effect of cranberry on the risk of UTI recurrence in otherwise healthy women.Methods: Literature published before January 2011 was obtained from 2 published systematic reviews, and we conducted updated searches in EMBASE and MEDLINE (through July 2017). We included randomized controlled trials that were conducted in generally healthy nonpregnant women aged >=18 y with a history of UTI, compared cranberry intervention to a placebo or control, and reported the outcome as the number of participants experiencing a UTI. Two researchers conducted abstract and full-text screenings, data extractions, and risk of bias assessments independently, and discrepancies were resolved by group consensus. Meta-analyses were performed by using Stata SE software (version 13). We employed a fixed-effect model using the Mantel-Haenszel method to estimate the summary risk if the heterogeneity was low to moderate (I2 300 participants.Conclusion: These results suggest that cranberry may be effective in preventing UTI recurrence in generally healthy women; however, larger high-quality studies are needed to confirm these findings.
Effectiveness of Dietary Supplements in Spinal Cord Injury Subjects.
Navarrete-Opazo A; Cuitino P; Salas I.
Disability & Health Journal. 10(2):183-197
BACKGROUND: Individuals with spinal cord injury (SCI) consume more dietary supplements than the general population. However, there is limited information regarding the clinical effectiveness of dietary supplements in SCI population. OBJECTIVE: To systematically review the effectiveness of dietary supplements for the prevention or treatment of health-related conditions associated with SCI. METHODS: Randomized or non-randomized controlled clinical trials were selected, comparing the effect of any dose and form of a dietary supplement (defined by the Dietary Supplement Health and Education Act), with either no treatment, placebo, or other medication. Data Sources included the Cochrane Database, DARE, LILACS, CINAHL, EMBASE, MEDLINE, OTSeeker, PEDro, PsycINFO, SpeechBITE, ScienceDirect, Scopus, clinicaltrials.gov, Google Scholar, and OpenGrey. Two reviewers independently classified articles from January 1970 through October 2015, and 18 articles were selected. RESULTS: Due to the heterogeneity of outcome measures across studies, a meta-analysis was not conducted. However, high-quality evidence showed that cranberry supplementation is not effective for prevention of urinary tract infections (UTIs) in SCI. Moderate-quality evidence supported a beneficial effect of vitamin D, alpha-lipoic acid, and omega-3 supplementation, although replication of results is needed. There were conflicting results for the effect of creatine supplementation on improvement of motor outcomes. Low-quality evidence does not permit assessment of the effectiveness of melatonin, whey protein, vitamin C, and Chinese herb in SCI. CONCLUSIONS: There is sufficient data suggesting that cranberry supplementation is ineffective for prevention of UTIs in individuals with SCI. There is insufficient data to support or refute the use of any other dietary supplement in individuals with SCI.
Can Cranberries Contribute to Reduce the Incidence of Urinary Tract Infections? A Systematic Review with Meta-Analysis and Trial Sequential Analysis of Clinical Trials.
Luis A; Domingues F; Pereira L.
Journal of Urology https://doi.org/10.1016/j.juro.2017.03.078
PURPOSE: We sought to clarify the association between cranberry intake and the prevention of urinary tract infections. MATERIALS AND METHODS: This systematic review, which complies with the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) statement, was done as a meta-analysis and trial sequential analysis of clinical trials. RESULTS: The findings clearly showed the potential use of cranberries for the clinical condition of urinary tract infection. Cranberry products significantly reduced the incidence of urinary tract infections as indicated by the weighted risk ratio (0.6750, 95% CI 0.5516-0.7965, p <0.0001). The results of subgroup analysis demonstrated that patients at some risk for urinary tract infections were more susceptible to the effects of cranberry ingestion. CONCLUSIONS: The results of the current study could be used by physicians to recommend cranberry ingestion to decrease the incidence of urinary tract infections, particularly in individuals with recurrent urinary tract infections. This would also reduce the administration of antibiotics, which could be beneficial since antibiotics can lead to the worldwide emergence of antibiotic resistant microorganisms.
Cranberries and urinary tract infections: how can the same evidence lead to conflicting advice?
Liska, D. J. Kern, H. J. Maki, K. C.
Advances in Nutrition; 2016. 7(3):498-506.
Cranberry has been used traditionally to prevent urinary tract infections (UTIs), primarily among generally healthy women prone to recurrent UTIs. Results from a number of published clinical studies have supported this benefit; however, meta-analyses on cranberry and UTI prevention have reported conflicting conclusions. This article explores the methodological differences that contributed to these disparate findings. Despite similar research questions, the meta-analyses varied in the studies that were included, as well as the data that were extracted. In the 2 most comprehensive systematic reviews, heterogeneity was handled differently, leading to an I2 of 65% in one and 43% in the other. Most notably, the populations influencing the conclusions varied. In one analysis, populations with pathological/physiological conditions contributed 75.6% of the total weight to the summary risk estimate (RR: 0.86; 95% CI: 0.71, 1.04); another weighted the evidence relatively equally across UTI populations (RR: 0.62; 95% CI: 0.49, 0.80); and a third included only women with recurrent UTIs (RR: 0.53; 95% CI: 0.33, 0.83). Because women with recurrent UTIs are the group to whom most recommendations regarding cranberry consumption is directed, inclusion of other groups in the efficacy assessment could influence clinical practice quality. Therefore, conclusions on cranberry and UTIs should consider differences in results across various populations studied when interpreting results from meta-analyses.

