Conference series LLC is privileged to announce 13th European Pediatrics Conference which will be held during August 31st- September 2nd, 2017 we prayerfully welcome all the eminent researchers, students and delegates to take part in this upcoming Pediatrics Conference 2017 to witness invaluable scientific discussions and contribute to the future innovations in the field of Pediatrics.
Pediatrics Conference 2017 will focus on the latest and exodus innovations in all Pediatrics areas of Pediatrics research which offers a exclusive opportunity for investigators across the globe to meet, network, and perceive new scientific innovations. This year's annual congress highlights the theme, "Current Advancement of modern theories and therapies to save a child" which reflects the innovative progress in Pediatric disease research. The three days conference includes child health care workshops, symposiums, special keynote sessions conducted by eminent and renowned speakers who excel in the field of pediatrics which include the topics Pediatrics, pediatric Oncology & Hematology, Pediatric Dermatology, Pediatric Gastroenterology, Pediatric Allergy and Asthma, Pediatric Cardiology, Pediatric Orthodontics, Pediatric Neurology, Pediatric Nephrology, Pediatric Endocrinology, Neonatology and Perinatiology, Treatments of Pediatric Diseases. This international Pediatric Conference also encourages the active participation of young student researchers as we are hosting Poster Award Competition and Young research Forum at the conference venue.
Related Pediatrics Conference September 14-16, 2016 Amsterdam, The Netherlands; Pediatric Surgery Conferences September 14-16, 2016 Amsterdam, Netherlands; Pediatric Dermatology Conferences October 10-11, 2016 Manchester, UK; Neonatology Conferences November 14-16, 2016 Valencia, Spain; Neonatal Conferences November 14-16, 2016 Valencia, Spain; Pediatric Neurology Conference November 14-16, 2016 Valencia, Spain;SIOPE 4th Paediatric Oncology Conference January 20–21 2016, Belgium; 40th Annual Association of Pediatric Oncology Social Work Conference April 13-15 2016, Rhode Island; 90th Annual Meeting of the Canadian Pediatric Society 4th International Conference on Pediatrics March 29-March 31 2016, USA; Annual Pediatric Emergency Medicine Conference March 29-March 31 2016, USA; International Conference and Exhibition on Pediatric Oncology August 04-06 2016 Canada; International Conference on Pediatric Dermatology October 10-12 2016, UK; 6th International Conference On Hematology & Lymph November 14-16 2016, USA; 15th International Paediatric Haematology & Oncology Update Meeting.
Related Pediatrics Conference September 14-16, 2016 Amsterdam, The Netherlands; Pediatric Surgery Conferences September 14-16, 2016 Amsterdam, Netherlands; Pediatric Dermatology Conferences October 10-11, 2016 Manchester, UK; Neonatology Conferences November 14-16, 2016 Valencia, Spain; Neonatal Conferences November 14-16, 2016 Valencia, Spain; Pediatric Neurology Conference November 14-16, 2016 Valencia, Spain; European Gastroenterology Conference October 24-26 2016, Spain; 90th Annual Meeting of the Canadian Pediatric Society Jun 22-25 2016 Canada; 28th International Pediatric Association Congress of Pediatrics Aug 17-22 2016, Canada; 2016 American Academy of Pediatrics National Conference & Exhibition October 22-25 2016, USA; 15th Asian Pacific Congress of Pediatrics January 21-24 2016, India; 6th Congress of the European Academy of Pediatric Societies October 21-25 2016, Switzerland.
Related Pediatrics Conference September 14-16, 2016 Amsterdam, The Netherlands; Pediatric Surgery Conferences September 14-16, 2016 Amsterdam, Netherlands; Pediatric Dermatology Conferences October 10-11, 2016 Manchester, UK; Neonatology Conferences November 14-16, 2016 Valencia, Spain; Neonatal Conferences November 14-16, 2016 Valencia, Spain; Pediatric Neurology Conference November 14-16, 2016 Valencia, Spain; International Allergy Conference March 29-30 2016, Spain; 18th International Conference on Allergy, Asthma and Immunology June 1 - 2 2016, UAE.
Related Pediatrics Conference September 14-16, 2016 Amsterdam, The Netherlands; Pediatric Surgery Conferences September 14-16, 2016 Amsterdam, Netherlands; Pediatric Dermatology Conferences October 10-11, 2016 Manchester, UK; Neonatology Conferences November 14-16, 2016 Valencia, Spain; Neonatal Conferences November 14-16, 2016 Valencia, Spain; Pediatric Neurology Conference November 14-16, 2016 Valencia, Spain;19th Annual Update on Pediatric and Congenital Cardiovascular Disease Feb 24-28 2016, USA; 50th Annual Meeting of the Association for European Paediatric and Congenital Cardiology June 1-4 2016, Rome; 18th International Conference on Pediatric Cardiology January 26 - 27 2016, Saudi Arabia; 7th World Congress of Pediatric Cardiology & Cardiac Surgery June 18-23 2017, Turkey.
Related Pediatrics Conference September 14-16, 2016 Amsterdam, The Netherlands; Pediatric Surgery Conferences September 14-16, 2016 Amsterdam, Netherlands; Pediatric Dermatology Conferences October 10-11, 2016 Manchester, UK; Neonatology Conferences November 14-16, 2016 Valencia, Spain; Neonatal Conferences November 14-16, 2016 Valencia, Spain; Pediatric Neurology Conference November 14-16, 2016 Valencia, Spain;16th Euro Congress on Dental & Oral Health Oct 24-26 2016, Italy; Japanese Orthodontic Society 74th Annual Meeting, November 18-20, 2015, Japan; Sri Lanka Orthodontic Society, February 5-8, 2016,USA; Saint Barthelme Dental Association, January 18-22, 2016, West Indies; 8th Asia-Pacific Dental Trade Fair and Scientific Conference, 08 - 10 April 2016, Singapore; 12th international symposium on periodontics restorative dentistry, June 16-19,USA.
Related Pediatrics Conference September 14-16, 2016 Amsterdam, The Netherlands; Pediatric Surgery Conferences September 14-16, 2016 Amsterdam, Netherlands; Pediatric Dermatology Conferences October 10-11, 2016 Manchester, UK; Neonatology Conferences November 14-16, 2016 Valencia, Spain; Neonatal Conferences November 14-16, 2016 Valencia, Spain; Pediatric Neurology Conference November 14-16, 2016 Valencia, Spain;6th Global Neurologists Annual Meeting on Neurology and Neuro Surgery August 01-03 2016, Germany; 14th International Child Neurology Congress May 1-5 2016, The Netherlands; Child Neurology Society 45th Annual Meeting October 26-29 2016, Canada; British Paediatric Neurology Association Annual Conference January 27-29 2016, UK; 3rd Pan-Slavic Congress of Child Neurology October 19-22 2016, Croatia; International Conference Of Pediatric Neurology of Egyptian Specialized Society of pediatric Neurology And Neurodisability March 2-3 2016, Egypt.
Related Pediatrics Conference September 14-16, 2016 Amsterdam, The Netherlands; Pediatric Surgery Conferences September 14-16, 2016 Amsterdam, Netherlands; Pediatric Dermatology Conferences October 10-11, 2016 Manchester, UK; Neonatology Conferences November 14-16, 2016 Valencia, Spain; Neonatal Conferences November 14-16, 2016 Valencia, Spain; Pediatric Neurology Conference November 14-16, 2016 Valencia, Spain;90th Annual Meeting of the Canadian Pediatric Society Jun 22-25 2016 Canada; 6th Congress of the European Academy of Pediatric Societies October 21-25 2016, Switzerland; International Conference and Exhibition on Pediatric Oncology August 04-06 2016 Canada.
Related Pediatrics Conference September 14-16, 2016 Amsterdam, The Netherlands; Pediatric Surgery Conferences September 14-16, 2016 Amsterdam, Netherlands; Pediatric Dermatology Conferences October 10-11, 2016 Manchester, UK; Neonatology Conferences November 14-16, 2016 Valencia, Spain; Neonatal Conferences November 14-16, 2016 Valencia, Spain; Pediatric Neurology Conference November 14-16, 2016 Valencia, Spain;4th Euro Obesity & Endocrinology Specialists Annual Meeting March 29-31 2016, Spain; Pediatric Endocrine Nursing Society (PENS) Meeting May 12-15 2016, USA; 10th International Meeting of Pediatric Endocrinology September 14-17 2017, USA; Pediatric Endocrine Society Annual Meeting April 30–May 3 2016, USA; 55th Annual Meeting of the European Society for Paediatric Endocrinology September 10–12 2016, France; 9th Asia Pacific Pediatric Endocrine Society Scientific Meeting November 17-20 2016, Japan.
Related Pediatrics Conference September 14-16, 2016 Amsterdam, The Netherlands; Pediatric Surgery Conferences September 14-16, 2016 Amsterdam, Netherlands; Pediatric Dermatology Conferences October 10-11, 2016 Manchester, UK; Neonatology Conferences November 14-16, 2016 Valencia, Spain; Neonatal Conferences November 14-16, 2016 Valencia, Spain; Pediatric Neurology Conference November 14-16, 2016 Valencia, Spain;International Conference on Nuclear Medicine and Radiation Therapy, July 14-15, 2016 Cologne, Germany; 8th Global Cardiologists Annual Meeting, July 18-20, 2016 Berlin, Germany; Complex Cardiovascular Therapeutics, October 29-31, 2015, Kobe, Japan; 6th Francophone Congress of Interventional Cardiology, November 04-06, 2015 Paris, France; Left Atrial Appendage Closure, November 20 – 21, 2015 Frankfurt, Germany; 7th Annual Coronary CTA in the Emergency Department: Hands-on Workshop, 14–15 November 2015, Miami Beach, USA; 64rd Annual Scientific Meeting of the Cardiac Society of Australia & New Zealand, Adelaide, Australia, August 03- 07, 2016.
Related Pediatrics Conference September 14-16, 2016 Amsterdam, The Netherlands; Pediatric Surgery Conferences September 14-16, 2016 Amsterdam, Netherlands; Pediatric Dermatology Conferences October 10-11, 2016 Manchester, UK; Neonatology Conferences November 14-16, 2016 Valencia, Spain; Neonatal Conferences November 14-16, 2016 Valencia, Spain; Pediatric Neurology Conference November 14-16, 2016 Valencia, Spain;4th International Conference on Immunotherapy in Pediatric Oncology (CIPO2015) September 25-26 2015, Washington; 9th Annual Advanced Conference October 07-09 20159th World Drug Delivery Summit, June 30-July 02 2016, USA, 2nd International Conference and Expo on Parenteral & Injectable, October 24-26 2016, Turkey, International Conference and Exhibition on HPLC and Chromatography Techniques, March 17-18 2016, UK, Interpretation & Reporting of Vascular Ultrasound Course (RPVI) 2016, April 1-3 2016, United States, Hands-On Cardiac Ultrasound Imaging & Doppler Echo Course 2016, Hands-On Abdominal Ultrasound Imaging & Doppler Course 2016, January 29-31 2016, United States, NYU's Clinical Imaging Symposium, January 11-15 2016, North America.
