text:
DANIEL WARE, III, a minor, by and through his parents and guardians,
DANIEL and JENNI WARE,
Appellants,
ANW SPECIAL EDUCATIONAL COOPERATIVE NO. 603,
1. Summary judgment is appropriate when the pleadings, depositions, answers to interrogatories, and admissions on file, together with the affidavits, show that there is no genuine issue as to any material fact and that the moving party is entitled to judgment as a matter of law. The trial court is required to resolve all facts and inferences which may reasonably be drawn from the evidence in favor of the party against whom the ruling is sought. When opposing a motion for summary judgment, an adverse party must come forward with evidence to establish a dispute as to a material fact. In order to preclude summary judgment, the facts subject to the dispute must be material to the conclusive issues in the case. On appeal, appellate courts apply the same rules and where we find reasonable minds could differ as to the conclusions drawn from the evidence, summary judgment must be denied.
2. To succeed on a claim for negligent infliction of emotional distress, a plaintiff must first establish that he or she has a qualifying physical injury under Kansas law. Second, the qualifying physical injury must (1) directly result from the emotional distress allegedly caused by the defendant's negligence and (2) appear within a short span of time after the emotional disturbance. Generalized physical symptoms of emotional distress such as headaches, nightmares, insomnia, vomiting, anxiety, and nervousness are insufficient to state a cause of action.
Appeal from Allen District Court; DANIEL D. CREITZ, judge. Opinion filed April 11, 2008. Affirmed.
Kala Spigarelli and Angela Trimble, of The Spigarelli Law Firm, of Pittsburg, for appellants.
Teresa L. Watson, David R. Cooper, and Terelle A. Mock, of Fisher, Patterson, Sayler & Smith, L.L.P., of Topeka, for appellee.
Before GREEN, P.J., GREENE and LEBEN, JJ.
GREEN, J.: Daniel Ware, Jr., and Jenni Ware, parents of Daniel Ware, III, a minor, appeal from a summary judgment granted in favor of ANW Special Educational Cooperative No. 603 (ANW) in Daniel Ware, III's negligent infliction of emotional distress claim.
When Daniel was 4 years old, he fell asleep on the bus on his way to school. The bus was operated for the purpose of transporting students to and from ANW's preschool. Daniel was inadvertently left on the bus by the driver. He woke up and began walking to his mother's place of employment. A relative saw him, picked him up, and returned him to his mother. Five months later, Daniel became ill when told he would have to start riding the bus again. He was later diagnosed with posttraumatic stress disorder (PTSD) approximately 9 months after the bus incident.
Daniel's parents brought suit against ANW alleging negligent infliction of emotional distress based on the incident in which Daniel was left sleeping on a school bus operated by ANW. ANW moved for summary judgment, arguing that Daniel did not suffer a compensable physical injury under Kansas law. The trial court, following well-established precedent, granted summary judgment for ANW on the basis that Daniel had suffered no immediate physical injury following the bus incident. On appeal, Daniel's parents contend that the manifestation of Daniel's PTSD meets the physical injury requirement in personal injury cases. In the alternative, Daniel's parents assert that the physical injury requirement of PTSD should be expanded to cover an injury suffered as a result of negligence. We disagree on both counts. Accordingly, we affirm.
On October 8, 2002, Daniel, then 4 years old, fell asleep while riding the bus to school. The bus transports students to and from ANW's school. At approximately 1 p.m., Daniel was left sleeping on the bus in the school district bus lot. Daniel awoke, left the bus, and began walking toward the downtown pharmacy where his mother was working. By chance, Daniel was seen by a relative while crossing a McDonald's parking lot. The relative returned Daniel to his mother at approximately 1:10 p.m.
Daniel's parents attempted to return Daniel to school that day, but Daniel became upset and began crying, saying he did not want to stay at school. They returned home with him. Daniel calmed down after he got home, approximately 1 to 2 hours following the incident.
Between the October 2002 bus incident and March 2003, Daniel expressed apprehensions about going to school. He told his mother either he needed a day off, he was sick, or he would rather help his father at work. Nevertheless, Daniel did not cry, tremble, or beg his mother not to take him to school. When ANW suggested that Daniel get on the bus and ride it again, Daniel stated that he would ride the bus if Neka Hall, his grandmother's foster daughter, rode with him and if his grandmother followed in her own car. Daniel rode the bus with Neka on more than one occasion without incident approximately 2 weeks following the initial incident. Yet, on one occasion Daniel began to cry when he realized his grandmother was not behind the bus. Daniel's mother rode the bus with him on another occasion when Neka could not; Daniel cried the whole way to school, held his mother's hand, and trembled.
Sometime in March 2003, Daniel became upset and vomited at school when he was told that he would be going on a bus field trip the next day. Daniel begged his mother not to let him go; he cried; he vomited on the floor.
In June 2003, Dr. Doug Wright, Daniel's initial treating therapist, diagnosed Daniel with PTSD. Wright based this conclusion on various symptoms: namely, vomiting, anxiety, nervousness, physically shaking, acting out, hypervigilance, sleep difficulties, bedwetting, a significant increase in weight, and a refusal to attend school. Wright stated that PTSD cannot be diagnosed for at least 1 month after an incident. He stated that the nature of the disorder was a physical reenactment of feelings associated with the initial trauma. Wright agreed that Daniel's vomiting was a physical manifestation of anxiety. He further believed that the anxiety was triggered or caused by events contemporaneous to the vomiting rather than the October 2002 incident. The trial court acknowledged that Daniel controverted this fact by pointing out that Wright also testified that while triggers were contemporaneous, the anxiety or stress was from the bus incident.
Daniel's second treating psychologist, Dr. Shawna Wright, agreed that Daniel did not sustain a physical injury and that the vomiting and other symptoms were physical manifestations of emotional distress and anxiety. She agreed with the diagnosis of PTSD as a result of the bus incident. She further acknowledged that Daniel had vomited as a result of the bus incident.
Daniel's expert, Dr. James Hunter, also diagnosed Daniel with PTSD and believed that there was nothing else to attribute the onset of Daniel's problems other than the bus incident. Hunter testified that Daniel did not sustain a physical injury when he was left on the bus.
In granting ANW's motion for summary judgment, the trial court held that under Hoard v. Shawnee Mission Medical Center, 233 Kan. 267, 662 P.2d 1214 (1983), Daniel's symptoms were not compensable physical injuries for purposes of a negligent infliction of emotional distress claim.
Did the Trial Court Err in Granting Summary Judgment to ANW by Deeming the Symptoms of PTSD Not a Physical Injury in a Negligent Infliction of Emotional Distress Claim?
The trial court granted summary judgment to ANW, concluding that under the undisputed facts Daniel has no compensable physical injury under Kansas law.
"'"'Summary judgment is appropriate when the pleadings, depositions, answers to interrogatories, and admissions on file, together with the affidavits, show that there is no genuine issue as to any material fact and that the moving party is entitled to judgment as a matter of law. The trial court is required to resolve all facts and inferences which may reasonably be drawn from the evidence in favor of the party against whom the ruling is sought. When opposing a motion for summary judgment, an adverse party must come forward with evidence to establish a dispute as to a material fact. In order to preclude summary judgment, the facts subject to the dispute must be material to the conclusive issues in the case. On appeal, we apply the same rules and where we find reasonable minds could differ as to the conclusions drawn from the evidence, summary judgment must be denied.'"' [Citations omitted.]" Korytkowski v. City of Ottawa, 283 Kan. 122, 128, 152 P.3d 53 (2007).
Indeed, summary judgment is appropriate in this case because the parties dispute no material facts. The only statements controverted by Daniel involve those made by his doctors that reach the key questions of law at issue. Daniel does not controvert the factual basis for these statements, but instead sets forth additional statements to clarify and lend support to his position. The trial court correctly acknowledged these statements in reaching its decision. Thus, the only issue before this court is whether the trial court correctly found that Daniel has no legal basis for a negligent infliction of emotional distress claim under Kansas law.
To succeed on a claim for negligent infliction of emotional distress, a plaintiff must first establish that he or she has a qualifying physical injury under Kansas law. Anderson v. Scheffler, 242 Kan. 857, 860, 752 P.2d 667 (1988); see also Grube v. Union Pacific R.R. Co., 256 Kan. 519, 522, 886 P.2d 845 (1994) (plaintiff must demonstrate a physical injury or a physical impact, which causes an actual injury, in order to recover for negligent infliction of emotional distress). Second, Hoard establishes that the qualifying physical injury must (1) directly result from the emotional distress allegedly caused by the defendant's negligence and (2) appear within a short span of time after the emotional disturbance. 233 Kan. at 279. Hence, Daniel must satisfy each of the requirements previously cited to succeed on his claim.
We will first determine whether Daniel's alleged symptoms qualify as physical injuries. Kansas courts have addressed various types of symptoms when determining whether they may be characterized as physical injuries for purposes of negligent infliction of emotional distress claims. See Anderson, 242 Kan. at 860 (holding shock, emotional pain, feelings of guilt, nightmares, and depression due to witnessing accident are not compensable physical injuries when there is no actual physical injury); Hopkins v. State, 237 Kan. 601, 612-13, 702 P.2d 311 (1985) (holding weight gain is not a compensable physical injury); Reynolds v. Highland Manor, Inc., 24 Kan. App. 2d 859, 861-62, 954 P.2d 11 (1998) (holding that plaintiff failed to meet physical injury requirement when she suffered headaches, diarrhea, nausea, crying, shaking, sexual problems, and feelings of stress, all caused by anxiety); Dill v. Barnett Funeral Home, Inc., No. 90,653, unpublished opinion filed February 13, 2004, rev. denied 278 Kan. 844 (2004), slip op. at 7-8 (holding that lack of sleep, recurring dreams, and general fatigue not a compensable physical injury).
In the present case, the symptoms experienced by Daniel included nightmares, vomiting, anxiety, nervousness, physically shaking, acting-out, hypervigilance, sleep difficulties, bedwetting, a significant increase in weight, and a refusal to attend school. Based on court precedents previously cited, Daniel's nightmares, anxiety, nervousness, trembling, weight gain, and sleep difficulties do not qualify as physical injuries.
The key symptom emphasized by the parties began in March 2003 when Daniel vomited after having been told he would be going on a bus field trip. Daniel relies heavily on Ely v. Hitchcock, 30 Kan. App. 2d 1276, 58 P.3d 116 (2002), which addresses vomiting, in arguing that vomiting is a physical injury. Although the plaintiff in Ely vomited at the scene of the disturbing incident, he was nevertheless denied relief. 30 Kan. App. 2d at 1289-90. The court stated: "Although vomiting may be the physical impact that a case requires, Ely did not seek counseling or any sort of help for his alleged trauma. As a result, Ely has not demonstrated a significant physical injury." 30 Kan. App. 2d at 1290.
In contrast, Daniel did receive counseling from Jeff Ready in November 2002 because of the initial incident and later symptoms. Nevertheless, this counseling was related to the other noncompensable symptoms Daniel was experiencing. Daniel did not begin to see Dr. Wright until June 2003, 3 months after the first vomiting incident. Furthermore, this first instance of vomiting occurred 5 months after the initial incident, far from the almost contemporaneous vomiting in Ely. Indeed, this factor is relevant. See Hoard, 233 Kan. at 275-76 (citing Clemm v. Atchison, T. & S. F. Rly. Co., 126 Kan. 181, 268 Pac. 103 [1928]; Whitsel v. Watts, 98 Kan. 508, 159 Pac. 401 [1916]). ANW correctly points to Gilliam v. USD # 244 School Dist., 397 F. Supp. 2d 1282, 1291-92 (D. Kan. 2005), where the court rejected that vomiting is a compensable physical injury under Ely when the vomiting fails to occur contemporaneously or shortly after the initial incident.
Daniel urges the court to consider two federal district court cases, Freeman v. Kansas State Network, Inc., 719 F. Supp. 995 (D. Kan. 1989), and Payne v. General Motors Corp., 731 F. Supp. 1465 (D. Kan. 1990), aff'd 943 F.2d 57 (10th Cir. 1991). The trial court took note of these cases, but ruled that our Supreme Court decision in Hoard was controlling and took precedence over the federal court decisions. Indeed, "[f]ederal court decisions on issues of state law are not binding on and have limited precedential effect in state courts. [Citation omitted.]" KPERS v. Reimer & Koger Assocs., Inc., 262 Kan. 635, 669, 941 P.2d 1321 (1997).
In Freeman, the court held that the plaintiff's inability to lactate, which prevented her from nursing her child, qualified as a physical injury, thus defeating the defendant's motion for summary judgment. 719 F. Supp. at 1000-01 (citing Hoard, 233 Kan. at 274, 277-79). There, the claimed injury did not occur until 6-7 weeks after the initial incident, although the parties agreed for purposes of the motion that the defendant caused the injury. The plaintiff presented expert evidence that cessation of lactation may occur weeks after a stress inducing event, thus leading the court to conclude that a period of 6 weeks is not unusual in that situation. 719 F. Supp. at 1001. The facts of Freeman are similar to the present case in that witness testimony established causation and the vomiting incident did not occur until some time after the incident. Nevertheless, Dr. Doug Wright established only that PTSD cannot be diagnosed for at least 1 month after an incident. This does not establish that a particular symptom, such as vomiting, tends to occur at a later time with PTSD. Dr. Shawna Wright also acknowledged that Daniel had vomited as a result of the bus incident. Nevertheless, absent clear testimony that PTSD can cause vomiting to occur as much as 5 months after an incident, Freeman lends little support to Daniel's claim.