redpajama_set_name: RedPajamaCommonCrawl


text:
\section{Introduction}
\label{intro}
Recently, STAR collaboration has reported on the first observation of significantly nonzero global polarization of $\Lambda$($\bar\Lambda$) hyperons produced in non-central Au-Au collisions in the RHIC Beam Energy Scan (BES) Program \cite{STAR:2017ckg}.
The magnitude of measured polarization is in general agreement with calculations from different hydrodynamic models \cite{Karpenko:2016jyx,Xie:2017upb} and AMPT \cite{Li:2017slc, Sun:2017xhx}. In the hydrodynamic models the $\Lambda$ hyperons produced at particlization (fluid to particle transition) hypersurface acquire polarization via spin-vorticity coupling mechanism. In case of AMPT the spin-vorticity coupling mechanism is introduced with the help of coarse-graining procedure. The magnitude of polarization depends on local {\it thermal vorticity} of the fluid, $\varpi_{\mu\nu}=(\dd_\nu \beta_\mu - \dd_\mu \beta_\nu)$ at the points of $\Lambda$ production, $\beta_\mu=u_\mu/T$ being the inverse four-temperature field. In this proceeding we report on an extension of our existing calculations of global $\Lambda$ polarization in RHIC BES \cite{Karpenko:2016jyx} and discuss the polarization component along beam direction.

\section{Model and results}
We study production and polarization of $\Lambda$ in a hybrid transport model, which consists of initial state UrQMD hadron/string cascade, followed by a 3 dimensional viscous hydrodynamic expansion. At a hypersurface where the local rest frame energy density reaches a critical value $\epsilon_{\rm sw}=0.5$~GeV/fm$^3$, the particlization (i.e.\ transition from fluid to particle description) is performed with the help of Cooper-Frye formula. Along with the rest of hadrons, $\Lambda$ as well as other heavy reasonances which decay to it, are produced and acquire their polarization at this hypersurface. Details of the cascade+viscous hydrodynamic model used are thoroughly described in \cite{Karpenko:2015xea}.

We have reported global polarization of $\Lambda$ hyperons calculated with this model in the energy range $\sqrt{\sNN}=7.7,\dots,200$~GeV in \cite{Karpenko:2016jyx}. It was concluded that, in line with the experimental results, in 20-50\% central Au-Au collisions the global $\Lambda$ polarization decreases with increasing collision energy from about 2\% at $\sqrt{\sNN}=7.7$~GeV to 0.2\% at $\sqrt{\sNN}=200$~GeV. Only about one quarter of $\Lambda$ are the ones produced directly at particlization, the rest are products of resonance decays, including cascade processes $X\rightarrow\Sigma^0\rightarrow\Lambda$. We have estimated \cite{Becattini:2016gvu} that such resonance feed-down results in 15\% reduction of the polarization of all $\Lambda$ at all collision energies in consideration.

We have extended this result with a 3+1 dimensional viscous hydrodynamic calculation for $\sqrt{\sNN}=200$ GeV RHIC Au-Au and 2760 GeV Pb-Pb collisions using a Monte Carlo Glauber initial state with parametrized rapidity dependence \cite{Bozek:2012fw} tuned to describe $dN/dy$ and directed flow of charged hadrons at these energies. The combined results are shown on Fig.~\ref{fig1}, left. For the Glauber IS, we show two lines (connecting $\sqrt{\sNN}=$200 and 2760 GeV points), the solid one corresponding to longitudinally boost invariant initial flow, and the dashed one corresponding to a small amount of initial shear longitudinal flow as described in \cite{Becattini:2015ska}. The latter results in higher initial thermal vorticity which in turn leads to a larger magnitude of $\Lambda$ polarization. Also, for the RHIC BES range we show the curves for both averaged initial state and event-by-event hydro with fluctuating initial state. From the plot one can conclude that 1) the global polarization signal in the model is relatively insensitive to whether the initial state is fluctuating or not, and 2) the global $\Lambda$ polarization further decreases with energy from RHIC to LHC, and although there are no published results yet from the LHC, we estimate that at the LHC the global polarization possibly goes below the experimental limit for being detected.