Related Pediatrics Conference September 14-16, 2016 Amsterdam, The Netherlands; Pediatric Surgery Conferences September 14-16, 2016 Amsterdam, Netherlands; Pediatric Dermatology Conferences October 10-11, 2016 Manchester, UK; Neonatology Conferences November 14-16, 2016 Valencia, Spain; Neonatal Conferences November 14-16, 2016 Valencia, Spain; Pediatric Neurology Conference November 14-16, 2016 Valencia, Spain; International Conference on Pediatric Nursing and Healthcare,11 Jul 2016 - 13 Jul 2016, Cologne, Germany,6th International Conference on Clinical Neonatology, 22 Sep 2016 - 24 Sep 2016, Turin, Italy, 34th Annual Meeting of the European Society for Pediatric Infectious Diseases May 10-14 2016, UK, 50th Annual Meeting of the Association for European Pediatrics and Congenital Cardiology June 1-4 2016, Rome.
Parents frequently want to have their kids treated by medical caretakers and other wellbeing suppliers who are pediatric masters, since youngsters have exceptional medicinal service's needs. Their bodies are developing and changing, and they frequently respond contrastingly to damage, ailment and even regular medicines.
Related Pediatrics Conference September 14-16, 2016 Amsterdam, The Netherlands; Pediatric Surgery Conferences September 14-16, 2016 Amsterdam, Netherlands; Pediatric Dermatology Conferences October 10-11, 2016 Manchester, UK; Neonatology Conferences November 14-16, 2016 Valencia, Spain; Neonatal Conferences November 14-16, 2016 Valencia, Spain; Pediatric Neurology Conference November 14-16, 2016 Valencia, Spain; International Conference on Pediatric Nursing and Healthcare,11 Jul 2016 - 13 Jul 2016, Cologne, March 17-18 2016, UK, Interpretation & Reporting of Vascular Ultrasound Course (RPVI) 2016, April 1-3 2016, United States, Hands-On Cardiac Ultrasound Imaging & Doppler Echo Course 2016, Hands-On Abdominal Ultrasound Imaging & Doppler Course 2016, January 29-31 2016, United States, NYU's Clinical Imaging Symposium, January 11-15 2016, North America.
Related Pediatrics Conference September 14-16, 2016 Amsterdam, The Netherlands; Pediatric Surgery Conferences September 14-16, 2016 Amsterdam, Netherlands; Pediatric Dermatology Conferences October 10-11, 2016 Manchester, UK; Neonatology Conferences November 14-16, 2016 Valencia, Spain; Neonatal Conferences November 14-16, 2016 Valencia, March 17-18 2016, UK, Interpretation & Reporting of Vascular Ultrasound Course (RPVI) 2016, April 1-3 2016, United States, Hands-On Cardiac Ultrasound Imaging & Doppler Echo Course 2016, Hands-On Abdominal Ultrasound Imaging & Doppler Course 2016, January 29-31 2016, United States, NYU's Clinical Imaging Symposium, January 11-15 2016, North America.
Conference Series Ltd is privileged to announce its 13th European Pediatrics Conference which will be held during August 31st- September 2nd, 2017 at Prague, Czech Republic. We cordially welcome all the eminent researchers, students and delegates to participate in this upcoming global event of Pediatrics Conference 2017 and witness the invaluable scientific exchange of ideas and views. We also invite you to contribute your thought to the future novelties in the field of Pediatrics. This year's annual congress highlights the theme "Current emerging trends and latest research for the betterment of child health" which reflects the innovative progress in Pediatrics Conference 2017.
The 13th European Pediatrics Conference provides the scope for opportunities to learn about new discoveries and technologies progressed by knowledgeable scientists and academicians. Pediatrics Conference 2017 offers excessive quality to suit the diverse professional development of medicines and technologies to treat infants and children of their pediatric disorders all over the globe. It is a perfect platform to discuss new ideas, current discoveries and developments in the field of Pediatrics Conference. The three days conference includes child health care workshops, symposiums, special keynote sessions conducted by eminent and renowned speakers who excel in the field of pediatrics which include the topics Pediatrics, pediatric Oncology & Hematology, Pediatric Dermatology, Pediatric Gastroenterology, Pediatric Allergy and Asthma, Pediatric Cardiology, Pediatric Orthodontics, Pediatric Neurology, Pediatric Nephrology, Pediatric Endocrinology, Neonatology and Perinatology, Treatments of Pediatric Diseases. This international Pediatric Conference also encourages the active participation of young student researchers as we are hosting Poster Award Competition and Young research Forum at the conference venue.
Prague is the 15th largest city in the European Union and is the capital of Czech Republic. The city is the home to about 2 million people. In the year 2014, the European Union saw around 18.8 thousand deaths of children before attaining the age of one year. This was an equivalent to an infant mortality rate of 3.7 deaths per 1000 live births. During the 10 years from 2004 to 2014 the infant mortality rate in the EU fell by more than a quarter. The most significant reductions in infant mortality were generally recorded within those EU Member States which tended to record higher levels of infant mortality in 2004, compared with the EU average. Despite this progression, some EU Member States still had relatively high infant mortality rates in 2014, for example, Romania (8.4 deaths per 1000 live births) and Bulgaria (7.6). In 2014, the lowest infant mortality rates in the EU were in Cyprus (1.4 deaths per 1000 live births), Slovenia (1.8) and Sweden (2.2). Infant mortality rates can be decreased by improving the infant health by preventing birth defects, premature birth, diagnosing the diseases at an early stage and providing the correct drugs and counselling.
Conference Series facilitated the "7th European Pediatrics and Pediatric Surgery", amid Sep 14-16, 2016 at Amsterdam, The Netherlands, which was a phenomenal accomplishment. Noticeable keynote speakers from multitudinal presumed foundations and associations tended to the social affair with their brilliant nearness. The regarded visitors, keynote speakers and specialists shared their creative exploration and unlimited experience information and palaver on different most recent and energizing developments in every aspect of Pediatrics examination at the platform of Pediatrics Conference-2016.
Conference Series is special to congratulate Pediatrics Conferece-2016 Organizing Committee, Keynote Speakers, and Chairs and Co-Chairs furthermore the Moderator of the meeting whose backing and endeavors made the gathering to move in the way of accomplishment. Conference Series thanks each individual member for the colossal stunning reaction. This moves us to keep sorting out occasions and gatherings for further research in the field of Pediatrics.
The Conference ends up being an extraordinary open air theatre for assignment of most recent data with cooperation of more than 150 pediatric experts. The participants profited from more than 30 addresses introduced by 30 provincial and worldwide speakers. The complete logical system and exercises offered for the current year were to a great degree superb. Every year it gives the best stage to Pediatricians, Pediatric Surgeons, Medical understudies, Pediatricians furthermore pediatric experts and industry specialists of the world to redesign learning, arrange, associate and create profession.
Pediatrics conference 2017 will focus on the latest and exodus innovations in all areas of Pediatrics research which offers an exclusive opportunity for investigators across the globe to meet, network, and perceive new scientific innovations. This year's annual congress highlights the theme, "Current Advancement of modern theories and therapies to save a child" which reflects the innovative progress in Pediatric disease research. The three days conference includes child health care workshops, symposiums, special keynote sessions conducted by eminent and renowned speakers who excel in the field of pediatrics which include the topics Pediatrics, pediatric Oncology & Hematology, Pediatric Dermatology, Pediatric Gastroenterology,Pediatric Allergy and Asthma, Pediatric Cardiology, Pediatric Orthodontics, Pediatric Neurology, Pediatric Nephrology, Pediatric Endocrinology, Neonatology and Perinatiology, Treatments of Pediatric Diseases.This international Pediatric Conference also encourages the active participation of young student researchers as we are hosting Poster Award Competition and Young research Forum at the conference venue.
Conference series LLC believes that professionally-oriented education in pediatric medicine is essential in the training of clinicians and academicians and organizes Euro Pediatric conference in Prague, Czech Republic this year which will provide the future leadership in this key area for global health.of 1000+ Global Events inclusive of 300+ Conferences, 500+ Upcoming and Previous Symposiums and Workshops in USA, Europe & Asia with support from 1000 more scientific societies and publishes 700+ Open access journals which contains over 30000 eminent personalities, reputed scientists as editorial board members.
The people all over the world should be fouced on learning about Pediatrics and its forwards in making a better health; this is going to be a best opportunity to influence the largest assemblage of participants from the Pediatrics community. Conduct presentations, distribute information, meet with current and potential scientists, make a splash with new drug developments, and receive name recognition at this 3-day event. World-renowned speakers, the most recent techniques, developments, and the newest updates in Pediatrics are hallmarks of this conference. We also welcomes the participation of Presidents, CEO's, Delegates and industrial executives from Pharma and Health care sectors making the congress a perfect platform to network, share views and knowledge through interactive keynote, plenary, poster and B2B discussions.