In Payne, the court held that an employee alleging employment discrimination had a compensable physical injury claim for purposes of negligent infliction of emotion distress when he experienced depression, fatigue, exhaustion, and nervousness. 731 F. Supp. at 1474-75. Nevertheless, because Payne directly contradicts the holdings of Anderson and Reynolds, both Kansas cases that have precedential effect, Payne carries little weight in this regard. See Anderson, 242 Kan. at 860; Reynolds, 24 Kan. App. 2d at 861-62. Furthermore, Reynolds held that headaches, diarrhea, nausea, crying, shaking, sexual problems, and feelings of stress, all caused by anxiety, were insufficient physical injuries. 24 Kan. App. 2d at 862. Moreover, the Reynolds court distinguished Payne and Freeman, noting that in those cases the plaintiffs alleged and offered evidence of significant, severe symptoms of physical injury, which was not done in Reynolds. 24 Kan. App. 2d at 861-64.
See also Schweitzer-Reschke v. Avnet, Inc., 874 F. Supp. 1187, 1196-97 (D. Kan. 1995) (holding one incident of vomiting and diarrhea plaintiff experienced on a date when alleged stress-inducing incident was not claimed to have occurred, and where symptoms could have been caused by other factors, is not a compensable physical injury); Holdren v. General Motors Corp., 31 F. Supp. 2d 1279, 1285-86 (D. Kan. 1998) (holding that symptoms of difficult breathing, weakness, fatigue, headaches, gastrointestinal discomfort, sexual dysfunction, knee injury, respiratory infection, sleep disturbances, and "'nerves'" requiring a prescription for Paxil were insufficient evidence of any compensable physical injuries).
When all is considered, Daniel has not suffered a compensable physical injury for purposes of a negligent infliction of emotion distress claim under Kansas law. Most of the symptoms alleged by Daniel have been ruled noncompensable in previous decisions. The only symptom that might qualify under existing case law was the vomiting. But see Restatement (Second) of Torts § 436A, comment c, p. 462 (1964) (recognizing that transitory, nonrecurring dizziness and vomiting do not make the actor liable where such symptoms are inconsequential and do not amount to any substantial bodily harm).
For argument purposes only, even assuming that Daniel could establish his vomiting as a physical injury, the vomiting occurred too remote in time from the initial incident, thus failing the requirements of Hoard, 233 Kan. at 279. Nevertheless, the dissent says that we have read Hoard too narrowly concerning the temporal proximity requirement and that the Hoard court did not draw a bright-line test for temporal proximity. Ware, slip op. at D-4 (Greene, J., dissenting). We agree with the dissent that there is no bright-line test for temporal proximity. Further, in asserting that Daniel's vomiting occurred within a short time after the bus incident, the dissent states: "In Hoard, the plaintiffs sought recovery for emotional distress where physical manifestation occurred from 6 weeks to 2 years after the incident. Ware, slip op. at D-4 (Greene, J., dissenting). Here, Daniel's physical manifestation occurred less than 6 months after the bus incident." Nevertheless, the Hoard court determined that the physical injuries suffered by the plaintiffs even 6 weeks after the incident was a substantial length of time: "The physical injuries suffered by the appellants occurred a substantial length of time, from six weeks to two years, after the incident." Hoard, 233 Kan. at 277. Although the dissent argues that Daniel's vomiting fits within the short span of time requirement, 5 months is a substantial length of time and is not within the span of time requirement established by Hoard, 233 Kan. at 279 ("Case law requires that the physical injuries must directly result from the emotional distress allegedly caused by the defendant's negligence, and must appear within a short span of time after the emotional disturbance.").
Should Kansas Courts Expand the Physical Injury Definition to Include the Manifestations of PTSD?
Daniel urges this court to expand the physical injury definition when the injury suffered as a result of negligence is PTSD, citing several cases outside this jurisdiction to support his proposition. Daniel reasons that the severity of this disorder and the resulting effects on a 4-year-old child, creating a lack for potential fakery that the physical injury requirement is meant to protect, warrant a departure from the general rule. We now turn to the cases relied upon by Daniel.
In Rodriguez v. Cambridge Housing Authority, 443 Mass. 697, 702-705, 823 N.E.2d 1249 (2005), a mother was brutalized in her home by an unknown intruder. Her young son found her bound, bleeding, and choking to death on her bed. He tried unsuccessfully to untie her. Both mother and son suffered PTSD following the incident. The Massachusetts Supreme Court recognized that more than 10 years earlier it had broadened its range of compensable symptoms for emotional distress claims to include a bystander claim like the one presented by the son. 443 Mass. at 701-03.
In Rowell v. Holt, 850 So. 2d 474, 477-79 (Fla. 2003), the court created an exception to the "impact rule," which states the emotional distress suffered by a plaintiff must flow from physical injuries sustained in an impact before he or she can recover emotional damages for distress. There, the court allowed the claim when the plaintiff was wrongfully imprisoned due to the negligence of his attorney. The court focused on the special duty of the attorney, foreseeability of the injury, and severity of depriving a person's liberty. 850 So. 2d at 479-80. Nevertheless, the court noted that the exception was strictly limited to wrongful imprisonment cases and stated: "This determination should not . . . be interpreted to cast doubt on the continued viability of the impact rule, nor should this decision be extended any further than as narrowly tailored. We reaffirm the role the impact rule plays as a safeguard against unduly speculative claims." 850 So. 2d at 481. Similarly, in La Fleur v. Mosher, 109 Wis. 2d 112, 115, 118-19, 325 N.W.2d 314 (1982), the court affirmed the physical impact requirement but created a special exception for negligent confinement cases, reasoning that the nature of deprivation itself is a sufficient guarantee that the claim is not frivolous.
In Collins v. Dunlap, 1999 WL 185130 at *1-2 (Conn. Super. 1999) (unpublished opinion), the court permitted the plaintiff to recover on a negligent infliction of emotional distress claim when she alleged psychological injuries, nightmares, and psychiatric injuries after the defendant rearended the vehicle in which she was a passenger. The court only required that the plaintiff prove both that the defendant should have realized that his conduct involved an unreasonable risk of causing emotional distress and that, if emotional distress did result, the distress might result in illness or bodily harm. Collins at *2. Collins did not address the nature of the alleged symptoms but only whether the plaintiff, absent a physical injury, was in the "zone of danger" to permit recovery. Collins at *2-3.
None of the cases previously cited bear the weight of reliance which Daniel places upon them. ANW points out that Rodriguez and Collins involved bystander or zone of danger claims clearly recognized by their own states' laws. Further, the young plaintiff in Rodriguez was hospitalized for 17 days after the incident. In Rowell and LaFleur, each court made narrow, fact-driven exceptions to the physical injury requirement based on the extreme nature of the negligent conduct–wrongful incarceration. Though it made an exception, the court in LaFleur took great pains to reiterate the public policy considerations supporting the physical injury requirement. 109 Wis. 2d at 115, 118-19.
Kansas has consistently held that generalized physical symptoms of emotional distress, such as those associated with PTSD and suffered by Daniel, are insufficient to state a cause of action for a negligent infliction of emotion distress claim. See Anderson, 242 Kan. at 860.
The physical injury requirement in Kansas is based on sound legal principle:
"The purpose . . . is to prevent plaintiffs from recovering for emotional distress that is feigned or counterfeit. [Citation omitted.] '. . . [E]motional distress is a common experience of life and is usually trivial. Therefore, the courts limit recovery to cases involving severe emotional distress which is evidenced and substantiated by actual physical injury.' [Citations omitted.]" Reynolds, 24 Kan. App. 2d at 861.
Clearly, the result that Daniel is advocating is at variance with current court precedents.
Like Kansas, a number of other jurisdictions seem to require either physical injury or physical manifestation to allow recovery under a negligent infliction of emotional distress claim: Kallstrom v. United States, 43 P.3d 162, 165-66 (Alaska 2002) (generally damages are not awarded for negligent infliction of emotional distress in the absence of physical injury, unless circumstances meet bystander exception or preexisting duty exception); Keck v. Jackson, 122 Ariz. 114, 115, 593 P.2d 668 (1979); Garrison v. Medical Center of Delaware, 581 A.2d 288, 293-94 (Del. 1990); Lee v. State Farm, 272 Ga. 583, 584-88, 533 S.E.2d 582 (2000) (recovery for negligent infliction of emotional distress is allowed only when there is some impact on plaintiff, and impact must be physical injury); Evans v. Twin Falls County, 118 Idaho 210, 218-20, 796 P.2d 87 (1990); Rickey v. Chicago Transit Authority, 98 Ill. 2d 546, 550-56, 457 N.E.2d 1 (1983) (adopting zone of danger rule but also requiring that plaintiff must show physical injury or illness as a result of emotional distress caused by defendant's negligence); Barnhill v. Davis, 300 N.W.2d 104, 105-08 (Iowa 1981) (recognizing that compensable mental distress should ordinarily be accompanied with physical manifestations of distress); Vance v. Vance, 286 Md. 490, 408 A.2d 728 (1979); Payton v. Abbott Labs, 386 Mass. 540, 544-57, 437 N.E.2d 171 (1982); Daley v. LaCroix, 384 Mich. 4, 8-16, 179 N.W.2d 390 (1970); Engler v. Illinois Farmers Ins. Co., 706 N.W.2d 764, 767-72, 765 (Minn. 2005) (applying zone of danger doctrine and also requiring that plaintiff suffer severe emotional distress with physical manifestations); Wilson v. General Motors Acceptance Corp., 883 So. 2d 56, 64-65 (Miss. 2004) (plaintiff must prove physical manifestation of injury or demonstrable physical harm); O'Donnell v. HCA Health Services, 883 A.2d 319, 324-25 (N.H. 2005); Muchow v. Lindblad, 435 N.W.2d 918, 921-23 (N.D. 1989) (applying zone of danger test and also requiring plaintiff to establish bodily harm); Kraszewski v. Baptist Medical, 916 P.2d 241, 245-48 (Okla. 1996); Melton v. Allen, 282 Or. 731, 736, 580 P.2d 1019 (1978); Houston v. Texaco, Inc., 371 Pa. Super. 399, 404-05, 538 A.2d 502 (Pa. Super. 1988) (The general law in Pennsylvania has been that, except in limited circumstances, a plaintiff may not recover for negligent infliction of emotional distress absent a physical manifestation of the emotional distress allegedly suffered.); Perrotti v. Gonicberg, 877 A.2d 631, 635-39 (R.I. 2005) (recognizing that Rhode Island follows zone of danger test and also requires that the plaintiff must suffer serious emotional injury that is accompanied by physical symptomatology); Strickland v. Madden, 448 S.E.2d 581, 583-84 (S.C. App.1994) (plaintiff must prove that bodily injury was proximately caused by emotional trauma); Maryott v. First Nat. Bank of Eden, 624 N.W.2d 96, 102-04 (S.D. 2001) (negligent infliction of emotional distress requires manifestation of physical symptoms); Hansen v. Mountain Fuel Supply Co., 858 P.2d 970, 973-75 (Utah 1993); Brueckner v. Norwich University, 730 A.2d 1086, 1092 (Vt. 1999) (if plaintiff has not suffered physical impact from negligent conduct, plaintiff must meet zone of danger test and also show that plaintiff in fact suffered substantial bodily injury or illness); Hughes v. Moore, 214 Va. 27, 29-35, 197 S.E.2d 214 (1973) (plaintiff must prove physical injury that was natural result of fright or shock proximately caused by defendant's negligence).
Moreover, some jurisdictions have combined the requirement of physical injury or physical manifestation with the common-law "physical impact" rule, which requires that the negligent conduct cause a physical impact in order for a plaintiff to prevail on a negligent infliction of emotional distress claim in nonbystander cases. See Lee v. State Farm, 272 Ga. at 584-88 (following physical impact rule and also requiring plaintiff to show that physical impact caused physical injury and that physical injury caused plaintiff's emotional distress); Wilhoite v. Cobb, 761 S.W.2d 625, 626 (Ky. App. 1988) (in a negligence case, there can be no recovery for fright, shock, or mental anguish that is not accompanied by physical contact or injury.)
The rule that some type of physical injury or physical manifestation is required in order to recover for negligent infliction of emotional distress is consistent with that set forth in the Restatement (Second) of Torts § 436A, p. 461:
"If the actor's conduct is negligent as creating an unreasonable risk of causing either bodily harm or emotional disturbance to another, and it results in such emotional disturbance alone, without bodily harm or other compensable damage, the actor is not liable for such emotional disturbance."
This rule appears to be followed by the majority of jurisdictions. Gonzalez v. Metro. Dade Cty. Health Trust, 651 So. 2d 673, 674-75 (Fla. 1995); see also Muchow v. Lindblad, 435 N.W.2d 918, 921-22 (N.D. 1989) ("A majority of jurisdictions follow the Restatement 2d Torts § 436A . . . requir[ing] bodily harm to recover for negligent infliction of emotional distress."). Comment b of § 436A of the Restatement sets forth three rationales for the rule that emotional disturbance alone is insufficient to recover for negligent infliction of emotional distress:
"The reasons for the distinction, as they usually have been stated by the courts, have been three. One is that emotional disturbance which is not so severe and serious as to have physical consequences is normally in the realm of the trivial, and so falls within the maxim that the law does not concern itself with trifles. It is likely to be so temporary, so evanescent, and so relatively harmless and unimportant, that the task of compensating for it would unduly burden the courts and the defendants. The second is that in the absence of the guarantee of genuineness provided by resulting bodily harm, such emotional disturbance may be too easily feigned, depending, as it must, very largely upon the subjective testimony of the plaintiff; and that to allow recovery for it might open too wide a door for false claimants who have suffered no real harm at all. The third is that where the defendant has been merely negligent, without any element of intent to do harm, his fault is not so great that he should be required to make good a purely mental disturbance." Restatement (Second) of Torts § 436A, comment b, pp. 461-62.