One expects that the global ({\it i.e.}\ integrated over all $\Lambda$ in an event) polarization vector is directed parallel to the one of global angular momentum, which is confirmed by our calculations. However doing a $p_T$ differential analysis we have found that, at high energies, for mid-rapidity $\Lambda$ the dominant component of  polarization is the one along the beam direction \cite{Becattini:2017gcx}. In a simplified scenario with no initial state fluctuations, this component has a quadrupole structure in the transverse momentum plane, and can be decomposed into Fourier series with only sine terms of even multiples of the azimuthal angle $\phi$ of the transverse momentum vector:
\begin{equation}\label{szfour}
 P^z({\bf p}_T,Y=0) = \sum_{k=1}^\infty f_{2k}(p_T) \sin 2 k \varphi.
\end{equation}
In this expansion, the dominant component is $f_2$, which we show on the right panel of Fig.~\ref{fig1}. Contrary to global polarization (left panel of the same figure) which decreases by almost 1 order of magnitude between $\sqrt{\sNN}$=7.7 and 200 GeV, $f_2$ decreases by only 35\%. Even at 2.76~TeV LHC energy, it reaches 1\% for $p_T=3$~GeV $\Lambda$, making it feasible to detect it in the experiment.

Another useful feature of the $f_{2k}$ components of the Fourier expansion is that, different from the global polarization vector, they are independent on the orientation (sign) of the event plane, which simplifies the experimental measurements.

The structure of the polarization component along the beam direction can also be accessed via correlations of the corresponding polarization components of $\Lambda$ pairs. One can show with a simple derivation that, keeping the second Fourier harmonic only:

\begin{equation}
P^z=f_2\sin2(\phi-\Psi)\quad\Rightarrow\quad \langle P^z(\phi)P^z(\phi+\Delta\phi)\rangle_\phi=
{f_2^2 \over 2}\cos2\Delta\phi,
\end{equation}

where $\langle A\rangle_\phi={1\over 2\pi}\int A(\phi)d\phi$. Note that such covariance function is independent of the event plane angle $\Psi$.

The resulting covariance functions for $P^z$ are plotted on Fig.~\ref{fig2}. The left panel corresponds to averaged initial state and a single hydrodynamic simulation for given collision energy, where due to the geometrical symmetry and the above argument we obtain the expected $\cos(2\Delta\phi)$ shape, with collision energy dependent amplitude. The right panel shows the covariance function calculated in event-by-event hydrodynamic case for $\sqrt\sNN=200$~GeV RHIC scenario. For the event-by-event case, we observe a relative enhancement of the covariance function at $\Delta\phi=0$, caused by vorticity patterns formed by hot spots in the initial state. The overall shape and magnitude of the covariance function are qualitatively consistent with the results in \cite{Pang:2016igs}.

Note that the quadrupole pattern of the longitudinal component of polarization is present in case of average (non-fluctuating) initial state. Even more, this effect is still present and has a similar magnitude when the initial state has a complete longitudinal boost invariance. The reason is that the longitudinal component of polarization is linked to the anisotropies in the transverse expansion, therefore the only requisite for it is anisotropic transverse flow, which also drives the elliptic flow. Indeed we have shown that in a simple Blast-Wave model there is a linear relation between the $p_T$ dependent $f_2$ harmonic and elliptic flow:
\begin{equation}
   f_2(p_T) = 2 \frac{d T}{d \tau}\frac{1}{mT} v_2(p_T)
\end{equation}
where $dT/d\tau$ is assumed time derivative of temperature $T$ (which in Bjorken picture depends only on proper time $\tau$) at the freezeout hypersurface, and $m$ is mass of particle.

\begin{figure*}[h]
\centering
\includegraphics[width=0.49\textwidth,clip]{fig/Piy_sqrts_avEbE-LHC}
\includegraphics[width=0.49\textwidth,clip]{fig/P2pt}
\caption{Left: collision energy dependence of global $\Lambda$ polarization along global angular momentum of the fireball, calculated with averaged initial state from UrQMD ($\sqrt{\sNN}$=7.7,\dots,200 GeV) and Monte Carlo Glauber ($\sqrt{\sNN}$=200,2760 GeV). Right: second order Fourier harmonic coefficien of polarization component along beam direction, calculated as a function of $p_T$ for different collision energies; 200 and 2760 GeV points correspond to Monte Carlo Glauber initial state.}
\label{fig1}
\end{figure*}

\begin{figure*}
\centering
\includegraphics[width=0.49\textwidth,clip]{fig/cosDeltaPhi_avIC}
\includegraphics[width=0.49\textwidth,clip]{fig/cosDeltaPhi_200hyd}
\caption{Covariance of polarization components in beam direction, for pairs of midrapidity $\Lambda$ separated by azimuthal angle $\Delta\phi$ in transverse momentum space. Right panel: results with averaged initial state from UrQMD ($\sqrt{\sNN}$=7.7,\dots,200 GeV Au-Au) and Monte Carlo Glauber ($\sqrt{\sNN}$=200 Au-Au, 2760 GeV Pb-Pb). Left panel: event-by-event hydrodynamic calculation with UrQMD initial state for Au-Au collisions at $\sqrt{\sNN}=200$~GeV.}
\label{fig2}
\end{figure*}