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Konda's crime against the kami had been revealed: He had stolen a living spirit. The abductee wasn't just any kami, though, but a scion of the O-Kagachi, guardian of the boundary between the material and spirit worlds. Konda's act utterly destabilized Kamigawa, and disorder spread on both sides of the great war. Seeing an opportunity, the akki horde marched on Eiganjo even as the O-Kagachi itself attacked the castle. All the while, Toshiro Umezawa played all the sparring factions against each other, deftly exploiting his allegiances to wrest That Which Was Taken from Konda's hands. Amidst this pandemonium emerged the one who had set everything in motion: the Kami of the Crescent Moon, an ambitious trickster who hoped to remake the world on his own terms. But the Crescent Moon had made a very powerful enemy in the ogre-mage Hidetsugu, who held the power to unleash the all-consuming Oni of Chaos on the world. As the O-Kagachi raged against Konda, who was protected only by the power of the kidnapped kami, the veil between the material world and the spirit world was torn to tatters. The distinction between spirit and living being blurred completely. And the war rose to a fever pitch, spurred on by the blind pride of Konda and the blind fury of the O-Kagachi. Kamigawa's last hope for peace lay in the hands of Toshiro Umezawa and Michiko Konda, the daimyo's sole heir.


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Who has heard of FASIIG or the Future Airspace Strategy Industry Implementation Group? This Group sets out a vision to modernise UK airspace and use technology to make it fit for the 21st century. It claims to ensure the UK remains connected to Europe and the rest of the world by simplifying and harmonising the way airspace and air traffic control is used through the Single European Sky project.
Its members are:
Airlines UK – a group of airlines and associated organisations
The Airport Operators Association
The Board of Airline Representatives in the UK (BAR UK) – the industry association representing the majority of airlines operating to the UK
The Civil Aviation Authority
The Department of Transport
The Ministry of Defence
Sustainable Aviation – "a long-term strategy which sets out the collective approach of UK aviation to tackling the challenge of ensuring a sustainable future for the industry. Launched in 2005, it is a world first bringing together major UK airlines, airports, manufacturers and air navigation service providers".
FASIIG made a submission to the Transport Committee on airspace modernisation and management. The Inquiry concluded by being closed down due to the last General Election in 2017. With the Inquiry into the National Policy Statement now just concluded, it is interesting to see what was said by FASIIG in the airspace management inquiry and ponder on what might have been meant by what was said.
Extracts from Future Airspace Strategy Industry Implementation Group (FASIIG) April 2017 submission to the Transport Select Committee on airspace management and modernisation inquiry.
(Submission to be found at http://data.parliament.uk/writtenevidence/committeeevidence.svc/evidencedocument/transport-committee/airspace-management-and-modernisation/written/49597.html )
What FASIIG said in evidence What they meant?
This (government) leadership and supporting policy has not been as evident for aviation and airspace as it is with other sectors such as rail.
When is the aviation industry going to get what it wants and why isn't it getting it faster?
Experience of recent airspace changes and research trials at lower altitudes is that the lack of overriding Government support has been a serious issue with, in some cases, individual MPs leading the charge to block changes. What the UK needs is clear leadership from Government and senior civil servants on this crucial issue within an unambiguous policy framework which is stable and supports and enables the change that is necessary to modernise the airspace.
When is the aviation industry going to get what it wants and why isn't it getting it faster? (see above)
Why are these upstart democratically elected MPs being allowed to challenge us?
There is also a risk that introduction of new policy leads to calls for reassessment and potentially reversion of recent changes and Government needs to be clear that this cannot be allowed to happen.
Unauthorised changes have now been made which help airlines reduce maintenance costs by stressing the engines less on take-off and flying at chimney pot height for 20 miles. We do not propose to retroactively consult on these changes or inconvenience ourselves by reinstating any pre-trial flight patterns/heights.
Policy therefore needs to provide clarity on the need for airspace designs to minimise the number of people overflown, the balance between overflying urban or rural areas and
AONBs and this policy is urgently needed. There is also a need for Government to give specific guidance on the methods and evidence that can be used for options appraisal,
environmental performance and assessment, and compensation arrangements where appropriate.
With reference to the recent trials at Heathrow and Gatwick it is clear that the public reaction to concentration is worse than we had expected, whether that is at 4,000ft, 7,000ft or 10,000ft – communities are annoyed by the unexpected noise and visual intrusion.
We are surprised that communities should object to being overflown every two minutes between 6am and midnight. We simply cannot understand what the fuss is about.
Communities do need transparency in order to understand what is happening and when, and they should have a mechanism that is effective for them to contribute to the debate or conversation, but it cannot be used as a decision-making mechanism.
It's OK to ask communities what they want but in the end its what the industry wants that matters. And we know best, dearie!
Despite this progress, low level airspace modernisation remains a significant issue and Government involvement in FAS is somewhat limited with DfT effectively representing Government as an observer rather than taking a more active role due to the lack of overriding policy on managing the impact of change.
Heavens! It's so much easier when you don't have to operate in a democracy.
It should be recognised that it is inevitable that modernisation will require changes to lateral flight paths and in some cases, new communities may be affected and tracks may be more concentrated. Even without introducing new routes, aircraft are increasingly using satellite navigation to navigate more accurately and are being flown in automated modes which mean that their tracks are already becoming more consistent.
If you think this is bad dear, wait till we're all on PBN (performance based navigation). You won't know what hit you.
On the merits of an Independent Aviation Noise Authority and desirability of classifying airspace within the National Infrastructure Commission's remit
The Civil Aviation Authority has a demonstrable track record of independence.
FASIIG members are concerned that an additional process will simply add to bureaucracy cost and risk.
If implemented, it is important that this role supports the industry in making changes in a sustainable way rather than becoming yet another barrier to modernisation and change – for example by conducting noise research. We absolutely do not want an independent noise body. And we are not going to have an independent noise body!
Nor do we want taxpayers' money being wasted on health studies or any such bureaucratic nonsense.
This role must not be allowed to become an appeals process against changes or become a further bureaucratic barrier to change. Rather it needs to be proactive in managing and facilitating change ensuring the views and concerns of all stakeholders in the aviation industry have been considered.
We absolutely do not want an independent noise body … . See above.
FASIIG is concerned too that the creation of an ICCAN suggests that noise is an issue to be considered above all other factors when managing airspace. It should be balanced with many other environmental, capacity and safety concerns.
Although it should be noted that we don't give a damn about the environment either.
FASIIG strongly endorses the classification of airspace within the National Infrastructure Commission's remit for that sub-set of airspace changes that are of national significance,
Such as the modernisation of the Terminal Area over London for example. The advantage of using the NIC is that it effectively de-politicises the decision making offering a more stable framework that transcends the life of individual governments.
Whenever we get support from an administration it gets sent packing by the wretched, ignorant voters, and then we don't get support from the next administration. Godammit. We just need to be above the law.
Inquiry status: Concluded
"Due to the general election on 8 June 2017 the Committee has now closed this inquiry. Following the dissolution of Parliament on 3 May 2017, all Select Committees cease to exist until after the general election. If an inquiry on this subject is held in the future, the Committee may refer to the evidence already gathered as part of this inquiry". No further discussion
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CategoriesFAS Heathrow Expansion National Policy Statement
Thanks translating what the industry really means when it waffles on!