Understandably, some jurisdictions, instead of backing away from the physical injury requirement altogether, have created exceptions to the rule. Indeed, some courts have recognized a limited exception in bystander cases. See Sinn v. Burd, 404 A.2d 672, 685 (Pa. 1979) (adopting foreseeability test in case where plaintiff saw her child being struck by automobile and killed). Further, a minority of jurisdictions have recognized an exception to the rule for emotional harm resulting from the negligent transmission of a death message by a telegraph company. See Hoard v. Shawnee Mission Medical Center, 233 Kan. 267, 274, 662 P.2d 1214 (1983). Nevertheless, a complete backing away of the physical manifestation rule appears to be problematic based on the rationale set forth in comment b of § 436A of the Restatement.
We find helpful California's experience with this issue. In Molien v. Kaiser Foundation Hospitals, 27 Cal. 3d 916, 921-31, 167 Cal. Rptr. 231, 616 P.2d 813 (1980), the California Supreme Court abolished the physical injury requirement, which created an independent cause of action for negligent infliction of emotional distress claims. Yet, a few years after that decision, the same court expressed concerns about the "limitless exposure to liability." Thing v. La Chusa, 48 Cal. 3d 644, 656, 257 Cal. Rptr. 865, 771 P.2d 814 (1989). Another California appellate court declared that Molien had created a "quagmire of novel claims." Andalon v. Superior Court, 162 Cal. App. 3d 600, 609, 208 Cal. Rptr. 899 (1984). By 1992, California abolished negligent infliction of emotional distress as an independent tort. Moreover, it had narrowed the scope of this claim to include only those cases in which a contractual relationship existed or those cases in which a bystander witnessed an injury to a loved one. See Burgess v. Superior Court, 2 Cal. 4th 1064, 1071-74, 9 Cal. Rptr. 2d 615, 831 P.2d 1197 (1992); Andalon, 162 Cal. App. 3d at 609-12.
Nevertheless, the dissent argues for the abolishment of the physical manifestation requirement, stating that "Kansas need not retain criteria for compensability that are no longer consistent with the state of medical science." Ware, slip op. at D-8 (Greene, J., dissenting.) In support of its position, the dissent cites a number of cases that have abandoned the requirement. All the cases, except one, fails to offer the appealing authority that should be required before abolishing the physical manifestation requirement.
For example, the dissent cites Molien, 27 Cal. 3d 916, in support of its position. Nevertheless, as previously discussed, California has abandoned its experiment of allowing recovery on an independent tort of negligent infliction of emotional distress. Second, the dissent cites Camper v. Minor, 915 S.W.2d 437, 440-46 (Tenn. 1996). Nevertheless, Camper, who claimed to have suffered emotional injuries after seeing an accident victim's lifeless body, consulted a psychiatrist within 2 weeks after the accident–not approximately 9 months like we have in this case. Third, in Doe Parents No. 1 v. State Dept. of Educ., 58 P.3d 545, 579-81 (Hawaii 2002), the court recognized an exception to the physical injury requirement. In doing so, the court stated: "[W]e have consistently held, as a general matter, that the plaintiff must establish some predicate injury either to property or to another person in order himself or herself to recover for negligently inflicted emotional distress." 58 P.3d at 580. Finally, in Brueckner, 730 A.2d at 1092, the court recognized the zone of danger exception: If plaintiff has not suffered an impact, plaintiff must show that he or she was within the zone of danger. This rule is inapplicable to this case.
In summary, we acknowledge that the physical manifestation requirement has been vigorously criticized by some courts as the dissent has noted. Moreover, as the dissent has pointed out, some courts have abandoned the requirement. Nevertheless, there are a number of states that still require some type of objective evidence of a plaintiff's emotional injury. Kansas happens to be one of those states that requires such evidence. It does not seem unreasonable to require some objective evidence of a plaintiff's emotional distress.
Because Daniel suffered no physical injury contemporaneous with or shortly after the bus incident, summary judgment on the negligent infliction of emotional distress claim was proper.
GREENE, J., dissenting: I must respectfully depart from my colleagues in the majority because I am convinced that Daniel Ware, III, a minor, presents an authentic claim for emotional injury that should be cognizable based on existing Kansas law. Moreover, if existing law does not support this claim, I would advocate that existing law be clarified or modified to recognize such a claim.
Noting that the case was decided on summary judgment, the uncontroverted facts are deserving of examination. The following plaintiffs' statements of fact were not controverted:
"1. Daniel Ware was a very happy child before this [October 2002] incident.
"2. After the incident of being left on the bus, Daniel is very withdrawn, negative and sad. He wants to stay in the house and stay close to an adult.
"3. Jenni and Daniel Ware Jr. took Daniel back to preschool the day of the incident and Daniel became very upset and was crying saying he did not want to stay so Jenni and Daniel Ware Jr. took him home.
"4. Jenni Ware rode the bus with Daniel on one occasion when Neka Hall could not ride with him. Daniel cried to [sic] whole way there, held Jenni's hand and shook.
"5. Daniel vomited at school or at home every time Jenni or Daniel Ware Jr. took him to school after March 2003 until the end of May 2003.
"6. Jenni Ware took Daniel to see a Dr. Ready possibly in November 2002 to receive counseling. Jenni Ware also took Daniel to a Dr. Wright to receive counseling. Dr. Wright diagnosed Daniel with post traumatic stress disorder that was he believed brought on by being left on the bus.
"7. Daniel Ware was still treating [sic] for his condition at the time of his deposition.
"8. Daniel Ware suffered from behavior problems after this incident.
"9. Daniel Ware could not sleep by himself after the incident, he slept with his parents every night.
"10. Daniel was prescribed and took Zoloft and Lamictal to treat his emotional distress.
"11. Jeff Ready, LCP, the first professional to see Daniel, (which was three weeks after the date of the incident), testified that Daniel had a genuine reaction to what happened.
"12. Doug Wright, Ph.D., was the initial treating therapist. He testified that he diagnosed Daniel with Post-Traumatic Stress Disorder (PTSD) with a variety of symptoms, including but not limited to nightmares, vomiting, anxiety, nervousness, physically shaking, acting-out, hyper-vigilance, sleep difficulties, bedwetting, a significant increase (35 lbs) in his weight, and a refusal to attend school.
"13. Doug Wright also testified that the problems Daniel was having had been continuous since the incident on the bus and in Dr. Wright's opinion was clearly linked to the bus incident.
"14. Dr. Wright further testified that PTSD cannot be diagnosed for at least one month after an incident and that the nature of PTSD is a physical re-enactment of feelings associated with the initial trauma.
"15. Dr. Hunter, Plaintiffs' expert, also diagnosed Daniel with PTSD and that there was nothing else to attribute the onset of Daniel's problems other than the bus incident.
"16. Dr. Hunter further testified that Daniel had hyperphasia, weight gain and vomiting, all physical reactions caused by Daniel being left on the bus in October 2002.
"17. Shawna Wright, Ph.D., L.P., became Daniel's treating therapist after Doug Wright. She testified that she agreed with Daniel's initial diagnosis of PTSD and that the PTSD was a result of the incident on the bus.
"18. Shawna Wright also testified that Daniel vomited while treating with her and that the vomiting reaction was due to the bus incident in 2002."
Additionally, the concessions of counsel for the defense are remarkable. In argument on the summary judgment motion, he stated:
"[I]n the light most favorable to plaintiff this kid did sustain a real mental injury. And on the basis of this factual record for summary judgment purposes I'm not arguing about that. The boy is in counseling. We are not debating that." (Emphasis added.)
First, I would hold that the physical manifestation of the emotional injury, vomiting that is triggered by a reenactment of feelings associated with the initial trauma, meets the criteria of Hoard v. Shawnee Mission Medical Center, 233 Kan. 267, 662 P.2d 1214 (1983), because it "directly resulted" from the original bus incident and it appeared within a sufficiently short span of time after the original bus incident, especially when it is considered that the triggering reenactment of feelings was deliberately delayed by steps intended to preclude any such reenactment. I respectfully believe the majority reads and applies Hoard far too narrowly; our Supreme Court did not draw a bright-line test for temporal proximity but, rather, set forth several guidelines for such an injury.
"As in all actions for the recovery of damages for negligence, the appellants must show that the physical injuries complained of were the direct and proximate result of the emotional distress caused by the . . . negligent conduct. [Citations omitted.] Furthermore, it is a fundamental principle of law that recovery may be had only where it is shown with reasonable certainty that damage was suffered and that such damage resulted from the act or omission of which complaint is made. [Citation omitted.] Recovery may not be had where the cause of the injury is too remote and speculative and where the alleged resulting damages are too conjectural and speculative to form a sound basis for measurement. [Citation omitted.] Other states have held that . . . [such] recovery may be had if, but only if, there is shown a clear and unbroken chain of causal connection between the negligent act, the emotional disturbance and the physical injury. [Citations omitted.]" Hoard, 233 Kan. at 277.
In Hoard, the plaintiffs sought recovery for emotional distress where physical manifestation occurred from 6 weeks to 2 years after the incident. Here, Daniel's physical manifestation occurred less than 6 months after the bus incident.
Surely, we must recognize that the nature of Daniel's injury is unlike the typical emotional distress scenario. Here, Daniel did not suffer due to a horrific event that would never be repeated; Daniel suffered a horrific event in connection with an instrumentality that is a common element in the life of most students–a bus. The problem in this case that is absent from the usual case of emotional distress is that Daniel is expected to face the prospect of another horrific act every time he must do what nearly all students must do on a daily basis–ride a bus. His physical symptoms did not occur so long as he was provided some crutch to assure no repeat of the horrific event; but when he later realized he would be expected to resume bus riding without any chaperone or other crutch, the physical symptoms emerged immediately and continued persistently.
Here, I would argue there is no serious question that the physical manifestations of vomiting was the direct and proximate result of the emotional distress, that the damage suffered resulted from the initial incident, that the cause was neither remote nor speculative, and that Daniel's damages were neither conjectural nor speculative to form some claim for measurement. Moreover, I believe Daniel has shown that there was a clear and unbroken chain of causal connection between the negligent act, the emotional disturbance, and the physical injury. Thus, I conclude a fair application of Hoard precludes summary judgment for ANW Special Education Cooperative No. 603 (ANW).
Second, if these facts and arguments do not move Daniel's claim within controlling precedent, perhaps it is time for our Supreme Court to reexamine the Hoard criteria. Where there is undisputed evidence of emotional injury that is caused by or directly related to the defendant's actions, where it is substantiated by medical opinion and being treated by drug therapy, counseling, or other similar medical treatment, where the physical manifestations are shown to be causally connected to the negligent acts, and where the finder of fact is convinced by a preponderance of evidence that there is no fakery of symptoms, perhaps the Hoard criteria should be modified.
Posttraumatic stress disorder (PTSD) is now a psychological trauma that may produce measurable brain damage or is otherwise capable of forensic assessment. Moreover, there is no longer any scientific reason to believe that medical science is somehow more competent to sort out the physical than the mental consequences of tortuous events. In fact, the research does not support a categorical distinction between emotional and physical harm on the ground that people who suffer mental or emotional loss are more likely to malinger or are more difficult to detect when they do. See Shuman, How We Should Address Mental and Emotional Harm, Judicature, Vol. 90, pp. 248-49 (May-June 2007). As stated by that commentator:
"Whatever the best minds of the day might have thought about the difference in physical and emotional harm when tort law came of age, the best minds of today do not support such a stark mind-body dichotomy.
"Our current understanding rejects this Cartesian dualism and leads us in the direction of an integrated model for understanding harm. Illustrating this understanding is a diagnosis common in civil and criminal courtrooms, Posttraumatic Stress Disorder. . . . Today and tomorrow's scientific paradigms do not support differential legal treatment of mental and physical harm." Shuman, How We Should Address Mental and Emotional Harm, Judicature, Vol. 90, p. 248.
Notably, some of the jurisdictions that previously required the physical manifestation element for compensability of emotional harm have now abandoned the requirement. See, e.g., Molien v. Kaiser Foundation Hospitals, 27 Cal. 3d 916, 921-31, 167 Cal. Rptr. 831, 616 P.2d 813 (1980); Doe Parents No. 1 v. State Dept. of Educ., 58 P.3d 545, 579-81 (Hawaii 2002); Johnson v. Ruark Obstetrics, 395 S.E.2d 85, 92-97 (N.C. 1990); Camper v. Minor, 915 S.W.2d 437, 440-46 (Tenn. 1996); Brueckner v. Norwich University, 730 A.2d 1086, 1092 (Vt. 1999). As noted by the majority, however, wholesale abandonment of the physical manifestations element can be problematic. Accordingly, I would advocate clarifications of the requirements for compensable emotional distress that parallel the rationale of Hoard without the uncompromising bright-line test for temporal proximity imposed by the majority.
It is critical that the law keep pace with medical science. The frequency of PTSD, particularly in military veterans, will undoubtedly continue to advance the science of diagnosis as well as treatment of this emotional illness. The record on appeal in this case demonstrates that an authentic diagnosis of PTSD can be medically substantiated with reasonable reliability. Kansas need not retain criteria for compensability that are no longer consistent with the state of medical science.
For Daniel to be left without a remedy under all the undisputed facts in this case is antithetical to the general policy of tort liability in Anglo-American jurisprudence: those who are legitimately injured due to the act or omissions of others should have a remedy in our courts.
I would reverse the district court's grant of summary judgment in favor of ANW and remand for further proceedings.
Updated: April 11, 2008.
URL: http://www.kscourts.org/Cases-and-Opinions/opinions/ctapp/2008/20080411/98236.htm.