\section{Conclusions}

We have extended the results for global $\Lambda$ polarization in RHIC Beam Energy Scan \cite{Karpenko:2016jyx} by using Monte Carlo Glauber initial state with parametrized rapidity dependence, tuned to reproduce basic observables at $\sqrt\sNN=$200 GeV RHIC and 2760 GeV LHC energies. We find that, as expected, the global polarization of $\Lambda$ hyperons further decreases from the full RHIC to the LHC energy. However, at such high energies the dominant component of $\Lambda$ polarization vector in $p_T$ differential analysis is the one along the beam direction. This component of polarization has a quadrupole structure in the transverse momentum plane, and shows a mild decrease with collision energy. Its second order Fourier harmonic for $p_T=3$~GeV $\Lambda$ reaches 1\% at 2760 GeV LHC energy. Such quadrupole structure also results in correlations of polarization components of $\Lambda$ pairs. We stress that the longitudinal component of polarization is a generic effect which emerges even in a simple longitudinal boost invariant non-fluctuating hydrodynamic picture of heavy ion collisions.

\begin{acknowledgement} {\bf Acknowledgements}: This work was partly supported by the University of Florence
grant {\it Fisica dei plasmi relativistici: teoria e applicazioni moderne}.
\end{acknowledgement}

redpajama_set_name: RedPajamaArXiv


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February 24, 2000 Birthday Facts
Here are some snazzy birthday facts about 24th of February 2000 that no one tells you about. Don't wait a minute longer and jump in using the content links below. Average read time of 10 minutes. Enjoy!
15. Number of Babies Born
What day was my birthday Feb 24, 2000?
February 24, 2000 was a Thursday and it was the 55th day of the year 2000. It was the 8th Thursday of that year. The next time you can reuse your old 2000 calendar will be in 2028. Both calendars will be exactly the same! This is assuming you are not interested in the dates for Easter and other irregular holidays that are based on a lunisolar calendar.
What day is February 24 this year?
The day of the week of your birthday this year is Friday. Next year it will be Saturday and two years from now it will be Monday. You can check the calendars below if you're planning what to do on your birthday.
There are 25 days left before your next birthday. You will be 23 years old when that day comes. There have been 8,376 days from the day you were born up to today. If you've been sleeping 8 hours daily since birth, then you have slept a total of 2,792 days or 7.64 years. You spent 33% of your life sleeping. Since night and day always follow each other, there were precisely 283 full moons after you were born up to this day. How many of them did you see? The next full moon that you can see will be on February 5 at 18:30:00 GMT – Sunday.
Fun stat: Your first one billion seconds (1,000,000,000) will happen sometime on November 2, 2031.
If a dog named Bobus - a Irish Terrier breed, was born on the same date as you then it will be 119 dog years old today. A dog's first human year is equal to 15 dog years. Dogs age differently depending on breed and size. When you reach the age of 6 Bobus will be 42 dog years old. From that point forward a medium-sized dog like Bobus will age 4.5 dog years for every human year.
Douglass Watson
Steven Hill
Dominic Chianese
Pete Duel
Paula Zahn
Mark Moses
Billy Zane
Ashley MacIsaac
Nancy Castiglione
View the complete list of February 24 celebrity birthdays.
Who are the famous February 24 birthdays?
Here's a short list of famous people in history who were born on Feb 24.
Andrew Inglis Clark, Australian engineer, lawyer, and politician (d. 1907)
Ralph Erskine, English-Swedish architect, designed The Ark and Byker Wall (d. 2005)
Ernst Reiss, Swiss mountaineer (d. 2010)
Ali Mazrui, Kenyan-American political scientist, philosopher, and academic (d. 2014)
Pablo Milanés, Cuban singer-songwriter and guitarist
Eddie Murray, American baseball player
Teodor Currentzis, Greek conductor and composer
Ashley MacIsaac, Canadian singer-songwriter and fiddler
Stella Young, Australian comedian and journalist (d. 2014)
Trace Cyrus, American singer-songwriter and guitarist (Metro Station)
View the complete list of February 24 famous birthdays.
What no one tells you about your first name's personality. Are there magical powers hidden in your given name? Every moniker has an undeniable character and personality. Check out Brenda's personality and get smart about names today. (Sponsored links)
What happened on my birthday – Feb 24th?
King Huneric removes the Christian bishops from their offices and banished some to Corsica. A few are martyred, including former proconsul Victorian along with Frumentius and other merchants. They are killed at Hadrumetum after refusing to become Arians.
Treaty of Nagyvárad between Ferdinand I and John Zápolya.
The London première of Rinaldo by George Frideric Handel, the first Italian opera written for the London stage.
The signing of the Treaty of Yandabo marks the end of the First Anglo-Burmese War.
The Treaty of Dancing Rabbit Creek, the first removal treaty in accordance with the Indian Removal Act, is proclaimed. The Choctaws in Mississippi cede land east of the river in exchange for payment and land in the West.
Arizona is organized as a United States territory.
United Airlines Flight 811, bound for New Zealand from Honolulu, rips open during flight, blowing nine passengers out of the business-class section.
Japan launches its fourth spy satellite, stepping up its ability to monitor potential threats such as North Korea.