redpajama_set_name: RedPajamaCommonCrawl


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Ben Carson launches 2016 White House bid
Political neophyte to propose flat tax, $2 trillion stimulus, NATO successor
Ben Carson plans to assemble an all-star team of corporate and economic experts after his announcement Monday to help him devise specific, detailed, goal-oriented plans to reshape and resize government, trim costs and create a more fair tax system. (Associated ... more >
By John Solomon - The Washington Times - Sunday, May 3, 2015
Ben Carson, the pediatric neurosurgeon turned political sensation, will formally launch his improbable bid for the Republican presidential nomination Monday from the same streets of Detroit where his rags-to-riches story began six decades ago as a black child raised by a single mother in poverty.
The rising conservative star intends to embrace his perch as the political neophyte in the crowded field of White House contenders, running a campaign that challenges political and media conventions on everything from economic policy to racial relations, the latter a topic Republicans long have struggled to address on the big stage.
Mr. Carson plans to immediately shake up a race that so far has lacked much substantive policy talk by embracing specific policy prescriptions, including a proposed $2 trillion economic stimulus funded entirely by repatriated American profits overseas, a flat tax system for all Americans, and a plan to eliminate the U.S. budget deficit quickly and to eliminate U.S. debt within a decade.
"Nearly all the ills we face today — from unrest in the inner cities to our weakness on the foreign stage — stem in some way from a weak economy and weak leadership," Mr. Carson said in an interview with The Washington Times that was brimming with optimism and confidence.
"I actually think we can unleash an economic renaissance in America that can erase the debt in seven years, if we have the courage to act to get government out of the way of success, out of our lives and out of our business."
The 63-year-old first-time candidate is bracing for attacks by his opponents that his outlook is too rosy or oversimplified and his resume lacks the necessary governing experience.
SEE ALSO: Ben Carson leads wide-open contest for GOP youth vote in '16: poll
He counters by saying he faced similar pessimism and doubts decades ago when he was confronted as a surgeon with twins conjoined at their head. He conducted the first-ever successful separation surgery, against the odds.
"Professional politicians can tell you what can't be done. That is the problem with Washington today. But as a doctor who stood on his feet for 50-plus hours and saved two lives, and who has performed more than 15,000 surgeries on children — some deemed hopeless — I can only see what is possible when you apply yourself," he said.
Mr. Carson plans to assemble an all-star team of corporate and economic experts after his announcement Monday to help him devise specific, detailed, goal-oriented plans to reshape and resize government, trim costs and create a more fair tax system.
"Politicians have golden calves, political conventions and cash constituencies that keep them from acting boldly. CEOs and corporate board members are judged only by results, and they know it only counts if you get the job done and create impact. That's the culture we need in the White House," he said.
He plans to dispense with platitudes, offering an agenda of specific policy prescriptions, starting with a $2 trillion economic stimulus fueled not by tax increases or debt, but rather by a tax holiday that encourages American companies to repatriate their offshore profits and invest in the U.S. economy.
He also wants to cut corporate tax rates significantly to make them competitive with other major economic powers and to create a simple, flatter personal income tax that eliminates all deductions and has a top rate of 10 to 15 percent, he said.
"Will Americans miss their home mortgage and charitable deductions? Sure. But they will have as much or more disposable income as the current system with far less complication and more opportunity to invest in economic growth, their retirement and their favorite charitable causes," he said. "The tax code that today sits at more than 70,000 pages really ought to be only 10 pages. Most Americans will agree that makes sense."
On education, he plans to scrap big-government solutions like No Child Left Behind and Common Core in favor of a smaller Education Department that distributes more block grants. He also wants to create a massive private charitable effort that funds a new era of school choice where students can go to private schools with the help of donated funds from philanthropists and companies, and where single moms can stay in school or get a job with the assurance of good daycare for their kids.
Mr. Carson thinks such an education and support system could eventually lead to term limits on welfare, or help end public assistance outright.
"The American dream ought not be limited to getting a pack of food stamps, a middling cell phone and a poverty-level check each month from Uncle Sam. It ought to return to the opportunity to become self reliant and successful because the economy is expanding and the ability to climb the economic ladder is real, not just a hollow promise," he said.
On foreign policy, Mr. Carson embraces the Ronald Reagan vision of peace through strength, seeing in President Obama and some of his Republican rivals a reluctance to use military might and a failure to articulate a national interest in foreign policy.
He said he believes ground troops are necessary to win the war against the Islamic State and that drone strikes to incapacitate al-Qaeda and other terror groups and spinoffs around the world need to be stepped up.
"I don't like war. But if you are facing an enemy whose goal is your annihilation, you need to annihilate them first," he said. "It's pretty simple."
He lambasted Mr. Obama for making a "bad deal" with Iran that he says will only lead to greater risk for American allies like Israel and Saudi Arabia and launch a nuclear arms race in an already volatile Middle East. He insisted any deal with Iran must have strict, irrevocable verification procedures that ensure Tehran never gets a nuclear weapon.
"We have 40 years of history that tells us Iran can't be trusted and that their intentions toward us, Israel and its Sunni neighbors are hostile," he said. "A deal without teeth is no deal at all."
Mr. Carson also criticized the administration for what he called America's failure to engage Russia in a way that meets U.S. interests and assures allies in Europe of their security. He said NATO has become outdated and that he'd like to form a new military alliance that included greater participation and security for Eastern Europe countries threatened by what he called Mr. Putin's "expansionist ambitions."
While sounding hawkish at times, Mr. Carson also sharply rebuked the George W. Bush administration for waging a failed war in Iraq and drawing resources from the war on terror, saying he once told Mr. Bush in a private conversation that the Iraq mission would be foolhardy.
"There was no U.S. national interest in deposing Saddam Hussein or sending our troops on an undefined mission that cost lives, money, equipment and it did nothing but create further instability and give Iran a vacuum" to expand its power, he said.
Virtually unknown to most Americans outside his meteoric medical successes, Mr. Carson roared onto the political scene in 2013 when he confronted Mr. Obama at the National Prayer Breakfast in Washington for creating what he said was too much dependency on government and too little emphasis on liberty, personal responsibility and self-reliance.
His popularity soared with conservatives, with his books reaching best-seller status and groups across the nation clamoring for him to come speak to packed rooms.
Last year he retired from daily surgery, moved to Florida and changed his political affiliation from independent to Republican. He named Houston businessman Terry Giles to explore the possibility of him running for president and in March formed an official exploratory committee (Carson America) with the Federal Elections Commission.
While playing to packed rooms and halls, Mr. Carson has had a few stumbles with the media, which have seized on some of his off-the-cuff comments that compared current U.S. government tactics to Nazi Germany and suggested Obamacare was one of the worst things to happen to black Americans since slavery.
Rather than retreat or blame the media, Mr. Carson wrote a political essay expressing humility and telling voters he still had plenty to learn as a politician on the trail if he was to run for president.
"Though the learning curve is steep, I am doing everything I can to acquire more knowledge of critical issues and surround myself with capable and wise advisers as I consider this monumental step," he wrote in a March 24 column in the Times.
He had been a Times columnist before announcing the formation of his presidential exploratory committee.
While absent government and political experience, Mr. Carson can draw from a rich personal biography, rising from the streets of Detroit, freeing himself from poverty and tempering a rich youthful temper thanks to the determination of his mother — a divorced single parent who insisted he read every day and not watch much TV.
Mr, Carson attended Yale University and then went on to medical school at the University of Michigan. By the age of 33, he had become the head of pediatric neurosurgery at Johns Hopkins Medical University, where in the early 1990s he garnered worldwide fame with a successful surgery that separated two baby boys joined at the head since birth.
Eventually, Mr. Carson would conduct several such risky surgeries across the globe and his expertise was demanded in some of the most challenging pediatric neurosurgeries of the last two decades.
His rise as a black child in poverty in Detroit to world-accomplished surgeon earned him the prestigious Horatio Alger award in 1994 and was celebrated in 2009 in a made-for-TV movie called "Gifted Hands." He also was awarded the Presidential Medal of Freedom in 2008 from Mr. Bush. His formal portrait is scheduled to be unveiled this summer in the U.S. Portrait Gallery.
Likely to be the lone black candidate in the GOP presidential primaries, Mr. Carson has been comfortable talking about issues of race, decrying an epidemic of black-on-black crime in America and suggesting Mr. Obama has pursued a policy of pandering to minorities that has tried to substitute government subsidies for personal responsibility and opportunity.
When other GOP candidates were slow to react to the Baltimore police riots last week, Mr. Carson jumped into the fray by issuing a statement urging parents and grandparents in the city where he had worked for three decades to get their children under control.
And when a woman at a recent forum suggested it might be "sensitive" for him to talk about the issue of the Baltimore riots, Mr. Carson laughed.
"It's not sensitive at all. I want to talk about it," he said. "Because it is not about race. It's a black community with a police department that reflects the community's racial makeup. What happened in Baltimore is really about distrust in government power and frustration with an economic system that hasn't worked for the black community."
On the issue of government, Mr. Carson adamantly supports reining in the size of federal agencies and their spending and thinks warrantless surveillance is unnecessary.
"We can get a subpoena or warrant from a judge in a flash, at any time of day or night. So there is no reason why law enforcement should be allowed to skip the requirements of the 4th Amendment," he said.
• John Solomon can be reached at jsolomon1@washingtontimes.com.


The following is a guide to dress codes and writing invites to events at your Grotto. This is only a suggestion and guideline, meant to provide a common language for all Prophets.
The following are several presentations/programs that have been given at OGA meetings. There has been enough interest expressed in these programs that the OGA has decided to make them available for use by all Grottoes. Please note that the contents of these programs is the responsibility of the individual who created them, and that they may not express the views or opinions of the Ohio Grotto Association.
This is a membership presentation that has been used succesfully in lodges to recruit new members to the Grotto. It is a Powerpoint presentation that is designed to highlight the activities and happenings of O-Ton-Ta-La Grotto.
This presentation can be customized to fit your Grotto specifically. All that needs to be done is to make a few small changes to the history section and to the events that have been done previously.
This presentation is free for Grotto use. Please give credit to O-Ton-Ta-La Grotto and the OGA for sharing it.
This presentation is designed to discuss the fundamentals of planning and officer development within a Grotto. This is not a "how-to" for solving issues, but an overview of various aspects of creating an environment in which the Grotto can grow.
The beginning of this presentation is a little heavy and sets a more somber tone. The message here is that we need to move into the future by acknowledging our past and using it to guide us in the future. There are some notes on the individual slides to give pointers on what to talk about or discuss.
This presentation is designed more for officer and prospective officer attending. It is free for Grotto use. Please give credit to PM Josh Anderson for developing this presentation.
This presentation is meant to be a lead discussion. The purpose of which is to make the attendees answer four simple questions about the Grotto in 2-3 words only.
The questions asked in this presentation are: "what is the Grotto?", "Why did you join the Grotto?", "What does the Grotto offer new members?", and finally "What should the Grotto be offering new members?". The goal is to have the participants actively answering and commenting on the answers given, but the answers should be limited to quick 2-3 word responses. This is not a program for pontificating, but for honest and fun discussion.
This presentation was written by Andersons Talk, the public speaking firm of PM Josh Anderson and PM Mark Anderson. It is free for Grotto use. Use outside of the Grotto is prohibited, please see AndersonsTalk.com for more information..
"Who's On First: A Baseball Guide to Grotto" is a presentation designed to highlight the different roles in a Grotto and the Prophets that fill them. This presentation can be given as a talk, with 30-45 minutes being an easy amount of time to fill, or it can be condensed down and given in a shorter period. The other benefit of this program is the write up for it is a complete article that can be handed out to members for later reading.
There is no slide show or short notes version of this presentation. This presentation only consists of the linked article, which also includes an activity sheet.
This is the first planned presentation of a series of baseball themed talks to be given at upcoming OGA meetings. Please give credit to PM Josh Anderson for developing this presentation.


text:
CMS Releases 2022 Final Home Health and End Stage Renal Disease Rules
The Centers for Medicare and Medicaid Services (CMS) published the final 2022 rules for End Stage Renal Disease (ESRD) and Home Health on November 8 and 9 respectively, each with an effective date of January 1, 2022. WSHA will provide hospital-specific analyses of the home health rule to the CFO or designated finance person for member hospitals that provide these services in the coming weeks. These rules affect hospitals providing renal dialysis, home health, home infusion, hospice and long-term care. The final home health rules make permanent selected blanket waivers related to home health aide supervision that were issued to Medicare home health agencies during the COVID-19 public health emergency and establishes survey and enforcement requirements for hospice programs as set forth in the Consolidated Appropriations Act of 2021. It also finalizes revisions to the infection control requirements for long-term care facilities that will extend the mandatory COVID-19 reporting requirements beyond the current COVID-19 PHE until December 31, 2024. (Andrew Busz, AndrewB@wsha.org).
Andrew Busz


text:
<?php

/**
 * Description of HttpRequest
 *
 *
 * Used in LSYii_Application.php
 * <pre>
 *    'request'=>array(
 *        'class'=>'HttpRequest',
 *        'noCsrfValidationRoutes'=>array(
 *            '^services/wsdl.*$'
 *        ),
 *        'enableCsrfValidation'=>true,
 *        'enableCookieValidation'=>true,
 *    ),
 * </pre>
 *
 * Every route will be interpreted as a regex pattern.
 *
 */
class LSHttpRequest extends CHttpRequest
{

    private $_pathInfo;

    public $noCsrfValidationRoutes = array();

    /**
     * Return the referal url,
     * it's used for the "close" buttons, and the "save and close" buttons
     * So it checks if the referrer url is the same than the current url to avoid looping.
     * If it the case, a paramater can be set to tell what referrer to return.
     * If the referrer is an external url, Yii return by default the current url.
     *
     * DEPRECATED
     * #To avoid looping between two urls (like simpleStatistics <=> Expert Statistics),
     * #it can be necessary to check if the referrer contains a specific word (an action in general)
     * #So if you want to forbid a return to a certain page, just provide an alternative url, and the forbidden key world
     *
     * The checkLoopInNavigationStack-Method will check for looping, though the forbiddenUrl array is not required anymore
     *
     * Not all "close" and "save and close" buttons should use it.
     * Only close button for pages that can be accessed since different places.
     * eg: edit question, that can be accessed from question list or question
     *
     *
     * TODO: implement it for all those pages
     * List of pages where it should be implemented :
     * - All pages accessible via the top nav-bar (eg: create a new survey, edit template, etc.)
     * - All pages accessible via quick actions (home page, survey quick actions, question group quick actions, etc.)
     * - All pages accessible via question explorer (only "add question to group" for now)
     * - Edition of question and question group, which are accessible via summary or list
     * - Import question, question group
     *
     * TODO: remove misused of it
     * It should not be used for pages accessible from only one place
     * - Token activation
     * etc.
     *
     * In doubt, just use getUrlReferrer with a default link to home page for full page layout pages,
     * or a link to the survey summary for sidemenu layout pages,
     * with the controller action as forbidden world.
     * So the close button will never loop.
     *
     * TODO : Each time a new quick action or button is added to access an existing page, the "close" & "save and close" button should be updated to use getUrlReferrer()
     *
     * @param $sAlternativeUrl string, the url to return if referrer url is the same than current url.
     * @return string if success, else null
     */
    public function getUrlReferrer($sAlternativeUrl=null)
    {