text:
Q: Dirichlet's Kernel, Identity for complex numbers It is easy to prove that $ 1/2 + \sum\limits_{k=1}^{n} \cos(kt) = \frac{\sin(n+1/2)t}{2\sin(t/2)} $ for every real number t.
I know also that this identity doesn't hold for complex numbers but i can't find out why.
Is there any hint you have in mind ?

A: In your question, $t$ is real because it is a value between $[0,2\pi)$ since it is an angle so it wouldn't make any sense to plug on some $a+bi$ unless you plugged in $\arg(a+bi)$.

Dirichlet kernel is generally defined as
$$
D_N(\theta) = \frac{1}{2\pi}\sum_{-n}^ne^{in\theta} = \frac{1}{2\pi}\sum(\cos(n\theta) + i\sin(n\theta))
$$
Now $\theta$ is angle and $n$ is an integer so I don't see why you would insert a complex number for those two values. However, if we let $\theta =\pi/2$, then
$$
D_N(\theta)=\frac{1}{2\pi}\sum_{-n}^n\cos(n\pi/2)+i\sin(n\pi/2)
$$
Now we are summing real and complex numbers in the Dirichlet kernel but the result will be real. For $n=1$, we get
$$
D_N(\theta) = (-i + 1 + i)/(2\pi) = 1/(2\pi)
$$
Now, let's make sure what I said is the Dirichlet kernel agrees with what you have. Since your definition excludes $2\pi$, I will as well to show that the definitions are equivalent.
\begin{align}
D_N(\theta) &= \sum_{-n}^ne^{in\theta}\\
&= 1+\sum_{k=0}^ne^{ik\theta} + \sum_{k=1}^ne^{-ik\theta}\\
&= 1 + 2\sum_{k=0}^n\cos(k\theta)\\
&=1/2 + \sum_{k=0}^n\cos(k\theta)
\end{align}