Fidel Castro retires as the President of Cuba after nearly fifty years.
A Metrolink train derails in Oxnard, California, following a collision with a truck, leaves more than 30 injured.
View the complete list of February 24 historical events.
Curious about this Pistachio? This is a party item you can activate and send to your friends when you play the free game Jump Birthday Party. It's a fun and easy-to-play mobile game for all ages. Get free 1,000 gold coins when you download today!
What does my birthday February 24, 2000 mean?
Your birthday numbers 2, 24, and 2000 reveal that your Life Path number is 1. It represents initiative, potential and singularity. You are a born leader. You insist on your right to make up your own mind; you demand freedom of thought and action.
The following celebrities also have the same life path number: Paul Governali, Bert Convy, Cyril O'Reilly, Tooba Siddiqui, Greg X. Volz, Sid Field, Bounty Killer, Martin Kemp, Ray Brooks, Chris Fountain.
What is the birthday horoscope for Feb 24, 2000?
The Western zodiac or sun sign of a person born on February 24 is Pisces ♓ (The Fish) – a mutable sign with Water as Western element. The ruling planet is Neptune – the planet of dreams and imagination. According to the ancient art of Chinese astrology (or Eastern zodiac), Dragon is the mythical animal and Metal is the Eastern element of a person born on February 24, 2000.
What is the birthstone for February 24?
Amethyst is the modern birthstone for the month of February while Bloodstone is the mystical birth stone (based on Tibetan origin). The zodiac gemstone for Pisces is amethyst. Lastly, the birthday stone for the day of the week 'Thursday' is sapphire.
Fun fact: The birth flower for 24th February 2000 is Violet for modesty.
Feb 24th Birthday Wish
What is a good birthday trivia for February 24?
The number-one hit song in the U.S. at the day of your birth was I Knew I Loved You by Savage Garden as compiled by Billboard Hot 100 (February 26, 2000). Ask your parents if they know this popular song.
I Knew I Loved You
I do not know how you feel about this, but you were a female ♀ in your last earthly incarnation. You were born somewhere around the territory of Southern Japan approximately on 1250. Your profession was shepherd, horseman, forester.
Your brief psychological profile in that past life: You are a person with huge energy, good in planning and supervising. If you were just garbage-man, you were chief garbage-man.
Lessons that your last past life brought to present: You are bound to learn to understand other people and to meet all life difficulties with joyful heart. You should help others, bringing them spirit of joy.
How many babies were born on February 24, 2000?
Base on the data published by the United Nations Population Division, an estimated 130,960,864 babies were born throughout the world in the year 2000. The estimated number of babies born on 24th February 2000 is 357,817. That's equivalent to 248 babies every minute. Try to imagine if all of them are crying at the same time.
What is the popular baby name on 24 Feb 2000?
In the United States, the most popular baby name is Emily. This name was given to 25,953 baby girls. For the boys it's Jacob. This name was recorded 34,471 times in the year 2000. Any chance you are Emily or Jacob? (Source: ssa.gov)
News headline for Florida Man February 24
What's your bizarre Florida Man story? The #FloridaManChallenge is breaking the Internet and social media. Some crazy men, women, or creatures from the Sunshine State are making headlines every day of the year including your birthday. Try this fun exercise. Pick your search engine of choice and type in "florida man February 24" and see what kind of wild news headline you will get. This viral craze started in 2013 and gets resurrected now and then. The latest was from Tumblr and found its way to Twitter. As they say, the rest is history.
Roman Numerals for February 24, 2000
XXIV.II.MM
February 24, 2000 Birthday Facts Summary
Here's a quick list of all the fun birthday facts about February 24, 2000. Celebrities, famous birthdays, historical events, and past life were excluded.
Day index: 55th day of 2000
Day of week: Thursday
Day of week birthstone: Sapphire
Week index: 8th Thursday of 2000
Day of week this year: Friday
Day of week next year: Saturday
Day of week in 2025: Monday
Days until next birthday: 25 days
Days spent sleeping: 2,792 days
Full moons since birth: 283
First one billion seconds: Sometime on November 2, 2031
Age in dog years: 119 dog years old using a Irish Terrier breed
Life path number and meaning: 1 – It represents initiative, potential and singularity. You are a born leader. You insist on your right to make up your own mind; you demand freedom of thought and action.
Western zodiac sign: Pisces ♓ (The Fish)
Western zodiac ruling planet: Neptune – the planet of dreams and imagination
Western zodiac gemstone: Amethyst
Eastern zodiac animal: Dragon
Eastern zodiac element: Metal
Modern birthstone: Amethyst
Mystical birthstone: Bloodstone (based on Tibetan origin)
Birth flower: Violet for modesty
Number one song: I Knew I Loved You by Savage Garden (February 26, 2000)
Babies born in 2000: 130,960,864
Babies born in 2000 every day: 357,817
Babies born in 2000 every minute: 248
Popular girl's name: Emily – 25,953 babies
Popular boy's name: Jacob – 34,471 babies
Roman numerals: XXIV.II.MM
Try another birth date of someone you know or try the birthday of these celebrities: June 1, 1969 – Teri Polo, American actress; November 27, 1973 – Twista, American rapper and producer; June 21, 1968 – Sonique, English singer-songwriter and DJ.
P & R (+72)
P & A (+17)