       $referrer = parent::getUrlReferrer();
       $baseReferrer    = str_replace(Yii::app()->getBaseUrl(true), "", $referrer);
       $baseRequestUri  = str_replace(Yii::app()->getBaseUrl(), "", Yii::app()->request->requestUri);
       $referrer = ($baseReferrer != $baseRequestUri)?$referrer:null;
        //Use alternative url if the $referrer is still available in the checkLoopInNavigationStack
        if( ($this->checkLoopInNavigationStack($referrer)) || (is_null($referrer)) )
        {
            // Checks if the alternative url should be used
            if(isset($sAlternativeUrl))
            {
                $referrer = $sAlternativeUrl;
            }
            else
            {
               return App()->createUrl('admin/index');
            }
       }
       return $referrer;
    }

    /**
    * Method to update the LimeSurvey Navigation Stack to prevent looping
    */
    public function updateNavigationStack()
    {
        $referrer = parent::getUrlReferrer();
        $navStack = App()->session['LSNAVSTACK'];

        if(!is_array($navStack))
        {
            $navStack = array();
        }

        array_unshift($navStack,$referrer);

        if(count($navStack)>5)
        {
            array_pop($navStack);
        }
        App()->session['LSNAVSTACK'] = $navStack;
    }

    /**
    * Method to check if an url is part of the stack
    * Returns true, when an url is saved in the stack
    * @param $referrerURL The URL that is checked against the stack
    */
    protected function checkLoopInNavigationStack($referrerURL)
    {
        $navStack = App()->session['LSNAVSTACK'];
        foreach($navStack as $url)
        {
            $refEqualsUrl = ($referrerURL == $url);
              if ($refEqualsUrl)
              {
                  return true;
              }
        }
        return false;
    }

    protected function normalizeRequest(){
        parent::normalizeRequest();

        if(!isset($_SERVER['REQUEST_METHOD']) || $_SERVER['REQUEST_METHOD'] != 'POST') return;

        $route = Yii::app()->getUrlManager()->parseUrl($this);
        if($this->enableCsrfValidation){
            foreach($this->noCsrfValidationRoutes as $cr){
                if(preg_match('#'.$cr.'#', $route)){
                    Yii::app()->detachEventHandler('onBeginRequest',
                        array($this,'validateCsrfToken'));
                    Yii::trace('Route "'.$route.' passed without CSRF validation');
                    break; // found first route and break
                }
            }
        }
    }

    public function getPathInfo()
    {
        if($this->_pathInfo===null)
        {
            $pathInfo=$this->getRequestUri();

            if(($pos=strpos($pathInfo,'?'))!==false)
                $pathInfo=substr($pathInfo,0,$pos);

            $pathInfo=$this->decodePathInfo($pathInfo);

            $scriptUrl=$this->getScriptUrl();
            $baseUrl=$this->getBaseUrl();
            if(strpos($pathInfo,$scriptUrl)===0)
                $pathInfo=substr($pathInfo,strlen($scriptUrl));
            elseif($baseUrl==='' || strpos($pathInfo,$baseUrl)===0)
                $pathInfo=substr($pathInfo,strlen($baseUrl));
            elseif(strpos($_SERVER['PHP_SELF'],$scriptUrl)===0)
                $pathInfo=substr($_SERVER['PHP_SELF'],strlen($scriptUrl));
            else
                throw new CException(Yii::t('yii','CHttpRequest is unable to determine the path info of the request.'));

            if($pathInfo==='/')
                $pathInfo='';
            elseif(!empty($pathInfo) && $pathInfo[0]==='/')
                $pathInfo=substr($pathInfo,1);

            if(($posEnd=strlen($pathInfo)-1)>0 && $pathInfo[$posEnd]==='/')
                $pathInfo=substr($pathInfo,0,$posEnd);

            $this->_pathInfo=$pathInfo;
        }
        return $this->_pathInfo;
    }

}

redpajama_set_name: RedPajamaGithub


Since I started my studies in political philosophy, I have been interested in the political theory of the family, and the political theory of immigration, broadly conceived. At the moment, I am pursuing questions at the intersection of both areas. In particular, I am interested in proposing feasible immigration and citizenship arrangements that are particularly sensitive to the interests of children. The motivation for this project springs from the realization that current immigration and citizenship arrangements are not only poorly equipped to protect children's interests, but can also, at times, contribute to the vulnerability that the most marginalized children face in their lives.
One question that is very relevant for this overall project is the question of what grounds the right of children to acquire citizenship (I address this question in Ferracioli, forthcoming). Traditionally, political philosophers have paid little attention to the citizenship arrangements of liberal states, and have focused primarily on their immigration arrangements. Indeed, their focus has been on advocating for their preferred theory of justice in migration on the assumption that liberal states would also ensure that their citizenship laws and policies would not conflict with what justice requires, by for instance, ensuring that no one would be rendered stateless (But see Baubock 2006; Shachar 2009; Carens 2013 for exceptions). However, as I hope to show in the remainder of this discussion, current citizenship arrangements fail to track children's interests even when they don't lead to statelessness, and even when they don't conflict with the demands of a just immigration arrangement.
To illustrate the problems with our current citizenship arrangements, consider the following citizenship principles that currently apply to children: (i) citizenship should be granted to those who have been born in the state (jus soli), (ii) citizenship should be granted to those who have at least one parent who is a citizen of the state (jus sanguinis), and (iii) citizenship should be granted to permanent immigrants who have legally resided in the state for a significant period of time (jus domicilii). There are compelling reasons for thinking that jus soli, jus sanguinis, and jus domicilii, whether employed alone or in combination, fail to do justice to children.
Consider next the principle of jus sanguinis. One problem with this principle is that not all children have a parent who is a citizen of the state where they reside. Even worse is the fact that some children do not even enjoy the benefits of a parent-child relationship, as it is the case of those who have lost their parents or have been abandoned by them. Yet, both the fact of lacking a citizen parent and lacking a parent all together can place children in a position of extreme vulnerability, which is of course made all more acute by the subsequent denial of citizenship on the basis of that vulnerability.
Finally, consider the norm of jus domicilii adopted by most states that accept that permanent immigrants should be granted citizenship after many years of legal residence. One problem with jus domicilii is that not all immigrant children who reside in a state do so after having been granted legal access to its territory, and so are typically not eligible for citizenship, no matter how long they have resided there (Bhabha 2014). Children who seek asylum in a state but are neither granted refugee status nor returned to their state of origin have a strong claim to enjoy reliable access to important rights and benefits in their state of residence and yet are typically not entitled to citizenship via jus domicilii. The same is true of children who 'illegally' cross international borders with their parents or other family members. These children cannot consent to such dangerous immigration projects, and yet, they are particularly vulnerable to suffering human rights violations as a result of the precarious socio-political position in which they and their families find themselves. Again, the very fact that renders these groups of children particularly vulnerable to all forms of abuse and violence (i.e., their lack of legal authorization to be in the territory) weakens their claim to enjoy secure access to important rights and benefits that come with citizenship.
Given these shortcoming, I believe that the right of children to citizenship should depend solely on the actual relationship between child and state, and not on their place of birth, family lineage or long-term residence. The idea is that a child's claim to citizenship is distinct from that of an adult, and separate from that of her parent(s) (if she has one), and that any child who resides in a liberal state has a right to acquire citizenship there. The foundation of this right lies on the unique paternalistic relationship between child and a liberal state, a relationship that gives the latter a duty to act on what is in the former's best interests. I have called this citizenship principle Jus Paternus (Ferracioli, forthcoming).
In future work, I hope to investigate the implications of giving center stage to this paternalistic relationship in our theory of citizenship rights. After all, our views of social justice, global justice and parental rights will change dramatically once we recognize that the state owes much more to its resident children that is currently assumed.
Baubock, Rainer. 2006. "Stakeholder citizenship and transnational political participation: a normative evaluation of external voting." Fordham L. Rev. 75: 2393.
Bhabha, J., 2014. Child migration and human rights in a global age. Princeton University Press.
Carens, Joseph. 2013. The Ethics of Immigration. Oxford University Press.
Ferracioli, Luara. Forthcoming. Citizenship for Children: By Soil, by Blood, or by Paternalism?
Shachar, Ayelet. 2009. The birthright lottery: Citizenship and global inequality. Cambridge, MA: Harvard University Press.


This year has been one of the most eventful years of my life. I've gone through many physical and emotional changes as well as learning what I like and where I want to be in the years to come. In this post I wanted to talk about a few of my 2019 goals as a way to document my current aspirations so that I can look back if I ever feel unmotivated or lost with my direction as the months progress.
In 2018 I started working with my first freelance client, creating content for them on a regular basis and learning the tricks of the trade when it comes to copywriting. Obviously, I have a lot more to learn, so I'm hoping that in 2019 I can grow my freelance business just a bit more than it currently is. I recently began working with my second client and while it is time consuming, I also feel like I could manage to squeeze in one more alongside my personal writing.
My blog has always been a constant in my life the past 3 years, but my engagement in the hobby has been very up and down. I tend to go through phases and sometimes I just won't really be into it as much as I was before. However, the last few weeks of meditating regularly and improving my productivity has sparked my interest in it once again and I am really pushing myself to create more unique and interesting content. I want to grow my blog significantly in 2019 and really be able to say that I have a platform I am proud of, not just one I post on once a week with a last minute idea.
Ever since moving to London I haven't been very kind to my body. I've let myself drink more than I'm used to and haven't really cared about the food I've been eating, kind of in the mindset of being on a vacation even though I'm not. As I mentioned in my meditation post, the act of meditating regularly and putting effort toward my mental well-being also inspired me to do the same with my physical well-being. In 2019 I want to be better at controlling my sudden unhealthy food urges so that I can avoid feeling as lethargic and bloated as I had been the last few weeks. However, I will never restrict myself. If an urge is strong enough I know that I'm better off giving in now rather than dealing with an even bigger craving later on down the line.
This habit has slowly become one that I need to start my day with. Sure, sometimes it feels as tedious as having to get ready for a workout because it is a mental workout that requires effort and focus. However, I've noticed the positive effects it's had on my mental health and overall disposition and I want to perpetuate it. Going forward I want to continue starting my day off with a 5 minute session to begin on a less anxious foot before work and maybe even a short meditation break half way through the day.
Ever since getting a bit busier with my freelance work I've stopped making the effort to leave the house while it's still light out. I used to always take a long walk along the canal and it really impacted my mood in a positive way, so I want to do that a bit more in 2019. I will probably still be working from home for the foreseeable future so it's important that I find the best routine that will help me incorporate daytime walks into my schedule.
I am the last person to ever suggest something thrilling or spontaneous and that has begun weighing on me as I get older. My anxiety has limited my options significantly in life and I don't want to continue giving into it out of fear that I'll miss out on some great opportunities in the future. Moving to England was the biggest chance I have ever taken and it's been working out pretty well so far, which has shown me that I am capable of handling these changes and will probably be better off if I take more of them. I want to say 'yes' more than I say 'no', even if it's for small, insignificant things as a way of working myself up to bigger, more impactful things later on down the line.
I worry so much that it's comical. My boyfriend has even contemplated filming a short comedy skit about my anxious behaviour (in a loving way) as a means to kind of understand where I'm coming from and help me make light of it. In 2019 I want to really try and control my tendencies to worry about silly and irrational things. Most of it is attributed to my deep-seated anxiety, but I have uncovered a few techniques that have helped to curb these tendencies when possible. This is a big one for me because most of my actions are driven by how worried I am about certain choices I make, so I know that it will significantly change my perspective on life.