A: I think, i get to see why it's not. Consider N=1, t=πi for the identity i have given.
Thank you for your time everyone!

redpajama_set_name: RedPajamaStackExchange


This article was published 29/3/2014 (1848 days ago), so information in it may no longer be current.
While 13 Manitoba-grown acts were nominated at the 43rd annual Juno Awards — handed out over two nights this weekend in Winnipeg — only two emerged with hardware: Winnipeg-born jazz bassist/composer Mike Downes and Brandon-born violin virtuoso James Ehnes emerged with hardware.
Ehnes also had the distinction of being only double winner at Saturday night's Jian Ghomeshi-hosted, industry-only gala, at which 35 of this year's awards were handed out. The remaining six will be awarded during Sunday night's broadcast which airs on CTV at 8 p.m. from the MTS Centre.
Ehnes picked up Junos for both Classical Album of the Year: Solo or Chamber Ensemble and Classical Album of the Year: Large Ensemble or Soloist(s) with Large Group Ensemble. Ehnes is performing a three-night stand with the Nashville Symphony Orchestra and couldn't make the gala.
Downes, meanwhile, snagged Traditional Jazz Album of the Year for Ripple Effect.
The darling of the Junos, broadcast host and five-time nominee Serena Ryder, was crowned Artist of the Year — one of the most prestigious awards of the night — beating out Céline Dion, Michael Bublé, Drake and Robin Thicke. She's up for four more prestigious awards at Sunday night's telecast, including Single of the Year, Album of the Year and Songwriter of the Year.
Rather unbelievably, none of the big genre categories, including Alternative Album of the Year, Rap Recording of the Year, Pop Recording of the Year and Rock Recording of the Year, are televised, meaning that, unless you were streaming the gala, you missed out on some big wins — such as Tegan and Sara finally getting a Juno.
The twins' synthpop opus Heartthrob was crowned Pop Recording of the Year, besting efforts by Bublé, Robin Thicke, Walk Off The Earth and Hedley. "Oh my god we haven't won anything since 1996. We want to start with our piano teacher," Sara said in her acceptance speech. "This was an important one for us, we've been all kinds of bands. We wanted to make a pop record. Thanks for honouring that." It may well be their weekend; Tegan and Sara are up for Single of the Year, Group of the Year and Songwriter of the Year at Sunday's show.
Montreal indie rock juggernaut Arcade Fire — which leads the pack with six nominations for its Talking Heads-indebted double album Reflektor — won its first Juno of the weekend at the gala. Reflektor was named Alternative Album of the Year, beating out local electropop act Royal Canoe, Rah Rah, The Darcys and Yamantaka // Sonic Titan. Arcade Fire could pick up five more awards at Sunday's broadcast, at which it'll be "performing" at Sunday's broadcast via video.
Two of Canada's most buzzed-about cowboys took home Junos. Dean Brody's Crop Circles was named Country Album of the Year — an honour, Brody said backstage, that's better than being named one of Hello Magazine's 50 Most Beautiful People. "The other is just ammunition for all my friends." Brett Kissel (who was born in 1990 in case you haven't felt old yet today) was named Breakthrough Artist of the Year.
The Nicest Guy in Canada has an aw-shucks quality that didn't go unnoticed. "I'll never forget this night," Kissel said in the night's most earnest, but sincere, speech. He was just as charming backstage. "I'm feeling incredible. I'm excited to share this with everyone back home on the cattle ranch." Adorable. He's also been wearing the same cowboy hat since he was 12.
Rock album of the year went to Matt Mays' Coyote, beating out efforts by CanRock stalwarts such as Matthew Good and Headstones. The Nova Scotia-raised rocker was absent when his name was called — "I was out there talking about surfing. Sorry everybody, that was lame" — but gave a touching acceptance speech dedicating the award to his guitarist Jay Smith, who died last year. "We lost a good friend and a brother," Mays said. "This goes out to his family. It goes out to my band who played through a really tough time." Mays was nominated for two Juno awards at the 2005 awards in Winnipeg.
Juno Gala at the Winnipeg Convention Centre.
Rap Recording of the Year went to Drake's Nothing Was The Same, shutting out releases from Shad, Rich Kidd, SonReal and broadcast host Classified — who won in this category last year. Drake wasn't at the gala; he's probably kicking it with Rihanna somewhere. R&B/Soul Recording of the Year went to JRDN — aka Ralph Jordon Croucher — and the always best-dressed Kardinal Offishall for Can't Choose.
Backstage, Kardi talked about how far the Junos have come since Rascalz famously refused its 1998 award for Best Rap Recording because it was presented in the non-televised portion of the ceremony. Rascalz won the award for Cash Crop, which contained Northern Touch, one of the most important songs in Canadian hip hop. "Classified is co-hosting the award show. We've come a long way with the Junos. Tonight was really a proud moment."
Triple threat George Leach — he's a musician, artist and actor — snagged Aboriginal Recording of the Year for his sophomore album, Surrender. Backstage, he spoke about the unifying power of music. "Music is to bring people together. It's never to separate," he said, later adding, "I think music is one of the last platforms for people to say what they want to say."
Winnipeg noisecore act KEN mode, who won the inaugural Metal/Hard Music Album of the Year Juno in 2012 were beat out by Whitby, Ont. progressive metal act Protest the Hero, whose Volition was awarded the trophy.
Roots & Traditional Album of the Year: Solo went to Justin Rutledge's Valleyheart, while Roots & Traditional Album of the Year: Group went to The Strumbellas' We Still Move on Dance Floors.
Ron Sexsmith's 13th album, Forever Endeavour, proved to be lucky number 13, snagging him the Juno for Adult Alternative Album of the Year. Backstage, he mused on the AAA category. "This category didn't exist when I won (for Other Songs) in 1998. I won in roots and traditional, which I felt bad about, because I beat all these fiddlers. I'm happy they created this island for misfit toys."
Contemporary Jazz Album of the Year went to Christine Jensen Jazz Orchestra's Habitat. Montreal-based jazz composer and saxophonist said backstage she'd like to see more women on the production side of music. "Listening to the speeches and seeing how many men are involved in producing music, I'd like to see more women producing."
Electronic Album of the Year is a consistently interesting category, and 2014 was no exception. Halifax-raised DJ Ryan Hemsworth beat out Noah Pred, Graze, Blue Hawaii and this writer's projected winner A Tribe Called Red for Guilt Trips.
Chantal Kreviazuk and Raine Maida accepted this year's Allan Waters Humanitarian Award for their tireless philanthropic and humanitarian work, particularly through War Child Canada.
"It's important to note that we accept this award on behalf of the people who get up everyday and do virtuous things," he said.
People like Dr. Denis Mukege, a Congolese gynecologist who "repairs the bodies and lives of women who have been raped as war intimidation tactic," Kreviazuk said. She emotionally spoke of one woman in particular, Alice, who worked alongside the doctor to help survivors. Two weeks ago, before Dr. Mukege was due to fly to Winnipeg to receive an honourary Doctor of Laws from University of Winnipeg, Alice was brutally victimized herself. "Alice told him to say hi to Winnipeg, and thank everyone for their compassion," Kreviazuk said. "When an injustice happens, sometimes it feels like we're responsible. Sometimes it feels like we're a victim. Whatever that feeling is that is stirred inside you, it's a call to action."
The rest of the awards, including Single, Album, and Songwriter of the Year will be handed out Sunday.


text:
Беранци () е село в южната част на Северна Македония, в Община Могила.

География
Селото е разположено в областта Пелагония, северно от град Битоля. От запад на селото е рида Древеник, като на изток се разстила землището на селото в Пелагония, общинският център село Могила се намира в съседство на юг.

История
В XIX век Беранци е изцяло българско село в Битолска кааза на Османската империя. Църквата в селото "Свети Атанасий" е изградена в 1878 година.

Според статистиката на Васил Кънчов ("Македония. Етнография и статистика") от 1900 година Беранци има 540 жители, всички българи християни. Според Никола Киров ("Крушово и борбите му за свобода") към 1901 година Беранци има 40 български къщи.

В началото на XX век българското население на селото е под върховенството на Българската екзархия. По данни на секретаря на екзархията Димитър Мишев ("La Macédoine et sa Population Chrétienne") през 1905 година в Беранци има 432 българи екзархисти. При избухването на Балканската война седем души от Беранци са доброволци в Македоно-одринското опълчение.

По време на Първата световна война Беранци е част от Иваневска община и има 534 жители. По време на войната край Беранци загиват над 120 български войници, които са погребани в полково гробище край селото, където има и 4-метров мраморен паметник.

Според преброяването от 2002 година селото има 445 жители, всички македонци.