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Cover Reveal: Saving Mercy by Abbie Roads
Saving Mercy by Abbie Roads
Series: Fatal Truth Series
Genre: Dark Romantic Thriller
AVAILABLE ON NETGALLEY
Amazon | iBooks | B&N | Google
He's found her at last…
Cain Killion knows himself to be a damaged man. His only redeeming quality? The extrasensory connection to blood that he uses to catch killers. His latest case takes a macabre turn when he discovers a familiar and haunting symbol linking the crime to his horrific past—and the one woman who might understand what it means.
Only to lose her to a nightmare
Mercy Ledger is brave, resilient, beautiful—and in terrible danger. The moment Cain finds her the line between good and evil blurs and the only thing clear to them is that they belong together. Love is the antidote for blood—but is their bond strong enough to overcome the madness that stalks them?
Book Review: Love & Rockets by Maggie Wells
Love & Rockets by Maggie Wells
Another gem from witty wordsmith Maggie Wells!
Third in the Coastal Heat series, Love & Rockets follows in the footsteps of the previous installments: the title can be read as a standalone romance, and it stands out among its peers as superbly written.
Maggie's use of the English language never fails to amaze me. While reading, I often think: "Wow, I never would have thought to express __________ in that way." Rather than watered down prose, her vocabulary and syntax challenge readers, giving credit to their intellect and/or powers of deduction.
Like the other titles in the Coastal Heat series, Love & Rockets features relatable, well-developed characters and sources of conflict that readers can identify with: family tensions, societal hierarchies, career demands, and—last but not least—the treacherous "dating" landscape.
A Maggie Wells hero has chinks in his armor, a source of vulnerability that makes him human (one of my favorite aspects of the author's storytelling). Her heroines, on the other hand, wear pride and independence like a badge and struggle to admit when they need help. This dynamic, when aired with the author's mastery of the craft, never fails to deliver a page-turner.
Finally, I found the aspects of Jake's job to be well-researched, and I liked that the novel's rhetorical devices (i.e. descriptions and comparisons) often revolved around the subject of space science. The latter adds an extra layer of "art" to an already well-written novel.
Book Review: Race the Darkness by Abbie Roads
January 15, 2017 January 15, 2017 1 Comment
REALLY impressed with this debut from Abbie Roads!
As Race the Dawn's premise is quite complex, I really didn't know what to expect from the title. Preternatural elements, religious fanaticism, and convoluted interpersonal relationships make this a difficult read to categorize. For me, it strikes a balance between my two favorite genres, romance and mystery/suspense, with a sprinkling of paranormal thrown in to keep readers on their toes.
Learning about Xander's ability, post-trauma, gets the novel off to an interesting start. The hook did its job of investing me in the characters and action, and the momentum never lapsed. Thankfully, there was no sagging middle to contend with. Instead, the action chugs along at a steady pace, offering readers a new discovery in nearly every chapter.
The author's writing really impressed me. Her vivid descriptions held me captive (no pun intended), and even the villains had a complexity and depth to them that goes beyond the typical good guy-bad guy scenario.
Race the Dawn is unlike anything I've ever read before. As this one was a win for me, I've already started on another from the author (Hunt the Dawn).
« Sep Oct »


Mark off the width and height of the robin. Draw two ovals that will help to define places for its head and body. Draw a line, which will act as the beak. Add lines for the perch.
Define places for the legs, wings and beak of the robin.
Detail the shape of the robin's wing. Add its eye, toes, crest and tail.
Contour the robin, trying to vary the thickness and darkness of the line. Add more detail and the handrails. Erase all guidelines.