Although representational art inspires deep affection and enjoys broad democratic appeal, until The Representational Art Conference was created there was a thorough lack of academic attention to the work of traditionally trained artists in the 21st Century. Michael Pearce and Michael Adams put together the first conference in 2012 to create a venue for the discussion of the philosophy and practice of artists involved in the universities, colleges, ateliers and private studios where the techniques of the old masters are still taught and used in the present day. The CLU administration led by President Chris Kimball enthusiastically endorsed the idea, providing underwriting for the conference.
The TRAC2019 team includes: Michael Pearce, Jeff Miller, Cindy Keitel, Terry Spehar-Fahey, Rachel Schmid, Joey Peterson, Kate Artmann, Nathan Tierney, Aihua Zhou. Thank you so much for all your hard work putting the event together!
Why we do the Representational Art Conferences.
We believe that because representational art is a source of great pleasure to a large community it deserves to be written about, thought about, and talked about by intelligent people who are excited about understanding what makes it so satisfying.
We believe that the reasons people love representational art are varied, but equal in value – that the sensual pleasure of the experience of it is of equal value to the intellectual disinterested examination of it.
We believe that the community of people who love representational art also love meeting each other and sharing in the pleasure they find in it – we want to provide that meeting place and encourage discussion.
We believe that by talking about and understanding the ideas that drive 21st Century representational art we will be able to steer the direction of our culture toward a more optimistic vision of what the world is and might be.
We pursue excellence in our speakers and demonstration artists, seeking out people who will present challenging ideas and offer varied experiences of representational art from different disciplines and backgrounds.
We provide an exciting program that fills each day of the conference with varied activities and thought-provoking challenges, while also giving people plenty of opportunities for social interaction.
We provide the only academic conference about representational art in the world.
We share resources that help people who love representational art to connect with like-minded organizations and individuals.
We help disseminate the ideas that are shared at the conference.


FORT WAYNE, IN – The Canton Charge (5-6), powered by the Cleveland Cavaliers, allowed a season low for points in a win over the Fort Wayne Mad Ants (5-5), 96-81, at the Allen County War Memorial Coliseum on Monday night.
Canton led the entire game after taking a 9-8 lead on a Blossomgame turnaround jumper with 5:00 remaining in the first quarter. Jaron finished with 11 points after being converted into a Two-Way Player by the Cleveland Cavaliers yesterday. Bonzie Colson II posted his third double-double of the season with 14 points and 10 boards in 28 minutes. Kobi Simmons scored 9 of his 18 points in the fourth quarter, while JaCorey Williams (16 points, 2 steals) and Levi Randolph (13 points, six rebounds, three steals) led the Charge reserves.
Alize Johnson paced Fort Wayne with 16 points and 13 boards in 37 minutes on assignment from Indiana. Fellow Pacer Ike Anigbogu had a double-double added a double-double of 14 points and 13 rebounds in 36 minutes on assignment. Stephan Hicks had 15 points and five rebounds in 38 minutes.
The Charge have two home games in three nights this week beginning with a Sugardale Dollar Dog Night this Thursday, December 6th at 7:00 p.m. against the Long Island Nets (TV: ESPN+; RADIO: 99.7 FM). For Charge Nation Memberships, group outings, game day promotions and up-to-date information, head to CantonCharge.com or call 866-444-1944. The Canton Charge are part of the Cleveland Cavaliers and Quicken Loans Arena organization and are also owned by a group led by Cavaliers Chairman and Quicken Loans Founder and Chairman Dan Gilbert. The group also owns and operates the Cleveland Monsters of the American Hockey League, who play their games at Quicken Loans Arena in downtown Cleveland.


text:
Our management team shares a customer focus that is centered in the company's mission and values, supported by a rich history of customer commitment at every level, and driven to deliver advanced technologies, superior solutions and exceptional service and support.
Thomas Logan
Chairman and Chief Executive Officer
Thomas Logan is the founding Chairman and Chief Executive Officer of Mirion Technologies, where he is responsible for all aspects of the company's operations. Previously, Mr. Logan served as CEO for Global Dosimetry Solutions. Mr. Logan has more than 30 years of energy industry experience. In addition, he has extensive experience within the contract manufacturing and consumer products industries. Mr. Logan holds a Bachelor of Science degree and a Master in Business Administration from Cornell University.
Mike Freed
Chief Operating Officer
Mike Freed assumed the role of Chief Operating Officer in July of 2017. He was previously the HPD President from July of 2016. Prior to this, Mr. Freed was employed as a Principal Consultant for Bain and Company for over 5 years. Mr. Freed also served the United States Navy as a Submarine Officer/Combat Systems Officer and Submarine Officer/Nuclear Engineer aboard Nuclear Submarines, and on the Chief of Naval Operations Personal Staff. Mr. Freed holds both an MBA from the University of Virginia Charlottesville and a BA in Economics from Northwestern University.
Mike Brumbaugh
Executive Vice President and Chief Information Officer
Mike Brumbaugh has been Chief Information Officer of Mirion Technologies since January 2008. Previously, Mr. Brumbaugh headed the data services development division based in Düsseldorf, Germany for Vodafone, the world's largest mobile service provider. He also served as the CTO for Vodafone's Global Platform division based in the U.S. Prior to Vodafone, Mr. Brumbaugh served as Vice President for Technical Services for Verizon Wireless and was Vice President and Executive Director of Information at AirTouch Cellular. He also held numerous director level positions in IT at Pacific Bell. Mr. Brumbaugh holds a Bachelor of Arts degree in Economics from the University of California, Irvine.
Emmanuelle Lee
Vice President and General Counsel
Emmanuelle Lee has served as Deputy General Counsel of Mirion Technologies since 2011 and General Counsel since 2018. Ms. Lee's prior positions include corporate counsel positions with FrontRange Solutions (now Ivanti) and PeopleSoft (now Oracle), and attorney at the law firm of Ropers Majeski, Kohn & Bentley. In addition, she started her career as a parliamentary aid to the late Xavier de Villepin, a French Senator who represented French expatriates and headed the Senate Committee for Foreign Affairs, Defense, and Armed Forces. Ms. Lee received her Juris Doctor from University of Santa Clara, California and her French law degree from Université de Paris II Panthéon-Assas.
Anthony Rabb
Chief Financial Officer
Anthony Rabb has served as Mirion Technologies' Chief Financial Officer since October 2015. He brings to Mirion over 25 years of experience in financial leadership roles in manufacturing and services organizations spanning energy, technology, consumer products & services, financial services and the maritime industry. Mr. Rabb has managed global financial organizations with responsibility for finance, accounting, treasury, investor relations, tax, information technology, acquisitions, business development and operations. Prior to joining Mirion, Mr. Rabb served as CFO for Vigor Industrial, SunEdison, Brand Energy as well as General Electric's Sensors & Instrumentation Unit. Mr. Rabb began his career at General Electric where he held various leadership roles in finance and acquisitions in both GE Capital and GE's lighting business. Mr. Rabb holds a Bachelor of Arts degree in Economics from the University of Colorado at Boulder.
Shelia Webb
Shelia Webb assumed the role of Chief Technology Officer in July 2019. She was previously the Spectroscopy Division President for three years. Prior to the Canberra acquisition, she served as Vice-President of Engineering for Canberra Industries. Throughout the past twenty three years, she held a series of management positions within Canberra in Product Management, Product Development and Services. She began her career in Oak Ridge, TN managing a Radiochemistry Laboratory while working for Lockheed-Martin Energy Systems in the Analytical Chemistry Division. She holds Bachelor of Science degrees from Tennessee Wesleyan University.
Iain Wilson
President, Sensing Systems Division
Loic Eloy
President, Radiation Monitoring Systems Division
Louis Biacchi
President, Dosimetry Services Division
James Cocks
President, Detection & Measurement Division Americas
Bruno Morel
President, Detection & Measurement Division Europe, Africa, & Asia


text:
Q: Getting OME while rotating Bitmap I am trying to rotate Img(Bitmap), by the fallowing code. its working fine up to 5-6 rotations, after that am getting OME?
private void rotateImg() {
    Matrix matrix = new Matrix();
    matrix.postScale(curScale, curScale);
    matrix.postRotate(curRotate);
    try {
        temp = Bitmap.createBitmap(temp, 0, 0, temp.getWidth(),
                temp.getHeight(), matrix, true);
        setImage.setImageBitmap(temp);
    } catch (OutOfMemoryError e) {
        curRotate = curRotate - 45.0f;
        Toast.makeText( this,"Out Of Memory",Toast.LENGTH_LONG).show();
    }
}

here "test" is an static bitmap file loaded from SDCard.

A: The first answer is probably one potential solution.  The issue here is that you're creating a lot of Bitmap objects, which are fairly big, and they're not getting gc'd for whatever reason.
A better solution might be to use a single bitmap, and apply the rotation / scaling when you draw it.  For example, if you were drawing on a Canvas that's part of a View, rotateImg could simply rotate the matrix and call invalidate on the view, and then in the view's onDraw method you'd use the void drawBitmap (Bitmap bitmap, Matrix matrix, Paint paint) on the canvas to render the bitmap.  Docs are here.