Личности
 Родени в Беранци
  Веле Мачкаров (Мачкароски), битолски селски войвода на ВМОРО, участвал в отбраната на Крушевската република с отряда на Питу Гули
  Димитър Берански (? - 1906), български революционер от ВМОРО, четник на Велко Велков - Скочивирчето
  Петре Дундар (? – 1635), български хайдутин

 Починали в Беранци
  Васил Атанасов Дончев, български военен деец, майор, загинал през Първата световна война

Бележки

Села в община Могила

redpajama_set_name: RedPajamaWikipedia


I am a spiri...the community page. I would also like some support with SEO and if all goes well some support creating social media profiles and linking them all together, so one blast can reach all platforms. I'd like to pay in two installments. Project completed in one month. I would like to change coloring to coincide with new business name. thanks.
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text:
Tempe Restored
Around London: Masques of the Stuart Court; saving London's heritage; IEDs at the NAM; and, Eighties fashion at the V&A…
by exploringlondon July 18, 2013 July 18, 2013
• The sights and sounds of the elaborate masques of the early Stuart Court – described as a cross between a ball, an amateur theatrical, and a fancy dress party – are being recreated at the Banqueting House in Whitehall. Historic Royal Palaces have joined with JB3 Creative to create an "immersive theatrical experience" for visitors to the building – one of the last surviving parts of the Palace of Whitehall – with the chance to try on costumes, learn a masque dance and witness performance rehearsals for Tempe Restored, last performed in the building in 1632. Inigo Jones will be 'present' as masque designer to talk about his vision for the performance. Weekends will also see musicians performing period music and on 27th July there will be a one-off evening event at the Banqueting House based on Tempe Restored. Admission charge applies. Performing for the King opens tomorrow and runs until 1st September. For more, see www.hrp.org.uk/BanquetingHouse/. PICTURE: HPR/newsteam.
• A new exhibition looking at how some of London's great Georgian and Victorian buildings were lost to bombs and developers before, after and during World War II – and how people such as poet John Betjeman campaigned to save them – opened in the Quadriga Gallery at Wellington Arch near Hyde Park Corner yesterday. Pride and Prejudice: The Battle for Betjeman's Britain features surviving fragments and rare photographs of some of the "worst heritage losses" of the mid-20th century. They include Robert Adam's Adelphi Terrace (1768-72) near the Strand, the Pantheon entertainment rooms (1772) on Oxford Street, and Euston Arch (1837). The English Heritage exhibition runs until 15th September. Admission charge applies. For more, see www.english-heritage.org.uk/daysout/properties/wellington-arch/.
• IEDs (Improvised Explosive Devices) will be 'uncovered' in a new exhibition opening tomorrow at the National Army Museum. Unseen Enemy will tell the stories of the men and women in Afghanistan who search for, make safe and deal with the impact of the IEDs through personal interviews, images and mementoes. The exhibition has been developed with "unprecedented access" from the British Army, Royal Air Force and Royal Navy and will include a range of equipment used in detecting and disarming the devices, such as bombsuits and robots as well as medical equipment used to help those injured in explosions. The exhibition is free. For more, see www.nam.ac.uk.
• On Now: Club to Catwalk – London Fashion in the 1980s. This exhibition at the V&A explores the "creative explosion" of London fashion during the decade and features more than 85 outfits by designers including John Galliano, Vivienne Westwood and Katherine Hamnett as well as accessories by designers such as Stephen Jones and Patrick Cox. While the ground floor gallery focuses on young fashion designers who found themselves on the world stage, the upper floor focuses on club wear, grouping garments worn by 'tribes' such as Fetish, Goth, High Camp and the New Romantics and featuring clothes such as those worn by the likes of Boy George, Adam Ant and Leigh Bowery. The exhibition also includes a display of magazines of the time. Entry charge applies. Runs until 16th February, 2014. For more, see www.vam.ac.uk. Meanwhile, tomorrow (Friday) night the V&A will celebrate the 25th anniversary of designer Jenny Packham with a series of four free catwalk shows in its Raphael Gallery. Booking is essential. Head to the V&A website for details.
Banqueting House Chelsea Galleries Hyde Park Corner Inigo Jones Museums News Stuart Twentieth century West End Westminster WhitehallAdam Ant Adelphi Terrace Banqueting House Boy George Chelsea Club to Catwalk - London Fashion in the 1980s Euston Arch Hyde Park Corner IEDs Inigo Jones John Betjeman John Galliano Katherine Hamnett Leigh Bowery masques National Army Museum Oxford Street Palace of Whitehall Pantheon Patrick Cox Performing for the King Quadriga Gallery Robert Adam Stephen Jones Strand Tempe Restored Unseen Enemy V&A Vivienne Westwood Wellington Arch Whitehall

redpajama_set_name: RedPajamaCommonCrawl


Located in the desirable residential area of Nascot Wood, the site was formerly part of West Herts College who vacated the site in favour of a new campus in the town centre.
In addition to the retention of all the trees on the site that were covered by Tree Preservation Orders, a new open space was created along the site frontage.
The houses were arranged on an angled grid creating long treelined boulevards and framed vistas throughout the site. The ground floor of the apartments building included a Tesco Express serving the surrounding area as well as the development itself.


Many home health companies pay nurses and therapists a flat fee for each patient visit. Under the federal overtime laws, such an arrangement may be appropriate, but only if certain specific conditions are met. You may be entitled to overtime.
Many home health companies pay nurses and therapists a flat fee for each patient visit. Under the federal overtime laws, such an arrangement may be appropriate, but only if certain specific conditions are met. For example, if the employer also pays hourly for meetings or pays a set amount to be "on call" outside of normal business hours, then the employer might be required to make extra overtime payments for all work over 40 hours in any week. Work is defined not only as patient care but can also include drive time, charting, taking samples to the lab, preparing schedules, phone conversations with other medical personnel or patients, meetings, etc. Many nurses and therapists who work full time often spend well in excess of 40 hours per week doing all the activities their jobs demand. Courts have rejected employers' attempts to deny overtime when paying workers a fee-per-visit if some portion of the worker's pay is tied to the number of hours worked.
Many home health companies that pay a fee per visit rely upon the fact that regulations are confusing so that they can avoid paying overtime. Home health nurses and therapists should not remain in the dark about whether they are entitled to overtime. We are here and available to discuss whether you may have a claim.
All calls are confidential. Know your rights. Call us today.


Cut: Oval cabachon. Great polish!
Note: Fine Blue Lapis Lazuli with classic Pyrite inclusions and calcite veins. This stone was cut with attached transluscent Afghanite making this a rare and collectable gem! Hand crafted in Afghanistan, these beautiful stones are perfect for jewelry or collections.
Brought to you direct from Afghanistan by Gem Line.


text:
MYABSPATH=$(readlink -f "$0")
PATCHBASE=$(dirname "$MYABSPATH")
CMBASE=$(readlink -f "$PATCHBASE/../../../../")

for i in $(find "$PATCHBASE"/* -type d); do
	PATCHNAME=$(basename "$i")
	PATCHTARGET=$PATCHNAME
	for i in $(seq 4); do
		PATCHTARGET=$(echo $PATCHTARGET | sed 's/_/\//')
		if [ -d "$CMBASE/$PATCHTARGET" ]; then break; fi
	done
	echo "### Patches in $PATCHTARGET"
	cd "$CMBASE/$PATCHTARGET" || exit 1
	git am -3 "$PATCHBASE/$PATCHNAME"/* || exit 1
done