Typically desserts are something which those of us with diabetes approach with caution.
If you're blessed with strong self-restraint, choosing small portions of desserts can be an effective way of sampling a sweet without sending your blood sugar levels too high.
To enjoy dessert without such strict size restrictions, try a dessert choice from below.
Whilst the choices made a relatively low in carbohydrate, we would advise testing blood sugars two hours after eating to see which choices and quantities are appropriate for you.
Fruit is quite high in natural sugars (fructose) so keep fruit portions sensible. Berries and kiwi fruit tend to be better for sugar levels than banana and citrus fruits.
Natural yoghurt is a great lower calorie alternative to cream, and if you're watching your calories, low fat yoghurt will reduce the calories further.
Most supermarkets these days have a range of sugar free desserts including mousse and jelly. Sugar free desserts are often simple to prepare and low in calories too, particularly if you use skimmed or semi-skimmed milk in mousses.
A low carb cheesecake can be achieved by replacing crushed digestive biscuits for the base with a lower carb alternative. Almond meal is a good substitute for digestive biscuits. Sugar is typically used in the cheesecake filling but this can be replaced with a sweetener. Add fruit of your choice for a mouth watering topping.
Give your fruit intake a twist by having chocolate covered strawberries. Using dark cooking chocolate will help you to keep the carbohydrate values.
Start by preparing the chocolate. Take cooking chocolate and chop it into even sized chunks. You will need a glass bowl that will fit securely over a saucepan without getting close to touching the bottom of the saucepan.
Put an inch or so of water into the saucepan and apply gentle heat and when it starts to simmer turn off the heat and place the glass bowl, with the chocolate chunks in, over the saucepan.
The chocolate will melt over the steam in the saucepan. As the chocolate starts to melt, stir it with a spatula until the chocolate is fully melted.
At this point remove from the glass bowl from the saucepan and keep stirring until the chocolate consistency is smooth. Keep the stalks on the strawberries to make dipping easier and when covered, lay them down on a plate or baking tray. Put the plate or tray into the fridge for a few minutes to allow the chocolate to set.
With a few choice substitutes and perhaps a couple of attempts, low carb cakes are possible. The key to low carb baking is in replacing sugar for an appropriate sweetener and replacing flour with almond meal.


I may perhaps have to narrow this down to factors, justification and human improvement gaps of either of the two.
A single perhaps intolerant just due to the fact they have no new option to life as convincing as what they currently know, and any new positions are threats to one's personal, also perceived as getting greatest explanation to life and determinant of existence. Any new, option view acts as a threat as a result of other person or group existence can't be tolerated.
Soon after a considerable period of observations and interactions, disagreeing parties are capable to find out about limits of interaction and boundaries, opening up new understanding presented by other celebration for a distinction more than what is identified, understanding and identifying places of popular requires and interests to nurture across the positional divide.
Overtime there comes a time when places of cooperation are stronger than positions and each and every position starts to adopt fascinating functions in each and every other, mixing up traditions' components for what can assistance all to survive and reside with each other in peace on the basis of respect of boundaries, space a and time for nurturing co-existence values, relationships and targets.
Certainly religions are only a topic matter that can be identified and provided its location separate from the human becoming. That way, it is much easier to create superior religion time and once more as we adapt it or them to new international challenges.
The moment we fuse religion with the becoming and with it aspect of the becoming, it complicates efforts to discern outdated, antisocial and anti-ecological elements of religion, or even anti-peace religious components as life continues to evolve. This is so as religions attain far more private, group and organisation values or culture and textures than any factor else. At this point, it will be quick to reserve humanity as superior to these other so known as religious, provided the fears connected with these sophisticated processes of religions.
Extra to say, religions and their out of manage rituals demands are quite enslaving than humanity is demeaned and threatened or even destroyed. Right here the query of rationality comes into play.
Devoid of humanity there can't be superior religions. Of course, no 'liberty', no innovations and above all, no improvement.
Ubuntuism is an fascinating case for humanity, at such occasions when it is abused below the guise of religious or faith groups, and its irreversible, from time to time irrational values by elements of religion their competitiveness, unwavering strive to dominate other folks rather than respect, cooperate and operate with each other towards superior beings, render religions, certainly, unfashionable and lacking future in the Planet of the sane, the peaceful, holistically and sustainably created.
Ubuntuism is a foundation of human existence as defined from interactions with non-human beings to attain life which means and peace – each instant and eternal. In Africa, the foundation of Ubuntu is nonetheless powerful in spite of introduction of new religious movements by the outdoors planet. New religious movements act mainly on the sensory levels and attempting to take them deeper causes unsustainable conflict -rather. Ubuntu represents human-nature and supernature interaction from earliest occasions, and experiences formed to realize evolutionary states and improvement conflict in order to thrive into highest states of peace as men and women, households and communities.
Across Africa, it is nonetheless alive, awake and normally rises from the subconscious levels to influence new religious and faith movements to operate in its way. Ubuntu is functional humanity. Whilst the philosophy is African, it is doable practice that it is practiced elsewhere considering that the strive for humanity is universal.
Africa socialism and socialism elsewhere, or even Buddhism have a harmonious point of intersection. It is a "religion" and philosophy but greatest understood as a philosophy.
Especially, as an academic and researcher, Ubuntuism is a quite thrilling aspect to adventure into and inform greatest oneself and Planet of understanding.
Religious intolerance and tolerance, then, represent improvement level conflict components present for everyone to encounter, encounter and discern in order to get to the subsequent levels -evolutionary and revolutionary. From becoming religiously intolerant men and women develop into tolerant as aspect of the adaptation approach to survive and thrive.
For that reason, it is significant to have ego states in verify and at rest, understanding, respect and make relationships basing on positives and popular targets as crucial to constructing religious tolerance, reaching sustainable peace and improvement.