A: Why are you creating the bitmap every time? Is there any specific reason?
If not use the following code:
private void rotateImg() {
    int cx = temp.getWidth() / 2;
    int cy = temp.getHeight() / 2;
    matrix.preTranslate(-cx, -cy);
    matrix.postRotate(curRotate);
    matrix.postTranslate(cx, cy);
    setImage.setImageMatrix(matrix);
}

A: Maybe you have to use bitmap.recycle() method each time you call this method. Try something like this,
private void rotateImg() {
    Matrix matrix = new Matrix();
    matrix.postScale(curScale, curScale);
    matrix.postRotate(curRotate);
    try {
         temp.recycle();  //removes the memory occupied by this bitmap object
          temp=null;
        temp = Bitmap.createBitmap(temp, 0, 0, temp.getWidth(),
                temp.getHeight(), matrix, true);
        setImage.setImageBitmap(temp);
    } catch (OutOfMemoryError e) {
        curRotate = curRotate - 45.0f;
        Toast.makeText( this,"Out Of Memory",Toast.LENGTH_LONG).show();
    }
}

redpajama_set_name: RedPajamaStackExchange


text:
Karabin maszynowy Vickers 12,7 mm – powiększona wersja karabinu maszynowego Vickers, używana przez flotę i armię brytyjską w czasie drugiej wojny światowej. Konstrukcją nie różnił się od wersji kalibru 7,7 mm.

Historia powstania
Konieczność posiadania takiej broni wynikła z doświadczeń pierwszej wojny światowej, która z jednej strony udowodniła znaczenie karabinów maszynowych, a z drugiej pokazała ich niewielką skuteczność przeciwko nowemu wynalazkowi, jakim były czołgi i wozy opancerzone. Szybki rozwój samolotów też wskazywał na konieczność posiadania szybkostrzelnej broni przeciwlotniczej o dużym zasięgu i sile rażenia. Niemieckie eksperymenty z karabinem maszynowym Maxim kal. 13 mm i francuskie z Hotchkissem 13,2 mm, skłoniły armię i flotę brytyjską do skonstruowania własnego odpowiednika.

W tym celu wykorzystano wypróbowaną i niezawodną konstrukcję, jakim był ulepszony przez Vickersa mechanizm km Maxima, który odpowiednio powiększono, by wykorzystał nabój 12,7 × 81 mm. Dla poprawienia chłodzenia, wszystkie Vickersy 12,7 mm miały żebrowaną osłonę chłodnicy lufy.

W 1928 r. admiralicja brytyjska przeprowadziła test karabinów Vickers 12,7 mm i Browning wz. 1924. Amerykański karabin strzelał silniejszym nabojem, ale był cięższy i nieco bardziej zawodny. Ostatecznie zadecydował fakt, że identyczna konstrukcja karabinów Vickers miała ułatwić szkolenie żołnierzy i obsługę broni.

Przed drugą wojną światową km Vickers 12,7 mm był podstawową małokalibrową bronią przeciwlotniczą Royal Navy i uzbrojeniem brytyjskich wozów pancernych. Podobnie jak jej mniejszy wariant, broń była niezawodna i solidna, jednak stosunkowo słaby nabój nie miał wystarczającej siły rażenia. W armii lądowej Vickersy stopniowo zastępowano w czołgach przez km-y Besa kal. 15 mm (wozy pancerne np. Guy i czołgi piechoty jak Matilda używały Vickersów najdłużej). Także z powodu słabej skuteczności RAF zrezygnował z wielkokalibrowych karabinów maszynowych i z km-ów 7,7 mm przeszedł od razu na działka 20 mm HS 404.

Modele

Mark I – wersja rozwojowa, nie produkowana seryjnie. Oficjalne oznaczenie: Gun, Machine, Vickers, .5-inch, Mk. I. Szybkostrzelność ok. 450 strz./min.

Mark II, IV i V – wersje lądowe, przeznaczone dla czołgów i wozów pancernych. Wersja II, z 1932, była pierwszą seryjną, wersja V – finalną, udoskonaloną, o ujednoliconym montażu, umożliwiającym zamienne stosowanie km-ów 7,7 i 12,7 mm. Wprowadzona w 1935, wersja Mk V ważyła 28,9 kg i miała szybkostrzelność ok. 500–600 strz./min. MK V wyprodukowano ok. 1000 sztuk, poprzednich nie więcej niż 100.

Mark III – wersja dla floty, zasilana 200-nabojową taśmą w wymiennych bębnach. Najczęściej montowana na poczwórnych lawetach, z karabinami ustawionymi pionowo jeden nad drugim. Większość przedwojennych niszczycieli miała dwa takie zestawy, większe okręty cztery do ośmiu. Montowany także na kutrach torpedowych i artyleryjskich w napędzanych wieżyczkach z jednym lub dwoma karabinami. Royal Navy używała łącznie ponad 12 500 wkm-ów Vickers, jednak ze względu na malejącą skuteczność, stopniowo zastępowała je działkami Oerlikon 20 mm.

Uwagi

Przypisy

Linki zewnętrzne
 Serwis o karabinach Vickers

Wielkokalibrowe karabiny maszynowe
Brytyjska broń strzelecka II wojny światowej
Brytyjskie karabiny maszynowe
Vickers