redpajama_set_name: RedPajamaGithub


When I shared the candlesticks makeover a while back some questioned the yellow chairs. They are actually my breakfast room chairs and I like to switch them up now and then. For those who have not seen the whole dining room they may look a little off in here. The pictures I shared in that post did not show the ceiling which is yellow.
When the dining room was painted yellow the ceiling was painted, too. Then when I decided to lighten up the walls last year I just could not handle painting the ceiling again so I left it. I really like the color of it. The drapes have yellow in them as do the botanical prints on the gallery wall. This ties in with yellow in other parts of the house, too.
I like when all the ceilings aren't just white. If I could paint more ceilings in my home without it killing my neck, I would.
I also ordered these cute light bulbs to replace the regular frosted candle tip bulbs that were here before. These don't put out much light, but this room is rarely used anyway. If I need to I can replace these with the other bulbs when we have guests.
Gallery wall of botanicals I framed last year.
This is what it looks like with the chairs that go with this table.
Now these chairs are back in the breakfast room again. Poor chairs, they don't know where they belong.
Do you have ceilings in a color besides white?
this is great. I love to do interesting things with ceiling...from decoupage, to moldings, to stencils. It can add so much and ceiling are such a big part of a room.
You know I adore yellow and this ceiling is a wonderful yellow.
Oh Kim, I love your yellow ceiling! I've never noticed it before.
The yellow ceiling in your dining room looks wonderful. I have several ceilings that aren't white in my home.
Looks great. I love the yellow.
It's nice that you can change out your chairs between the two rooms. No colored ceilings in my house.
Well, I actually couldn't have said till you asked! I just looked up and my ceilings are khaki. My daughter painted everything before I moved in. Can you believe I didn't know? You can tell I'm not a painter!
Your ceiling color is pretty, Kim.
Our dining room color is topsail..a blue from SW. It was painted that color when we painted the dining room interesting aqua from SW. When we had the room painted Nomadic Desert, we left the topsail. I didn't know if I would like it, until I saw it after the walls were painted. I do like it and I am glad we left it topsail which is almost no color at all..just a sort of shadow of blue.
Actually Kim our kitchen ceiling is faux tin. It was left a tin colour and when we moved in our painter painted all our ceiling cloud white.
I love the yellow ceiling! It enhances an already gorgeous room!
I love your yellow ceiling. When we remodeled our place, the decorator begged me to paint the ceilings a color. We had just a few of them painted soft blue, and I really like them.
I love how all the yellow ties in, Kim.
Your dining room is gorgeous!!Love your ceiling color.I have boring white ceilings.And I am not painting them anytime soon LOL.
I like the chairs in there to. They look good with both tables. My walls have a yellow tone that i am thinking of painting. I also like the lighter feel.
Well, you probably know that yellow is my favorite color...I never noticed the painted ceiling in the dining room...I love it that it is a darker color...as I am repainting each room, I am having the ceilings done too...Love your dining room..I have always admired your hutch from afar!...Beautiful!
Yep--Love your painted ceiling. I have a coffered ceiling in the dining room and the uppermost part of it is painted a soft, soft green. I also have a guest bath with a pale blue ceiling.
Oh...pretty, pretty! I like being able to change things around, from room to room, too.
My ceilings are all white - I have a very open concept house...so it means all white...or all some other color on the ceilings!!
But, I did paint the openings of the skylights (2 in the Kitchen and 1 in each of 2 Bathrooms) a yellow gold - and we love it!! It's like sunshine!! Instead of a reflection of the white!!!
walls and cabinets in her kitchen (popular with 50's houses) with a red paisley wallpapered ceiling. It was so bright and cheerful! I loved it!
That is a great shade of yellow. What is the color name?
All my ceilings are blue. Love painted ceilings, especially if you have crown molding or a medallion.
This is such a gorgeous room, I've never had a ceiling that wasn't white, but it so works for you in that wonderful dining room!
I am crazy about that chandelier! Do you know Sarah Richardson? She would pick out something similar. Great minds think alike. Good for you! Beautiful, very beautiful.
Forget about the ceiling...that room is beautiful. I have the exact same rattan chairs and I love them. I wanted to buy the ones from Pottery Barn until I found these nice substitutes. Love the ceiling medallion, too. I need my husband to hang up mine. Beautiful post!
No ceilings painted a color, but I like the idea.
You have a great eye with color! Blue and yellow are wonderful together. Love the dining room with the yellow chairs! Really nice!
Your transformations are incredible.. and I don't know where you get the energy. I've not thought to switch up chairs, a great idea!
No I don't have painted ceilings Kim, but after seeing yours it may change when I start doing much needed interior paintings. Love the yellow and I think in looks great! I also love either style chair with your table, gorgeousness!!!!!!
Looks great kim, I did the same thing in our previous house. I used a color called bread basket, it just added that extra warmth I needed. Not sure I will be painting the ceiling in this house 11 foot just a little to high for my comfort. Wonderful ideal changing the chairs the way you do, gives the room a completely different look. Your home always looks beautiful.
That ceiling adds a lot to your room. I have all my ceilings painted except our guest rooms. Here's a thought...save your neck and hire out to have the ceiling painted. At 60, my painting days are over, it kills my shoulders. I sit back and let the pros do it in 1/4 th time I can.
Love the ceiling in yellow, and the yellow chairs look great with it:) I say keep the yellow in that room.
Love the ceiling - and the chairs, Kim! Really like that chandelier!!! The entire room is beautiful!
I have two ceilings other than white. One is a blue gray on the cedar porch ceiling that I love, and a dated cranberry in a formal livingroom that I not so much love anymore. One son's room used to have a 3 color splatter on the ceiling too but that was painted last summer. I'd rather have yellow!
My daughter's porch ceiling is an aqua blue...traditionally thought to thwart wasps...but SO pretty...I want to paint mine so badly! Love your yellow ceiling!
The yellow ceiling is so beautiful!!! How warm and sunny feeling.
When I lived in the south I was haunted by the haint blue on porch and interior ceilings.
I love it Kim. That image with your chandelier and the cabinet beyond looking up to the ceiling color is just divine. Full of your personality...sunny and warm.
I do not have ceilings in a color other than white, but I would like to. I'm not a yellow person, but that yellow is fantastic and I love it with the yellow chairs! And that chandelier...wow! Beautiful room!
I love your painted ceiling. Mine are usually all white, for the same reason you don't want to paint more ceilings...they are a pain in the neck!
Love the way you switch your chairs around.
I hate to admit it, but all of our ceilings are cream colored! You are an adventurous painter and it has certainly paid off big time in the dining room!
All of our ceilings are white, but I love your yellow dining room ceiling! I'm loathe to paint the ceiling though, because at sunset there's something that happens to the reflection of the sun on the water, and it reflects on the ceilings, making them seem to come to life.
Your yellow ceiling is just incredible! LOVE it! And the chairs too! There is too much white in the world!!!!!
Love, love, love the yellow color. I've been looking for the perfect yellow for my diningroom and kitchen. Do you remember the brand and name?
Love, love, love your yellow ceiling. And, I think your breakfast room chairs look fabulous in your dining room.
Yellow is my favorite color, and that is an awesome shade.
The yellow looks perfect in there.
I want a blue, or better yet, sky blue with some clouds, in my foyer.
I love your yellow ceiling. Yes I have blue ceilings in my dining and living rooms and walls are different colors. I love the look.
There is nothing in this room I don't love. I think the yellow ceiling is beautiful. I love the botanical prints too. I used to have very similar ones years ago and sold them at a yard sale (big mistake).
I LOVE the ceiling yellow. I like to paint my ceilings. Sometimes I paint them the same color as the wall to make them appear taller, sometimes a totally different color like my bathroom which I painted orange! I definitely consider it the fifth wall. LOVE the yellow chairs too!
I LOVE painted ceilings! Most of the ceilings in my house are painted. It's an especially pretty way to call attention to your crown molding too! Love it!
LOVE every.single.piece. in your china cabinet!
I love the yellow ceiling.
I love that you change things around! I think both sets of chairs look great! Your ceiling looks beautiful!
I don't have one white ceiling in my house. Blue in the sunroom and every other room is 1/3 intensity of the wall color.
And my girls chose some pretty bold paint colors in their rooms - and the ceilings are the same color as the walls!!
I love your dining room Kim, so beautiful!! The yellow is absolutely perfect.
I adore your yellow ceiling.
I love painted ceilings as they are the fifth wall. My dining room has a blue ceiling.
I love your dining room! The yellow doesn't scream at you it just adds dimension and keeps you interested in the space. My ceilings are blue in the Living and dining room and few people notice... I like it that way!
I paint my ceilings a lighter shade than what's on the wall. I get the wall paint and then ask them to make the ceiling paint with a 1/4 tint of the wall paint. When you first look at the ceiling you think it's white but against the moulding, you can see it's really not. I love it.
That's a great shade of yellow, Kim.
Kim, I would also paint every ceiling if it wasn't so much work. Our family room and powder room ceilings are done in a faux copper finish. Love the yellow and the chandy. Thanks for linking to the OHP this week.
All my home paint colors are listed under the tab at the top of my page under the header.


Note: This is the fourth of the five Ale Association Challenge Quests.
You only have 2 minute and 30 seconds to complete this challenge - don't forget to talk to Gerthar as soon as you finish the 6th beer, as you must talk to him before the time runs out.
Jasmine's Garden is between the Bree-town Hall and the Stone Quarter. As you are coming from Staddle, cross the courtyard and take the alley straight on between city hall and the jail. Keep to your left hand side and turn into the garden.
Hint: Once completed, you will only have 1 minute and 38 seconds to get to the Stone Quarter and complete the drinking there.
The Ale Association Challenge is underway.
Gerthar is in Jasmine's Garden in Bree.
You should speak with Gerthar to continue the Ale Association Challenge.
The beers are in Jasmine's Garden in Bree.
Gerthar has challenged you to drink six beers before the time runs out.
You should speak with Gerthar to receive further instructions on the Ale Association Challenge.
This page was last edited on 6 December 2016, at 15:55.


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Article: Call for Long Term EB-5 Reauthorization By Carolyn S. Lee
Published: 01-08-2018, 11:25 AM
Call for Long Term EB-5 Reauthorization
by Carolyn S. Lee
Looking ahead to what 2018 may hold, I hope the prospect deferred of long-term EB-5 reauthorization materializes at last.
The past few years have been difficult for the industry and investor families. Legislators, industry groups, investors and advisors have endured a roller coaster ride with mounting expectations of change followed by drops to the status quo. We can all use the ride coming to rest.
Immigrant investor families and U.S. enterprises investing in the EB-5 program need a measure of certainty. U.S. projects that have used or are considering using EB-5 capital need to believe EB-5 still works. The immigrant families who have already invested can't back out. Their investment is already creating U.S. jobs, and they deserve to know that the EB-5 program won't evaporate in some weeks or months. Prospective investors are faced with the Hobson's choice of investing in the Program today with all its present uncertainties, or waiting until tomorrow and being possibly shut out altogether due to significantly higher investment requirements.
Let's be clear. EB-5 Program 2.0 will not be perfect, just as 1.0 isn't. The new legislation will have many unanswered questions, and some of those questions will be answered unfavorably to all or some in the final legislation. The big step forward will be the inclusion of measures intended to weed out bad actors and attract the good. But this, too, will be a mixed bag as these measures' workability and efficacy are unproven and much will be left to USCIS discretion. And no advance endorsement can be offered without seeing the actual text of the next legislative draft. But assuming no curveballs, an imperfect 6-year program is better than continued short-term extensions, because serial uncertainties have put EB-5 on life support.
The EB-5 program is in its adolescence. Let's recognize also that with its potential for inexpensive capital now proven, we'll see strong disagreements about how the Program should mature. These disagreements can't stand in the way of long-term reauthorization, as they will always be with us. As a tiny sliver of immigration as it is, there is lots of room for diverse winners. To build a foundation for even bigger wins and more winners, we need a Program with some lifespan. So let's all pull for a long-term reauthorization of EB-5, a job creating engine running at no cost to taxpayers. It is time.
Carolyn S. Lee is the Managing Partner of Miller Mayer's EB-5 practice group. She is Chair of the American Immigration Lawyers Association (AILA)'s national EB-5 Committee and has previously served as Vice-Chair and Chair. Carolyn's current advocacy focuses on long-term reauthorization of the EB-5 regional center program and workable reform. Carolyn represents Regional Centers, developers, funds, and investors. She has written numerous in-depth publications on "material change," the "at risk" requirement, and TEAs. Carolyn lectures widely on EB-5 issues and is recipient of numerous awards for excellence including the 2016 Outstanding 50 Asian Americans in Business, the 2015 AILA Presidential Commendation, and the 2008 AILA Joseph Minsky Award. She is listed on International Who's Who of Corporate Immigration Lawyers and The Best Lawyers in America in Immigration Law.


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Olga Rypakova
Photo Credits: Erik van Leeuwen / Wikimedia Commons
Full Name Olga Rypakova
Profession / Role Athlete
Date of Birth 30 Nov, 1984
Born on 30th November 1984 in Oskemen, Olga Rypakova is a track and field athlete from Kazakhstan. Initially, she was a heptathlete but post 2007; she focussed only on the triple jump and long jump.
Her Achievements:
At the London Olympics in 2012, Olga won a gold medal in triple jump. In the next Olympics held in 2016, she secured a bronze medal in the same discipline.
Silver medal at the World Championships of 2011, held in Daegu. She also clinched bronze medals in the competition of the year 2015 and 2017, held in Beijing and London, respectively.
Gold and a silver medal at the World Indoor Championships of the year 2010 and 2012, held in Doha and Istanbul, respectively
Won a gold medal in heptathlon and bronze medal in long jump at the Asian Games of 2006, held in Doha. Olga again won gold medals in the Games held in 2010 and 2014.
She also earned three gold medals at the Asian Indoor Games: one in pentathlon in the year 2005 and two in 2009 in triple and long jump


We sell ink cartridges for Brother printers. If you know what printer model you are using, this will help you to choose the right cartridge. These ink cartridges are high quality and produce clear colours with true blacks for printing both images and text.