We have a legacy of providing specialized logistical solutions to our clients and growing with them. In fact, our brand name was given to us by one of our longest-serving Japanese customers.
In the Japanese language, there are two meanings to Shinyuu – best friend (親友), and true courage (真勇). A name is an omen, and over the years, we have grown to live up to the expectations of our brand name.
We believe business need not be a zero-sum game – where one party has to lose, in order for the other to gain. A relationship based on trust, is particularly important in the supply chain business, where multiple companies are involved to move resources from the suppliers to end-consumers.
And it takes courage to stay true over the years; it is the only way of conducting business we know.
This manifesto will act as a commitment from both sides to developing a mutually beneficial relationship, one based on trust, openness, a genuine understanding of and interest in our clients' businesses and a commitment to the long-term.


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Tennessee Declares State of Emergency As Road Conditions Deteriorate
Robertson County, Tenn.
Tennessee Declares State of Emergency
The Tennessee Emergency Management Agency (TEMA) has activated the Tennessee Emergency Management Plan and declared a State of Emergency at 9 p.m., CST, on Monday, Feb. 16, 2015.
The road conditions in Tennessee are deteriorating rapidly, motorists are backed up on two major Interstates, and a number of counties are requesting assistance with various response actions.
Current Situation · I-40 east bound at mile marker 156 in Hickman County is backed up 12-miles into Humphreys County to around mile marker 152. · I-24 west bound from the 96 mile marker to I-840 is to be closed down due to crashes and a previous back up.
Power outages have spiked in Tennessee as of 9 p.m., CST, currently at 55,682 customers, impacting at total of 19 counties with Bedford, Davidson, Fentress, Knox, Monroe and Smith having the highest outages.
Response Actions · TEMA has requested the Tennessee National Guard for State Active Duty to deploy initially a 10-person crew with five Humvees for motorist wellness checks.
THP has requested National Guard specifically for the Humphreys County back-up on I-40 east bound.
TEMA is transporting 216 bottles of water and 225 ready packs is being transported to the backup on I-40
Roane County has requested five chainsaw crews from the Tennessee Wildlife Resources Agency to assist with debris clearing.
Williamson County Sheriff's Office has requested salt for the I-65 north at the I-840 east bound entrance ramp.
Robertson County is fairing better than many other cities in Tennessee but we do have significant icy road conditions and snow accumulation. To see a report on road conditions in Robertson County (CLICK HERE)
A little after 10:pm Monday evening a call came into 911 to stop the trains because a car had become stuck on the rail road tracks. The incident occurred at the E College St crossing in Greenbrier. The officers were able to dislodge the vehicle, no one was injured. Click photo for ALBUM.
Smokey took a tour of Robertson County Monday evening, it was very exciting. Andy White of CT&T Computer Service Center drove us around in his Chevy 4×4 so we were ready for anything.
While on our tour we saw a good number of vehicles stuck in the snow including a car stuck on the rail road tracks in Greenbrier. Luckily several officers came to the rescue and were able to free the vehicle.
The general condition of the roads are reasonable if you have a vehicle equipped with 4 wheel drive, otherwise it's probably best to stay home.
Most of the county looks like a ghost town so it would seem that most people are staying off the roads. It will probably be another day or so before all the roads are clear.
For Company Closures and City Services Cancellations (CLICK HERE)
For Local School Closings (Click Here)
For a message from the Robertson County Mayor Howard Bradley (CLICK HERE)