redpajama_set_name: RedPajamaWikipedia


text:
January/
Interventional Neuromuscular Ultrasound
The favorable cost profile of ultrasound compared with MRI makes it a valuable tool for obtaining anatomic information in patients with neuromuscular problems.
By John W. Norbury, MD; Michael S. Cartwright, MD, MS; Francis O. Walker MD; Steven Mandel, MD; Daniel P. Moore, MD
The advent of high resolution ultrasound (US) has presented clinicians with a powerful complement to the electrodiagnostic evaluation of conditions affecting the peripheral nervous system.1 The favorable cost profile of ultrasound compared with magnetic resonance imaging (MRI) makes it a valuable tool for obtaining anatomic information in patients with neuromuscular problems.2 Additionally, ultrasound presents the neurologist with a useful tool to treat many of the conditions that are seen in neuromuscular clinical practice. In theory, a clinician can offer patients "one-stop shopping" where the patient's condition is diagnosed and treated in the same visit.3
Interventional neuromuscular ultrasound encompasses a range of procedures that are used to diagnose and treat conditions of the peripheral nervous system using ultrasound guidance. Over 1,500 scientific publications support the use of ultrasound for these types of procedures.4 In practice, most of these procedures consist of US-guided regional anesthesia, US-guided biopsy of nerve lesions, and US-guided therapy with agents such as corticosteroids.5
There are several advantages to using ultrasound to guide procedures when compared with either "blind" procedures or other forms of guidance such as fluoroscopy, computed tomography (CT), and electrical stimulation. Unlike CT and fluoroscopic guidance, US-guided interventions do not expose the patient or the provider to ionizing radiation. US-guided procedures are sometimes perceived as less unpleasant than procedures guided by electrical stimulation. Ultrasound also allows the operator to "survey" the soft tissues surrounding the target and identify structures that should be avoided during injections, such as vessels, tendons, and nerves. While scanning nearby structures, ultrasound sometimes reveals musculoskeletal pathology that is also amenable to intervention. US-interventions can help the operator avoid perineural injections and allow the operator to choose the path between the skin and the target structure that is the safest, shortest, and easiest. Ultrasound's portability allows the procedure to be carried out efficiently in the office setting.5 In the authors' experience, US-guidance also allows excellent local anesthesia so that the procedure is only mildly unpleasant or even painless for the patient. Finally, many patients enjoy "seeing" the pathology1 and sometimes even the real-time procedure image. Watching the images can even serve as a helpful distraction from the procedure.
Ultrasound guided procedures can be divided into direct and indirect guidance. Indirect guidance refers to marking the site of the target structure and then performing the intervention without real-time guidance. Direct guidance refers to the technique where the operator monitors the position of the needle in real time. Direct guidance can further be divided into "in plane" or long axis approach and "out of plane" or short axis approach (Figure 1). Both have their advantages and disadvantages. The long axis approach allows visualization of the needle during the entire procedure. The short axis approach is somewhat technically easier to perform and may be desirable for some superficial structures.
For neuromuscular procedures, the authors prefer the long axis approach, because it allows direct visualization of the needle tip during the entire procedure for safer and more accurate needle tip placement. When performing a long axis procedure, it is imperative to make the angle between the needle and the transducer as parallel as possible. This will maximize sound wave reflection and improve visualization of the needle.
While there are many variations in the general approach to ultrasound-guided interventions, the following is the sequence of steps that we employ in our laboratory. The most important principle in performing any procedure is to keep in mind the Boy Scout Motto: "Be Prepared." In our practice, we have an operator and an assistant present during the procedure at all times. All equipment must be within reach of the operator prior to starting the procedure. Proper ergonomics is essential, as repetitive stress injuries are very common among ultrasound users (Figure 2A).6 As vasovagal reactions happen from time to time, it is generally advisable to have the patient lie down during the procedure. It can be helpful to keep the needle out of view of the patient.
Prior to performing a procedure, the operator should perform a diagnostic scan to identify the target structure. Doppler flow can assist in identifying blood vessels, nerves, and tendons that must be avoided. The skin can then be marked with an indelible pen (Figure 2B). The area is prepped, draped, and an ultrasound transducer cover is applied. Vapocoolant spray is used for surface anesthesia prior to insertion of a small gauge (25 or 27) needle to inject local anesthetic along a tract toward the target (Figure 2C). This confers the advantage of excellent local anesthesia as well as a "dry run" of the procedure. In the case of corticosteroid preparations, the confirmation of successful placement will be made easier by the characteristic hyperechoic crystalline appearance of the injectate.
Needle tracking refers to the technique whereby the operator achieves continuous visualization of the needle during the entire procedure. Several principles are important to keep in mind in order to improve needle tracking to prevent or recover a "lost needle" during the procedure. After the site of entry has been marked with an indelible pen, it is important to meticulously line up the path of the needle with the long axis of the transducer. The needle is then inserted while the operator is viewing the probe and the needle on the skin. After the needle has been inserted at least as far as the transducer itself, then the operator shifts his or her gaze to the screen to "confirm" the needle placement. After this point, the operator must either move the needle or the transducer, but not both at the same time. Often a "caffeine tremor" can be helpful, whereby the needle is gently "jiggled" in the tissue. The resulting movements are used to localize the needle. Some commercially available ultrasound machines have software that can assist in needle tracking. One example of this is "beam steering" in which the angle of the beam is directed in a plane more perpendicular to the needle to improve visualization (Figure 3A). Color flow can also be useful in tracking the needle (Figure 3B). Finally, commercially available echogenic needles are sometimes easier to see than traditional needles.
Ultrasound Guided Injections of the Carpal Tunnel
In the electrodiagnostic laboratory, median neuropathy at the wrist is the most commonly encountered entrapment neuropathy in the upper limb. It is also the entrapment neuropathy most amenable to therapeutic intervention. A recent randomized controlled trial has demonstrated the short-term efficacy of blind carpal tunnel injections.7 A Cochrane Database Systematic Review has demonstrated improvement in symptoms for one month following a blind carpal tunnel injection; however, improvement beyond one month could not be demonstrated.8 In 2008, Smith described the ulnar approach for carpal tunnel injections, which is the technique we employ at East Carolina University.9 In this technique, the median nerve is injected from the ulnar aspect of the tunnel, and the nerve is dissected from both the flexor tendons and the flexor retinaculum. See figures 4 and 5. Evidence suggests that changes in gliding characteristics of the median nerve10 and changes in the subsynovial connective tissue11 are important factors in the development of carpal tunnel syndrome. Presumably, these pathologies are addressed in an US-guided carpal tunnel injection, but not in a blind injection.
In our practice, a mixture of 1cc 1% lidocaine and 1cc 40mg kenalog is used for this procedure. Prior to the injection, it is important to inform patients that they will experience numbness for one to two hours. Patients who undergo a bilateral injection may be advised to have an alternative driver available on the day of the procedure.
Ultrasound Guidanced Injections of Other Nerve Entrapment Sites
Several other entrapment neuropathies are amenable to diagnostic and therapeutic US-guided injections. The technique for injecting the lateral femoral cutaneous nerve in patients with meralgia paresthetica has been described by Hurdle.12 In this procedure, the anterior superior iliac spine (ASIS) is palpated, and the nerve is identified sonographically just medial to the structure. Due to the variable course of the lateral femoral cutaneous nerve, ultrasonography has clear advantages to blind techniques for injection. Ultrasound guided interventions can be used to treat piriformis syndrome.13,14 Also, ultrasound guided interventions have been proposed for ulnar neuropathy at the elbow, but studies supporting ultrasound guided injections for ulnar neuropathy at the elbow are not nearly as common as they are for carpal tunnel syndrome.15,16
Ultrasound Guided Neurotoxin Injections
The use of injected botulinum toxin to produce chemodenervation is now common to treat focal dystonias, spasticity, blepharospasm, and a variety of other conditions.17 Typically, the needle is guided into the target muscle using anatomic landmarks, electromyography (EMG), and sometimes a stimulating needle. However, there are cases in which the muscle may be electrically silent, difficult to specifically stimulate, or difficult to locate using these techniques alone, and in these cases ultrasound guidance has proven very helpful. A recent study demonstrated the benefit of ultrasound guidance for repeat injections for cervical dystonia in patients that had previously developed dysphagia following EMG-guided injections.18 In this study, ultrasound was used to identify the very thin sternocleidomastoid muscle, and repeat bolutinum toxin injections uder ultrasound guidance were safe and did not result in the dysphagia that occurred during EMG guidance. Similar benefit has been demonstrated in using ultrasound to guide botulinum toxin injections into the forearm musculature in those with writer's cramp.19
In addition to injection into muscles, botulinum toxin can also be injected into salivary glands to decrease sialorrhea in conditions such as Parkinson's disease and amyotrophic lateral sclerosis. Since glandular tissue is electrically silent, EMG guidance is not helpful in this setting. Ultrasound can be used in either an indirect or direct approach to locate the parotid and submandibular glands and guide the injections safely.20/p>
Ultrasound-Guided Biopsies
Ultrasound can also be used to quickly and painlessly select appropriate tissue for biopsy. For example, myositis can be a patchy condition, particularly dermatomyositis.21 Healthy muscle is mainly hypoechoic on cross-sectional ultrasound, with some brighter connective tissue. This has been described as a "starry night" appearance and has also been described as appearing "marbled," similar to a cut of steak.22 Conversely, diseased muscle is more homogeneous and hyperechoic, and therefore patches of diseased muscle can be easily identified with ultrasound. This allows the physician performing the muscle biopsy to identify muscle that is affected, but not too damaged, to increase the diagnostic yield of the biopsy.
While the advantages to US-guided interventions for the treatment of conditions such as carpal tunnel syndrome have been outlined above, concrete scientific evidence establishing the benefits of these procedures is lacking at present. The benefits and cost-effectiveness of these interventions must be established in the literature in the near future.
Several experimental neuromuscular procedures are on the horizon. One exciting emerging interventional procedure is percutaneous "ligamentomy" of the transverse flexor retinaculum.23 In this procedure, the median nerve is dissected away from the transverse carpal ligament with saline (Figure 6). Subsequently, the ligament is repeatedly fenestrated with a needle similar to the technique used for needle tenotomy of the common extensor tendon. If successful, this intervention may provide an attractive alternative to surgical arthroscopic and open releases of the carpal tunnel as the recovery time is only one to two days in the primary author's experience.
Norbury JW, Cartwright MS, Walker FO, Gutierrez C, Moore DP, Mandel S. Ultrasonographic evaluation of entrapment neuropathies in the upper limb. Pract Neurol. 2011;10:38-44.
Parker L, Nazarian LN, Carrino JA, et al. Musculoskeletal imaging: Medicare use, costs, and potential for cost substitution. J Am Coll Radiol. 2008;5:182-188.
Nazarian LN. The top 10 reasons musculoskeletal sonography is an important complementary or alternative technique to MRI. AJR Am J Roentgenol. 2008;190: 1621-1626.
Griffin J, Nicholls B. Ultrasound in regional anaesthesia. Anaesthesia. 2010;65 Suppl 1:1-12.
Tagliafico A, Bodner G, Rosenberg I, et al. Peripheral nerves: Ultrasound-guided interventional procedures. Semin Musculoskelet Radiol. 2010;14:559-566.
Siegal DS, Levine D, Siewert B, et al. Repetitive stress symptoms among radiology technologists: Prevalence and major causative factors. J Am Coll Radiol. 2010;7:956-960.
Peters-Veluthamaningal C, Winters JC, Groenier KH, Meyboom-de Jong B. Randomised controlled trial of local corticosteroid injections for carpal tunnel syndrome in general practice. BMC Fam Pract. 2010;11:54.
Marshall S, Tardif G, Ashworth N. Local corticosteroid injection for carpal tunnel syndrome. Cochrane Database Syst Rev. 2007.
Smith J, Wisniewski SJ, Finnoff JT, Payne JM. Sonographically guided carpal tunnel injections: The ulnar approach. J Ultrasound Med. 2008;27:1485-1490.
Oh S, Belohlavek M, Zhao C, et al. Detection of differential gliding characteristics of the flexor digitorum superficialis tendon and subsynovial connective tissue using color doppler sonographic imaging. J Ultrasound Med. 2007;26:149-155.
Ettema AM, Amadio PC, Zhao C, et al. Changes in the functional structure of the tenosynovium in idiopathic carpal tunnel syndrome: A scanning electron microscope study. Plast Reconstr Surg. 2006;118:1413-1422.
Hurdle MF, Weingarten TN, Crisostomo RA, Psimos C, Smith J. Ultrasound-guided blockade of the lateral femoral cutaneous nerve: Technical description and review of 10 cases. Arch Phys Med Rehabil. 2007;88:1362-1364.
Huerto AP, Yeo SN, Ho KY. Piriformis muscle injection using ultrasonography and motor stimulation--report of a technique. Pain Physician. 2007;10:687-690.
Reus M, de Dios Berna J, Vazquez V, Redondo MV, Alonso J. Piriformis syndrome: A simple technique for US-guided infiltration of the perisciatic nerve. preliminary results. Eur Radiol. 2008;18:616-620.
Kim JM, Oh HM, Kim MW. Real-time visualization of ultrasonography guided cubital tunnel injection: A cadaveric study. Ann Rehabil Med. 2012;36:496-500.
Alblas CL, van Kasteel V, Jellema K. Injection with corticosteroids (ultrasound guided) in patients with an ulnar neuropathy at the elbow, feasibility study. Eur J Neurol. 2012.
Brashear A, Gordon MF, Elovic E, et al. Intramuscular injection of botulinum toxin for the treatment of wrist and finger spasticity after a stroke. N Engl J Med. 2002;347:395-400.
Hong JS, Sathe GG, Niyonkuru C, Munin MC. Elimination of dysphagia using ultrasound guidance for botulinum toxin injections in cervical dystonia. Muscle Nerve. 2012;46:535-539.
Likhachev SA, Chernukha TN, Chernenko NI. Treatment of writer's cramp with botulotoxin capital A, cyrillic. Zh Nevrol Psikhiatr Im S S Korsakova. 2011;111:49-53.
Sriskandan N, Hannah A, Howlett DC. A study to evaluate the accuracy of ultrasound in the diagnosis of parotid lumps and to review the sonographic features of parotid lesions - results in 220 patients. Clin Radiol. 2010;65:366-372.
Amato AA RJ. Neuromuscular disorders. New York: McGraw-Hill Medical; 2008.
Walker FOC, M.S. Neuromuscular ultrasound. 1st ed. Philadelphia: Elsevier; 2011.
McShane JM, Slaff S, Gold JE, Nazarian LN. Sonographically guided percutaneous needle release of the carpal tunnel for treatment of carpal tunnel syndrome: Preliminary report. J Ultrasound Med. 2012;31:1341-1349.
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Florida is home to quite a few dangers that can lead to an injury. From hot weather that can quickly cause dehydration, to reptiles that are as close as anyone will ever get to seeing a living dinosaur.
The Florida Health Department collects data on the leading causes of fatal injuries by age group. Below are the leading causes of death among Floridians over the age of 15.
Among all age groups, poisoning and motor vehicle accidents were the top causes of death.
Although accidents happen, protecting yourself against specific dangers can help you prevent injuries. For example, one way to prevent a fatal poisoning is to always read the labels of medications and household chemicals. Also, keep the poison control number readily available should you need to call someone immediately.
Drivers can also prevent injuries by choosing a safer vehicle. Advances in vehicle safety can help drivers stay protected if they're involved in an accident, and prevent collisions from occurring.
One of the best ways to prevent a drowning is to learn to swim. Still, in sudden, life-threatening situations, even the strongest swimmer can drown or suffer near-drowning injuries.
Adults on medications should find out how these prescriptions may impact their balance and increase their risk of falling.
At one point or another, everyone will suffer a minor or even serious injury; these injuries could be caused by accidents, slip and falls, and any number of other dangers. Although you cannot always prevent an injury, you can prepare for responding to it.
When you've been hurt in an accident, contact an experienced chiropractor who can complete an examination and customize a treatment plan so you can recover comfortably and quickly.