A Vernon-Verona-Sherrill High School alumnus is one of 91 sailors aboard USS Freedom (LCS 1), making history as the Navy's first littoral combat ship deployed to Southeast Asia.
Operations Specialist Seaman Kyle Kiner, from Verona, joined the Navy in 2012. He never imagined he would be assigned to Freedom, a technologically advanced, revolutionary class of ship. Fast, agile and mission-focused, LCS platforms are designed to operate in near-shore environments and employ modular mission packages that can be configured for three separate purposes: surface warfare, mine countermeasures or anti-submarine warfare.
Freedom, homeported in San Diego, left on her maiden deployment March 1. Kiner plays a crucial role in the ship's operations department, specifically trained to gather, process, display, evaluate and disseminate tactical information throughout the ship. Kiner's other duties also include participating in boat operations, aircraft flight operations and fire drill evolutions.
As an 18-year-old with numerous responsibilities, Kiner feels he is far ahead of his peers on legacy ships. "It is a lot of hard work," said Kiner. "But I know this is good for me in the end." Working with the Freedom has given Kiner the opportunity to excel as a sailor and as a person, giving him the chance to learn various skill sets and pick up a keen work ethic. Kiner has earned many shipboard qualifications and completed countless hours of training.
"The Navy helped me become a lot more mature than I used to be before I joined," said Kiner. "It made me realize that I can't take things for granted, like being with my family and being able to talk to them every day." Although time spent with his family is very limited, Kiner says they are very supportive of his decision to enlist.
Kiner joined the Navy out of profound admiration of his brother Kevin Kiner, a lance corporal in the Marine Corps. "The day I saw him graduate from boot camp, I knew he had changed completely," said Kiner. "Everyone was so proud of him. I was so proud of him." Soon after he graduated, Kiner followed in his brother's footsteps.
Trailing close behind Kiner was his wife Makenzie Kiner, who also joined the Navy to become a sonar technician. They both knew this decision would make things tougher for them, but all in all, they enjoy being in the military together.
"After this deployment, I am looking forward to experiencing California with my wife," said Kiner. "Most of all, I can't wait to go to Disneyland for my birthday."


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Immunotherapy Researchers Win Nobel Prize
October 01, 2018 – Jason Harris
CURE's Top 5 Stories: September 2018
October 01, 2018 – Jessica Skarzynski
FDA Approves Once-Weekly Kyprolis Regimen for Myeloma
October 01, 2018 – Jason M. Broderick
Airbnb Announces Medical Care Housing Program at Biden Cancer Summit
September 29, 2018 – Jessica Skarzynski
FDA Approves Libtayo for Cutaneous Squamous Cell Carcinoma
Paying for Cancer Care at All Costs
September 28, 2018 – Katie Kosko
Preventing Myelofibrosis from Progressing to Acute Myeloid Leukemia
September 28, 2018 – Brielle Urciuoli
Myeloproliferative Neoplasms Take a Toll on Patient Job Status
FDA Approves Vizimpro for EGFR-Positive Lung Cancer
September 28, 2018 – Jason M. Broderick
Chemotherapy Before Surgery: Which Regimen is Best for Invasive Bladder Cancer?
September 27, 2018 – Kristie L. Kahl
Immunotherapy pioneers James P. Allison, Ph.D., and Tasuku Honjo, M.D., Ph.D., have won the 2018 Nobel Prize in Physiology or Medicine for their research that eventually led to the use of immune checkpoint inhibitors to treat cancer.
BY Jason Harris
Immunotherapy pioneers James P. Allison, Ph.D., and Tasuku Honjo, M.D., Ph.D., have won the 2018 Nobel Prize in Physiology or Medicine for their research that eventually led to the use of immune checkpoint inhibitors to treat cancer. The Nobel Assembly at Karolinska Institutet announced the award in a statement Monday.
"Cancer kills millions of people every year and is one of humanity's greatest health challenges," the committee said. "By stimulating the inherent ability of our immune system to attack tumor cells, this year's Nobel Laureates have established an entirely new principle for cancer therapy."
Allison, chair of Immunology and executive director of the Immunotherapy Platform at The University of Texas MD Anderson Cancer Center, is best known for his work in T-cell response mechanisms and his discovery that blocking the signaling of the immune checkpoint protein CTLA-4 improved antitumor immune responses. His research led to the development of Yervoy (ipilimumab), the first FDA-approved immune checkpoint inhibitor. The agency approved Yervoy the treatment of advanced melanoma in 2011.
Honjo, a professor in the Department of Immunology and Genomic Medicine at Japan's Kyoto University Graduate School of Medicine, discovered PD-1 on the surface of immune cells in 1992 and later demonstrated that the protein inhibited immune response. His research eventually led to the development of Keytruda (pembrolizumab) and Opdivo (nivolumab), both of which were approved for the treatment of advanced melanoma in 2014.
Clinical trials have shown that PD-1 blockade has resulted in positive outcomes for patients with lung cancer, renal cancer and lymphoma.
Allison said in a press conference that he first learned the Nobel Committee's decision from a phone call from his son at 5:30 a.m. He was still in shock hours later.
"It still hasn't completely dawned on me," he said. "As a basic scientist, to have my work impact people is one of the best things I can think about. It's every scientist's dream to do fundamental work that's important, but then to have it translate into helping people is all that much better. Then to have that work recognized by the Nobel Committee is going to bring attention to the issues, the importance of basic science, and that there is hope for cancer patients."
In 2015, Allison won the Lasker-DeBakey Clinical Medical Research Award honoring investigators whose contributions have improved clinical treatment. That same year, he won ASCO's Science of Oncology Award and the Pezcoller Foundation–AACR International Award for Cancer Research. He was also recognized as a 2014 Giants of Cancer Care® in Scientific Advances. Honjo and Allison were joint recipients of the first Tang Prize for Biopharmaceutical Science in 2014.
Honjo won the Smalley Award from the Society for Immunotherapy of Cancer in 2015 and the Keio Medical Science Prize in 2016. That award from Keio University recognizes researchers who have made an outstanding contribution to medicine or the life sciences. Honjo is the eighth Keio Prize winner to later become a Nobel Laureate.
Final results from the phase 3 KEYNOTE-006 trial of patients with unresectable stage 3/4 advanced melanoma showed that frontline Keytruda continues to demonstrate long-term efficacy. At two years, patients assigned to Keytruda had an overall survival (OS) of 55 percent versus 43 percent for those assigned to Yervoy.
The FDA approved Keytruda in this setting in 2015 based on results from this trial.
In the study that led to the approval of Yervoy for patients with unresectable or metastatic melanoma following at least one prior systemic treatment, OS was longer with Yervoy alone compared with the experimental tumor vaccine gp100. Patients treated with Yervoy alone had a median OS of 10 months compared with six months for those treated with gp100.
Follow-up studies have since shown that 20 percent of patients survive at least three years posttreatment, with many living for 10 years and beyond. Subsequent research has led to agents targeting additional immune checkpoints, often PD-1 and PD-L1, to treat a range of cancers including head and neck, gastric kidney, bladder, gastric, liver, colorectal, and cervical cancers and Hodgkin lymphoma.
Allison said that one patient with metastatic melanoma from the phase 1 trial is still alive almost 19 years later following a single dose of Yervoy. He said that clinicians and investigators have come to accept immunotherapy as the fourth pillar of cancer care along with radiation, surgery and chemotherapy.
"What we're looking forward to is combinations, not just of multiple checkpoints but of checkpoints with radiation, checkpoints with chemotherapy, [and] checkpoints with genetically targeted small molecule drugs," he said. "Immunotherapy is going to be part, it's not going to replace the others, but it's going to be part of the therapy that essentially all cancer patients are going to be receiving in five years."
This article originally appeared on OncLive's web site, title "Allison, Honjo Win Nobel Prize for Research on Immune Checkpoints."
Talk about this article with other patients, caregivers, and advocates in the Immunotherapy CURE discussion group.
/articles/immunotherapy-researchers-win-nobel-prize


Make custom Oxbow Lacrosse Pinnies from Lightning Wear. We specialize in custom reversible jerseys and team apparel.
These are on the truck to Morgantown WV. Thanks for the order and we hope you love them as much as we do!
Can the Boston Red Sox keep up their lead in the AL East race?


Distributed By – ABC-Paramount Records, Inc.
Variation with revised cover with blurb at bottom-right saying: " Includes California Dreamin' ". Same sleeve as The Mama's And The Papa's* - If You Can Believe Your Eyes And Ears but label variation : no number under cat# and different font.
First pressings had no song titles on cover with a toilet fully visible to right of the bathtub and are referred to as the "Toilet Cover".
Cover does NOT have RIAA Gold Record Award Seal like reissue.


Get an overview of the impressive dimensions of the event location "StageOne".
The Stage One Event Hall - 3D visualized and animated.
The first «Webvideopreis Schweiz» was presented in the Stage One Event Hall.


One of our deepest longings is to belong to a "tribe", to be accepted, liked and loved. Most of the things we do in life are intended to please others and fulfill their expectations so they can accept and love us in return. Most of the time this is unconscious and it can work in mysterious ways, not being easy to spot at first sight.
Jon Young shares the story of a young man who was slowly finding his connection with himself, Nature and others until one day he stopped the practice of the secret spot altogether (even when it was doing him a lot of good). When Jon asked him why, he didn't know. After a week of reflection, the young man shared his experience: when he had tried to share the sacredness of his newfound re-connection with Nature, he was rejected by the attitude and words from one of his buddies, the closest indeed, from a group of long-term friends who used to meet for drinks and chatting each week.
Through some mentoring, he discovered that there were others who were eager to listen to his stories of Nature and reconnection, so Jon suggested he turned to them and let go of any expectations about his buddies.
With time, he found the peace and joy he needed and his buddies started asking him how he managed to be so balanced and grounded. That was the moment for him to share his stories with them again, this time without fear of being rejected.
When we start reconnecting and find our call, gifts and purpose, something extraordinary happens. We want to share this joy and newfound sacred gift with our loved ones, our significant other, our family, our work colleagues or classmates, our community and even the world.
The same happens when we slowly (or suddenly) understand in our souls, heads and bodies, what is happening in the world: the pain, the separation, the oppression, the abuse…we want to share this new-found and important "information" with all we care for.
We have the expectation that they will "get us" and join us in our joy for the newfound path… or join us in the grief for the world and the activism for what's sacred and worth…wouldn't be wonderful?
But people have each their own shadows, gifts and paths. More than anything, they have their own timing and space for their calls to happen to them (and for these calls to be answered)…so when we share our own findings with them and they don't respond, this only means they are not ready. We need then to look further and find other anchors and people we can trust with our stories, fears and gifts of transformation. When we do that, we not only "find our tribe", we also give our loved ones some time to "catch up" and be themselves around us.
Us? We may start being ourselves more so: from their perspective we may become more alive or just different. We may start making changes in our lives, from what we eat to what we wear, where we work and what topics interest us…these changes will have an impact, so letting go of expectations will help your loved ones to navigate the already difficult transition they are perceiving in you.
The good news is that your own transition may eventually infect them, but please don't hold this expectation too dear. It may never happen, it may not be their path, their time or their place to change.
If you love them, let them be. If they love you, they may do the same (remember, no guarantees).
It won't be easy, but whatever the end results, you both will be what you need to be.